Blog Entries by David Drummer
Posted 12/22/2011
Often I have patients who enjoy lifting weights ask me: “When can I squat again?” They ask because they’ve been educated to know that a large part of the reason they’re in our clinic seeking treatment is because they have a forwardly tilted pelvis and a strong tendency to arch their backs backward, and that doing resisted squats with a barbell on their shoulders will make it difficult to get out of this position. This is because when they do squats with a barbell on their shoulders, they have to arch their backs, which is not something we want when going through a PRI physical therapy program. I think many postural restoration therapists would tell a weight lifter that they should NEVER perform a resisted squat. As a former power-lifter, a former patient at the Hruska Clinic, and now a certified PRI therapist at the Hruska Clinic, I have a slightly different perspective, though don’t misunderstand what I am about to say. Don’t tell people that Dave at the Hruska Clinic says its okay to squat, if you don’t inform them of the parameters REQUIRED before I allow them to squat.
If a person cannot perform a full functional squat (See photo 1) without cheating, and without falling over, they have absolutely no business squatting with a barbell on their shoulders. I also feel it is important for a person to be able to touch their toes (See photo 2) without straining and without stretching their hamstrings before they can squat. The reason is because if you can’t do a full functional squat or touch your toes then you still do not know how to live without depending on your back and you’re only going to make matters worse if you squat with a barbell on the shoulders.
After my patients have reached these parameters, I still make suggestions as to what they could do to work their legs aggressively while minimizing back activity. I suggest squatting on a platform holding dumbbells (See photos 3-5). If you look at the pictures provided you’ll see that my back is rounded as I perform this squat with the dumbbells. Try to do controlled reps…you don’t have to go super slow, but don’t rush through them either. You should also keep your weight through your heels and don’t rock forward over your toes. This will help you get a great sense of your quads and glutes working. Taking short breaks (30-45 seconds rather than, say, several minutes) between sets will help to intensify your workout. Another option for working the legs would be walking lunges (See photos 6-7). I would suggest that you be sure your heels strike the ground before your toes or forefoot, and maximize pushing your weight through your heels rather than your toes/forefoot throughout the exercise. The key to keeping your back activity to a minimum is to stay rounded through your back. Try reaching for or touching your toes as you do this. If this doesn’t sound like much of a challenge, try walking a hundred yards this way…go get on a local football field and see how your quads and glutes feel afterward. If you’re trying to minimize your reps and maximize your leg strength say for football consider hip sledding, seated leg presses or supine (on your back) leg presses as you’ll be less likely to overuse your back compared to squatting with a barbell on your shoulders.
With this all said (not forgetting that you ALWAYS need to be able to perform a full functional squat and be able to touch your toes) I do feel for a select few individuals (i.e. a football lineman come to mind) squatting is an appropriate exercise. Few others in my opinion really have a need to squat with a barbell on their shoulders. If you truly can perform a quality functional squat without compensation, can touch your toes, and you decide to do barbell squats, you’d better frequently be checking to see if you can maintain these parameters or you’re increasing your risk for injury.
Photo 1
Notice with the functional squat, my knees/legs are not rotated out but rather they are forward and parallel to each other. Also my back is rounded and my heels are down.
Photo 2
With the standing reach test, my legs are straight, my back is rounded, and some, but not all of my movement is coming from my hips, yet I am able to touch the floor.
Photo 3
Photo 4
Photo 5
As seen in photos 3-5, squatting can be done holding onto weights for the purpose of being able to better stay rounded through your back than you can do if you place a barbell across your shoulders. You may not be able to handle as much weight this way, but try increasing the number of reps and reducing the wait time between sets. Many people would argue that this is more of a deadlift than a squat. In any case, holding the dumbbells rather than a barbell reduces the chances of extending through your back.
Photo 6
Photo 7
I prefer a walking lunge where you’re reaching towards the floor as shown rather than holding the trunk erect because you’ll be less inclined to use your back. You’ll get a great leg and butt workout while keeping your back muscles relaxed.
Questions for Dave? Send him an email !
Or, leave a comment!
Posted 11/16/2011
I’m sure most people have heard the phrase: No pain no gain. As a physical therapist I have noticed for several years the meaning of that phrase has been lost. Occasionally when I teach patients activities for their physical therapy program it is clear that they are experiencing a reproduction of the pain we are working to overcome. On numerous occasions I’ve heard a patient say, “No pain no gain, right?”. The answer to that question is “wrong”. A better phrase in my opinion would be “No effort no reward”. Pain should not be a part of the equation. Don’t get me wrong, when you use some muscles more effectively because of a new exercise program or even occasionally from your physical therapy program, your muscles may become sore, sometimes to the point of feeling like a cramp. Sometimes that soreness/stiffness can last for days.
When we guide our patients through a program there are specific muscles you should feel working (and some you should not), but when the word pain is associated with those activities we have a problem. If you’re actually experiencing pain beyond what I’ve just described from an activity, I would argue that you’re doing the activity wrong…and it is your therapist’s job to help you learn to do the activity correctly. Once we understand that, we can now start making changes in your life that can help take away your pain.
Train smart and train hard.
~Dave
Questions or Comments?
Posted 07/22/2011
Questions for Dave? Send him an email !
For more information about the position your body is in and why, Click here!
Posted 09/23/2010
Yea, I know it’s cheesy, but hey it works. With fall comes a little outdoor work, and one of the biggies is raking leaves. In our clinic we try to help patients understand the importance of overcoming right side dominant tendencies which can be seen when you rake. With rare exception, when people rake, they stand with their weight shifted to the right and position the right hip behind the left. Next, we pull the rake in front of ourselves from right to left by rotating through the trunk to the left. Because of the way our bodies are made it is just easier and more natural to do it this way, but it also feeds into a pattern that increases imbalances in our bodies that lead to dysfunction and pain. Therefore, we recommend that you try to change things up by doing just the opposite. Try it. You’ll find it awkward at first, but with some diligence you’ll get the hang of it and likely find you have less back discomfort after you rake this year.
Along with the idea of shifting your weight to the left, positioning the left hip behind the right hip and pulling the rake in front of you to the right, I suggest you also try to use a broom this way, and in a few months try to shovel snow the same way. And if you’re a gardener who will be digging up your garden this fall to prepare for next spring, try to support your weight on your left leg as you push the shovel into the ground with your right foot, then turn the shovel over clockwise with your right hand being closer to the shovel head than the left hand. I hope this helps you experience less discomfort this fall with your outdoor chores.
To email Dave with any questions or comments, !
Posted 07/23/2010
Often, we see athletes in our clinic who are involved in a variety of activities and they wonder why they have pain. After all, they’re “in shape”, and often they’re young and otherwise healthy. Many of them report that they are sure to cross-train because they’ve heard cross training helps to prevent injuries and over training. Part of the problem is their understanding of real cross training. If your idea of cross training includes running, biking and weight lifting, then you’re missing something very important. It’s something we try to stress to our patients, and you may have read about it in some of our other staff’s writings. It’s the fact that our bodies can and therefore should be worked through multiple planes of motion.
I think sometimes we as therapists think this idea is self explanatory, but may in reality confuse many of our patients or readers, so let me explain. Think of the different planes this way: Imagine you’re standing and do any of the following moves: 1) Walking straight forward (or backward) is one plane of movement we call the sagittal plane, 2) Side Stepping either left or right is another plane called the frontal plane, and 3) Rotating either left or right (this can be your whole body, or can occur throughout your body. i.e. at your hips, trunk, neck) and is called the transverse plane. Ideally, when you are training for any sport, it is in your best interest to work all of the planes of motion. If, as stated above, you’re only running, cycling, and weight lifting, you are neglecting the frontal plane and have minimal transverse plane motion.
I would suggest any of the following activities to make your training more dynamic through multiple plane of motion: tennis, basketball, volleyball, roller blading/skating, racket ball, throw a Frisbee with a friend, play catch with a football/baseball (just don’t throw the ball/Frisbee directly to your friend, but rather chase it a little). Don’t be limited by these few suggestions. Come up with some activities that you can do with your friends/family that make your body work in multiple directions.
Train smart and train hard.
~Dave
Questions or Comments?
Posted 06/03/2010
A couple of weeks ago, I wrote about my perception of problems associated with sports performance and weight training. I shared my thoughts on traditional barbell squats, and gave some suggestions for alternative ways to strengthen your legs. Today, I would like to touch briefly on another common lift that is performed, and that is the bench press. A couple of thoughts I have with the bench press are: 1) If you’re going to perform bench presses, I would like to see you place your feet on the seat of the bench rather than on the floor. What this will do for you is reduce or eliminate extension through your back (refer to my previous blog entry for the problems with too much back extension). It will also decrease your stability on the bench and make the lift a more dynamic activity. Sure this will reduce the amount of weight you can safely manage, but I believe you will actually reap much bigger rewards in terms of sports performance; and 2) Don’t forget to work the muscles that oppose the pecs that you’re developing with the bench press. If you don’t incorporate activities that draw the shoulder blades back, you will develop forward head and shoulder posturing that can lead to neck and shoulder problems which will certainly not boost your sports performance. Until then, continue to check out blog entries from all of the therapists here at the Hruska Clinic.
Train smart and train hard.
~Dave
Questions or Comments?
Posted 05/12/2010
Now more than ever, weight lifting has become an integral part of sports training programs at all levels, including in our high schools and junior high/middle schools. I appreciate the idea of integrating weight training into sports to maximize strength and performance, but unfortunately, like many things, we have taken it to an unhealthy extreme. It is my opinion that weight lifting, especially in the high schools, has become more a focus of lifting the maximum amount of weight possible at all costs, regardless of form and control, so we can place our names on the wall of the training room at school. I have to admit that more than twenty years ago when I was in high school it was the same way. I loved the feel of a heavy barbell across my shoulders when squatting, or a bar that starts to bend when dead lifting or bench pressing, but somewhere along the line things have changed. I don’t remember athletes injuring themselves weight lifting when I was in high school, but today we see a lot of young athletes coming into the clinic with back injuries from squatting, dead lifting, and power cleans. As of yet, I haven’t seen any pec tears from bench pressing, but I assure you, if our attitude on weight lifting doesn’t change, it will be a common occurrence.
In our practice, there are certain tendencies or patterns that we see in essentially all people. Some of those tendencies are for people to be extended through their backs (pelvis is rotated forward causing you to compensate by arching backward through the spine). This leads to pain from strained back muscles, or other injuries such as a spondylolisthesis (this is when one of your vertebrae becomes injured leading to instability of one vertebrae on another, thus allowing the vertebrae on top to shift forward on the lower one & is a serious injury). Improper lifting or even simply lifting excessive amounts of weight can increase this tendency, and lead to even greater degrees of injury, pain, and dysfunction. The power lifts for your back and legs which include squats, dead lifts, and power cleans, all by nature require some back extension and therefore increase the risk for injury as the weight is increased.
Because athletes want to increase their power and overall sports performance, I would like to suggest the following: First, before you embark on or continue with a weightlifting program, I believe you always need to be able to perform a full functional squat where you can keep your feet roughly shoulder width apart and parallel to each other (not turned out or in). You also need to be able to keep your weight through your heels, reach forward and down slightly with your arms to round your back, and then squat without letting your knees turn out as you squat low. You should also be able to hold this position as you breathe repeatedly in through your nose and out through your mouth.
.jpg)
If you can do this, it would then be appropriate to begin a strengthening program that might consist of the following dead lift or squatting exercises: Stand on a platform while holding dumbbells with your palms facing in, and then perform multiple sets and repetitions of squats while keeping your back rounded and weight through your heels. Another alternative for squatting would be single leg squats where one foot is resting on a bench or chair behind you while the other is on the floor. Keep your back rounded while you perform several sets and repetitions of squats. When doing this, you must keep the knee of the leg that is working forward, rather than letting it turn in or rotate out. Also, you should keep your weight through your heel as you reach down to touch your toes with each rep. You can alternate legs after every ten reps or so.
These are just a couple of options, but the key is keeping your back rounded, performing multiple sets and reps and not getting caught up in “maxing out”.
Train smart and train hard.
~Dave
Questions or Comments?
Posted 02/10/2010
Runners are known to be very ambitious and dedicated athletes. They are also known to stretch a lot, especially their hamstrings. For many if not most runners, the more they stretch their hamstrings, the tighter they feel. There is good reason for that. If you would like some insight into the problem with overstretching hamstrings from a physical therapist’s perspective, click here. You might be surprised by what you learn. Our next entry will focus on the difference between static (example typical hamstring stretch) versus dynamic warm-up for preparation for running.
Train hard and train smart!
Dave
Posted 01/22/2009
Dave has written an article for Performance Conditioning, Volleyball edition, on the hamstring muscle. To read his article, click here.
More blog entries can be found in the archives…
