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 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.

Posture Correction: A Waste of Time?

One of the most popular topics in the health and fitness field today is posture and posture correction. Everyone wants "perfect posture." There are entire websites devoted to it and even more exercise programs that guarantee the delivery of perfect posture. Oh and the products! The ball chairs, the unstable shoes, what wonderful inventions! But before we get carried away, what exactly is perfect posture anyway? Is posture training even necessary? I do not think so.

Not Functional.

Now before you think I am off my rocker, here is some food for thought, first mentioned to me by Dr. Eric Cobb (of Z-Health fame): How many of you actually hurt when doing absolutely nothing? Who hurts when just standing there or lying down?

People complain of shoulder pain when bench pressing, back pain after cleaning or yard work, or hip pain when sprinting, yet to this day, I have never had anyone come in and say to me "Hey Colin, when I stand really still and do not move at all, my knee hurts." It just does not happen.

Which is strange, because nearly every client that comes to me wanting to improve posture does this because he thinks that improving his posture will take his aches and pains. Or someone else wants to improve her posture because she thinks it will help her move or perform better. Man, if only my shoulder blades were pulled back a little bit more, I would be able to dunk a basketball, run a 4.3 40, and bench press twice my body weight!

The problem I have with "posture correction" training is there is no ideal posture. Yep, I went there - and this is corroborated by research. For example, in Stuart McGill's Low Back Disorder: Evidence Based Treatment and Prevention, McGill notes that there appears to be no ideal posture for sitting, and the best seated posture is actually a rotation through different ways of sitting. This ensures that the load of supporting the body's weight is shared among different tissues. On the other hand, a static posture loads the same tissues repetitively, which over time can lead to pain and so-called "wear and tear."

The other problem I have with actively trying to correct posture is that posture should be an unconscious event. The brain chooses the way it feels the most comfortable to stand or sit, and in order to change what is considered comfortable, movement patterns need to be changed. Trying to fix caveman tendencies by thrusting your chest out and pulling your shoulder blades back is simpy going to move feelings of tightness and irritation from the supraspinatus and shoulder to the rhomboids and neck.

Which brings me to my final point - I realize would just be a critic if I did not supply an alternative. Well, if people generally hurt when moving, whether it be lifting weights, performing in an athletic event, or simply doing some work around the house, then would it not make the most sense to fix movement patterns? To run a dynamic assessment instead of a static one? Now, which type of assessment is up to the person doing the assessing. There are a lot of viable options and practically all forms of movement can show one abnormality or another. A simple FABER or Thomas test takes 10 seconds and gives plenty of feedback on how well the hips are doing their job. Something a bit more advanced like gait assessment can be used to evaluate movement on the whole body level.

I am sure there are some people reading this that are thinking: "I just want better posture so I look better," which is fine. Once movement patterns improve, whether it be through dynamic joint mobility, strength training, corrective exercise, or (preferably) a combination of all three, posture will get better. The body likes to save energy, and with efficient, pain-free movement, posture corrects itself.

With that said, it amazes me that someone with back pain will see a doctor or therapist, only to have their range of motion on a few muscles tested and then receive a few static stretches to work out 'tight' muscles. A client will bring me a sheet of paper looking something like this:Client: "Yeah, my doctor says to do this every morning when I wake up and before I go to bed at night and my back will stop hurting."

Me: "So how is that working for you?"

Client: "Not very good."

It is no wonder that the US loses billions of dollars of productivity yearly to back pain.

Mouth Guards for Weight Training; Maryland Personal Trainer

A good bit of research has been coming out lately stating that clenching the jaw when performing a physical task (such as jumping or lifting a weight) increases strength and power (1). This phenomenon has been dubbed concurrent activation potentiation and is essentially a fancy way of saying "when one muscle contracts hard (or a group of muscles), other muscles like to contract hard too".

An easy way to demonstrate this is to shake friend's hand as hard as you can. After doing the test run, retry, but this time tense up your body first. If you did it right, your strength will go up and your friend will be thoroughly impressed by your handshaking prowess.

Jaw clenching is not particularly new in strength circles. Powerlifters, Olympic weightlifters, and other strength athletes have been using tension to increase weight totals for years. However, when this new research started pouring out, so did new products.

Why weren't mouth guards this cool when I was growing up?

Enter the mouth guard for weight lifting. While mouth guards have long been a staple for contact sports, the weight lifting mouth guard was created in the same spirit as the mouth guards designed for people who grind their teeth at night and suffer from the resulting tooth damage and jaw pain. Therefore with this miraculous product you can clench your jaw during your entire workout and experience big strength gains without damaging your teeth, right? Not so fast...

So what's the catch?

My issue is that products are being marketed to the average trainee - lately I have seen people wearing these for the duration of a normal workout. The problem with jaw clenching is that even though you may recruit more motor neurons, you are also training your jaw at the same time for increased tension. Often the only demand we consider in training is that of the targeted muscle group while in reality we are always adapting on a whole-body level. No study needed - this is just the application of the SAID principle (Specific Adaptation to Imposed Demand), which is the cornerstone of exercise physiology. In short, if you regularly train by clenching your jaw, you are going to get good at creating tension in your temporalmandibular joint (TMJ), which is not a desirable adaptation.

Getting to Know Your TMJ

The TMJ is a very sensitive area because it is a hotbed of motoneuron activity. Wait, what? Basically, there are a lot of nerve endings around the TMJ because it needs to both be able to create a lot of force in order to chew food, yet have very fine control in order to help produce speech. As a result, this area is often the site of various dysfunctional muscle activity. Unconscious jaw clenching is a well documented condition known as bruxism. This can lead to tooth damage, headaches, and in severe cases, extreme jaw pain. So why on earth would it be a good idea to create voluntary jaw clenching for any extended period of time? Wearing a mouth guard during a workout in order to jaw-clench on every set to squeeze out an extra tricep pushdown is simply not a worthwhile pursuit.

The Final Verdict

By no means am I saying that jaw clenching is a bad thing to do. If you are actively competitive in a strength sport, then risking developing jaw pain for an edge on the competition may very well be worth it. Even for non-athletes, there could be some merit in jaw clenching during very high intensity sets. However, the average weight trainer has no business purchasing a mouth guard in order to clench his jaw for all 10 sets of bicep curls. It is simply a surefire way to end up with a headache and a sore jaw with little to show for it.


References

1. Ebben, W.P., Flanagan, E.P., & Jensen, R.L. (2008). Jaw clenching results in concurrent activation potentiation during the countermovement jump. Journal of Strength and Conditioning Research, 22(6): 1850-4.

Walking for Recovery; Maryland Personal Trainer

Walking is my favorite recovery method. Every day I am off from the gym, I try to get in a 30 minute walk after a good dynamic joint mobility session. Walking is a great recovery method because it increases blood flow, reinforces good movement patterns, and burns some extra calories, all without adding significant loading or volume.

However, not all walking is created equal. As crazy at it sounds, I am serious - most people just do not know how to walk. There are three things you should avoid when walking for recovery:

Elbow Walking:

Necessary?

In general, arm swing is a good thing. When walking, the foot does not strike the ground directly under the center of mass of the body. As a result, in addition to propelling your body forward, the ground reaction force produced from walking also rotates the body. As a result, we swing our arms so we do not spin in circles when we walk (1).

However, just take a look at the above picture. That stride length does not warrant that much arm swing. Additionally, "proper" arm swing is driven by the shoulder. In an efficient stride, force travels up from the foot to the opposite shoulder before reaching the elbow. The elbow should allowed to move some, but it should not be forced. Nothing about walking should be forced - it should be relaxing. And yes, carrying little hand weights when you walk will mess up your stride faster than anything.

It may sound a little goofy, but the research supports it. Stuart McGill notes in Low Back Disorders: Evidence-Based Treatment and Prevention that proper arm swing results in up to 10% less compressive force on the spine.

Strolling

A fast walk is much "healthier" then a slow walk. Efficient movement is fast, and this fast movement changes loading patterns and increases blood and fluid movement. Additionally, slow walking applies a nearly static load to the same spinal tissues, while fast walking spreads the load around, making fast walking a good therapy exercise for people suffering from back pain (2).

Treadmills

This may come as a surprise to some. Treadmills are not all that great because they encourage poor movement patterns. When on a treadmill, the treadmill moves your leg back for you, rather than having to actually rely on your muscles to do the work. Additionally, a lot of steps can be taken during a long walk, making the 30 minutes to an hour you spend on a treadmill capable of inflicting more harm then you would think.

Too many people sit all day at work, go home and sit some more, and then walk or jog on the treadmill as their only exercise. As a result, many people take way too many steps on a treadmill which ultimately leads to some funky movement patterns in the real world. Why should you care? Because poor movement leads to wasted energy, which dissipates into tissue and leads to so called "wear and tear".

Go outside. Seriously.

I am not saying that the treadmill is worthless - it just should not be relied on as a primary exercise tool. If it is too cold out or you just can not get to a place where you can walk, it works in a pinch; just try not live on it.

Conclusion

Walking is not just exercise that grandma does at the mall - even high-end athletes can benefit from walking for recovery. It is not rocket science either, just make sure you go outside, try not swing your arms like a maniac, and walk with a little speed and you will be on your way to better movement and faster recovery!

References:

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

2. McGill, S. M. (2007). Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Champaign: Human Kinetics.

Splitting it up

My fitness blog and training log are now going to be separate entities. I will still keep my log up to date for those interested in the minutiae of my day to day workouts. I will also still post some updates on my training on the blog like when I hit a longtime goal or something similar. I will keep a link to my training log on the right hand side navigation bar as well, so it will still be easy to find!

Exercise Spotlight - The External Rotation; Maryland Personal Trainer

This week's exercise is the external rotation, depicted in the video below:





Targeted musculature: Teres minor, infraspinatus.




Why: Increased performance!


How the External Rotation Can Increase Performance

Despite the over-prescription of the external rotation in the physical therapy arena, external rotations are one of the most useful (and overlooked) exercises for healthy people participating in regular resistance training.

The pectoralis major and the latissimus dorsi (yes linking to wikipedia) attach to the humerus in such a way that when they contract, they create a torque of internal rotation around the humerus. In simpler terms, when doing a bench press and the chest contracts to press the bar up, the chest musculature is also "twisting" the humerus.

To prevent the humerus from over rotating, the external rotators must contract in conjunction with the chest and back in order to stabilize the glenohumeral (shoulder) joint. If the pectoralis major's capacity to produce internal rotation during a bench press exceeds the ability of the external rotators to produce a counteracting force, 2 things could happen:

1. Very rarely, injury could result
2. Much more commonly, the brain prevents the pecs from overcontracting. This leads to less than optimal performance!

So, in order to prevent this from happening, add some external rotations to your program!

Variations

There are multiple ways to do the external rotation. As depicted in the video above, cables offer an excellent choice. Dumbbells, small weight plates, and bands can also be used. Additionally, as I wrote about in the tempo article, tempo can be added to the external rotation to increase difficulty and in some cases specificity.

Furthermore, changing the amount of shoulder abduction can change which of the external rotators is recruited (1). So, it can be useful to incorporate a variety of shoulder positions, such as the arm against the body and the arm fully abducted. A video of an external rotation with the arm against the body is shown at the top of the page. A video of an external rotation with the shoulder abducted can be found below:




Brief Rant on the History of the External Rotation

The external rotation is a popular physical therapy exercise targeting the infraspinatus and teres minor muscles. In addition to externally rotating the humerus, the teres minor and infraspinatus also depress the head of the humerus. This increases the amount of space below the acromion, theoretically relieving any impingement on the supraspinatus tendon. Since a lot of shoulder pain is simply written off as "supraspinatus tendinitis", external rotations are commonly prescribed to relieve shoulder pain. If you are having trouble visualizing this process, this journal article, has some great pictures on page 4 that show typical a "shoulder impingement".

Occasionally, this is effective, but the fact of the matter is that the glenohumeral joint is extremely complicated and nearly the entirety of the upper body musculature is involved in its stabilization either directly or indirectly (by acting on the scapula or humerus). Additionally, the external rotators end up pulling the head of the humerus forward in the socket when they contract, which can cause pain in and of itself.

In short, if you end up at a physical therapist's office for shoulder pain and they give you a band and tell you all that you need is external rotations, run the other way! As a personal trainer, I have worked with far too many clients who came right from a physical therapy clinic with that exact unfortunate experience.

Conclusion

If your bench press has been stagnant, try adding external rotations to your program. If you already incorporate them, try a variety of angles. If you have not used this exercise regularly in your training, you should notice a difference in your pressing strength within a few weeks!



References

Poliquin, C. (1997). The Poliquin Principles. Dayton Publishers & Writers Group.

Tempo for Dummies; Harford County Personal Trainer

A lifting tempo refers to the speed of lifting a given load. Tempo can be used to increase the effectiveness and difficulty of many exercises. Unfortunately, most trainees ignore tempo or always use the same tempo. If you are currently not using tempo in your training, read on to find out how even a beginner can incorporate tempo into his or her training today for improved results!

Some Definitions

Before you get started on the rest of the article, we will have to get some definitions out of the way. Concentric contraction occurs when muscle contraction is paired with muscle shortening. This is the actual lifting of a weight against gravity. Eccentric contraction occurs when muscle contraction is paired with muscle lengthening. When lowering a weight, a muscle working eccentrically. Isometric contraction occurs when a muscle is contracting but there is no movement. This happens briefly (or longer if intentional) with every repetition when the weight changes directions. Every time you do a single repetition, all three types of muscle movement are involved.

Tempo Notation

The most common notation (how you write out tempo on a piece of paper) is a "A/B/C/D" format. "A" refers to the amount of time (in seconds) spent on the eccentric portion of the lift (lowering the weight), "B" refers to the amount of time spent paused at the bottom of the lift, "C" refers to the amount of time spent on the concentric portion of the lift (raising the weight against gravity), and "D" refers to the amount of time spent paused at the top. If an "X" in place of a number, it means "as fast as possible".

An example:

Pull-up - 3/0/X/1 tempo

To execute a pull-up with 3/0/X/1 tempo, you would lower yourself over a 3 second duration(the 3), have no pause at the bottom (the 0), explode to the top (X), and pause for 1 second at the top of the pull-up (the 1).

If you have read my training log at all, you may have noticed this notation next to several exercises.

Uses for Tempo

There are literally endless ways to use tempo in training. Since most muscle damage occurs during the eccentric portion of the lift, many bodybuilders routinely slow down the eccentric portion of the lift to increase muscle damage in hopes of spurring on more muscle growth (1). Additionally, time under tension (which is considered by some as an important variable in building muscle) can be increased by slowing down both concentric and eccentric portions of the lift. Furthermore, pauses can be used during repetitions to work through sticking points on certain lifts.

How to use Tempo in your Program

All this may sound pretty complicated, but it does not have to be! There are several ways which you can immediately use tempo in your workouts today.

1. Tempo can be used as a means of progression

By adding tempo to a lift, the difficulty of movement can be increased without the need for additional weight. This is great for people who are working out at home with limited equipment or people recovering from injury that can not tolerate excess loads. Here is an example:

Push-up

Even for relatively casual trainee, or a more serious female trainee, doing a push-up gets easy pretty quickly. However, the push-up is great for increasing shoulder stability and is an excellent way to work the pecs, triceps, and anterior deltoids. On top of that, when done properly, push-ups result in little strain on the shoulder. One way to make the movement more difficult is to add weight and bands. However, this is not always convenient or possible with a lack of a training partner. Additionally, some shoulders may not tolerate the increased load. Fortunately, the difficulty of a push-up can be increased without equipment by adding tempo.

If you can do 10 good push-ups, try using a 3/1/X/0 tempo. This would involve taking 3 seconds on the way down, a brief pause at the bottom (with the chest barely off the ground), exploding to the top, and repeating without rest. From week to week, rather than increasing the amount of reps, the length of the pause can be increased. A 5 second pause for 10-20 reps will be challenging for even the most fit individuals, especially if done towards the end of a workout. This can be a great way to get some blood flowing to the muscles after some sets of heavy pressing.


2. Tempo can be used to learn new lifts

Doing a bodyweight chin-up can be a daunting task for many female (or male) trainees. Accentuated eccentrics can be used to help speed up this learning process. Start by jumping up or getting assisted to the top of a chin-up bar. Now, lower yourself as slowly as possible to the bottom. Jump back up to the top and do this for several reps.

From workout to workout, add a rep to each set. Eventually, you can drop the reps down and increase the eccentric duration. For example:

Workout 1: 10 sets x 3, 2 second eccentric
Workout 2: 10 sets x 4, 2 second eccentric
Workout 3: 10 sets x 5, 2 second eccentric
Workout 4: 10 sets x 3, 3 second eccentric

Progress like this for 4-8 weeks. If done properly with enough frequency (at least twice per week), a normal chin-up should result (depending on base strength levels and bodyweight). This can also be used for learning to do a "guy" push-up, a pull-up, or any other challenging body-weight exercise.

3. Tempo can be used to enhance functional and prehabilitative exercises

This is one of my favorite uses for tempo. The term prehabilitative exercise is used to describe typical physical therapy exercises applied before injury takes place. After all, why wait to get injured to strengthen important stabilizers or mobilize stiff joints?

Functional exercise was originally intended to describe exercise with carryover to real life or sporting activities. Lately, the term "functional" has been applied to just about everything under the sun, despite lack of carryover. In this instance, I am referring to the former definition.

Many muscles typically targeted by rehabilitative exercise do not take into account the way the muscle functions in the gym or in every day activities. For example, the lower portion of the erector spinae musculature is not used to extend the back but rather to prevent the lumbar vertebrae from shearing forward (literally falling towards the ground when bending over) (2). For many lifts and every day activities, this generally involves isometric contraction, or very small concentric and eccentric contractions of the lumbar erector group. Additionally, high levels of endurance of the low back musculature has been shown to decrease injury risk, where differing levels of strength has not (3). In other words, people with high low back endurance were less likely to experience back pain and injury, but the raw strength of low back muscles has not been linked to injury prevention.

Therefore, an exercise using the lumbar erectors can be more functional (or have more carryover) if performed with a slow tempo.

So as an example, with the back extension, if you normally grab a weight and do a lot of fast reps, try leaving the weight behind, and adding a 2/0/2/0 tempo. Once you increase the repetitions to 15, slow the tempo down and drop the number of repetitions. At a point, you can even add in pauses at the top and bottom. So one month you might do 2/0/2/0, the next month 4/0/2/0, then 4/1/2/0, and finally 4/2/3/1.

The same thing can be done for the upper body. The external rotation is one of the most commonly prescribed exercises for shoulder pain. The infraspinatus and teres minor muscles, which are targeted by this exercise, often do not contract rapidly during gym lifts. For example, during the bench press, one of their main functions is to prevent the head of the humerus from over-rotating, as contraction of the pecs and lats results in internal rotation. Strengthening the external rotators of the humerus with varying tempos can increase their capacity to act as stabilizers, resulting in more force production during lifts which require these muscles to act as stabilizers (like the bench press).


*Side note: Using tempo for assistance exercise is not always ideal. For example, in a baseball pitcher, the external rotators must eccentrically contract at high speeds to slow down the pitching arm once the ball has been released. For this population, it is not be appropriate to always do upper body assistance work with a slow tempo.


Conclusion

By incorporating tempo into a training plan, a trainee can increase the intensity of exercise an exercise without adding weight, increase the variety of stimuli the body is exposed to, increase the functionality of certain exercises, and learn new exercises that were previously out of reach. With all these potential benefits, what are you waiting for?



References

1. Miles, M.P & Clarkson, P.M. (1994). Exercise-induced muscle pain, soreness, and cramps. Journal of Sports Medicine and Physical Fitness, 34(3): 203-16.

2. McGill, S.M., & Norman, R.W. (1987) Effects of an anatomically detailed erector spinae model on L4/L5 disc compression and shear. Journal of Biomechanics, 20(6): 591.

3. Biering-Sorensen, F. (1984). Physical measurements as risk indicators for low-back trouble over a one-year period. Spine, 9: 106-119.