Thursday, September 21, 2017

Why Altitude Masks are a Scam



You've all seen those guys in the gym—the ones who look like Bane and sound like Darth Vader hopping from one exercise to the next. Maybe you've though to yourself, "what is that awesome looking gadget," or, if you're like me, something along the lines of "what exactly does this tool think he's accomplishing?"

Many Olympic marathoners utilize altitude training to take their fitness to the next level (pun intended), so it makes sense that these masks would be worth the money.

What these companies aren't telling you, however, is that the research doesn't support these absurd-looking masks. On the contrary.

The positive adaptations of altitude training include an increased red blood cell count. This is one such adaptation that will only come from prolonged exposure to higher altitudes (meaning wearing a mask for an hour a few times per week isn't going to help in that arena. I most often see people wearing these masks on exercise machines (like the bro in the photo). Even if these masks were to work, you certainly wouldn't want to wear them for an exercise that doesn't rely on oxygen for energy (anaerobic exercises).

Another huge flaw in the reasoning behind wearing these masks is that they do not result in a change in barometric (atmospheric) pressure, as we would find in mountainous regions. Instead, they merely restrict your respiratory muscles, which effectively make breathing more challenging. These two things are not the same. In fact, in my opinion, limiting the efficacy of the respiratory muscles is just dangerous and foolish.

Finally, the current theory for altitude training is the "live high, train low." This means that athletes should live in higher altitudes, but train in lower altitudes so as not to impede their physical performance (obviously we cannot perform maximally at 10,000 feet above sea level). The altitude training masks directly contradict this principle, as people are not wearing them to do their household chores, but rather to do biceps curls in the squat rack. You definitely don't need to be an exercise physiologist to understand why this won't confer any added athletic benefits.

If you want to improve your aerobic capacity, avoid the scams and gimmicks. You can't take a shortcut to attain peak fitness levels (without the use of PEDs, of course), so quit throwing your money down the drain and put in the hard work. These masks will make you the laughing stock of your gym and they certainly won't provide any physiological advantage in your training.

Friday, September 8, 2017

Fixing Your Achy Wrists



Do you experience pain in your wrists while doing exercises like bench presses or planks? If so, then read on!

As I've mentioned 1,000 times (and you're probably sick of me saying it already), we always have to look distally (farther away) from the area in question. Think of your entire arms as a train. If the shoulder isn't working properly, you bet that you're gonna have elbow and wrist problems too. Take a look at the photo on the right from Thomas Myers' Anatomy Trains. You can see here that the pecs of the chest will influence the structures all of the way down to the fingers.

The number one complaint I hear from clients when doing the front squat is that their wrists hurt them. While the wrist pain is the symptom, the cause typically arises with poor shoulder mobility. If your front rack position is sub-par, your wrists now have to bear the brunt of that load. The lower your elbows are, the more wrist extension you need to compensate. In this instance, you need to work on opening up the pecs and lats to ease the stress on your wrists.

Because of this horrendous shoulder mobility, his wrists suffer.

I see similar problems arise in pressing movements. In the bench press or the overhead press, clients occasionally lack the necessary strength in their forearm flexors, so they fall into a hyperextended wrist position throughout the lift. A more "neutral" wrist position can save them a lot of discomfort. In these cases, the problem might not be mobility, but grip strength. I would have these people do exercises like hangs from the pull-up bar, plate pinches, or farmer walks to combat this. Sometimes, cueing alone can also go a long way to correct this issue.

This image from Liftbigeatbig explains different wrist positions. We never
want significant extension in pressing movements.
Ultimately, if you feel pain in your wrists you have to check out how your shoulders are moving to properly assess the issue. Shoulder instability can manifest itself in a variety of different ways. Continuing to address your wrist alone will have little to no effect. I see a lot of people working to stretch their forearms to alleviate wrist pain, but rarely do they address other possible contributing factors like shoulder stability or grip strength. Global corrections will stimulate an entire chain reaction of positive effects.

Thursday, August 17, 2017

Try this Hack to Get Bigger


While I've previously explained that stretching seldom helps improve your flexibility in the long term, there are some benefits that come from stretching. This exciting study from 2015 done by Miranda et. al. tested stretching as a means for increasing training volume (the number of repetitions performed in a set or session) in the wide-grip seated row exercise. There were two groups of participants, both of whom performed three sets to failure with two minutes of rest in between sets. The only difference between the groups was that the experimental group performed 40 seconds of a passive pectoralis major stretch at the end of their allotted rest periods. The idea here was to stretch the antagonist (opposing) muscles.

What the experimenters found was fascinating: there was a statistically significant difference in the antagonist stretching group. Those participants performed more repetitions in all three sets. Additionally, the experimental group demonstrated greater contractions in the latissimus dorsi and the biceps brachii muscles.
 

While this particular study only tested one exercise, it is likely that we can utilize this concept with other movements to reap similar benefits. For instance, in doing a bench press, you could stretch the latissimus dorsi. Before your set of leg curls, stretch out your quadriceps. You get the idea. This hack can help you get more training volume, which will ultimately result in greater hypertrophy (muscle growth)!

The mechanisms behind these findings are still unclear. My guess would be that stretching the antagonist muscles would allow for greater range of motion throughout the exercise, and thus, a stronger contraction in the agonist muscles. For example, the pecs have to stretch during the top of the rowing exercise. A bigger stretch in the pecs could possibly allow for the lats to generate a stronger contraction.

Static stretching before a set may be disadvantageous for power production, and thus, I do not prescribe it before movements like the clean and jerk. However, in a bodybuilding routine, there may be some added bonuses to stretching during rest periods to accumulate more total training volume.
This concept has not yet been applied to strength-based movements, but it could be an interesting point for experimentation on your own before the big lifts. Give this trick a try and see how you like it!

Thursday, June 22, 2017

The 4 Exercises that Your Shoulders Hate



It is common for a lifter to seek boulder shoulder status. While having protruding, rounded shoulders certainly looks nice, the shoulders are very vulnerable to injury. The demands of a sedentary, desk-ridden society already makes our shoulders unhappy, and if you translate this dysfunction into the gym, you're gonna have a bad time.

I have dealt with my own shoulder issues in the past, and I know just how aggravating it can be to have to modify workouts or avoid certain movements. Ultimately, I had to learn the hard way what exercises provoked my shoulder pain. Many common-place shoulder exercises can be effective for deltoid and pectoralis hypertrophy, but they also promote instability and compensation. For both myself and my clients, there are four main exercises that I avoid for the sake of sparing their shoulders:
  1. Pec flies. Regardless of whether you're using cables, dumbbells, or even the pec-deck machine, you're most likely better off without them. With this movement, many lifters tend to go well beyond the necessary range of motion to isolate the pectoralis muscles in transverse shoulder flexion. You also run the risk of sufficiently irritating your biceps tendons. Instead, they end up stretching the hell out of their anterior deltoids and forcing their shoulders into a yucky internally rotated position that makes me cringe. For chest development, I prefer to have clients do reverse grip bench press, neutral grip dumbbell bench press (with a slow eccentric focus), and Spoon presses. If you're hell-bent on keeping pec flies in your workout routine, try to minimize the range of motion so that your arms only go slightly above parallel, and make sure you maintain a slight bend in your elbows.
  2. Behind-the-neck lat pull-downs. I've addressed my feelings about behind-the-neck exercises previously, so to save you from a redundant rant, I'll give you the abridged version: these movements (especially in lat pull-downs) encourage you into flexed cervical spine and often reinforce poor shoulder movement. Very few people possess adequate shoulder and thoracic mobility to perform these. If you really want wings, stay away from these. Instead, try rowing variations, pull-ups (you add weight or go chest-to-bar if you want a greater challenge), straight arm pull-downs, and maybe the occasional Red Bull. (I couldn't resist...)
    Yikes!
  3. Box dips. In a recent Instagram video, I mentioned that I stray away from programming dips on a bench or a box. Effectively, this variation places unnecessary stress on the anterior capsule and tendons of the shoulder. To perform these, a client must flare the elbows out excessively, while the shoulder again shifts into a precarious position. You will see this as well on bar dips, but to a lesser degree, because the athlete's shoulder and elbows are closer to his center of mass. The ideal way to do dips, in my opinion, though, is on the rings. The rings force the athlete to properly adduct his shoulder, and his arms are closest to his center of mass (thus resulting in a more mechanically advantageous position. If you're currently unable to do ring dips, stick to push-ups on the rings, and then slowly progress to a full ring dip.
  4. Upright rows. I'm sure you've heard trainers shun this exercise before. While I think it can be helpful for developing the shoulders for the right client, there are always other options. I've found that they cause more harm than good for most people, as usually the anterior deltoids are the strongest part of the shoulder. Instead, many people would benefit from training the posterior or rear deltoids with back flies to balance out the omnipresent imbalance from front to back.
In general, gym goers can benefit from fewer pushing exercises and more pulling exercises. I usually propose a 2:1 ratio for upper body pulling:pushing days. By this, I mean that you should only spend about one day per week doing bench press, push press, etc. (or at least with those movements as your primary focus), and two days with a pulling/rowing focus. The anterior deltoids and pectoralis tend to run the show (especially in men), and, thus, can cause a lot of pathologies and mobility restrictions. Your rhomboids, rear deltoids, lats, and lower trapezius can always benefit from some more love and attention.

There are plenty of safe and effective exercises that will still give you strong shoulders, such as those that I've listed in this article. You can be smart about your upper body training and avoid nagging injuries that will keep you sidelined for weeks at-a-time. Make these changes to your routine, and your shoulders will be happier in the long run!

Friday, April 28, 2017

Debunking the Myth of the Vastus Medialis




The quadriceps complex is comprised of four main muscles: the rectus femoris, the vastus intermedius, the vastus lateralis, and the vastus medialis (which seems to have become the most buzzworthy muscle of the four). The vastus medialis obliquus (commonly referred to as the VMO) is the middle “tear drop” shaped muscle of the quadriceps complex. Both personal trainers and physical therapists often blame generic knee pain on this guy being weak, but the literature just does not seem to substantiate that concept. If a doctor or physiotherapist has ever told you that you need to strengthen your vastus medialis, then he or she is spouting off outdated and false information.

I have seen many an article claiming that one can “isolate” the vastus medialis, or emphasize its activation, by raising the heels in a squat, by narrowing one’s squat stance, or by doing some wild exercises. These exercises are frequently prescribed to individuals with patellar tendinopathy, patellar tracking, or post-op ACL tear patients. While these concepts sound excellent in theory, the data has shown that those ideas are effectively no more than broscience. The vastus medialis and lateralis muscles contract together, and no amount of heel raise, hip external rotation, or close-stance squats will change that.

Do decline squats increase VMO activation?

The first exercise myth about the VMO is that raising the heels will increase its activation in the squat. While using Olympic lifting shoes or standing on a board will undoubtedly increase total quadriceps recruitment, as your torso will be more upright, the vastus medialis receives no preferential treatment. Rather, the vastus lateralis and medialis simultaneously work harder to squat when the heels are elevated. Similarly, the high bar squat is more quad-dominant than a powerlifting low-bar squat, and a front squat is the most quad-dominant of the three.

Does squat depth influence VMO activation?

When analyzing the angles at which the vastus medialis and lateralis are most active, Lee et. al. found that 90° or less of knee flexion was optimal. Essentially, deeper squats allow for greater vastus medialis and vastus lateralis contraction. Again, both muscles are being targeted in this instance, so the VMO is working harder, but so too is the vastus lateralis.

The other take home here is that if you want quads of the Gods, you can’t skimp on your depth. If you have to ask someone if you’re going low enough, you’re probably not! If mobility is an issue for you, then you should seek the advice of a qualified professional and dedicate time at the end of your sessions to improving your bottom position.

What about narrow-stance squats?

None of the research to date indicates that squatting with a narrow stance impacts the vastus medialis to a higher degree. In fact, it doesn’t appear that it changes the activation in any of the quadriceps muscles at all. I’m not quite sure where this myth arose, but it seems to be contradicted by the literature.

Squatting with your feet close together won't increase VMO activation,
but it may result in faulty mechanics and potential for hip impingement.
One study with Paoli et. al. looked at the EMG in 8 different thigh muscles, measuring activity in three different squatting widths and three different intensities (no load, 30% of 1 RM, and 70% of 1 RM). They tested both quadriceps and hamstrings muscles, and there was effectively no statistical difference in any of the muscles except for the gluteus maximus. No matter how close the lifters stances, their quadriceps muscles (vastus medialis included) were no more or less active at any intensity.

Surely foot position matters?

This is one that I have heard for years, and even believed myself for a while: trainers boast that externally rotating the feet will preferentially recruit the VMO, whereas a parallel foot position would lead to more evenly divided muscular recruitment. Unfortunately, no studies to date have confirmed this concept.

Murray et. al. tested twenty physically active adults in 4 different foot positions during a partial squat on the Power Tower machine. They found no real differences in EMG amplitude in differing levels of external/internal rotation. Similarly, Ninos and colleagues tested two varying foot positions (externally rotated and neutral) in the Olympic squat, and there was no noteworthy difference in vastus medialis activation.

The take home? If you have strong quads, you have a strong VMO.

Trainers have managed to come up with many creative circus-trick exercises for targeting the vastus medialis muscle, but while they might look exciting to try in videos, the basic foundational leg movements are all you need; squats, lunges, step-ups, and split squats will help you build strong quadriceps muscles, and, in turn, strong vastus medialis muscles. You can perform your leg extensions with your feet externally rotated all day, and you still won’t be able to isolate your medial quadriceps. Instead, just stick to those previously mentioned core movements and reap the benefits of your tree trunk legs!

Friday, March 10, 2017

4 Interesting Facts about Mind-Body Connection


The body and mind are intimately intertwined. We must always look at the bigger picture. Despite Western medicine’s attempt to further break the body up into distinct “parts,” everything is connected. Your stress at work and your shoulder pain are absolutely related. Your toxic relationship and your sinus infection is likely the result of your body’s symbiosis. Emotional stress manifests itself physically, and, conversely, physical pain impacts our emotions.

“Muscles” are just used for classification purposes, but that is not exactly how your brain works. You’re never just using one muscle at a time, and the same thing goes for your organs: nothing works in solitude, but rather, your body is a symphony.

Everything is originated in your brain. The brain is responsible for the function of all bodily functions (heart beat, digestion, respiration, etc.), and it also controls your perception. Thus, it would be foolish to consider pain without first understanding the cognitive processes behind it
  1. Research suggests that thinking about contracting a specific muscle is beneficial for improving muscular hypertrophy. A study of 18 resistance-trained men found that "individuals can increase triceps brachii or pectarilis major muscle activity during the bench press when focusing on using the specific muscle at intensities up to 60 % of 1RM." Essentially, thinking about activating a muscle can increase its activation at lower intensities.
  2. A history of injury to a certain area can perpetuate symptoms, even after your body has healed. Pain and trauma form pathways in your brain. There's an adage that says "neurons that fire together wire together." This means that if a pathway of pain becomes familiar to you, it can be difficult to dissociate the two things. Let's say you tore your UCL in your elbow throwing a baseball. You may still experience pain when throwing, even long after the tissue has healed, because your brain associates throwing with danger.
  3. You can improve on a skill using mental imagery. "Vandell et. al. reported that groups of subjects who mentally practiced basketball free throws or dart throwing demonstrated improved skills similar to those who physically practiced the task. The [mental practice] and [physical practice] groups improved 23% and 24%, respectively, as compared with no improvement in a control group that did not practice either task," mentioned Warner and McNeill. That means that the group who practiced a skill using mental imagery alone had nearly the same level of improvements as did the group using physical practice!
  4. Mental practice can improve balance. Fansler et. al. tested 36 elderly female subjects. Women were randomly assigned to one of three groups: non-sense+physical practice, relaxation+physical practice, or ideokinetic facilitation+physical practice. The final group "showed fewer subjects with negative change and more subjects with greater than 100% improvement." Effectively, the combination of mind-body awareness along with physical practice elicited significant improvements for the subjects. "This improvement in balance, which is a fundamental component of human movement, suggests that [ideokinetic facilitation] has promising usefulness in health care." Perhaps this study could be expanded into other areas, as well!
Wim Hof, a dutch man known as the "Ice Man" has been able to achieve incredible feats using meditative breathing. He regularly goes for dunks in freezing cold water, hikes frigid mountains in only his shorts, and has even demonstrated control over his autonomic nervous system. If you haven't heard of this guy, I recommend watching this video and reading more about him! He's a pretty incredible and inspiring man.

There's still much research to be done on the concept of mind-body connectivity. I believe that with a strong mind, we can build a strong body. We cannot achieve what the mind doesn't believe. Incorporating mental imagery into your routine might just be the change you need to break through your training plateaus!

Monday, February 20, 2017

Much Ado about Hip Mobility



Since I've made a post about shoulder restrictions, I've received a few requests about how to loosen up stubborn hips.

This is my dad, unintentionally showing off his
perfect bottom position and impressive ankle
dorsiflexion.
One thing I'd like to mention, which has been noted in previous posts, is that some people are just genetically and anatomically better suited for squats. Let's take my father, for example. My dad, who does not exercise, and has no notable sports background has a picture perfect squat. He has never mobilized a day in his life, and no one taught him proper squatting mechanics. In fact, I was stunned to watch him squat down to reset our Internet modem with absolute ease. Others will take weeks or months of mobility/motor control drills to execute a partial squat. If you're interested, Dr. Stuart McGill has an excellent video discussing this concept. Unfortunately, there's nothing we can do to change one's acetabulum or femurs.

Don't be discouraged! There's hope for you yet. What we can do, instead, is put someone who may be...inept at squatting into a position that optimizes his or her anatomy. We can play around with foot position, stance, and different squat styles to see what is best suited towards their anthropometry (limb length/proportions). I always recommend that those who are struggling with their squat mechanics work with a qualified coach/movement practitioner to improve. If that is not an option for you, then you should spend some time playing around on your own trying different set-ups.  Record yourself when possible. Remember that your squat will not necessarily look the same as mine.

Once you've settled on your ideal stance and foot position, now we must consider the role of motor control (yay for unintentional rhyming) in the squat. As you can imagine, there are many possible compensatory patterns that one might display throughout the movement. From knee valgus/varus, to shooting the hips back too far, to letting the chest drop, I've seen it all; this is when attention and mindfulness become especially important. Again, it will be invaluable to have a coach review your mechanics in these cases. With just a few simple cues, most errors are immediately fixable, and then you may continue to practice these on your own and engrain the proper sequencing in your head.

One exercise that I typically use with my clients who are learning to squat is the pole squat drill: this allows the person to understand how their weight should be distributed, and helps them achieve a lower bottom position almost immediately. I would also introduce them to the quadruped rock, which mirrors the sequencing in a squat and warms up the hips. These movements are best suited in the beginning of a session.

For clients who still have difficulty squatting after those drills, the goblet squat should become your friend. It is generally easier for individuals to assume a better position in a goblet squat. Holding weight in front of the body forces you to maintain a more vertical torso and achieve better depth. I always prescribe these (typically with a pause at the bottom) before moving clients on to barbell variations.

While many people spend an endless amount of time trying to stretch the hell out of their hip flexors, I find that those efforts are often wasted. Instead, implementing movements such as the goblet squat with a tempo (slow negative and 1-2 second pause) will allow you to kill two birds with one stone. Similarly, tempo single-legged exercises will do wonders for opening the hips. Bulgarian split squats necessitate a decent amount of hip flexibility, so it may be beneficial to start with a traditional lunge, again with a slow eccentric phase.

Finally, at the end of the session, the happy baby pose is ideal. Not only does this provide a nice stretch, but it's actually quite relaxing. You can also use this time to practice your diaphragmatic breathing. Focus on pushing your belly against your thighs as you inhale through your nose. Exhale through your mouth, and repeat. 1-2 minutes should be more than enough.

In the long run, an arsenal of hip flexor stretches isn't going to address the source of the problem. Teach yourself proper squat patterns, train your lower body with an eccentric emphasis, and show your hips some love. If you're diligent in your efforts, you'll be dropping it low on and off the dance floor in no time.