Essential Hip Health Drills

I’ve recently mentioned California-based physical therapist Kelly Starrett, and his very interesting blog MobilityWOD.com. (I’m doing his Mobility Course in Denver at the end of April.) One of his posts discusses why sitting is poison for your ability to move. (Also, check out Why sitting all day is slowly killing you for more details on this evil activity.) He’s on to something. Sitting is bad and we need to do something about it.

You sit too much.

By the way, if you’re saying, “But I don’t sit that much,” I have several questions for you:

1) Are you a non-Amish/non-lumberjack American in the modern world? If you say “yes” then you sit too much.

2) Do you own a car? If you say “yes” then you sit too much.

3) Is there a desk and/or a computer involved in your life? Clearly your answer is “yes” because you’re reading this.

4) Are you a cyclist? If it’s “yes” then you sit too much.

5) You sit too much.

Deep posterior hip muscles

Effects of sitting

So what does sitting do to us? First, we get restrictions in a bunch of our muscles and tissues. Particularly we see restrictions in our posterior hip capsule. This type of restriction can contribute to a condition called anterior femoral glide syndrome, which can cause pain at the front of the hip and generally bad movement. Further, the various

muscles in this region can become impaired, tight and weak. Sitting shuts down these muscles and our brain literally forgets how to use these extremely important movers and stabilizers. All of this can result in various aches and pains, poor balance, difficulty sitting and standing, poor running form, poor lifting form–it’s all bad!! What’s the solution?

Mobilize & strengthen

Superficial posterior hip muscles

The best way to address these restrictions is to move. We’ve got to move the tight tissues and we have to re-learn how to operate these muscles that have likely gone dormant. What follows are three drills borrowed and adapted from Shirley Sahrmann and Nick Tumminello.

Simply doing these movements and feeling a stretch in the hip will help loosen tight tissue, but we want to go beyond that. Again, we need to re-learn how to use these muscles and in order to do that you must contract them as you’re doing these drills. Think of adjusting the tension of your glutes in much the same way as you’d adjust the tension of your bicep during a bicep curl. You’ll maintain tension throughout the movement even as the muscle become stretched. You’ll probably

find it difficult to maintain a perceptible contraction as the glute stretch. Work on it. It’s a skill that you should develop in order to overcome pain and perform better. It’ll take practice but the payoff will be tremendous.

Stuff You Should Know About

Here are several things from food, books, exercises and blogs of which you should be aware. This is information and exercise that will improve your health and performance.

Look at this blog: MobilityWOD

MobilityWOD.com or Mobility Workout of the Day is a blog from Dr. Kelly Starrett. Kelly is a San Francisco-based physical therapist and Crossfit affiliate. His blog is chock full of how-to videos designed to improve your movement and fend off or overcome injury. Just the other day I watched Tight Ankles = Bad Squatting. I tried the drill and my years-long on-again-off-again right ankle pain was gone! Gotta love instantaneous results!

Read this book: Diagnosis and Treatment of Movement Impairment Syndromes by Shirley Sahrmann

Okay, read this book only if you’re a fitness or injury rehab professional. Diagnosis and Treatment of Movement Impairment Syndromes is a tremendously detailed text on how to identify and fix movement problems. I’m wading through it right now and it’s a challenge but the information is amazing. If you’re in the fitness/rehab industry, definitely get this book. Dr. Sahrmann’s second book is Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. I’m looking forward to that one too.

The author, Shirley Sahrmann, DPT is a pioneering, award-winning physical therapist. She’s a professor at the Washington University School of Medicine in St. Louis.

Take this supplement: Vitamin D

Vitamin D is important for a wide range of healthy human functions. Vitamin D is a key component of calcium absorption and thus bone health. Low levels of Vitamin D are associated with asthma and some cancers. It seems to offer a protective effect against multiple sclerosis and it boosts immune function. Unfortunately Vitamin D doesn’t show up naturally in too many foods. Some foods are fortified with Vitamin D but supplementation may be the best way to ensure adequate Vitamin D intake.

Humans with sufficient sun exposure have the ability to manufacture Vitamin D. It’s still cold in much of the country so that means minimal sun exposure–so there’s a good reason to supplement. (Interestingly, using to much sun screen too often may be problematic in Vitamin D production. Like many things, eliminating sun exposure may be unhealthy. Don’t be terrified of the sun.) Further, people with dark skin and older folks have a tougher time manufacturing Vitamin D.

Recommendations vary but it’s from 2,000 and 5,000 IU per day from supplements and sun is a good idea. Big men need more Vitamin D than small women.

Do this exercise: the deadlift

Picking up heavy things off of the ground is something homo sapiens have been doing since… well… before we were actually homo sapiens. As long as there’s gravity we’ll keep doing it. That’s what the deadlift is: pulling a weight off of the ground from a dead stop. The deadlift isn’t just for powerlifters either. It’s a tremendous total-body strengthening exercise that anyone can do with proper coaching. If you learn to deadlift then you’ve learned to use good body mechanics to lift an object.

Here’s a good instructional article on the deadlift from Stronglifts.com. And here’s a rather poetic video on the deadlift from Crossfit.

Eat this: coconut oil

Coconut oil seems to carry a whole raft of health benefits. Weight loss, improved immune function, better digestion, favorable cholesterol profile are a few of the likely benefits of coconut oil consumption. You can cook with it, put it in smoothies, rub in on you skin and put it in your hair. What other product is so versatile?

Eyes and Your Health

If you’re a client of mine then you’re at least a little aware of how important eyes, visual skills, and visual reflexes are to our health and performance. As part of the Z-Health Performance System, we’re taught that vision sits atop our neurological hierarchy. If we have a visual impairment (could be anything from a phoria, a convergence/divergence issue, diplopia or other issues) then literally our survival is at risk. Now there’s more information regarding the far-reaching importance of our eyes to our health.

The New York Times has a fascinating article titled Aging of Eyes is Blamed for Range of Health Woes. The article discusses research from the University of Kansas that reveals the impact of aging eyes on our circadian rhythms (aka body clock) and by extension our general health. The article states, “This internal clock relies on light to function properly, and studies have found that people whose circadian rhythms are out of sync, like shift workers, are at greater risk for a number of ailments, including insomnia, heart disease and cancer.”

Of particular importance is the role of blue light, the cells that pick up the light, and melatonin production. It seems that some cataract surgery may hinder the relationship between these factors. Here’s what the article says:

“Researchers in Sweden studied patients who had cataract surgery to remove their clouded lenses and implant clear intraocular lenses. They found that the incidence of insomnia and daytime sleepiness was significantly reduced. Another study found improved reaction time after cataract surgery.

‘We believe that it will eventually be shown that cataract surgery results in higher levels of melatonin, and those people will be less likely to have health problems like cancer and heart disease,’ [researcher] Dr. Patricia Turner said.

That is why [researcher] Dr. Martin Mainster and Dr. Turner question a practice common in cataract surgery. About one-third of the intraocular lenses implanted worldwide are blue-blocking lenses, intended to reduce the risk of macular degeneration by limiting exposure to potentially damaging light.

But there is no good evidence showing that people who have cataract surgery are at greater risk of macular degeneration. And evidence of the body’s need for blue light is increasing, some experts say.

‘You can always wear sunglasses if you’re in a brilliant environment that’s uncomfortable. You can remove those sunglasses for optimal circadian function, but you can’t take out the filters if they’re permanently implanted in your eyes,’ Dr. Mainster said.

Because of these light-filtering changes, Dr. Mainster and Dr. Turner believe that with age, people should make an effort to expose themselves to bright sunlight or bright indoor lighting when they cannot get outdoors. Older adults are at particular risk, because they spend more time indoors.”

Fascinating stuff!!! (By the way, when you workout, do you exercise your eyes? Do you consider your eye muscles? Think about it.)

Book Review: Easy Strength

If you’re reading this blog then you probably have some interest in getting strong(er). Since you’re interested in this laudable endeavor, you should know the names Pavel Tsatsouline (just Pavel will do) and Dan John. Further, you should be aware of their newest book Easy Strength. The book is targeted at athletes (which really is everyone to some degree) and coaches. The gist of book is how to get stronger with the least effort. The idea is to spend the minimum amount of time getting stronger so that the athlete has plenty of time and energy to practice his or her sport.

Most anything from Pavel or Dan is worth reading and understanding. Easy Strength is no exception. The book is more than just a bunch of different workouts. Four quadrants are examined in which an athlete might find him or herself during a career.

Quadrant I sees the athlete (often a kid) introduced to all sorts of games, exercises and movements. This quadrant is an inch deep and a mile wide. An athlete in Quadrant II may play a specific sport which requires a mix of strength, speed, mobility, endurance, etc. Think basketball, football, soccer, wrestling… An athlete in this quadrant must work on all these qualities and thus can’t be the best at any one quality. The athlete must live with compromises. Quadrant III is where most of us live. We’ve narrowed our focus to a few things but we’re not world champs. Quadrant IV is for pinpoint specialization. Here you’ll find weightlifters, sprinters, elite distance athletes, etc. These athletes have a very narrow focus and thus have very narrow training needs and requirements. The authors refer back to these quadrants throughout the book, and give considerations for the training needs of each of these athletes.

A quick word on the word “stronger.” It doesn’t necessarily equate to “bigger.” Many athletes (and everyone else on earth) need strength but not lots of muscle mass. Easy Strength takes this into account. Meanwhile some readers do want more muscle mass. This issue is also discussed in the book.

Oh, and the book is also chock-full of all kinds of workout programs and reasons to use them. A continual theme throughout the book is “less-is-more,” and the workouts reflect this idea. The problem is there are so many interesting workouts that like me, you may find yourself wanting to do “this one and that one and that one and that one too!” Pavel and Dan would tell you to pick one and stick to it. Get all you can out of it then move to another workout. Don’t blend this one with that one. So I picked one. It’s the 40-Day Workout. The workout is similar to the Power to the People deadlift workout. For a very thorough description of this workout read Dan John’s blog post called Even Easier Strength. Here’s the basic rundown:

Pick five exercises: a press, a pull, a hinge (deadlift, kettlebell swing, Romanian deadlift), a squat, a loaded carry, possibly an ab movement. (A pull and a hinge may be combined as in a deadlift for instance).

Do these exercises five days a week. Do about 10 reps per exercise. That may come in sets of 2×5 reps, 5×2 reps, 3×3 reps, six singles or other combinations that come out to about 10 reps. Work hard–but not very hard. These workouts are practice, not a red-line suffer-fest. The workouts should feel fairly easy. You should feel strong at the end of your workout, not flattened and half-dead. Don’t max out on reps or weight but rather nudge the weight up gradually as you move through the 40 days.

I’ve taken about a month off from lifting. My goal is to get stronger generally and a little more muscular. My workout looks like this:

Warm-up: Z-Health mobility work, core activation, jump rope, kettlebell swings, body weight lunges/squats, med-ball throws or some combination of these.

Main lifts:

Front squat
Barbell overhead press supersetted with face-pulls, batwings and some band pull-aparts
Deadlift
1-arm farmer walk
strict leg lifts
(Technically there are more than five exercises here, but the additional shoulder exercises are supplemental exercises, not heavy main lifts.)

To get a little bit of a cardio boost I go through the work as fast as I can–but not too fast. I rest as needed but I’m pretty much lifting as quickly as I can load and unload the plates. I’ll take more rest as the weights get heavier.

I’m really enjoying this workout. I get to lift every day. I don’t kill myself doing it and it’s fun to add a little weight each time. Plus it’s simple. I don’t have to mind too many variables. A couple of my clients are playing with this workout as well.

Easy Strength is a great read. It’s fairly profound in its message with extremely valuable information from the most experienced strength coaches in the world and reasonably easy to understand. If you’re even semi-serious about getting stronger–as any human should be–you need this book.

Running News

The New York Times Phys-Ed section discusses a recent Harvard study on running form. The study examined injury rates among heel strikers vs forefoot strikers. The subjects were 52 runners on the Harvard cross-country team. Researchers looked at four years worth of data on injured runners. The pertinent finding is this:

“About two-thirds of the group wound up hurt seriously enough each year to miss two or more training days. But the heel strikers were much more prone to injury, with a twofold greater risk than the forefoot strikers. (Emphasis is mine.)”

Be careful though. This finding doesn’t necessarily mean that everyone should immediately change their running form. The article quotes says:

“Does this mean that those of us who habitually heel-strike, as I do, should change our form? “If you’re not getting hurt,” Dr. Daniel Lieberman says, “then absolutely not. If it’s not broke, don’t fix it.”

But, says researcher Adam I. Daoud, who was himself an oft-injured heel-striker during his cross-country racing days, “if you have experienced injury after injury and you’re a heel-striker, it might be worth considering a change.”

For further discussion and analysis on these findings, have a look at Runblogger’s post (and how these findings are being misused in advertising) and the post at Sweat Science. Both of these guys do a great job of telling us what the data does and does not show.

Thoracic Mobility

This will sound odd but without reservation I can tell you that I’m all kinds of giddy over the thoracic spine (aka t-spine)! I’ve been reading quite a bit lately about the t-spine and learning about the implications of proper t-spine mobility and strength. Bret Contreras has a good article on the topic. Mark’s Daily Apple has two articles on the topic, this one and this one. This PDF from Mark Buckley is very informative. And Nick Tuminello discusses the do’s and don’ts of the spine in general in How Not to Warm Up. I’ve got a few drills to show you that should be done by any modern Westerner–that is, anyone who sits for a living, drives a car, watches TV and/or bicycles. But first, what is the t-spine?

Hello spine.

Anatomy

Your spine or vertebral column normally consists of 33 bones. You have seven cervical vertebrae in the neck region, 12 thoracic vertebrae that make up the mid-back, and five lumbar vertebrae that make up the low back. Down at the very bottom you’ve got the sacrum and the coccyx, aka the tailbone. So think of your t-spine as starting from the base of your neck and ending on an even level with the top of your hip bones. So why should you care about this region?

The thoracic spine is built for movement. This part of our spine was made to twist, flex forward and sideways, extend back plus a combination of all the above. But look at the modern Western lifestyle: We sit and we hunch. We hunch at a computer. We hunch over a steering wheel. For fun, we hunch in front of a TV. If we’re cyclists, then we hunch even during our athletic event. If we play golf or softball then we get rotation but generally only in one direction. In other words, the t-spine spine gets very little movement. What are the implications?

Organ function
It’s fairly obvious that most of our internal organs rest near our t-spine. Those organs are innervated by nerves that exit out of the thoracic spine. This means those organs send and receive information to and from the brain by way of the t-spine. Have a look at the chart and notice which organs receive their nerve supply from the t-spine region.

Your organs' sources of nerve innervation

If this part of your spine is immobile then you could have compromised organ function. That could mean anything from hand and wrist pain to breathing issues, thyroid issues, heart dysfunction, kidney dysfunction, digestive trouble, and who-knows-what-else. Thus mobilizing this area may well improve organ function.

Limb function & pain issues (or avoidance thereof)

Proper t-spine movement is tied very strongly to good shoulder and arm function and to good low-back health. (I’ve had personal experience with this, both with my own pain issues and with various clients.) A gunked up t-spine means the shoulders are going to move badly. A tight t-spine will likely result in shoulders that are unstable. Thus the shoulders may pay the cost of poor t-spine movement. Similarly with the low-back.

The lumbar spine is not a terribly mobile part of the body. It has about 6-7 degrees of rotation in each direction. The t-spine however has about 35 degrees of rotation each way. Your entire spine rotates as you walk, run, swim, reach behind you and obviously if you golf, swing a bat or throw a punch. If you lose t-spine rotation then your lumbar spine will likely start to compensate and rotate more than it was designed to. So that low-back pain you keep heating and icing and stretching, etc? It very likely may be caused by poor t-spine movement.

Appearance

Why do most of us work out? We may say “just to be healthy” or “my doctor told me to, but the real honest reason most of us exercise is for looks. There’s nothing bad about looking good! Good t-spine movement and positioning can help you look better instantly.

Remember that we’re a hunched over society. Look around you. How many rounded shoulders do you see? This doesn’t look great. Imagine if people drew themselves up, lifted their collarbone, and lengthened their spines. No question but that we’d look stronger, healthier and more attractive.

Okay, so there’s some info on what your t-spine is and why proper movement is vital. Now it’s time to move! (Please pardon the discrepancy between the audio and video. I’m trying to figure out what the problem is. Youtube is a challenge for some reason.)

Can Yoga Be Harmful?

“With it went my belief, naïve in retrospect, that yoga was a source only of healing and never harm.”
– William J Broad, NY Times

If you haven’t read or heard about it, the New York Times recently ran an article titled How Yoga Can Wreck Your Body. It’s far from the perfect article. For one, it’s full of anecdotal evidence. Second, many of the examples given of yoga causing injury consist of people doing rather extreme versions of a pose or movement. I think the article does bring up valid questions: Can yoga cause harm? Is it always safe for everyone?

I’ve had a couple of harsh experiences with yoga. Once I had a teacher that thought since I looked big and strong I could do some sort of headstand. I figured I would follow the teacher’s lead and give it a shot. Without question I was not ready for this pose. I left the class with a very painful shoulder. This instructor had been teaching for years and was very highly sought after at the gym where I worked. I was in another class where an instructor all but insisted that I move deeper into a pose and I simply couldn’t do it. My nervous system was trying to protect me by preventing further movement into this position and she had me trying to force my way into a deeper range of motion. Again, by the end of class, I was in a bit of pain. This is not what I was after.

My observation is that yoga is often championed as a panacea cure-all for any number of ailments: back pain, knee pain, mental stress, possibly even digestive issues. I can’t say everyone says this type of thing but in every gym setting where I’ve worked yoga is discussed and presented in this glowing fashion. But is yoga really any different from any other type of exercise? Might there be a few risks?

First and foremost, yoga is movement. So is running a 100 m sprint. Driving a golf ball is also movement. The power lifts are movements. Typing on a keyboard and watercolor painting? Also movement. Guess what: Movement can cause injury! (By the way, try NOT moving and see how healthy you become.) Further, yoga is a lot of very different movements. One may be quite safe, another quite unsafe. All parts of yoga can’t be viewed fairly as the same thing.

We can probably agree that movement is essentially necessary and usually healthy. We can probably agree that walking is typically safe and healthy. But what if we have a sprained ankle? Or a damaged vestibular system such that we can’t tell which way is up? Then even walking might be quite harmful. Lifting weights is similarly healthy in most cases. If we have a herniated disk or if we use bad technique then lifting may be very unhealthy. Why would we view yoga as any different? If we have poor kinesthetic sense then moving into any number of poses could cause pain and/or injury.

Further, we as Americans often have the view of “If a little bit is good then a BIG WHOLE LOT must be great!” More is better in other words. I’ve heard some yoga people speak proudly of not only how deep they can move into a pose but also how quickly they can move from one pose to another. Sounds a lot like the talk in any weight room. Just substitute weight and reps for poses and depth of motion.

Glenn Black is an experienced yoga teacher who’s interviewed for the Times article. He speaks to other yoga teachers and practitioners on the issue of injuries. He talks about ego. (I think the popular image of yoga is that it is an ego-less type of thing. But what human activity is free of ego?) Black says, “My message was that ‘Asana is not a panacea or a cure-all. In fact, if you do it with ego or obsession, you’ll end up causing problems.’” This seems a very wise statement, and I’m pleased that this article may start to shed light on the idea that yoga should be evaluated the same way as any other type of exercise.

Retraction on the last article

My previous post, the Skinny on Fat, contained some information regarding fat and cholesterol from Dr. Joe Mercola. Someone contacted me regarding him and some of his very questionable practices and beliefs. Among other things, he’s been ordered by the FDA to stop some illegal claims for his products. If nothing else, some of his business practices are on the shady side. Beyond that, he’s an advocate of homeopathy, which is non-scientific quackery at its finest. Most disturbingly, he has participated in a “vaccine awareness” public service announcement. He helps play up unfounded fears of vaccines which no one in the serious scientific community find plausible. For this reason I’m deleting the section of my last article in which he’s referenced.

The Skinny on Fat

History

I call this portrait "Health Food."

I grew up in the years of the low-fat craze. We were told that reducing dietary fat and cholesterol—particularly animal fat—was the best way to lose weight and improve our health. We saw wide scale proliferation of fat-free and reduced-fat food products. These products were then stuffed with sugar and weird chemicals that were and are very detrimental to our health—but hey!!—there wasn’t any fat. Ironically, this low-fat era saw an exponential expansion of American’s waistlines and all the associated chronic diseases such as heart disease, diabetes and cancer.

Now we’re seeing that a lot of our dietary guidelines were way off the mark. Turns out in fact that a lot of those guidelines were based on very shaky evidence and that researchers of the time were not in agreement on the data. A very thorough look at this evolution of our dietary guidelines can be found at the City Journal in an article titled The Washington Diet. Here’s an excerpt:

“As science writer Gary Taubes notes in Good Calories, Bad Calories, Senator George McGovern’s Select Committee on Nutrition and Human Needs, in coming up with its diet plan, had to choose among very different nutritional regimes that scientists and doctors were studying as potentially beneficial to those at risk for heart disease. Settling on the unproven theory that cholesterol was behind heart disease, the committee issued its guidelines in 1977, urging Americans to reduce the fat that they consumed from 40 percent to 30 percent of their daily calories, principally by eating less meat and fewer dairy products. The committee also advised raising carbohydrate intake to 60 percent of one’s calories and slashing one’s intake of cholesterol by a quarter.

Some of the country’s leading researchers spoke out against the guidelines and against population-wide dietary recommendations in general. Edward Ahrens, an expert in the chemistry of fatty substances at Rockefeller University, characterized the guidelines as ‘simplistic and a promoter of false hopes’ and complained that they treated the population as ‘a homogeneous group of [laboratory] rats while ignoring the wide variation’ in individual diet and blood chemistry. The Food and Nutrition Board of the National Academy of Sciences released its own dietary suggestions, which saw ‘no reason for the average healthy American to restrict consumption of cholesterol, or reduce fat intake,’ and just encouraged people to keep their weight within a normal range.”

Practical information

The very strong and very thoughtful lads at T-Nation.com give us a simple and worthwhile article on fat titled Fats Made Simple. This article goes into the various attributes of different fats and oils, which are best to cook with, which ones are best used as a topping, and which ones to avoid altogether. The issue of Omega-3 and Omega-6 fatty acids is discussed. I won’t go into every detail but here are some key points from the article:

— Use saturated fats for cooking. These are less likely to become rancid and toxic during the cooking process.

— Use unrefined oils. DON’T use refined oils.

The author’s top 6 oils are:

–red palm

— coconut

— macadamia nut

— extra virgin olive

— hemp seed

— walnut

AVOID THESE OILS:

— safflower

— sunflower

— canola

— corn

— sesame

— peanut

— pistachio

— pumpkin

— soybean
(Next time you’re looking at ingredient labels, see if you spot any of these oils–particularly corn, canola and soybean. Chances are you’ll find at least one if not several. They’re in everything!)

An eating plan

The Perfect Health Diet is an example of a a diet that’s high in healthy fat. It was developed by two scientists who wanted to address some of their chronic health issues. This plan has adherents eating about 2/3 plant foods and 1/3 animal-based food. Besides a high fat content, the diet is further characterized by complete avoidance of sugar and cereal grains such as wheat, corn and oats; this due to their inflammatory nature. (If you cut out the processed food then you’ll cut out a lot of sugar, wheat, corn etc). Legumes such as soy and peanuts are also to be avoided as well. Here are more details of the diet.

Please take note, dietary animal fat should come from free-range grass-fed sources. Most of the mass-produced grocery store meat is chock full of garbage such as added hormones and antibiotics. Plus the animals are fed stuff they’re not meant to eat.

I’m currently on this eating program. Admittedly, I haven’t followed it 100% but I’m working in that direction. I definitely feel more energetic having reduced my grain intake. I realize when I do consume grain, I tend to get a bit bloated. The odd thing is eating and really enjoying a lot of foods that for years I thought were really bad for me: butter, bacon, whole eggs, chicken with the skin on it, organ meats. I’m quite interested in sticking with this plan, further “perfecting” my eating, and seeing where it takes me.

Denver Fitness Journal

All Things Health and Fitness by Kyle Norman, MS, CSCS, FMS, RRCA Running Coach