Archives for May 2014

How to Ask a Better Question

My article following the Stanford event with Dr. Stuart McGill discussed “It depends” as a correct answer to unclear questions. Many times during the question and answer sessions, Stuart touched on the tendency to ask general questions with the expectation of specific answers. I want to discuss how to formulate and ask a better question. I’m passionate about asking better questions myself and helping you ask better questions.

I remember a lonquestion signg time ago working as a young physical therapist. I would have a patient in my exam room and he would say, “You know, your treatment and your exercises really helped me with my low back pain. My wife has low back pain too. Do you think she should do these exercises as well?”

My answer was, “Absolutely not. I would prefer that she not do any exercise in regards to her low back pain because the potential of making things worse is equal to the potential of making things better. If I meet her, see her and evaluate her or if she goes somewhere else with a responsible individual, she may very well find out that she’s got the same type of problem you do or she may have a completely different problem.”

Either way, low back pain is a symptom—not a diagnosis. I can’t provide a treatment plan for a symptom. I can do things to cover up the symptom but I can’t cure the problem unless I first diagnose the problem.

I would much prefer to answer questions about people or groups of people than I would about exercises. If I make one statement about a certain exercise, I’m absolutely sure that what I say will get misapplied due to a lack of clarity.

First of all, asking a question about a training or rehabilitation program for an individual or group requires us to get specific. Begin by stating the primary goal—which in rehabilitation is often getting rid of pain. We add the goals of removing movement dysfunction and combating mobility and motor control problems to the goal of getting rid of pain.

Think about that. If we confront every functional issue, remove all mobility and motor control problems and they still have pain, then we, as musculoskeletal specialists, have done our job. The person’s pain is coming from some other part of this situation than their movement dysfunction.

We frequently see musculoskeletal pain presented and yet we find an underlying disease process. The fact that we go through a differential diagnosis every time somebody has musculoskeletal pain is a hallmark of a responsible therapist, chiropractor or physician.

The first thing we’ve got to do is make sure it’s not something else

With any question about a specific individual, we need a health history.

  • Have they had previous injuries?
  • Do they have a disability of some sort?
  • Is their goal realistic or are there multiple unrealistic layers to the goal?
  • Are there any time constraints?

Believe it or not, that’s still not enough information, which is why I’m so passionate about something like the Functional Movement Screen, the Y Balance Test or vital signs. I want to know if all the systems are functioning at an average level, at minimum.

FMS-Stanford

How’s their cardiovascular system? Well, we could find that out just by simply doing some vital signs and seeing their response to a cardiovascular load. We could also do a number of strength tests on you to find out where you rate within your group in your age, your sex or in your particular sport or category.

Here’s where I’ll give you a shameless plug for the program that Lee Burton, Alwyn Cosgrove and I did last year on how to take movement screening information and some other information and put it directly into a program.

How can we intelligently make decisions when more information is introduced? If I’ve got a 14-year-old cross-country athlete who wants to train with me in her off-season, I will typically have a complete and thorough past medical history. I will have had a conversation with her and her parents. I will have at least done some vital signs, body composition tests and a movement screen.

Her body composition shows me that she has far less lean body mass than other females her age. Obviously after meeting her, we see the ectomorphic physique and realize that part of this could be her nutritional plan. She might not be getting enough protein.

She could be growing a little more muscular than she currently is if her nutritional components matched her athletic goals and her growth spurt. I may impose a questionnaire and find out how much good source lean protein she gets every day and what her nutritional favorites, staples and dislikes are.

Her movement screen shows me that she’s got ‘2s’ on every test at least with no asymmetries and no discomfort or pain. A vertical leap test shows me that her power is extremely low. A few other tests of overall body strength show a strength measurement that is not average for her age. However on the treadmill, her endurance is impressive.

Obviously, I see some biomechanical errors in her running cadence but instead of trying to change those right away and become her running coach, I think—what would she be like with five extra pounds of muscle, stronger quads, glutes and abdominals, a more erect posture and reduced anterior head posture? Would she stand more erect if her self-esteem was higher and she didn’t feel so intimidated when she was in the weight room?

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I’ve got a situation here where an athlete wants to perform better at an endurance sport but I have every reason in the world to challenge her assumptions about the benefits of a strength-and-conditioning program. The weight room is not simply for people who want to get stronger for the purposes of strength.

Strength is the single best way to hit ‘save’ on a good movement document. We often talk about motor control as a demonstration of  stability and strength—a demonstration of how we manage force. But strength is simply an outgrowth or an extension of superior motor control—the ability to both control motion and create motion.

I share the belief with most strength coaches that a fundamental strength quotient is the cornerstone upon which other athleticism is built. Can we achieve athletic goals without a good, strong base? Absolutely. Young children often develop impeccable technique long before they have impressive strength.

But as bodies get bigger, biomechanical stresses increase, sports loads and competition becomes more intense and that great technique possessed by the growing body all of a sudden starts to erode. The body changes, the lever arms get bigger and the stress gets higher.

If that same 14-year-old female athlete had had three ‘1s’ on her movement screen, regardless of where they were, I would put a hold on her strength training. I don’t want to hit ‘save’ on that document.

My goal is still to get her stronger. Her strength measurements are extremely low but I don’t know if her strength measurements are low because she’s weak or because she can’t move through the positions where I’m testing her strength. We’ve long thought of strength moves as being the defining factor of individual strength. In reality, weakness in some positions and strength in others, averages for the overall strength quotient.

Some powerlifters don’t look very strong by Olympic lift standards. Likewise, some gymnasts don’t look strong by powerlifting standards. To be called strong without reservation, someone would have to show me a battery of strength moves with both load and bodyweight and cover most of their functional positions and patterns.

How many of us does that apply to? The more functionally you work out, the more it probably applies to you. The more specialized you work out, the stronger you may appear in your comfort zone but the weaker you may appear outside of that comfort zone.

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Part of coaching is taking the athlete outside of their comfort zone, making them more adaptable and ultimately changing their environment. We may be training them in the same weight room but the exercises and the loads—everything is getting ready to change.

The best way to survive environmental change is adaptability and the best way to be more adaptable is to keep learning pathways open. Maintain a good range of motion. Keep adequate mobility. Motor control should be at least ‘good enough’ with body weight.

An intuitive, well-educated coach can systematically load that athlete until they’ve developed the strength reserve that can take them where they want to go.

In rehabilitation, we’ve got to ask a lot of questions before we discuss the injury or the treatment plan for that injury. In strength-and-conditioning, in personal fitness and in wellness, we’ve got a lot of information we need to consider before we take that focused isolated approach.

One of my favorite terms is ‘manage your minimums.’ If we could set minimum standards for movement, flexibility, motor control, mobility and strength within your particular group, then we could find out if you have any minimums. It is my philosophy to manage those first. From that foundation, try to grow and train in the direction that best suits your environment and your goals.

We’ve got to ask ourselves better questions and we’ve got to ask our mentors better questions. If we do both of those things, we’ll get better answers.

We’ll have better outcomes.


Interested in the video of the Stanford Event: Assessing Movement with Gray Cook, Stuart McGill & Craig Liebenson? 

Visit MovementLectures.com to see preview clips and video description.
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Revisiting Athletic Body in Balance

In 2003, I had the honor of having my book Athletic Body in Balance published by Human Kinetics, and for the first time people could read a perspective I’d been toying with since the early 1990s. Now, just past the 10-year anniversary of Athletic Body in Balance I want to tell you what’s happened since then, and what I would add or change if I were to re-write the book today.

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Before we do that, let’s take a quick look at the original premise. Think of the title first—Athletic Body in Balance. Imbalances are an indicator of disharmony and every philosophy that stands the test of time preaches balance.

For me, the entire secret sauce in my career is that I haven’t been pulled back and forth in the hypothetical debate of “Is this better than this?” when considering a horrendous imbalance.

Throughout my writing, beginning with Athletic Body in Balance, I nudge readers not to consider a parts approach to movement, but to instead consider a patterns approach. If we follow that logic, it would be more prudent to look at imbalances in patterns before we try to find imbalances in specific parts.

FMS Hurdle Step

Let’s peel this onion for a second. If there are imbalances in a movement pattern, we break down that pattern. If there’s a problem with a specific part, we’ll find it. But if there’s no problem with a part, we work on the pattern as a whole. The parts just aren’t working well together. The whole should always be greater than the sum of the parts.

That’s what movement is.

What are the benefits of working on a whole movement pattern? You have to create your own mobility. You have to create your own stability. We can increase or decrease loads, stresses and support to make the pattern a little easier to do, but working through an entire pattern is the natural way to acquire that pattern.

Nature shows us this every day. A baby learns to walk through reciprocal patterning and crawling. Those are still patterns—they’re whole patterns. They don’t do foot, ankle and hip exercises to become walkers. They crawl, and then they struggle through the walking patterns. There are a lot of falls incurred while learning to walk.

That’s all part of the plan. It’s a negative-feedback system. If they don’t do the right strategy, program and weight shifting, they don’t get a reward of movement success, and if they don’t get a reward, they don’t save that motor program into the brain.

Everything a baby does and everything nature provides us is self-limiting. This means our ability to pursue greater amounts of volume, intensity and frequency are limited by technical ability, attention to detail, mobility, stability, sensory input and interaction with the environment.

Here’s another thing I want you to walk away with: Fix movement through movement.

In Athletic Body in Balance, one of the things I wanted to do from the very beginning was to create an appreciation for setting a baseline. A lot of people talk ‘test–retest,’ but what they do more often is ‘trial–retrial.’ They try something, do something and try it again, but that’s not really test–retest.

I introduced the Functional Movement Screen in Athletic Body in Balance, but I realized since I was writing to the consumer, I had to have a self-done movement screen—something for the reader without a professional in the room.

In this video, I’ll introduce the premise of self-movement screening and show you the original video we shot showing the self-done movement screen depicted in the book.

The self-screen is a way to gauge your own progress when you’re training yourself, and when the availability of a professionally mentored movement screen isn’t available.

That’s a quick summary of what I hope is the timeless information in Athletic Body in Balance, but you may be interested to hear about some of the additions I would make now. The best way to discuss these is through the people who influenced me in recent years.

I’d like to start with Dr. Ed Thomas, who confirmed many of the suspicions I had about learning movement. Dr. Thomas is a walking encyclopedia of physical culture, physical education and physical preparation history. He’s a Fulbright scholar; he’s a PhD. He’s accomplished in yoga and martial arts, and he’s an expert on club swinging.

Throughout Athletic Body in Balance I was passionate about keeping the reader in touch with the importance of jumping rope. Jumping rope is a remarkable self-limiting activity for lower body, core, alignment, interval training, springiness and building a good power base.

Had I known about Indian clubs at the time of Athletic Body in Balance, I would have introduced club swinging as the upper body counterpart to jumping rope for the lower body. I can’t say enough about how important it is to get a command of club swinging.

There’s a true movement difference in the upper and lower body. The upper body is mobility-driven, involving hand and eye coordination—in touch with circular patterns no matter what the sport or activity. The lower body is constantly in touch with the environment, often with a jarring impact. It’s transitional and most responsible for locomotion, whereas the upper body is mostly responsible for manipulation.

The activities of jumping rope and club swinging generate the same result—adaptability and physical resiliency—lubricating the wheels and truing the alignment. You have to stand up straight to turn Indian clubs, and you have to stand up straight to jump rope. You may think you’re standing up straight, but if you can’t turn the clubs or jump rope, you’re not.

True alignment is something many of us aren’t aware of. We determine this when we try to learn something like the Turkish getup, another activity that didn’t make it into Athletic Body in Balance because I didn’t know about it at the time.

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Kettlebells weren’t introduced in Athletic Body in Balance, and yet I’ve spent quite a bit of time studying kettlebells with Pavel Tsatsouline and Brett Jones. I came to know Pavel’s work when I watched a DVD of him talking about deadlifting and found myself in total agreement with everything he said.

At the time Athletic Body in Balance had already been published and it occurred to me that I assumed everyone knew and used the deadlift. I’ve had a huge appreciation for the deadlift since my high school football days. I was wrong for assuming that because I appreciated the deadlift, my readers already did too. I consider jumping rope a fundamental move. I think the Turkish getup and the deadlift are also fundamental moves.

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A few years ago when Tim Ferris asked me to suggest some of my favorite strengthening and corrective moves for his work in Section 8 of The 4-Hour Body, I gave him the deadlift and the deadlift variations, the Turkish getup and the chop-and-lift. If you pay attention to the way your body performs and use the obvious intentional left-right comparisons of chopping, lifting, single-leg deadlifting and the Turkish getup, you will gain strength, master movement and keep your body balanced at the same time.

If you want to make gains, you have to push forward, which takes us to the Turkish getup.

The Turkish getup expresses our mobility, stability and a basic level of strength, but it also gives us an opportunity to focus on breathing and to appreciate alignment. You get good at Turkish getups by becoming more efficient—not by doing a gut check and muscling through it. If you push too hard in the getup, you turn it into a bench press. If you don’t take it seriously enough, you’re sloppy. You have to find a groove, and you have to accomplish it well on both the left and right sides.

I thank Pavel for the introduction to kettlebells. I thank Brett Jones for his mentorship with kettlebells. I wish I had a way to go back and add kettlebells to Athletic Body in Balance.

Gray and Erwan

Next I’d like introduce you to a Frenchman named Erwan Le Corre. Erwan is the founder and developer of the art and science called MovNat, meaning move naturally.

A couple of years ago I packed up my pregnant wife and two teenage daughters and went to the mountains of West Virginia to spend five days exploring movement with Erwan. We learned to put our bodies in every conceivable position in nature—not for the point of working out, but to navigate a rocky terrain, climb an obstacle, swim across an expanse, run on changing surfaces, or to perhaps realize in this position in this environment, crawling was the fastest path.

Erwan let nature instruct and all he did was give us occasional bullet points. It fit with the new neuroscience that tells us we shouldn’t tell people to focus on their bodies and internal ideas. When I wrote Athletic Body in Balance, I didn’t tell you to engage your abs or fire your glutes, nor did I show you a technique to activate a specific muscle. Those are futile suggestions because the people who can engage already do, and those who can’t won’t find it from a verbal suggestion.

The language of movement is written in feel.

If we can engineer a situation where people feel more, they can do more. Erwan brought that concept home for us when he made simple suggestions. We would be running, and he would say, “Listen to yourself. Can you hear yourself running?”

One of the other things Erwan taught was that our balance improved as we were fatigued. When we’re so fatigued we’re just trying to get our breath back, he took us back to a balance beam—2x4s laid on the ground. We let the body listen to the information coming up from the feet and exert only what’s necessary to maintain balance.

If you introduce balancing to people who are fresh, they try to over-think something they’ve been doing since they were two. I’ve since started incorporating the balance beam as a superset after any vigorous exercise. Erwan teaches with that external focus. He let us be frustrated by a task, and then he dropped a pearl of wisdom on us. He layered wisdom on top of, not over-instructing anything.

Along those lines, I wish I’d said something about the farmer’s carry in Athletic Body in Balance. As you become fatigued in your workout, save some activities that don’t require a lot of motor programming but that require fundamental programming. If I were your coach in a CrossFit gym or an NFL mini-camp, there are some activities we’d do under fatigue. We wouldn’t do anything that required a lot of skill, but we could still jump rope. We could do the farmer’s carry. We’d get on the 2×4 balance beam.

DanJohn - Farmer Carry

A heavy farmer’s carry forces you to align your ear, shoulder, hip, knee, ankle and foot on your stance leg, and take short, well-aligned strides.  The best way to carry that weight across a distance is with good alignment and posture. Once your grip is smoked, your workout is over because your grip is an indicator of the amount of stability and integrity you have in reserve.

These are little markers, external focus and low skill moves we’d do toward the end of your workout.

Most of us are far too verbal in our movement instruction. 

When I wrote Athletic Body in Balance, I didn’t introduce you to Indian clubs and Dr. Ed Thomas’ historical perspective, and I wish I had. Through Pavel, I re-embraced the deadlift, learned about the Turkish getup and was introduced to the kettlebell. Erwan moved the idea of training from the gym, dispensed with all the equipment and showed us how a natural environment typifies the self-limiting physical development model.

Don’t just tell me how much you lift. Don’t tell me how fast you are or what kind of quarter-mile splits you run. Tell me how well you move, too. Otherwise, this pursuit could be robbing from a fundamental base that will support a much longer and better experience for you.

I’m very proud of the influence Athletic Body in Balance has had in our field. On a personal note, if this is the first time you’ve heard this information, go get screened or screen yourself. The first thing you get is the confirmation: Am I on a functional track or have I been creating or allowing dysfunction on this path?

I want you to keep moving for a long time. I want you to grow strong and age gracefully.

Here’s an excerpt from Athletic Body in Balance for a little more information.

If you’re interested in more discussion on Athletic Body in Balance,
I fleshed this out in a 90-minute talk on movementlectures.com 

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Come see Brett Jones and me in June as we discuss the transition from assessment to strength training: Foundational-Strength