Mastering Fitness

Personal Trainer, Fitness Educator, and Web Developer

Become a fitness master

Programs, books, and more to come

Category: Assessments (Page 3 of 3)

Why Do I Have Two Bones in My Forearm?

Any answer to why you have two bones in your forearm (and lower leg) would simply be conjecture, but it’s helpful to consider the rationale.

Start at the wrist.

Frontal cross-section of the wrist joint.

As the picture above shows, the radius hangs a little lower than the ulna. So when you place your palm on the ground, as you would for a push up, the ground sends most of its force up through the radius. But if we follow it up to the elbow, we see that the ulna is the main bony connection to the upper arm. That is, there’s a gap between the radius and humerus.

What gives?

Those anatomy books that you have to buy for your classes are super helpful. Gilroy’s is my favorite. It’s beautifully illustrated. Learning anatomy is much easier when you have great visuals.

The problem is that they’re misleading to those who have never looked at a cadaver. When you’re examining at an actual body, everything looks the same. Every tissue is pink.

You think veins are actually blue? Pink.

Nerves are yellow? Pink.

Parietal cortex is green? Frontal cortex is red? Occipital cortex is blue? Pink.

So looking at these books makes it easy to get lost in simple solutions. Maybe you have a picture of just pronator teres in your book. It’s easy to get stuck into thinking pronator teres is going to do everything.

The interosseous membrane seems to get lost in discussion since it isn’t contractile like your traditional muscles. But this tissue is huge when we look at both bones of the lower extremity.

Going back to our push up forces travelling up the radius, what happens next? The radius pulls the interosseous membrane which pulls the ulna superiorly. Now we have forces transmitted through the ulna, which go to the humerus, then to the scapula…

This way, forces are dispersed. Similar things happen when we contract our elbow flexors, which mostly connect to the radius. They pull the radius, which pulls the interosseous membrane, which pulls the ulna… Without this, it would be much easier to overuse the humeroradial joint.

This point is illustrated everywhere you can find an overuse injury.  Runners get iliotibial band syndrome. Tennis players get lateral epicondylitis. People who work on their feet get plantar fasciitis.

Don’t keep all your eggs in one basket. The simple fix is to spread the load and stop asking the little guy to handle it all.

Depression is Not Something to Take Lightly

Why? Because sad shoulder blades are the number one cause of my headaches.

Well, I don’t know that they’re sad, but they’re definitely depressed.

The fitness industry has raved about the lower trapezius fibers for YEARS now, and with good reason! They are consistently weak in people from all different backgrounds.

The problem arises in the methods to spot and fix it your low trap weakness.

Continue reading

A Lesson in Regression

Not enough coaches out there discuss properly regressing clients.

Don’t get me wrong, I hate to do it because I love to see people moving forward, but you have to think about what’s best for your clients. Trying to drive through problems will make them mentally frustrated in the short-term and pathologically physically dysfunctional in the long-term.

When Should I Regress?

When you cannot get your client in the position you want them in, they should be regressed. There’s no shame in their body not being able to handle a certain load; it will get better, they will get stronger, and they will thank you for it.

For example, I was watching my good friend do some half kneeling cable chops the other day that he wasn’t happy with, to say the least.

I looked at it:

  • His spine was scoliotic (I think I made that word up).
  • The weight was very light.
  • This was obviously frustrating him, potentially enough to ruin his day.
  • The amount of tension all over his body was remarkable, even though this task should be easy for him.

He was struggling. He’s needs to be put in a situation where he can succeed.

Proper regression of your clients requires a few steps.

What’s the Problem?

The beginning step to regressing is to determine the “weak link in the chain”, so to speak, and use this information to help the client out.

For my friend, there were a few things going on. In order of importance…

  1. Spinal instability
  2. Shoulder instability, stemming from the unstable spine, weak scapular muscles, overactive big muscles, and dysfunctional small muscles.

The spinal instability is the biggest problem because it is the most proximal problem. If we were to leave the spine alone and just attempt to fix his shoulder, positive changes would never stick.

Emme Whiteman KB Armbar

Offer Assistance

After determining the weak link, you’ve got to figure out a way to make this a non-issue.

When in doubt, move closer to the ground. The closer the body is to the ground, the more stability someone can get through their points of contact.

In my friend’s case, I put him in sidelying and told him to slowly row a light band. Each component of this regression has its own specific purpose. Let’s break it down.

  • We bring him down to the ground into sidelying position to give his spine more stability.
  • Adding the row makes the movement more complex. The primary reason for the row is to challenge his spinal stabilization pattern. For now, I almost don’t even care how the shoulder moves as long as it’s not producing pain.
  • I chose a row and not a push because the front of his shoulder is already very overactive.
  • Then I told him to row very slowly because his pulling technique has years of faulty patterning reinforcing it. Going slow will allow him the time to think through a new movement pattern and “feel it out” while getting those front side muscles to relax.

Looking back, I would make the row a simple isometric so that he can focus on the spine while strengthening his upper back and learning how a full range of motion row should feel. I may also lean towards a push instead of a pull to load the anterior core more once he’s progressed.

Sounds impressive, right? Not so much. It may be embarrassing for the client, but if you can get them past this psychological stage, they will perform better physically.

Emme Whiteman Squatting

Where to Go Next?

Obviously, you don’t want their entire workout on the ground forever.

In a situation like this, where the client was once an extremely able-bodied individual (he was the fastest man in Georgia!), they need a training effect. They need to do something cool. I don’t care at all about the actual training effect, or the muscle he’s going to lose, or even so much the diminished strength, but I want him to enjoy training. Everything else is minutia at this stage.

The easiest way to get someone to stop working out is to take away all of the fun.

Blindly trusting a boring program doesn’t last forever. Eventually they will get sick of it and stop taking your advice.

The importance of this is stressed when you consider that they may never again do the things they used to call “training”. Maybe the guy never squats deep again. Maybe he never benches a barbell again. Maybe he never does another bilateral deadlift.

You will need to find things that can challenge this type of client so that they don’t forever feel like a patient. Now go get creative.

Why Gross Movements are Not a Sufficient Assessment

Gross movements are multi-joint movements. They can also be disgusting and offensive, but we’ll save those for a more off-topic post. Some common examples of the gross movements we’re discussing in this post are the overhead squat, push up, and lunge.

I don’t want to belittle these tools because they are extremely useful. They can suggest a lot of things about the way a person moves, but those things still need to be confirmed. Some conclusions cannot be drawn from gross movement alone.

To break it down to basic logical thinking: gross movements are NECESSARY in an assessment, but not SUFFICIENT as an assessment on their own.

A Reading from the Book of Gray

As I believe the great Gray Cook has said, “It could be a mobility problem. It could be a stability problem.”

Gray Cook
Gray Cook

No truer words have ever been spoken in the wonderful world of client evaluation.

This reminds me of an assessment I did just the other day. During the gross movement portion of our assessment, our client was doing lunges. After banging out a few reps, he began to complain about his big toe feeling stiff.

The obvious prediction is that his toe will present stiff, showing some soft-tissue restrictions. I then cried, “It’s a mobility problem, Gray!

Surprisingly enough, when we laid him down on the table, I was able to take his toe right back. His great toe extension was completely normal at 70 degrees. My guess was wrong. Since he has normal motion in his toe, he doesn’t need to be more mobile there. He does need more STABILITY, however, since his lack of stability in his lower body makes him incapable of accessing his mobility.

Ideally, he uses his butt to extend his hip and push his foot into the ground. In this case, the butt isn’t turning on, so the big toe grabs the ground, giving him stability and extending his hip. I know it’s hard to picture, so stand up and try it out.

Ultimately, this finding means we don’t have to prescribe pointless toe mobilizations, and instead points us to a hip extension weakness. We program things like clam shells and glute bridges to turn his butt muscles on and this toe thing clears up.

Always Get Better at What You Do

As seemingly everyone in the fitness industry says, “If you’re not assessing, you’re guessing.”

Seek out the information to become a better trainer (which is why you’re here, duh!).

  • Watch an assessment from someone who knows what they’re doing. If they have their own custom assessment, fine-tuned to their liking, there’s a good chance they know what they’re doing.
  • Read the literature. Start with Kendall’s book, Muscles: Testing and Function, to get an idea of some common tests, and go from there. Mike Robertson and Eric Cressey think this is a must-have, and that’s enough for me, but if it’s not for you, there was also a positive review of it in the Journal of the American Physical Therapy Association.
  • Watch people move. Not only is it fascinating (to a geek like me, at least), but you can learn a lot. Look out for limitations, compensations, and normals. Warning: this has changed me. Now instead of looking for the size of a woman’s chesticles, I grade her upper back development. Slumped shoulders = DEALBREAKER.
  • Practice! Play around with your significant other (HA!). Ask your friends if you can try this new test you just learned on them. More and more repetition will make you more and more comfortable with what you’re doing and more and more confident in what you’re seeing.

See the Big Picture

A thorough assessment is actually something that vastly improved the life of my friend and co-administrator of this site, Jae Chung. As you may know, Jae had pain in his foot… FOR EIGHT YEARS. The $500 he spent on orthotics did nothing. The foot doc only looked at his foot, and subsequently missed the boat, failing to see the big picture.

It’s like blaming your low squat numbers on weak muscles, when in actuality, it’s your technique that’s holding you back. Stop focusing on the symptoms and find the actual problem.

Don’t miss it!

Fast forward in time, Jae comes to IFAST to see Bill Hartman, gets his first thorough assessment, and is cured soon after.

Eight years of pain, gone. For those who don’t know, chronic pain sucks the life force out of you. It’s amazing to imagine how much better he felt mentally after just a short assessment. I want that quality of life for all of my clients, and I hope you do, too.

The doc who just looked at Jae’s foot wasn’t thorough enough. Don’t make the same mistakes with your clients.

Newer posts »

© 2024 Lance Goyke

Theme by Anders NorenUp ↑