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Browsing Category Exercise

How to Utilize Strength Training to Improve Bone Health

March 25, 2020 · by Garrett McLaughlin

| Article written on March 24th, 2020 at 12:35pm | Follow Garrett on Facebook and Instagram |

Preserving optimal levels of bone mass is important as we age. Did you know that approximately 52% of American adults over the age of 50 have low bone mass at the femoral neck or lumbar spine?

Part of the difficulty lies in the fact that the majority of peak bone mass is accrued before 18 years of age in females and 20 years of age in males. Therefore, if we don’t take the necessary steps early in life to be active and/or follow a proper nutrition plan, we could potentially set ourselves up for bone related issues later in life.

According to the National Osteoporosis Foundation, approximately 10 million American adults, 8 million of which are women, have osteoporosis. Another 35 million have insufficient bone mass or osteopenia. Adults who do not incorporate regular strength training may experience a 1% to 3% decline in bone mineral density every year. Research studies show that significant increases in bone mineral density can be achieved after 4 to 24 months of resistance training. However, termination of strength training is likely to lead to a reversal in gains.

Need help improving bone mass or recovering from a bone stress injury? Click here to speak with Garrett about individualized strategies that can help you.

Over the years, I have worked with countless people who suffer from osteopenia, osteoporosis, and bone stress injury. Despite being caused by very different factors, all of these can and should be addressed with a structured and progressive strength training program. Strength training and proper loading have been shown to maintain/stimulate bone growth and prevent future decline in bone mineral density. Along with other nutritional and lifestyle factors, a daily dose of exercise can be a worthwhile strategy in promoting overall bone health.

Before we go on, let’s define the terms osteoporosis, osteopenia, and bone stress injury so we are all crystal clear on what this article is describing…

Osteopenia is a mild thinning of the bone mass where formation of new bone is not sufficient to offset normal bone loss. Not as severe as osteoporosis.

Osteoporosis literally means porous bone and is a disease in which density and quality of bones are reduced. Osteoporosis carries a greater risk of fracture.

Bone Stress Injury refers to a phenomenon in which bones cannot tolerate repeated mechanical loads, resulting in structural fatigue, local bone pain, and tenderness.

Since I work predominantly with runners in the Healthy Running Program, I’d like to use this article to speak directly to those who have a bone related disorder, previous history of a bone stress injury, or a combination of both. With the repetitive, sub-maximal nature of running, bone stress injuries are not uncommon and have been shown to comprise approximately 30% of all running-related injuries. This means a proactive approach and understanding of one’s medical history are important to reduce the likelihood of enduring a bone stress injury with the demands of running.

Like I mentioned previously, strength training and progressive loading are proven strategies to prevent the decline of bone mineral density, increase overall bone mass, and rehabilitate from a bone stress injury. Doing so under the supervision of a trained healthcare professional is important. That’s because these programs should be individualized to your needs and progressed at a proper rate over time.

Research shows that a minimum of 6-8 months are needed to see measurable results in bone mass. This is largely in part to one remodeling cycle of bone resorption, formation, and mineralization which takes 3-4 months to complete. Therefore, depending on your need to improve bone health, patience and consistency are necessary factors for success.

Strength training and weight-bearing activities specifically have been shown to provide beneficial effects on bone health. Not only does it increase or prevent the decline of bone mineral density as we age, but it also improves strength, balance, and coordination to reduce to the risk of falls which may contribute to fracture.

In order to achieve maximum benefits with strength training, the program must…

Include dynamic movements over static
Achieve adequate strain intensity
Consist of discrete and intermittent bouts
Include variable loading patterns
Be supported by optimal nutrition
Emphasize adequate intake of calcium and vitamin D

Since strength training is such a vast and complex topic, let’s get more specific and explore two of the most impactful exercises when addressing bone health. These exercises include the squat and deadlift.

The squat and deadlift are staples within the strength training world and for good reason. That’s because they create an axial/compressive load on the musculoskeletal system, can be loaded quite easily with a dumbbell, kettlebell, and/or barbell, and have numerous variations to stress the body in a variety of ways. Like I mentioned above with the requirements to achieve maximum benefit, the squat and deadlift check all of the boxes.

Of course, when suffering from injury or bone related disorder, form and technique become a priority to stimulate the bone in the correct way without creating injury. In the following videos, let’s cover a basic squat and deadlift progression so you understand proper form and how to progress these movements over time to see the best results possible.

Progression #1: Squat

The squat is a foundational knee dominant movement that you’ll commonly see in the gym and also throughout your daily routine. Whether you are lifting weights or getting up and down from a chair, this movement is essential and can be used as an exercise to improve bone density. When using the squat to improve bone mineral density, form and patience should take precedence over load. Once you are proficient with performing the exercise properly, increasing load by adding resistance or progressing to a harder variation will be important and necessary to stress the body enough for a positive change in bone density. This video demonstration will walk you through (3) different variations of the squat to see the best results.

Begin with 2-3 sets of 8-12 repetitions and progress to 4-8 repetitions over time with a heavier resistance. Rest for 1-2 minutes in between sets or complete a few sets in the morning and a few sets in the evening.

Progression #2: Deadlift

The deadlift is a foundational hip dominant movement that you’ll commonly see in the gym and also throughout your daily routine. Whether you are lifting weights or picking up a box from a floor, this movement is essential and can be used as an exercise to improve bone density. When using the deadlift to improve bone mineral density, form and patience should take precedence over load. Once you are proficient with performing the exercise properly, increasing load by adding resistance or progressing to a harder variation will be important and necessary to stress the body enough for a positive change in bone density. This video demonstration will walk you through (3) different variations of the deadlift to see the best results.

Thank you for taking the time to read this article on ‘How to Utilize Strength Training to Improve Bone Health.’ The key thing to remember is that regardless of your situation there are a multitude of factors that go into improving bone health. In terms of exercise, weight-bearing activities and the strength training exercises shared in this article can be helpful in the rehabilitation and prevention of a bone related disorder and/or bone stress injury. However, your best defense is creating good exercise, nutritional, and lifestyle habits early in life to lay a solid foundation of bone mass for later on in adulthood.

If you or someone you know is struggling with a bone related disorder or bone stress injury, click here to schedule your free consultation. Garrett is an athletic trainer and functional movement expert that can you help you implement an individualized program to improve bone health and reduce your risk of bone stress injury.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Sources:

Bone Stress Injuries by Kiuru et al.
Bone Stress Injuries in Runners: a Review for Raising Interest in Stress Fractures in Korea by Song et al
Bone Health In Athletes: The Role of Exercise, Nutrition, & Hormones by Goolsby et al
Resistance Training is Medicine: Effects of Strength Training on Health by Westcott et al
Physical Activity and Bone Health by Kohrt et al
Muscle Strength, Bone Mass, and Age-Related Bone Mass by Burr et al

Basic Plyometrics to Improve Bone Health

March 19, 2020 · by Garrett McLaughlin

| Article written on March 19th, 2020 at 5:41pm | Follow Garrett on Facebook and Instagram |

Preserving optimal levels of bone mass is important as we age. Did you know that approximately 52% of American adults over the age of 50 have low bone mass at the femoral neck or lumbar spine?

Over the years, I have worked with countless people who suffer from osteopenia, osteoporosis, and bone stress injury. Despite being caused by very different factors, all of these can and should be addressed with a structured and progressive exercise program. Exercise and proper loading have been shown to maintain/stimulate bone growth and prevent future decline in bone mineral density. Along with other nutritional and lifestyle factors, a daily dose of exercise can be a worthwhile strategy in promoting overall bone health.

Need help improving bone mass or recovering from a bone stress injury? Click here to speak with Garrett about individualized strategies that can help you.

Before we go on, let’s define the terms osteoporosis, osteopenia, and bone stress injury so we are all crystal clear on what this article is describing…

Osteopenia is a mild thinning of the bone mass where formation of new bone is not sufficient to offset normal bone loss. Not as severe as osteoporosis.

Osteoporosis literally means porous bone and is a disease in which density and quality of bones are reduced. Osteoporosis carries a greater risk of fracture.

Bone Stress Injury refers to a phenomenon in which bones cannot tolerate repeated mechanical loads, resulting in structural fatigue, local bone pain, and tenderness.

In long distance runners, approximately 50% of bone stress injuries occur in the tibia alone, while other common injury sites are the femur, fibula, calcaneus, and metatarsal bones. This is highly dependent on a combination of factors, including individual weight-bearing patterns and running biomechanics. Since the majority of long distance runners, compared to short distance runners, strike with a rear foot (heel) pattern, this places greater load on the long bones such as the tibia and femur.

Bone stress injury can be classified by location into two categories, including low-risk and high-risk. These are outlined in the following table…

Aside from running biomechanics, weight-bearing patterns, and increasing your intensity or duration too rapidly, there are several risk factors for bone stress injury which must be taken into consideration. These include…

Living a sedentary lifestyle
Genetics- white females are at the highest risk of bone disorders compared to African American females and males
Drug usage, including: antacids, steroids, and antidepressants
Lack of calcium, vitamin D, and other nutritional considerations
A history of previous fractures and low bone mineral density
Bone characteristics including a thinner cortex
Female athlete triad and interrelationship of energy availability, menstrual function, and bone mineral density
Hormonal imbalance
Biomechanical factors, including: leg length discrepancy, small calf circumference, pes cavus and pes planus, vertical loading rates, peak hip adduction, and rear foot eversion
Sport, training changes, terrain/running surface, inadequate recovery time, inappropriate or sudden change in footwear

Like I mentioned previously, exercise and a progressive loading program are proven strategies to prevent the decline of bone mineral density, increase overall bone mass, and rehabilitate from a bone stress injury. Doing so under the supervision of a trained healthcare professional is important. That’s because these programs should be individualized to your needs and progressed at a proper rate over time.

Exercise, and weight-bearing activities specifically, has been shown to provide beneficial effects on bone health. Not only does it increase or prevent the decline of bone mineral density as we age, but it also improves strength, balance, and coordination to reduce to the risk of falls which may contribute to fracture.

In order to achieve maximum benefits with exercise, the program must…

Include dynamic movements over static
Achieve adequate strain intensity
Consist of discrete and intermittent bouts
Include variable loading patterns
Be supported by optimal nutrition
Emphasize adequate intake of calcium and vitamin D

Plyometrics is a form of exercise that contains higher magnitude jumping, hopping, and landing-type movements which can be helpful in optimizing bone health. This should only be considered when progressed to properly following lower impact weight-bearing exercises and deemed safe by a healthcare professional following a bone stress injury. From a preventive standpoint, I recommend plyometrics to all of my asymptomatic running clients in healthy doses to properly stimulate the skeletal system.

Why plyometrics may be better than other weight-bearing movements is because they are higher intensity with a larger magnitude and rate of loading. This greatly increases ground reaction forces and stress on the bones to stimulate positive changes in bone mineral density. Also, they can range in difficulty and intensity, and require little equipment and minimal time.

Where do you begin? In the following, I outline 5 of my favorite plyometric drills to optimize bone health. These are simple hopping drills that require no equipment and can be completed in any setting. The important thing is they are progressive in nature and also take into consideration variable loading patterns and intermittent bouts.

Plyometric Drill #1: Ankle Hops

Ankle Hops are an entry level plyometric drill that teaches runners how to properly store and release energy at the lower leg. Since tibial and other lower leg bone stress injuries are prominent in the sport of running, this drill begins increasing load directly in that area while paving the way for more complex movements.

Begin with 2 sets of 5-10 repetitions and progress to 4 sets of 5-10 repetitions over time with a greater degree of intensity. Rest for 1-2 minutes in between sets or complete a few sets in the morning and a few sets in the evening.

Plyometric Drill #2: Line Hops: Double Leg Lateral

Double Leg Lateral Line Hops are a nice progression from Ankle Hops that start to introduce a load in the frontal plane (lateral). Running is a very predictable and repetitive movement pattern and, therefore, lateral and rotational movements can help provide variability to stimulate a positive response to the skeletal system.

Begin with 2 sets of 5-10 repetitions in each direction and progress to 4 sets of 5-10 repetitions over time with a greater degree of intensity or distance. Rest for 1-2 minutes in between sets or complete a few sets in the morning and a few sets in the evening.

Plyometric Drill #3: Line Hops: Single Leg Lateral

Single Leg Lateral Line Hops is an important progression from the double leg hopping drills I shared previously. As much as we can increase intensity by performing more repetitions, more distance on each hop, or a faster speed, progressing from double leg to single leg is necessary. Running is an exclusively single leg sport, therefore, implementing plyometrics on a single leg will not only provide a greater load on the skeletal system but better replicates the demands of running.

Begin with 2 sets of 5-10 repetitions in each direction and on each limb and progress to 4 sets of 5-10 repetitions over time with a greater degree of intensity or distance. Rest for 1-2 minutes in between sets or complete a few sets in the morning and a few sets in the evening.

Plyometric Drill #4: 4-Square Single Leg Hops with Stick

The 4-Square Single Leg Hops with Stick continues to increase load on a single leg while adding more variability to these plyometric drills. Since bone needs dynamic and variable movement patterns to continue stimulating growth, this drill is a nice progression when ready. Due to the added complexity of this drill, I recommend emphasizing a “stick” landing each time. This will improve control and stability to be challenged further in the next progression.

Begin with 2 sets of 2-4 complete rotations in each direction and on each limb and progress to 4 sets of 2-4 complete rotations over time with a greater degree of intensity or jump height. Rest for 1-2 minutes in between sets or complete a few sets in the morning and a few sets in the evening.

Plyometric Drill #5: 4-Square Single Leg Hops

The final plyometric drill in this progression is the 4-Square Single Leg Hops. Similar to the last drill, it require multi-directional hopping to provide variability and several ways to increase intensity. Start simple by mastering the drill in a small space. Once proficient, you can increase the distance of each jump, height of each jump, or overall speed going through the square.

Thank you for taking the time to read this article on ‘Basic Plyometrics to Improve Bone Health.’ The key thing to remember is that regardless of your situation there are a multitude of factors that go into improving bone health. In terms of exercise, weight-bearing activities and the plyometric drills shared in this article can be helpful in the rehabilitation and prevention of a bone related disorder and/or bone stress injury. However, your best defense is creating good exercise, nutritional, and lifestyle habits early in life to lay a solid foundation of bone mass for later on in adulthood.

If you or someone you know is struggling with a bone related disorder or bone stress injury, click here to schedule your free consultation. Garrett is an athletic trainer and functional movement expert that can you help you implement an individualized program to improve bone health and reduce your risk of bone stress injury.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Sources:

Bone Stress Injuries by Kiuru et al.
Bone Stress Injuries in Runners: a Review for Raising Interest in Stress Fractures in Korea by Song et al.
Bone Health In Athletes: The Role of Exercise, Nutrition, & Hormones by Goolsby
Effects of Plyometric Training on Bone Mass in Adolescent Girls by Witzke et al.

Loading Strategies to Resolve Patellar Tendinopathy

March 7, 2020 · by Garrett McLaughlin

| Article written on March 7th, 2020 at 1:17pm | Follow Garrett on Facebook and Instagram |

Anterior knee pain is common amongst runners, athletes, and the general population. In this article, I will attempt to explore different considerations regarding patellar tendinopathy specifically and provide various loading strategies for rehabilitating the knee back to full function.

Click here to connect with Garrett directly about your knee pain.

The patellar tendon is located directly at the front of the knee and connects the quadriceps, patella, and proximal tibia. Pain is usually localized to the inferior pole of the patella and during movements that load the quadriceps. Cook et al reports that approximately 1/3 of athletes who presented with patellar tendinopathy were unable to return to sport for more than 6-months. Therefore, early detection in less severe stages is crucial, as well as the acceptance that resolution of symptoms could take an extended period of time.

Anterior view of the knee joint and patellar tendon.

What’s important to realize about an injury to the patellar tendon is that we are dealing with a dense fibrous connective tissue that connects muscle to bone. According to Thorpe et al, the main function of tendons is to “transfer muscle generated force to the bony skeleton, facilitating movement around a joint, and as such they are relatively passive, inelastic structures, able to resist high forces.” Despite being able to resist against high forces, as in running, jumping, and many sporting activities, tendons are susceptible to injury based on various scenarios…

The force placed upon the tendon exceeds the tissue’s load capacity
A series of small and repetitive forces are applied for a duration long enough to cause tissue breakdown
Other biomechanical factors are creating compensation elsewhere throughout the kinetic chain which ultimately increases load on the tendon

Regardless of which scenario proves to be true, the end goal of any tendon rehabilitation program is not the absence of pain, but return to full, pain-free function. Like with most injuries, rest is important and will allow the injury to calm down temporarily. However, tendon pain will likely resume when load is re-introduced to the area if the capacity of the tissue is not restored.

In the research article, ‘Current Concepts in Biomechanical Interventions for Patellofemoral Pain,’ Willy et al describe a homeostasis model first created by Scott Dye in 2005. This model suggests that the injury process can be stimulated in response to sudden bouts of increased training loads or stressors. For example, a runner or athlete that is conditioned for a specific distance or intensity but decides to increase one or both of these factors before the tendon is ready to handle the increased workload. That’s why I recommend all runners follow a structured and progressive training program which increases mileage in a safe and effective manner to build tissue tolerance.

Willy et al states that once homeostasis of the tissue is disrupted, sudden increases in training loads may no longer be able to be tolerated even if these are routine daily activities. Therefore, once the tissue is in a pathologic state, the ability to load without pain decreases significantly. The goal now becomes to re-establish this homeostatic relationship to stabilize the tissue, then progressively restore the loading capacity to be more tolerant to the forces it will encounter. Basically, excessive loading created this situation but it will also be a key factor in resolving it for long-term success.

Now, before we cover the loading strategies to resolve patellar tendinopathy, it’s important to touch on cadence, aka step rate, and it’s impact on the knee while running. Overstriding (image B below) is a term that refers to the foot landing too far in front of the body’s center of mass at initial contact. What this does is create a braking mechanism and thus increases energy absorbed at the knee.

Progressively loading the quadriceps and patellar tendon will certainly make the area more tolerant to the forces of running. At the same time, increasing cadence by just 5-10% has been shown to decrease energy absorbed at the knee by 20-34%.

Running at a higher cadence reduces stride length, disperses the amount of force over more steps, and allows the foot to land closer underneath the body’s center of mass. A combination of both approaches is important to consider in order to reduce the likelihood of injury and/or return to running following patellar tendinopathy. Click here to read a more in-depth article that I wrote on the topic called, ‘The Impact of Cadence on Running Mechanics.’

When incorporating the following loading strategies, it’s important to keep in mind the 24-hour rule. Basically, you want to stress the patellar tendon in a healthy way that limits pain to nothing above a 3 out of 10. And if pain lingers, it should resolve completely within 24-hours. This is an important concept to understand with tendon pain. A certain degree of pain is acceptable and might be needed to elicit the desired response from the tendon. However, if your pain exceeds these parameters then modifying certain variables, such as the exercise, tempo, load, and position might be warranted.

Decline Squat Progression

The Decline Squat is a fantastic exercise that utilizes a slant board or elevated heel position to increase demand on the knee. Like with all of these progressions to rehabilitate patellar tendinopathy, it’s important to understand the dose and response relationship before increasing the intensity in anyway. What I mean is, start simple and progress slowly after seeing how the tendon responds to the added load, tempo, and number of repetitions. The different variations of this movement allow you to gradually increase load on the knee joint in a progressive manner. In this video, I demonstrate the bodyweight, goblet, and 2-dumbbell Decline Squat progression.

Spanish Squat Progression

The Spanish Squat is a somewhat newer exercise that I’ve only used for the past 2-years or so. Like with all of these progressions to rehabilitate patellar tendinopathy, it’s important to understand the dose and response relationship before increasing the intensity in anyway. What I mean is, start simple and progress slowly after seeing how the tendon responds to the added load, tempo, and number of repetitions. The different variations of this movement allow you to gradually increase load on the knee joint in a progressive manner. In this video, I demonstrate the bodyweight, goblet, and 2-dumbbell Spanish Squat progression.

Lateral Step-Up with Counterbalance

Since the knee is largely influenced by stability at the foot, ankle, and hip, it’s important to successfully complete one of the bilateral exercises mentioned above and then move on to a single leg variation. The Lateral Step-Up with Counterbalance allows the body to be held in a position that loads directly into the knee joint. Like with all of these progressions to rehabilitate patellar tendinopathy, it’s important to understand the dose and response relationship before increasing the intensity in anyway. What I mean is, start simple and progress slowly after seeing how the tendon responds to the single leg position, load, tempo, and depth of the step. This exercise is usually recommended after laying the foundation with the two bilateral progressions demonstrated above.

Despite showing you two different loading progressions to properly rehabilitate patellar tendinopathy, it’s not my intention for you to complete both of these. I would start by determining which is the best starting point for you and following that path to create a more tolerant and pain-free knee. Once that’s achieved, the Lateral Step-Up with Counterbalance is a suitable next step to incorporate single leg loading and stability. This is especially important if your goal is to return to running or a change of direction sport.

I hope this article has helped you better understand patellar tendinopathy, as well as recommended strategies to reduce pain and increase function. As always, it’s important to consult with a trained healthcare professional to be properly diagnosed and understand the underlying factors which may be contributing to your injury. Please take a second to click here so we can create a structured plan to resolve your knee pain once and for all.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

3 Core Exercises That Are NOT Making You a Better Runner

December 21, 2019 · by Garrett McLaughlin

| Article written on December 21st, 2019 at 07:44am | Follow Garrett on Facebook and Instagram |

Core training is a hot topic in the running world, and for good reason. That’s because runners understand that the mid-section, or “core,” plays a vital role in maintaining form and proper mechanics throughout the running cycle. But, not everyone is targeting this area properly to see the results they are working so hard for.

Anytime you are executing a strength training or rehabilitation program, one of the key principles is specificity. Specificity can be viewed in two different ways…

Is the program specific to your individual needs, weaknesses, and imbalances?
Does the program take into consideration the specific demands of the sport/activity that you are trying to return to or improve performance in?

If you are lacking specificity in anyway, it’s not surprising why the results may be less than stellar. Therefore, I implore you to assess your current core training routine and determine what adjustments can be made for more reliable results. If you are unsure of how to make the necessary changes, this article should provide some insight into which direction to move towards.

Before we dive into the specifics, it’s important to realize that there is no such thing as a “bad exercise.” Every exercise can be beneficial depending on the person, goal, and execution. However, when it comes to running, the sport itself has a unique requirement at the spine, pelvis, and rib cage, which narrows our emphasis on the particular exercises which may be the most impactful.

Now, let’s discuss 3 core exercises that are NOT making you a better runner. And, provide recommendations on how you can improve specificity, and thus, running performance.

#1: Crunches

Crunches are the dinosaur core exercise in the strength training world. They’ve been around for years and years, and their effectiveness is heavily debated by many. In my opinion, this is a valid exercise to improve strength of the abdominals and anterior core musculature. But, if we think about the principle of specificity, it does not train a movement which you would utilize while running.

Rather than strengthening the abdominals with Crunches, let’s change our approach to still target this area but while promoting stability at the spine, pelvis, and rib cage. The best exercise which does that is called the Dead Bug.

The Dead Bug is an entry level anti-extension core stability exercise. In contrast to the Crunch, the Dead Bug uses the same musculature to fire and prevent extension of the spine. This action is vital while running as it limits excessive anterior pelvic tilt, stabilizes the spine, and positions the rib cage to promote good use of the diaphragm and respiratory system.

To learn more about the Crunch vs. Dead Bug, watch this video…

#2: Standing Lateral Flexion (Side Bends)

I completely understand the desire to complete the Standing Lateral Flexion exercise due to it’s targeted nature at the obliques and lateral core. We all want a slim waist and more defined midsection. However, while running it’s actually more efficient to prevent against this side-to-side spine motion which would greatly increase the amount of ground reaction force upon foot strike.

Of course, I’m not saying don’t target this area because it’s vital for efficient gait, as well as athletic and everyday movements. Instead, let’s change how we are doing it to reinforce stability and control at the lateral aspect of the spine, rib cage, and pelvis. This can be accomplished with the Side Plank and it’s many variations.

The Side Plank is a staple in the strength training and rehabilitation world, and for good reason. It’s often labeled as an anti-lateral flexion core stability exercise since it directly opposes the side bending action of the spine. By improving stability and preventing this type of motion, you are able to maintain alignment of the spine, levelness of the pelvis, and more efficient mechanics at the lower extremity.

To learn more about the Standing Lateral Flexion vs. Side Plank, watch this video…

#3: Cable Trunk Rotations

Cable Trunk Rotations is a fantastic core exercise to build stability and resilience in the rotational plane. Unlike the exercises mentioned above, you actually do rotate to a small degree while running as the opposite arm and leg move in a coordinated and reciprocal way. That’s why this one falls into more of a grey area if we consider our specificity principle.

The biggest issue I usually see with strengthening through a large rotational range of motion is the minimal amount of rotation inherent to running. Instead of utilizing this full range of motion, it might be more impactful to build strength in a smaller range that better replicates running. Or, switch your Trunk Rotations for the Pallof Press!

The Pallof Press is a fantastic anti-rotation core stability exercise. That means, the same muscles which create rotation are working to prevent motion at the spine. The Pallof Press can be a good substitute for Cable Trunk Rotations to build stability and resilience to minimize excessive rotation and promote good positioning of the trunk over the lower extremity.

To learn more about Cable Trunk Rotations vs. Pallof Press, watch this video…

At the end of the day, it’s important to perform a strength training and rehabilitation program that is specific to your needs. Of course, building strength is never a bad thing and you can select endless exercises to do that. However, I tend to see runners strengthening specific muscles in isolation without improving stability at the core. Both of these are needed for long-term spine health and injury resilience, but stability will more readily carryover to efficient running mechanics.

Do you want to see better results with your running in 2020? Are you tired of under-performing or consistently struggling with injuries? Click here to learn more about the Healthy Running Program.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

How to Progressively Warm-Up the Calf & Ankle: A Basic Pre-Run Loading Protocol

December 9, 2019 · by Garrett McLaughlin

| Article written on December 9th, 2019 at 4:33pm | Follow Garrett on Facebook and Instagram |

One area runners need to spend more time emphasizing within their dynamic warm-up is the calf complex and ankle joint. Since running adds a lot of forces on the musculoskeletal system and these areas are so active throughout the running cycle, preparation is key to reduce the likelihood of injury and improve performance.

Let’s be honest, the lower leg often gets neglected in most dynamic warm-up and strength training programs. This is can be a problem since it’s generally an area which experiences a higher volume of running-related injuries. Therefore, properly preparing the ankle and calf for running can increase resilience to injury and preparation for subsequent runs.

In this video blog, I will outline a series of drills that progressively load the calf and ankle. Next time you warm-up for a run, follow this protocol or utilize specific exercises to fill in the gaps. This will ensure you are best prepared for the rigors of distance running.

Calf & Ankle Range of Motion

In the general context of this article, you might be wondering why I am recommending calf stretching and ankle mobility. In no way will this help prepare you for the amount of loading that the lower leg endures while running. However, ankle dorsiflexion is an important range of motion needed during the mid to late stance phase and where many runners are often limited. If you have limited range of motion at the ankle joint, I recommend addressing this early in your dynamic warm-up with some simple flexibility and mobility drills for no more than 60-90 seconds.

Wait, click here to self-assess ankle dorsiflexion to see if you need this!

Calf Raises

With any dynamic warm-up, it’s important to start simple before progressing to more specific drills that introduce higher loads. That’s why the calf raise is a logical entry point. To perform the calf raise, simply raise the heels off the floor while keeping all of your weight evenly distributed across the toes. If you need assistance with balance, hold on to a wall or sturdy object and focus on moving through the full range of motion. Perform 10 to 20 repetitions to increase tissue temperature, lubrication of the ankle joint, and activation of the calf complex.

Single Leg Calf Raises

Specificity is important as you are preparing the body for a particular sport. In this case, since running is so single leg dominant, you must incorporate drills that take this into consideration. The single leg calf raise is the unilateral version of the calf raise demonstrated previously. This further challenges the ankle and calf, as well as increases tissue temperature and joint lubrication. Perform 10 to 20 repetitions before completing the following drills.

Ankle Hops

The next two exercises are typically where most runners fail to connect their dynamic warm-up with the plyometric-like demands of running. Since running imparts 2-4 times bodyweight on a single leg, while essentially bounding from one leg to the other, the dynamic warm-up must account for this. Ankle hops is a great “in-between” exercise that places the ankle and lower leg under greater load and replicates the elastic and shock absorption demands of running. Complete 2 sets of 10-20 repetitions while gradually increasing the intensity of each hop.

Single Leg Ankle Hops

The last drill that is a perfect segue to running is single leg ankle hops. The theme continues in which we are progressively increasing the amount of load and demand on the ankle and calf to replicate what the body will endure while pounding the pavement. Single leg ankle hops is a challenging single leg plyometric activity that targets energy storage and release. For the purpose of improving readiness to run, you don’t want to over exert yourself with this drill. Instead, complete 2 sets of 5-10 repetitions as the final step before you set out on your run.

What’s important to realize about this progressive dynamic warm-up for the ankle and calf is that the same principles can be applied to any and every area of the body. By no means do I recommend only warming up in isolation. But, if you have a history of lower leg and foot injury, or feel like these areas need extra TLC, then by all means utilize the drills outlined to better prepare for running.

Please click here or comment below with questions and feedback pertaining to this article. Thanks for reading!

By: Garrett McLaughlin, MS, ATC, CSCS, ART

4 Exercise Variations to Strengthen Your Hip Flexors

November 27, 2019 · by Garrett McLaughlin

| Article written on November 21st, 2019 at 3:09pm | Follow Garrett on Facebook and Instagram |

The hip flexors are a group of muscles at the front aspect of the hip. They get a ton of attention due to our increasingly sedentary lifestyle, and as a result, the shortness/tightness developed which can create a nagging sensation and/or limit flexibility. However, aside from stretching this muscle group, strengthening should be a part of your weekly routine.

Over the years, there has been such prevalence on strengthening the gluteals for better performance and reducing the likelihood of injury. Almost to the point where people, especially runners, are doing entire workouts devoted to this muscle group. As much as I think the gluteals are important, we must look more closely at the biomechanics of running and the role the hip flexors play throughout gait. Because in the end. this muscle group cannot be neglected.

Due to their location, the hip flexors help lift the knee in front of the body towards the chest. They are also active eccentrically to store energy throughout hip extension and push-off before pulling the hip forward during swing phase, and into the flexed position I stated previously. Because the psoas muscle spans all the way to the lumbar spine and the other hip flexors have many different pelvic attachments, they play a role in stabilizing the pelvis and lumbar spine during single leg stance and running. Therefore, it’s important that these muscles are strong, stable, and resistant to fatigue. This will prevent a breakdown in running form as mileage increases.

Since hip flexor strengthening is not talked about enough, I want to share with you a simple and effective 4 exercise progression that I commonly prescribe to my running clients. This will provide the guidance needed to properly target this muscle group.

Let’s begin…

Hooklying Band Resisted Marching

This hooklying band resisted marching exercise is a dead bug and core stability variation with emphasis on resisting hip flexion. When setting up for the movement, make sure you are maintaining a neutral spine and not using a resistance so hard that it causes you to lose position. Place the band around the feet and engage the flexed hip to prevent the stretched band from pulling you out of 90 degrees of hip flexion. Hold for a second or two, then switch sides. Complete this movement for 2-3 sets of 8-12 repetitions each. When proficient, increase the tension of the band or progress to exercise #2.

Watch the video below to learn more…

Hip Bridge with Band Resisted Marching

The hip bridge with band resisted marching is very similar to the previous exercise, but while holding the top of a hip bridge. What this does is require the gluteus maximus and opposite side hip flexor to work simultaneously. This muscle activity is very similar to running where one leg is extending to push-off while the other is flexing through swing phase in preparation for foot strike. Complete this movement for 2-3 sets of 8-12 repetitions each. When proficient, increase the tension of the band or progress to exercise #3.

Watch the video below to learn more…

Long Lever Bridge with Band Resisted Marching

The long lever bridge with band resisted marching is essentially the same exercise as #2 but with a lengthened lever arm. By extending the legs further out then the traditional hip bridge, this will place more emphasis on the hamstring muscle group. Not to mention it creates a greater degree of hip flexion to move through and more tension in the band. Therefore, it’s a harder variation than the previous two exercises. Complete this movement for 2-3 sets of 8-12 repetitions each. When proficient, increase the tension of the band or progress to exercise #4.

Watch the video below to learn more…

Single Leg Stance with Isometric Resisted Hip Flexion

As much as ground-based exercises do a great job at building strength in particular areas, we must always ensure that this strength carries over into an upright position. Because, plain and simple, that’s where running and everyday movements happen. The single leg stance with resisted isometric hip flexion challenges the non-weight bearing leg to engage the hip flexor and maintain a 90/90 position at the knee and hip. In addition, single leg stance requires a greater degree of stability and balance, so this exercise can really tie things together. Complete this movement for 2-3 sets of 30-60 sec holds each. When proficient, increase the tension of the band or cycle back through this exercise progression again with more repetitions or a harder band.

Watch the video below to learn more…

What’s important to realize is that this is a progression of exercises. Therefore, determine which exercise should be your starting point and begin building hip flexor strength, while only progressing to the next variation every 4-6 weeks. Each week, try to increase the amount of repetitions, resistance of the band, or time, to make the exercise more challenging. This will help you improve strength, endurance, and stability while becoming more proficient in the movement.

If you have any questions about the exercises outlined in this article or want to work more closely together to receive an individualized strength training program, please click here to contact me or comment below. Thanks for reading!

By: Garrett McLaughlin, MS, ATC, CSCS, ART

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