FreFloDo: Here We Go Again

I think OK GO says it best. I leave you with the lyrics of "Here It Goes Again" to say it for me. Thanks, Wylie, for telling me about this latest "functional training" method.

Real World EPO Horror Stories

This is a link to an interview of cyclist Joe Papp by Dr. Dawn Richardson, posted on the VeloNews website. If you think doping isn't dangerous and doesn't mess with your physiology, you might be compelled to think again after reading this. Thanks to Bobber for posting a link to the story on the STLBiking message board.

Video Upload Test

Blogger now supports direct upload and posting of video within your blog. Pretty easy with a small clip. Not so easy with a larger file, for some reason.

Great Quote

Vern Gambetta posted this quote on his blog this morning:

“The glory of great men should always be measured by the means they have used to acquire it.” Francois de La Rochefoucauld

Thanks, Vern.

That Old Stability Ball Wall Squat: Now Permanently in the Lexicon

Well, here it is. Straight from the NSCA's latest journal. Just knock me out. With all due respect to my colleagues, I do not use this exercise. With anyone. Even my 75 y.o. mother-in-law or my back patients. In my mind it promotes the following dysfunctional movement patterns:

1. Posterior positioning of center of gravity with a squat-like movement. No one can move like this in the real world (without the stability ball holding them up)--they will fall over backward.

2. Lack of slight, normal torso/hip flexion (with lumbar stabilization) that should occur with squat-like movement.

3. Lack of ankle dorsiflexion that should occur as a part of an entire lower extremity sequencing with any squat movement. Yes, dearie, those knees need to move over the toes.

It intrigues me that someone would use this with anyone that remotely resembles an athlete. Why not just bodyweight squats holding one dumbbell or a medball at the chest? I have gotten away from ever using DBs in the hands for lunging or squatting, preferring to use an implement at the chest or over the shoulders. Many times I've watched personal training clients "slink" across the gym with horrible upper body positioning and lower body mechanics. Most people need to first master lunging and squatting with bodyweight only; then extra resistance can be added, but it needs to stimulate and promote optimal torso positioning (IMHO).

Maybe my real problem is that when I have seen this exercise used in the past, the person doing the exercise is not attending to the movement; and the person who gave them the exercise is not giving any feedback on their body mechanics. I cannot tell you how many times I've seen clients/patients mindlessly flexing and extending their knees, with poor mechanics, jabbering away with the person who gave them the exercise to do. There is no effort or expectation to move well!

Every day, for decades, we move our bodies, getting off the toilet, out of the car, off the couch, freely in space. There is no stability ball, wall or Smith machine bar to lean back on. How is it that these type of squat exercises are now perceived as safer, better or appropriate for building leg strength and mechanics? Why is simple squatting such a misunderstood and under-utilized method of strengthening? In my book, it is the foundation for everything else we do.

You can teach people basic squat mechanics without a stability ball or wall behind the back. You might have to give more manual and verbal cues; you might start with sit to stand. You might even have to demonstrate! Hmmm...can you do it yourself? Try to teach it to an inexperienced person and see what you think. If you raise the expectations for your client, you might just be surprised at how well they move, if given the right instruction and a chance.

Oh no, here come the questions about leg extensions!

In the next two months, the road cyclists will head to the gym to begin their off-season resistance training in earnest. From my point of view, for the majority of cyclists, the value in resistance training is to hold your body together so you can ride your bike most efficiently (transfer power in the saddle and out) and combat the postural and overuse / muscle imbalances (general wear and tear) that long term riding and training can bring on.

It can also be good cross training to get your ass out of the saddle, when you need some active rest. And don’t forget the general lean body mass and bone density benefits. By learning to resistance train appropriately, one develops lifetime physical competencies that benefit your general musculoskeletal health and function as you age.

There might be some women who could benefit from some increased general strength, particularly upper body. There may be some men or women who lack the torso stability to efficiently transfer power to the pedals. But to determine this, we need to evaluate that individual’s weaknesses off and on the bike and see what’s going on. We should never just blindly apply a stock resistance training program; first evaluate the athlete! Does s/he really have some deficits that might be addressed with off the bike training? This type of evaluation is RARELY available to cyclists who want to resistance train in the off- season. And every fall, an army of well-intentioned cyclists line up for the leg extension machine with their basic program from a book or pay big bucks to hop on the PowerPlate and have no idea how what they are doing relates to their on-bike performance.

So what are you waiting for? Give me a shout and let’s figure out what your needs are, so you can stop wasting time in the gym and start doing something beneficial for yourself—on the bike and for your health.

My First Visit to the New Bird Barn

Albert's first at bat (above). He had an off night. Wainright pitched 8 solid innings, but gave up a home run in the ninth. Interesting to note, that Wainright batted 8th, not 9th. Dodgers won, 2-1.

Eckstein seemed to have the most comprehensive, active warm up. Didn't notice to many other guys doing much more than the traditional stuff. Wonder what they do inside, prior to taking the field? Whoop it up on the Powerplate? Game time temps were in the mid to high 90s. I really wanted to Build-A-Fredbird, but didn't. That's a hint for you, G, and Sister.

Wacky Posture and Somatotype Ivy League "Science" Tale

Found this completely crazy story and image in a BoingBoing post by Mark Frauenfelder. Read the original story by Ron Rosenbuam from the January 15, 1995 New York Times Magazine. I find posture fascinating, but this takes the cake.

Who knew the origins of somatotype had such creepy roots in mid-20th century American social science and that all of these famous Americans were photographed nude as freshman entering Ivy League schools? Apparently the Smithsonian has since (1995) destroyed the remaining negatives and photos from the collection of William Sheldon's papers.

Has anyone read this?

I Got a Question for My ATC/PT Homies

Who uses wall slides (wall squats with a swiss ball behind the back and a small ball between the knees) as a regular part of return to function/sport, LE strengthening exercise?

What aspects of this exercise make it useful in rehab? Is it particularly helpful with any specific dx or issue?

Why would you prefer it to a basic sit-to-stand or teaching someone a bodyweight squat?

Help a sistah out here!

(Personal trainer-types feel free to chime in!)

Re-Grounding Myself in the Physical Therapy World

Just spent a challenging, but rewarding 50+ hour week back in an ortho-sportsmed clinic. Talk about cobwebs....When was the last time I actually evaluated someone with a true L5/S1 myotome strength deficit or used parrafin? Everyday I was reminded how and why my practice patterns and ideas have evolved into what they are at this point. But I was also reminded by some wonderful patients that I am a pretty damn good therapist.

PTs in this country face some real barriers in typical outpatient clinic settings. The billing system is just one of them. Really, the current method of billing (CPT codes, time based) needs to be destroyed. Why can't we just bill a flat fee per visit--and do what we, as professionals, think is appropriate without any interference or question? That's what I do with my personal patients--they are all self-pay and I charge LESS than the average itemized PT visit, spending the full visit time, one-one-one with the patient. Why insurance companies refuse to accept a flat fee bill for patient reimbursement, is beyond me.

I've got more clinic work this week. More opportunities to learn and grow. I am grateful it is with a great group of professionals who value quality. One friend of mine recently had the pleasure of doing some PRN work for a large rehab company that required her to only spend 20 minutes per patient.