A Philosophy of Strength and Health

Over the last few years I have become a fan of Ross Tucker, mostly through his "The Real Science of Sport Podcast." He brings a measured, thoughtful approach to sport and sport science. In the latest episode  (Season 6, Episode 20, Oct 3 2024), he gives a 12 minute master class on what it is to do "high performance." The discussion starts around the 40 minute mark.  As a physical therapist, I am most interested in how all of this relates to rehabilitation and the return to sport process. Here are my key take-aways: 1.  Apply principles, not knowledge. With principles in place, you are better equipped to determine what knowledge to apply to your situation. 2. Performance science is implementing a "logical, systematic process" not just throwing technology, staff or money at performance questions. Process & Systems >>>> Stuff. Develop a "framework to understand your environment" that is free from bias and helps you systematically app...

ACL injuries do not happen in a void. People sustain injuries when their infrastructure is unable to manage a specific set of physical circumstances. To describe the mechanism of the injury without the context of the person and their level/type of sport, is to miss valuable insight. In sport, we prepare the person, to the best of our understanding, to meet the physical demands of that sport. We do not just work to prevent one particular injury; we prepare athletes to navigate the total sport physical environment. By "we" I mean the coaching and support staff -- specifically the athletic development staff.  Athletic development (AD) coaches prepare athletes through the development of physical literacy and movement competencies via movement progressions. It is more than strength, power, agility; it is the acquisition of knowledge, skills, abilities and behaviors to manage themselves within the entire sporting environment. At the higher levels of sport, AD coaches coordinate wit...

Young coaches and clinicians are overwhelmed with information and ideas. There is so much stuff to wade through these days.  (Here is a thought: instead of constantly crying out for "more" research, how about firmly eliminating and deleting the piles of myth and bad information out there that clutter the landscape? How about refining our processes of implementing the good knowledge that is already out there? Listen to the The Knoweldge Project podcast episode 42 with Atul Gawande -- love his thoughts on medical ignorance vs ineptitude, along with the problems of autonomy/assumptions of mastery afforded medical professionals after completing formal training and acquiring titles/letters.) Part of maturing as a professional is building a solid bullshit filter and the confidence to say "No" to methods or tools that do not serve you well. This comes from making your own mistakes and learning from the mistakes and experiences of others. Shout out to all the mentors.  Eli...

Knee rehab is rife with shallow work. Historically, we have been distracted by the idea of "neuromuscular control" -- people standing on unstable surfaces with a 30 deg knee flexion angle, being perturbed, in search of the holy grail of hamstring co-contraction. And we forgot to ask people to bend and straighten their knee. To develop knee extensor strength -- THE KEY TO KNEE HEALTH. We now (again) have to use isokinetic devices to tell us what the knee extensor strength is because we have lost the skill and ability to program and observe movement that develops and is indicative of that strength & capacity. Note: I am not saying it isn't important to inform RTS with objective measurement. I am saying that many clinicians now rely on those occasional measures solely because they do not have the ability to design in session challenges / progressions that ask the patient to demonstrate and express the necessary capacities and movement competencies.  Now, there is a new d...

The term "strength" comes with many images and stereotypes. The most common stereotype usually includes intimidating men who look like action figures, in spaces that look like iron jungles. Strength is associated with mass gain, limb girth increases, muscle hypertrophy and maximal force production against an external load. With regard to lower body strength, we speak in terms of multiples of bodyweight (BW), with the ratio of 2x BW historically viewed as necessary and desirable. We have historically trained in terms of 1 RM. There has been a trend recently to adopt a VBT (velocity based training) approach, as we know 1 RM changes on a daily basis and technology now allows us to more finely tune things with velocity as the target within each set. These things can be helpful as we initially learn to measure and document progress. But I think it is important to step back from this narrow outlook, because this view of strength does not serve all of us well, in either the rehab or...

2015. Chloe Kim warms up for a commercial video shoot at 11 pm. It is 20 deg F. I talk explicitly with my athletes about warm up and the importance of taking it seriously. This is specific work that gives us information and it forms the foundation for that particular session. It is not just about raising body temperature or sweating. Nor is it a time for mindless busywork. There will be general things that work for an entire team; but there will also be things that are specific to the individual athlete. It is important to allow each athlete to have input into their warm up. Personal accountability here helps develop good overall habits and lays the foundations for a lifetime of using movement for self-care. Intentional effort is important. This is the time where one learns to become "in tune" with the body and its potential physicality. The only way to do this is to work through a variety of movements, repeatedly, over time. These experiences allow you to choose those moveme...

I am reviewing things for a new project and this blog post from April 2020 has some things I want to keep in mind. Thought I would share it again. Might prompt some good reflection for the physio crowd. ----- Last week Donie Fox had a great article for HMMRMedia --  "Using Foundational Legs Exercises as the Cornerstone of Rehabilitation."  Check it out if you haven't already. Donie's article is important in my mind because it addresses a critical issue in the rehab world. There is a serious lack of appreciation for and mastery of the use of basic movements (squats, lunges, step ups) to build foundational lower extremity strength. Donie and I have decided to go into more depth on this topic in our next few podcasts. We will also hopefully touch on return to running programming criteria. Here are some barriers, in my opinion, to rehab professionals adopting a "foundational legs" approach. I'm not trying to be overly critical or a curmudgeon here. I am simp...

  I don't ever remember being intimidated by overhead lifting. I was lucky to get expert instruction early in my career. But there are many sport and medical professionals who are unsure of the safety of lifting overhead. Some are adamantly against it. Bilateral work with a bar, overhead and behind the head, is advanced and demands full ROM. It doesn't require extra ROM, but it does require normal, full ROM. Athletes and non-athletes who do not have normal, full shoulder ROM clearly need to do more remedial, single-arm overhead work. Everyone needs to earn the right to do advanced movements. Many just need to take some time to find the motion they actually have; if you haven't put your hands over your head very often, you probably don't know what you are capable of doing. But let me be clear: I've worked with many people who never ever need to use a barbell. I did what was appropriate and necessary for their needs, not my ego or somebody else's idea of what...

 "We did core today."  That phrase makes me furrow my brow and chuckle at the same time. I suppose it is a vestige of bodybuilding and assigning body parts to workouts. We can do better for our athletes if we evolve our mindset and programming to think beyond the isolated torso. And that black hole of training called "stability." If you must give a session or a part of a session a name, I'd like to suggest an alternative framework. We'll stay on the "c" theme, but start from a foundation of movement, not stillness. To do this, I ask you to leave behind ideas of isolating and activating torso muscle groups. Embrace the terms connection, coordination and control. --- Most of life (and sport, for that matter) are not still.  In archery, biathlon, gymnastics or rowing, the stillness we observe is part of one or many transitions from one posture to another. The athlete demonstrates significant control and coordination for a relatively short time; moving...

Pulls -- high pulls and straight arm pulls -- are staples of the competitive weightlifter. Non-weightlifting athletes also use them to compliment things like medicine ball throws. Over the years, I have moved away from barbell pulls, especially high pulls, for non-weightlifting athletes. This may seem like picking nits. However, my job is to bulletproof athletes. I work hard to do it with the least additional joint wear and tear possible, while keeping things simple. First, I don't like the idea of promoting any type of arm pulling if we are going to do any power cleans or power snatches in the future. Arm pulling is the opposite of what we want with these movements.  Second, it is a skill to hold, accelerate, decelerate and lower a barbell when doing pulls. There is a significant anterior load and traction on the upper traps and long thoracic nerve that must be controlled, particularly when you lower the bar. (Thank you Joe Pryztula for reminding me of this!) Most weightli...

Last week Donie Fox had a great article for HMMRMedia -- "Using Foundational Legs Exercises as the Cornerstone of Rehabilitation." Check it out if you haven't already. Donie's article is important in my mind because it addresses a critical issue in the rehab world. There is a serious lack of appreciation for and mastery of the use of basic movements (squats, lunges, step ups) to build foundational lower extremity strength. Donie and I have decided to go into more depth on this topic in our next few podcasts. We will also hopefully touch on return to running programming criteria. Here are some barriers, in my opinion, to rehab professionals adopting a "foundational legs" approach. I'm not trying to be overly critical or a curmudgeon here. I am simply trying to share my observations after 20 years of working at all points on the rehab and performance spectrum. Ok, here goes. 1.  "Protection" mindset vs "performance" min...

In support of my HMMRMedia article today , I wanted to give people a look at some of the Spectrum Squat variations I have used -- and show athletes doing them in actual training sessions. The athletes featured are Morgan Northrop (US national team, aerials skiing, 5' 6" and 128 lbs), Eli Kimche (high school senior, golf, 6' 4") and Nolan Berry (high school senior at the time, basketball, 6' 10" and 220 lbs). The video quality isn't super high, but this is the real deal, flaws and all. Morgan and Eli do a fantastic job of using their full range of motion. Eli is doing is first ever Spectrum Squats in these videos and is learning to rack the KBs. He only has KBs at home so we work with what we have during the COVID -19 times. Morgan is a pro at Spectrum Squats and has used them to their fullest throughout every training year. The video of Nolan is for all of you working with tall, somewhat inflexible athletes. I worked with Nolan...

Over the next few days, Martin Bingisser will be sharing a video lesson and several articles related to programming for leg strength. James Marshall wrote a great piece -- "Training the Legs Through Movement" -- that was featured last week. Donie Fox and I will have follow up articles in the next few days that build on this idea.  In preparation for the video lesson discussion, Martin sent out some questions. I thought it would be good for me to write out my thoughts and take some time to reflect. Here are my thoughts on two of the questions. I hope my reflections spark your curiosity and direct you to the article by James and the follow up articles that will appear later today and this week. Sorry for the wacky formatting. I have been trying to get it all neat and tidy, but Blogger has not cooperated with me today. So I'm playing with it all right now. Alpine ski racer Cooper Iacobelli explores the Russian boxes. ---- One point both James and Donie have...

There are many ways to train power. At this point in my career, I think many athletes are better off training power without a barbell. I am not against it, but it demands a high level of skill, specific equipment and time to do it safely. Developing athletes are better off expressing this aspect of physicality via sprinting, jumping, bounding, throwing and putting. Exploit the acceleration, distance and time elements of the power equation. Power = Work / Time Power = Force x Distance / Time Power = (Mass x Acceleration) x Distance / Time Training for power doesn't always mean we have to train for maximal power, with heavy resistance as the key variable. And when we do need to train for maximal power, we should have the tissue and joint infrastructure ready to handle the demands of those tasks. We need the right foundational movement competencies so we are prepared. As James Marshall said in his most recent HMMRMedia article , we need a system and framework that purposefully ...

Hypertrophy. Pursuit of mass looms large in performance -- for dudes. Gets to be obsessive sometimes in knee rehab. Girth is easy to measure. Feel the burn, see some results. But do those numbers reflect improvement in function? Size matters. But is it the priority, especially at the start of the process? Now patients can do some pretty functional (and slick!) e-stim at home with their own Power Dot or Compex units. These things can be helpful. We don't have to waste precious time during an in-person session now. Then there is BFR. I'll be brutally honest: I don't like it and I don't bother. I think it is a major distraction from the real work that needs to be done in rehab. Why are physios so drawn to gadgets? Why aren't we more concerned with management of gravity and ground reaction forces? Connect the brain to the leg to the ground and move. Focus on coordination and control throughout the full ROM before anything else. Girth before capacity and joint ...

Many people ask me about teaching athletes to squat. So I thought I'd put together a post showing some of my "go-to" teaching movement sequences and share a few helpful points. This post will not go into any depth about working with people who have significant mobility restrictions -- we'll save that for a future post. But this should give you some practical tools and cues to help you build your process and progression. A word of caution -- I use capital letters in this post.  And that's my first point: We all need a process. This is the process I've developed over the last 15 years or so. It's not perfect, but I've found it helpful -- for me. EVERYONE I work with uses this process. So everything I do within my system of programming builds from the elements in this process. New movements will have familiar elements of movements already learned.  Second point: You will probably need to use a few explicit instructions at the start. Stance ...