Posts Tagged ‘injury’

Deadlifting 405 lbs without a belt is a terrible idea. Why this had not occurred to me before I’d done it several times is beyond my comprehension, but the important thing is that I know it now.

The failure to think through what I was doing, or, rather, laziness bought me a horrible back injury after my 405 single: I hadn’t warmed up and pulled it with awful form – bar away from my body, back engaged too early, rounded lumbar curve.

After the lift, my back was tight, hurt when I bent forward, and a tingling ran down the back of my glutes to my hamstrings. All classic signs of a slipped disk.

I dodged a massive bullet – now, two weeks after the injury I am 80% sure it’s not a slipped disk. This is what happened, for your learning pleasure.

Day 1 after the injury: tightness starts, hurts a little bit to bend over, pain and tightness localized in the lower left quadrant of my back.

Days 2-10: Like an idiot, I continue to lift. I don’t deadlift, but bent-over-rows and power cleans are especially aggravating to the injury.

Days 11-18: continuing to lift, its starting to occur to me that I may be doing more harm than good. After every lift, the pain is intense, but after a good night’s sleep, it seems to loosen up.

By now I had pretty much narrowed the injury to either a Quadratus Lumborum or Spinal Arrector tear or, far worse, a slipped lumbar disk.

Final days, including today: Looked up stretches for the lower back and such online. Lying on my bad, I did about three thirty second bent left leg crossovers to loosen my glutes and lower back. I then got off the bed and stood feet shoulder width apart in front of the wall and did an assisted hamstring stretch to loosen my hammies and glutes again. The final two things I did were massage my hip flexors and stand perpindicular to the wall and take my palm, raise it over my head, and touch the wall to my right (stretching my obliques, lats, and also hip abductors). I cannot tell you how much these helped.

I didn’t go to the doctor, which could have and probably should have been my demise. But I lucked out.

Point is, be tender with back injuries, and DO NOT LIFT WITH AN INJURED BACK. The back is something that will ruin your life if you really mess it up right.

Also very much of note, and I will end on this: when dealing with injuries (especially the back), look for other areas that may be related to the problem. For me, my excessively tight hamstrings had caused my comparatively weak left side back muscles to eventually give up and go into spasm (a state of constant contraction designed to minimize further injury). Just as referential pain can indicate problems elsewhere in the body, an injury to a certain part is not necessarily indicative of a problem with that specific part. An excellent example is knee pain associated with leg presses. The knee is not necessarily being injured to the extent you feel it, but, rather, the quadriceps muscle is in a state of high activity, while the equally important hamstring muscles are relatively relaxed. As the insertions of these muscles are both on the epiphysis of the tibia, both act on it. The tight quadriceps pulls on its connection to the tibial tuberosity and by the nature of human anatomy the patella (kneecap) as well. Normally these static contractions of the muscle tonus are equally balanced between the pull of the quadriceps and hamstrings, but with the hamstrings relaxed relative to the quadriceps, the condition called “runner’s knee” presents itself.

Thanks for listening as always!

-Matt

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In training, we have something called a “master cue.” The master cue is something that you give when your client is doing an exercise that will (hopefully) correct any form defects they are developing in the heat of the set (or just keep them going with good form). For the squat, a good master cue is “ass first, hip drive.” For the deadlift, an excellent one is “chest up, drive your heels through the floor.” The skill of cueing is important in training because the cue is the smallest effective bit of information you can possibly give the client and, ironically, can be the most useful. Why not explain it before the set? Well, you should. When the client is in the middle of a set, though, they can’t possibly pay attention to a technical description of the lift or look at you doing a demonstration. They don’t have the concentration capacity to apply 100%, look at you, understand, and consciously correct their form in the middle of a squat. The master cue gives them something they can process immediately and apply. Instead of spending 30 seconds explaining which muscles they should be feeling when, you give them something easy and digestible, something that gives them the “a-ha” that they can put in effect immediately. Think about it. When I say, “chest up, push the heels through the floor,” you can do that immediately. It’s simple. You don’t even need to think about it. Chances are, while you were sitting there your back straightened a little and your chest rose just as you read that. Compare that to me saying, “Your lumbar spine should be extended but not too much, don’t engage the back till it’s past your knees, keep your ass low to the ground at the start,” and you realize the importance of the master cue.

Not to say that all you need are cues. The technical description of a lift is very important too – it breeds understanding of the true biomechanics of the lift and helps you to coach yourself. The difference is that one deals with understanding and requires thought and a mental process to ingrain it as, “that lift,” whereas the other, the master cue, doesn’t require thought, it just requires action. It is saying, “do this,” as opposed to “when you set up like this, that should be as such.” And that is the skill of the master cue.

Now, the second half.

Something I realized at the gym today while doing my bench press was the common misunderstanding (even by trainers) of the phrase, “Slow descent, fast push.” To explain the true nature of what this phrase really means (and not the misconception), I have to start with the har

d stuff.

Something I learned in physics class a long time ago is that muscles have a spring constant (backed up here: http://ajpregu.physiology.org/content/278/6/R1661.full). What is a spring constant? In physics, a spring constant is the amount of force required to extend or compress a spring “x” distance. Since muscle is elastic in nature  (to a point), it stores energy as it is extended and releases that energy (to a small but effective degree) to contract again.

Shamelessly edited from google images.

Now, it’s only logical to remember that muscles are not perfect springs. They do, however fit the definition as materials that store elastic energy as they deform due to force.

But how does this relate to physiology and exercise? Cue the misused “slow down, fast up” cue. The good nature is there, but the meaning has been lost behind the cue.

When force is applied to muscle at rest, the stretch muscle engages unconsciously as a result of a motor nerve feedback loop. As the muscle stretches, it contracts to oppose the force being applied to it (to prevent damage to the skeletal system, nerves, and especially the muscle body itself). An excellent example of this is the jaw clasp test: holding the mouth slightly open and relaxed, ask a friend to (or do it yourself) tap with one finger, applying the force downwards, the top part of the chin, just below the lip (the mandibular protuberance). Chances are, unless there is something gravely wrong with you, your relaxed jaw will not bounce downwards, and the masseter muscles in your jaw will resist with just enough force to hold your jaw in almost the exact same position.

If you think about this, it’s an incredibly evolutionary advantageous adaptation. If muscles were strictly under somatic (voluntary) control, chances are, our ancestors would have had far more dislocation, sublaxation, and ligament tear injuries. The system favors muscle injuries over synovial and ligamentatious injuries. The advantage of a system that experiences solely muscle belly injuries (a pulled muscle) over damage to the connective tissues of the body is that muscle tissue is vascularized. Vascularized tissue (as opposed to avascular) is tissue that has blood vessels running through it, meaning it is fed by an active blood supply. Muscle is vascularized. Connective, ligamentatious, and cartilagineous tissue is avascular. What this means is that, being that the latter three types are only fed by proxy, by synovial fluid or other means, they are much less quick to heal than muscle tissue, and more likely to heal in a less-than-useful fashion. Muscle tissue, since it has excellent blood supply, heals very quickly, flushes waste very quickly, and, when healed actively (used in the fashion it is designed while healing), will heal with a minimum of scar tissue.

So now we know why and how the stretch reflex works, but where does it tie into the cue and the spring constant?

Contracted muscle tissue has a much higher spring constant than relaxed tissue, which means that contracted muscle stores a much higher percentage of the energy that gravity exerts on the weights in your hands as it descends than relaxed muscle. When you get to the bottom of the exercise, the energy stored in the muscles is at its maximum. This higher fraction of elastic energy already stored means that less energy will be required in ATP form to drive the weight up. As a side note: this does NOT make the exercise any easier on the muscle, nor will it affect gains in muscle mass – the amount of mechanical stress, that is, actual physical damage to the muscle tissue, remains the same for the exercise, and as such the muscle will be rebuilt and experience hypertrophy and hyperplasia to the same degree as with higher ATP energy required.

When a trainer tells you, “slow down, fast up,” know the true meaning of this cue. When you are going, “slow down,” (on what is called the eccentric phase of the rep) you should be focusing on storing the elastic energy in the muscle groups you are using. It’s a hard feeling to describe, but you’ll feel when you do it right, especially on the bench press. It manifests as a unique tightness in your muscles; it’s a really powerful feeling. You’ll feel in control, even with heavy weight, as opposed to the shaky feeling everyone’s experienced. The best friend of the powerful spring feeling is GOOD FORM. 

Now, when you get to the bottom, DO NOT “let go.” What I mean by this is relaxing at the bottom of a rep. Again, you can feel this on the bench press the best. It’s when people get trapped under the bar. Save your rest for the top of the rep. If you “wait and relax” at the bottom of the rep, you release all the elastic energy stored in the descent, and force your muscles to do much more work going back up. It’s akin to learning the rowing stroke; you never “wait” at the catch, you drive as soon as you hit the “legs vertical” point. Think of the bottom of the rep as the “trigger.” You pull on that trigger and all that force builds up to the bang as you shoot the weight up. Yanking the trigger (by just letting the weight fall back down each rep) will throw the shot off and just ruin maybe even the set.

There you have it, the “true” meaning of “slow down, fast up.” What an anticlimactic ending.

As a side note, the reason the deadlift is so damn hard is because you come all the way to the floor, put the weight down, release all the elastic energy in your posterior chain, and pick it up again. What a mean, mean exercise.

Another late post, apologies for any typos, Organic Chemistry is getting the best of my time lately.

Let’s be optimistic and assume you did some of the lifts mentioned in the last post. Or that you’ve been lifting for a while and decided to amp up your training. Or that your training periodization calls for a change-up this week.

Point is, recovery should be on every single athlete’s mind. Considering when you work out, especially with high-volume or high-load routine (lets say today was your 1RM day), you are putting massive loads on not just your muscles, but your entire “human system.” When you exercise, you place both physical and energetic demands on your muscles that result in molecular level trauma and oxidative stress on the muscular cells, respectively. What does this all mean? You’re really beating the hell out of your body.

But don’t worry! This is what you are supposed to do! You have to place these demands on your muscles to get healthier (and stronger). To reap the benefits of muscle anabolism (metabolic growth), you need to place the cells under stress – specifically stress that causes signals to be sent around the body “requesting” the release of testosterone and IGF-I (insulin-like growth factor 1), two chemicals that influence muscle growth. Heavy loads, high volume (reps X sets) with small rest periods, and exercises that work multiple muscle groups (squat and deadlift, people) have all been proven to increase post- and intra-workout testosterone and  IGF-I levels, leading to high muscle anabolism. This would be great if only exercise and hormones were involved, it’d be simple. But it’s not.

Now, once you have it in your mind, you don’t really need to think about it, but it’s important for any athlete or really anyone who’s interested in fitness to understand the subtle nuances of muscle recovery:

When you exercise, as mentioned before, muscle damage occurs. After said damage happens, an immune response is stimulated, opening blood flow to the muscles and promoting a flow of oxygen and nutrients. This blood flow has the double effect of both providing the muscle what it needs to recover and allowing the expedited removal of reactive oxygen species (jargon for “free radicals,” the product of oxidative stress from glycolysis in the muscle). This immune response is important, so let me go on record now and say if you have DOMS (Delayed Onset Muscle Soreness, also known as “Ow, I really hit my legs hard yesterday), do not take NSAID’s like Advil or Tylenol. They decrease the inflammatory immune response (as well as inhibiting a few enzymes that aid muscle anabolism) and therefore “starve” your muscles of the beneficial flush of blood they get from the workout.

While on the subject of muscle soreness post-workout, also known as DOMS, I’d like to go over some of the subtleties of the condition. First off, as with anything, know your body. This isn’t as simple as it seems: you need to know your threshold for pain and know how to differentiate between different types of soreness and pain. Why? Because they will influence what you do “next.” For bone pain or joint pain, very specific types of pain, LAY OFF IT. There is nothing you can do – bone needs rest to recover and cartilage, which makes up your joints, is avascular (it has no blood flow, and as follows logically takes much more time to heal and does not benefit from a blood flush like muscle). For muscle soreness, I’ve found the best approach to this is to slowly work out the muscle in the safest manner possible. Individualized, as the level of soreness dictates, I call this type of training, “Recovery training,” as it is distinctly different from “Rest.” For example, let’s say your traps are very sore from some Power Shrugs (an advanced technique I’ll get into in another post, just imagine the motion of shrugging and the muscle it uses on your body) yesterday – so much to the point that you really don’t even want to deadlift today. That’s okay, but you cannot just let the muscle sit and expect it to heal. This is where the immune flush response becomes valuable. What you want to do today is to do light shrugs, maybe 20-50% of your normal load, higher reps than normal with comfortable rest to encourage blood flow to the muscle. Working the muscle is ALWAYS better than letting it sit and fester.

Even with a muscle tear, the best trainers (Mark Rippetoe, for one: http://vimeo.com/20303779) advocates training the muscle in the most effective manner the muscle functions (curls for bicep, etc.) to encourage muscle anabolism rather than the formation of scar tissue that makes the rebuilt patch completely useless.

Now that we’ve gone over soreness, let’s talk about food. Specifically the fuel with which you are going to build your muscles. Ideally, post-workout, to take advantage of both the immune flush and the release of testosterone and IGF-I, you should be eating a meal of relatively high protein and unsaturated fat content and medium carbohydrate content approximately 30 mins and 2 hours after your workout. Defining “high” and “medium?” It depends on your body composition and workout intensity, but I’ve always gone by the “30-30 in 30” rule: 30 grams of complete protein (see bottom) and 30 grams of a carbohydrate that is NOT high fructose corn syrup within 30 minutes of your workout. Personally, I drink an protein shake with 42-50 grams protein (along with calcium, vitamin C, other supplements) and about 50 grams of carbohydrate immediately following my workout. When I get home, about 1:30 after my workout, I’ll pan fry myself a steak or two chicken breasts and have some Greek yogurt and Colby pepper cheese to go with it. The methodology behind it is this: All are high in protein, the steak gives me a complete protein source, the yogurt gives me an acceptable amount of carbohydrate along with protein, and the cheese makes it all more palatable and provides a source of saturated fats (which are important in testosterone production). Some will recognize this as a “paleo” diet, and they’d be right. I’ve seen my squat and other lifts go up as a result of cutting out HFCS and adding more protein to my diet. But I’m getting off track.

Sleep, next to fuel, is the most important factor in recovery. 6-7 hours is acceptable, but 8-9 is ideal. While you are far away in dreamland, your body is hard at work fixing all the damage you did today squatting and deadlifting. It makes sense – your body is completely at rest, brain isolated from the motor neurons, muscles at rest. When does the DOT do roadwork? At night, when there’s no traffic. Do yourself a favor and don’t skimp on sleep, or not only will you feel like crap the next day, but all of your lifts will suffer and you risk putting your entire program in jeopardy of not meeting your goals.

Since we’ve covered immediately after and in the near future of your workout, the only thing left is for me to scare you into following my advice!

Overtraining: a condition characterized by a decrease in strength and endurance marked by tiredness, muscular fatigue, and weight gain.

How do you get this? Not resting/recovering enough. Overtraining is linked with a whole bunch of other responses your body has to stress, the main one being what psychologists call “General Adaptation Disorder.” GAD comes when the body is put under constant and unrelenting stress (among the reasons for periodizing your training) and is not allowed to recover. Characterized by immune depression, increased insulin activity resulting in high fat storage, and catabolism (breaking down) of muscle tissue post-workout, GAD is anyone’s worst nightmare. GAD and Overtraining go hand in hand because when one occurs, the other is never far behind. The only way to save yourself and avoid these conditions is to allow adequate recovery time after every workout, and, if you are going to train heavy for several sequential days, allow decompression time for your body to recover.

I’ll leave you with this: You get nowhere just solely breaking down your body. It’s important to know both how to train and how to rebuild after training. Approach your rest days with the same scrutiny and vigor with which you tackle your “on” days.

As always, shoot me any questions you might have, and thanks for reading!

-Matt

 

 

Complete Protein: a source of protein that contains the amino acids Tryptophan, Threonine, Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Valine, and Histidine in a manner useable to the human body.