The latest Inner Circle webinar recording on Assessing Shoulder Capsular Mobility is now available.
Assessing Shoulder Capsular Mobility
This month’s Inner Circle webinar is on Assessing Shoulder Capsular Mobility. This is a recording of an actual inservice we performed with the students and interns at Champion this week. I’m super excited to be able to record and share things like this with my Inner Circle. It’s like having a front row seat at our inservices! I think this offers many benefits over the traditional webinar/lecture format, as you can watch the interaction and also see some of the clinical techniques better.
In this webinar, we discuss:
The anatomy of the shoulder capsule and glenohumeral ligaments
How different arm positions stress different aspects of the capsule
How to determine which ligament and aspect of the capsule is tight
How to assess range of motion at different positions to assess different portions of the capsule
How to perform range of motion and capsular mobility assessment of the shoulder
Any half way decent strength and conditioning program must be individualized to the unique needs and goals of the trainee. Developing programs that specifically address our clients’ “goals” is fairly straightforward, however, mastering how to design programs that also consider their “needs” can really take you to the next level as a personal trainer or strength coach.
When designing training programs, we often begin individualizing based on age. That’s a great place to start, but there are many limitations with just using age. I want to review how we design programs using “age” by starting with a review of chronological, biological, and training age.
More importantly, I wanted to introduce a new “age” we use at Champion called “movement age.” This may be the most important, yet most neglected as well.
Chronological and Biological Age
At the very beginning of the spectrum when discussing the “age” of your client is their actual chronological age, which is their precise age. While this probably isn’t as big of an issue when discussing the training program of two people aged 34 and 38, it is much more relevant when comparing two people aged 14 and 18.
Chronological age is a good place to start, obviously, but their biological age is far more important. The anatomical maturity of a 14 year old is quite different from an 18 year old and does become a variable that must be adjusted for within your program design.
Line up 6 kids that are aged 14 and you’ll see the difference. One looks like he is 10 years old, another looks 18, and the rest all fall somewhere in between. According to the data accumulated at Wikipedia, girls will go through puberty between the ages of 10 and 16, while boys tend to go through puberty between the ages of 11 and 17. That’s a 6 year range!
Our focus with those with a low chronological age is different that the older high school athletes. While strength and power tend to become more of the focus in the older trainee, we focus on what we call the ABC’s of movement with our younger trainees, focusing on Agility, Balance, and Coordination. Strength training is included but the results are obviously going to be limited by the hormonal and skeletal maturation differences.
But, I urge you to not downplay this stage of athletic development. Developing the basics of movement skills is important and unfortunately this generation of children are not getting the same development as past generations. In fact, our younger athletes at Champion see some of the biggest changes in athleticism. These programs are impactful.
Here are my 2 and 6 year olds working on their athleticism!
So it’s apparent that chronological age has limited usefulness and biological age is a much better place to start. However, chronological age does not take into consideration the experience of the trainee.
As chronological age becomes less relevant with older trainees, the next variable to consider is their experience in training. Image the difference in two individuals:
Trainee 1 – 28 year old – Wants to lose 10 pounds – Did not participate in athletics growing up, has never participated in a strength and conditioning program, currently has desk job.
Trainee 2 – 28 year old – Wants to lose 10 pounds – Was athletic growing up playing multiple sports in high school, and club sports for fun in college, trained at a sports performance center through high school, hasn’t trained consistently in 10 years.
Trainee 3 – 28 year old – Wants to lose 10 pounds – Was athletic growing up playing multiple sports in high school, and club sports for fun in college, trained at a sports performance center through high school, consistently trained through college and has continued since college.
We have people that are 28 years old and want to lose 10 pounds. Same age, same goal. Do they all start with the same program? Of course not.
Training age takes into consideration the experience of the trainee. Have they strength trained before? Do they know how to perform the lifts with proper form? Do they know how to exert force with intent (more on this in a future post…)?
Remember the success of your programs are based around how the body adapts to the stress applied. You can pretty much do anything to Trainee 1 to stimulation enough stress to make a change, which is good because they have a lot to learn! On the other end of the spectrum, Trainee 3 has a great understanding of how to train and has been exposing his body to different stresses for years. To make progress in this trainee, you’ll likely need a more complicated periodization scheme to create a different stimulus for their body.
There is one HUGE flaw with training age. Just because you have been training for several years does not mean you understand how to train, or even that you know proper technique!
Don’t assume that since someone has been training consistently for years that they have been training correctly!
This is a common finding in people that have dabbled in strength training in the past and are starting a formal program or starting to work with a personal trainer or strength coach for the first time.
The last age we consider when designing strength and conditioning programs is one of the most important, but often neglected. We can have an advanced trainee in regard to chronological age, biological age, and training age, however, can they move well? At Champion, we’ve started to use the terminology “Movement Age” to discuss someone’s ability to move.
We don’t even have to make this too complicated – can they hinge, squat, lunge, step, rotate, push, and pull?
We simply define the ability to “move” as using proper form through the movement’s full range of motion. This then becomes a scale:
Can they move with assistance?
Can they move without assistance?
Can they move without assistance with load?
Can they move without assistance with load and speed?
It’s amazing how our movement skills have deteriorated. How many of your high school athletes can touch their toes? Isn’t it amazing?!?
In order to advance from beginner, to intermediate, to advanced trainee in our Champion program design system, you need to demonstrate maturation of your chronological, biological, training, and movement age.
On the Performance Therapy side of Champion, we work with a lot of athletes that want to optimize themselves and get the most out of their bodies. It’s amazing how many of the “advanced” athletes we see have poor movement skills. They don’t hinge well, or squat well past neutral, or can’t even balance themselves in a half kneeling position!
This can lead to imbalances, asymmetries, and compensation patterns that can suck performance, lead to tissue overuse, and eventually breakdown. This is especially true if you try to just blast through your poor movement skills and add load and speed to your lifts.
Sometimes we don’t need an advanced and complicated strength training periodization scheme, sometimes we just need to clean up movement patterns. Consider this taking one step back to take 5 huge steps forward. Movement age may be the most important variable to consider when designing strength and conditioning programs.
I feel like we’ve been discussing anterior pelvic tilt lately in several articles and an Inner Circle webinar on my strategies for fixing anterior pelvic tilt. I wanted to show a video of a great example of how a simple assessment really tells you a lot about how pelvic positioning should influence how we coach exercises such as squats and deadlifts.
In this video, I have a great example of a client that has limited knee to chest mobility and with boney impingement. However, if we abduct the leg a bit, it clears the rim of the hip and has full mobility with no impingement.
As you can see, because he is in anterior pelvic tilt, he is prepositioned to start the motion in hip flexion, so therefor looks like he has limited mobility. I have a past article on how anterior pelvic tilt influence hip flexion mobility, which discusses this a little more.
While you are working on their anterior pelvic tilt, you can work around some of their limitations. I hate when people say there is only one way to squat or deadlift.
Our anatomy is so different for each individual.
Some need a wider stance while others need more narrow. Some need toes out while some need more neutral. Do what works best for your body, not what the text book says you are supposed to look like.
One thing I talk about a lot when it comes to training and rehabilitation is the need to train the body in all three planes. This often requires moving in one plane of motion and stabilizing in the other two. We are often very good at moving in the sagittal plane, and poor at stabilizing in the transverse and frontal planes. This is a big topic of discussion in my program Functional Stability Training of the Lower Body.
To enhance this triplanar stability, we often attempt to facilitate greater contraction of the gluteus medius muscle during sagittal plane exercises. The lunge in particular is a great exercise for triplanar stability as the narrow stance challenges strength in the sagittal plane and stability in the transverse and frontal planes.
The Effect of Ipsilateral and Contralateral Loading on Muscle Activity During the Lunge
A recent study was published in the Journal of Strength and Conditioning Research that investigated the effect of holding a dumbbell in either the contralateral or ipsilateral hand during a split squat and forward lunge. (Note: they called it a “walking lunge” but I am 99% certain it was a forward lunge, so I’m just going to say forward lunger in this article… probably just semantics.)
The study found that:
Holding the dumbbell on the ipsilateral side had no effect on glute med activity.
Holding the dumbbell on the contralateral side resulted in a significant increase in glute med activity, but only during the forward lunge, not the split squat.
I was a bit surprised that glute med activity was not impacted during the split squat, but perhaps the static nature of the position inherently requires less transverse and frontal plane stability.
There was one other finding from this study that I thought was interesting. Kinematic differences during the forward lunge were found between a group of trained individuals in comparison to a group without training experience.
This makes sense as the forward lunge is a complex movement pattern that requires an understanding of how to control the pattern. It requires both mobility and stability, but also the ability to control the eccentric deceleration phase.
However, there were no kinematic differences between training age during the split squat, meaning that both novice and experienced trainees performed the split squat in a similar fashion. This make split squats a great exercise to incorporate in the early phases of training for those with limited training experience, eventually progressing to forward lunge as they get better at moving and stabilizing the pattern.
This helps solidify the use of split squats in our lunge regression system.
I like simple studies like this. Having the rationale to make small tweaks to your program is what sets you apart. It’s the small things that may not be obvious at first but will produce better results over time.
Based on these results, I would recommend using the split squat with bilateral dumbbells to maximize strength gains since a unilateral load did not alter glute med activity. The split squat is more of a basic exercise, so why not just use it to work on strength gains in the novice trainee. As the person progresses, you can add the forward lunge variation with a contralateral load to enhance triplanar stability.
Systems. That’s a word I say VERY frequently throughout the day at Champion PT and Performance. Our center revolves around systems.
The two biggest mistakes I see with new personal trainers and strength coaches are very simple:
They don’t have a plan
They don’t have a system of developing a plan
One of my biggest pet peeves in this industry is just slapping together a bunch of exercises without a solid rationale. This often happens when you pick the exercise first. Maybe you just went to a new continuing education course and learned a new exercise, or you just read a new article on the web, or saw an exciting new exercise on Youtube. You’re excited and want to try this shiny new exercise.
The second phase of our coaching evolution often revolves around understanding the fact that it’s better to build a solid program first, then fill in the exercises second.
That’s great, you’re evolving. But… my second biggest pet peeve is writing programs month-to-month. I use the phrase “start with the end in mind” quite often when it comes to program design. Most of our clients have clear goals that we should be prioritizing when designing their program.
If their season starts in 4-months, or their wedding is in 12-weeks, to achieve the best results we should assure the program is designed to peak and maximize their performance at the perfect time. You can’t do this when writing programs month-to-month. You need to have the program mapped out ahead of time. Sure, you’ll probably tweak the program a few times as the client progresses, that’s the art of coaching, but it’s always better to start with the end in mind.
3 Systems You Need to Have in Place to Be an Elite Strength Coach
I really think that if you want to become an elite strength coach or personal trainer (or heck, physical therapist…), you need to have a few systems in place. It really all comes down to developing systems to allow you to quickly and easily provide your expertise in a consistent and reliable fashion.
You Need to Have a Program Design System
When we are just starting out in this field, program design is one of the most challenging aspects your job. It’s because you don’t have a system in place and try to re-create the wheel each and every time you write someone a program.
You don’t need to sit down and start from scratch with each and every client. You need a program design system to accomplishes the goals you’ve established and style of training you provide.
You Need to Have a Periodization System
Once you understand how to design a program, the next system to master is how to string together multiple programs. This is essentially periodization.
There are periodization schemes that fit well with specific goals and specific clients. Developing a system of categorizing all this is the next step in becoming an elite coach.
You Need to Have a Coaching System
Lastly, it doesn’t matter how good of a program you can write, or how well you periodize the program, your results are going to suffer if you don’t know how to coach.
The third system that I think you need to reach that elite level is a coaching system. This involves developing a consistent approach to cueing, analyzing technique, making adjustments, progressing and regressing exercises on the fly, and connecting with you clients in general.
Just like anything else, this can be a system as well.
How to Develop Your Own Systems
Systems take time and experience to develop. This is natural. But finding an excellent mentor and always seeking out continuing education is a great step. You have to find what works for you.
I’ve learned so much from some of the experts in the field by studying their systems. I am always assessing how other people do things and trying to determine which aspects of their system I can adopt and integrate into what I am currently doing myself.
Alwyn Cosgrove has done a great job outlining his systems in his educational work. Mike Boyle has as well. But the person that I can say I have probably learned the most from over the years is Mike Robertson. As my readers know, I really connect to Mike’s style of coaching, ability to teach information, and his focus on developing his own systems.
Physical Preparation 101
Luckily for us, Mike has just released his latest DVD which completely overviews his program design and coaching systems. And when I say “completely overviews,” I mean it! Mike has just release Physical Preparation 101, a whopping 12-DVD set that discussing exactly how Mike has built his systems.
I watched almost all of the 12 DVDs over the weekend and can say that if you don’t currently have a system in place, this is the resource you should invest in to begin developing your system.
The program is $100 off this week for the launch and a must have for all of our educational libraries. Click below to save $100:
When designing programs to enhance strength, there are many variables that you can (and should) manipulate to facilitate improvement. These can obviously include the sets and reps (volume), loads (intensity), frequency, and rest time (density). However, how we periodize these variables is also very important. Periodization is the systematic structuring of how you plan on manipulating these variables over time.
You probably know me well enough by now to know that I value systems and planning. One of our fundamental principles in program design at Champion is to “begin with the end in mind.” It drives me crazy to see programs written month-to-month without a goal in mind.
So it makes sense to develop a system of how you plan on periodizing your strength training, wether in the personal training, sports performance, or even rehabilitation setting.
While the strength and conditioning world has really embraced the concept of periodization, physical therapists are notorious for a complete lack of periodization. It’s not uncommon to perform “3 sets of 10″ in the rehabilitation setting forever.
Perform a Google search for strength training periodization and you’ll find a sea of conflicting terminology that is likely to make you dizzy. Linear periodization, reverse linear periodization, non-linear periodization, undulated periodization, conjugated periodization, concurrent periodization, and block periodization are some of the many types of periodization programs that you can find.
Unfortunately there is little consensus on terminology or definition, feeding the confusion for people looking to learn about periodization even more. Add to that the ability to essentially say anything you want on the internet without needing any scientific validity and you’ll find a dozen different “best” ways to get strong.
But the real question still remains – does strength training periodization even matter? And if so, what type of periodization is best?
Effect of Periodized Versus Non-periodized Programs on Strength
Since the rehabilitation setting does such as poor job at implementing periodization into programs when returning from injury, we should start by establishing the need for periodization.
The article reviewed 7 studies comparing periodized and non-periodized programs on strength in untrained individuals. Of these studies, 4 reported significant benefits of periodization over no periodization.
Similarly, there were 7 studies comparing periodized and non-periodized program on strength in trained individuals. Of these 7 studies, 4 reported significant benefits of periodization and the remainder reported no differences. Using periodization may therefore have a beneficial effect on strength gains in both the trained and untrained population.
I wouldn’t say the research is overwhelming, but leans towards at least some form of periodization being more effective than using no periodization at all. I think we would all anecdotally agree with this as well.
Effect of Linear Versus Non-Linear Periodization
Now that we have established we should use some form of periodization, the focus now shifts on determining what the best form of periodization may be to improve strength.
Lets simplify, and perhaps oversimplify, the forms of periodization for this conversation as either linear periodization or non-linear periodization.
Linear periodization refers to the slow decrease in reps and increase in load. For example a 4-phase program may look like this:
Program 1 – 3 x 12 with a light load
Program 2 – 3 x 8 with a moderate load
Program 3 – 4 x 5 with a moderate to heavy load
Program 4 – 5 x 3 with a heavy load
As the reps go down, the weight goes up. This has been the most classic form of periodization used for the last several decades.
Antagonists to the linear periodization model often point out that the benefits seen early in the program in regard to strength and hypertrophy are not maintained throughout the program as the focus continuously shifts from program to program.
This has lead to several variations of non-linear periodization, including one of the most common, undulated periodization. Undulated periodization involves continuously shift the focus of the program on either a daily or weekly cycle.
A weekly undulated periodization program may look like this:
Week 1 – 2×15
Week 2 – 3×8
Week 3 – 5×5
While a daily undulated periodization program may look like this:
Monday – 2×15
While many have stated that undulated periodization is more beneficial at eliciting strength gains, does the research agree?
Of these 17 articles, here are a few bits of information:
12 compared linear periodization to daily undulating periodization. 3 compared linear to weekly undulating. 1 study compared all 3.
7 studies were on untrained people (<1 year experience), 10 on trained (> 1 year), and no studies included advanced trainees (>5 years).
16 out of 17 studies reported significant increase in strength in both linear and undulated periodization. 12 studies found no difference between the two periodization models. 3 found undulating better than linear and 2 found the opposite.
The overall meta-analysis also agree and the article concluded that there is no difference in strength gains between linear and undulated periodization.
However, when analyzing trained individuals, people that had previous experience with linear periodization had an improvement in strength when switching to undulated periodization. There was no difference between the linear or undulated periodization in untrained individuals.
Based on this it appears that as your training age increases, you may need to change your training stimulus to maximize your gains. However, linear periodization will work fine in new trainees.
Realize that the majority of articles you read on the internet are geared towards the very small percentage of people that fit into the advanced trainee grouping, when in reality, this is not what 95% of us see on a regular basis, especially in the rehabilitation and general population personal training worlds. Sure, advanced periodization programs are needed to get from 500 lbs to 600 lbs on a lift, but probably not as much from getting from 100 lbs to 200 lbs.
Linear periodization offers a great way to introduce and teach movement patterns with a lower load and higher rep scheme, then as the movement skill is perfected, the load can safely increase.
Periodization for Strength Training and Rehabilitation
Because the topic of periodization is so large, important, and so often neglected in the rehab and personal training setting, this month’s Inner Circle Webinar is going to be on Periodization for Strength Training and Rehabilitation. In this webinar, I am going to discuss the above concepts in much more detail and show you how we periodize some of our programs for healthy people and those coming back from injury in the physical therapy setting.
The webinar is Monday May 18th at 8:00 PM EST and will be recorded for Inner Circle members.
Mike is the President and Co-Founder of Champion Physical Therapy and Performance, located in Boston, MA. Champion offers an integrated approach to elite level physical therapy, personal training, and sports performance.
Click below to learn more about seeing Mike and his team for 1x consultations or ongoing physical therapy, personal training, or sports performance training: