The quest for a healthy spine and shoulders


Paul Edmondson encourages us to rethink the balance principle when devising programmes for clients, in order to combat the impact of our sedentary culture on musculoskeletal health. Join us in our quest for a healthy spine and shoulders.

Every good story has a quest – the quest in this story is that of healthy spines/shoulders in training, as well as life in general. With every good quest, there is a hero and a villain. The villain in this story is our sedentary, desk-based, Zoom and iPhone culture of 21st century industrialisation. This has amplified significantly during lockdowns, where most have been sitting at home for 12 hours a day. Fear not though trainers, for your programming is the hero. You can rethink the balance principle in your training regimens!

For years, writing programmes for clients to achieve health and fitness was all about balance for symmetry, joint health and promoting an optimal posture environment – the use of equal ‘push vs pull’ exercises were considered ideal and, 20 years ago, spot on.

Today’s western culture, though, is drastically different – dare I say even more sedentary – and, with the influx of devices, computers, tablets and phones dominating our day-to-day work/social/play lives, things have taken a drastic turn.

Those 12 hours made up of endless Zoom meetings, an addiction to scrolling on phones and watching TV are impacting on musculoskeletal health significantly, particularly that of shoulder/spinal health.

It’s all too easy to say, “Get up and break the sitting cycle” and “Put your phones down” (which invariably lasts five minutes max) but, barring a few stand up and stretch breaks and the odd 5–10-minute walking meeting, the desk culture is with us to stay. As for the phone, many have an addiction to it, so we must accept that it is part of our culture and, as such, better programme to defend against the negative health impacts. A few 30-second stretches here and there are not going to unwind the 60-70 hours a week of stagnant seated postures.

To give some context and some stats, neck, upper back and shoulder pain episodes have risen uncontrollably in the past 18 months, rising to equal the prevalence of low back pain (where almost four in five adults suffer from aches/pain/tension, as opposed to 2.5 in every five adults prior to lockdown one).

The hours spent with gravity beating the spine into a flexed position negatively impact on the position and motions of the spine/shoulder and scapula – all of which narrows the ‘space’ in which the shoulder joint can operate and function day to day. If there is less space, there is less freedom of motion and, if the joint has fewer ‘freedoms’, mobility, stability and strength inevitably decline.

So, to alter the newly adapted postures above, first and foremost we must engage in daily rituals of low-level shoulder and spinal 3D mobilisations to maintain the health of these structures – remember, ONLY MOVEMENT maintains the health of a joint and defends against arthritis. No pills, supplements or foods will suffice, for the joints and bony/ligamentous tissues do not have a direct connection with our circulatory (blood) system to ‘pump’ nutrients to those tissues; instead, it must be ‘pushed’ through osmotic pressures (movement). Don’t move a joint and it will rot and die away. Try not brushing your teeth for two to three years and see what happens.

So, engage in mobility to maintain health of the joints, but the long-lasting ‘secret sauce’ is to put force through these required ranges of motion, teaching the body’s nervous system how to own, control and be resilient in movement.

Before we get into my top five exercises, remember this: the recipe for change is to perform twice as many ‘pull’ movements for every ‘push’ (2:1 pull to push) in your programming.1 Prioritise ‘horizontal push movements’ as opposed to vertical pulls, as these directly influence the anterior shoulder capsule, which is what we need/want to open up more.

So, without further ado, my top five exercises to combat the decline of spinal/shoulder health and to build good-quality, mobile, resilient joints/muscles are listed below.

1. TRX low row

This is my number one due to its brilliant simplicity, with myriad benefits, that is easily adaptable for any demographic – young, old, fit, not-so-fit and anyone in between.

The TRX low row utilises bodyweight as resistance (which is ‘life/sport’ – aka ‘functional’) and a quick change of foot starting position changes the demand for the user to work within the confines of their own strength/fitness abilities.

While it hits the necessary motions required here to train – T-spine extension, scapula depression and retraction, and shoulder external rotation – perhaps the most advantageous benefit that makes it number one is that research has found this exercise to have the highest amount of back musculature recruited/activated, while at the same time having minimal compression forces directed at the spine.

Dr Stuart McGill compared this exercise to three commonly used back exercises (the barbell bent over row, cable row and machine seated row) and the motor unit activation was significantly higher – meaning maximal ‘bang for buck’ with minimal spine risk/effort.2

When executing the exercise, maintain a tall ‘active plank’ position and imagine the handles as a steel bar. Bend the bar downwards as you initiate the pull for maximum effect.3

2. ViPR shovel drill

This awesome exercise utilises whole-body motion, in an upright stance, with the inclusivity of triplanar motion of the spine/scapula/shoulder – particularly ‘picking on’ T-spine extension and rotation. The T-spine is the foundation for movement accessibility for both the scapula and shoulder combined; the better the T-spine can move, the more efficient and effective the health/motion is at the shoulder complex. Desk-based posture will inhibit the spine first and shoulder dysfunction is a direct result thereafter, so attacking the primary joint is a must and extension/rotation are the motions that will be ‘lost’ first.

When executing this exercise, maintain a tall body position and allow the hips and scapula to ‘drive’ the rotation – not the arms. This will ensure motion will impact on the spine/scapula/shoulder in integration, rather than isolating stress to the shoulder with too much arm motion.4

3. Dumbbell prone T-row

This third offering utilises a different beginning position and offers the choice to move in a variety of situations, giving the body ‘choice’ to move well in all aspects of life, which is good for effective/efficient movement mastery.

Prone allows gravity to feed/drive more extension to the T-spine – in our desk-based environment, gravity does the opposite and ‘beats’ the spine into flexion. When the single arm reach drives the rotation, the entire arm/shoulder/scapula/T-spine/core to hip have to ‘control’ the driving/moving arm, strengthening all components in all three planes of motion. A great ‘bang for your buck’ exercise.

Ensure a tall body, active plank position as you reach the arm long, following the fingertips with your eyes.

4. Barbell bent over row

Even though it fell short of the TRX low row for muscle activation and ‘lesser’ spinal compression, this old-school exercise still has tremendous benefits when included in a training regimen.

This compound ‘big lift’ challenges body-wide strength in the sagittal plane and, because of the bent forward standing position and the barbell hanging down at the legs, the ‘pull’ of gravity challenges each of the 17 muscles at the scapula, which focuses and teaches strength/stability of the delicate rotator cuff (prone to weakness and dysfunction)5, but also links this local shoulder strength to integrate with the rest of the body, laddering up to whole-body global strength in one fell swoop. Plus, we can’t play down the effects of big compound barbell movements on aesthetic benefits, such as increasing muscle mass and driving down body fat due to secretion in anabolic hormones. Again, lots of benefits for health and fitness!

5. 3D plank variation

Although NOT a horizontal pull – which would be the main staples for healthy spine/shoulder programming – I wanted to include this ‘core’ exercise because of its wonderful simplicity, packed full of health benefits for all the regions of the body we are focusing on.

This exercise uses only bodyweight, with three progressive levels of challenge, each level incorporating the primary joints of target in all three planes of motion.

The first level has four points of contact with the ground, using a hip driver in all six angulations. The second level has less contact with the ground using a leg driver, increasing leverage and dynamic stability/strength to the spine/shoulder regions. Level 3 now switches to an arm driver, increasing more local leverage and strength in motion to the spine/shoulder. Think of each level as progressions that you must earn to go to the next level – keeping you and your clients safe, as well as slowly and incrementally increasing their strength in the spine/shoulders.6

These are my five favourite spine/shoulder exercises but feel free to select and implement your own. Try the 2:1 pull to push balance in your programmes and watch the pains and dysfunctions begin to disappear. Enjoy!

Want to learn more from Paul? Check out his blog on Functional hypertrophy – theory and practical application.

Author Bio:

Paul Edmondson is a dedicated leader within the fitness industry, having worked with, and for some of the leading pioneers and biggest brands in the world both nationally and globally. Paul has presented in 24 countries, over 5 continents on behalf of Gray Institute, ViPR, TRX, Anatomy Trains, Trigger Point, SKLZ, institute of Motion and at the IDEA World conference. His thought-provoking sessions are designed to bridge the gap between the traditional and new sciences to better equip trainers to serve their unique and individual clients. Paul takes pride in delivering complex content in a simplified and application specific manner that is perfect for trainers wanting to learn more, and is determined to drive forward those he works with to help them become “better versions of themselves”

References
  1. Rusin J, Shoulder/Pulling Health, https://drjohnrusin.com, accessed on 14 September 2021.
  2. McGill S, Low Back Performance – https://pubmed.ncbi.nim.nih.gov, accessed on 14 September 2021.
  3. TRX Suspension Training instructor education – 5 TRX exercises to build a stronger back, https://sg.eastcoasttrainingzone.com, accessed on 14 September 2021.
  4. ViPR Global LMT 1 online/live course (whole-body strength using myofascial lines).
  5. Siff M and Verhoshansky Y, http://educ.jmu.edu (Conjugate Strength Training – James Madison University), accessed on 14 September 2021.
  6. Gray Institute, Matrices (Functional video digest series), V45 ‘Matrix system functioning’.

 





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