The
result can be knee pain from the instability (a weak hip will allow
internal rotation and adduction of the femur) or back pain from the
immobility and accompanying forward lean. How a joint can be both
immobile and unstable is the interesting question. Both
weakness and/ or immobility of the hip in either flexion or extension
causes a corresponding compensatory action at the lumbar spine. This is
the problem in squatting. In our joint above/ joint below concept, the
lack of hip motion compromises the low back in squatting. As
the spine moves to compensate for the lack of strength and mobility of
the hip, the hip loses more mobility. It appears that lack of strength
at the hip leads to immobility, and immobility in turn leads to
compensatory motion at the spine. The end result is a kind of
conundrum: a joint that needs both strength and mobility in multiple planes. Let's
look further at the interrelationships. The weakness of the hip in
preventing adduction causes stress at the knee. We've oversimplified
this to a glute medius weakness, however the weakness often extends to
the glute max and the hip rotator group. In this case we need
frontal plane control to prevent patella femoral problems, IT band
issues, etc. In the sagittal plane, poor psoas and iliacus strength
and/or activation will cause a pattern of lumbar flexion as a
substitute for hip flexion. Poor strength and/or activation
of the glutes will cause a compensatory extension pattern of the lumbar
spine that attempts to replace the motion of hip extension. In other
words, if you can't move your knee up (i.e flex the hip), you'll flex
the lumbar spine to achieve a motion that appears similar.

The Lumbar Spine (Stability) The
lumbar spine is even more interesting. The low back is clearly a series
of joints in need of stability, as evidenced by all the work in recent
years in the area of core stability. Strangely
enough, the biggest mistake I believe we've made in training over the
last ten years is engaging in an active attempt to increase the static
and active ROM of an area that obviously craves stability. In
other words folks, you don't need to stretch your low back. Trust me, I
know what you're going to say. "It feels good to rotate." It does feel
good when I do that stretch. Check out my article, Is Rotation Even a Good Idea? (link to Is Rotation Even A Good Idea?) on my site. Do
you know what I tell coaches and trainers when they tell me "it feels
good when I do X," I tell them scratching a scab on a cut also feels
good. However, the result is bleeding and scar formation. This
is how I feel about rotational stretches for the low back. They're like
scratching a scab. I believe that most if not all of the many rotary
exercises done for the lumbar spine were misdirected. Both Sahrmann (Diagnosis and Treatment of Movement Impairment Syndromes) and Porterfield and DeRosa (Mechanical Low Back Pain: Perspectives in Functional Anatomy) indicate that attempting to increase lumbar spine ROM isn't recommended and potentially dangerous. I
believe our lack of understanding of thoracic mobility has caused us to
try to gain lumbar rotary ROM and this is a huge mistake. So let's get
back to lifting. The lesson here is, never, and I mean never
use any kind of rotary torso machine. Eliminate all the trunk twists,
Scorpions, etc. that you do to "warm-up" your low back. As McGill says,
"Spare the spine." All this talk over the past ten years has
been about core stability, not core mobility. The lumbar spine needs to
be stable, not mobile. Squat tall with the bar high; deadlift with a
flat back. If you have a history of low back pain, go single leg.

Thoracic Spine (Mobility) The
thoracic spine is the area about which we seem to know least. Many
physical therapists seem to recommend increasing thoracic mobility,
though few seem to have exercises designed specifically for thoracic
mobility. The approach seems to be "we know you need it, but
we're not sure how to get it." I think over the next few years we'll
see an increase in exercises designed to increase thoracic mobility.
Interestingly enough in SAHRMAN
Diagnosis and Treatment of Movement Impairment Syndromes, physical
therapist Shirley Sahrmann advocated the development of thoracic
mobility and the limitation of lumbar mobility. We've added a simple thoracic spine mobility drill to our warm-up to try to get the thoracic vertebrae to regain lost motion.
From
a lifters point of view, thoracic mobility may seem less important, but
if you suffer from low back pain or from neck pain, thoracic mobility
work will spare both the lumbar and cervical spine.

The Scapulo-Thoracic Joint (Stability) As
we continue up the kinetic chain, we get to the scapulo-thoracic joint,
which is the transfer station to the upper body. This is the interface
of the shoulder blade and torso and also the key to a healthy shoulder.
Logic dictates that this is a joint that needs stability. As a
lifter, this is the key to the health of the rotator cuff. As we all
know, our fascination with supine pressing has made rotator cuff
tendonitis almost a badge of honor in the lifting world. Charles
Poliquin has frequently talked about lower trapezius strength and its
relationship to shoulder health. Bottom line. The scapulo-thoracic
joint is usually weak and under worked. Most strength athletes don't do
nearly enough back work and, rarely do mid-back work like rows. If
they do row, they like the bent row, which often compromises the lumbar
spine as it attempts to work the scapula stabilizers. Most, if not all,
lifters need more rows for the scapulo-thoracic joint as well as
isolated exercises for the scapula-thoracic joint. Low trap
raises as well as exercises that have become know as Y's, T's, W's, and
L's or U's all directly target the scapula stabilizers
Take a quick test. Try a max set of inverted rows.
Can
you do 10? Most "strong" guys can't get 10 reps where they touch their
chest to the bar without cheating. As soon as they fail they
immediately go into the excuse book. Excuse one is that their
incredible size keeps them from touching their chest to the bar. My
next question. Why does your incredible size allow you to bench? That's
when they usually just shut up and acknowledge their weakness. Work to
stabilize the scapula and at the same time, to develop the strength of
the retractors like the rhomboids and lower traps. Just because you
can't see them in the mirror doesn't mean they're not important.

The Shoulder The
gleno-humeral joint is similar to the hip. The gleno-humeral joint is
designed for mobility yet frequently becomes immobile. The
shoulder is a complex system in that the gleno-humeral joint is
strongly interrelated with the scapulo-thoracic joint. I like the "You
can't shoot a cannon from a canoe" analogy here. The
scapulo-thoracic joint is the stable base that allows a mobile shoulder
to work. We need to be able to lock the shoulders in place in a
retracted and depressed position with the scapula stabilizers for the
gleno-humeral joint to function properly. The bottom line is
that a stable shoulder complex will make for a healthy shoulder
complex. The best exercise to feed this interrelationship is what we
call Wall Slides. Wall slides can best be described as an active range
of motion exercise for the gleno-humeral joint, combined with a
stability exercise for the scapulo-thoracic joint.
The
key to the Wall Slide is that the shoulder blades remain retracted and
depressed while the gleno-humeral joint attempts to move the arms
overhead. They are the "air guitar" of overhead pressing. Many
beginners will actually cramp in the lower trap/ rhomboid area as they
attempt this exercise. The key is that the forearms must slide up in
contact with the wall while the shoulder blades stay down and back. Don't be surprised if you can't do it. It'll take some time. Only lift the arms overhead as far as pain free ROM allows. Initially this may be a small range, but trust me, it'll improve. From
a lifter's standpoint, the important take-away is that good shoulder
health is all about what you can't see. I think most lifters should
stay away from heavy overhead work until they master the wall slide. I
also think the need for a combination of stability and mobility in the
gleno-humeral joint presents a great case for exercises like Stability
Ball and BOSU Push-ups as well as unilateral dumbbell work. The inability of joints to function normally places stress on the joints above or below. In the book Ultra Prevention
(actually a great nutrition book, too), the authors describe our
current method of reaction to injury perfectly. Their analogy is
simple; our response to injury is like hearing the smoke detector go
off and running to pull out the battery. The pain, like the
sound, is a warning of some other problem. Icing a sore knee without
examining the ankle or hip is like pulling the battery out of the smoke
detector. What we need to realize is that "We get old too
soon and smart too late." Oscar Wilde said, "I am not young enough to
know everything." Every day, I learn more and more about the
body. What I learn allows me to be a better coach and a better
educator. Often, what I learn contradicts what I formerly believed.
Just remember, the world was once thought to be flat.


Michael Boyle is an internationally recognized coach, educator, and
consultant. In addition, Mike is the creator of the widely successful
Functional Strength Coach (link to www.functionalstrengthcoach.com) DVD series. To learn more or to read more go to www.michaelboyle.biz.