Brian Schiff’s Blog

Throughout my speaking and training, I advocate single leg strengthening.  Additionally, I try to incorporate balance and stability training progressions that target common muscle imbalances and reduce injury risk.

It is common knowledge that the hip can often affect the knee.  Likewise, the foot and ankle complex can also impact the knee.  Single leg training often exposes and corrects limb deficiencies and simulataneously improves function and performance.

I have been producing a TRX functionally fit mini-series for PFP magazine.  The first two editions focus on single leg suspension reaching progressions.  I thought I would share those with you as there may be portions you can apply to your own training or to others.

I use these progressions with runners, court and field athletes, and general clients alike.  They work the entire kinetic chain and emphasize anti-gravity control in multiple planes.  These progressions can be part of an advanced rehab regimen or fitness program.  Below is a picture of the phase one sagittal plane reach:

To see the entire progression (part 1), check out my column by clicking on the image below. 

I just recently returned from speaking at the AFPA Fitness Conference in Ocean City, MD.  I gave four different talks but invariably I always end up educating fitness pros on exercise selection, modification, and progression based upon individual client response.

It is so easy in the health and fitness industry to use set protocols or schemes we are comfortable with across the board even when we know clients are unique.  I have seen enough pathologic knees, shoulders, etc. over the years to know that everyone’s body reacts in its own unique way to exercise.

The primary tool we need to use to understand where a person’s body is in terms of inflammation and healing is pain.  We need to educate our clients to be forthright about ongoing pain before, during and after sessions.  So, what causes pain?  Often it stems from inflammation.

I told the trainers this past weekend that cryotherapy will do wonders for many conditions.  In fact, I see many discontinue ice after the first 2-3 days.  This is a BIG mistake in my opinion.  Who ever said ice will not help sub-acute or even chronic inflammation for that matter?  I am adamant that clients ice in the presence of pain.

Pain is a marker and evaluative tool we need to embrace to better tweak rehab and exercise progressions.  Cryotherapy is crucial in reducing persistent inflammation.  I particularly like to use it immediately following workouts to reduce any new post-exercise soreness and inflammation that may creep up with higher volumes and intensities in the session.

Today, I wanted to share two of my favorite cryotherapy resources with you.  You see, I want my clients to be proactive and vigilant with their own personal rehab and wellness programming.  That often necessitates that they purchase tools to use at home.  This way they are ready when unexpected pain or inflammation strikes.

My preferred solutions are:

• Biofreeze– a topical ointment or spray that helps reduce pain from aches/strains and joint pain.   My personal massage therapist uses it and I find relief in my neck with it after each session.  I carry this in my OpenSky store because it is effective.  You can see more by clicking on the image below:

• Custom fit cold compression wrapsfrom Cold One – I personally own the shoulder, low back and knee wraps.  These conform to your body and velcro down so you don’t have to hold them on or worry about them not hitting the right area.  Click the image below for more info.  You can even save 10% right now using the promo code BSCHIFF10.

I think you will find these resources useful in the recovery of musculo-skeletal pain and inflammation.  While heat may be used and feels good, I prefer cold therapy to reduce pain and inflammation.

It is no secret that Americans are trying to stay more active well into their baby boomer years and beyond.  The million dollar question is how will what you do today affect your joints down the road. 

Scholars, scientists and medical experts do not seem to agree 100% on what is too much, but most tend to agree that excessive running, obesity, irregular or unusually intense activity (think weekend warriors here), muscular weakness and even decreased flexibility may all contribute to arthritis.

The New York Times recently ran a story about the cost of total joint replacement and suggestions on how people can be proactive to reduce the risk and debilitating effects of arthritis.  Click here to read the article.

I think one of the most amusing yet ironic things about science is that it often contradicts itself.  Obviously, we know being overweight increases stress on the load bearing joints.  Most people would also knowingly acknowledge that improved strength and flexibility would make for healthier knees and hips. 

The big question mark for me is impact loading, or simply the argument of whether to run or not to run.  Some docs say no way.  Others say yes.  Yet others offer more ambiguous words on the subject.  So, what do I think?

I honestly believe there may be no absolute answer.  I am not convinced running on a treadmill is all that much better for you as some would suggest either.  My body tells me blacktop surfaces are better than cement sidewalks, while the soft earth is better yet still.  I use the treadmill in the winter and for speed work but if you run events too much treadmill work will let you down on race day as the body is ill prepared. 

Much like exercise prescription, I think joint loading and tolerance is a very individual matter indeed.  Biomechanics, posture, training history, medical history, repetitive movements, footwear, nutrition, body type, recovery, etc are just a few of the variables one must consider when passing judgment on exercise prescription and limits.

Beyond that, the best indication to reduce or remove an activity for a short bit or long term is obviously pain.  But before doing so, one must correctly identify the source of the pain.  At times, the pain may seem like a joint issue when in fact it could simply stem from poor muscle recruitment, lack of mobility or faulty movement patterns thereby subjecting joints to undue stress.

I say all this to say we must be careful in saying one should not do something definitively.  Some folks run well into their 80’s without issues.  Others break down after one endurance event.  In the end, we must face facts.  The human body is complex and no two people are exactly alike.  I had left hip pain years ago that felt like arthritis.  My orthopd told me the x-ray showed a few mild bone spurs and mild hip dysplasia. 

His advice?  Quit running.  I did for 6 months and the pain did not subside.  So, I began a progressive running program and changed up my strength training to more single leg based work.  Guess what?  My pain went away 100%.  This tells me the impact itself was not likely the cause of my pain, but more likely a muscle imbalance that I overcame through more efficient strength training.

We must look at science, anecdotal findings and clinical experience to pull out general patterns and thoughts all the while continuing to use assessment, feedback and results to lead us to the best conclusion for each client, patient or athlete.  You must use all this information to make the best decision for your situation as well.

So, I have made part of my living the past several years helping people overcome shoulder pain.  I often laugh when I hear people say “how hard can putting together an exercise program really be?  It’s not rocket science or anything.”  Well, maybe not, but getting it just right may mean the difference between a healthy shoulder and really hurting.

There is a new study soon to be released saying weight training injuries are on the rise (especially in males).  In fact, injuries are up 50% from the period between 1990 and 2007.  The majority of these injuries involved free weights.  Many of the upper body injuries I see almost always involve the rotator cuff and/or labrum.  Why?  There are some primary reasons such as:

1. Improper form
2. Poor or absent spotting
3. Exceedingly high loads in what I term the “high risk” soft tissue zones
4. Too much volume/frequency
5. Lack of posterior chain strength due to pressing dominance
6. Too little recovery
7. Pushing through pain

What most people fail to understand is that the high repetition associated with weightlifting coupled with unfavorable biomechanical stress through long lever arms leads to eventual mechanical breakdowns/failure.  The basic translation = fraying, degeneration, tendinitis, tendinosis and tears.

This pattern equates to lost time in the gym and in some cases surgery.  The ironic part is the damage is often done in the early lifting years but not seen or felt for a decade or two later.  This is why the young twenty somethings like to debate me on the modifications I suggest for bench presses and such.  Yet, read what one former power lifter recently emailed me below: 

Yes you can count me as another one of your satisfied customers.  I followed your 6 week injured series religiously and have recently moved on the your healthy shoulder series.

My main concern at this point is to avoid injuring the shoulder again and I will follow your advice on the 7 bonus exercises listed.  My background fits the profile mentioned in your manual – 46 years old, former power lifter, injured dominant shoulder doing barbell presses about 6 months ago.  I have been doing presses for over 30 years and unfortunately never read about the scapular plane.

The take home message is that modifying the load and adjusting the arc of movement with certain lifting exercises will indeed prevent common shoulder injuries and keep you in the gym for many years to come without the fear of a lifting injury.

While the hard core lifters and competitors may scoff at my application of the science and my suggestions now, they may also suddenly come to realize the potential consequences of their ways when a debilitating shoulder injury hits.  Am I saying full range of motion and heavy loads are absolutely forbidden?  No, but I do think you should ask yourself how often and for what purpose am I doing certain lifts in certain ranges of motion.

Additionally, I am saying that insufficient muscular balance coupled with repetitive load to near failure will over time result in acquired laxity, accelerated tendon degeneration and potential mechanical failure.  Gravity and friction are two forces that will tear a shoulder down over time with exercises such as pressing, flies, dips, upright rows, side raises and push-ups to name a few. 

So, the next time you feel a “twinge” in the shoulder with lifting, it may be time to consider backing off and making some changes in your routine as time and experience has taught me the rotator cuff and A-C joint will eventually say "enough is enough."  If you want more information on my exercise modifications, check out my shoulder book at www.rotatorcufftraining.com.

Wow!  It has been a busy two weeks for me.  I have been putting the final touches on a DVD and writing a ton of articles lately.  I just returned from speaking for Power Systems at a Total Training Seminar in Missouri in late March.  It is always interesting speaking and hearing other presenters.

There is usually no shortage of controversy and conflicting opinions either when it comes to fitness and training.  One speaker mentioned that it is perfectly okay to allow the knee to go over the toe with exercise.  In fact, this presenter said it was desirable to maximize training.   My talk (later on) was on bodyweight training for a healthier knee.

Naturally, I was asked what I thought about the earlier comment.  My answer was “it is complicated.”  I am not sure that is what the audience wanted me to say.  Pressed again later on, I acknowledged that in a repetitve training environment, lunging and squatting with the knee over the toe is not something I recommend.  However, if I am retraining a client to be able to descend stairs one foot over the other, the knee does in fact move beyond the toes.

So, there are times in life, where we need to think outside absolutes and adjust our thoughts and training to meet the needs of people at a current time and space so to speak.  The real trick is knowing the client, their medical condition, their needs and measuring the response from the body.  I hate protocols because no two people are the same, nor do their bodies heal and react the same way.

But, let’s get back to the knee.  I talked about assessing the knee and then integrating the “right exercises” to not only correct dysfunction but also to improve fitness and performance.  If you think body weight training is useless or for sissies, you may want to think again particularly if you like to run and have any issues with patellofemoral pain (most women do have PF pain or early arthritis).

Consider the research from the Journal of Orthopaedic and Sports Physical Therapy in 2003 where Powers et al. determined that PF joint forces are significantly  greater with external loading versus bodyweight only in flexion angles begining at 45 degrees during eccentric loading (lowering down while peaking at 90 degrees) and concentric loading (rising up) at 90 and 75 degrees.   What does this mean for you?

Essentially, if you are a runner and suffer from PF pain, you may want to limit deeper range of motion with squatting and/or consider limiting the amount of external loading as well.  Even better, you should be doing single leg training keeping this same information in mind.  Training is an exact science and most people get it wrong all the time.  That is why I am currently working on a Fit Knees DVD series to give trainers and consumers relevant and science based information to direct their training for optimal health and performance.

I just finished volume three in this series and it is ready for official release this Friday.  If you are a runner and want a blueprint to train for injury prevention and peak performance, this DVD is for you.  Or, if you are a runner who is currently injured or has been plagued by overuse injuries, it is still for you as I have a complete progressive rehab series on the DVD to get you back up and running again. 

As a runner myself, I have put these strategies to good use with much success.  I thought it was fitting to relase the DVD this week as I prepare to run my 4th half marathon in Charlotte this weekend.  Below you will see the product display. 

As a blog subscriber or reader, I am offering you $10 off the normal price of $34.95 through midnight Saturday.  Simply visit www.fitknees.com and use the copuon code BFITRUN (all caps) at checkout.  I am confident you will find it valuable as it covers training from A-Z with warm-up prep, foam rolling, balance training, strength and power exercises, rehab and stretching.  It is 65 minutes of power packed content.  Here’s to healthier knees and happy running!