To Roll or Not to Roll: Techniques that Work

In part 2 of this self-myofascial release (SMR) blog, I've examined the specific applications of SMR. For those of you interested in learning more about the science, application of SMR & mobility assessment I have secured you a $50 off promo code  http://www.radroller.com/#_a_CB for an on-line certification I recently completed. In case you haven't read it, here's a link to part 1 http://prepairtoperform.blogspot.ca/2016/06/to-roll-or-not-to-roll-overview.html

   

 

Case Study

In order to evaluate the current P2P model, I've been assessing and using my clients as case studies and wanted to share one of those experiences. Today I found myself working with a client who's been complaining of lower back problems, a common complaint affecting approximately 80% of the adult human population (NASM Essentials of Personal Training text: P.6). Specifically she was having pain over her PSIS (hip bone) on the right side. It was preventing her from squatting deadlifting, from performing numerous other functional activities and worst of all, from attending my 9am, Tues morning nashFIT class (OMG).

The Assessment Results:

1. Right active straight leg raise instability

2. Right active straight leg range of motion restriction / tightness

3. Weak 1 foot Bridge on the left side

4. Weak glute on the left side and weak rectus femoris on the right side

5. Synergistic dominance & over activation of left hip flexors

6. Tight abductors and restricted range of motion of the adductors

7. Significant instability from the all fours position, specifically with the right hand and left knee on the floor (i.e. bird dog).

8. Moderately tight quads both sides but more so on the left side

9. Overhead Squat:

• Significant shift to the right and for right pelvic rotation
• Fwd torso lean
• Right PSIS uptilt & right fwd rotation of the pelvi

As mentioned previously, I would typically 1. release all tight muscles then 2. stretch the same before performing 3. strengthening antagonist activities (i.e. RSS). A recent trend amongst SMART practitioners is to down play the role of, if not flat out reject the use of foam rolling / SMR as part of pain reduction, improved mobility & stability or intelligent movement reeducation (i.e. motor programming). If SMR could not consistently help achieve either of the above, it would clearly suggest self myofascial release is an unimportant tool in corrective therapy.

P2P Corrective Flexibility & Movement Correction: I intentionally left the self-myofascial release techniques to the end.

In my best estimation, her results were indicating a shift away from immobility on the left side, possibly due to tightness in the left hip flexor group. Due to the shift and reduced left side adduction range of motion I began correcting left TFL tightness. Instead of starting with a release, I went straight to the S's :)

Step 1. Strengthen glutes (i.e. hip extensors with the Cook hip lift)

Step 2. Reassess overhead squat (no change to shift)

Step 3. Tfl stretch (i.e. stretch hip flexors)

Step 4. Reassess overhead squat (no change to shift)

At this point I was questioning my results and begin checking ankle mobility. Which was worse on the right than the left and therefore could not explain the shift. I then corrected many of the other errors with strengthening exercises. Nothing significantly changed the shift, but nearly all of the assessment results had been temporarily corrected.

Enter Self-Myofascial Release: At this point, it was time to begin myofascial release techniques.

Step 1. release left quadriceps, left lateral thigh. Here are a couple of videos showing these techniques
https://www.youtube.com/watch?v=41Tgsmol8Og (quadriceps SMR)  & active mobility assessment & lateral thigh SMR)

 

Step 2. reassess both the Jane Fonda (adduction) and Overhead Squat.

Result: minimal change to the right lateral shift but slight improvement to Jane Fonda lateral line mobility.

Step 3. foam roll / release the left (not as shown) TFL using the "pin and move" technique outlined in the photo'd article (above) & trigger point manual below.



Step 4. reassess both the Jane Fonda and Overhead Squat.

Result: upon retesting, the client immediately said "I can squat". The shift and rotation we're nearly 100% removed and the Jane Fonda assessment symmetrical on both sides.

Without a doubt, SMR was the biggest, corrective difference maker.

I'm a big believer that there are a lot of different ways to slay the movement restriction dragons. Regardless of the techniques trainers and therapists use, the scenario & outcomes above represent a common occurrence in both the fitness & rehabilitative fields. I do believe that the combination of release, stretch and strengthen is more impactful then self-myofascial release alone (see below video). But, to all those who suggest that foam rolling / SMR is unimportant, I suggest you keep an open mind & recognize that well educated execution of SMR can help empower people towards less pain, better movement and a reduced incidence of future injury.

Who Should Foam Roll?

Foam rolling isn't for everyone or required at all time. Nor will it fix all problems. In fact, in some cases the mobility restriction & or trigger point your rolling was protecting an underlying joint instability. Understanding the above statement, I have 4 recommendations:

1. Combine SMR with active mobility. Choose a movements in the same plane and ensure you have intregrated active tension (i.e. the client creates the movement, the trainer guides and supports it to minimize movement errors).



1. Combine SMR with stability training. Balance training or these 3 core integrated movements 1. plank, 2. side plank and 3. bridge. Both methods are highly effective at ensuring the nervous system turns on and therefore receives important feedback from the joints prior to intense training.
2. I've talked about the "dead zone" in previous mobility blogs, but once a new ROM is available, it's essential to actively perform medium paced & tensioned movement within that range.
3. Do not self-care foam roll if you currently suffer from any of the below counter indications.

What are the Most Effective Rolling Methods?

 

Regardless of the chosen technique or tool, simply rolling up and down muscle isn't the most effective method. But rolling the entire muscle is an important aspect of the search and destroy method I teach clients. Here are a few helpful self-applied rolling tips:

The Search:

• Start at the distal point of the muscle. Distal = start farthest from the middle of the body and then perform the following. Move 2 inches towards the middle 1 inch away. Each of these movements should take 2-3 sec.
• When you find an irritated and or unusually raised area (feels like your path was obstructed), stop and begin to "destroy"
• The rolling technique also aids in lymphatic drainage and recovery post exercise.

Destroy the Enemy: there a numerous techniques that work really well but they all start with pinning the tissue. Pin & move, trap & move, call it what you want. Either way, compress the tissue then move, ideally in multiple directions. Here are a few techniques that work well:

1. Step 1. Compression Pressure: find the right amount of pressure. Think 5-7 out of 10 with a 5 being green light uncomfortable but bearable for a prolonged period of time. 7 being yellow light proceed with caution but definitely intense. Anything above 7 and generally in the company of profanity and hatred towards others = the no go red light.
2. Step 2. Pin & Move: all of the embedded videos use the pin and move technique.
• Antagonist contraction. One way to help tissue release is contract the opposing muscle. If my quads are tight fire the hamstrings (i.e. perform a hamstring curl). This can be done without movement, but movement can help create glide between the myofascia and the muscle.
• Span the muscle.  this involves rotation in the opposite of the muscle fiber. Think of like this. Whatever movement you perform in the gym to train that muscle is move in the direction of the muscle. Perform the perpendicular direction while rotating the limb.
• Cross friction. Performed in the same direction of spanning but with a shifting pressure. Feel like you are pulling the tissue side to side without rotation. Attempt to move the tissue as far side to side as possible. If you do this properly (which is a stretch ha ha), this is the best method for breaking scar tissue and myofascial adhesions.
• Pivots. Since undifferentiated fibroblasts (beginning of adhesions) glue to other material in every possible direction and muscles have proprioceptors capable of sensing movement in all directions, it's essential to add a rotating friction motion. Think of this movement like this placing an orange on a fresh juice compressor and twisting. Or cross friction but with added rotation.
• Here's a video link showing all these techniques with the calves.
 
3. Step 3. Details:
• How long? Hold the compression for a minimum of 30 sec but upwards of 90 sec while performing any and all of the techniques below.
• How often? I generally recommend the following:
• Everything should get covered 1x (good & symmetrical mobility) -3x (poor & asymmetrical mobility) per week. That can be broken down as follows
• Pre workout: 1-2x per week for dominant muscles being worked using pin and move techniques
• Post workout: 1-2x for dominant muscles worked that day
• 1x per week stand alone recover and regeneration day. Maybe in combination with a low intensity yoga class.

Takeaways:

1. SMR is a difference maker
2. SMR is only 1 tool in the toolbox. But, think of it as a hammer Vs a sledgehammer. Don't be the idiot who doesn't own a hammer :) 
3. It's debatable as to why it works. What isn't debatable, is that it has numerous positive effects.
4. Other techniques are equally beneficial, maybe more so depending on the job. A hammer could work, but sometimes a rubber mallet or sledgehammer might the better choice for the job.
5. Regardless of how the positive outcome was achieved (i.e. activating the nervous system, increasing blood flow, removing trigger points or breaking myofascial adhesions), it's clear that myofascial release techniques impact mobility and functional movement.
6. They can be self administered, but best learned under the supervision of a trained & certified massage / trigger / SMR professional. SMR is contraindicated for some people & conditions including:

1. Excruciating pain or bruising isn't the end goal and should be avoided. This is the biggest mistake I see amongst trainers when using these tools. Use the traffic lights pressure - pain scale.
2. Rolling is most effective when employing both search and detroy methods.

References: from the Trigger Point Myofascial Compression Techniques: Principles & Practices Manual 2014

Chaitow L., DeLany J. (2008). Clinical Application of Neuromuscular Techniques: The Upper    Body Vol.1. Philadelphia: Elsevier.

Cook, G., Burton, L., & Hoogenboom, B. (2006). Pre-participation screening: The use of fundamental movements as an assessment of function—part 1. North American Journal of Sports Physical Therapy. 1(2). 62-72.

Knapp, Kali (2016). Self-care modalities: improved performance and decreased injury for female athletes. S & C Journal, 38(2), 70-78.

Diego, M., & Field, T. (2009). Moderate pressure massage elicits a parasympathetic nervous system response. International Journal of Neuroscience, 119(5), 630-638.

Healey, K.C., Hatfield, D.L., Blanpied, P., Dorfman, L.R., & Riebe, D. (2013). The effects of myofascial release with foam rolling on performance.  Journal of Strength and Conditioning Research, 28(1), 61-68.

MacDonald, G.Z., Penney, M.D.H., Mullaley, M.E., Cuconato, A.L., Drake, C.D.J., Behm, D.G., & Button, D.C. (2013). An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. Journal of Strength and Conditioning Research, 27(3), 812-821

Sullivan, K., Silvey, D., Button, D., & Behm, D. (2013). Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. International Journal of Sports Physical Therapy, 8(3), 228-236.

I look forward to receiving your feedback and hearing your own success SMR stories.

Chad Benson, MSc, CSCS, CPT
email: info@bcpti.ca
Website: +BCPTI
Instagram: @prepair2perform & @bcpti
Facebook: Chad: Activated71 & BCPTI: http://ow.ly/4mK7yR
inkedIN: Chad: http://ow.ly/4mK7QL  & BCPTI: http://ow.ly/4mK7fB

To Roll or Not to Roll: Overview

Everyday I see hundreds of people sprawling around the floor in agony, while searching for pain free mobility. So, either, we are a masochistic society or it works. Yet many fitness experts still propose that foam rolling doesn't work. The result: controversy & a lot of semi-informed opinions.

Let's be honest, if the benefits of foam rolling didn't outweigh the associated discomfort, people would never do it. But, how does it actually work? and what are the best ways to achieve these benefits? Clearly there are a lot of effective methods to improve mobility. Regardless of the specific methods & tools chosen, I definitely think an integrated approach to movement is most appropriate. However, Since it's a blog and not a PhD dissertation, I decided to evaluate the effectiveness of SMR  (self myofascial release / foam rolling) only. If I went down the rabbit hole of examining all the different foam rolling devices & the possible paths to improving mobility, this 2 part Blog will continue for 2 months.

Given the recent excitement around mobility and stability, the increasing use of SMR techniques amongst athletes & fitness goers, conflicting opinions, my recent attempts to create a mobility based course, being a certified SMR master instructor, and obtaining my most recent certification (RAD Mobility 1 - $50 Off Promo Code is cb), it is time to dig deeper. To that end, this blog will focus on current research, some of the best practices and my personal experiences.

Beyond the reasons above, I chose to write about SMR for several important reasons:

1. It's self-care corrective tool that nearly everyone can access and use safely. 
2. It's an instant mobility difference maker. When I show my nashFIT & BCPTI students www.bcpti.ca the SMR before and after reveals, they become super excited about mobility.
3. I asked myself the following questions. What is my philosophy of movement correction? What does the science of mobility & corrective exercise say? What have I seen over my 12+ years of correcting movement.
4. If you ask 12 mobility "experts", you can expect a minimum of 10 different opinions regarding what SMR does, when to use it, how to use it, what is the best tool for the job.
5. Most people are not aware of the most effective SMR methods.

What is SMR? The simplest definition is "poor man's massage".
Self-myofascial release (SMR) is a technique that uses a rolling tool (foam roller, ball or rolling stick) to relax overactive / irritable tissue (i.e. trigger points), turn on underactive muscles & maybe breakdown adhesions between the gliding surfaces of soft tissue. Regardless of the actual outcome, recent theories suggest that compression & pressure along with movement over top of the issued area can engage the nervous system to either relax an overactive, or turn-on underactive muscle & muscular chains. Since trigger points & myofascial adhesions can both make a muscle tight and weak, it's important to a.) determine and b.) use the most effective techniques for the specific issue. Therefore, SMR isn't as simple as rolling up and down a sore area or tight muscle, it's a system of systematic search and destroy.

Science of SMR

Research has clearly indicated that SMR & other massage related techniques have multiple benefits (see below). For additional resources refer to the references listed in the online RAD Mobility 1 certification, which can be purchased on-line or the references at the end of this blog. If you are interested in learning the:

1. Science of mobility & pain
2. Passive range of motion assessments
3. Cutting edge SMR techniques designed to help you work with clients and or individualize your own warm-up and recovery program, I'd highly recommend this course http://www.radroller.com/products/rad-mobility-level-1 . Readers of this Blog have access to a special discount code (see above).

Other potential benefits and reasons to SMR that I've experienced are:

1. The apply pressure & hold method. Reactive hyperemia = occlude blood flow through pressure. When the pressure is released a rush nutrient rich blood flows into the muscle. It's the same philosophy associated with voodoo flossing.
2. Reduced pain sensation. Compression techniques alone or in combination with either muscle shortening or lengthening procedures can lead to a significant reduction in perceived pain.
3. Weak muscles activate &become strong. The pin & move techniques listed below create what is referred to as a muscle spindle lengthening technique (Trigenics, Neurkinectic Assessment & Myoneural Treatment Procedure). The perceived stretch of the mechanoreceptor leads to CNS activation and temporary strengthening of the previously weak muscle.
4. Improved strength of distal muscles. Muscles in the same kinectic or myofascial chain are activated (turned on) as a result of stimulating tissue anywhere along that chain. For example rolling your big toe will nearly always turn on / strengthen a previously weak glute.
5. Improved mobility of distal muscles. When the plantar fascia on the bottom of the feet are rolled, significant increases in straight leg toe touch as well as sit and reach ROM occur. These results are not permanent but longer than static stretching. The ROM improvements last much longer when "dead zone" strengthening is included. These improvements in posterior fascial line mobility occur in absence of strength loss (Sullivan, 2013).

The current P2P Prepair2Perform) RSS Corrective Mobility Model / Process:
Over my years of detecting and correcting movement errors, I've learned & tried a lot of different corrective techniques. Regardless of the exact technique, I always use 1 lens...does it work & can I reintegrate the changes into a progression based training program? Recently, I've been heavily contemplating the structure of my P2P model. Below is a bird's eye overview of the P2P corrective mobility model. I also have an integrative corrective movement model but it's less appropriate for this content. Regardless of the system, SMR is an integral part of the P2P program.

Step 1. perform a functional movement assessment.
Step 2. Release / SMR all muscles believe to be tight / overactive
Step 3. Stretch the tight / overactive muscles
Step 4. Strengthen the opposing or antagonist muscles
Step 5. reassess the restricted movements.

In part 2 of this blog I will examine SMR via case study & show you some of the best ways to quickly overcome several common mobility related issues. I will post this next Tues at the 7pm Pacific time.

References: from the Trigger Point Myofascial Compression Techniques: Principles & Practices Manual 2014

Chaitow L., DeLany J. (2008). Clinical Application of Neuromuscular Techniques: The Upper    Body Vol.1. Philadelphia: Elsevier.

Cook, G., Burton, L., & Hoogenboom, B. (2006). Pre-participation screening: The use of fundamental movements as an assessment of function—part 1. North American Journal of Sports Physical Therapy. 1(2). 62-72.

Knapp, Kali (2016). Self-care modalities: improved performance and decreased injury for female athletes. S & C Journal, 38(2), 70-78.

Diego, M., & Field, T. (2009). Moderate pressure massage elicits a parasympathetic nervous system response. International Journal of Neuroscience, 119(5), 630-638.

Healey, K.C., Hatfield, D.L., Blanpied, P., Dorfman, L.R., & Riebe, D. (2013). The effects of myofascial release with foam rolling on performance.  Journal of Strength and Conditioning Research, 28(1), 61-68.

MacDonald, G.Z., Penney, M.D.H., Mullaley, M.E., Cuconato, A.L., Drake, C.D.J., Behm, D.G., & Button, D.C. (2013). An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. Journal of Strength and Conditioning Research, 27(3), 812-821

Sullivan, K., Silvey, D., Button, D., & Behm, D. (2013). Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. International Journal of Sports Physical Therapy, 8(3), 228-236.

I look forward to receiving your feedback and hearing your own success SMR stories.

Chad Benson, MSc, CSCS, CPT
email: info@bcpti.ca
Website: +BCPTI
Instagram: @prepair2perform & @bcpti
Facebook: Chad: Activated71 & BCPTI: http://ow.ly/4mK7yR
inkedIN: Chad: http://ow.ly/4mK7QL  & BCPTI: http://ow.ly/4mK7fB

Battle Rope & Burn

Battle ropes are becoming hugely popular amongst fitness goers and athletes alike. From visuals of Sidney Crosby & Steven Stamkos in big brand fitness commercials, to aging adults, the trend is real & best of all, battle rope training is scientifically supported.

Much of the information linked into headers 1-3 came directly from a recent NSCA Personal Training Quarterly article. I am big proponent of getting the most work out of the least amount of time. To that end, follow the information, workouts & tips below.


Fullbody integration increases metabolic demand and coordination requirements. When clients have been assessed and progressed properly, go ahead and add lower body movements to the
whip, throw & crank. 

The benefits of HITT training are well known and not worth repeating at this time. But one, essential pre-training caveat is required. Never train at high intensity if you:

1. Are new to fitness
2. Have a personal or family history of cardiorespiratory incident
3. Haven't received a submaximal or maximal cardiorespiratory fitness assessment from a certified professional or personal trainer

And remember,

• Low intensity, steady state & long, moderate intensity intervals are the foundations for HITT.
• Have a trainer perform a submaximal cardio assessment in order to ensure you are working at the appropriate level. These assessments are used to create safe, highly individualize training programs.

1. INVOLVE AS MANY MUSCLES AS POSSIBLE

"The metabolic cost of a given exercise relates directly to the amount of muscle worked (3)."

Battle ropes are upper dominant but simply adding a deep squat or lunge hold can add additional cardio challenge and metabolic demand.

2 arms are better than 1. "Although both single- and double- arm exercises can be very effective for increasing the metabolic demand of a workout, double-arm exercises may be more effective." Additionally, the higher the intensity of the exercise (rip - rolling - tidal), the greater the metabolic impact.

2. USE SHORTER REST PERIODS

"The cardiovascular and metabolic effects that battling rope exercises create are increased by using one-minute rest intervals for every 30sec of work compared to two minutes of rest (7)."

The 1 work: 2rest work:rest interval has been shown to increase fat burning during HITT based training. However, upper muscles can be resting when lower body muscles are being worked. See point 5 in the bullets below. Therefore a work:rest ratio of 1:1 or 1:0.5 can be used when working this way. That means, you can perform 60sec of exercise & 30 sec recovery Vs working 30sec and resting 60sec. More importantly, you will receive most of the same benefits while shortening the duration of your workout.

3. USE SUPRAMAXIMAL INTERVALS - SMIT
The greater the intensity, the longer the EPOC / calorie after burn. SMIT goes above HITT training, which is performed at 100% of VO2max. SMIT involves interspersing maximal-intensity bursts of physical activity intervals performed at more than 100% VO2max with the same rest interval. How can someone go above 100%? It isn't for the faint of heart, but 100% of V02 is usually 90-95% of max HR. So SMIT equals HR's above that. Unless you are SUPERRRRR fit stay clear of SMIT; you will achieve great benefits for HITT.

4. MY INTEGRATED BATTLE ROPE APPROACH

When performing battle rope exercises, always choose a athletic stance with a strong upright posture as your base. Be certain to keep your shoulders down and back (i.e. avoid up and down shoulder movements) while whipping, throwing & cranking.

The research has shown that interval based training at higher HR's create the multiple health, performance and fitness benefits. But, again it's essential to receive a cardiovascular assessment before performing any for of high intensity cardiovascular training. At the British Columbia Personal Training Institute all instructors learn submaximal cardio tests that can easily be performed before embarking on your HITT / SMIT journey. I've previously outlined interval based cardiovascular training programs for various client fitness levels. Here are my specific suggestions for integrating battle ropes into your training program:

1. Think Ripple (low), Rolling (med), Tidal (high) for different levels of intensity.
2. Add speed of movement for greater intensity. It's simple perform more reps than you did previously but in the same amount of time. Or same reps in a shorter period of time.
3. Add another movement like squat, lunge, side shuffle, jumps or fast feet for added challenge and intensity.
4. Use ropes as a finisher during upper body weight training
1. When you are done pumping iron and you drive a little extra swell and condition your heart simultaneously, choose 2-4 movements (1 Whip, 1 Crank, 1 Chop / Slam).
2. Perform each movement for 30-40 double (harder) or single arm (easier) or 15sec per arm single / 20 sec / movement if double.
3. Active recover with leg or arm swings for 1 min to 90 sec
4. REPEAT 2-4X
5. Use a mini integrated circuit including (x # of reps per movement or 20sec / movement w 30 sec rest). Since different muscles are being used you need less rest to perform this style of circuit. Try the following:
1. Upper Dominant = Battle Rope, Boxing
2. Lower Dominant = Speed Ladder, Step / Plyo Box or Micro Hurdles
3. Fullbody = Sandbell, Multijoint Resistance Training, Kettlebell, Bulgarian Bag, Medicine Balls, ViPR etc.
4. Here are 3 samples:
Don't like being inside during the summer, all you need is a line, skipping rope, bench or stairs and your own rope.




Start with easier movements, lower velocities, less complex movement patterns, lower wave intensity and more rest. When you are ready (i.e. HR / breathing rate recovery improves / happens more quickly between sets) progress each of these elements.

If you have never tried battle rope training, and want to experience it in an integrated format, I have a simple solution. I helped create a group exercise format called Powerwave for Steve Nash Fitness Clubs. It's currently being offered at numerous facilities around the lower mainland. Drop in and tell them the Director of Fitness Education sent you. Enjoy the battle.

REFERENCES
Tumminello, N. (2016). Utlilizing battling rope exercicse for HITT and SMIT. Personal Training Quarterly. MARCH 2016  |  Vol. 3 - Issue 1.
 

Ratamess, NA, Smith, CR, Beller, NA, Kang, J, Faigenbaum, AD, and Bush, JA. The effects of rest interval length on acute battling rope exercise metabolism. The Journal of Strength & Conditioning Research 29(9), 2375-2387, 2015.
 

Chad Benson, MSc, CSCS, CPT

email: info@bcpti.ca
Website: www.bcpti.ca
Instagram: @prepair2perform & @bcpti  
Facebook: Chad: Activated71 & BCPTI: http://ow.ly/4mK7yR
LinkedIN: Chad: http://ow.ly/4mK7QL  & BCPTI: http://ow.ly/4mK7fB

www.bcpti.ca

The Foundations for Loaded Movement & Fascial Training: Active Mobility & Stability

Flexibility / mobility training is growing trend in the fitness industry. However, during the implementation process, the basic fundamentals of movement, like fascia, pain & flexibility science, assessment and biomechanics are often neglected, misunderstood or mismanaged. Therefore I was inspired to revisit the concept of mobility, especially as it relates to flexibility & stability. As important as flexibility / mobility training is to my own training, I also train these movement qualities knowing that  “mobility is best gained and then maintained when accompanied by joint stability & fascial integration”. Mobility is an active process that engages the movement portions of the brain in such a way as to help improve elasticity & stimulate permanent active range of motion changes.  In addition to freedom of movement, many muscles must contract simultaneously to create stiffness or stability around a joint.  When this occurs maximal strength, power and flexibility can occur in an environment where the risk of injury is decreased rather than increased.

“mobility is best gained and then maintained when accompanied by joint stability & fascial integration”

Mobility is best expressed as the ability use the entire available range of motion (ROM) without pain or restriction. Those who have mobility can also do so with strength and elasticity throughout the entire range of motion (ROM). We often refer to this form of complete mobility as loaded movement, a term coined by Michol Dalcourt. Above is a warm-up, using rhythmic movements that demonstrate how I Prepair the body for loaded movement training. Below is a great link to some of my favorite overall slow mobility exercises. These are usually performed by those who have significant movement impairment and muscle imbalance.
http://www.bcpti.ca/6-min-full-body-mobility-flexibility-sequence-nearly-everyone-can-2/

Loaded Foundations: mobility & stability
If loaded movement training is the ultimate outcome of mobility based training, what's the best path to achieve this elusive ability. In this blog, we are only going to discuss the foundations of loaded movement and save the final pieces of the movement puzzle for part b. At different points during my fitness career I've either focused more on stability or mobility, believing each was the greatest movement impairment solution my clients required at that time.  Through these experiences and continued learning, I've come to realize it's a constant juxtaposition between the two; requiring both at all times.  At the saying goes, there's no point robbing from Peter to pay Paul.  In that sense when joint instability is perceived, the central nervous system signals & creates events to restrict range of motion.  The two most commonly acknowledged ways to restrict range of motion are trigger points and pain.  Therefore adding range of motion without motor control (i.e. flexibility) via movement coordination & strength can be equated to opening Pandora's box.  The following is 6 tips to improve fundamental mobility but avoid the pitfalls of passive flexibility.

 

Foam roll / Self-Myofascial Release. The recent body of research in this area is clear. Increased blood flow, improved No2 delivery, increased ROM without a loss of strength, power or endurance & reduced risk of acute muscle strain are a few of the proven outcomes of foam rolling. Take a look at the recent flexibility research from two of the most current  mobility certifications available on the market.

 

Active not Passive stretching leads to a permanent change in mobility.  Passive mobility improves range of motion but does so through inhibition of the nervous system. Inhibition likely creates a "dead zone" at the newly achieved ranges and to a lesser degree throughout the entire range of motion (i.e. desensitization of mechanorecptors). A dead zone = a lack of motor control, strength & therefore stability in that range.  The inhibitory & dead zone affects likely explain recent research showing that static/passive flexibility decreases performance and potentially increases the risk of injury.

Active not Passive stretching improves stability. 

When a new range of motion is established motor control within that range requires eccentric concentric and isometric force inputs / training.  Without movement training, coordination & joint stability are compromised, thus preventing joint stability during high velocity, increased load, fatigue or reactive situations.

Active not Passive stretching improves your injury resistance.  Training in a proprioceptively nourished environment is required to improve joint stability.  When a muscle has not been used within a range of motion for a prolonged period of time innervation / activation is reduced to that area.  Due to instability and for the reasons outlined above this increases rather than decreases the risk of injury.
 

Posture Matters:  Sadly, the vast majority of the human population has some form of postural distortion which directly impacts their ability to perform in fitness, life and sport.

1. The spine houses the peripheral nerves which relay info from the brain

2. the spine & it's posture are essential components towards arm and leg strength.
3. Instability is perceived as a threat and occurs when proprioception is altered (shortened & lengthened muscles). 
4. Poor posture is a major reason why said proprioception is altered.
Result: the central nervous system decreases signaling to the peripheral nervous system which in turn decreases strength to the arms and legs.

Level the Pelvis: One of the more interesting tidbits I've learned over my career in regards to creating postural symmetry (i.e. level pelvis) in the lumbo-pelvic hip complex. Leveling the pelvis improves mobility of the joints in the arms and legs. From that realization I was inspired to make this video of 6 exercises designed to stabilize and level the pelvis three-dimensionally. If I were to add anything to this program, it would be the Gray Cook Hip Lift (https://youtu.be/s4I9F9rIqwM?list=PL699322D32F4B5DDE ) which is a one footed bridge. Each of these exercises is commonly part of my dynamic warm-up I perform prior to most functional and/or athletic training. The more of these movements I perform (see Core Activation Video below), especially with proper alignment, deep core stabilization (i.e. drawing in & core bracing), the less likely I am to feel nagging pain or sustain an injury during high intensity workouts. Mobility over stability is the reason I and most of my client's have been & remain injury free while continuing my unconventional, athletic style workouts.

Regarding flexibility, it's my opinion that most flexibility programs fail to create permanent change. Beyond the tips listed above, you can also read another blog I recently wrote. http://www.bcpti.ca/mobility-stability/ . When the CNS recognizes either a) instability b) a "dead zone" c) poor movement coordination d) strength it restricts motion of some muscles and down regulates activation of others. Interestingly, when you stretch a tight muscle, especially if there is an underlying joint instablity, the CNS can be temporarily tricked towards increased flexibility. However, and beyond the Pandora's Box discussed below, once the temporary desensitization of mechanoreceptors wears off, the CNS quickly recognizes the true instability issue hasn't been resolved. To prevent serious ligament & tendinous type injury, The CNS then signals a cascade of events to create movement restriction via preventive road blocks. Each of the following "road blocks" can restrict movement & force generation to the effected muscle & myofascial chain.

1. Pain
2. Myofascial adhesion
3. Trigger point

In this sense, stretching without myofascial release & stability leads to a temporary flexibility change.

Take for an example a client with a winging scapula. The picture on the R is an assessment of internal shoulder rotation and extension (i.e. reach under).

1. Pic 1 = myofascial release
2. Pic 2 = popular mobilization technique in combination with a traditional internal rotation movement /passive stretch 
3. Pic 3 = common shoulder stability exercise for a weak muscle the serratus anterior.

 

The question isn't which technique to use, the question is what amount of each is required. If for the example the teres major, pecs & pec minor are overactive and have road blocks (i.e. adhesion or TP), it must be resolved 1st, then apply 2-3 with the appropriate amount to create the greatest change.

1. self-myofascial release
2. apply assisted mobility
3. strengthen the underactive serratus anterior

 

When it comes to flexibility Vs mobility, be careful of Pandora's box. If you stretchor inhibit tight muscles before a workout it may temporarily turn-down the mechanoreception & the central nervous system protective mechanism of tightness. It’s temporary, but stretching alone can disable the key mechanism (muscle tightness) needed for stability over an unstable joint. Therefore, increased range of motion via stretching alone may cause injury due to instability. This is especially true of stretching prior to athletic events and functional training (i.e highly unpredictable training environments). Therefore ,step 3 above is essential to the success of improved mobility. Similarly stretching without strengthening the new ROM creates a "dead zone", and negative, albeit temporary outcomes. To resolve this, Active Mobility seems to be the logical approach. Here is a 6 step process to progressively improve proprioception, strength & coordination within a "dead zone".

1. Apply vibration to the entire system or the specific muscle
2. Stimulate the nerve spinal root using oscillatory self rolling or massage
3. Progressively achieve improved ROM with contract relax cycles (i.e. PNF)
4. Progressively overload all especially eccentric strength at the new end ROM
5. Progressively overload ballistic stretch via stretch shortening activities
6. Integrate the new ROM back into sport life and fitness

Numerous resources and courses on this are available to help you learn techniques to execute against the 6 steps above.

1. https://cdn.preterhuman.net/texts/body_and_health/Pavel%20Tsatsouline%20-%20Relax%20into%20Stretch%20(2001).pdf - achieving a new end range of motion with contract relax cycles
2. www.functionalrangeconditioning.com - strengthening at end range of motion
3. http://www.dragondoor.com/dv023/ - adding stretch shortening cycle & spring back via fascial integration at end range of motion

 

Regardless of the case presented thus far, it doesn't mean that passive flexibility training is unimportant, rather it means that flexibility without stability is dangerous. Without nervous system integration, the outcome of improved ROM is usually lost within 30 min - a few hours of completing the stretching protocol. The movements in the accompanying videos were generally created around the concept of mobility over top of stability. Although it's beyond the scope of this article, step 1 in this process of mobility is always a functional movement assessment & corrective flexibility. To that end, an assessment is performed and asymmetrical fascial release, activation & movement patterns performed to create reasonable symmetry before applying any of the active mobility exercises shown in any of the links within this document. When correctly applied, asymmetrical movements will help remove spinal & lumbo-pelvic hip complex instabilities. The goal is symmetry of the supporting structures before attempting improvements in flexibility and therefore creating mobility improvements that last. Here are a couple of mobility rules to keep in mind the next time you stretch:

1. Remove muscle asymmetries first. I prefer a symmetrically tight person over a bendy asymmetric one. If the L quad is tighter than the R, stretch the L 2x as much.
2. When performing a stretch focus on stabilizing nearby joints. For ex. during the Dead Bug, keep the spine neutral (no change in any portion of the spinal posture) but allow the legs and arms to move freely away from each other. The same applies for the Bird Dog.
3. Avoid static stretches prior to functional, high intensity, high velocity training (i.e. Pandora’s Box). If static / passive mobility is used, some form of dynamic warm-up is required prior to activity. Ideally save the static stretches for the post workout bendiness.
4. Flexibility is analogous to an iceberg - there is so much more going on underneath the surface. Once you have achieved the desired flexibility, add progressive strength to the newly created range of motion.

Good luck, have fun, and remember exercises are only as effective as a person performing them. I always recommend that fitness goers seek professional assistance when performing finely detailed movements, especially if they have been suffering from long-term pain. In part b, we will learn how to take out newly created mobility and add load (i.e. loaded / fascial movement training).


Chad Benson, MSc, CSCS, CPT
email: info@bcpti.ca
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