Motor Control Drills to Improve Hamstring Flexibility

Hi everyone,

I have been getting a lot of e-mails asking about a tight hamstrings article a few months ago and for those of you in that "last category" who are asking me about motor control drills, this post is for you. I have even had people track down my personal training website and call my business phone to ask about the article! Below I will explain what was "beyond the scope" of the original hamstring article.

When it comes to making neural improvements to increase your range of motion (and be able to finally touch your toes), the Z-Health system is simply the best around.

I could never touch my toes (not even close!), but I had just decided to live with it. I actually got into Z-Health due to some chronic back pain I was having. As I worked through the program and my pain, I consequently was able to drastically improve my range of motion, all without stretching.

Before I first started doing Z-Health, when I was trying to touch my toes honestly couldn't reach more than 2 inches past my knees! I tried stretching several hours per week, but that didn't help and it took up a lot of time.

After my first session, I got about 6 inches closer to touching my toes (but was still about 6 inches off - I was really high up there!). Within one month of doing about 5-10 minutes of drills each day, I was able to touch my toes. Over the next few months I picked up a few more inches. I can almost palm the floor now after doing a few drills!

To be honest though, the extra range of motion was just the icing on the cake. I actually got into Z-Health due to some chronic back pain I was having following an unfortunate accident. Now, I'm pain free in addition to all the range of motion increase I received.

My clients love it too. One of my favorite responses was "You know, if you had told me that I would be able to palm the floor when I walked in here today, I would have never have believed you." The most common response though is "simply amazing".

If you hop over to the Z-Health website, you will see there is all kinds of stuff available. There are different products for warm-ups before working out, things to improve your sports performance, even certifications for trainers like myself. I am currently R and I Phase certified and use it every day with clients and patients (I work with some chronic pain patients in addition to personal training). 

If you are interested in some motor control drills to improve your hamstring flexibility, here is my specific recommendation:

I strongly recommend picking up the R-Phase DVD. Skip the introduction DVDs and the Neural Warm-Up DVDs and all the other stuff (you can always pick it up later if you play sports and really like the R-Phase DVD) and go right for the R-Phase DVD set.

When you get the set, you will receive 2 DVDs and a book. The book contains about a half an hour to an hour of reading. It outlines what the system is, gives instructions for how to perform the drills, and has pictures each motor control drill and how to perform them properly.

There are 2 DVDs - the follow-along and the "technical" DVD. Now, I KNOW you are going to want to just pop in the follow-along, but haste makes waste!

The follow along is designed to be used once you have a decent understanding of the drills. If you remember from the original hamstring article I wrote, the idea behind these drills is to increase the brain's familiarity and comfort with the body. If you don't perform the drills properly, you won't get a benefit. That's where the Technical DVD comes in.

The technical DVD explains each drill in detail, the common pitfalls, and how to do it perfectly. If you do the drills perfectly in line with the technical DVD, you will see big improvements in flexibility, and not just in your hamstrings! Remember that the brain controls flexibility on a whole-body level, so as you train your brain, you'll get more flexible all over.

To jump start your progress, learn and practice the following 4 "high pay-off" drills with the DVD:

Toe Pulls

Ankle Tilts

4-Position Hip Circles

Thoracic A/P Glide

These are the 4 drills that have been proven to be very effective in the vast majority of the population. Look up these drills on the technical DVD and then practice them. It will only take about 10-15 minutes to learn and you get several inches (at least!) more when trying to touch your toes. 

The better you get at the drills, the more your brain can learn, and the more you ultimately get out of them.

Additionally, everyone's body is different and deficits will be at different places. As you work through the DVD, retest your toe touch range of motion after each drill. You will find that some drills will increase your range of motion by a significant amount, and some drills will do nothing. 

Make a mental note of which drills improve your range of motion (should be 1-3 drills). Also make a mental note of which drills you really struggle to perform properly (usually 1-3 joints aren't "smooth"). 

With that information in hand, here is your action plan:

- Pick up the R-Phase DVD and learn the 4 "high pay-off" drills.

- Once you master the 4 high pay-off drills, throughout the week, perform the drills that give you a big range of motion increase and the drills that are difficult. Try to do a "short focused session" (2-3 minutes of drills) a few times per day, rather than allocating a large chunk of time. A few 3 minute sessions per day will only add up to 10 minutes!

On a weekend day, go through the follow-along. After you finish, go for a 20 minute walk.

Following this strategy will get you touching your toes in no time! I can't say enough good things about this system - I strongly recommend to anyone picking up the R-Phase DVD set.


Click here to pick up the R-Phase DVD Set


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If you are a professional trainer or health care worker interested in using Z-Health with clients or patients to reduce their pain and improve their range of motion, I strongly recommend checking out the Essentials of Elite Performance seminar.

Now writing for the Examiner; Maryland Personal Trainer

I am moving over to the examiner.com to write as the Baltimore Weightlifting Examiner. My column over there will entail 3-4 short articles a week about various fitness related topics including strength training, nutrition, and supplementation.

This site will be revamped soon, but for now, you can follow me there! Thanks!

Working Around Low Back Injuries Part 4; Maryland Personal Trainer

In the last part of this series, I will discuss working around the SI joint in the gym.

The sacroiliac joint, as depicted above, is where the sacrum attaches to the ilia.

Just like the lower back, SI joint can hurt for a variety of reasons. Some SIs hurt with compression while some hurt with extension. Some injuries will hurt with rotational forces as well. For example, if only the right side of the SI joint hurts, single leg work on the right side might actually cause more pain than a bilateral movement like a squat. You will need to experiment at first and figure out the nature of your injury and choose exercises accordingly.

With that said, with SI injuries, make sure you avoid putting excess pressure directly on the SI itself. When doing a seated exercise, make sure your spine is neutral and your pelvis is not in a posterior tilt. When bench pressing, make sure that your arch is not causing extra pressure on the top of your butt.

Additionally, since the glutes have attachments on the sacrum and illium, sometimes glute and hamstring heavy exercises are not appropriate. If your injury hurts with glute contraction, your options become more limited.

The safest bet (as I have frequently mentioned before, I know) is the trap-bar deadlift (assuming the injury is not recent and you can handle the compression). The trap-bar deadlift results in less compression than a typical back squat or deadlift, and since the weight is held by at the sides, hyper-extending the spine is hard to do.

Glute-ham raises are also another option, assuming they are pain free. This is a great bilateral exercise that hits the hamstrings and glutes hard while minimizing compressive force and rotational torque.

When all is said and done, figure out whether your injury is related to compression, extension, or rotational forces about the SI. For compression related injuries, an approach similar to working around flexion-related low back pain is appropriate. For extension injuries, an approach similar to working around facet joint injuries is appropriate. And for pain with rotational torque, stick to bilateral work and limit your single leg exercise choices to those that are pain free.

Conclusion

Just because you have a back injury does not mean you have to stay out of the gym. Figure out what type of movement causes your back pain and act accordingly. One thing to consider is that you do not need to have a current back injury to apply these strategies. If you have a history of recurring back pain associated with flexion or extension, you can follow the tips outlined in this series to avoid recurring injury. Building muscle, losing weight, increasing strength - these are all life-long pursuits. You only get one spine, take care of it.

Working Around Low Back Injuries in the Gym Part 3; Maryland Personal Trainer

In part 3 of this series, I will discuss working around extension-related back pain. In order words if this:

hurts your back, you have extension-related back pain. Usually this is the result of a facet joint injury. Facet joints are technically the articulations between the superior and inferior articular processes of two vertebrae. Just think of them as the connection point between some of the projections off of the back of the spine. Here is a picture:

The thing about facet joints is they have a habit of being very sensitive. When the spine goes into extension, like the first picture above, force builds up at the facet joints which can lead to pain. Facet joint injuries are most common in younger lifters, as a general rule (but certainly not always the case), weight-trainers 30 and under are more likely to complain of facet joint pain whereas trainees over 30 are more likely to complain about flexion-related pain.

Working around facet joint injuries in the gym involves avoiding extending the lumbar vertabrae. Note, this is not the same as the exercise commonly dubbed the "back extension" but rather describing the situation shown in the first picture.

When selecting exercises for a facet injury, minimizing compressive force is not the #1 priority since usually the discs will be unaffected by this type of injury. As mentioned earlier, exercises that can result in excess extension should be avoided.

Oftentimes when dealing with facet injuries, it is not the exercise itself but the way the exercise is performed that needs to be changed. An example would be the deadlift. Many lifters, especially working with heavier weights, lean back at the top of the deadlift:

 

This places some load on the facet joints and is simply not appropriate for someone with a facet injury. By focusing on hip extension and ending the lift without lumber hyperextension, the facet joints can be spared. The top of a deadlift in this situation would look like this:

The problem with this type of deadlift is that while the form may be textbook, when lifting maximal loads, like the lifter in the first picture, deadlifting is hardly textbook. When you are holding 400+ lbs like the person in the first picture, some leaning back is necessary or you would simply fall forward. That is why for someone with facet joint injuries, I prefer to use the trap bar deadlift for some of the heavier work. Since the center of mass of the trap bar is directly in line with the lifter's foot, there is no need for back extension at the top.

Other Lifts to Watch For:

Again, with facet joint injuries, back extension should be avoided. Just like with the deadlift, any movement where a majority of the weight is in front of you can result in some back extension. This includes holding a bar in a front squat or zercher squat grip. At the top of these lifts, a small amount of extension is necessary to stay balanced. Other deadlifting variations where the bar is in front of the legs can be problematic.

Standing movements also can cause a lot of extension. Standing Overhead Military Presses or even heavy curls can throw the back into extension. To work around this, choose a different exercise or lower the weight and tighten up the form.

Additionally (and often overlooked), pressing movements can be an issue. The bench press is frequently overlooked for its role in facet joint injuries. When bench pressing, it is common to form an arch on the bench to create stability. This allows the lifter to support more weight.

As mentioned on CriticalBench (where I snagged this pic), a good arch can significantly improve your bench pressing abilities. However, a tight arch like in the picture above can be very painful for someone with a facet joint injury. In this situation, simply laying on the bench normally with the feet relaxed (or even propped up a bit, I know, the horror) is more appropriate for repetition work.

But What If You Want to Put Up Big Numbers?

Now that is the million dollar question. If you have a facet joint injury, particularly if you have been weight training with it for the long term, I am not saying that these exercises are completely forbidden. If you want to build an impressive bench press, I would recommend performing your repetition and assistance work without a tight arch, but still practice arching and use it for your maximal sets (assuming it is pain free). Many lifters develop painful facet joints after frequent arched benching and deadlifting. Oftentimes, when these techniques are performed sparingly, such as for testing a rep max or performing a maximal set, they will not cause the lifter any pain. Every person is different though, so if it is still causing you pain, find out why this is the case and fix it. 

That is it for this edition, I will wrap up this series tomorrow by covering working out around sacroiliac joint pain.

Working around Low Back Injuries in the Gym Part 2; Maryland Personal Trainer

In the previous installment of this four part series, we talked about what exercises were and were not appropriate for training around a lower back muscle strain. In part 2 of this series, I will discuss working around back pain in flexion.

One of the primary causes for back pain in flexion (bending forward) is a herniated or bulging disc. The main risk factor for a herniated disc is poor lifting technique, age (being older) and sitting a lot (the more you sit, the more likely you have a herniated disc). These are rare in children and young adults - these populations typically have pain in extension rather than flexion.

In the picture above, the left side of the picture is a depiction of the front of the spine. When flexing the spine (by rounding the back), the herniation is excacerbated as more fluid is forced out of the disc. However, disc herniations are not the end of the world. Studies have estimated that 70% of the population in the United States has an asymptomatic (pain free) disc bulge or herniation. As a result, disc pain can be a tricky thing. However, there are three main things you want to minimize avoid: flexion (as we already discussed), shearing force, and compressive force. The less we make the disc work, the better off it fares.

Before working out with any sort of disc injury, make sure your doctor has cleared you for exercise. 

Minimizing Back Flexion, Shearing and Compressive Forces

Take a look at the picture of the spine above. This is the neutral alignment of the spine. When weight training, especially if you have a herniated or bulging disc, it is of utmost importance to avoid leaving neutral spine under load. If you are working with a physical therapist or other professional, he may mobilize the spine at some point. However, spinal stability is always the first priority for anyone with a recent disc injury; so flexion under load (i.e. while lifting) should be avoided at all costs.

The spine is great at handling compressive force (force travelling from the top of the discs to the bottom) but it can not handle much shearing force (force moving posterior to anterior or vice versa; across the bone). Shearing forces are very high a flexed spine as the erector spinae do not have the appropriate angle of pull to counteract it, so again, avoid flexing the spine while lifting.

Additionally, movements that involve rotation, lateral bending, flexing at the hip can produce shearing forces. As a result, at least while under load, try to avoid movements that involve bending forward or involve twisting or bending of the spine.

Any movement that hip flexion and significant erector spinae involvement is capable of creating high levels of compressive force. Back squats and traditional deadlifts can be very troublesome for people with a history of back pain in flexion.

Appropriate Exercises

Lower body: Someone with a history of back pain in flexion should make ample use of single leg movements. For adding weight, dumbbells are always the preferred method for adding weight. Reverse Lunges, Bulgarian Squats, Split Squats, Single Leg Squats are all great ways to work the legs when working around this type of back pain. 

For someone further along in the recovery process, front squats and trap-bar deadlifts are great ways to use more weight while minimizing compressive forces in the spine.

Core: When working with this type of back pain, exercises such as the plank, side plank, cable hold, and any exercises which emphasizes resisting movement rather than creating it will result in much less compressive force than a traditional abdominal movement like a sit-up or crunch.

Upper Body: Just like with the erector strain, bent over rows and seated rows can potentially be problematic. Use dumbbells and chest-supported versions to reduce stress on the injured areas.

That is it for part 2. For the younger audience, I will cover pain in extension in part 3, which will be up tomorrow.

Working around Low Back Injuries in the Gym Part 1; Maryland Personal Trainer

Sometimes, training the lower body while dealing with a recent back injury may seem impossible. However, it does not need to be. Here are some things to consider when working around injuries:

Type of Back Injury
  
There are four main types of lower back injuries: muscular pulls, pain in flexion, pain in extension, and sacroiliac joint injuries. As always, when working with an injury, make sure a doctor has cleared you for exercise before trying anything out. In part one of this four-part series, I will discuss working around muscular strains in the erector spinae.

Muscular Pulls:

Strained muscles are a common injury in the erector spinae muscle group. This can be caused by a lot of things such as the erectors trying to do too much work, not properly warming up, or simply moving in a range of motion with which the nervous system is not comfortable.

 The Erector Spinae

For training around this injury, you should try to load the erector spinae as little as possible. The erector spinae have two main functions - the lower portion of the erector spinae group keeps the lumbar spine in place when the lumbars are subjected to shearing force (such as when the body body is bent over), while the upper portion helps extend the back. When dealing with an erector sprain, we generally want to avoid both of these situations.

Side Note: Now, I am not saying that the best course of dealing with a muscular strain is to not work out the muscle group at all until it heals completely. I am aware the lighter loads can stimulate blood flow and improve recovery. The purpose of this article is for discussing how to train the lower and upper body at high intensities when working around strained erectors.

Training the Lower Body:

Since we are trying to avoid both back extension and shearing force, lower body work should focus on keeping the torso upright. Most single-leg (unilateral) work, particularly lunge variations such as reverse lunges, split squats, bulgarian squats are all appropriate (as long as they are pain free). If one movement irritates your strained muscles, try a different one or lower the weight.

Training the Upper Body:

When training the upper body after an erector strain, you should avoid exercises which require forward bends, such as bent over barbell rows. Additionally, any movement which requires erector action to stabilize the body (such as a seated row or a standing curl) may not be appropriate. Replace the seated row with a chest supported t-bar row. 

Any machine that you can use with a chest support will significantly decrease erector spinae involvement.

Exercises to Avoid:

Squats - Squatting variations, even single leg squats, can result in significant erector spinae involvement. While front squats are generally prescribed for many lower back pain issues, the barbell front squat is not appropriate for recent lumbar strains. While this lift results in less compressive force than a back squat, the nature of this injury is not related to lumbar compression. Due to the bar placement, a front squat demands significant spinal erector involvement, making it a poor choice for someone with a recent lumbar strain.

All Deadlift variations (even single leg deadlifts) - these simply require too much erector involvement, both from the lower and upper portions of the erector spinae.

Barbell Rows - For the same reasons as the deadlift.

Seated Row - Your erector spinae generate the force necessary to stablize your body while performing a seated row, so these are not appropriate for recent sprains.

Exercises performed while standing  - Depending on the nature of your erector strain, standing exercises such as curls and overhead press may or may not irritate the strain. This will require some trial and error to figure out, as it is highly variable dependent upon the nature of your injury.

Conclusion

An erector spinae strain is no reason to stay out of the gym. Simply by modifying your exercise selection you can get a full workout in despite your unfortunate injury. Tomorrow I will cover part 2 - dealing with pain in flexion.

Stretching, Force Relaxtion, and Creep - How Stretching Can Cause Ligament Damage

Ligaments are a type of connective tissue that contributes greatly to the structural integrity of the body. Ligaments are known for tying bones together and are particularly important because they contribute significantly to joint stability.

 Ligaments of the Shoulder

Ligaments rupture after they are stretched too much. Generally, this is the result of a traumatic collision. However, ligaments can be over-stretched and weakened simply by overzealous stretching due to their unique properties.

First off, ligaments exhibit a trait known as force relaxation (1). When ligaments are stretched and the stretch is held at a given length, the ligament will stretch out and slowly give less and less resistance to the force. As a result, holding a moderate intensity stretch for a long period of time can potentially result in more ligament lengthening than a brief intense force.

Secondly, ligaments also exhibit creep (1). When a ligament is stretched with a constant force, and the force is maintained, it is continually stretched. Once a ligament reaches a given length (dependent on the ligament), failure occurs. When a ligament fails (torn, ruptured, or stretched beyond its capacity) it is irreversibly damaged.

Sometimes, stretching can result in ligament damage based on the properties of force relaxation and creep. Here is how it plays out:

1. A stretch is being held that is putting stress on the ligament. The ligament begins to stretch out and provide less and less resistance (force relaxation).

2. The person stretching feels like they can go further (since the ligament is resisting less) and he increases the stretch back to the same force he used at the start. Since the force is being maintained, the ligament continues to stretch (creep).

3. As this pattern continues, eventually the ligament can be stretched too far.

A ligament may can be deformed without tearing or rupturing it. This may result in joint instability due to less contribution from the damaged ligament. Though ligaments can heal, they have a poor blood supply and generally never reach pre-injury levels of strength. Since serious ligament injury does not heal well, both ligament tears and significant joint instability are oftentimes treated surgically.

Solution

The first thing you should do is that when you stretch, make sure you are actually "feeling it" in the muscle rather than in the ligamentous tissue. For example, when stretching the hamstrings, you want to feel it actually in the hamstring rather than behind the knee. Bend the knee some until you hit the target spot. If you are stretching out the external rotators of your hip, make sure you actually feel it around your hip rather than in your knee.

Secondly, save the static stretching for after a workout. Ligaments can handle more load and are more resilient when warmed up. Additionally, extra blood and fluid in the target area as a result of working out will make it easier to stretch.

At the end of the day, its important to remember that ligaments only can handle ~10% change in length before undergoing permanent damage, while muscle length is largely regulated by neural activity. This is why I like Z-Health so much - improving proprioception is much more effective than stretching for decreasing excessive muscle tension.

References

1. Enoka, R.M. (2002). Neuromechanics of Human Movement. Champaign: Human Kinetics.