Coaching versus Correcting

Foundational-Strength

Coaching versus correcting can be confusing if we don’t look at it in a proper way.

It’s absolutely amazing to watch someone like Pavel, Brett Jones, Mark Toomey or Dan John coach a movement. They can take a bad lift or a bad movement and with just a few well-placed words, make that movement better. We’ve all stood back in awe of how economical they are with their coaching cues and instructions.

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That’s by design. We’ve learned this by watching an inexperienced golf professional stand on the driving range and give a student 45 things to think about in the golf swing. That’s not a good idea, and it’s not a good idea to do that in the kettlebell swing either.

We’ve learned from about 25 years of motor learning research that we shouldn’t give internal cues—we should give external cues. We don’t tell people what to engage or what to fire or what to relax. We give them an external cue, like ‘float the kettlebell.’

We could say ‘engage your lats,’ or we could just coach a movement that requires that to be done. If you’ve ever seen me put a little elastic tubing in someone’s arm pits, pull backward and let them reach down to try to deadlift a kettlebell, I’m articulating that same lat engagement cue with a tactile weight shifting, vestibular and proprioceptive cue.

Since I wrote Athletic Body in Balance, I’ve been saying that the language of movement is written in feel, not in words or pictures.

When we first learned to move, we did it by the way it felt. If toddlers lean too far forward trying to run, they land on their faces. When we run and don’t lean far enough, we don’t really go much faster than walking.

Natural movement

That forward lean is something that’s communicated to us through gravity and the environment. Whenever possible, we try to do those fundamental tactile, proprioceptive, feel-based cues, and then maybe just add a word to refine it. 

Now, consider coaching versus correcting. If I take an athlete to the ground and ask them to do crocodile breathing or ask them to learn to breathe or open up their chest when doing an arm bar, that’s different. I’m actually coaching a correction, and in those cases, we can give a little more verbal insight.

Often, when people are doing a corrective maneuver—and I’ve seen Pavel do this very well—we coach breathing. Pavel said in Simple and Sinister that two very complementary yet contrasting breaths are seen in the Turkish getup and in the swing.

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We can use the breath to relax the neurological system, or we can use the breath to fortify greater strength in a very powerful, crisp movement. The breath can often be the driver.

Here’s my point: When I watch expert coaches coach, they always (or nearly always) get it right. They don’t bring the coaching cues that work to everyone, only because everyone is not ready for those cues.

When an individual can’t even bend over and touch their toes, they’ve got a problem, and not just a movement problem. It’s a sensory problem. They feel the kind of tightness most people feel when grabbing and clasping their toes, but they’re feeling that halfway through the range of motion. I don’t know if there’s anything I, or any of the other coaches, can say to make that better.

toe touch

We’re going to have to do a corrective. If we’ve cleared their leg raise or if we’ve cleared a lot of the barriers to that, I may do something like the toe touch progression or leg lowering. Now, these aren’t exercises in and of themselves. They’re just correctives because I’ve still got to get them touching your toes.

Once I get them touching their toes, I’ve still got to make sure they have proper alignment, balancing and coordination in deadlifting. Then, one day I’m going to convert that to a crisp hard-style swing.

The art of this is in knowing when to coach and when to correct. Using the movement screen as a strength-and-conditioning filter, your best investment is to try to correct first if somebody gets a ‘1’ on the movement screen. Break it down. Use a corrective strategy.

I think Mark Cheng, Jeff O’Connor and Brett Jones took this to the next level in Kettlebells from the Ground Up 2. They took what Brett and I did with Kettlebells from the Ground Up, a breakdown corrective view of the Turkish getup, and demonstrated that within the Turkish getup are corrective opportunities.

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Listen to what the getup tells you. Do the correction. Resume the getup. Is it better or not? More correction may be necessary, but if you listen to the breathing cues and the movement cues, you can easily get over some of these obstacles or speed bumps within the getup. These are two products I think will really help you get your head around correctives.

I want to add one bit of advice—when the people I work with and the people I train do correctives, it’s not a month-long thing. It’s a session thing. As a matter of fact, it’s a ‘couple of minutes’ thing. We drop a corrective that’s not so difficult that you can’t potentially see the benefit almost immediately.

If Pavel tells you a certain way to breathe, relax and to stretch, or we tell you a certain way to do a crocodile breath before your rib cage mobility efforts, these are going to get you a very big bang for your buck—tangible results in the opening part of a workout.

That is my definition of a corrective. I’ll run the entire loop, hopefully within five to ten minutes. If you’ve been to a previous event of ours, you’ve probably seen us do this. We do the corrective where it’s needed, but we don’t introduce unnecessary correctives.

We often see people in our workshops sampling a corrective they don’t need, only to look up at the instructor and say, ‘I really don’t feel much from this.’ Why should they? They don’t have anything that needs correction. They’re reading far beyond a third-grade level. If I hand them a third-grader’s book, they may not get much from that, but the person who needs it is going to notice a tangible benefit.

How? we’re going to go through the extra inconvenience to set a baseline beforehand with a simple move, a simple breakout, a simple corrective or even doing the screen. Then we’re going to revisit that to confirm the fact that the investment was worthy.

From there we go right back into coaching. If you’ve got ‘2s’ and ‘3s’ throughout your movement screen, there’s a good chance the biggest barrier to you doing a respectable lift is just technical precision, whether it be bodyweight, straight bar or kettlebell.

When the movement screen gives you at least a ‘2’ or ‘3’ on everything, you’re demonstrating the requisite mobility and motor control. You just need to learn to control your breath, own your alignment and have a good feel perspective of what that lift is supposed to do.

This is when the coaching cues change everything. I became a better presser the moment Pavel said, ‘Pull the weight down out of the air with as much energy as you used to press it up into the air.’ That helped me reset my scapula. I was standing there thinking, ‘Why didn’t I think of this?’

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It was because Pavel has spent a lot of time coaching pressing. The cue worked for me because I was at least ‘2s’ on my shoulder mobility at that time, maybe not now or maybe it’s better. Who knows?

The point is this: Had I been a ‘1’ on my shoulder mobility, I wouldn’t have received the benefit of that coaching cue with nearly the impression I did. A ‘1’ is a simple template that says we should probably correct this. In most cases, if the person is fit and otherwise ready to train, they should be able to go from a ‘1’ to a ‘2’ in the preparatory phase of a strength session.

When that ‘2’ is in play (a lot of the things we’ve done in the past tell us that ‘2’ is going to be available for about 30 minutes) that is the window of opportunity where most good strength-and-conditioning effect can occur in a single-dose workout. That means even though someone walked in with a ‘1,’ we’re going to be training with a ‘2.’ Now, if we overload them or let them have poor technique, we might insult the move and send them back to a ‘1.’

Let’s be honest here. What is a ‘1’ on the movement screen? In many cases, we might want to call it a mobility or flexibility problem, but flexibility problems don’t respond to stretching like we think because many times that ‘1’ on the movement screen isn’t just a tight muscle. It’s a strategically placed parking brake with agreement from the brain and the body suggesting ‘If we allowed any more motion, this idiot would probably injure us. We’re not going to allow this person’s drive to train or be fit actually sideline us and injure us in the process.’

Parkingbrake

When we see a limited leg raise, limited shoulder mobility, an inability to lunge on one side or a horrendous squat, instead of just thinking, ‘Let’s find that tight muscle and attack it with foam rolling,’ let’s figure out why the parking brake is on in the first place.

Sometimes, the biggest problem with  flexibility is that the person performs a few powerful moves—loading moves, sprinting moves or lifting moves—without enough motor control or integrity. They scared their body so bad or leaned against the edge of their ability that they imposed a parking brake, and that parking brake has been engaged since they’ve been training. Sometimes, the biggest performance gain comes from correcting the ‘1s’ and then re-coaching the ‘2s.’

This is a very important thing to consider going into the StrongFirst event that Brett and I are doing in King of Prussia, Pennsylvania on June 20-22, 2014. We’re going to breeze through the movement screen, but then show how everything is in play if you know when to coach and when to correct.

The Functional Movement Screen as a coaching asset does that for us. Don’t waste your valuable coaching cues on a ‘1.’ In many cases, you’re only 10 to 15 minutes away from a ‘2’ anyway. By using video or still photography, we can get quick feedback on how clean movement gets.

Save your coaching cues so you and the person you’re coaching can get immediate and tangible benefits from them.

If you’re standing there taking the coaching cues you’ve learned from the masters and putting them on somebody who has their parking brake on, or who has closed down learning pathways because of a few ‘1s’ on the movement screen, you’re not going to bring much honor to the wisdom of those coaching words.

Drop coaching cues where they belong and you’ll get the same benefit as the masters.

Know when to coach. Know when to correct. Come see us in June.

brettandgrayFoundational-Strength

For more on correction through Reactive Neuromuscular Training (RNT) listen to my lecture available through movementlectures.com

gray-cook-RNT

 

The Timeless Pattern

We train patterns, not parts.

Yoga, martial arts, kettlebells, dance, gymnastics and the wide array of natural movements caused by our environment are all brought to being through patterns, not by parts. The parts of the body and the structure of the body submit themselves to the will of the pattern.

Patterns that exploit opportunities to deal with force result in stronger parts. Patterns that rely on quick reaction time create parts that respond in an instant. Patterns that create flexibility yield parts that are extensible. In all of the situations that are real in life, we develop better patterns, and the parts respond.

The essence of ‘functional exercise’ is that the exercise carries over into numerous activities—activities that create fundamental foundations, which support more specific skills. These things are so important that they must have markers. Just like healthy brain waves have markers, healthy blood pressure has markers and healthy body composition has markers, shouldn’t healthy movement patterns have markers?

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The Functional Movement Screen (FMS) is a test built on the layers of fundamental and functional movement that create markers to give feedback about movement pattern quality. Activities like gymnastics, martial arts and yoga usually have the intense scrutiny of a mentor, coach or instructor. These moving art forms are highly qualitative. Much of modern exercise has become largely quantitative, therefore requiring a skilled coach and trainer to maintain quality in the presence and pursuit of quantity.

Western culture focuses on the quantity of movement and neglects the quality of movement. Finding balance will create a more holistic outcome. As we seek to train the quantities of strength, endurance, power and sports skills, let’s use something like a simple movement screen every four months to see if our pursuit of fitness also establishes function, and to see that our pursuit of quantities maintains a minimum standard of quality.

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I’ve noticed two distinct qualities in the people having the greatest success using the Functional Movement Screen and the insight it provides into exercise program design:

1. They practice the technical skill of movement screening until it becomes nearly automatic.

2. They apply the principles of movement screening to themselves to manage their own movement quality.

These qualities demonstrate that it’s not enough to be a good practitioner. At a personal level, you must absolutely believe in what you do.

Action points to consider:

If the concept of movement screening just feels right to you, you can get certified in the Functional Movement Screen in a home-study course. Once you’ve done that, we invite you to look at our curriculum.

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This curriculum involves the Movement book, and lecture videos on Applying the Model,  Key Functional Exercises You Should Know and  The Future of Exercise Program Design. As you learn the technical skill of Functional Movement Screening, you will develop your philosophy of functional movement and learn to use the systematic logic provided by the model of Functional Movement Systems.

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If you’re a little skeptical and aren’t quite ready to take the step to become certified in the Functional Movement Screen, we still invite you to start with our curriculum and look at the logic behind the model. If you’d like to hear a lecture, watch the three videos I just mentioned. Start with Movement if you’re a reader.

Stanford — “It Depends”

My recent experience at Stanford was one of the most rewarding and exhausting endeavors I’ve ever confronted. I’ve practiced swings in front of Pavel Tsatsouline, done dry needling under Edo Zylstra and passed an oral anatomy exam at the University of Miami. Each was a trying endeavor that offered great rewards.

Sharing the stage at Stanford with Stu McGill may have topped them all because of the public venue. Stu and I both survived, and I hope we reinforced a friendship in the process. Toward the end of what seemed to be a 40-hour day, we entertained some questions, and it quickly became apparent Stu has a standard answer: “It depends.”

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These words are often used to skirt a question, but when a man with Stuart McGill’s pedigree answers “It depends,” it really does depend. I think Stu’s response is a concise way of saying, “Don’t ask me for a specific answer to a general question, because we’re talking about human beings. We’re discussing the time they’re going to invest in either rehabilitation or training. We don’t want to waste anybody’s time and we definitely don’t want to do any harm. When you ask a general question and ‘it depends’ is the answer, there are specific things that haven’t been taken off the table.”

As I heard this answer, I realized the underlying question was, “When can we just coach people?”

If you’d prefer to listen instead of read, here’s a longer audio version of this article, Episode 42 of Gray Cook Radio

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We all love the reward of seeing someone move or perform better just because we’re in the room, doing what we do and saying what we say. Our manual, tactile and verbal cues are some of the most artistic things we can ever do. We speak and movement improves—how cool is that?!

Kelly Starrett

Kelly Starrett

I’d like to use four coaches as examples to make this point: Kelly Starrett, Shannon Turley, Stuart McGill & Dan John.

On my way to Stanford, Kelly Starrett picked me up at the San Francisco airport and took me to his gym. I watched his coaches take his ideas and turn them into motion, movement and respectable lifts.

Shannon Turley

Shannon Turley

Shannon Turley is the Strength and Conditioning Coach for the Stanford football team. We watched him move three groups through his facility. No music. No disrespect. No horseplay and no chatter. The athletes knew their roles and moved smoothly. Shannon, his strength and conditioning staff and the football staff were precise with their commentary and critique.

Stuart McGill

Stuart McGill

On Saturday at Stanford, I observed Stuart McGill. He demonstrated that a spine that screens well doesn’t necessarily test well under load. I completely concur. Screen poorly? We need to work backward with an SFMA and a clinical exam. Screen well? It only means you screened well at bodyweight, not that you lift well or load well. Anything else is an assumption.

Dan John

Dan John

Lastly, I’m always on my game when I have a coach of Dan John’s wisdom and experience in the room. He was on the front row in the Stanford auditorium, fitting the puzzle pieces together, open to new ideas, but standing firm in the things he has witnessed across his career.

Kelly Starrett, Shannon Turley, Stuart McGill and Dan John inspire by their words and example, and represent the best we have in coaching. I aspire to have that kind of coaching wisdom and art, though I don’t necessarily consider that my role. 

I was originally exposed to rehabilitation and performance at the same time, and like a child learning English and Spanish, I can easily and effortlessly transfer between each ‘language.’ I simultaneously pushed myself to become a strength coach and a physical therapist, and never formed a singular allegiance to either. This knowledge transfer seems natural to me and makes evident the impact that its absence can have on great coaching.

Good coaches hone their instruction, critique and cues until nearly perfect.

Great coaches intuitively differentiate those athletes ready for coaching and those who probably need to do extra work, remedial work or need a second opinion.

This insight regarding who to coach and who to send down a corrective path prior to coaching is entire point of my work in movement screening.

FMSentry-point-diagram

I had an opportunity to sit in the Orthopedic Grand Rounds at the University of Miami School of Medicine, because the Physical Therapy department and the Medical department reviewed orthopedic cases together in a large theatre format. I vividly recall listening to inexperienced clinicians ask specific questions while providing no background information. My professors would answer in patient words much like Stu’s, “You haven’t given me enough information to give you the answer I know will work most often.” Only an irresponsible clinician would answer a medical question without knowing the subject’s basic vital signs, health history and current state of health.

I see the movement screen as vital signs for our work, a starting point detailing the cooperation (or lack thereof) of mobility and motor control.

Coaching became a major theme of my weekend at Stanford. We’re all attempting to determine when to push people and when to cue and coach motor control. We also need to be able to realize when we can’t induce change.

Can we take somebody with a poor movement screen,‘1s’ and maybe even ‘0s’, and put them in positions where if they brace themselves they can accept load? Absolutely. The gym is full of such people. The athletic arena is full of them. Do we make the situation better by loading it?

The movement screen has a mobility bias, and loaded screens have a stability and motor control bias. I reiterated at Stanford that my statement about ‘mobility first’ is not simply an invitation to stretch or mobilize. You must first explain why mobility is limited or compromised.

Look closely and you will often find that a tight muscle is limiting a movement pattern where motor control or stability is poor. What you choose to do should make it move better. I don’t care whether you work on motor control or mobility, as long as you improve mobility.

Even with a major movement restriction that distorts almost everything else you do, we can always find a few positions where you can still handle load. Great, I’ve turned you into a statue. We want a moving, dynamic and adaptable human being. This is why the patterns of the movement screen are so important: acceptable movement patterns under appropriate loads usually improve, but we must first agree on situational definitions of acceptable and appropriate.

Push mobility into normalcy and realize that if people are moving at close to a normal level with no inappropriate vital signs, they will respond to coaching.

What type of coaching will they respond to? That espoused by the coaches I mentioned: Kelly Starrett, Shannon Turley, Stuart McGill and Dan John. These professionals have developed amazing coaching wisdom and continually get wonderful results. Through much experience, they intuitively know who to coach, when to coach and how much load to impose.

If we take their proven coaching methodologies and apply them generally across 30 diverse bodies (different in personality, psychosocial interaction and physical movement patterns), we’re not going to replicate their results. Nothing they do is random and nothing they do is rigid. It is precisely addressed to the situation and it always ‘depends.’

Not content with hearing ‘it depends’ from the best people in the world? Give them a better question!

First, answer as much as you can, and then ask a focused question. Let them know you took care of the vital signs and took all the things off the table that would impede great coaching. My work has been to make you give us a better question so we can give you a better answer.

Gray Cook Stuart McGill Stanford Q&A

I specifically avoided covering the SFMA, our medical movement screening with its complete decision tree on stage. That was not my role.  My mission at Stanford was to demonstrate the FMS, its attributes and its limitations, and to detail the benefits of using it as a starting point. Flunk a movement screen due to pain or movement-pattern incompetency, and the best coaching in the world probably won’t help much. Pass a movement screen, undergo further load-focused testing and now you are ready to look at strategies. Test and retest for much-needed feedback on what works.

The four men I mentioned are much more than coaches. Stu is a respected researcher and Kelly is a true innovator. Dan is the athlete and coach with the wisdom of a sage. Shannon has been doing things that look, on the surface, random and non-specific, but his results are impressive. His athletes perform as well as most of the other athletes they compete against, but they move significantly better. He measures often and his program values movement as a biomarker.

In summary, exercise should:

  • Add a benefit to your health and performance,
  • Not impose unnecessary risk factors,
  • Be coached,
  • Be programmed and,
  • Yield continual results or provide remarkable maintenance. 

If you want a cleaner answer, learn to ask a better question, or accept the very correct ‘it depends.’

Further commentary on the Stanford event

Dan John: “Back” from Stanford

Patrick Ward: Conference Review: Assessing Movement with Stuart McGill and Gray Cook

Laree Draper: Post-Stanford, My Take on the FMS

Phillip Snell: Stanford Review

Bobby Maybee: The Stanford Event, A Review from a Chiropractor

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Can You Handle the Steps at Stanford?

nytI was unbelievably proud and surprised to see the New York Times article on New Year’s Day about Stanford’s football success, and some of the strength and conditioning innovation behind it.

Coincidentally, next week I head to Stanford for a talk with Stuart McGill. It’s an event arranged by Craig Liebenson, where we’ll discuss the implications of movement screening and assessment, and look at some future trends.

The Stanford steps I’m referring to in the title aren’t a set of stadium stairs or concrete steps anywhere on the campus. I’m referring to the organized and systematic approach the Stanford Sports Medicine, Rehabilitation and Performance teams use to manage athletes, and to communicate among themselves, the coaches and athletes.

One element of their system is our Functional Movement Screen. The Functional Movement Screen often gets associated with injury prevention or injury risk, but that’s shortsighted.  Even as a young physical therapist and strength coach, when we created the FMS I knew it needed to be a management tool. I envisioned movement as a biomarker, a biological indicator we weren’t already using.

By that point, we’d done a pretty good job mapping anatomy, and an equally good job developing both general and sport-specific performance measures. One place where we needed improvement was in looking at movement patterns—the behavior that connects the parts and the performance.

Here are the criteria I put forth for the screen.

  • It has to be a simple and reproducible test.
  • It can’t have significant expense dedicated to equipment or data collection.
  • It must not be an isolated assessment.
  • It must not involve physical capacity.
  • It must target movement competency.
  • Can the parts work together in fundamental movement patterns at one bodyweight load?

I knew if we could identify a movement biomarker and make it work, it would definitely enhance the injury-management model. I speculated that it would also give insight into systems and practices that might help reduce the effect of an injury.

It could easily be said that the NFL has a 100% injury rate. Is the issue the prevention of injuries in situations where we know they’re going to occur, like in tactical maneuvers and collision sports? Or is it to minimize the effect of an injury by having an otherwise healthy body?

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An injury rarely occurs in isolation, but when it does, the rehabilitation process is smooth, efficient and effective. It’s when something like an ACL injury is complicated by a stiff hip, a weak core and poor ankle mobility that rehabilitation becomes more complex.

The first rule in orthopedics is to always clear the joints above and below the problem area. If you follow this tenet, you’ll often discover why the area is problematic in the first place. The movement screen is simply a constriction that compresses movement quality into an acceptable range and captures it when it’s outside of that range.

The overlying theme is that our methods should be determined by our measurements. By measuring things, we gain perspective. That perspective can be used to create a systematic approach. The systematic approach can be tested against the current program to gauge whether better decisions can be made with the available information.

Stanford is a shining example of information utilization. I’m absolutely sure that people will look at what Stanford is doing and try to copy the programming. If they have a different population, a different environment, a different competitive season and a different type of athletic recruiting situation, Stanford’s system may not work. My prediction? They’ll try anyway.

stadium stairsPeople won’t go through the steps Stanford did to develop their program. They’ll just copy. Copying alone may offer some degree of improvement, but Stanford is the leader because of their measurements, because of their metrics, and because of the insight they gain by quantifying the effect of the decisions they make.

The first and most important issue is the creation of clear, consistent and honest communication in regard to movement. It’s easy for an athletic trainer or a physical therapist to say someone has completed rehabilitation. It becomes harder to make that statement when the pain-free athlete still can’t pass a Functional Movement Screen.

It’s also extremely easy for strength and conditioning professionals to assume they’ve improved a situation. We often see speed increases in one or two drills, where a strength coach has made an improvement in one area at the expense of movement—losing fundamental mobility and stability. How much of the strength is really actionable and how much of the strength is functional?

A baseline is the starting point—one that holds rehabilitation professionals accountable for function in the rehabilitation process, and holds strength and conditioning professionals accountable for maintaining an appreciable level of function throughout the performance enhancement process. From here, metrics and measurement can make the difference.

Organizations that use the Functional Movement Screen in both athletics and rehabilitation are instantly better—not because the movement screen is so good, but because it creates clear, consistent communication with actionable results.  I’m proud of the work Stanford is doing in both rehabilitation and performance enhancement—and not just in football but across the board.

It’s as simple as this: Find the right things to measure and measure them consistently. Measure them often. Develop programming that improves them. Create a program without negative side effects that manages minimums, and you’ll have a feedback loop that will help you refine your decisions for the rest of your career.

The results are in the steps. Don’t copy Stanford’s methods without also copying their measurements and metrics. You can handle those steps—it’s as easy as remembering the old carpenter’s rule: Measure twice, cut once. 

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To Stanford, with Stu McGill and Craig Liebenson

The upcoming Stanford event with Stu McGill and me is the brainchild of Craig Liebenson. It probably came from an issue Craig observed in his position lecturing, publishing and mentoring young clinicians in functional rehabilitation. Craig noticed people thought Stu and I were at odds about concepts like screening, assessment and spine stabilization.

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Craig is a shining light in the chiropractic world, showing that a blend of good rehabilitation, good conceptual physical therapy and exercise choices are equally as important as manual therapy, manipulation, dry needling or soft tissue work. If you’re not doing one at an expert level, the other will barely get you halfway.

Craig proposed for us to get together so people can hear what he was able to glean from our work, and we jumped into making it happen. Stu and I are probably both in the process of paring down the most important concepts we’d like to be recognized for. Two of the concepts that polarize people are spine sparing and spine stabilization. We’re both passionate about these, and I want to elaborate at bit.

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One of Stu McGill’s original concerns in his work was spine sparing. That means if you’re trying to rehabilitate, stabilize or train a spine and you haven’t looked at all the reasons a spine may have to compensate—lack of hip extension, lack of medial rotation on one hip, poor balance on one leg, poor thoracic spine mobility—you’re not doing a very good job at sparing the spine. You’re trying to add a positive to a situation that would do better if you removed a negative.

Only in a few situations will spontaneous stabilization emerge from creating mobility in the system. Some stabilization training has to occur, but if you look at what we say about stabilization, if you neglect the screening and evaluation process, and you don’t identify the things that could be causing the spine to compensate in the first place, you failed to recognize the spine isn’t the problem. The spine is the victim. Until you attack the problem and then rehabilitate the victim, you’ve done nothing.

FOR WEBbook covers

It’s believed that 50% of back patients will probably get better regardless of what we do.

When you have an episode of low back pain that inconveniences you or disables you in some way, without someone to responsibly evaluate and rehabilitate you, you could very easily recover from that episode.

But here’s what you’re going to do: You’re not going to play golf anymore. You’re going to give up running. There are lifts in the gym you no longer do. You’re in constant search of a mattress to make you more comfortable.

In many cases, you just pare down your life and limit it so you’re more comfortable, but in no way are you more functional. The pain is gone, but it’s because you don’t agitate it—not because you rehabilitated it.

Stu’s concept of spine sparing is the most important concept in this entire body of work. My contribution was in trying to create a filter in both our movement screen (the FMS) and in our medical equivalent movement screen (the SFMA) to say, ‘You don’t just have a stability problem. You have multiple mobility or movement problems.’

gray2013If your action isn’t affecting a movement pattern, what is your action doing?

In concept, Stu and I are in total alignment in responsibly attacking the weakest link, but remember, one of the things people debate about our work is low back pain, and low back pain is not even a disease or a dysfunction. It’s a symptom and it can come from everything from tight hips to poor lifting mechanics to bone cancer.

The most responsible action in back pain is not to reach for a remedy, but to thoroughly, objectively and consistently attempt to map out the contributing factors before pursuing spine stabilization.

This leads me to a second point where I feel people think we’re in opposition. Stu and I are in pursuit of biomarkers—biomarkers that help predict problems and progress people. These are biomarkers that set baselines so you can appraise the value of your work and the amount of progress you’re offering to the people who train and rehabilitate with you.

Stu and I have also been asked if we find a valuable biomarker, ‘Can you move it? ‘Can you help it?’ Stu has adopted some remedies, as have I, but we came from two different incubators.

I’m a clinician coming out of a small clinic in Virginia with a very small education budget and no research budget. I’ve never been completely attached to a university and I’ve never had a research grant. All I had to work with were the tools I had, to be resourceful and see if I could make a simple filter to help me and my staff be a little bit better at what we did.

PavelwithStuStu has had an unbelievable research window into the inner workings of the human body with EMG, force plates and biomechanical analysis. He’s gone deep into the anatomical structure of what the spine should and shouldn’t do. And he’s also looked at the functionality of what the spine does in our most vigorous activities and during rehabilitation.

In recent strength and conditioning culture, Stu has become somehow married to the side plank. But really, he simply identified the side plank as a biomarker. Many people then took that side plank and used it as an inoculation—not as a remedy, and not as a treatment when warranted.

Many people assumed if they just add side planks to a rehabilitation or functional exercise program, they by default stabilize the spine…because Stu has a body of spine stability work and they saw him write about the side plank. Therefore, if everybody in their program hits the side plank, by default they’re stable.

That’s not Stu’s message at all. Anything Stu does, he’s going to precede it with a test and follow it with a re-test. Those tests will show him the appropriateness and benefit of the activity.

Sometimes people doing some of the exercises we discuss may trust us so much, they neglect to do the pre-test and post-test that validates they were in the right place at the right time with the right person.

What it boils down to is this: Stu and Craig and I get questions about dry needling, active release (ART), PRI, DNS or ways to get the body and the central nervous system and the movement patterns to line up. We have opinions about these, but you don’t need to ask our opinions. Run these things through our filters. If you’re correctly doing dry needling, you will change movement. If your approach to PRI or DNS techniques is on board and preceded and followed by objective evaluation, you’ll have your answer without asking.

I don’t want to be remembered for my contribution to exercise nearly as much as my contribution to assessments, screens and evaluations used so we don’t waste time with the wrong exercise.

We want to be better marksmen with our exercise choices.

We have many wonderful remedies to improve movement, restore mobility and improve stabilization. These remedies are often applied because they have value to the experts who invented them, but it’s hard to create that same value without perspective. People often take the right medicine to the wrong situation, and therein lies the need for screening, research-based biomarkers, assessments and medical intervention when warranted.

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Ultimately, the people who attend this Stanford event or get the audio, video or text transcript will realize if you lean a little bit closer and dismiss the idea of a magic bullet, you’ll discover our careers have been heading on a collision course of collaboration and support—not conflict.

This event is over.
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In the meantime, if you’d like to hear more from Stu, Craig and me, here are a few of our conversations.

 Craig Liebenson & Gray Cook: A Dialogue on Function

Stuart Mcgill & Craig Liebenson: From The Lab to The Trenches

Craig Liebenson & Gray Cook: Misunderstandings About The FMS and SFMA

Craig Liebenson & Gray Cook: Hat Tip to Professor Janda