Posts Tagged ‘mobility’

BY DR. QUINN HENOCH (web)

These days, “mobility” work seems as popular as actually improving strength and athleticism.  There are many schools of thought and various techniques as to how to improve mobility.  However, there are some things that should be universal no matter who you follow or what methods you use.  We shall call them “Mobility Rules Of Thumb.”

This will be a 2-part series.  Here in Part 1, we will lay some conceptual framework and discuss five rules.

WHAT IS MOBILITY?

The term “mobility” has been defined in many different ways.  I believe the definition can vary depending on context.  In general, I refer to mobility and how it will be referred to in this article series as:

The potential for motion and the ability to produce that motion, within a given joint system.

Mobility includes soft tissue flexibility and extensibility as well as joint range of motion, arthrokinematics (small accessory movement within a joint), and osteokinematics (larger movements of bones at joints in the three planes).  Possessing “normal” qualities of these attributes does not mean you have the motor control/stability to control movement, it just means that you have the potential to produce it.

WHY

We use mobility-corrective strategies when abnormalities in the above mentioned parameters are found, which are affecting one’s ability to perform desired movement patterns and/or when one is experiencing pain when performing desired movement patterns.

WHEN

Techniques to improve mobility can be performed before, during, or after training.  They should be a means to an end.  Meaning, your mobility correctives should ACTUALLY WORK to make the improvements that you are seeking.

Below are 5 Rules Of Thumb regarding mobility work that everyone should follow.

#1 MOBILITY CORRECTIVES SHOULD BE PRECEDED BY A SCREEN OR ASSESSMENT

You should have a clear reason for doing something.  If you have difficulty performing an overhead squat (or whatever movement pattern you have trouble with), that does not mean you automatically need to perform five different hip or ankle mobility correctives.  You have no idea if that is the problem, and you have not differentiated whether it is actually a mobility problem or a lack of stability/motor control.  What if you, in fact, possess adequate mobility in your joint systems, but just do not have the control to demonstrate it?  Spending time passively tugging away could be a waste of time or potentially harmful.

Find a qualified human who can help you figure out exactly what you need (if anything) to mobilize, or check out the Quinn Henoch and Darkside Strength YouTube channels, as we have talked at length about self screens and assessments.  Screen and assess – don’t guess; that turns into an hourlong warm-up, of doing the same correctives with little improvement,  which brings us to our next rule.

Check out this VIDEO where I discuss the importance of screening and assessment.

#2 CHANGES SHOULD OCCUR QUICKLY

If it is the correct drill, a positive change should happen quickly – as in, your movement quality should immediately be improved if it is the right drill.  I know what some may be thinking – “But Quinn, it takes way longer than a few seconds to break up scar tissue and restore sliding surfaces!”  And you would be correct,  which is exactly why that is not what is happening when we use our foam rollers, lacrosse balls, and bands.

The literature is pretty clear on this.  It is beyond our physiological ability to create the necessary shear force to our tissues to cause an abrupt structural change.  Thank goodness for that too, because if you think about it, we would have to be pretty fragile to be able to sit on a foam roller and break up our tissue.

We do not understand the exact mechanism, but what the roller or lacrosse balls do is send a neural input to the brain.  In turn, the nervous system decreases the neural drive (tone) to that area, and we feel some sort of release.

Having said all of that, foam rolling and lacrosse ball work definitelyworks.  However, the mechanism in which it works is important with regards to dosage and intensity.  So 5 minutes is not 10x better than 30 seconds.   And putting 3x the amount of pressure down into the ball is not necessarily 3x as effective, since we know we are not actually breaking up adhesions.  The nervous system acts and responds quickly.  So figure out the minimum dose you need in whatever mobility drill you like, to feel your release, and then move on to some full range of motion movement.  THAT is the key to remodeling tissue.  Reset the nervous system with your mobility drills, so that you can move through a full range of motion, then move through a full range of motion, then repeat.  Over time, your tissues will adapt accordingly, and the need for correctives should diminish.

Check out the VIDEO where I discuss the differences between muscle tightness and muscle shortness.

#3 STRETCH DISCOMFORT IS NOT THE SAME AS PAIN

Stretch discomfort is a sensation that is felt over a relatively large area (depending on the size of the body part you are targeting).  It can be moderate in intensity, but allows you to still feel in control of the situation.  It is not so intense that you are gasping for air, tensing up, or watching the clock for the 30 seconds to go by so you can get the hell out of there.  If that is you during your mobility correctives, then the benefits of your mobility work are being missed.  Since we learned that permanent structural changes are not going to occur in that moment, inflicting that type of intensity and pain will do nothing but send a threatening input to your brain regarding that position.  By creating that threat, the nervous system will probably not allow you to access any new range of motion that you created anyway.  What we want is to create an input to the brain that makes a certain movement or range of motion less threatening.  Ease off the intensity so that you can breathe and demonstrate control of the situation.

If you feel a sharp pinpoint sensation in the joint or tissue which you are mobilizing that does not release in the usual time, or that only goes away when you completely release the stretch, OR gets worse the longer you hold it, then alter your position.  Again, you are doing nothing good here.

If you are acutely injured and the mobility drill that you are performing recreates the exact pain that is associated with your injury, you probably want to lay off.  Maybe go see someone (see ROT #1).

This goes for things such as Instrument Assisted Soft Tissue Mobilization (Graston, ASTYM, etc).  I have had physicians send patients to me after telling them that they “needed” this type of treatment.  They also told the patient that if it didn’t hurt and if the patient was not not bruised afterward, then I was doing it incorrectly.  I would kindly refer those physicians to ROT #1.  I am a fan of those tools, but they can be used without bruising or being overly painful and should be incorporated with the idea ofaugmenting movement as opposed to trying to create movement.

#4 IMPINGEMENT IS NOT A STRETCH

ROT #3 discussed the duration and intensity of your mobility drill.  With ROT #4 we will discuss the location.  You should not feel discomfort in the side of the joint that is folding or shortening.  For example, lie on you back and hug your right knee to your chest.  If you feel an uncomfortable pressure or pinching in the front crease of the right hip, this isimpingement – not tightness – and indicates faulty mechanics of that joint.  In theory, you should feel a stretch on the side that is lengthening (your butt in this case), but not much of anything in the side that is shortening.  Do not jam into this feeling in an attempt to release it, because impingement is a positional problem, not a tightness problem.  To correct it, we must alter position.

For another example, raise your arm over your head as close to perpendicular with the ground as you can.  If you feel a pinch in the top of the shoulder (the crease of the deltoid), this is impingement.  The stretching sensation (if any) should be felt on the underside of the joint (lats for example), since that is the side of the joint that is being lengthened.  The VIDEO gives two examples of impingement vs stretch, starting at the 1:20 mark.

#5 A BAND IS A MOBILIZATION TOOL.  IT IS NOT THE TOOL

Banded mobilization drills have been a part of the rehabilitation community for decades (like before most of us were alive) thanks to the likes of people such as Geoff Maitland and Brian Mulligan.  These techniques were designed to give the practitioner better leverage and to alter joint mechanics enough to make a once painful or threatening range of motion, less painful and threatening.  This school of thought uses the appropriate mobilization (ROT #1) to create the appropriate neural input (ROT #2) to restore movement.

Bands are also a great tool when impingement is present (see ROT #4) to assist in clearing some space in the joint for better mechanics during a particular range of motion.   However, if impingement is not present and you are creating the appropriate mobilization sensations in the appropriate areas (see ROT #3 & 4) without a band, then you should not use one.  In fact, a goal should be to perform your mobility work with as little band work as possible.  Few people play a sport with a band hooked around their hips.  Nor do we lift appreciable amounts of weights that way.  It is the exact opposite.  In athletics and training, there is a tremendous amount of compression happening in the joint, not distraction.  So while the band is fantastic for an initial mobility protocol to get out of a little pain, we must then be able to create mobility under compressive forces.   What you feel after using the band will not always translate if you go straight to heavy back squats.

Based on what we have discussed, this is probably not appropriate for most people.

The message here is certainly not to deter individuals from trying to improve mobility.  I simply wish to impart bits of advice to make your mobility game safer and more effective.  In Part 2, we will discuss several specific examples of our 5 Rules of Thumb.

By Dr. Quinn Henoch (web)

Earlier this month, I was given the opportunity to present and coach at a weekend training camp for competitive exercisers. Doug Chapman, coach and owner of HyperFit USA in Ann Arbor, Michigan, hosted the camp. I was asked to present on self-assessments for movement and mobility improvement and to also lead the athletes through some warm-ups on both days.

This was a training camp in every sense of the word. The talent level ranged from open and regional athletes to Games athletes such as Julie Foucher, Neal Maddox, Chyna Cho, and Heather Welsh. I watched (no I did not participate, although I did accumulate one and a half wall balls, two pistols, and three consecutive strict muscles-ups over the course of the weekend) as these athletes practiced countless skills and were taken through workouts that tested all energy systems and aspects of their fitness game. It was truly an amazing thing to behold.

As I watched, coached, and consulted with the athletes, there were some common themes that I noticed regarding the movement and mobility game. These things were consistent with my experience working with CrossFitters in the clinic as well. Below are some tips for you crazy mo-fos (although these are appropriate for any athlete).

1. DON’T FORGET ABOUT THE THORACIC SPINE FOR SHOULDER MAINTENANCE

As is the case at weekend events such as these, I spoke with many of the attendees about individual issues they were having. At events where the athletes are mostly of the powerlifter or weightlifter population, most of the issues are from the low back and below. However, at this camp, there were many issues related to the shoulder. This is not surprising, considering the insane amount of shoulder intensive volume that CrossFitters undertake.

As I was taking the campers through self-assessments, it was clear that many had restricted movement through the ribcage and thoracic spine. I have spoken at length about the importance of this for shoulder health in a previous article.

We used a couple of tests to grossly screen and assess scapula-thoracic function:

1. THE APLEY SCRATCH TEST, in which we are looking for no more than one and a half hand lengths between your fists, or symmetry when comparing side to side.image1

 2. THE LUMBAR-LOCKED ROTATION TEST, in which we are looking for about 45 degrees of rotation, or symmetry when comparing both sides.

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3. SEATED. We are again looking for at about 45 degrees of rotation or symmetry when comparing side to side.

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Restrictions in thoracic rotation were usually to the same side as the problematic shoulder when consulting with the individual athletes.

There are not many rotational components to competitive CrossFit – probably because rotational movements are more difficult to objectify and score. So inherently, most of the training is within the sagittal (front to back) plane, and the lack of rotational capacity through the upper back reflected this. Although the shoulder intensive movements may not technically require a large amount of rotation, if you are having issues in your shoulders, then it can be beneficial to restore all planes of movement within your ribcage and thoracic spine. After all, that is the foundation with which your shoulder sits, so restrictions there can lead to compensatory shoulder function. Here are a few drills to first undo all of the extension that training locks us in and then to restore rotation. Perform 2-3 sets of 5, or as needed.

Obviously, there are many other aspects to shoulder health and maintenance, but this is a good start.

2. NOT EVERYONE IS MEANT TO SQUAT TOES FORWARD

I know what you’re thinking – and no I’m not going to open up the knees-out debate again – but I think some athletes may have an unnecessary obsession with trying to obtain a toes forward squat. Of course, there are plenty of people who can squat beautifully with their feet perfectly straight, and that absolutely works for them. However, due to numerous anatomical variables, there are far more athletes who benefit from positioning their feet with some degree of toe out when squatting. Trying to jam into positions that are unnatural for their anatomy may even cause orthopedic problems. The rules are (1) that your feet must start and finish in the same place, (2) you must maintain three points of contact (big toe, little toe, and heel), and (3) the knee should track over the second toe. When you squat, you should feel like your ankles, knees, and hips are hinging naturally and comfortably. A great way to explore your bottom position and figure out where your natural hinges are is to use a kettlebell as a counterbalance.

I am pretty strict about the movement in this video; however, you can sit in the bottom and really explore different positions. The bell will keep you from falling on your ass. Move your knees and toes out, in, forward, backward, whatever. Figure out what is most comfortable. This helped a couple of people at the camp figure out a more comfortable bottom position.

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“Hey Ilya, you’d lift more weight if you straightened your feet.” – No one ever

3. IT IS OK TO SAY GOODBYE TO THE BARBELL WHILE YOU FIX YOUR SH*T

Many of the conversations with the athletes went something like this:

Athlete: “It only hurts when I do __insert barbell lift here__.”

Me: “Well you may have to take that out of your training until you can clear  up what you have going on.”

Athlete: “But…. Huh…? No… No……. NOOOOO!!!!!!!!!!”

OK, it wasn’t that dramatic, but I did get some very sad looks. Listen: If anybody wants you to keep lifting weights, it’s me. However, if something hurts and you continue to do the things that flare it up, it is very difficult to (1) figure out what exactly is going on in the first place, and (2) help it go away. This is especially the case when adding the fatigue factor of CrossFit. Stop shaking up the muddy water. Turn off the engine so the mechanic can work.

Barbell training is fantastic for strength gain because we can load it heavier than most implements. However, a symmetrical barbell can wreak havoc on someone who has asymmetrical ranges of motion or movement patterns. If you are far out from a competition, it is a perfect time to let things calm down. If overhead barbell work hurts something, use kettlebells or dumbbells in one or both arms. Many will find that these implements are much more comfortable than trying to manipulate a barbell while dealing with an issue. No, you cannot load those as heavy as a barbell, but if we are only talking about a WOD, then you really have no excuse. Kettlebells and dumbbells will still give you an overhead stimulus and can be plenty heavy enough to make a high volume WOD as awful as you want it to be.

If full snatches and cleans are causing issues but the power variations do not, guess what? Do power. Then figure out why your squat sucks. Remember, it’s called TRAINING. If you think blowing through hundreds of painful reps is going to do you any good, it will not. All it will do is make your brain associate pain with that pattern, further deepening your hole. Modify the movement to something that will give you the closest stimulus to what you are looking for and find someone to help you figure out what’s causing your issues.

*IMPORTANT POINT: I am not referring to the normal aches and pains of hard training, or the things that last a few days or a week. I am referring to athletes that are having the same issues for weeks to months or longer.

4. IT’S NOT ALWAYS THE ANKLES

During my lecture portion of the camp, I had a young lady demonstrate an overhead squat. She could not attain a below parallel squat without rounding her lower back. I then asked her to place her heels on plates, and I had her squat again. Her squat improved. I asked the group why the plates helped. The consensus was that she must have had restricted ankle dorsiflexion. This was definitely a possibility, but we had not tested her ankles; so that was an assumption. One of the major points of my presentation was taking the guesswork out of your mobility program.

We screened the young lady’s ankle range of motion with the test in the picture below. Keeping the foot flat and not collapsing the arch, we are looking for it to be at least 4” inches away from the wall when the knee touches. This gives you around 20 degrees of closed chain ankle dorsiflexion, and is plenty for most to attain a full squat.

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The athlete cleared the test on both sides and had no history of ankle or foot injuries. If it wasn’t the ankles, why couldn’t she squat without the plates? Putting the heels on plates also provides you with a forward weight shift. Meaning, you can sit down and back much easier without falling on your butt. It’s a counterbalance – just like the kettlebell is a counterbalance in the drill I described above. Ideally, our abs should provide the counterbalance. After one last quadruped test, in which the athlete demonstrated that she could attain very deep hip flexion position with a neutral spine, it was evident what the problem was: We had a trunk and pelvic stability issue.

Don’t assume your ankles are tight. Test them. If you find a limitation, here’s a good drill. There are many others out there.

If your ankles are fine, but you need weightlifting shoes or plates under your feet to squat, then perhaps stability is the problem. Try this drill.

5. CORRECTIVE WORK AIN’T A WOD

This tip is inspired by a very memorable moment during the camp. On the morning of Day 2, I led the entire group through a 45-minute movement/warm-up progression. One of the movements I had them perform was a bottom-up kettlebell screwdriver. My instructions were the following: “Grab a LIGHT kettlebell. The strongest guy in the room should be using no more than 20lb.” I watched as several athletes, who I knew were not the strongest people in the room, and even a couple that had come to me with shoulder problems grab a 20lb kettlebell. I let them struggle for a few seconds and then instructed them to go lighter. I looked over to see what the actual strongest man in the room, Neal Maddox, had grabbed. He was holding a 5lb kettlebell. I watched as he performed his bottom-up screwdrivers with focus and precision. Neal also happened to have the most experience in athletics in the room. He understood.

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Neal’s words to me regarding the situation – “I ain’t trying to be a hero.”

The moral of the story is that if you are going to perform corrective work, make the quality of the movement the priority. Remember, there are no gold medals for corrective exercise.

I want to thank Doug Chapman of HyperFit USA for allowing me to be a part of his camp. It was one of the most well-run events I have ever attended. The itinerary was followed to a T, and the organization was phenomenal.

What I was most impressed with was the training that the athletes were put through. One of the common criticisms of CrossFit is that the randomness of the programming does not allow for proper adaptation. Doug’s programming was far from random. Skills, energy systems, time domains, modes – it was all planned to maximize desired adaptations and minimize failure. It was training. Anything but random. If you are a competitive CrossFitter and take your training seriously, I recommend you attend one of these.

By James Hoffman (source)

There has been a lot of hullabaloo regarding the concept of mobility. Although virtually all sports and sporting movements require an element of flexibility, the idea of being highly “mobile” has been taken severely out of context. This in turn has led to a lot of training time being spent focused on contorting arms and legs in every direction and not on the critical factors to athletic success, such as strength and power. Let’s simplify these concepts down to useable terms and discuss their implications for training and athletic development.

Flexibility is a non-specific evaluation of the range of motion about a given joint or muscle action. The goal of flexibility training is to increase the terminal range of motion for that given joint or muscle action. Therefore the greater the range of motion, the more flexible one is. This can be evaluated both bilaterally and unilaterally using gross or fine movements.

Mobility is a task-specific assessment consisting of two major elements:

  1. The range of motion required to perform the task with good technique

  2. The ability to generate forces needed for athletic performance within that full range of motion, including its terminal ends

For one to be mobile, they not only require the necessary flexibility to perform the task, but they must also effectively control their body by generating sufficient forces within that full range of motion.

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Extreme flexibility doesn’t necessarily mean mobility. Unless she could also stand up front a heavy squat after that degree of hip flexion.

For example, someone who practices yoga can achieve incredible ranges of motion and by our previous definition, this would make them highly flexible. The task of yoga, however, does not require the individual to generate large forces throughout those ranges of motion, but mostly just hold them isometrically.

A gymnast is also highly flexible. However, their training requires that they be able to move their body and generate large forces and rates of force development throughout the entirety of that range of motion. Based on our previous definitions, this would make the gymnast not only highly flexible, but highly mobile as well, whereas the yogi would possibly be only flexible, and not mobile.

Gymnasts are perfect examples of people who are both highly flexible, and highly mobile.

So how do we develop mobility in athletes? Mobility can be achieved through three main practices:

  1. Flexibility training (static and dynamic stretching, foam rolling, vibration, etc..)

  2. Highly-associated full range of motion weight training (Full high bar squats, SLDLs, DB or cambered bench presses, etc…)

  3. Practicing the sport movement (golf swing, snatch, wrestling, sprinting, etc…)

As we can see, flexibility training and mobility training can and should be done concurrently.

However, one major misconception in training for sport is that of developing high degrees of flexibility for the sake of being flexible. Although flexibility training might seem harmless, perpetually increasing joint range of motion is not inherently good. In fact, in some cases, developing unnecessarily high degrees of flexibility can lead to increased joint laxity, decreased soft tissue stiffness, and possibly limit stretch shortening cycle force contributions. Although static and dynamic stretching tend to receive a lot of attention, vibration is also an excellent tool for developing acute flexibility. Although the jury is still out, over time there also appears to be a chronic effect from vibration on improving flexibility.

So if we have determined our athlete lacks the appropriate mobility to be successful in their sport tasks, our approach starts by including all three of our mobility practices. Remember, the key is not only developing flexibility, but also the strength to manage that newly achieved flexibility. Over time, the athlete likely will start gaining the necessary range of motion for the sport task, though still may lack the strength to effectively compete with their new technique. Once the necessary range of motion is achieved, flexibility training can be removed, and the emphasis should lie on the associated weight training movements and sport practice. It should be noted that if the athlete is unable to perform their sport tasks throughout a full range of motion, they will also likely have trouble achieving a full range of motion in weight training. This means that you will likely need to continually encourage them to squat deeper, pull further, and press more completely on a daily basis.

So what might this look like in practice? Let’s say we have a rugby player who cannot crouch and keep a tight back in the scrum at appropriate depths. Our intervention might include things like:

  • Sit and reach stretching

  • Vibration sessions used pre-training

  • Dynamic warm-ups before training and practice

  • Weight training movements including SLDLs, good mornings, back extensions, and bent over rows (as part of a comprehensive strength and conditioning plan)

  • Practicing getting set properly in the scrum during practice or during sled training

Once they are able to crouch to an appropriate depth and keep a tight back, we can likely remove the stretching component of their training as well as the vibration, while simultaneously encouraging them to increase ROM on weight training movements such as doing SLDLs and bent rows from the floor or a deficit, or setting the good morning pins down one level.

Once flexibility has been achieved, the emphasis should shift to mobility and improving the athlete’s strength throughout that newfound ROM. Once they have achieved the appropriate levels of mobility to function within the task, maintenance can be achieved from simply from practicing the sport task, and though the use of good periodization practices.

Remember that in the context of sport mobility, training for flexibility for its own sake is not necessarily a good practice. Rather, we want to use flexibility training for the indirect purpose of improving mobility. Mobility dictates that we not only improve range of motion, but also our force producing capabilities throughout that range of motion.

Weightlifters need a high degree of mobility.  The great Tarenenko illustrates this perfectly, via his catch position with a 550+ pound clean and jerk.

Weightlifters need a high degree of mobility.The great Tarenenko illustrates this perfectly, via his catch position with a 550+ pound clean and jerk.

Once you’ve established good mobility in a sport movement with the help of dedicated flexibility training, just engaging in full ROM weight training and practicing that sport movement maintains that new level of mobility in most cases. To get good mobility and keep it, you don’t have to live in a yoga studio forever after.