Thoughts on Posture: Part II

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In the previous post, I discussed a few thoughts, ideas and myths surrounding our posture. A key concept is that posture actually isn’t tied very strongly to back pain. There are still good reasons to learn and practice good posture though.

Proper posture while lifting

Let’s think of a squat or deadlift. In these exercises, the legs are the engines that drive the exercise. They provide the “oomph” to move the barbell (or whatever implement) we’re holding in your arms/hands. The trunk is the transmission between the engines and the arms/hands/object.

The deadlift done wrong (left) and well (right.)

Keeping the spine braced in a neutral position ensures the best, most efficient transfer of force from the legs into the barbell. If the spine twists or bends then we leak force and risk injury.

Hold this posture during a push-up.

Glutes, abs and shoulder muscles are engaged. Keep it this way during a push-up.

 

 

Similarly, look at a push-up. Here, the arms and the shoulders are the drivers and the rest of the body is the implement we’re moving. We again want to keep the trunk rigid and braced, not loose, deflated and floppy. With proper technique we get a more thorough range of motion and stimulate the working muscles more. By doing a push-up in good posture, you’ll essentially get more out of the exercise than if you do it with poor posture. Risk of shoulder and back injury is reduced too.

Bad push-up!  No!

Bad push-up! No!

We can expand our view of posture out to any number of sports from running to golf to tennis to whatever else you like. In the vast majority of our sports, we want to keep solid posture so we can most effectively transmit force (usually) into the ground and into something like a club, a ball or an opponent.

In the grand scheme, good solid posture will enable you to lift more weight which will enable you to reach your fitness goals faster and more effectively. We can also make our sporting movements more effective through the use of good posture. You’ll avoid injury too which will allow you to train longer and more consistently.

Posture and safety.

Okay, in the last post, I mentioned that pain isn’t strongly linked to posture. Yet in this post (above) I’ve suggested that braced, neutral posture while lifting can help prevent injury. Am I contradicting myself? Not entirely.

If we load our joints at the far ends of where they can move then we do risk doing damage to joint tissues and this may bring on pain. So we want to avoid excessive spinal flexion, and/or spinal extension, and/or spinal twisting when lifting. Yes our spine can and should bend and twist, just not under heavy load. Rather we should put the spine in neutral and brace with the trunk muscles before we lift.

Posture for looks

Why do most people work out? Looks, no? For most of us, looks is somewhere on our list of reasons we exercise. We want to look lean and strong. Adopting good, erect, tall posture will instantaneously improve our appearance. Incredible! Tall posture makes us appear leaner and stronger. Slumped posture makes us look pudgy and weak. Look at the pictures and you be the judge.

(Ironically, when I look around the gym, I see lots of people exercising in very bad posture. Presumably they want good looks yet they engage in activities that only reinforce bad posture. Crunches may be the most effective way of promoting slumped, head-forward-style bad posture.)

Posture and confidence — (Yes posture and the brain are linked!)

Power Posture!

Power Posture!

The same tall posture described above makes you feel better and more confident. Don’t believe me?

He looks like a leader.

He looks like a leader.

Here’s the abstract from a study looking at this phenomenon (emphasis is mine.):

“Building on the notion of embodied attitudes, we examined how body postures can influence self-evaluations by affecting thought confidence, a meta-cognitive process. Specifically, participants were asked to think about and write down their best or worse qualities while they were sitting down with their back erect and pushing their chest out (confident posture) or slouched forward with their back curved (doubtful posture). Then, participants completed a number of measures and reported their self-evaluations. In line with the self-validation hypothesis, we predicted and found that the effect of the direction of thoughts (positive/negative) on self-related attitudes was significantly greater when participants wrote their thoughts in the confident than in the doubtful posture. These postures did not influence the number or quality of thoughts listed, but did have an impact on the confidence with which people held their thoughts.”

Here’s an excerpt from an article in Scientific American on the same subject:

“More impressively, expansive postures also altered the participants’ hormone levels. Using salivary samples, Carney and colleagues found that expansive postures led individuals to experience elevated testosterone (T) and decreased cortisol (C). This neuroendocrine profile of High T and Low C has been consistently linked to such outcomes as disease resistance and leadership abilities.”

and

“Together, these recent discoveries bolster the notion that power is grounded in the body. Not only does power change the body, but altering one’s postures changes one’s power, or at least the psychological experience of it.”

Finally, for a little more about the power of posture, here’s Amy Cuddy discussing the topic in a TED Talk:

4/24/14 Workout

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This was a challenging workout. We’ve changed barbell exercises from the deadlift. This new exercise is something like the first pull of a power clean in which we pull the barbell up to the high hang position and hold for five seconds. I’m calling it a “high hang hold.” That was followed by a bunch of double push jerks and 1-arm snatches. I realized I can better work on my technique with the 12 kg bells rather than the 16 kgs.

  • High Hang Hold: 225 lbs x 3 reps x 5 seconds – 260 lbs. x 3 reps x 5 seconds – 295 lbs. x 3 reps x 5 seconds
  • Double push jerks: 12 kg x 200 reps
  • 1-arm kettlebell snatch: 12 kg x 150 reps done continuously
  • Bike ride: 1 minute on/1 minute off x 5 times repeated twice.

 

I Met My ACL Surgeon and Workouts: 4/15/14, 4/17/14, 4/19/14 & 4/22/14

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ACL business

Last Thursday I met both my ACL surgeon and my physical therapist. Both come through Kaiser Permanente.

After my conversation with surgeon Dr. Kurt Spindler of the Cleveland Clinic, I had several important questions to ask regarding ACL reconstruction. I wanted to make sure my surgeon has thorough experience and continues to do ACL reconstructions on a regular basis. I wanted someone familiar with athletes and I wanted someone who would be closely involved with my rehab.

Dr. Melissa Koenig answered my questions very thoroughly. I feel that I’m in very good hands with her. She was complimentary and supportive of my efforts thus far to maintain as much mobility and strength as I can prior to surgery. She thought I’d do quite well.

Workouts

Several workouts to document. Here they are, including one long (for this time of year), wet, tough bike ride.

  • 4/15/14
    • Squat: Worked up to a 3 RM at 225 lbs.
    • Double 1/2 snatch: 16 kg x 10 reps x 4 sets
    • Double push jerk: 16 kg x 10 reps x 4 sets
    • 1 arm snatch: 20 kg x 5 reps each arm x 3 sets
    • 1 arm clean jerk: 20 kg x 5 reps each arm x 3 sets
  • 4/17/14
    • Deadlift: Worked up to 1 RM: 265 lbs. x 3 – 315 lbs. x 3 reps – 335 lbs. x 1 – 350 lbs. x 1 rep x 5 sets
    • Kettlebell rows: 40 kg x 5 reps x 3 sets
    • Double jerk: 16 kg x 80 reps in 10 minutes
    • 1 arm snatch: 16 kg x 80 reps in 10 minutes
    • Bike ride: 20 miles
  • 4/19/14: Somewhat light/easy workout.  Bike ride afterwards.
    • Power clean: 115 lbs. x 5 reps – 135 lbs. x 5 reps – 145 lbs. x 5 reps – 155 lbs. x 5 reps
    • Squat: 95 lbs. x 5 reps – 115 lbx. x 5 reps – 135 lbs. x 5 reps – 135 lbs. x 5 reps – 155 lbs. x 5 reps – 185 lbs. x 5 reps
      • I got to full depth on the squat for the first time since the knee.
      • In speaking with my physical therapist, he recommended working on my knee flexion.
      • A decently weighted squat is a pretty easy way to get the knee to flex!
    • Superset x 3 sets
      • Pull-ups: 4-3-2-1 reps each set
      • Stability ball leg curl: 15 reps
    • Superset x 4 sets
      • ab wheel:  6 reps
      • face pull: I used a thicker on each set for 15 reps – 15 reps – 12 reps – 12 reps
    • Bike ride: 41 miles and it was tough! Rode from Denver to Golden, over to Morrison and back into Denver via the Bear Creek Trail. Got rained on. Cold, wet, tired and hungry by the end. Food and alcoholic beverages were quite tasty afterward.
  • 4/22/14
    • Split squat: 95 lbs. x 5 reps each leg – 115 lbs. x 5 reps – 125 lbs. x 5 reps x 3 sets
      I don’t do these often enough. I’m glad the class instructor is having us do these. I’ll probably squat on the weekend.
    • Push Press: 115 lbs. x 6 reps – 120 lbs. x 6 reps x 3 sets
    • Double kettlebell jerk: 16 kg x 100 reps done in sets of 10
    • 1 arm kettlebell snatch: 16 kg x 200 reps done in sets of 5 each hand. I paused at 100 reps. Tough but very doable.
    • stability ball leg curl: 20 reps x 4 sets

My double jerk position needs more work.  I still need better lat and probably tricep flexibility to get in proper position.  It’s a work in progress and I’m making progress.

4/10, 4/11 & 4/13/14 Workouts

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Several days gone by and I’ve had several good workouts. I did some power cleans for the first time since the ACL and everything felt fine. I also rode up Lookout Mt. in Golden, CO and again, things felt good. Here’s what it all looked like:

4/10/14

  • Power cleans: 135 lbs. x 5 reps x 5 sets
    • Knee was stable.
    • Weight felt fine.
  • Front squats: 135 lbs. x 2 x 5 reps
    • Easy/light day for squats
    • Front squats are more challenging than back squats but that means I can load myself lighter.
  • Good mornings: 135 lbs. x 6 – 145 lbs. x 6 – 155 lbs. x 6 – 165 lbs. x 6 – 175 lbs. x 6 – 185 lbs. x 6
    • Heaviest on GM I’ve gone since the knee.
    • I do these on light days, deadlift on heavy days.
  • Kettlebell snatch: 16 kg x 40 reps – x 50 reps – x 30 reps = 120 reps total
  • Super set: 3 sets
    • 1-leg squat: 30 lbs x 7 reps
    • cable anti-rotation: 15 lbs x 3 seconds x 10 reps

4/11/14

Lookout Mt. from the air.  My favorite climb.

Lookout Mt. from the air. My favorite climb.

Bike ride up Lookout Mt: about 2 hrs/20 miles.

  • Tough ride but good.
  • Early season climbing is always an eye-opener.
  • Knee felt fine.
  • Lunch and beers afterward! Yeehaw!

 

4/12/14

  • Jump rope & mobility work
    • First time for any jumping since the knee.
    • 5 x 50 reps
  • Circuit: 8 rounds
    • Weighted pull-ups: 20kg x 4 reps
    • Kettlebell swings: 32kg x 20 reps – 36kg x 15 reps – 40kg x 10 reps for all remaining sets
    • Push-ups: 10 reps – 3 reps plyo push-ups – 10 reps – 3 plyo reps – 10 reps – 3 plyo – 10 reps – 10 reps = 59 reps total
    • 1-leg hops: 20 reps
    • This was a moderate workout. I went at an easy pace and worked until I was moderately fatigued.

This past week I was successful doing power cleans, jump rope, and 1-leg hops. This is fairly aggressive stuff and everything held together well. I’m very pleased.

Surgery is scheduled for May 1. It’s a little tough to contemplate after seeing so much quick progress since the initial injury. That said, I’m ready to get fixed up.

 

4/8/14 Workout

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It was a good workout today. I returned to the Tuesday/Thursday barbell & kettlebell class at the Glendale Sports Center. I really love this class but I haven’t been going because I probably haven’t yet been ready. But lately I’ve felt very solid so I figured it was time to give it a run. I haven’t done anything very powerful recently and I wasn’t sure how it would go with the kettlebell exercises. Can’t know ’til you try it though.

  • Squats: Worked up to 175 lbs. x 3 reps x 3 sets
    • Most weight I’ve done since the ACL
    • Can’t go quite as low as before but this is no surprise. I’m still below parallel.
  • Press: Worked up to 115 lbs x 3 reps x 3 sets
  • 2-handed Bent-over kettlebell rows: 16 kg x 10 reps – 20 kg x 10 reps – 28 kg x 10 reps
  • Kettlebell double push-jerk: 16 kg x 10 x 10 reps for 100 total reps.
    • Knee felt fine.
    • Technique is rusty.
  • Kettlebell 1-arm snatch: 16 kg x 20 reps (10 one hand then 10 in the other hand) x 5 sets for 100 reps.
    • Felt fine!
    • Probably will do a few tomorrow. I need to build some callouses on my hands.
  • Farmer walks: 32 kg

I’m very tempted to try a barbell power clean some time soon.

  • Road bike ride: About 20 miles
    • tempo ride
    • Done at a “comfortably challenging” pace.
    • Great day to ride. Felt good.

4/5/14 Workout

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Oh joyous day! I did several sets of back squats! I love me some squats and it felt like a big breath of fresh air doing them. First time for barbell squats of any kind since the knee went out. I got down to a fairly respectable depth (just below parallel.) The knee felt pretty good. There was some tightness/bruised-type feeling on the outside of the knee but only at the deepest depth. I followed that with deadlifts and some other fun stuff. Here’s what it looked like:

  • Squats: 95 lbs. x 5 reps – 115 lbs. x 5 reps – 135 lbs. x 5 reps, 5 reps, 10 reps
    • Life affirming!
    • Felt very solid.
  • Deadlift: 155 lbs. x 3 – 205 lbs. x 3 – 225 lbs. x 3 – 2625 lbs. x 3 – 290 lbs x 3 reps
  • 1-arm kettlebell clean & press: 16 kg x 10 reps each arm – 20 kg x 10 reps each arm
  • Ab wheel roll out: 7 reps x 3 sets

I followed this workout with intervals on the bike: 1 minute on/1 minute off x 5 sets followed by several minutes easy pedaling, then I repeated it.

Relatively Good ACL News & 4/3/14 Workout

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ACL News

I saw a non-surgical orthopedist yesterday and he walked me through my MRI. It wasn’t the worst news in the world. There were no bad surprises. I do have a grade III sprain aka a fully torn ACL. I have a grade II sprain of my MCL. No surprises there. The good news is my minisci are intact and undamaged. That’s great news! There’s also no bone damage. I’m really happy about both of these things. Surgery will be required but this injury could’ve been quite a bit worse.

I told him about my activities (staying as active and mobile as possible so long as I’m not in pain) and he approved. He said most people who get this type of injury sit down, prop up their leg, and move as little as possible. The muscles whither and their movement suffers. They go into surgery in bad shape and they come out worse. Recovery takes much longer under these circumstances.

This is no good. I’ll meet both meet with a surgeon and start physical therapy in two weeks. Some people have expressed exasperation and frustration at the pace of this process. I’m not one of them. I’m not the only guy wandering around Denver with an injury and this isn’t life threatening. I’m grateful that I have insurance, I don’t have some awful, exotic injury or illness and I’ve got people around me who can help. Anyway, the doc said surgeons typically wait on the surgery for two reasons: 1) We want to reduce swelling as much as possible and 2) We want to restore as much range of motion as possible. This stuff takes time and there’s no way around it.

4/4/14 Workout

  • Good morning: 135 lbs x 6 reps – 145 lbs x 6 reps – 155 lbs. x 6 reps x 3 sets
  • Super set 1
    • pull-ups x 4 reps
    • push-ups x 4 reps
    • goblet squat x 4 reps: I worked up from 16 kg to 20 kg to 24 kg
    • I accumulated 74 reps on pull-ups/push-ups but I didn’t time it.
    • My squat depth is getting better and I’m very happy about that. My knee is tolerating the movement well.
  • Super set 2
    • windmill: 16 kg x 5 x 2 sets – 20 kg x 5 – 14 kg x 5; What’s the windmill? Watch the video.
    • stability ball leg curl: 13 reps x 4 sets

    All’s well. Might get in a bike ride today.

ACL News & the 3/31/14 Workout

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ACL information & Dr. Howard Luks’s excellent blog:

Got a call from Kaiser and apparently the MRI indicates I don’t have a fully torn ACL. There’s evidence of a big sprain (which is a type of tear) and some damage to the MCL. I don’t know about any damage to the minisci.

On the surface, this sounds good. I’m not certain though that a partial tear is much better than a full tear. Of course I got online and started looking up partial tears and such. I found the site of Dr. Howard J. Luks, MD of New York. His blog is incredibly informative and I got a lot of useful information on all things ACL-related. There’s this post on partial ACL tears which discusses the difference between an ACL reconstruction and an ACL augmentation:

“The difference between an ACL reconstruction and an ACL augmentation is fairly simple. During the process of an ACL reconstruction we will reconstruct or replace the entire ruptured ligament. Anatomically, the ACL is composed of two separate bundles and a complete reconstruction will compensate for both of those bundles. In an ACL augmentation, you have only sustained a partial tear. That means that a portion of your ACL remains intact and might be normal. Many high volume ACL sports medicine orthopedic surgeons are capable of reconstructing only the torn portion of the partial ACL tear. This leaves the normal portion of the ACL alone. There are many advantages to an ACL partial tear augmentation over a full ACL reconstruction. While the discomfort, and the nature of the surgery is virtually identical – – – it is far more likely that someone who undergoes an augmentation will have a much more natural feeling knee when all is said and done. The reason for that is because the normal ACL has certain nerves within it. Those nerves give the brain certain feedback as to the position of the knee joint. It turns out that those nerve fibers are quite important. If we preserve the intact portion of your ACL, then we are preserving those nerve fibers and hopefully preserving the integrity of your knee in the long run.”

Perhaps an augmentation is in my future? I’ll have to ask about that on Thursday when I meet with an orthopedist.

Another post, 4 Tips to Prepare You for ACL Surgery, included (you may have guessed) these four tips:

  1. The technique for performing an ACL reconstruction has evolved significantly.  Over the last few years nearly all high volume ACL surgeons have gone to an “anatomic” approach.  That means that during ACL surgery we put the new ligament in exactly the same position your native ligament was.  Believe it or not, that’s not how we were originally trained how to do it.  The older technique was easier… which is likely the reason why some surgeons still use it.  Take Home Message:   An “anatomic” reconstruction has become the gold standard.  It is a more technically challenging procedure, so be sure to review with your surgeon what technique they plan on using.
  2. Volume matters !  An ACL surgery is a technically challenging procedure. ACL surgery should be performed by those of us who are experienced ACL surgeons.  Take Home Message:  Be sure to find a surgeon that performs a fair number of ACL reconstructions each month… not a few each year. 

    ACL Surgery

    The Dark Side of the Moon?

  3. When we reconstruct the ACL we need to create a new ligament. We can choose to use your hamstring tendons, a piece from your patella, or a donor graft from cadaver tissue. Different grafts are better suited for different situations.  Women tend to be “quadriceps dominant” so a patella graft might better suit their needs.  A patella tendon graft might be better suited for high level contact athletes.  A hamstring graft is a strong graft well suited for most all activities.  The research shows that a cadaver graft in a young active person should probably be avoided due to a high failure rate. Take Home Message:  One graft does not suit all needs for people considering ACL surgery. Be sure to do your research and talk to your surgeon about your goals so the proper graft can be chosen.
  4. If you have suffered an ACL tear, you are at very high risk for re-tearing the ACL in the same knee — or tearing the ACL in the other knee.  Many people have a predisposition due to a “neuromuscular” impairment.  (I hate big words too) That basically means the way you jump, land, pivot, etc needs to be evaluated to correct your biomechanics to diminish your risk of  requiring another ACL surgery.  Take Home Message: Physical therapy is an absolutely critical part of the overall recovery process.  Finishing up with a formal neuromuscular evaluation may play a role in diminishing your risk of a second ACL tear.

The first point about the anatomical graft was news to me. I’ve read a lot on ACL repairs and that bit was new to me. I’ll definitely have to ask about it when I see the doc. On to other things…

3/31/14 Workout:

  • Deadlift:
    • 155 lbs. x 5 – 205 lbs x 5 – 225 lbs. x 5 – 245 lbs. x 5 – 265 lbs. x 5 x 2 sets
    • Used the sumo stance
    • Knee never buckled.
    • Felt good!
  • Super set 1: 4 sets
    • step-up on plyo box: no weight x 10 reps
    • pull-ups: 20 kg kettlebell x 5 reps
  • Super set 2: 4 sets
  • Ab wheel: 5 reps x 3 sets

Everything felt decent. Went up in weight on the deadlift and felt fine. I tried the sumo stance a while back and the knee wanted to cave in. Today it didn’t. Good.

3/28/14 Workout

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Today I repeated the pull-up/push-up superset for 10 minutes.  Last time I did this for sets of 2 reps on each exercise and did as many as I could in 10 minutes.  I accumulated 40 reps. This time I did 3 reps on each for 10 minutes and I got 57 pull-ups and 54 push-ups. Then I did some other stuff. Here’s how it all went:

  • super set 1
    • pull-up x 3
    • push-up x 3
    • AMRAP (As many reps as possible) in 10 minutes
  • super set 2
    • anti-rotation cable press: 15 lbs. x 5 sec hold x 5 reps x 5 sets
    • Y-T-A-W shoulder patterns: 10 lbs x 5 reps x 5 sets
  • Reactive Neuromuscular Training (RNT) band split squat: to exertion (15-20 reps) x 2 sets
      • My right knee often wants to cave in since there’s no ACL to help stabilize it.
      • This exercise is done to help create more knee stability.
      • I use high reps (10-20) for endurance and pattern repetition rather than strength.
      • I try and do something like this every day, ideally throughout the day. I’m “practicing” more than I’m “working out.”
      • It looks like this, but instead of a person holding a band, I looped the band around a nearby support.

 

3/26/14 Workout

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I got in another bike ride yesterday of about 10 miles.  Felt good! Seems to help loosen up the knee. I walked my dog along a trail next to a creek. I managed to successfully navigate various rocks, roots and other things that typically appear near trails. More evidence of success. Here’s my workout for today:

  • Rower: 1000m
  • Warm-up circuit: 3 x
    • Band walks
    • 3D lunge: Can’t really do this full bore but did what I could.
    • 1 – leg squat: Can’t go very deep on right
  • Deadlift: 135 lbs. x 5 – 155 lbs. x 5 – 185 lbs. x 5 – 205 lbs. x 5 – 245 lbs. x 5 reps x 2 sets
    • by far the heaviest weight lifted since the ACL tear
    • felt good!
  • Super set
    • Stability ball leg curl: 12 reps x 4 sets
    • kettlebell windmill: 35 lbs. x 5 reps x 4 sets
  • Step-ups: no weight x 12 reps x 3 sets

I love deadlifting and today it was very enjoyable to lift something moderately heavy. Tomorrow is pull-ups and push-ups.