Why do you have FAI?

FAI, or femoro acetabular impingement, is a hip “abnormality” in the shape of either or both of the femoral head and acetabulum. If you have it, or suspect you have it, you’re probably relatively young (seemingly too young for hip problems), and you’ve probably been dealing with hip and/or groin pain for a while without knowing what was going on, until someone finally came up with FAI.

I was diagnosed with it in 2007 after almost two decades of on-again, off-again hip pain and dysfunction. Since then, I’ve read a lot, chatted with many people who have it, and have trained many clients with it. I recently wrote briefly about my own experience with FAI, and have also written an at-home exercise ebook for FAI (Coming in November!).

As more is known about FAI, more research is being published. I’ve pulled out five particularly interesting facts (or so I think) from the research, and have included my interpretation of them and their potential relevance. Enjoy, and please ask questions in the comments and I’ll get to them as soon as I can. One note: use of the term “young” in this post refers to people under the age of fifty. Funny how our concept of “young” changes as we age! With respect to hips and FAI, studies tend to focus on people under fifty.

Fact #1: FAI is much more prevalent among men than women, with studies suggesting anywhere from 14% to 24% occurrence in young men with asymptomatic hips , but only 6% in young women with asymptomatic hips.[1]
Interpretation: FAI is a real thing, even among people with no symptoms. The question is, what does it mean? If someone has FAI but has no symptoms, should we do anything about it? Take my hips for instance. I had twenty years of hip pain in my left hip, and zero years of pain in my right hip, but I have FAI in both. My sense as a trainer is that it’s important to recognize that not all hips are built “to spec” and that the two biggest areas where we should keep FAI in mind are in relation to stretching and squats. With hip stretches, I keep tabs on whether it causes pain or discomfort. If it does, I’m going to tend to assume we’re pushing into a bony end range (maybe FAI; maybe another hip structural anomaly), and I’m going to back off that stretch. I’ll talk about squats down a few facts.

Fact #2: FAI is twice as common among men with limited hip internal rotation as those with normal hip rotation range of motion.[2]
Interpretation: I think an important question to ask about this finding is whether FAI is more common in the presence of reduced internal hip rotation, or whether reduced internal hip rotation is an early sign of FAI. Either way, I think the take home is similar to the take home for fact#1: If someone has limited hip internal rotation, there might be a structural contribution, so be careful with your efforts to increase internal rotation range of motion. In fact this might be a situation where seeking input from a good physical therapist, athletic therapist, or chiropractor would be in order.

Fact #3: “We performed a database review of pelvic and hip radiographs obtained from 157 young (mean age 32 years; range, 18-50 years) patients presenting with hip-related complaints to primary care and orthopaedic clinics…At least one finding of FAI was found in 135 of the 155 patients (87%)”[3]
Interpretation: Yikes! 87% of young, symptomatic hips had FAI? I think the take home here is obvious: Don’t ignore comments of hip pain. Perhaps this is a good reminder that the body is pretty good at telling us when something is wrong, if we’re willing to listen. I always hate to suggest this, but feel I would be remiss if I didn’t: If your hip hurts after you play your chosen sport, maybe you should question whether playing that sport is appropriate for you? That’s not to say that if something hurts a bit, you should stop playing. Definitely not! But if your hip constantly hurts during or after a specific activity, despite having spent months (or years in my case) with a manual therapist and a good training program, maybe your body isn’t built to do that activity. For me, this brings a flashback to the 2007 Canadian Ultimate Championships, and me sitting in the stands between games with a big bag of ice on my left hip while snacking on vitamin I (Advil). Note I did this “in between games”; not after stopping playing because my body was clearly telling me that I was damaging my hip. So yes, this is me suggesting you aim to be smarter than I was.

Fact #4: People with FAI have less range of motion in body weight squats than do people without FAI.[4]
Interpretation: People who have FAI probably shouldn’t squat. How can you tell? Is it painful? Does your pelvis shift to one side during the squat? Do you start to round your back at the bottom? These are signs that you lack the range of motion or stability required to squat so your body is finding alternative ways. If you see this, try to fix it, and if you can, great. But if you can’t fix it, then you are probably someone who shouldn’t squat. Thankfully it is possible to be awesome without squats in your workout.

Fact #5: Hockey players have a higher prevalence of FAI than do skiers and soccer players, and the rate increases as they move up, with particularly high levels noted at the midget level.[5]
Interpretation: FAI might be something people develop in response to biomechanical forces? And it would appear that there is something in the way hockey players skate that produces higher rates of adaptation. It would be interesting to see if similar numbers are seen in figure skaters, to see if it is a skating thing, or if it is a skating with the torso in a flexed position thing? In terms of what I suggest, I need to disclose that I have a conflict of interest: I am Canadian. And that means I can’t suggest that someone consider not playing hockey, because I don’t want to have my passport revoked. But you may want to re-read fact #3.

If you have FAI, are you a hockey player? How’s your hip internal rotation? How does your squat look? Do squats cause hip pain? Do you keep doing them anyway? It’s interesting to think that our bones change in response to our activities. That may seem revolutionary, but in fact it’s a long-known truth. In fact it’s even got a name: Wolff’s Law. I’ll talk more about Wolff’s Law in the next FAI post, sometime in the next few weeks. And I’m very excited to be launching my new ebook: Training Around Injuries: At Home Exercises for FAI in November. Did I mention it’s a video-embedded ebook?

If you want to be notified when more of my FAI blog posts come out as well as when the FAI ebook comes out, sign up for the Training Around Injuries mailing list. As with all my stuff – I’ll keep it spam-free.

Sign up for updates on FAI posts and the FAI ebook



References:
[1] KA Jung, et al, “The prevalence of cam-type femoroacetabular deformity in asymptomatic adults”, The Journal of Bone and Joint Surgery, 2011.
[2] Michael Leunig, “Basic and Clinical Science Advances in Understanding FAI
[3] Leah M. Ochoa et al. “Radiographic Prevalence of Femoroacetabular Impingement in a Young Population with Hip Complaints Is High”, Clin Orthop Relat Res. Oct 2010,
[4] Mario Lamontagne, et al, “The Effect of Cam FAI on Hip and Pelvic Motion during Maximum Squat”. Clin Orthop Relat Res. 2009 March.
[5] Marc J Philipon Et al. “Prevalence of Increased Alpha Angles as a Measure of Cam-Type Femoroacetabular Impingement in Youth Ice Hockey Players”. Am J Sports Med 2013 Apr.

The oil light just came on in your car?

I was driving home from a great camping trip at Sandbanks this past weekend and as the road curved slightly, my oil light went on along with the melodic “beep….beep…beep…”. My response was obviously to put my finger to my lips and gently say “shhhhh”, and it eventually went off, only to come on again at the next curve. I think it’s only turns to the right. It’s been like that for a month or so. Usually when this happens, I wait until it comes on more frequently and then just add some oil, and the problem stops. And yes, by problem I mean, the oil light coming on.

My friend who was in the car with me asked that he not be named, so I’ve changed his name here. My friend Terry, Terry McTillivray, laughed slightly nervously at my response to the oil indicator. When I mentioned that I would just add more oil when I got home, I took great pleasure watching his reaction out of the corner of my eye. He tried to be calm but it was like I had fried his brain with such a sickening statement. He opened his mouth and raised his hand as though to talk, but no words came.

Eventually he said, “you’re going to check the oil level first right? You know that too much oil is as bad as too little, right?

“Oh it’ll be fine. I do it all the time. I won’t put a full bottle in.” I replied, enjoying the conversation and especially his reaction immensely.

I debated continuing with my hateful talk, but I decided it was time to come clean and share my perspective.

I realize that guys find it almost physically painful to hear about someone treating their car as poorly as I do, and it actually amuses me greatly. Because here’s the thing: You find it offensive that I don’t take my car in to get fixed when it’s giving me a  clear signal that there’s something wrong; but meanwhile you hurt your foot a month ago, are still bothered by it, but you haven’t done anything about it. I will only have my car for another year or two, but you’re stuck with that body forever.

So yes, I admit it. I treat my car like crap. To all of you who think the “one owner” description in the used car ad is a good thing, remember that owner might have been me. But I maintain my body pretty well. Definitely better than I maintain my car. Yes, I have set that comparative bar pretty low.

What about you? Do you treat your car better than you treat your body? Did a feeling of anger overcome you as you read about my car-abuse, yet you don’t afford your body the same reverence? Are you willing to consider that maybe not maintaining your body is a bigger sin than shushing the oil indicator light?

 

Elsbeth Vaino, B.Sc., CSCS, loves driving her Volkswagen but is much less fond of maintaining it.

Do you enjoy these posts? If so, sign up for the newsletter so you don’t miss any. We send it out as a summary email every few posts.

* indicates required



Ten Commandments of Coaching

I was just editing the Custom Strength Coaching Manual, and as I got to the how to coach section, I decided to share it publicly. I feel lucky to have spent a decade teaching skiing prior to becoming a trainer. The CSIA (Canadian Ski Instructors Alliance) does a phenomenal job of teaching their teachers how to teach. It’s really impressive, and in fact it’s something I am trying to emulate with the trainers who work with me. They provided daily opportunities for the instructors to take “session” with senior instructors to work on their own skiing ability as well as their teaching ability. My guess is that every ski instructor in Canada (maybe the world?) knows the term Pedagogy. I wonder what percentage of trainers do?

My goal is not to disparage personal trainers. Because it’s not their fault. Unfortunately the infrastructure surrounding personal training, including the certification process, is weak in comparison with other industries. This unfortunately leads to many personal trainers being in a situation where they are ill-equipped to be a great trainer. In my opinion, lack of focus on pedagogy is a big part of that. And so without further ado, here are ten pedagogy tips from the Custom Strength Coaching Manual:

  1. When teaching a new movement, should you say it or show it
    • The answer is both
    • Sometimes you will also need to put them in the position so that they can feel it
      • Tell them before you do this. “I’m going to put my hands on your hips” or “do you mind if I put my finger on your butt” (if you want them to feel their glute).
      • I do not recommend butt-touching when coaching teenagers.
  2. Are you talking enough? Too much?
    • Auditory learners need to hear it versus just seeing it, but resist the urge to ramble. I still have Frank’s (Ski School Director) voice in my head on this topic as a lesson during ski instructor training: “Shut up and ski”.
  3. How many things can a person focus on and how many corrections can you make?
    • There’s no single answer, but it’s probably 2 or 3. Aim for as few things to focus on as possible.
  4. When is in-gym performance “good enough”; when must it be corrected or changed?
    • This will depend on the client.
    • We strive for excellence, but not everyone has the movement capacity for excellence (yet).
    • If their current movement is horrendous, then we work to a standard of acceptable.
    • If it’s good, now we aim for excellent.
    • There are a lot of steps between first year on skates and Wayne Gretzky, and each step in between is an accomplishment.
  5. If you asked a client to focus on keeping their back straight and pushing through the heels, and they do that, but you see them also moving their hand incorrectly, do you correct their hand?
    • Unless it is dangerous, the answer is NO! They did exactly what you asked of them – congratulate them for it. Fix the hand at the next session.
    • Even at the next set – let them focus on the same few points as the last set – let’s make that correction really stick.
  6. How much encouragement does your client need?
    • Everyone is different. Aim to figure out what works best for your client and offer that.
    • Or figure out what is your way and stick with that. Just make sure everyone gets at least some encouragement each session.
  7. Are your cues and instructions working?
    • If you find all of your clients are doing a certain exercise wrong, the problem is probably you. Maybe it’s your demo, or maybe it’s how you’re saying it. Either way – give thought to whether you could be teaching it better.
    • If you see or hear someone else using a coaching cue that really works, don’t be shy about copying it. There’s no shame in learning from others. I have some coaching cues that come from clients. Sometimes they just put it in a way that really makes sense. If that happens, thank them and tell them you’d like to use that. They won’t judge you for your lack of perfection; they will be flattered and honoured to have contributed.
  8. Most of the time your instructions should be movement-based instead of muscle-based
    • Your clients are unlikely to know their anatomy like you do, and even less likely to have a finite enough sensation to be able to discriminate what muscle they are engaging.
    • There are of course exceptions, but this will largely be when breaking an exercise down; the default should be to describe the movement you want to see, not the muscles they will use to get it.
  9. Bring out the video camera
    • Sometimes we try to correct a client’s movement, but in their mind, they are already doing what you’re asking. Show them! Video them doing the movement and then show it to them. Talk about what you see. Tell them “this is where your back is rounding a bit. If you bend your knees more here, you’ll be able to stay straight.”
  10. Are they listening? If not, why not? Is it you? Is it the program? Is it them?
    • Do your clients trust and respect you?
    • Is the exercise level appropriate? Too easy? Too hard?
    • Are they engage-able?
    • Anyone can coach a motivated athlete with great movement, but are you a good enough coach to get results from that difficult client who doesn’t work hard, or has poor movement, or poor comprehension? They will tax you, but they will also make you better.

Here’s a great blog article about pedagogy that I highly recommend for anyone who works with people.

Elsbeth Vaino, B.Sc. CSCS, is a personal trainer in Ottawa, Canada

Do you enjoy these posts? If so, sign up for the newsletter so you don’t miss any. We send it out as a summary email every few posts.

* indicates required



4126117225_7ed47633c6_b

Carb tolerance related to geography?

I’ve long suspected that how we respond to food is influenced by where we come from. It just made sense. Human evolution is just too smart to not have adapted to the foods around us. I’ve also often thought that for those of us living in countries like Canada and the USA, that we can’t just take for granted that the food here is what we are meant to eat. Many of us are first or second generation in this country, which, following my thought process, suggest that we may be displaced nutritionally. And having seen different people respond very differently to the same food, it only made sense to me.

Which is why this blog post by a nutritionist at Precision Nutrition caught my attention. It reviews recent research about genetic variations as they relate to carb-tolerance, and how those variations seem to have geographic ties. Here’s the full article for those like me who find this stuff fascinating, and here’s my super-brief summary version:

  • Research has recently shown that ability to make amylase correlates with obesity
  • Amylase is made by the AMY1 gene
  • It turns out we don’t all have the same number of copies of genes; and in fact we can have from 2 to 16 copies of AMY1.
  • Those with more copies of AMY1 can breakdown carbs more effectively than those with fewer.
  • “People living in historically agricultural societies like Japan had, on average, seven copies of AMY1, while people near the arctic circle in places like Yakut, Russia had, on average, four copies of AMY1.”
  • “If you have more than nine copies of AMY1 then you are eight times less likely to be obese compared to someone who has fewer than four copies of AMY1.”
  • The article points out that the variance above was based on a small range of BMI (25-27kg/m2), so care must be taken in interpreting the meaning.

Fascinating stuff! It’s very clear that there is much more to learn on this topic, but still – interesting!

I guess because this is about carbs, but this topic makes me think of the new research Gary Taubes is doing. In principle, it’s an impressive undertaking, as they are looking at individuals in isolation where they can actually monitor response to food as opposed to counting on the ever-flawed self-reporting. What concerns me is that all of their participants are overweight or obese. If the research above holds true, then those who are overweight or obese have a different carb-tolerance than those who are not. So if Taubes’ research does show that a low-carb diet is better for their participants, is it applicable to the entire population? Or just to those who are already overweight?

Clearly the result of that study is still going to be interesting and important; but it probably shouldn’t be taken as being “the best diet”.

All that to say – there is interesting research going on in the world of nutrition!

Elsbeth Vaino, B.Sc., CSCS, is a personal trainer in Ottawa who finds nutrition and exercise research to be intriguing.

30 Day Core Challenge Results

Monday was the last day of this edition of The Core Is The Core 30 Day Challenge. What is this challenge you ask? It’s my response to the many other “core” challenges out there that tend to be all about the abs. Not that there’s anything wrong with abs. But there’s more to the core than abs. Lots more. But I’ll stop ranting in honour of those of you who’ve read my rants on this before. For those who are still curious what The Core Is The Core is about, you can read all about it here, and maybe even sign up for the next edition (Starting November 1st).

Now for the results!

A huge congratulations and shout out to the 9 people who completed at least 28 days of daily core exercises and thus get added to the Winner’s Circle. I’ve included first or nickname (if that’s what was given) or first name and initial only (if full name was given) as I don’t know for sure if they want to be identified by full name on the interweb. But hopefully they and their friends know who they are:

  • Zuweina
  • Tom M
  • Swatty
  • Suzanne M
  • Sara
  • MarieDee
  • Madeleine
  • Julian H
  • Jocelyn H

Why is it in reverse alphabetical order? Call it the will of the person whose last name starts with a V. My blog; my list order. :)

Well done folks! Seriously – that’s impressive! Those of you reading this who haven’t tried might think this is an easy challenge, but we actually had 60 registrations, so we’re talking a 15% completion rate. It’s not a hard challenge in the sense that it doesn’t take long each day, but it turns out consistency is tough!

Each time I hope more and more people will complete it, but honestly I’m still happy for those of you who start but don’t finish as I recognize it’s not a simple task. Certainly those who get 15 or more days in – that’s awesome. That means you’re contributing 15 days toward a stronger, healthier core. So great!

I like to peak at the submissions to see what exercises get done the most. If you were wondering, here is the top 3 in each category:

Anterior core (aka for the six pack):

  1. Plank
  2. Curl Up
  3. Dead bugs

Lateral/rotary core (aka your sides):

  1. Side plank
  2. Bird dogs
  3. Shoulder taps

Posterior core (aka your butt):

  1. Glute bridge
  2. Single-leg glute bridge
  3. Deadlift

Core Plus (aka exercises that aren’t usually classified as core but really require a lot of core):

  1. Push-ups
  2. Squats
  3. Split Squats

Wondering what these exercises are? Google is probably the fastest way to find out, or you can sign up for the next The Core Is The Core 30 day challenge and learn by receiving our daily core exercise email.

 

Elsbeth Vaino, BSc., CSCS, FMS is a personal trainer in Ottawa who enjoys spreading the word about the value of training the whole core; not just the abs. If you live in Ottawa and are looking for a trainer, give her some consideration.

Ski Season.Is.Coming.Soon. Are You Ready?

September is a funny month. It gets darker earlier, leaves start changing colours, and here is less and less produce available at the local farmer’s market. The funny part is the divide: Those of us for whom this elicits excitement about the snow that will soon follow; and those of you who are depressed about it.

If you’re in the depressed category, my condolences. It’s going to be a (hopefully) long and snowy winter, and it’s going to suck without having an awesome way to enjoy it. If you’re hoping this not-the-most-sincere-condolence is followed by some great advice on how to cope, well, sorry again. Take up skiing?

Now for the rest of us. Woohoo! Okay, so who’s buying new gear this year? Boots? Jacket? Skis? Have you picked it out yet? What about ski trip plans? West? Europe? I hear skiing in Japan is amazing! I’m in the market for skis and cannot wait to get them. Thinking about the Salomon X Race, although I’m torn. They rip on the hard stuff, but they’re not exactly dainty in the bumps, although they manage.

Now that I’ve got you excited about skiing and gear talk, I’m going to go for a little bait and switch here. (cue wa waaahhh sound). Any plans to prep your body for ski season? You have to admit that it’s a bit odd that we spend so much time and money researching and buying new gear, but many of us barely put a moments thought or effort into prepping the one piece of equipment that we don’t have the luxury of replacing. It’s true we can replace some of the parts, but unlike skis, the 2014 model of a hip or knee joint is nowhere near as good as the one that came with your body. Or I should say – nowhere near as good as it was when it still worked well. Joint replacements, and surgeries can work wonders for worn out joints. But what if we put some time and effort into joint maintenance before throwing them to the steeps, the deeps, the ice, and the bumps?

Most of us would never think of starting our first day on an un-tuned ski, but we’ll go with an un-tuned body. And the craziest thing about that is that a tuned body can enhance our ability to enjoy skiing much more than a new ski will. Okay, if your skis are really old, maybe equally so.

Seriously snow-lovers: add body tune-up to your pre-season plan. The morning after your first day on snow, you’ll be happy you did.

Wondering what you need to work on? Check out this clip from a presentation I gave at the Ottawa Ski Show:

If you live in Ottawa and you’re looking for an option to get you fit for skiing, consider coming and training with us at Custom Strength. In addition to our semi-private training, we will be offering group classes starting  October 1st. The Kettlebell Strength, Movement and Mobility, and Sports Conditioning classes will all go a long way toward preparing you. Get in touch with us if this sounds awesome.

For those of you who live elsewhere, join a gym, and either find a great trainer or consider picking up my 12 week Ski Training ebook.

Now back to the fun stuff. Let’s hear what you’re buying, and of course, feel free to share your favourite ski porn in the comments section. Here’s my perennial favourite:

 

 

Elsbeth Vaino is a personal trainer and former ski instructor who is eagerly waiting for ski season to start.

A New Challenge Element to The Core Is The Core 30 Day Challenge

The Core Is The Core 30 Day Challenge has a cool new twist! In addition to challenging yourself to make it the full 30 days (28 days actually as you get 2 days off), this time you can also challenge your friends! Here’s how that works:

Step 1. Ask your friend if they mind being challenged.

Step 2. Sign up for the challenge (too obvious?). Here’s the registration form if you’re not already signed up (it’s free), and here are some details about the program in case you’re scratching your head.

Step 3. Go to the Custom Strength Facebook page and write “I challenge (tag your friend) to the Core Is The Core Challenge”, or if your friend is not on Facebook, then write that in the comments below this post. You can challenge up to 3 people.

Step 4. Your friend must confirm acceptance of the challenge by replying to your post or comment with a “challenge accepted” either on the FB comment or in the comments below.

Step 5. Your friend must also sign-up (even more obvious?).

In addition to tracking how you do against the calendar (28 submissions required for the coveted Winner’s Circle), we’ll also track how well you do against your friend(s), and report back at the end of the program so you’ll know who is more awesome. What? Are you questioning the contention that doing better on a core challenge correlates with being more awesome? Show me one study that disputes this claim.

Head here for details and a sign-up link for the next The Core Is The Core 30 Day Challenge.

Bend at the hips, not the knees, and definitely not the back

Do you ever get low back pain? And can you do this?

My guess is that if you do get low back pain, you probably can’t hip hinge. As I note in the video – be strict with your form. If you can’t feel whether the dowel (or broom handle, just something very light and straight) is coming off your butt or if your head is moving from it, or if your upper back is arching away from it, then get someone to watch you, video yourself, or use a mirror. This is one of the few times I want you to be critical of yourself. If you can’t bend over to the point where your back is almost parallel with the floor while keeping the dowel touching those 3 points, then that’s a problem. Because really what it means is that when you bend over doing normal daily activities, you’re probably bending in your low back. And for many people, doing that hundreds or thousands of time (365 days per year – how many times a day and how many years – it multiplies up!) is a big problem for their back.

If I’m wrong – if you can hip hinge well and you have low back pain – please comment below as I’ll be very interested to talk with you.

I’m in no way trying to suggest that this is the magic pill for low back pain. What I AM saying is that bending at the hips instead of the back tends to reduce the amount of extra strain on your back, which usually makes your back happier.

What about those doctors who say to bend at the knees instead of the back? If you could see me now, you’d see that I’m shaking my head. Bending at the knees instead of the back is a great way to develop knee pain. It’s also impractical. Think about it – if you are bending to reach something that’s low and in front of you, how will bending at the knees get you there? When bending at the knees, you go straight down. So it’s practical for something you’re picking up at your feet, but if it’s something in front of you, not so much. And even with the item directly below you, if you don’t have phenomenal ankle and hip mobility and a very stable core, it’s not going to work well, because your heels will come off the floor which will shift your knees foreward, and your back will round. Not a great position for most people. Bending at the hips on the other hand – that’s gold! Look how big your hip muscles are! Yes I am saying you have a big butt. At least in comparison to your knees. Those hip muscles were built for bending, so use them.

Work on the two-legged hip hinge above if you can’t do it, and think about incorporating that into your daily life. Pay attention to even the little things, like brushing your teeth: I bet when you lean forward to spit, you bend at the low back. Try bending at the hips instead: it gets you to the same place but your back will prefer it.

Once you get to the bottom of the two-legged hip hinge, start to bend your knees, and you’ll open up a whole world of heavy lifting potential that is much safer for your back. Some of you recognize that what I just described is actually a deadlift. Sure is! And what a great exercise. Head over to this post if you want some guidance on what a good and a bad deadlift looks like. Please do keep in mind that using great form is not a free ticket to lift stuff that’s too heavy for you – common sense is still your good friend. Don’t alienate her.

There are some scenarios where a one-legged hip hinge is a better option for picking stuff up. In the gym we refer to this as a single leg Romanian deadlift, and those of you who have great trainers are saying “hey, I do that in my workout”. Yes, if your trainer has you doing single leg Romanian deadlifts (or SL RDLs) and is vigilant about working on your form, it’s probably a fair assumption that he or she is a good trainer. Unless you look like a weeping willow while doing your SL RDL – that’s a pretty sure sign you don’t have a good trainer.

Here’s a video of the single leg RDL.

What’s that it looks like the bird drinking the water?

Bird drinking water RDL

That’s the one we use at Custom Strength to reinforce what I mean when I say a hip hinge. One of my clients was asking if I had a top hat for them to wear. Think I may go buy one to see if it improves their ability to hip hinge. Anyone know where to find a top hat in Ottawa?

If you’re looking for some more exercise and movement ideas for someone who has low back problems, you may be interested in this article, “6 Exercises for Low Back Health“. Just please note this point near the top of that post:

“If daily living causes you low back pain, I strongly suggest that you look to a health care practitioner as your primary source of guidance for your back health. I won’t suggest what type of professional you see, just that someone who is a doctor, osteopath, physical therapist, chiropractor, athletic therapist, or massage therapist sees and hopefully provides some treatment for your back.”

 

Elsbeth Vaino, B.Sc., CSCS, is the owner and one of the personal trainers at Custom Strength in Ottawa. If you’re in Ottawa and you are thinking ‘I could really use a trainer who thinks like this’, you’re in luck – we’ve got a summer special promotion at the moment.

You sit all day, then you play a sport…

You spend all day like this?

Photo credit: JeremyFoo on Flickr
Photo credit: JeremyFoo on Flickr

Then you go play like this?

Photo credit: bianditz on Flickr
Photo credit: bianditz on Flickr

Or this?

Skiing is awesome
Skiing is awesome

This?

Photo credit: tulannesally on Flickr
Photo credit: tulannesally on Flickr

Or…
hockey posture

Maybe it’s…

Photo credit: cypresschargers on Flickr
Photo credit: cypresschargers on Flickr

And you say you’re having problems with your hips or shoulders? Weird.

Don’t get me wrong: I am a big supporter of staying active, and I think playing sports is the best way to do that. I really do. It’s exercise; it’s camaraderie; it’s often outside in nature; it’s a fantastic stress-reliever; and it’s fun which means we want to continue doing it. But seriously people – if you’re a desk jockey and an athlete, you’re punishing your poor body with those postures! Get yourself to the gym and give your body a fighting chance to survive!

When you’re there, remember that sport-specific training is as much about training movements that counteract what you do in your sport as it is about training the movements and muscles you need to perform. Or at least it should be if you want your body to let you continue enjoying your sport.

Elsbeth Vaino, B.Sc., CSCS, is a personal trainer in Ottawa Canada, who works primarily with athletes whose athletic careers include player fees instead of salaries, and the accompanying desk-job-atrophy.

You may also enjoy these posts:
My experience with hip injuries and FAI
The 4 Things I know about sports injuries
Best ever scapular stability exercise

Home Exercises for FAI

Foam rolling the adductors

Lots of people foam roll, but I’ve noticed not many seem to roll their adductors (groin). It’s too bad, because I notice that when I show this to my clients at Custom Strength, that it is very clear many of them need it. Ideally, these people would also be getting manual therapy on their adductors as well, but let’s start with the easier solution, and show you a video about how to roll the adductors. It’s one of the 40+ exercise videos that  is included in my upcoming Training Around Injuries: Home Exercises for Femoro Acetabular Impingement (FAI) ebook.

The reason I’m sharing this exercise now is that a friend of mine mentioned this evening that she is having some adductor pain, that started with a pull in a game (ultimate) a couple of weeks ago. She noted it had been better but then was acting up again. I suggested seeing her massage therapist (although manual therapist – which would include physio, athletic therapist, and chiropractor would have been a better suggestion). I also suggested rest and stretching may be good options, and then went on to talk about the “why”. Just a quick note: I’m not by any means qualified to give advice about how to fix a groin strain: that’s what manual therapists and sports medicine doctors do. But I do have opinions (one of which is to see a manual therapist), and so I shared them (including the ‘go see a manual therapist’ part). Note how many times I mention ‘ see a manual therapist’ in this paragraph? By all means please do read on and do watch the foam rolling the groin video, but what’s the real best option to do when you have some unknown groin injury? Hint: go see a manual therapist or sports medicine doctor.

Health care recommendations aside, I am an exercise nerd, so of course, I also talked about why this may have happened. Now I don’t haven any idea how she moves (other than being a great ultimate player), so it really could be anything. But it made me think of a great blog article by Michael Boyle called “Understanding Sports Hernia May Mean Understanding Adduction“. You really should read it, because it’s a fantastic article, especially if you’re in the strength and conditioning or physio realm.

  • Coach Boyle notes that two of the five adductor muscles (pectineus and adductor brevis) have secondary roles  as hip flexors, although they are not strong hip flexors.
  • In the chat with my friend, I used the analogy of the spare tire on your car – it gets you there, but it’s not as good as a full tire (unless your spare is a full tire, but you know I’m referring to cars with the mini spare tire). Same deal with muscles in the body – when a muscle is doing it’s secondary job, it tends to not be as good at it. If you continue driving on the spare tire, it’s going to either seriously limit your speed, or it’s going to blow. Same goes for when a muscle is consistently asked to do it’s secondary function in addition to it’s main function.
  • Coach Boyle is talking about hockey and soccer athletes, where the skating stride and kicking motion both involve adduction and hip flexion, thus potentially pectineus and/or adductor brevis are being asked to work overtime.
  • Ultimate doesn’t have exactly the same thing, but I don’t think anyone will dispute that the cutting and pivoting we do will involve both hip flexion and adduction. So perhaps the same story.
  • One very interesting point Coach Boyle notes: that the two cases of sports hernias he refers to both seemed to have also involved soft tissue restrictions in the pectineus. Which is what lead to Coach Boyle coming up with that theory.
  • He goes on to describe what the physical therapist he was working with described as “benign neglect”, where the symptoms of an injury go away and thus the assumption is that the problem is gone. Apparently not!

Which brings us back to my point above: go see a manual therapist when you get a groin pull. But also try foam rolling it, like so:

Make sure you check out part 2 of Coach Boyle’s Understanding Sports Hernia article, where he talks about prevention and shares a tonne of knowledge including many, many amazing exercises.

This is also serving as a reminder that I’ve been meaning to bring in more weighted lateral squat variations for my clients who play ultimate. It’s funny how sometimes several things remind you of the same thing within a few days, even though you hadn’t considered it in a while. In addition to this discussion (and my re-reading these articles), I also saw the following excellent Eric Cressey video the other day that made me think “why aren’t we doing that at Custom Strength?” Those clients of mine who are reading this, if you’re an ultimate player, and if your hips tolerate lateral squats, you’ll be seeing these soon!

 

Elsbeth Vaino, B.Sc., CSCS, is a personal trainer at Custom Strength in Ottawa, Canada. 

For more on my upcoming hip training ebook, head over to this post titled, My experience with hip injuries and FAI.