The NEW Functional Training: Dynamic Joint Mobility, Tension, Relaxation, and Lifting for Rehabilitation and Performance

That was the name of the presentation I gave this morning at the Resident/Fellow Meeting at Duke Sports Medicine. I had 30 minutes including questions.

I didn't do as well as I or my wife would've liked, because, well, I could care less what these people thought of me as a professional. (Wrong attitude? Probably. That being said, the doc who scheduled me must've thought well enough of me to put me on that schedule. Plus, it didn't make me any money and wasn't pertinent to my current life goals.) In fact, she thought I did so poorly that she gave graded me a D+! Part of it was of course that she knew most of the material; also it was a different crowd; and I was out of my element; it was 7am and I don't usually get up until then. Her basic point was that I failed to make mine.

Two years ago, I would've been on the money cause I wanted to be seen as "The Man." I would have shown those Ortho's and PT's how smart I was and how much I knew and how much they didn't. Now, as I mentioned, it doesn't further my goals or contribute to my ability to be a Fitness Professional. I just care about my clients' reaching their goals. Of course, as I write this, I guess I must be feeling some remorse or doubt for not performing upto my inherent expectations. But it was funny: as I was prepping yesterday, I heard Loral Langmeyer's (author of "The Millionaire Maker") voice in the back of my head, "Only particpate in those activities which draw you closer to achieving your financial goals..." My wife pointed out that maybe I was listening to the wrong voice while prepping...Funny thing is, while we were discussing this very point this morning on the way to work, I got a call regarding my other business, the one that will provide for my future, and I wouldn't have gotten that call had I not stopped working on the lecture and done the work necessary for that business. Of course my lovely and wonderful bride also pointed out that if I had been practicing for the last 4 months, God love her, then maybe I would've had a better presentation. I then reminded her of Loral...

All that being said, I'm glad I went. I'd cut the talk down if I had to do it again and focus on just one or two points and really hammer them. And I guess I do care to a certain extent what people think of me: I just want to be excellent at what I do and for deeper reasons than I care to go into publicly. So I'm torn between being excellent in what I currently do, and developing my other business, which has a much bigger impact eternally. I'll never know what would've happened if I'd devoted more time to the lecture. I may have portrayed myself better in front of this particular crowd, but conversely I'm not sure I would've developed my other business to its current degree or would be looking at the opportunities now in front of me...Interestingly, I've gotten good feedback regarding my participation in the RKC and it was much more important to be excellent and provide an excellent experience for those who particpated..."Where your treasure is, there your heart is also..."-Jesus

Below is a copy of the outline I used and my comments that I attempted to elaborate on (my comments are in yellow):

What is Functional Training?
-Current Paradigm:
--Functional Movements
Squatting, lunging, stepping, reaching, pulling, pushing, pressing, throwing
Often unilateral or alternating/cyclic in nature (Single leg squat, alternating lunges…)
--Proprioceptively Enriched: Balance Challenging
Standing on Bosu, Airex, Dyna-Disc, etc
-Circus Tricks?
What exactly are we training here?
What are our goals?
What outcome do we expect?
Are we using common sense?

Problems With Current Functional Training Paradigm
-SAID Principle Violation
What is the SAID Principle?
Specific Adaptation to Imposed Demands
Lift heavy, get stronger; run fast, run fast; etc
You ALWAYS get EXACTLY what you train for.
-Too much skill: Wobble board
How much of this is a skill?
If you practice long enough, will you succeed in achieving “perfect balance?” Will your skill become better?
-Too much tension:
Too much tension leads to chronic postural defects (Startle Reflex)
Current “Stability Training”
-Wrong kind/wrong amount of Tension
Not matching the amount of tension to the load
Heavy bracing/flexing to lift light loads or breath-holding while sprinting
-Not enough Tension?
Can damage joints and soft tissue structures
Incorrectly pressing a weight overhead
-Promoting Weakness?
“Jam” your joints and you’ll shut down surrounding muscles (Arthrokinetic Reflex)
-Neurologically Incorrect: Joints v. Muscles
Current Functional Training seeks to improve proprioceptive function through the muscles via the stretch reflex, muscle spindle fibers, and the GTOs
Problem: There are more proprioceptors in the joint capsules than the muscle bellys.
Specifically: MECHANORECPTORS, the largest, fastest, and most populously concentrated type of proprioceptor
Should focus our efforts on the joints themselves, not the muscles.
-Demonstration:
Ask for 2 volunteers
Glute-med muscle testing pre and post Single leg balance on Bosu (give the fix after the next section)

The NEW Functional Training
-Joint Mobility: Passive v. Active
Definitions: Passive—someone other than the individual moves joint thru ROM
Active: Individual moves own joint through ROM
Why? Motor Learning.
Pianist Example
-Tension and Relaxation: Jekyll and Hyde?
Tension can make you strong and safe: Lifting near maximal and maximum loads
Tension can make you weak and dangerous: Unstable surface training
Relaxation can be safe and make you strong: Necessary for recovery; reduce the negative effects of tension
Relaxation can be dangerous and make you weak: Not staying tight under heavier loads
-Isometrics, Irradiation, and Strength
Isometrics: Muscle fibers contract but neither lengthen or shorten
Already used in rehab setting
Used in performance setting whether intentional or unintentional
Heavy Supports with weight
Stretch-Shortening Cycle: All movements
-Irradiation: the recruitment of other muscles to “share” loading of target muscles
Get tighter = get stronger…sometimes (short term)
Demonstration 1: The fist
Demonstration 2: The handshake
Take home point? Increased short-term tension recruits more muscles and makes you stronger
Application: Heavy loads are required to increase strength—increased tension increases the ability to move heavy loads.
-Joint Mobility and it’s Relationship to Muscular Tension
Back to the Bosu demonstration:
Too much tension, in this case caused by an unstable surface, immobilizes joints, invokes the Arthrokinetic Reflex, and therefore promotes muscle weakness
The Bosu fix: Outside Toe Pull + 3 steps
Followed by Glut. Med. Test

Training for Rehabilitation v. Performance
· Opposite Sides of the Same Coin?
o Who are the best athletes? The ones who can best express the balance between tension and relaxation and have fluid movement and body control, i.e.: mobility. Michael Jordan
o Why do people get injured? They lack the ability to balance tension and relaxation and/or they lack body control, coordination, and mobility
o How do we get athletes to perform better? More coordination without a decrease in mobility (There is some truth in lifting weights make you muscle-bound.)
o Both should be trained the same way: Full ROM with an accompaniment of strength through the new ROM
· Mobility before Movement
o Why increase loading in movements thru speed or external resistance before we have full ROM and control through that ROM?
o Increase strength of muscles by releasing arthrokinetic reflex
o
· Unloaded movements for neural re-education and connective tissue strength
o Dynamic Joint Mobility Exercises
o Demonstration of Z-Health
· Loaded movements for hypertrophy and absolute strength
o Increased mobility increases both hypertrophy and absolute strength
§ My Squat Testimony

Case Study: My History
Athletic: Cross Country, Wrestling (Regional Champion), Powerlifting (WNPF NJ State Bench Press Champion, 220lbs, Junior Division, 1993), Olympic Weightlifting (2000 National Qualifier, 105kg; 1999 NJ State Champion, 105kg)
Medical: Broken L Arm: 1989; Dislocated R Patella: 1989; L Rotator Cuff Strain: 1993; Bilateral Patella-femoral pain: 1993; R Rotator Cuff Strain: 1994; R Groin/Adductor Strain: 1996; Chronic R Popliteus Strains: 1997-2000; R Wrist Sprain: 2000; Chronic Right Posas Spasms: 1997-2006; Chronic R ITB Pain: 1989-2006; L4-L5-S1 Nerve Root Impingements: 2002, resulting in radiculothapy: 2002-2003; R Hip Labrum Tear: 2005 (Cortizone: April ’05); L Hip Labrum (Double) Tear and Articular Cartilage Damage, Degeneration, Arthritis, Trochanteric Bursitis: 2005; R Quad Tendon Tear, 2005
By January of 2005, I had tried all of the following methods to alleviate the pain in my hips and right knee: chiropractic, ART, acupressure, acupuncture with and without electrical stimulation, deep tissue massage, e-stim, myofascial release: both active and passive care, “core” training, stability training, balance training, etc.
I could “activate” my TvA, my VMO, my Glut. Med, and any muscle you wanted, but I couldn’t get out of pain.
The result? A cortisone shot in April 2005. The result of that? More pain and another labral tear in my left hip in September of 2005
By January of 2006, I had so much pain in my body, specifically my knees and my hips, I had to hold onto my sink to sit on the toilet
That’s when I discovered “Z-Health”
Demonstration: KB Pistol


More Information?
Z-Health, Dr. Eric Cobb
Power to the People, Pavel Tsatsouline
Fast and Loose, Pavel Tsatsouline
Low Back Disorders, Dr. Stuart McGill

This ought to ruffle some feathers...