Tag Archives: Health

Stretching is a waste of time

I spend most of my time working with clients who want more mobility, be it the ability to get a greater shoulder turn in the backswing or to turn more to ‘load the hips’ in the downswing. The flip side of this is that I spend most of my time working with golfers who spend far to long sitting, either at a desk 8-10 hours a day or on a plane/train/car traveling to the next tournament 2-3 days a week. Unsurprisingly, a fair few of them arrive on my client roster with the mobility of a clam, meaning even basic human movement patterns, such as the squat or hinge are challenging endeavours.

Seeing that part of my job is centred on optimising movement patterns and mobility, these clients expect me to help them improve in this area. However, what isn’t expected, indeed even resisted by some, is when I break down my ‘mobility’ methods, It’s often not what people expect. For most clients, there is very little to no static stretching whatsoever.

The response is pretty predictable – “how am I going to improve my mobility/flexibility if I don’t stretch?” Or “But I’m stretching everyday at the moment; surely I need to do more if I’m going to get better?” My response is to ask whether there religious stretching routine to date has actually improved their mobility. The answer is always No.

images

No matter how much time a client spends stretching, they typically see only transient improvements in flexibility and negligible improvement in motor control when performing any movement using that new range of motion. Static stretching alone is not the answer. In fact, it barely provides any benefit at all.

As a result, I’ve dropped almost all static stretching from my programs in favour of some more advanced mobility methods I’ll discuss here.

Why stretching doesn’t work?

Well first off, muscles can’t actually be lengthened – There are various research studies that have looked at this exact topic. Secondly a single 20 second static stretch has been shown to noticeably reduce force output – hardly ideal if your about to go and do a strength training session or complete a high power output activity such as golf.

Most importantly however, tightness in the muscle is often just a symptom not the cause of the problem and therefore stretching is just a band aid for the symptoms and will not fix the cause in the long term. A muscle is tight because it’s protecting a perceived instability, compensating for another area, or is guarding against a perceived threat. So if your tight first you need to ask why said muscle is tight?

For most of us with tightness one or all of the factors above are also at play in limiting range of motion.  Stretching doesn’t address the cause of the muscle being tense in the first place. If the muscle is actually ‘tight’, static stretching should allow the muscle to become less tight, and those gains should be permanent if they are appropriate to the restriction. However, particularly in an area like the hips, that are designed to have a large range of motion before actual end range due to a bony block or capsular ending, the muscles are most likely hanging on to give stability to some other part of the body. Static stretching won’t fix the issue on a permanent basis, as you’ll simply return to being tight as a drum again to give you the stability to move.

You need to fix the stability issue, which is the cause. Not attack the tight muscle, which is just the symptom with static stretching.

As a quick aside: The hip joint can get to 170 degrees of flexion, and in some angles outside of the sagittal plane it can get to more than 200 degrees flexion. It can also extend to between 40-60 degrees, which adds up to way more than the necessary 180 degrees to do a split. This leaves soft tissue restrictions as the reason most people can’t hit the splits. Sure, some have structural issues with the shape of their hip joints, but that can’t be something that could account for the entire population.

42

Bodybuilder, Flex Wheeler, used to hit the splits on stage, carb depleted and dehydrated while packing more muscle than 95% of the population, proving the concept of “muscle bound” reducing flexibility to be completely and utterly false.

Let’s look at the hip flexors as a specific example, a tight hip flexor is often the result of femur sliding forward (anterior glide), resulting in the glutes becoming stretched and weak (this is what’s meant by a capsular issue). Additionally, if a segment is unstable, so other areas become tense to try to provide the stability needed to move. In the case of the hip flexors, they attach to the spine, so If you core musculature responsible for stabilising the spine is weak, your hip flexors will try to stabilise your spine and they’ll stay tight to give stability.

There is huge interplay between the core and the hip. It’s not enough just to look at the hip in addressing your poor mobility. To echo the message of smart people such as Gray Cook, Charlie Weingroff , and Mike Robertson who have really made this stuff mainstream, we need proximal stability to have distal mobility. In other words, we need relative stability through the trunk to make full use of the range of motion available in joints such as the hips and shoulders.

Another example would be tight hamstrings – many people have hamstrings that feel permanently tight and couldn’t touch their toes if their life depends on it. Many of these golfers still cling to the idea that static stretching of the hamstrings is the answer, down this road lies nothing but frustration and wasted time!

These individuals typically display a pelvis that is anteriorly tilted, placing the hamstrings in a stretched position to start with, coupled with an inability to posteriorly shift weight back into the hips. If we can improve the lumbo-pelvic position and alignment, both statically and dynamically, we’ll improve that feeling of hamstring ‘tightness’.

If not stretching, then what should I do?

As I said earlier muscle, or any soft tissue for that matter, doesn’t have the physiological properties to permanently deform and lengthen. That leaves us with optimising adjacent players in gross movement patterns to improve the pattern itself, and create an illusion of muscles gaining length or suppleness. True mobility, therefore, is dependent on an athlete’s ability to create proper movement strategies.

Below is the plan of attack we use with our clients to get their mobility restrictions in the right direction:

Screen Shot 2016-05-11 at 23.15.39

While many people think foam rolling or other SMR techniques are a method of stretching, they’re not. The muscle isn’t undergoing any kind of length change, but rather a neural down-regulation that reduces resting tone in prime movers, meaning you can move more easily and with a better chance of having balanced tension around the joint. It’s a testament to how resetting the neural tone of a tissue can help increase range of motion faster than simply stretching. Picking up that tight hamstrings example again, foam rolling/ SMR techniques hitting the glute, glute med, and adductors are often useful to reduce tension in these muscles and allow a more posterior pelvic tilt. Here’s a tact and floss SMR technique that I’ve found particularly effective:

But again, un-gluing a chronically tight area without restoring stability to the tissues it’s trying to help stabilise will only result in it getting tight again.

Dynamic mobilisation comes into play with the newly unlocked joints and tissues. The role of active mobility is to train the body to use the range of motion in the most effective way possible so that the likelihood of maintaining this new range is higher.

When doing any active mobility, focus on keeping the spine tense and the core active while sinking deep into the stretches, hold each for a single breath per rep, and continue on to the next one. Continuing our hamstring tightness example, modified quadruped rock backs, kneeling adductor mobilisations or kneeling posterior hip/glue mobilisations work well.

Lastly, we need to ensure this new range of motion sticks and is usable within functional movement patterns. This is where motor control and movement pattern correctives come into play.

For the those with tight hip flexors this is where exercises teaching core control and separation of hip extension from lumbar extension are really useful. For those with tight hamstrings we will now utilise toe touch correctives, to address the poor pattern. As shown in the video below elevating the toes and squeezing an airex pad placed between the legs is a good option as it encourages posterior weight shift and engages the glutes to encourage posterior pelvic tilt respectively. As with dynamic mobility be sure to keep the core tense and focus on breathing.

Closing thoughts

If you happen to be the individual with tight hamstrings and a poor toe touch pattern, used as an example here, you’re in luck as all you need to do is follow along with the exercises in these videos and let me know how much better your hamstrings feel and your toe touch is after a month or so. However, the point of this article really was to highlight the limitations of static stretching and show the system we use in our programs to develop mobility instead of stretching. For any mobility restriction you have targeted foam rolling/SMR, followed by dynamic mobilisation work and finally pattern correctives will do much more for you than mindlessly static stretching ever did.

If you would like to see more articles like this, covering how to deal with other specific mobility restrictions such as tight hip flexors, t-spine or shoulder mobility, let me know in the comments and if enough people ask for it we’ll get it written.

Random golf fitness thoughts: April edition

1. Fitness isn’t just making the young guys hit it further and play better, it’s helping the older guys play longer and stay competitive

Bernhard Langer’s appearance on the Masters leaderboards was a reminder that working on your fitness isn’t just crucial for the younger guys on tour, or for adding distance to your drives (although it does that!), a good training plan’s main priority will always be to keep you healthy and playing longer.

As Langer has said himself in more than one interview for the PGA tour website:

“In my case it’s very necessary and I’m not sure I would still be here if it hadn’t been for the fitness”

Indeed, if you don’t know Langer has had two bulging disks in his lower back, as well as neck problems, and at the tender age of 19! He credits fitness work and mobility work for preventing these issues from becoming worst and allowing him to overcome them.

2. Go barefoot during your warm-ups

Going barefoot in your warm-ups (where developing movement quality and mobility should be our priority) really ups the ante on what we’re trying to achieve.

Going barefoot allows you to keep proper track of movement quality (foot positioning, is foot twisting, rollin, lifting etc). For example when we are doing ankle mobs we need to keep our feet on the floor and prevent the foot from rolling at all to make sure the motion is coming via ankle dorsiflexion not pronation. When the foot is in a shoe not only will the heel give you a falsely good impression of dorsiflexion but there is likely to be an element of heel lift and pronation that is hard to detect.

When doing stability work such single-leg balances, stork turns, single-leg mad ball taps and even single-leg hops if you are jumping on a comfortable enough surface, removing the shoes can be useful for the same reason. However, keep it to unloaded work in your warm-ups as form and comfort could suffer in heavier work, particularly in squats and other anterior chain dominant work.

3. Train outside

For most of you reading it will be heading towards summer and the weather will be getting better so why not! Training outside has not only been shown to have some great benefits on health, mood and mental state but, one of the things I’ve noticed over the years, with power work work, particularly med ball throws is that athletes seem to “hold back” when they’re indoors. They won’t throw at full speed because they’re already worrying about causing damage or more likely where the rebound will go, there just seems to be more inhibition as opposed to throwing outside in a big open space to a partner who is pretty far away. Maybe it’s the quantifiable feedback of actual distance, or maybe it’s just less restriction – but either way the effort and results are usually better.

4. Emphasise full-body exercises that teach transfer of force from the lower body to the upper body.

As we move into the golf season introducing exercises that teach transfer of force from upper to lower body, oftentimes with a rotational element are a great idea. First off, they offer great ‘bang for your buck’ allowing us to train multiple qualities in one exercise. Secondly, they utilise force transfer in a way more akin to the golf swing and begin to bridge the gap between the strength you built in the off-season and using it on the course. Just make sure you have mastered the appropriate regressions before making use of these exercises

Cable lift variations in a split stance or with a lunge are my favourite to accomplish this task in core exercises, but push presses, landmine presses, and rotational rows are also great options.

If you haven’t already be sure to check out the full article on in-season training I wrote here.

Lastly, this blog has been going a year or so now and this week is on track to be the biggest in terms hits so far, so a huge thank you to you all for reading and continuing to support! Special shout out too to The Grateful Golfer and Golf is Mental for there likes and comments on what seems like pretty much all the posts I’ve written in that time! Incidentally comment any golf fitness questions you have and I’ll do my best to answer them in next months Random Golf Fitness Thoughts.

Thanks again,

Nick

 

Elbow Pain in Golfers: What to do

Today’s article is something a bit special! It’s a guest post from Sports Chiropractor and author Tom Feeney. Tom is a Sports Chiro specialising in myofascial release in Newcastle upon Tyne. He has treated Premiership, Olympic, NHL, and WWE athletes and the general public since 1997. His work has featured in The Telegraph, Athletics Weekly, Train Magazine, and 220 Triathlon, with his article on performance therapy for golfers being published on Stack and TPI.

In this article Tom takes a look at the research on Elbow pain in golfers and offers some practical solutions to get you pain free, back to the course and back to full training in the gym. I think you’ll really enjoy it so without further ado!

Tendon pain at the elbow is common in golfers. When on the inside it is called Golfer’s Elbow and when on the outside it is called Tennis Elbow. Some tips:

  1. Research shows Myofascial Release is better than standard therapies.
  2. Exercises help- try isometric (no movement) and eccentric (negatives) exercises.
  3. There is some inflammation in some tendon problems, ice may help after heavy use.
  4. MRI may be better than diagnostic ultrasound in identifying LE.
  5. Steroid injections don’t provide long-term benefit.

Should I ice it? The inflammation debate!  There may  be some swelling but in most cases ice is not needed.

Over the last few decades, LE stopped being considered a tendinitis because little evidence of inflammatory markers were found.  Tendinopathy became the new term of choice, but recent research found convincing evidence that the inflammatory response is a key component of chronic tendinopathies like LE.   My take: some inflammation is there, but it may be an important part of healing.  Only ice after heavy use.

What causes the pain?

In a nutshell, tendinosis involves too much tendon breakdown and not enough repair. When repetitive micro trauma damages cells, they create new collagen which is structurally different.

Is exercise the answer?

Exercises helped relieve pain in the short-term compared to no intervention 2011 study.

Exercises should progress from isometrics to eccentrics:

Isometric exercises involve putting a muscle and tendon under tension, but no movement. In some cases I give this exercise with the wrist and finger in varied positions.

Eccentric exercises with a band for LE are often helpful and easy to do.

Will it go away on its own?

2002 study found in 83% of cases of LE resolved at 52 weeks with no intervention.

Does manual therapy help?

Researchers compared Active Release Techniques (ART) and Myofascial Release to a control  group receiving therapeutic ultrasound, the release techniques were found to be much more effective. Two case reports  also found them effective. A recent study found myofascial release effective in treating plantar fasciitis, which is similar to tennis elbow.

What about injections?

Steroid injections were found to provide worse outcomes than placebo in a 2013 study.  “There may be a short-term pain relief advantage found with the application of corticosteroids, but no demonstrable long-term pain relief” – 2014 review.

Are MRIs or ultrasound scans needed?

2014 review concluded, “power doppler ultrasonography and real-time sonoelastography (is) expensive, and …this technology did not significantly add to the sensitivity and specificity of Gray-scale Ultrasonography”.

There is evidence of MRI signs of oedema on the asymptomatic side of many LE patients. Thickening or partial tearing was not found on the asymptomatic side. Therefore if the non-painful side shows swelling, it may not be important for an MRI to find the sore side has swelling!

Conclusion

Combine manual therapy with an exercise program, before getting an injection.

 

You can find more from Tom at his website www.whitleybaychiropractic.co.uk

10 foods to eat to support your training

Theres an old adage  around training circles that results are 20% training and 80% nutrition. This adage has stood the test of time because its true. If your diet is sub-optimal you will get sub-optimal results from your training.

1. High protein foods. Beef, chicken, turkey, lamb, pork, tuna, salmon, tofu. Pretty much anything goes here. You should be aiming to consume between 1/1.5 grams of protein per kilogram of bodyweight so you’re going to need to eat a fair amount of meat and fish. Don’t worry about avoiding the fattier cuts either, eating fat doesn’t make you fat but it has been shown to increase testosterone levels, which has numerous health benefits associated with it.

2. Low starch vegetables. This includes basically any vegetable, except potatoes and corn. These provide a myriad of micronutrients needed by your body to optimise everything from muscle repair and hormone levels to immune response and should form the largest part of most of your meals, especially if you are seeking fat loss.

3. Fruits. Fruits provide many of the benefits of low starch vegetables in terms of micronutrient consumption. However fruits also come with a higher level of sugars mostly in the form of glucose and fructose. This can be great if you need energy to get you through training or a long day on the course, but should be limited if on a fat loss diet.

4. Extra protein. As I said your going to need to eat a lot of protein. Protein is essential to maintaining and building muscle, it has also been shown to be very satiating, great if your looking for fat loss and are on a restricted calorie diet. Whey protein supplements are easy, convenient and cheap way to increase your protein intake.

5. Fats & Oils. Your body needs fats! Fats are essential for cell repair, optimising hormone levels and joint health. However this is not an excuse to head down to the nearest fast food restaurant and get everything deep fried, lets stick to good, natural, healthy sources of fats. Avocado, coconut, whole nuts, butter, olive oils and fish oils are great choices.

6. Dairy. Dairy gets a bad rap, but the fact is relatively few of us are actually intolerant and unable to digest dairy. Consume a pint of organic milk, a natural greek yoghurt, or a few slices of a good quality cheese and your getting the perfect ratio of carbs, fats and protein to repair and grow. After all, think how much babies grow and they only drink milk!?

7. Starchy foods. Think potato, pasta, rice, oatmeals, grains, etc. Keep them wholegrain and unprocessed and you have a great source of energy to support your training, your golf and everything in between throughout the day. High carb foods should however be limited on a fat loss diet, only at breakfast and post workout, or limiting yourself to 1 or 2 portions a day are good rules of thumb for most with body composition goals.

8. Vitamins & Probiotics. A good multi-vitamin and a probiotic, is the combination of supplements recommended by Mark Twight, trainer to superman and the cast of 300. The multi-vitamin is an insurance policy, plugging any holes in your micro nutrient intake left by your whole food diet. The probiotic helps breakdown the extra fat intake from the meat proteins, allowing the body to utilise this nutrient source more effectively.

9. Zinc & Magnesium. These two nutrients are of at low levels in the general population. Happily though, they are widely available in supplement form. Vital for recovery from resistance training they also aid in giving you a good nights sleep, which as we all know does wonders!

10. Creatine. Creatine has been the subject of more clinical trails than any other supplement in the history of sports supplements. It is safe and effective. Unless you are one of the rare non responders creatine will increase your lean muscle mass and make you stronger.

The joint by joint approach, popularised by amazing fitness professionals such as Gray Cook and Mike Boyle, simplifies the stability and mobility needs of each joint up and down the body’s kinetic chain. Each of our joints have a particular requirement for stability and mobility, but they tend to be much happier when you focus on one or the other.

JointByJoint

Integrate this concept into your mobility and warm up protocols and see if your joints, movement quality and performance do not improve hugely.

Link

I’ve been banging on about banging on about how important posture is for a while now. As you’ve probably got bored of me saying it, here’s some amazing articles and posts on posture on and off the course. Some really top class fitness and golf professionals amongst this lot too, definitely worth a look!

http://bit.ly/uMoPVc

http://bit.ly/1aLzvW9

http://bit.ly/1dLkZxs

http://bit.ly/16JkY5S

http://markjonespga.wordpress.com/2013/08/21/distance-killer-2/

http://harrietgl.wordpress.com/2013/08/23/posture-and-productivity/

Mobility drills from the best in the business

Couple of videos with some mobility and foam rolling drills from my go-to guys for mobility work, and fitness industry legends, Joe DeFranco of DeFrancos gym and Eric Cressey of Cressey Performance. Brilliant way to get that mobility and flexibility for a properly executed golf swing. Great way to warm-up in the gym and on the course too.

Nutrition for on-course performance

Good nutritional practices have been demonstrated to improve mental focus, decision making, concentration, cognitive and motor skill function, and ultimately performance in countless studies of athletic and non athletic populations. Here are 3 nutrition tips to improve your performance on the course.

1. Consume slow digesting carbs regularly. Foods such as oatmeal, sweat potato, brown rice or bread, or low GI fruits are good choices. What we are trying to achieve here is keeping energy levels constant and avoid the crashes the result from sugar highs, affecting concentration and focus on the course. (Step away from the mars bars in the pro shop!)

2. Consume proteins with those carbs. The digestion of protein reduces the insulin spiking affect of carbs which leads to fluctuating blood sugar  and energy levels on course. Additionally in order to support all the hard work your putting in, in the gym, you should be looking to consume at least 1- 1.5grams of protein per kilo of bodyweight to aid muscle growth and repair (If your overweight use your target bodyweight).

Think adding a bag of nuts to the fruit you take out on  the course. Alternatively, my two favourites a peanut butter sandwich, or a protein shake made with whey protein, instant oats powder and water. (I have also been known to carry blocks of cheese around the course with me for a good combination of carbs, fats and proteins, but i’m given to believe this makes me seem strange!?)

3. Hydration, Hydration, Hydration. This obviously becomes increasingly important for those lucky enough to play their golf in sunnier climbs. Even so studies have shown dehydration to be surprisingly prevalent in both athletes and non athletes (i.e. your probably dehydrated right now!) and also to impair cognitive function, motor skills and quantifiably reduce performance level.

An educated guess of 2 litres a day, plus a litre over the course of a round in warmer conditions, would be a good starting point for you to adjust accordingly to what works for you. Replacing electrolytes via sports drinks isn’t as necessary, as Gatorade and Lucozade would have you believe, in a relativity low intensity physical activity such as golf. Additionally they often contain large amounts of sugar that will spike insulin and blood sugar.