It’s been a while since my last post and a lot of things have happened since then, so this update will contain a random assortment of topics that I've been thinking about for the past couple of weeks. I've also included several links of some great material I've recently come across on the topics of physical therapy, strengthening & conditioning.
I recently took an Olympic weightlifting coaching course offered by USA Weightlifting (USAW) along with another physical therapist/strength coach friend of mine. Overall the course was very educational and I wanted to share my experience from a PT perspective.
The United States Olympic Committee recognizes USAW to officially conduct Olympic weightlifting competitions throughout the country in which the top performers are then selected to compete in the Olympic Games, World Championships, and other national and international competitions. Since I've never had formal instruction on how to properly perform the snatch, clean and jerk exercises I knew I wanted it to come from the quintessential authority on the topic. The two-day course consisted of some lecture presentation but was mostly practical group instruction on how to perform the lifts as well as their variations and progressions.
I jotted down several notes throughout the weekend which I later expanded upon as I thought them relevant from a physical therapy perspective:
On shoulder stability:
During shoulder rehabilitation we so often give the cue of retracting the scapula before performing an exercise, such as “squeeze your shoulder blades back.” While I understand the purpose of this is to strengthen and re-educate scapular retraction in a patient who may have lost the ability to do so, sometimes I think the whole “move the shoulder blades back and down” cue can be over-utilized.
Picking something up off the ground or lifting up an object that is a short distance away from you may require your scapula to be in a positionally protracted state. In another scenario, let’s say someone has to carry something heavy out of the trunk of his/her car and walk into their house. In this situation, I’m not really sure that retracting the shoulder blades may be the best strategy to provide gross shoulder girdle stability.
An alternative cue that I find success with is to “pack” the shoulder. Instead of squeezing the shoulder blades back into a retracted position to perform functional tasks, the scapula remains in a relatively more neutral position and more emphasis is given to depress the shoulder. The scapular retraction muscles are still engaged but in more of an isometric fashion along with the pectoral, posterior deltoid and rotator cuff musculature. The scapula remains stabilized but in a more functionally neutral position, and the rotator cuff remains engaged to approximate the head of the humerus into the glenoid fossa for glenohumeral stability.
Not that there’s anything wrong with cable rows or cable column shoulder extensions for shoulder patients--I actually use them all the time. But another useful exercise may be programming a kettlebell rack hold for time or for a walking distance. This way you can target the core in addition to neuromuscularly educating various upper extremity muscles for shoulder stability.
On lumbopelvic mobility and squat depth:
People have different body types and ranges of motion in their lumbar spine and hips. To some extent, someone can address hypomobility with flexibility exercises, mobility drills, static and dynamic stretching, foam rolling, joint mobilizations or soft tissue interventions. But if there are certain immutable anatomical characteristics that prevent one from reaching a certain depth on their squats, attempting to train one to do so is like trying to fit a square peg into a circle.
A good example of this is the degree to which one can tilt their pelvis anteriorly or posteriorly. At the base of someone’s squat depth, ideally you want a slight lumbar lordosis and anterior pelvic tilt. If anterior pelvic tilt range of motion is the limiting factor here, the lumbar spine will begin to flex and lose the slight lordosis which can lead to increased sheer forces on interverterbal discs and other structures.
If this appears to occur prematurely such as when the femurs are still above parallel, a troubleshooting strategy can be to re-assess pelvic tilting mobility in standing or in quadruped. I prefer in quadruped as you are able to see the client’s pelvic mobility with the hips in flexion and can easily appreciate lumbar spine mechanics as they tilt from anterior to posterior.
Another strategy is to experiment with different stances of foot width and hip rotation positions. A wider stance with the toes pointing slightly outward (to cue hip external rotation) may allow a more congruent osteokinematic roll of the head of the femur within the acetabulum. Smoother femur-on-pelvis motion may allow further pelvic tilting and the kinetic chain then grants more freedom for the lumbar spine to maintain that lordosis.
Although I don’t see myself participating in Olympic weightlifting competitions at all, I feel like there were so many principles from the course that can apply to sports rehabilitation and high-performance training. If you are a sports physical therapist or trainer who works with competitive athletes looking to improve their strength and sport performance, this would be a great entry-level course to teach the foundations of these Olympic lifts. Additionally, on a personal level the course offered a new, fun and challenging means of exercise for me to try to develop more explosive strength which I hope will carry over into competitive sports I participate in.
Lateralizations & Regressions
Charlie Weingroff recently released his DVD set entitled “Lateralizations & Regressions” which you can read about or purchase here:
Mr. Weingroff is another physical therapist and trainer with extensive experience in both the rehabilitative and strength & conditioning worlds (read full bio).
I haven’t gotten my hands on this yet but I am highly tempted to as his practice model blends principles of physical therapy with high performance training. The more I learn about each discipline, the less I want to dichotomize them. Mr. Weingroff’s mantra says it best: Training = Rehab, Rehab = Training.
Jonnie Candito HQ
Jonnie is a 22 year old, drug-free powerlifting competitor in the USAPL. His YouTube channel has lots of great content on squatting, deadlifting and much more. Does a great job of describing things without being too esoteric, and just appears to be a no-frills, humble guy who genuinely wants to help people get stronger.
He also provides a 6-week training program at no cost on his website http://www.canditotraininghq.com/free-strength-programs/
...which has been positively reviewed to great detail here by Powerlifting to Win: