Hip Adduction: What It Is and Why You Need It – Part I

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All human movement occurs in three planes. Forward/back movement occurs in the saggital plane. Rotational movement happens in the transverse plane. Side-to-side movement take place in the frontal plane. This post is about the very easily overlooked frontal plane movement known as hip adduction.

His left hip is adducting.

His left hip is adducting.

(Adduction’s opposite twin is known as “abduction,” or movement of the limb away from the body’s midline. I have no idea why it was named abduction. I think it should’ve been named “out-duction.”)

Hip adduction. What is it? 

Look at his right hip and  you'll see adduction.  HIs leg has moved toward his body's midline.

Look at his right hip and you’ll see adduction. HIs leg has moved toward his body’s midline.

Adduction is the movement of a limb toward the midline of the body. If we think of the hip then we’re looking at the pelvis and the femur moving toward each other. Hip adduction can happen either with one leg off the ground and the leg moving toward the pelvis (Think of a soccer kick.) or it can happen with the foot on the ground and the pelvis moving toward the leg. (This should happen every time we take a step.)

Hip adduction is vital for everything from walking and running to skiing. Two aspects of hip adduction must be considered. First we must be mobile enough to achieve hip adduction. Equally if not more important, we must be able to control movement into and out of hip adduction.

Why is hip adduction important?

  • Without it, you have problems.

All of our limbs and joints are connected. We are a closely linked system of systems, not just a bunch of individual parts. What happens in one part of the body can strongly influence what happens elsewhere in the body.

The image on the right shows excessive hip adduction during gait. Too much of this may lead to knee or back pain. It's also indicative of poor balance skills.

The image on the right shows excessive hip adduction during gait. Too much of this may lead to knee or back pain. It’s also indicative of poor balance skills.

With that in mind, consequences of poor mobility and control of hip adduction can include back pain, hip pain, knee pain, ankle/foot problems and even shoulder or neck problems. Issues such as IT band syndrome and hip bursitis may be consequences of poor hip adduction skills.

  • Balance

Clients with balance problems often have poor hip adduction abilities. Their hip abductor muscles on the outside of the hip are often tight which limits their ability to move into adduction. This shows poor mobility. Typically, when they try to stand on one foot, the unsupported side drops uncontrolled into adduction which shows poor adduction control.

(Sometimes I hear clients say, “I think it’s just a balance thing,” as if balance were some ephemeral, magical thing that has no relation to muscles, limbs, joints and control of those parts via the nervous system. Balance isn’t “just a thing.” It’s a movement skill that is learnable and unlearnable.)

  • Sports performance

Preparing for a backhand, his left hip undergoes hip adduction.

Preparing for a backhand, his left hip undergoes hip adduction.

Sports performance may suffer due to hip adduction problems. Significant hip adduction skills are required for effective skiing, running,  golf, and tennis to name a few sports. Without good hip adduction skills, an athlete may not be as fast, powerful and effective as he or she may wish.

During the backswing, his right hip undergoes hip adduction. Follow through has hip adduction occurring in his left hip. If a golfer can't adduct on both ends of the swing then there will likely be problems with the shot.

During the backswing, his right hip undergoes hip adduction. Follow through has hip adduction occurring in his left hip. If a golfer can’t adduct on both ends of the swing then there will likely be problems with the shot.

 

In Part II of this post I’ll show not only how to mobilize the hip into adduction but also how to build strength and stability.

 

Gluttony Season is Almost Here. What’s Your Plan?

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Halloween kicks off several months of partying, gobbling, and guzzling. Very soon, swirling all around you there will be a galaxy of the richest and tastiest food and drink. Not only do you have a list of occasions for feasting, but also the days grow cold and dark. That means you’re less likely to be active and more likely to huddle in your warm, cozy home.

Is it any surprise that you tend to gain unhealthy weight under these conditions?

In all truth, it’s not a done deal that your health and fitness must suffer. You’re a grown-up. You can make good decisions. With some forethought, planning and awareness, you can avoid the slide backwards into feeble flabbiness.

Here’s an idea: Start your New Year’s Resolution early. Put in some thought and effort before you’re beset on all sides by wicked temptations. If you start building just a few healthy habits now, you can do a lot to minimize the usual holiday temptations and pitfalls. With some thinking and a plan in place, you can feel confident and you can avoid the guilt that often comes with holiday over-indulgence. Here are a few examples:

  • Will you exercise 3-5 days per week? For 30 minutes? (Or if you’re not currently exercising, can you start with just one day per week?)
  • Will you eat 1-2 fist-size servings of vegetables at each meal?
  • Will you limit sweets and/or booze to one day a week?
  • Will you talk to a friend or loved one about eating better and exercising together?
  • Will you consider hiring a trainer now instead of in January or February?

If it’s important then why wait?

 

Off-Season Part I: Resting is Weird.

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I just finished a 10-mile trail race and I feel good. I’m pleased that my Achilles held up. It seems I took the right approach to addressing the pain in that are.

I am grateful and very happy to have had a lot of fun over the past few months in the great Colorado outdoors. This spring and summer were full of activities including the following:

Besides these events, I put in the time to train for all of them. I’ve also continued lifting though for most of these past few months it’s been at a minimal level, about twice a week though that has changed recently. It’s been a lot of fun and a lot of hard work, but now it’s definitely time to shift gears.

I’m feeling a bit tired and beat-up. I can say without hesitation that it’s time for some rest. Rest is an interesting concept. Most people probably get a little too much rest. Some of us find it difficult to take time off though. Strangely, it can be a challenge to time away from challenging physical work.

Saying, “It’s so difficult to take a break from all this grueling stuff,” sounds loaded with pretentious fake humility. I don’t say this to sound like some sort of supreme, tough-guy super-athlete. There is a strange type of mental state that many of us have that isn’t entirely rational, healthy or wise. Our love our chosen activity(-ies) can verge into irrational dependence and obsession.

Our running, riding, swimming, climbing, skiing, lifting, — our athletic achievements and work — define us. What are we without the sweat, toil and achievement?

We also start to think crazy thoughts. Take just 48-72 hours off from working out and many an exercise aficionado starts to go insane. We think things like,

“All my muscles have shriveled like prunes and I’ve gained 30 lbs of pure fat!”

“My lung capacity is probably that of an emphysema victim!”

I am nothing but crippled, human lard!

That’s just after a few days! Taking several weeks or a whole month away from training can be excruciating!

This is all nonsense crazy-talk. It’s foolish to think we can keep pushing and pushing to no end. Following a serious season of training and/or competition, rest is exactly the activity an athlete needs. It’s easy to accept this fact on an intellectual level. It’s more difficult to accept it emotionally.

So It’s Your First Race…

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Running your first race should be exhilarating, challenging, life-affirming and, of course, fun. I find races to be very emotional. There’s a type of excitement near start that I don’t find many other places. There’s more to this process than just showing up and running though. Thoughtful preparation pays off big-time for an optimal race experience.

Any new experience is guaranteed to come with some surprises. If you’ve trained hard and done everything in your power to ensure a successful race, then you don’t want anything to detract from all that effort. To minimize the chances of trouble, here’s a rundown of things you may want to think about as you prepare for the big race.

Getting to the race

Is your race out of town? If so, do you know how to get from your hotel to the race? How long will it take? If you’re racing at home, how long does it take to get from your house to the race? Set your alarm appropriately. (My suggestion: Set it a little earlier than you think you need to.)

Will you drive to the race, take public transportation, ride a bike or travel by foot?

If it’s a weekend or holiday, what’s the public transportation schedule? Are there street closures for the race? If so, what’s your route to the race?

Exactly where does the race start and finish?

Where do you want to meet your friends and family after the race?

How about bathrooms? Where are they? Early morning race jitters can demand multiple trips.

Sometimes the answers to these questions aren’t obvious.

Sleep

You should aim for a good night of sleep two nights before your race. It’s very typical that you won’t sleep well the night before a race. You’ll have some jitters and if you’re away from home then your normal rhythms and habits will be altered. Don’t worry too much about it. You’ll be fine, but get good sleep 48 hours prior to your event.

Gear and clothing

Many races allow you to drop off warm-up gear and extra clothing. If that’s the case then where do you leave things and where do you pick them up?

If you’re traveling what do you need to pack? By race day, you should know what sorts of things are essential. The Road Runner’s Club of America gives the following checklist:

  • shoes
  • insoles or orthotics
  • socks
  • shorts
  • underwear
  • long sleeve shirt
  • short sleeve shirt
  • tights
  • jacket
  • gloves or mittens
  • headgear: winter hat, cap, visor, headband
  • watch
  • race number if picked up early
  • safety pins or race belt to which attach race number
  • course map
  • race instructions
  • change of clothes for afterwards
  • athletic tape
  • skin lube or powder
  • sunscreen
  • water bottle or hydration pack
  • sunglasses
  • towel
  • pre-race food/fluids
  • post-race food/fluids
  • wallet/money

Depending on the weather, you may or may not need things like a winter hat or gloves. If you’re racing in a Spring or Fall race, especially in places near mountains or the water, then the weather could change radically and quickly. Don’t assume the weather will be what you expect it to be. If you think you might need it, then pack it! It’s much better to have a piece of gear and not need it than to need it and not have it.

I like to start packing several days beforehand. I always seem to almost forget something. If I start packing early then it’s far less likely that I forget anything.

Finally, race day is not the day to try anything new. No new shoes. No new clothes. No new caps, glasses, socks, or anything else. As the RRCA stresses, “No new is good new.”

Nutrition

Breakfast

If you’re a morning runner then you have it figured out. What did you normally eat for breakfast while training? Stick with it. If it’s new, then don’t do it! You might pay for it with some nasty GI troubles.

If you’ve been running in the evenings and your race is in the morning, then it may take a little more thought. The pre-race meal varies widely from person to person. Generally, you want to eat anywhere from 1-2 hours prior to the race. You want to have enough time for the food to digest, but not so much time that you’re famished at race time.

My GI tract is fairly calm and I can tolerate a fairly wide range of pre-race meals. Other people are the polar opposite and they need to be very precise in the timing and content of pre-race food.

Fruit and yogurt, oatmeal, UCAN, or a smoothie are a few examples of things I like before a race. I’d avoid the steak & eggs trucker special if I were you.

Race nutrition

If your race is something like a 5k then food during the race isn’t much of an issue. It’s not long enough to demand much in the way of sustenance. Water’s probably the only thing you’ll want.

If your race is longer then you may need some calories during the race. Similar to breakfast and race gear choices, this should be determined in your training. Some things to consider:

Will you carry a hydration system and your own food? Will you carry a hydration pack or a hand bottle?

If you plan on eating/drinking from the aid stations, what foods and drinks to they provide? Have you used those products in your training? Recognize that consuming anything that you’re not accustomed to while running may cause you some digestive woes and grind your race to a potentially messy halt… or at least a walk.

Finally, your swag bag will likely contain various snack-type items such as gels, bars, electrolyte drink mix or something similar. If it’s unfamiliar to you then don’t eat it before or during the race. Save it for after.

If you remember nothing else regarding nutrition practices then remember this: No new is good new. (Have you heard that before?)

Running your race

Don’t start too fast.

Your first race! Adrenaline! Excitement! You’ve trained hard, you’re wide awake and you feel electric! Today’s the day for greatness! … And you start out too fast.

I am nearly certain that anyone who’s ever run a race has started out too fast. I have! Some time later that fast start has to be paid for with a slower pace. At worst, it can reduce you to a walk to the finish line.

(I think it’s not only inevitable but also essential that everyone experience a too-fast start at some point. It’s not fun but it’s a very valuable learning experience. It teaches humility and respect for proper pacing.)

No matter how good you feel, no matter how exceptional and strong you believe yourself to be, you won’t do your best if you launch out of the gate too fast. If you’ve been training with paced runs then you’ll know your race pace. Stick to it even it feels way too slow. If you haven’t used paces before then pay attention to how you feel. Pay attention to your breathing and effort. Remember that your hard effort needs to be spread over the entire distance of the race. If you’re feeling strong later in the race then that’s the time to pick it up a bit. Don’t do it at the start though.

Temperature

Spring and Fall morning races may be cold at the start. It’s tempting to bundle up and feel toasty warm. The problem is that once you start running you’ll be hot as hell. If it’s a cold day then you should be a little chilly at the start. You should be a little uncomfortable. Generally, I find that if my hands and ears are warm then I’m comfortable. (Turns out cooling and heating of the hands can have powerful effects on performance. If the topic interests you then read this from Peak Performance )

Finally

This racing thing can be a lot of fun. If you do some planning then it can be a smooth experience. Experience is the best teacher. The more you race the easier the preparation becomes.

Hip Internal Rotation: You Need It.

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All human movement can be described in three dimensions. We move in the saggital plane (front/back), frontal plain (side-to-side), and the transverse plane (rotation.) Certain movements are one-plane dominant: Distance running is mostly a saggital plane movement. Swinging a baseball bat is mostly a transverse plane movement. Ice skating and rollerblading feature a lot of frontal plane movement. Still, each of these movements also contain elements of the other two planes.

(Beyond moving in these planes, we also must stabilize our limbs against forces that are trying to move us in each of these planes.)

In my observation, a lot of people lack movement skills in one or more of these planes. Many times it seems clients lack adequate transverse plane movement, especially in the hips where the femurs attach to the pelvis. (We describe transverse plane hip movement as internal and external rotation.)  If we lack good transverse plane hip movement then we may have trouble with all sorts of activities from walking to running to skiing to golfing. Poor transverse hip mobility may result in back pain, knee pain or even shoulder or neck pain. Restricted transverse plane movement may also negatively impact sports performance.

I’ve found that restrictions in the transverse plane are often hidden. , Many people may feel tight hamstrings, tight pecs, or tight neck and upper back muscles, but rarely do I hear encounter a client who’s aware of something that doesn’t move well in the transverse plane. It seems a lot of us are walking around with no clue that we lack adequate rotation in any of our joints.

Why might an individual lack internal or external rotation? It could be any number of reasons. I believe our modern, seated, immobile lifestyle is probably a major contributor. Other reasons could be an anteverted or retroverted femur. These are structural issues of the femur that can’t be changed. Some sort of past injury could also be a culprit. All three issues could be at play.

I rest my case that hip internal and external rotation is important.

Here’s a video discussing hip internal rotation, why it’s important, and how to achieve it. Live it up kids!

Running Technique: 3 Simple Cues

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Running form is a frequently discussed topic among injured runners and runners looking to perform better. How should we run? Is there one ideal way to run? Should we run on the forefoot, mid-foot or heel? Does our core matter? What should our upper body do when we run?

There are many schools of thought in the running world and there doesn’t seem to be any ironclad consensus on any of these questions. If you’re running pain-free and you’re performing as well as you’d like then I don’t believe you should change your running form. In other words, if it ain’t broke, don’t fix it.

If, on the other hand, you experience pain when you run or if you’re not as fast as you’d like to be then some technique changes may be in order.

Run tall.

A lot of us run in a hunched type of posture that resembles the way we sit (and sit and sit…) in our work chairs or in our cars. This hunched position may be problematic and may be contributing to running problems. To address this issue:

Imagine a chain is attached to the top of your skull. That chain pulls you up. It lengthens your spine and makes you tall. See if you can feel this long, tall spine as you run. As part of this process, keep your gaze up and out toward the horizon. Don’t stare at the ground directly in front of you. This tall posture should help with some of our other running form considerations.

Tight hip flexors may contribute to a hunched posture. The following stretch sequence may help.

Run light.

The impact of the foot hitting the ground is worth considering as it concerns injuries. Recent evidence suggests runners who hit the ground lightly are injured less than runners who hit the ground hard.

You may run with earphones and you may be unaware that you stomp and pound the ground with each footfall. So to run light, remove the earphones and pay attention to the sound you make.

Imagine you’re weightless. Your strides are feathery light, and energetic. You don’t pound the ground but rather you glide across gossamer.

Another way to run lightly comes through this skipping drill:

Use a short, quick gait.

One way to lighten the impact of running is to drop the foot very nearly under your hips. This should result in your shin being vertical or near-vertical. Look at the picture. Try running like #2. The skipping drill from above can help you feel that foot landing directly below your hips.

Runner #1 is pounding. Runner #2 is running lightly.

Want to run lightly? Run like #2.

Don’t concern yourself with whether or not you’re hitting on the heel, mid-foot or forefoot. Where the foot lands is more important than on what part of the foot hits first.

Quickening your cadence too much can be a problem. There is an obvious point at which gait can becomes too quick and inefficient. An excellent way to work on your cadence is to use a metronome. Kinetic Revolution has a great article that discusses research on cadence as well as how to introduce metronome running into your training. The article also links to a digital metronome that you can download.

Change takes work.

Running may seem like something we should all be able to do. In fact, most of us can execute some version of movement in which we rapidly put one foot in front of the other. Kids learn to run without detailed instruction and without much in the way of typical running injuries. Shouldn’t adults be able to do the same thing? Maybe or maybe not… If we hurt while running or if we think we’re too slow, then some sort of alteration to our running style may make sense.

Changing your gait takes some tinkering, some awareness and mindfulness. It won’t happen automatically. Physical therapist Rick Olderman helped me to change my running gait. He once said that “if it feels normal, then you’re doing it wrong.” He meant that in the early stages of changing how we move, it should feel weird and unnatural to us. Learning any new skill requires some struggle and awkwardness. If you practice frequently and work at it then things should improve at a reasonable rate.

Personally, I never listen to music while running. I pay attention to how I run, where my foot falls, how I move. I don’t want to fall back into bad habits.

Finally

I can’t guarantee that any of these changes will result in either a pain-free running experience or a podium finish in a race.Time with a physical therapist, podiatrist, chiropractor and/or a running coach may be what you need.  That said, these cues have helped my running as well as several of my clients’ running experience. I’ve also incorporated things like the short foot drill, ankle dorsiflexion work, and a wide variety of single-leg squats and lunges (here, here, here for instance) to improve my movement competence. Clearly, there are a lot of moving parts to consider when we run!

What Does Your New Year’s Resolution Mean to You?

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Here we are again! The early weeks of the year are a time for high aspirations and lofty plans to reinvent ourselves by way of time in the gym. Everywhere we look we see exciting ads on social media, print media and TV for all sorts of diets and workout plans. These products are pitched with soaring rhetoric delivered by beautiful people to those who likely perceive themselves as being less-than-beautiful—but they have hope! (Or maybe they’re desperate.)

What will all this look like by, say, April? A lot of those ambitious plans will be tossed aside, buried and forgotten. Multitudes will give up entirely and blame themselves. It’ll all start again next year…

The M-word

The title of this post asks a question—and it’s a crucial question!—because your Big Resolution depends on the answer. Do you have an emotional connection to your New Year health & fitness goal? If so, is it positive or negative? Does your goal have meaning to you? How do you feel about your resolution?

The big word here is motivation. There are several types and the one that’s driving a new year’s resolution can make it or break it.

I found an excellent three-part series from Psychology Today called Weight Loss Motivation: Secrets to Staying on Track (Part I, Part II, Part III.) The article does an excellent job of discussing several different flavors of motivation. Two types of motivation will get you where you want to be. The other two… aren’t so helpful.

Identified and intrinsic motivation

Part I of the article describes these two types of motivation as follows:

“Identified motivation is when you have a positive view of losing weight or it is a behavior that you value. Maybe you want to be healthy for a loved one and your future together. For identified motivation there is a strong sense of personal importance and meaningfulness in the task.

Intrinsic motivation is the prototype of self-determination because the behavior is engaged for its own sake, for the simple pleasure and interest in the activity. This motivation involves a focus on the task and produces energizing emotions such as interest, enjoyment, and challenge.”

An example of identified motivation might be a grandparent or parent who recognizes the value of being healthy, strong, and able so he or she can keep up with the kids and grandkids. These people value a high quality of life and they see that a vigorous exercise and healthy eating is the way to get there.

I’ve met a lot of people in the gym like this. Exercise may not be their first love but a positive sense of purpose drives their actions.

I’ll use myself as someone who is intrinsically motivated to exercise and eat right. Essentially I love to pick up heavy things and sweat a lot. I love the process of training for a race or a bike tour. I love being in the gym with the weights. Skiing, cycling, and hiking are pure fun. I do these things for the sake of doing them. They are a reward in themselves.

Both types of motivation involve high degrees of autonomy. An individual motivated in such a way makes a conscious choice to engage in exercise, healthy eating and the like. His or her values and identity align closely with their healthy lifestyle and action. His or her efforts toward fitness occupies a significant and positive place in his or her life. Thus a trip to the gym, a run, a bike ride a swim or a healthy meal is motivated from within.

Part II of the article discusses two studies (here and here) that looked at long-lasting weight-loss management to understand why some people are successful while so many others are not. Regarding the findings the article says:

“These groundbreaking findings have shown that what plays a central role in the maintenance of exercise and physical activity behaviors are:

  • Enjoyment
  • Perception of competence
  • And intrinsic reasons for weight loss”

External and introjected motivation

External and introjected motivation are a stark contrast to identified and intrinsic motivation. The article describes these motivations:

“External motivation works on external demands and operates on the contingency of if/then:

‘If I lose 10 pounds, then I will go to my 15 year high school reunion.’

This motivation is purely external to your interest in losing weight. It is done in order to obtain a reward or avoid a negative consequence.

Introjected motivation is also motivated by external reasons to change. But it differs from external motivation in that it is done for somewhat internal reasons as well.

The problem, however, is that these internal reasons are negatively focused. They come from feelings of guilt or shame.”

It’s clear that these types of motivation involve doing something the individual would rather not do. Negativity is at the core. There’s far less autonomy, less control by the individual in their choice and probably no fun at all. External forces are largely in charge here. We are rarely happy when we perceive that something is forced on us.

If someone is extrinsically motivated he or she isn’t necessarily doomed. The article says:

“In one study conducted in England on 425 government employees, researchers found that extrinsic motives such as appearance and weight management dominated in the early stages while reasons related to intrinsic motivation such as for enjoyment or revitalization were stronger in the maintenance stage.

Studies such as this show that external or introjected motivation can produce results but only in the short term, and as we know, weight-loss is a long term problem.

It’s okay to have extrinsic motivation as long as you are not operating only on extrinsic motivation.”

The F-word and the S-word

I’m not talking about those F- and S-words. I’m talking about feeling and should. In reality we pursue all of our fitness endeavors because we want to feel a certain way. We may want to feel strong, healthy, sexy, or confident. Maybe we feel exhilaration or feel a sense of accomplishment at the achievement of a challenging goal. These are positive fuel sources for our efforts.

On the other hand, we may pursue a fitness goal because we feel we should. We feel we should look better because we feel external pressure from popular images, peers and/or family.

My guess is that what drives these negative shoulds are hopes of alleviating lots of negative feelings. We may not feel loved or worthwhile. Maybe we feel guilt, shame, rejection or intense social pressure to look a certain way. Whether we fully know it or not, we may believe that being thin or muscular will give us a feeling of peace, love and acceptance.

The problem here is we are basing our happiness on how others perceive us. Chances are that if these negative motivations are driving us then even if we become muscular and thin—then all we are is muscular and thin… But we’re still miserable. Who wants that?

Finding positive motivation

There are some strategies that may help. I won’t reprint everything on the subject, but Part III of the article discusses something the writer calls the Foundational Why. This goes to the real reason(s) why you’re working out, dieting, etc.:

“Start by sitting down with paper and pencil and write down why you want to lose weight or get in shape. Write down every reason that you can think of.

After you have gotten all of your thoughts down, go over your responses.

What are the reasons? Do they come from outside yourself or from within? If they come from within, how much are they integrated with your sense of self?

For example, let’s say one of your responses is similar to one of the following:

  • Because I should
  • Because I am ashamed of my weight
  • Because I want to look good for summer

If any of these sounds close to your answers, it means that you are working from extrinsic motivation.”

Following this Foundational Why process, the article discusses the You-at-Your-Best Exercise. It goes like this:

“Think of a time where you felt you were at your personal best. What were you doing? Who were you with?

This event is like a snapshot of you in your finest hour and something that you feel most proud of. It could be a really big action or it could be a small action but it exemplifies you and your character.

Write down this event in detail and then go over it. What does this event say about what you value in life, about what individual strengths you already possess, about what you enjoy doing just for the sake of doing it.

Ask yourself:

  • Why did you choose this event?
  • Why is it meaningful to you?
  • What does it symbolize or represent?

The You at Your Best Exercise will help you connect improving your health to things that you really care about, to things that mean something to you, by showing you what your personal drivers are. 

For example, perhaps this exercise reveals that you are someone for whom family is really important. In which case, think of your foundational why in terms of your loved ones or connect them with your health goals. It could be exercising with your partner, or perhaps going on walks with your parents.

It may reveal that you get energy from your sense of ambition. In which case, setting ambitious goals is something that you value and drives you to succeed. Maybe then sign up for an upcoming marathon?

Perhaps it reveals that when you are at your best you are using your humor and sense of play. If so, consider how to tap into that energy when deciding what fitness classes or activities to join. For some people, the addition of wearing silly socks to the gym can change their attitude to working out. 

The idea behind this exercise is to understand what naturally interests you in order to draw upon that to create lifestyle changes that you will enjoy.”

It’s sort of in the touchy-feely realm but I like these ideas a lot. If someone has any negative emotions around fitness, exercise and new year’s resolutions then this type of work should be mandatory for achieving those gleaming goals. (Never mind exercise and fitness, understanding our motives is crucial for achievement in any discipline.) Through it we gain valuable awareness of ourselves, what drives us and what’s most important to us. There is simply nothing more important for success.

My Chronic Injury is an Addict

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I'm getting off the wheel.

I’m getting off the wheel.

I’ve had recent discussions with two clients about lingering injuries. The talks brought to mind how my approach to my Achilles tendon pain. I think this new mindset will prove essential to my staying healthy and avoiding future Achilles problems. Maybe it’ll be useful to you.

To be clear, I don’t currently have any Achilles pain. I’m able to run long, sprint, and trail run consistently with no trouble. I want to keep it that way for the rest of eternity and that’s what brought up these thoughts.

Both my clients and I have battled aches and pains in particular regions that have come and gone… and come and gone again over the course of time. Our shared narratives go something like this:

I have pain. I see a physical therapist or chiropractor. He/She prescribes exercises that help. They help. I quit doing said exercises. (Those exercises are BORING as hell. They don’t feel like exercise. They don’t feel like they’re making me stronger, leaner, or more powerful.) Pain comes back at some point. Repeat the process.

Does this chain of events sound familiar?

My aches and pains have caused me to miss training, miss races and forced me out of some of the activities that I enjoy with passion. I’d like to avoid this process, thus I need to do something different from how I’ve done things in the past, otherwise I can expect the same result as before. (We all know about the definition of insanity right?)

I’ve decided that my Achilles tendon is… well… my Achilles heel. It’s my weak spot. For whatever reason, this part of my body is susceptible to problems. Therefore it needs special consideration and care. I’m now motivated to continually do the things that seem to strengthen my Achilles tendon. I want to turn that weak spot into a bulletproof, iron-clad appendage that’s nearly indestructible.

That means almost every day I’m doing standing heel raises. Some days I do high-reps/low-weight. Other days it’s heavy-weight/low-reps. I do bent-knee heel raises and straight-knee heel raises. I do heel raises with a straight foot and with my foot turned in and out. Some days I do lots of heel raises. Some days I do fewer.

My point has less to do with heel raises to cure Achilles problems and more with my behavior and thinking around the problem. The point is that I now constantly tend to this thing that has been a problem for me. I view it as an ongoing project that will never really be complete.

The analogy I’ll make is to that of an addict. Overcoming addiction is an ongoing process. An addict is either getting better or getting worse but he’s never treading water and staying put. An alcoholic/coke addict/sex addict/shopping addict/whatever-addict is an addict forever. Like an addict, it would probably be more enjoyable for me to quit doing my dinky, boring exercises and tell myself that I’m OK. I could easily do whats comfortable and easy.

I could say, “I’m fine. I’m cured. I don’t need to worry about this problem. It’s behind me forever now.”

If I take that tact though I should expect my problem to creep back in, and I hate that thought.

Losing the ability to run and jump is a powerful source of motivation for me. With proper motivation comes the ability to apply willpower to the problem. With this mindset, the boring and tedious exercises become easy. Doing them isn’t an issue at all now.

As with almost everything we do in fitness (and everything else in the world) the real target here is the brain, not the injured/painful area. If I want continued success and progress then I must decide to take the appropriate action. If I want a specific outcome (Achilles pain gone forever, weight loss, muscle mass, etc.) then I must adopt the behaviors that will get me there. I need to make new habits. That requires conscious thought and deliberate action. The work won’t do itself.

So there.

 

Two Big Reasons to Trail Run (or just hike.)

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I’ve been trail running consistently for several weeks now. I see this as a marker of success in both the continuing rehab of my reconstructed ACL (surgery was May of 2014) and in overcoming stubborn Achilles tendon pain. If all this nice

progress continues, I plan on running the Aspen Golden Leaf half-marathon in October (Damnit!  It’s sold out. I need to move on that earlier next year.) and then the Moab Trail Marathon in November. So all this trail running has me thinking…

Nature & depression

Good for me.   Good for you.

Good for me. Good for you.

An article in the Atlantic titled How Walking in Nature Prevents Depression discusses a study that demonstrates the real psychological benefits to tromping around in the outdoors. Specifically, the researchers found this:

“Through a controlled experiment, we investigated whether nature experience would influence rumination (repetitive thought focused on negative aspects of the self), a known risk factor for mental illness. Participants who went on a 90-min walk through a natural environment reported lower levels of rumination and showed reduced neural activity in an area of the brain linked to risk for mental illness compared with those who walked through an urban environment. These results suggest that accessible natural areas may be vital for mental health in our rapidly urbanizing world.”

When I’m on the trail, I’m very much “in the moment” as the saying goes. I am consumed with the ground and where I put my feet. I’m aware of the plants, the rocks, the temperature, and if I’m in the right spot, I might hear the rush of a stream. I Iam deeply engrossed in the experience. Rarely if ever do I think about the hassles and conflicts that await me in good ol’ “civilization.”

Searing physical exertion is often a part of my trail running experience as well. Despite the pain, I keep coming back. It would seem some part of my brain wants to be there.

Trail running & movement variability

I’ve mentioned the idea of movement variability (here and here). It (to me) is an exciting concept and a hot topic in sports skill training and injury pre-/rehab circles. The smart people at Cor-Kinetic discuss movement variability in this impeccable blog post. The writer states:

Viva movement variability!

“Movement variability is inherent within a biological system. Not only is it inherent it is also beneficial for reducing risk of overload and enabling the ability to adapt to events that occur within our ever-changing environment. Elite athletes cannot reproduce exact and invariant movement patterns repetitively even through hours of devoted practice. The best movers are those that can execute the same stable end point skill but in many variable ways dependant on the constraints and context of performance. It could be that part of being resilient and robust lies in variability. The ability to tolerate load may come in part in the way in which it is internally processed through our coordinative variability.”

If we think about trail running, then we see that it takes place in a highly variable, constantly changing environment. As we run (or walk) we can’t consciously think about how we place our foot every time we step. Rather we must react. This is a job for our subconscious and our reflexes. The movement variability researchers suggest that through this process we may protect ourselves from a lot of potential injuries. (Nothing in the world however can protect us from all injuries.)

On the trail, we have to stay upright, balanced and moving while our running parts deal with all sorts of odd angles and shapes. The great part about negotiating this rocky, rooty, up-and-down environment, is that our feet, ankles, knees, hips—and especially our nervous system—builds what I call a movement database. Our brain soaks up the subtle changes in movement that we experience so we increase our runnings kills. We have an opportunity to as the Cor-Kinetic post says, “execute the same stable end point skill but in many variable ways dependent on the constraints and context of performance.” Our tissues are stimulated in a remarkably well-rounded way so that we become more durable than if we run only on flat, monotonous surfaces.

I’m pleased that I’m not the only one thinking this way. (I’d love to come up with an original thought some day.) Similar observations on trail running are discussed in the Running-physio.com article titled Trail running – Natural rehab?

The writer describes his own experience in trail running:

“Despite running long distances over challenging terrain and including more hills than I’ve ever done before I have far less pain running on a trail than I do on the road.”

And he suggests the mechanism by which this process may work:

“I’m not the only one to find this, so how can trail running reduce pain and help injuries?

It’s all to do with repetitive load – running on a fairly uniform surface stresses the same areas of the body over and over again. Those areas become overloaded and you start to develop pain. Trail running involves a variety of different surfaces – I usually run over grass, mud, gravel and forest ground with treacherous tree roots. This variety means the load on the body is constantly changing rather than overloading certain areas. It may also act as its own rehab – your body adapts to the constant challenges to your control and stability. Running a trail becomes like an advanced balance work out.”

Wisely, he goes on to discuss when trail running may NOT be the right thing for you and how to gradually introduce trail running into your routine.

All of this is anecdotal evidence. I don’t know of any strong studies that show trail running will fix any given injury. That said, a trail run fits the bill very well for a variable movement experience and it’s my belief that many runners who aren’t trail running will benefit from adding some time on the trail into their schedule.

 

Activity is Better Than Rest for Overcoming Lingering Pain

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I’m glad to see Outside Magazine delivering a message that may be very useful to anyone suffering from pain. (This is from 2009, but I just saw it.) The article mirrors my recent experience with my ACL rehabilitationThe Real Heal: Overcoming Athletic Pain says two things essentially:

  1. Rest usually doesn’t cure what hurts us. (In fact, too much rest makes us deconditioned and contributes bad feelings in general.)
  2. Moving and using our sore parts–confronting the pain–is essential to getting rid of pain.

The writer discusses his journey following a bike crash which hurt his knee (an acute injury). He rested and took pain medicine. He states (emphasis is mine):

“It turns out my belly-up approach was dated. New research is proving that the best way to treat nagging pain is to eschew pampering in favor of tough love. Doctors at the University of Pittsburgh are doing ongoing research showing that stretching irritated tendons actually reduces inflammation. And the principle extends beyond rickety wiring. Every expert I spoke with told me variations of the same thing: ‘Rest and ibuprofen cure few injuries,‘ said Dr. Jeanne Doperak, a sports-medicine physician at the University of Pittsburgh. ‘During rest you’re in a non-healing zone,‘ offered Dr. Phelps Kip, an orthopedic surgeon and U.S. Ski Team physician. ‘The body was designed to move.'”

Pain is very much a psychological thing. I can relate to this:

“And it just so happens that tendinopathy chronic tendinitis is the most diabolical of recurring injuries. Give me a broken foot over tendon trouble any day when something snaps, at least you know what you’re in for. My injury dragged on into winter, deep-sixing my mood. This is not uncommon: The link between pain and depression is so well established that sports psychologists use a tool called a Profile of Mood States to monitor injured athletes. (This is a graph evaluating tension, depression, anger, vigor, fatigue, and confusion. People in pain score extremely high in every category except for vigor.) I was five years removed from being a college athlete and I was Long John Silvering it up stairs at work. Strange questions crept into my head: Could I consider gardening exercise?”

I like the overall message of the article but I don’t agree with all the information:

  • The writer says, “… or imbalances in the body’s kinetic chain of movement (a weak core can cause lower-back pain).”

Though this is a popular concept, there is significant evidence that “core strength” (which can be defined and measured in a multitude of ways) has nearly nothing to do with back pain.

  • For runner’s knee, the writer suggests this: “Lie sideways on a table, legs straight, and slowly raise and lower the upper leg ten times. Do three sets. Easy? Ask your PT for a light ankle weight.”

I think this might be part of an effective strategy to address runner’s knee (if the problem is rooted in the hip which it often is; however it could be rooted in poor control of the foot and ankle), but there are several dots that I think need connecting between this exercise and full-on running. This exercise is very different from running in which the foot impacts the ground and the runner must control motion at the foot, ankle, knee and hip. If this is the only exercise given to a runner’s knee patient then I’m skeptical that the runner will fully overcome the issue.

  • A caption under a photo reads, “Preventive Measures: Recovering from a nagging injury? Next time you go for a run or a ride, try taking ibuprofen beforehand. As long as you’re cleared for activity by your doctor, inhibiting swelling prior to a workout can dramatically reduce post-exercise inflammation and pain.”

This is an interesting idea but I have strong reservations. Pain is a signal that should be respected. Even though pain doesn’t equal injury it’s still a message from our brain that there is a perceived threat that needs to be addressed. The pain could be signaling a threat related to poor movement control and tissue stress is leading toward injury. By taking a pain-blocking drug, we might simply be turning down that signal as we continue with what may turn into an acute injury. I would compare this to driving a car with a damaged muffler that needs replacing and instead of replacing the muffler, we turn up the stereo loud: No noise!!–but have we fixed the problem?

On the other hand, I understand that even if the movement problem is addressed, we may still feel pain. Taking a drug may help the brain experience the new, better movement in a painless way which might help break the chronic pain cycle. I’m curious to what degree this has been method has been investigated.

For me, as a personal trainer, I would never suggest someone take a drug and just keep going. Rather, I would speak with the person’s PT. If he or she OKs it, I would then advise someone to move and work below the pain threshold or at a very manageable level of pain.