It’s been a looong time since I’ve done one of these posts, and I’m going to try to make them more regular so you have some great exercises to try out and include in your strength and conditioning program. Today’s exercise is what I like to call the Supine Triple Flexion Pallof Press w/diaphragmatic breathing. It’s a mouthful, I know, but keep reading!
Guess what I am?
I first saw the Supine Triple Flexion Pallof Press done by Dr. Perry Nickelston, a very bright chiropractor out of New Jersey. After some thinking, I realized that this exercise is not only an excellent beginning variation of the Pallof Press, but also a nice place to start integrating low-level core stability and proper breathing patterns. Once your client or athlete has learned how to properly use their diaphragm while breathing in various unloaded positions, this would be a logical next step to begin integrating some core stability with diaphragmatic breathing.
The diaphragm
Take a look below as DSC coach Matt Skeffington demonstrates the exercise:
Key Points:
Begin on your back in a neutral spine position. Your head, scapulae, and sacrum should be in contact with the floor, with your neck packed and chest proud.
Assume a “triple flexion” position with your hips and knees flexed at 90 degrees, and your ankles dorsiflexed (essentially the 3.5 month position).
Brace your core and keep your ribcage down (think about pushing it down and to the sides).
Maintaining this position, grasp a D-handle attached to a cable or band just below chest level, and press straight out, with the goal being to completely lock out your elbows and not allow any rotation.
Once you are in the top position, while keeping your core braced and ribcage down, take a big breath in through your nose, focusing on 360 degree expansion (sometimes it helps to think about breathing into your back), then slowly exhale through pursed lips, getting all of your air out.
Return to the starting position, briefly reset, and repeat for 2-3 sets of 5-8 repetitions on each side.
A good cue (courtesy of physical therapist Mike Reinold) to use with your clients when teaching this exercise is “Neutral, Brace, Breathe.” This reminds them to find neutral spine, keep their core braced, and to use proper breathing patterns during the exercise.
Once you’ve mastered this version, begin incorporating iso holds where you hold the top position for a given number of breaths.
A regression for this exercise would simply be to have your client place their feet on the floor.
Try this one out on yourself and with your clients and let me know what you think!
I think there needs to be a paradigm shift in gyms across America. For the general fitness population, we need to ask these questions a lot less:
“How much ya bench?”
“How long did you do the treadmill/stepmill/elliptical?”
“How many burpees can you do in 10 minutes?”
Instead, we should be asking this question a lot more:
“How well do you move?”
Hopefully you move better than the Beverly Hills Ninja
Instilling and optimizing proper movement should be the number one priority of any training program. No matter what your goals are, your progress and achievement will be limited by your movement. Whether you are a powerlifter, triathlete, or stay-at-home mom, you will not be as strong, as fast, or as good at performing everyday activities if you cannot display basic, fundamental movements.
Dynamic coach Matt Skeffington may have said it best in his Facebook status last week:
Quality movement rules all. Want to improve your strength, fitness, speed, body comp, etc? Start by moving better!
So what comprises “good movement” and how do you move better? Those are loaded questions and the answers can be highly individual, but with the general population, I think there are a few principles that are important to take into consideration.
A good place to start is with a few points from Mike Reinold’s “Reverse Posturing” theory:
Lengthen shortened muscles
Release postural trigger points
Inhibit overactive muscle groups
Activate inhibited muscle groups
Strengthen synergistic force couples
Normalize proper joint biomechanics and arthrokinematics of the joint and other joints within the “chain reaction”
Then combine that with Dan John’s 5 basic human movements:
Push
Pull
Squat
Hinge
Loaded Carry
That’s a pretty good foundation right there. Collectively, these principles will lead to better posture, more ideal joint centration, and an increased ability to take joints through a full range of motion. Furthermore, they will allow you to move better and perform the fundamental movements that are essential in sport and in life. Most important of all, you will feel better and be less likely to get injured.
A great way to institute all of this within the context of your strength and conditioning program is by including “movement days.” Movement days are best placed in between your strength training sessions and one or two a week will suffice. If you train Monday, Wednesday, Friday, depending on your schedule, you could put a couple movement days in on Tuesday and Thursday. Not only do these days give you a chance to prioritize and practice good movement (which you should be doing during all of your training sessions anyway), but they are a great way to promote blood flow to your muscles and enhance recovery.
The point of these sessions is not to go “all-out.” However, that doesn’t mean you get to take 5 minutes between sets. These workouts should be relatively short with appropriate rest periods, and be sure to go “nice and easy” throughout. To give you an idea of what one of these sessions might look like, here are a couple sample movement days for the general fitness client.
After foam rolling and a dynamic warm-up, perform the following workout:
Sample Movement Day #1
A1) TRX Inverted Row – 3×8
A2) Yoga Plex – 3×5/side
B1) Kettlebell Swing – 3×10
B2) Split-stance PVC Pec Mobilization – 3×8/side
C1) Band Pallof Press – 3×10/side
C2) Squat-to-Stand w/overhead reach – 3×5/side
D) Sled Push - 3×20 yards
Sample Movement Day #2
A1) TRX Y’s – 3×8
A2) Walking Spiderman w/hip lift and overhead reach – 3×5/side
B1) Dumbbell Goblet Squat – 3×10
B2) Modified Yoga Pushup – 3×6
C1) TRX Fallouts – 3×8
C2) Single-leg Hip Thrusts off bench – 3×10/side
D) Dumbbell Farmer Carry – 3×40 yards
What you choose to include in your movement days doesn’t necessarily have to be set in stone or planned in advance. It’s important that you take into consideration how you feel and let your body dictate what exactly will comprise your session on that given day. For example, simply foam rolling and going through a mobility circuit once or twice is a great idea. Running some hills at 60-70% intensity is awesome, too. The possibilities are endless, but make sure that your movement days always prioritize movement quality, address what you need (a.k.a. specifically what you need to improve), and that the intensity is kept relatively low(er).
Try instituting a movement day in between your regular training sessions throughout the week. If you do, and follow some of the guidelines I’ve outlined above, I’m confident that you’ll move better, feel better, and be more successful in achieving your goals.
Recently in the gym, I’ve seen a case of Vladimir Janda’s Lower-Crossed Syndrome (Type A). In today’s blog, I’m going to briefly discuss LCS, tell you what it’s all about, and share with you some thoughts on how to go about correcting it. So, here we go!
Lower-Crossed Syndrome is a specific pattern of lower body muscle tightness and weakness that cross between the dorsal (back) and ventral (front) sides of the body. LCS is characterized by tightness of the thoracolumbar extensors which crosses with tightness of the iliopsoas and rectus femoris (two of the hip flexors). It is also characterized by weakness of the abdominals (particularly the deep abdominal muscles) which crosses with weakness of the gluteus maximus and medius.
Janda classified the thoracolumbar paraspinals, iliopsoas, and rectus femoris as tonic muscles, which are prone to tightness. He classified the rectus abdominis, transverse abdominis, gluteus maximus, and gluteus medius as phasic muscles, which are prone to weakness. There are also certain postural changes that are consistent with Lower-Crossed Syndrome. Two of the most prevalent ones, which I’ve seen in the case in question, are an anterior pelvic tilt and an increased lumbar lordosis. So where do we go from here, you might ask? Well, below are just some thoughts off the top of my head on where to begin when addressing Lower-Crossed Syndrome.
1. Tissue Quality!
I included the exclamation point because I can’t stress this enough. We need to get some length out of the hip flexors and thoracolumbar extensors. This starts with some dedicated SMR (self-myofascial release), or foam rolling. Of course, be sure to concentrate on the rectus femoris and the thoracolumbar region, but do not neglect other areas of the body. For example, while foam rolling your legs, get the TFL/IT band, adductors, glutes, hamstrings, and calves/peroneals. While foam rolling your back, spend some time on the upper, middle, and lower traps as well as the lats. Hit the posterior rotator cuff and pectorals while you’re at it. Our body is essentially a linked chain, so when an issue arises in one part of the chain, it is important not to forget about the surrounding areas, as that is where the true source of the problem may be.
Feel free to make a tennis or lacrosse ball your friend, too. These are great for digging into certain parts of the body. A personal favorite of mine is to use a lacrosse ball on the rectus femoris. While rolling out this muscle, pause when you feel a trigger point, and flex your knee with the ball applying direct pressure to the spot. This hurts like hell, but it works like a charm in breaking up nasty adhesions.
To further promote length in the hip flexors, include plenty of hip flexor mobilizations in your dynamic warm-up. Wall hip flexor mobilizations, as seen below, are an excellent choice, and I’d also recommend lunging variations.
A couple of my favorites are reverse lunges with posterolateral reach and walking spiderman lunges, but your basic forward lunges will suffice as well.
Also, even though there may be some debate questioning its overall effectiveness, I still believe in static stretching. Take the time after a training session to stretch your hip flexors. My favorite stretch is shown below by my co-worker Josh. With this stretch, make sure your chest is up tall and your spine is in neutral. Squeeze your hamstrings and glute hard, and hang out here for 30 seconds to a minute on each leg before repeating. To enhance the stretch, rotate towards your forward leg. To enhance it even further, rotate and reach posterolaterally (back and to the side). Always focus on rotating through your chest.
Lastly, find a good manual therapist, preferably one who practices ART (Active Release Technique) or Graston. It’s a step above SMR and will benefit you even more. I’ve been seeing an ART practitioner every week for a couple of months now and it has certainly made a difference in how I feel and move, which has positively affected my training in the gym.
2. Anterior Core Progressions
The anterior core needs plenty of attention and strengthening. The true function of the core is to stabilize the spine, so we will train the anterior core with stability in mind. A good place to start is with low-level strengthening exercises, such as front planks against a wall. I like the front plank against the wall because it allows the individual to find neutral spine without a huge challenge to the core. However, you may find that these are actually harder than they look! Stick with holds of 8-10 seconds for the appropriate number of repetitions. To add difficulty, perform one-arm holds or “march” your arms by retracting and protracting the scapula. Once the plank against the wall has been mastered, progress to a plank with arms on a table, and then to a plank from the floor.
From there, consider advancing to stability ball rollouts and TRX fallouts.
3. Glute Activation and Hip Hinging/Hip Thrust Progressions
In addition to the anterior core, the glutes need to be woken up and strengthened. One of the primary roles of the gluteus maximus is hip extension and a great place to start is with the tall-kneeling hip thrust. I like the tall-kneeling hip thrust because it makes it easier for the trainee to separate hip extension from lumbar extension. Let the individual master the tall-kneeling hip thrust and really feel the glutes working before moving on to supine hip thrust variations. Below, Mike Reinold shows the tall-kneeling hip thrust utilizing a dowel rod and tubing. I would start with just bodyweight and then progress to this version.
Notice the position of Mike’s feet in the video: they are together, with his feet about shoulder width apart. This is a very advantageous position for people with LCS, as it “slackens” the hip flexors and allows for more hip extension and a better glute squeeze at the top of the movement. Progress to bilateral and unilateral supine hip thrust variations after proper technique and glute firing has been achieved in the tall-kneeling hip thrust.
To hit more of the glute medius, toss in some hip abduction movements, such as mini-band walks and x-band walks.
4. Proper Coaching and Cuing
Those demonstrating LCS will need a healthy amount of coaching and cuing. Coaches must make sure that these clients are using correct technique at all times, especially during exercises aimed at activating and strengthening the anterior core and glutes. LCS clients are highly susceptible to compensating during these movements, so be certain that the exercises they are performing are consistent with their current level of ability. With their permission, be hands-on and ensure that they’re activating the targeted muscles.
Assist your client in finding neutral pelvis and neutral spine, especially during core exercises. A great cue I learned from Mike Reinold is, “Neutral, brace, breathe.” Find neutral pelvis/spine, brace the core musculature, and breathe. Remember, those with LCS have been stuck in this posture for a considerable amount of time; it is going to take tons of coaching, cuing, poking, and prodding to reverse it, which leads me to my final point…
5. Commitment
Coaches and clients should understand that, like most training and rehabilitation, correcting LCS requires time and effort. As a client, it is going to demand some changes in your training and possibly your lifestyle. For instance, are you a runner who constantly hangs out in anterior pelvic tilt? It may be worth your while to consider limiting your miles for a while during your off-season and focusing on correcting your LCS. Know that you will be starting your corrective regimen with repetitions of very basic exercises. You must master these exercises before your coach or therapist will consider giving you slightly more advanced movements. Foam rolling, manual therapy, stretching, and mobility will also be a regular part of your routine. If you buy into these modalities and your prescribed program, then you will ultimately reap the benefits of improved muscle balance and posture.
By no means is this an exhaustive list, but hopefully you’ve learned something about LCS and how to go about treating and addressing it.
