exercise

Stability and Mobility

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Picture a runner on the track, an image of power ready to be released at every stride. If we were to snapshot them mid activity, we would see that:

  • The foot, as it contacts the ground, needs to provide a stable platform
  • The ankle, resting on the foot, requires dynamic mobility
  • The knee, for optimal power transfer, requires both mobility in the ankle below it and the hip above.
  • The hip, being a joint with a high potential range of motion, should be mobile enough to support the function of the knee below and the pelvis / lumbar spine above.
  • The pelvis and lumbar spine, one of the biggest force transfer areas in the body, needs a high amount of stability.
  • The thorax responds to load and stress by restricting, when a more fluid movement pattern would benefit
  • The scapula, floating over the potentially stiff thorax, becomes unstable as a compensation
  • The shoulder joint itself, due to posture and poor use, will be restricted
  • The lower cervical spine may become unstable as a response to the restriction in the thorax
  • Finally, and balanced on top of the stack, the head and upper cervical spine stiffens.

Looking at the above list (initially drawn from the work of Gray Cook) it is possible to see why, if one area is not functioning as optimally as we might like, the areas around it will adapt their own function to compensate, which can eventually lead to the risk of injury.

As athletes and professional practitioners, we can help reduce this risk by reversing the process with a well considered mobility and strength training plan, allowing us help the areas that don’t move and should, as well as strengthening the unstable zones.

From a practical perspective, it is generally faster and more effective to get a restricted area moving successfully, since it tends to respond more positively, as well as naturally allow the unstable areas to relearn their correct function,

It can therefore be recommended that we focus on:

  • The ankle, using ankle circles, calf stretching and getting any old twists or sprains reset
  • The hip, by stretching the glutes, lengthening the hip flexors and ensuring the joint is well aligned
  • The thorax, needs three dimensions of movement, flexion, sidebending and rotation
  • The shoulder, the most inherently unstable joint in the body, often needs professional assessment to ensure it is not guarding a hidden injury to the joint, and can be helped by improving the function of the internal and external rotation most effectively

By improving the range of motion in these, we can support dynamic development in the rest of the body automatically.

Running it off does not work

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Each week, we see a number of runners and increasingly gym based athletes, who have had an injury for a while and have tried to train through it.

This never works for a number of simple reasons:

  • Unless it was a non traumatic injury, it will have happened due to a chronic issue somewhere, which needs to be addressed before the problem resolves fully
  • If it was traumatic, there will be a knock on effect, which can get worse if you attempt to train through in any way that loads the injured area
  • Training through, even if it does not dynamically load the injured place, demands modifications in your form and movement patterns, which can cause injury later on

The best approach instead is to use the PRICE principles and book in to get it checked by a professional, who is used to working with athletes.

PRICE:

  • Protect: Avoid loading the injured area and strap or support it if you do need to move
  • Rest: Cut back on your workload and give it some time to heal properly
  • Ice: If acutely injured, cold treatment can help reduce the swelling and pain
  • Compression: A simple bandage may help reduce the swelling and pain, particularly in joints
  • Elevate: By raising the effected area to level or higher than the heart, the chance of swelling is reduced, helping the body heal more effectively

Whether you’ve tweaked an achilles, strained your knee or have a chronic lower back problem whenever you run over a certain distance, don’t just ignore it, pop a pill and carry on, call in and get it resolved quickly and effectively.

80:20 Revisted

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With the forthcoming release of Dr Kelly Starrett’s new book, I have been reconsidering the advice we tend to offer injured (or preferably non injured) athletes. Dr Starrett (a Phd physical therapist) offers practical and applicable advice on injury prevention and recovery, stating that if you cannot perform basic functions safely (squatting, stretching etc) then you need to sort them out before you try running.

These days, with web access virtually ubiquitous in the western world, there is a surfeit of information available at our fingertips. The difficulty is in discerning what works and what doesn’t. With the rise of athletic “biohackers”, who promote tips and tricks for small percentage improvements, finding the signal amongst the noise is even harder.

For most of us, performance improvement comes down to three simple things.

  • Optimise Nutriton / Diet
  • Train efficiently
  • Recovery / Sleep

Dr Starrett covers much of this in his excellent book Becoming A Supple Leopard and reviews indicate he will cover this in the running guide.

Breaking down the above bullet points, optimising diet means ensuring you eat cleanly and sensibly most of the time, getting a suitable balance of proteins, fats and carbohydrates, with plenty of micronutrients. Nothing clever or fancy but by not doing this, you are ensuring that your body is not going to operate effectively. This is the base upon which all the others stand, mentally and physically.

The part we all think about is the training aspect. We plan, prepare and put in the hours and miles to attempt to achieve our goals. But are we doing it in the most efficient manner? Could we save time by cutting out junk miles or hours in the gym, since more is not always better. Is there such a thing as a recovery run, or easy workout? Would that time be better spent with friends and family, which might help improve our mental state, or doing mobility work (as described by Dr Starrett)?

This ties in to point 3, recovery and sleep. Do you recover enough? Are you waking refreshed and ready to go each morning without needing an alarm or two? There is no set formula for this since the factors involved in recovery are complex, including external stressors, but by tracking basic biomarkers (resting heart rate, blood pressure, oxygen saturation (SpO2) etc) and personal reflection, we are able to observe how our bodies are responding to the load we place upon them. If your resting heart rate is elevated and your SpO2 depressed then you are simply not recovering from the load. Another simple test is to attempt to create a change in your heart rate during a training session. If during a run or ride, you cannot easily elevate your heart rate by increasing pace or effort, then there is a possibility that you are neurologically as well as physically tired and as such, backing off would be advised.

Some people are beginning to use heart rate variability (HRV) to track their stress and recovery. Like many tools, this gives a view into the workings of the body, in this case the autonomic nervous system, which can be used to explore the effect training or stress is having. Many researchers and doctors have shown that there is a link between low variability and mortality from a number of causes but these are measured using ECG over a long period of time (24 hours), especially after an acute myocardial infarction. Some work is being carried out with regards to the use of HRV to track physiological changes due to stress and training and although this appears to be useful over long term measurements, such that trends can be visible, it appears to be a back up to the other measurements and as such, outside of the 80% rule of most efficient use of resources.

To conclude, eat to meet your nutritional needs, train efficiently and recover effectively. Then start making the 20% changes.

Movement

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We need to move, we evolved through movement. Its just that with our current life choices, we don’t move enough. We have cars, internet shopping, sofas, take away food. We no longer need to hunt, track, think or work for dinner. Our survival no longer depends on moving.

If you watch a child, they move naturally and gracefully. No one has taught them to keep a straight spine and bend at the knees when lifting, they just do.

And if we look closer at their movement patterns in comparison to ours, we can see that they initiate their movements from the centre, the torso, long before the limbs are used. This is where they know they have power, not in the shoulders, arms or legs but starting, rooted in the core. As adults, we have learned that our arms and legs are strong and neglect the trunk, the point where it is all connected.

A common set of movements, sometimes known as the primal movement patterns are, in developmental order:

Flex
Twist
Push
Pull
Squat
Lunge
Walk
Run
Play

We should become like children again and do these every day. Only then will we start to find out how we are restricted and what we need to change to get the best from our bodies.