Showing posts with label Physical Therapy. Show all posts
Showing posts with label Physical Therapy. Show all posts

Friday, June 16, 2017

How to Deadlift: The Set Up



In previous posts, I’ve discussed foot placement and hand placement/grips when setting up to deadlift. In this post, I’ll go over how to set up for the deadlift before you start to pull the bar off the floor. 

First, you want to place your feet and hands correctly on the bar. These placements should serve as reference points for the rest of your set up.  After getting your foot and hand placement right, you want to optimally position your body in order to pull the bar off the ground, with the best mechanical efficiency possible. To do this, you want your shins to be relatively vertical, your hips to move back, and your torso to lean slightly forward (figure1).  The deadlift is referred to as a “hip hinge” movement pattern.  This is not a squat, which is a knee-dominant movement pattern. A hip-dominant pattern like the deadlift requires you to use your glutes and hamstrings (a.k.a. your posterior chain) more than you would during a squat, which is more of an anterior chain movement, utilizing the quadriceps muscles to a greater extent. 

Figure 1: Deadlift setup

Relatively speaking, your hips will be higher at the start of a deadlift than the lowest point that your hips reach in a squat (figure 2). When deadlifting, your hips only need to get as low as necessary to get your hands on the bar.  Once you are in this position you will need to gather tension throughout your body before you start to pull the bar. This will allow you to better hold your position when you're lifting the weight, preventing you from rounding your back, tipping forward onto your toes, or compromising your deadlift position in some other way, shape, or form. 




Figure 2: Deadlift compared to a squat.

In order to gather tension in your body, you need to first set your lats. When setting your lats you need to imagine pulling the bar into your body/towards your shins. Doing this will help activate your lats and keep the bar close to your body later on when pulling the bar from the floor. 

 The next step to gather tension in your body is bracing your core. This is sometimes referred to as a Valsalva maneuver. A note on the Valsalva maneuver: if you are a healthy normal person and do not have high blood pressure, performing at Valsalva maneuver is not incorrect. In fact, it is the body's natural way of achieving spine stability as a protective mechanism so we don't injure ourselves. You can brace your core by breathing into your stomach and contracting your abdominals in order to create spinal stability and tension through your torso.

The next step is to slowly start to pull on the bar. This should not be an aggressive or violent motion that pulls you out of your position.  Doing this should allow you to start to turn on musculature that you have not turned on yet, helping you hold a better spine position and keep you aligned to lift the weight.

By this point you may not feel the most comfortable globally throughout your body. You're attempting to pull a relatively heavy weight off the floor while keeping your spine stable and lifting a weight that will help you get stronger, grow more muscle, and improve your physical performance.

Now you're ready to start to pull, the actual act of lifting the weight. We will go over this in the next post so stay tuned. 


As always, thanks for reading!


Ryan Goodell, PT, DPT, CSCS


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Tuesday, November 8, 2016

Dissociation Between Your Hips and Low Back



The inability to dissociate your hip and low back movements from one another is one of the most common problems I see when walking throughout the gym. This problem is especially easy to spot if you watch a good sample size of people deadlifting. I’d like to also mention that it’s very impressive to see just how much weight some people can lift while just pulling with their low backs. In addition to deadlifting, this disassociation issue can also be seen while running, jumping, and squatting. Notice that the aforementioned movements are all extension-based.

When I refer to dissociation between your hips and low back, I’m talking about getting extension from only your hip while your back remains relatively neutral, acting isometrically. By performing activities without causing flexion and extension moments at your lumbar spine, you can reduce the amount of stress and dynamic load you place on it. Dynamic load on your spine is not an ideal scenario. 

Individuals who like to extend with both their low back and their hips to create forward propulsion when running/sprinting-or performing any of the other activities listed above-like to move into relative lumbar flexion so they can then extend through those spinal segments. This is what is considered dynamic load. For example, in the picture below, both stick figure lifters end in the same position. The one on the left was in relative flexion and used hip and lumbar extension to finish the lift, causing dynamic load, while the one on the right used hip extension and isometric action at the lumbar spine.  Those who use the movement strategy of hip and low back extension together to create movement often have complaints of back pain, due to repetitive use of their back extensors. If you are familiar with the feeling of gradually worsening tightness or discomfort of your low back when exercising, this is one of the common causes. (Please note that there can be other causes as well.) 


This inability to dissociate can arise for multiple reasons. Three of the main contributors are weak anterior core musculature, poor neuromuscular control, and tight hip flexors. 

The anterior core musculature is made up of a couple different muscles aside from the popular rectus abdominis, aka the six pack. These include the internal/external obliques and transverse abdominis. Their job, as a collaborative unit, is to increase intraabdominal pressure during movements in order to keep the spine stable. If these muscles are weak and cannot counteract the forces of your hip flexors or momentum when moving forward, you will move into extension. 

Neuromuscular control can also present as a problem. The abs, hip extensors, and back musculature can all be plenty strong, but that doesn’t mean they sequence correctly. In my opinion this is the hardest problem to fix due to the repetitive nature of movement and the amount of repetitions required to create a new movement pattern. This is where people often get frustrated when they do not see immediate results because their previous movement pattern is so ingrained into the brain that it becomes hard to change. Hard to change, but still possible. This change in movement patterning calls for a lot of repetitive tedious exercises, which aren’t physically challenging but frustrating because they come with a lot of trial and error of movement till you get it right. 

Lastly, tight hip flexors. These buggers can cause many problems, and disrupting your hip and low back dissociation is just one of them. The iliopsoas muscle of your hip flexor group attaches to the lumbar spine and inserts itself onto the femur. You can think about your pelvis as having four ropes attached to it. These four ropes consist of your anterior core musculature, hip flexors, hip extensors, and spinal erectors/back extensors. If the hip flexors are tight, they throw off the balance between these four strings, moving you into an anterior pelvic tilt. When it comes time to perform an activity that requires hip extension, like squatting, jumping, and especially running/sprinting, the hip flexor will pull your spine into more extension as your hip extends, causing extension of the back and hip at the same time.



So how do you correct some of these issues listed above?

Simply put, strengthen the anterior core muscles, practice hip extension with isometrically acting back extensors while keeping a neutral back, and lengthen the hip flexors/make them more supple.
Some good isometric anterior core exercises to try are reaching planks and shoulder tap planks shown below. While performing these, making sure to contract the glutes and abdominal musculature at the same time. 





For neuromuscular control, I like to start with a prone hip extension and then progress to a birddog. It is important to pay attention to where the extension is coming from during these exercises, feeling the spine stay relatively neutral and the motion coming from the hip. It is good to concentrate on the glute contraction when performing these exercises and not attempt to extend the leg too high towards the ceiling. People do not generally tend to have a ton of hip extension. Normal is considered ~10 degrees of extension at the hip. If you are getting more than that, you might be getting it from the low back. 


 

 
To lengthen the hip flexors, I like the hip flexor bench stretch. I don’t have a fancy name for this one so if you have a better one please let me know :)

Hip Flexor Bench Stretch

Shown below is the proper way to perform this stretch. It is important to keep the abs tight to keep from going into extension of the lumbar spine. Remember to breathe as you perform this stretch as well.




When the abs are not held tight, you can fake hip extension as shown below. Most of this motion, however, is coming from the lumbar spine. Trust me, you are not impressing anyone with your stretching skills so just preform them correctly and get the desired affect even if it makes you look very inflexible. That is, after all, why you should be doing the stretch in the first place, so don’t cheat yourself.





This should be a good place to start if you have difficulty dissociating your hip and low back movement. If you have any questions about this topic feel free to leave a comment or send an email to the address listed below. 

As always, please like, comment, and share! That always is a huge help to get this information out there. 

Thanks for reading,

Ryan Goodell, CSCS


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New posts every Sunday! 
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