Sunday, August 22, 2010

How to Think About Training

This is a great comment from Robb Wolf's blog, that illustrates the way to think about training and injury.  BLUF: there's no free lunch.  There's certainly some risk of injury (the largest risk is a slight injury with moderate pain and a short rehab period; risk of catastrophic injury is very low, far lower for example than playing competitive sports), but there's also risk of injury if one does not train.  We see every day the virtual certainty of loss of function through weakness - it's such a certainty, it's not correct to call that outcome a risk!  It simply will happen if one does not train in functional movements, thereby preserving the strength in the muscles that allow our bones to bear our weight and support or movement as they are designed to do.

The writer is Dallas Hartwig, whom I've had the pleasure of meeting, and I respect his expertise greatly, even if I see fitness from an every so slightly different perspective. 

"Let me throw my comments out there regarding spinal degenerative conditions, specifically degenerative disc disease (DDD). Since the client in question is an active duty police officer (can I jump on her patrol car?), I'm going to assuming she's 50 or under, just for the sake of discussion. Given that I don't have any real info about her, I'm also going to assume that she doesn't have any history of spinal surgery, spinal trauma, overt instability of the spine, or compressive neurological conditions/symptoms. Lots of people have degenerative changes (often inaccurately lumped under the general term of "arthritis") in their spines and have no symptoms, but even if she has some spinal pain from degenerative changes of the discs or vertebrae, there's no reason that she can't still continue to train for her physical fitness test. As people age (or simply abuse their spines with poor postures and insufficient muscular strength to stabilize their spine under load or at velocity), the discs, which act as "cushions" between the vertebrae, can become drier and more brittle, and can actually become substantially thinner as part of this "drying out" process. This means that there is less space between the vertebrae, and can cause pain in a couple indirect ways (one of which is shifting more of the compressive load to the facet joints between the vertebrae). But for this discussion, let's mostly talk about what the trainer who sent in the question could/should actually do with this client to help her prepare for her fitness test (and the rest of her life!). As already mentioned, it's totally okay to work on big, heavy movements with clients like this, but maintaining a neutral spinal position during any of the movements is extra, extra important for them. One of the worst things you can do for a disc (especially one that is already less than bombproof) is to change spinal position under load, i.e. loss of lumbar lordosis at the bottom of a squat, lumbar hyperextension at the lockout of a DL, etc. So pay special attention to the quality of movement, and realize that you may have to dial down the intensity for a while to really dial in the technique. (I wrote about this on our Whole9 site: ) The other thing I'll comment on is shock absorption strategies, since additional impact on an already compressed and/or irritated disc or facet joint (especially with suboptimal positioning) can really fire things up. I'd look at her footwear and running technique, because the long-stride-and-monster-heel-impact kind of running, especially with poor hip strength or funky foot mechanics, can really transmit impact from the ground up to the back, and that can be distinctly un-fun for your client. So maybe get her working on a POSE-type running pattern with less impact, though I wouldn't steer most people towards Five Fingers-type footwear just yet. Also, think twice before prescribing high-rep box jumps, depth jumps, double unders, long runs, or other higher impact activities unless the client is pretty damn strong and good at keeping good spinal and lower extremity positioning when doing these things. At least for now, while prepping for her fitness tests, teach her how to maintain midline stabilization (neutral spinal position) with a variety of big, strong movements, and avoid the long, high-rep metcons that in my observation end up degrading into a whole pile of ugly movements in the name of "intensity" (Read: )

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