Guest Forum: Pick EC's Brain

Hi Eric, thank you for the great resource.

I was wondering if you could give me some insight in to an ankle injury and possible steer me in the right direction or offer some advice here.

I broke my ankle approx 5 years ago, playing basketball. I came down after a rebound and severely turned my ankle (inversion), which resulted in a sprained ankle and an evulsion(sp?) of the ligament in the medial/anterior part of my right ankle. Sorry I can’t remember the exact name of it. I had a cast on for only a week and a half then proceeded with rehab which consisted of strengthing and balance exercises as well as ultrasound to the affected areas. I think I may have rushed things too quickly with the strengthening which may of set me back a bit at first. My dorsiflexion ROM was severely compromissed. I couldn’t get the ROM past perpedicular of my ankle till about 3 months and then it was still slow going, even though my proprioception and strength were close to getting back to normal. I seemed to have injured my achilles as well since it was tender and swollen for a couple months. I’m believing this may have been the cause of the dorsiflexion problems.

Anyways I tried to give you the background as good as possible. Fastforward to today… I’m trying to get back in to the decathlon and have been doing tempo/GPP type work 2 to 3 times per week. My ankle can take a day or two of workouts then it tends to act up (tenderness on all sides of the ankle). Skipping rope and jogging seem to cause the most aggravation.

I’m guessing that there may be some scar tissue surrounding the joint which is causing me some problems. The overall size of the ankle is slightly larger than the uninjured one. It has been larger since the injury five years ago. As well the dorsiflexion of the right ankle is about 90% of the left. Stength and balance are generally the same as my other ankle.

In general the ankle hasn’t bothered me too much the last 5 years since I haven’t been doing too high a volume of running or skipping. Mainly sticking to the bike, doing my regular weight routine, playing volleyball, and basketball the odd time. As well calf raises (seated and standing) haven’t bothered me too much throughout the years.

I know that you can’t easily diagnose this over the internet but was wondering what you could offer me at least in terms of direction at this point.

By the way I live in the Niagara Region, Ontario, Canada, and have access to physiotherapists, ART specialists, accupuncturists, and probably others as I am willing to do what ever it takes! I have a few connections in the area.

Thank you very much in advance, and if you need any more specifics I will be happy to give them to you.

[quote]craigrasm wrote:
Eric Cressey wrote:
New research (Dr. Kraemer, in my lab, especially) and anecdotal evidence (CW’s programs) are showing the undulating periodization (or slight variations on the traditional protocols) and conjugated periodization (Westside-influenced) blow linear periodization out of the water.

I favor a conjugated approach, although an undulating approach would give you decent results as well.

Eric-
Would you mind elaborating on the undulating periodization approach,i.e. how to apply it to one’s training?

Could you possibly give an example of what an undulating cycle would look like for say a squat or bench press based on what you have prescribed or what you have used in your own programs?

Thanks for your time it is greatly appreciated. You and Mike do an excellent and thorough job with all the articles.

Craig

[/quote]

Undulating periodization basically offers variety by rotating different loading schemes for an exercise over a seven- to ten-day cycle. In any single workout, only one characteristic (e.g. maximal strength, power, “traditional” hypertrophy, and muscular endurance) is trained. The undulating approach attempts to train various components of the neuromuscular system in the same training period rather than training for strength first and then power. This is the case with the classic linear model, and definitely one of its shortcomings; the second you get proficient at one factor, you start to focus on another one and don’t really do anything to maintain the specific fitness you’ve attained.
Undulating periodization is markedly better than linear periodization. Here’s how a traditional four day undulating cycle might be set up:
M: Strength (e.g. 5x5)
W: Power (e.g. 6x3)
F: “Hypertrophy” (e.g. 3x8-12)
M: Muscular Endurance (e.g. 2-3x12-15)

Volume and intensity increase and decrease on a regular basis, but do not follow a pattern of higher intensity and lower volume as the mesocycle progresses. Some of CW’s programs are good examples of how traditional undulating periodization can be modified with outstanding results. In the first ABBH, you’ll see that he just canned the power and endurance days and played around with volume to address both sarcomere and sarcoplasmic hypertrophy. Smart dudes know how to do thisJ; people who can’t think outside the box just write ineffective program after ineffective program.

Personally, I think undulating is better than linear (and most would agree), but I still think that a conjugated approach even blows undulating periodization out of the water. It really comes down to attentiveness of the coach/trainee; one needs to understand how to manipulate volume and intensity to allow for supercompensation to take place. Once you do, you can train all these qualities in single sessions and maintain the specific fitness qualities throughout the training year, prioritizing individual qualities at certain times to prepare an athlete more for a season or to bring up weaknesses.

I would like to first thank you for taking some time to answer questions from the nation.

I would be interested in hearing your take on the use of lifting belts with athletes. I can completetly understand using belts if you are specifically training for powerlifting, but do you think that it is more beneficial for athletes to train beltless since they will not be wearing one during a game or practice. Does this cause a different recruitment and firing pattern of the abdominal/oblique/TA musculature. I know that with many sports the athlete will not be under anywhere near the same load, but an offensive linemen driving a defender comes to mind as an example of where this might be an issue. Thank you again for you time.

Hi Eric,

I was wondering if you could help with my weakpoints in squats and what may attribute to it. My feet are a tad wider than my shoulders and toes pointed slightly out. Under low - medium loads technique is pretty good, it’s just under heavy loads that form somewhat deteriorates, thus training for power can be problematic. The eccentric portion is fine, I still get the depth and everything, just the concentric portion does get somewhat ugly for my liking. When getting out of the hole, my knees sometimes collapse inwards, mainly towards the last few reps where I’m really trying to get the weight up. Once I have gotten the concentric portion moving and knees are where they’re supposed to be, my legs and hips drive faster than my torso. Instead of being rigid throughout, my legs are almost near lockout and my torso is still bent, and the remaining portion I kind of goodmorning it up. This only happens under heavy loads when I’m trying to get a bit more power, I’ve tried doing front squats and overhead squats to try keep my torso straight throughout. I can do those fine but when I hop onto back squats the problem remains.

Also, I’ve rowed for the past 6 years and have got quite a weak lower back from it. Constantly sitting down hunched over in the boat… argh. Now when I sit down for prolonged periods of times (an hour or 2), despite maintaining proper posture my lower back starts hurting… would you know what this may be attributed to? Scrum training in rugby doesn’t help… once we unpack it would be one hell of an effort to stand up… I do do a lot of heavy deadlifts and rackouts. Low reps are fine, but when the reps increase to say 8 upwards, the lower back really kicks in (found out the hard way when I swapped the ABBH parameters around). Any help would be great

Cheers

Thanks a lot Eric great advice as always, exactly the guidance that I was looking for, you are a great person, thanks again.
I’m not that technical with muscle movements, would you recommend me a biomechanics book, not to technical that will help me understand the “kinetic chain” of different sports, as you know I’m interested in swimming but would like to learn more and help other friends in different sports.
Once again thanks for your help and time, great work!!!

I’m almost embarassed to ask this question. It seems dumb compared to the others that have been asked, but I’m curious. What does your typical week in the gym look like?

[quote]Dean wrote:
I am a swimmer with shoulder problems, of the few physios and one doctor (“You’ve got lax joints so you’ll have joint pains all your life. Deal with it. I can give you cortisol injections”)[/quote]

If they’re giving you CORTISOL injections, you need to find some new doctors!

[quote]I’ve been to over the past few years I’ve been told I had tendontitis and weak rotator cuffs or tendon degeneration (?) due to the rotator cuff problem and the swimming. After doing the same sort of exercises for a good few years(admittedly on and off, with more emphasis on the off) with little success, your article has shown I really need to focus on underlying problems of scholiosis (probably causing all the musculature on the right side of my spine to be significantly bigger than that on the left) and kyposis, with scapular winging and the like.

Anyway my question is:
do you have any tips on how to find a good physio, chiropractor or other health professional who would go beyond the obvious shoulder impingement and try to solve the underlying problems? What qualifications to look for, questions to ask over the phone.

Thanks in advance. [/quote]

Pretty good question, although it’s a tough one to answer. Usually, a conversation with the professional is the best means of determining if they’re a good fit for you. Qualifications are important, too, although I’ve met professionals with loads of qualifications that don’t do a very good job with the hands-on aspect of care. As a general rule of thumb, the painful area is rarely the exact cause of the pain. In other words, if you have a lower back problem, for example, a good PT or orthopedist is going to check your feet, ankles, knees, and hips, too. He/she should also do a complete history of you, too.

Chances are that you’re dealing with internal impingement, which is common among athletes in sports that involve considerable overhead activity. It’s more an issue of hypermobility (think of a marble clanking off the sides of a jar) rather than external impingement due to a decreased subacromial space (marble is too big for the jar, or it’s moving without restraint). The best thing you can do is avoid painful activities and do a ton of work to strengthen your rotator cuff and scapular stabilizers.

Also, don’t be so quick to point the finger at the health care professionals as the problem. After all, you admitted yourself that you had only loosely followed their recommendations. I’d be willing to bet that those recommendations, if adhered to diligently, would have markedly reduced - if not eliminated - the excessive nature of your kyphotic curve. Take home message: all the knowledge and best healthcare providers in the world won’t mean a thing unless you do pitch in the effort, too.

Good luck!

[quote]Eric Cressey wrote:
RIT Jared wrote:

  1. I am a rugger. I play hooker, and I would like to build a superbly strong/thick/injury proof neck. I have tried some of the exercises CT reccommended for the racecar driver, but I currently do not have access to a neck harness. I can do several no-handed neck push ups, and many neck bridges. I also “made up” my own exercise in which I place a plate on my forehead and extend the neck from a lying position, training the sternocleidomastoids (sp?). Any more advanced exercises would be great.

Honestly, my best recommendation would be to either buy or make a neck harness. I paid $9 for mine, and although I only train neck every 4-5 lower body sessions, it’s definitely helped me to get the neck extended during the lockout portion of my deadlift (see pic). Also, since you’re going to be hammering the neck extensors hard, you’ll also want to do some work for the neck flexors in order to prevent imbalances in advance. You can do chin tucks (as outlined in NNM Part 4) or rig the chain on your neck harness up to a high pulley and go to town.

  1. Also, any advice on rugby training in general-- injury prevention or otherwise:

a) in-season
.1) team exercises
.2) individual gym exercises
b) out of season
c) nutrition (MSM, Gluco, etc)

Again, somewhat of a loaded question. You can’t go wrong with loads of posterior chain work. In terms of quad work, I would make a point of incorporating plenty of deep knee squats/lunges/step-ups, especially in the early off-season. You won’t get much of this on the field, so there’s a tendency for the IT band to tighten up and the vastus lateralis to become dominant. When this happens, you get lateral shifting of the patella and knee pain.

Don’t waste your time with wussy core training; stick with heavy basics incorporating loading rotation and lateral flexion.

Strongman implements would definitely be beneficial both from biomechanical, metabolic, and team motivation standpoints. Have competitions with tire flipping, farmer’s walk, etc.

Toss in some scapular stability stuff, static stretching post-match, and dynamic movement prep warmups, and you should be golden.

In terms of supplementation, stick with creatine, protein powders, during and after training drinks, fish oil, and antioxidants as your mainstays. The other stuff doesn’t warrant consideration until you’ve got the basics down. Stick with JB’s stuff for nutrition, and you’ll be a cut above the rest before you even step on the field.

Any other questions, just ask:) [/quote]

I have a killer neck exercise. It’s called the Judo press (by the person who showed me this). Essentially the person is doing a dumbbell chest press. The major difference is that instead of having the back on the bench, only the head is on the bench.

I find it works very well if you try to keep the body straight the whole time. It’s very tough, and I would recommend light weights for a while. Hope this could help you out!

[quote]Bri Hildebrandt wrote:

I broke my ankle approx 5 years ago, playing basketball. I came down after a rebound and severely turned my ankle (inversion), which resulted in a sprained ankle and an evulsion(sp?) of the ligament in the medial/anterior part of my right ankle. Sorry I can’t remember the exact name of it. I had a cast on for only a week and a half then proceeded with rehab which consisted of strengthing and balance exercises as well as ultrasound to the affected areas. I think I may have rushed things too quickly with the strengthening which may of set me back a bit at first. My dorsiflexion ROM was severely compromissed. I couldn’t get the ROM past perpedicular of my ankle till about 3 months and then it was still slow going, even though my proprioception and strength were close to getting back to normal. I seemed to have injured my achilles as well since it was tender and swollen for a couple months. I’m believing this may have been the cause of the dorsiflexion problems.[/quote]

Whoever was in charge of your rehab jumped the gun. By allowing you to just train around the deficit in dorsiflexion, he/she essentially established faulty movement patterns. You could have issues with ankle spurs, or there could be an underlying subtalar dysfunction; I’d need to see your ankles and feet to get an idea of what’s going on. Take a look at your feet and check to see if the callouses are at the bases of the second and third metatarsal heads (index and middle toes). If they are, you’ve got some issues with overpronation. It could just be tight plantarflexors, too, so get to work on stretching your calves just in case. Some dorsiflexion work would be a good idea, too.

Too much, too soon combined with some actual structural problems are a sure-fire recipe for disaster. I’d back off on the volume for a bit and opt for some low impact modalities (e.g. elliptical, rowing, heavy bag) for building your aerobic and anaerobic fitness to give the ankle a break. Pay close attention to training surfaces, too; grass is preferable to pavement, in your case.

[quote]I’m guessing that there may be some scar tissue surrounding the joint which is causing me some problems. The overall size of the ankle is slightly larger than the uninjured one. It has been larger since the injury five years ago. As well the dorsiflexion of the right ankle is about 90% of the left. Stength and balance are generally the same as my other ankle.

In general the ankle hasn’t bothered me too much the last 5 years since I haven’t been doing too high a volume of running or skipping. Mainly sticking to the bike, doing my regular weight routine, playing volleyball, and basketball the odd time. As well calf raises (seated and standing) haven’t bothered me too much throughout the years.

I know that you can’t easily diagnose this over the internet but was wondering what you could offer me at least in terms of direction at this point.

By the way I live in the Niagara Region, Ontario, Canada, and have access to physiotherapists, ART specialists, accupuncturists, and probably others as I am willing to do what ever it takes! I have a few connections in the area.

Thank you very much in advance, and if you need any more specifics I will be happy to give them to you.[/quote]

You can’t be too far from Dale Buchberger. He’s undoubtedly one of the top ART guys in the world, and just helped a buddy of mine significantly in only his first session. You’d be crazy not to see him.

What a breath of fresh air!

Question for ya Eric. Are there any books you’d suggest that deal with fixing common postural problems for a personal trainer?

Many thanks,
Maki Riddington

[quote]kryptoniteks wrote:
I would be interested in hearing your take on the use of lifting belts with athletes. I can completetly understand using belts if you are specifically training for powerlifting, but do you think that it is more beneficial for athletes to train beltless since they will not be wearing one during a game or practice. Does this cause a different recruitment and firing pattern of the abdominal/oblique/TA musculature. I know that with many sports the athlete will not be under anywhere near the same load, but an offensive linemen driving a defender comes to mind as an example of where this might be an issue. Thank you again for you time.[/quote]

Only on 1-2 RM loads for lower body exercises like squats, deadlifts, and good mornings. Also, only if the athlete is comfortable with the belt, as I know of lots of individuals who don’t even like them for max attempts. Considering that they might hit a total of 6-8 reps per month at an intensity of 90% or more on these exercises, there isn’t sufficient volume for the use of lifting belts to cause a problem with firing patterns. We learn via repetition, and 6-8 reps isn’t nearly enough to ruin core stability, especially if the athlete knows to push out against the belt and brace the abs.

Good question!

[quote]xil wrote:
Hi Eric,

I was wondering if you could help with my weakpoints in squats and what may attribute to it. My feet are a tad wider than my shoulders and toes pointed slightly out. Under low - medium loads technique is pretty good, it’s just under heavy loads that form somewhat deteriorates, thus training for power can be problematic. The eccentric portion is fine, I still get the depth and everything, just the concentric portion does get somewhat ugly for my liking. When getting out of the hole, my knees sometimes collapse inwards, mainly towards the last few reps where I’m really trying to get the weight up. Once I have gotten the concentric portion moving and knees are where they’re supposed to be, my legs and hips drive faster than my torso. Instead of being rigid throughout, my legs are almost near lockout and my torso is still bent, and the remaining portion I kind of goodmorning it up. This only happens under heavy loads when I’m trying to get a bit more power, I’ve tried doing front squats and overhead squats to try keep my torso straight throughout. I can do those fine but when I hop onto back squats the problem remains.[/quote]

Your glutes are weak, both from a hip extension and abduction perspective. Side-steps with the ankle band (as will be described in Part 5 of NNM) and supine bridges will help fix this problem. You can also do band abductions while seated on a low box. Stretch your hip flexors, too, and focus on keeping the chest high and elbows pulled forward.

[quote]Also, I’ve rowed for the past 6 years and have got quite a weak lower back from it. Constantly sitting down hunched over in the boat… argh. Now when I sit down for prolonged periods of times (an hour or 2), despite maintaining proper posture my lower back starts hurting… would you know what this may be attributed to? Scrum training in rugby doesn’t help… once we unpack it would be one hell of an effort to stand up… I do do a lot of heavy deadlifts and rackouts. Low reps are fine, but when the reps increase to say 8 upwards, the lower back really kicks in (found out the hard way when I swapped the ABBH parameters around). Any help would be great

Cheers[/quote]

It’s closely related to your first question. The problem isn’t that your erector spinae is weak; it’s that it’s too strong! It’s just a case of synergistic dominance, as your glutes aren’t doing their job in hip extension, so the lower back (and possibly hamstrings; they may tight, too) works overtime. You need to stretch your lower back out like crazy and do a ton of glute activation work as described above. You’ll really love Part 5, but get going with Part 4 first so that you’ll be prepared for it.

[quote]LuigiM wrote:
Thanks a lot Eric great advice as always, exactly the guidance that I was looking for, you are a great person, thanks again.
I?m not that technical with muscle movements, would you recommend me a biomechanics book, not to technical that will help me understand the ?kinetic chain? of different sports, as you know I?m interested in swimming but would like to learn more and help other friends in different sports.
Once again thanks for your help and time, great work!!!
[/quote]

“Kinetic Anatomy” by Thomas Behnke is a decent read. You might be better off with a good anatomy textbook first. The “Manual of Structural Kinesiology” by Thompson and Floyd is a pretty easy read for beginners. The absolute best thing you can do is interact with as many different professionals as possible: PTs, ATCs, orthopedists, and strength coaches. Get to seminars, and take courses at colleges with those in the “know.” Think, experiment, and learn.

[quote]mannyc wrote:
I’m almost embarassed to ask this question. It seems dumb compared to the others that have been asked, but I’m curious. What does your typical week in the gym look like? [/quote]

The only stupid question is the one that isn’t asked!

Sunday: Rest

Monday: Dynamic Effort Bench, full ROM 2-5x3-5 assistance work on presses (except on deloading weeks), some horizontal pulling and scapular stability prehab work

Tuesday: Dynamic Effort Squat

Wednesday: GPP, consisting of sled dragging, high rep recovery work, some dynamic flexibility, and some sprints if I’m feeling frisky

Thursday: Max Effort Bench (no full ROM pressing for the next few months, at least) - shirt work if desired

Friday: 50% of the time, I’ll do a upper back/scapular stability day; I find it keeps my shoulder healthy. This session won’t last more than 30 minutes, and I’ll usually do some sled dragging as a warm-up and occasionally grip work at the end (not lately, though). Other weeks, I’ll just do a bit of light recovery work and take it easy. I love to train, so these days are tough to swallow!

Saturday: Max Effort Squat/Deadlift (if I don’t train on Friday, I’ll do some of that work here, albeit with less volume)

Since I’m on my feet quite a bit while training others, I tend to mix it a little GPP throughout the day most of the time (e.g. band pressdowns and GMs, etc.). Equally important - yet neglected from this split - is how I pay attention to recovery. Beyond just eating clean, I’ll use EMS, the hot tub, and the pool on a weekly basis. I try to get ART about twice a month on whatever ails me (or just as money in the bank), and do quite a bit of self-myofascial release on the foam roller and static stretching (can almost do the splits!). Basically, I wasn’t blessed with great genes from a structural standpoint, and my endocrine system is kind of screwy, so I need to find different ways to scratch and claw for all my progress. Fortunately, it gives me a better perspective on helping others do the same.

Any questions, just ask:)

[quote]Maki Riddington wrote:
What a breath of fresh air!

Question for ya Eric. Are there any books you’d suggest that deal with fixing common postural problems for a personal trainer?

Many thanks,
Maki Riddington[/quote]

Unfortunately, none come to mind, as I have essentially blended a lot of biomechanics, anatomy, and strength training knowledge with what I’ve encountered in my dealings with various professionals.

Want me to write one?:slight_smile:

EC, - do you have a good alternative to the mini-band sidesteps for someone with no access to mini-bands ?

Eric,

You wrote:

“The absolute best thing that one can do to avoid these imbalances once things are corrected is learn about functional anatomy. Only then can you understand what each muscle does, how to train certain movement patterns, and how they “cancel each other out.” Muscle length and tension is something that needs to be constantly evaluated, so you should learn to be in-tune enough with your body to know that something feels tight or restricted.”

Not sure if this is the same thing you covered a few replys above but have you got some recommendations for books in this area.

I have no idea what is the difference between DB side bends and Saxon side bends.

I probably did not describe the diagnosis appropriately. The cartilage is worn OR traumatically damaged, and MRI should identify it. It is basically the question between arthroscopy in the latter case and some knee injections and medication in the former. Now, should I do any lower body work at all before MRI? If not, what about stretching? I should have asked the doctor, but…

EC,

YOu are the consumate professional and full of great knowledge. Thanks for all of your help so far.

Could touch more on your recovery/restoration protocols? I work in a Physical Therapy clinic and I have access to EMS but I am not quite sure how to incorporate it into my overall plan. Do you use the EMS exclusively for strengthening prime movers or are you using it more for prehab and or/restoration?

Could you go into detail with duration, intensity and set up of the protocols that you use?

Could you recommend and good books on EMS for strengthening for sports and not just low level rehabilitation protocols?

Thanks for your help!

[quote]DD90 wrote:
EC, - do you have a good alternative to the mini-band sidesteps for someone with no access to mini-bands ?[/quote]

Honestly, no. Hip abductor machines are quite possibly the worst thing you can do in this instance. As such, the mini-bands or ankle cuffs are the only way to go. You can get one for under ten bucks at Elite and it’ll make a world of difference. Plus, you’ll have it for the rest of your training.

Suck up and buy one!:slight_smile: