Elbow Pain and Tendonitis

If you suffer from elbow pain, you’ll find this video very useful!

As always, if you want to book a Pt with me in Bethnal Green or Blackfriars, do drop me an email Andrew@andrewstemler.com

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Pull ups again

Where ever I go I find people abandoned by the fitness industry!

My evidence for this  is the failure of so many people to be able to do a pull up.

Ive written about this phenomenon in the past. Often in slightly rude, slightly risque, terms.

But let me, again, emphasise how to get your first pull up.

Obviously any arm strength helps. If you’ve been bicep curling , doing push ups, tricep extensions, some other weird body building isolation exercise you got off the internet, you must be better of than someone who hasn’t used their arms since birth, but as my rude article  “Pull ups and girls” proved, generic exercises do not give you pull ups.

Its better to learn how to do a “negative”

you have to think a lot about how to get  up to the  bar to  be able to lower down from it. I cover this crucial issue in patronising detail in my article “If you do not have any pull ups, no one will want to marry you”.  Read it carefully

But here are some extra ideas for you to build in:

To help structure your training, here is an interesting regime that builds your pull ups from a single negative to 20

20-pull-ups_ilka-helo copy 2

As always, if you want to book a Pt with me in Bethnal Green  or Blackfriars, do drop me an email Andrew@andrewstemler.com

Keep up to date with fitness, therapy and thought and join my mailing list

So you hold a stretch for 2 minutes!! Or must you?

In this blog Ive been diving in and out of various flexibility regimes and training ideas. One of the developing themes has been “hold that stretch for 2 minutes”.

However, one of the exciting regimes Im looking at, is by Paul Zaichik. He discusses a different approach that is outlined in his blog post “Most Effective Stretching Modality: Alternating Contracting Target Leverage” (click here) . The basic summary that he offers is this:  “it involves alternating the directions of the stretch adding a muscular contraction in between”

Check this video out

Hmm, food for thought!

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Is stretching enough to fix pain?

Ever since I became a fitness instructor back in 1997, I was assured by every trainer and every therapist I met that pain can simply be stretched away.

In practice, results are far more mixed. Whether people are doing the wrong stretch, for the wrong time, or lying ,  if you are honest, stretching often isn’t a long term solution for pain.

I wrote about this in my “backaholic”  blog where I quoted some of the observations made by Stuart McGill And Boo Schexnayder

Soft tissue injuries result from excessive tension, so excessive tension in the rehabilitation situation is counterproductive…stretching of …chronically tight tissue is counterproductive. It may give an initial sensation of relief because the muscle spindles have been deadened, but this practice…weakens the tissue further because of the weakened proprioceptive response.” Boo Schexnayder

stop trying to Stretch and mobilise! Let tissues settle and regain their proprioceptive abilities so they tell the truth” Stuart McGill

Its important to recognise that stretching has an analgesic effect , but it seems to be attributed to switching receptors off in the muscle. ( I suppose its like I’ve cured your  headache by switching off the fire alarm, but I haven’ checked that there isn’t a fire!!).

Do bear in mind that pain has many causes. I have clients with bad backs, caused by rubbish abusive employers, I have clients who use their backs appallingly,  and are so tight their posture is disgusting, who have never had a minutes worth of pain.\

Nevertheless  stretching  has enough of an  albeit , muddled,  pedigree to justify its inclusion in pain treating especially if better protocols can be designed.

In the therapy world, the chances are we know everything, it’s probably a matter of nailing the sequencing to get optimal results.

We know for example not to train static stretching before sprint practice.  “in strict terms of performance, it seems harmful to include static stretching in the warm-up protocol of collegiate male sprinters in distances up to 100 m”. (ref)

So what do we have to do to make stretching work as a pain relieving protocol? Because just to say ” stretching is magic” doesnt cut it :

If you read “Effectiveness of calf muscle stretching for the short-term treatment of plantar heel pain: a randomised trial”. (Ref)  they found that “When used for the short-term treatment of plantar heel pain, a two-week stretching program provides no statistically significant benefit in ‘first-step’ pain, foot pain, foot function or general foot health compared to not stretching.”

Well check out Effectiveness of Myofascial Trigger Point Manual Therapy Combined With a Self-Stretching Protocol for the Management of Plantar Heel Pain”

This  2011 study combined trigger point therapy with stretching and concluded “that the addition of TrP manual therapies to a self-stretching protocol is superior to the sole application of self-stretching in the treatment of individuals with plantar heel pain at short term“. 

So its really worth thinking about combining trigger point therapy with stretching.

If you want to get an inexpensive handle on trigger points, buy this book

Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief (A New Harbinger Self-Help Workbook)

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If you are near the east end of london, you can book a PT session with me and ill show you how (andrew@andrewstemler.com)

So, for now, my conclusion is that, when applying stretching for pain relief,  it’s sensible to consider combining Trigger points with stretching. I’ll talk about the re education of tissues, rest period, elsewhere. This I think is also the view of Joe Hippensteel from Ultimate Human Performance. The UHP  stretch based method has recently shot to fame as it was popularised by  David Goggins in his book Can’t Hurt Me: Master Your Mind and Defy the Odds 

 

It’s still important to  say that every year dancers, gymnasts athletes and physical enthusiasts get flexible by using a mix of the work of  Zaichik,  Kurz and others.  That you can improve your range of motion  isn’t really up for debate.

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How long to hold a stretch?

If you a standard athlete  or anyone who hangs around at the gym you’ll know how long to stretch for. Its a 10-20 second hold of the stretch in your warm up, and maybe you go mad in the  after workout stretch and go for those 30 to 40 seconds hold.

The only problem is , you are wrong!!!

As I’ve already explained, in the first few weeks of a stretching regime, any increase in the range of motion is due to an improvement in Stretch Tolerance. This gives you a transient increase in range of motion, and you’ll probably feel a bit looser. If you use stretching as part of a pain reduction programme, these short stretches will help build your confidence. But, no actual  physical improvement in your muscle extensibility ( you’ve pushed open a rusty door and you are getting used to the grinding and  stretching noise the hinges make)

Holds For 2 Minutes PLUS

Well, now we enter the real world of  full on, proper, big boy stretching, and this comes with spooky therapy words like  “tensegrity” and “mechanotransduction” and the “Thixotropic Effect”, which states the longer a tissue is under load, the more adaptable it will become.   This all leads to the rule of thumb that says if we want to make physical changes to your muscles you need to apply  force to the tissues for around two minutes or more.

This two minute mark is determined as the average time  it takes a cells to recognise the stresses being placed on it.  The longer and more regular the stress, the more the body   goes. “we better adapt to this” .

Dr. Andreo Spina frequently states, “Force is the language of cells.” 

Keep in mind that stretching one time for two minutes will not create a permanent change.  It takes a lot of repeated stimulus over a long period of time to create actual changes to tissues.  This follows the Thixotropic Effect, which states the longer a tissue is under load, the more adaptable it will become.

To put this all in context, jumping straight to 2 minute stretching is a silly idea.  Use that first month to build up. I started with sets: 3 sets of 10 seconds, then 20 seconds, then a week later 30 seconds. We know that first period is building up tolerance, so, “just build up tolerance”

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The first 30 days of stretching!

It’s about time that you began to understand the secrets behind effective stretching. The secrets begin with understanding what the process is.

The first part of the process, in the first 30 days, is that improvements in  your range of motion in the joint occur because you tolerate the discomfort more (aka Stretch Tolerance) NOT, because you have lengthened the muscle.

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Reference

Law et al, 2009. Stretch exercises increase tolerance to stretch in patients with chronic musculoskeletal pain: a randomized controlled trial.   Find here

 

 

Deadlift homework: the Imaginary Bar drill

In the early stages many people struggle with the deadlift. This struggle is down to many factors: hamstring inflexibility, balance, proprioception (or lack of it) or simply, pure “what the hell is this”.

Mastering the move is made harder by the fact that many  people think they can only practice the move in the gym.  If you struggle, more practice is useful, hence the imaginary bar drill.

Focus on holding an imaginary bar, anywhere: at home, at work, in the pub.

Enjoy

If you need help drop me an email Andrew@andrewstemler.com

Its an S pull

s pull

Not that it really matters, but, the bar path in the olympic lifts isn’t straight up and down. There is a pleasing “S” curve to its path.

This is probably facilitated by a good “Lat Flare” as the bar passes the hips.

Thanks to Tommy Kono Weightlifting, Olympic Style”.

Thought I’d mention it.

 

Flexibility Standards

Do you need to be more flexible?  How flexible are you? What are your flexibility targets? It’s interesting ploughing through the flexibility literature looking for effective and reliable flexibility standards.

These  following two photos are from the  Men’s Gymnastics Coaching Manual and they give an “interesting” guide as to the possible  levels of flexibility that would be gymnasts may need. Im not sure to what extent it should guide normal people, but, it’s an interesting, if depressing, place to start answering the question of ” how flexible” do you need to be.

Tom Kurz suggests this reference chart in his famous book  Stretching Scientifically: A Guide to Flexibility Training

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