I’ve blogged about stiffness and shortness before, but I’ve recently received some questions about the different approaches in each case.  I also go into more detail in the Indy Performance Enhancement Seminar DVD’s… 

I think it’s important to distinguish between whether a muscle is short or if it is stiff when determining a corrective plan.  Treat each case the same and only half of your clients will improve.

A short muscle lacks length.  It may be that the muscle is positioned in a shortened position frequently and the muscle fibers have dropped sarcomeres in series or the connective tissues have adaptively shortened. 

If you actively and/or passively stabilize the proximal attachment of the muscle and move the joint into a position to stretch the muscle, the proximal attachment will move well before reaching the end range of motion of the joint.

A stiff muscle has greater resistance to stretch.  This may be due to hypertrophy or a greater quantity of connective tissues.  Think of two rubber bands made of the same material, but one rubber band is wider than the other.  The materials would have equal extensibility but because one has greater width, it take more force to stretch it the same length as a thinner band. 

In the case of a stiff muscle, if you actively and/or passively stabilize the proximal attachment and move the joint into a position to stretch the muscle, The joint will move through it’s full range of motion without movement at the proximal attachment assuming enough force is applied to stretch the muscle.

Short muscles require repetitive, prolonged stretching to encourage creep of connective tissues and the addition of sarcomeres in series to add length.

Stiff muscles can be corrected by balancing the stiffness across a joint by strengthening their antagonists and by holding the antagonists in a shortened position as they may have been adaptively lengthened over time.

Question:  Bill, What mobility activities do you use for lower level patients/athletes with increased kyphosis and limited glenohumeral ROM?

Answer:  If you come into my clinic on any particular day, you’ll see my shoulder patients doing many of the exercises from the Inside-Out DVD.  There’s certainly a reason we put those exercises in the program, and it’s simply because they’re effective in most cases.

Thoracic spine mobilizations with a foam roller and combined thoracic extension and rotation can be done with just about any shoulder patient.  Even in the early stages of rehab, the painful shoulder can be protected while important gains in thoracic spine mobility that will improve shoulder function are made.

I also like to use the active shoulder range of motion and scapular mobility exercises from Inside-Out.  The exception is when there may be a limitation in range of motion that requires a time dependent change in the tissues.  In this case, various stretching methods will be implemented.  The more common areas in athletes that require stretching are the posterior and inferior capsule.

In cases where muscle stiffness is the limitation, traditional, 30-second static stretches, and PNF stretching works quite well.  In cases of tissue shortening, longer duration methods such as low load passive tension stretches for up to 20 minutes or eccentric quasi-isometrics may be in order.

Bill

Question:  Is there a difference between training for injury prevention and training for improved athletic performance?

Answer:  No.

Think about it.

Can an athlete perform at his best with significant asymmetries in joint movement from one side of the body to the other?

Not likely. (Note: there are a few exceptions like the shoulders of baseball pitchers and tennis players)

Is an athlete more likely to be injured with significant asymmetries in joint movement from one side of the body to the other?

Yes. (AJSM 19:  76-81 (1991), Spine. Sept; 8(6):  643-51)

Can a fatigued athlete produce and absorb high levels of force and perform at an optimal level?

Not likely.

Is a fatigued athlete more likely to get injured?

Yes.  (Neuroscience Letters 333(2):  November 2002, pp.  131-135; MSSE 34(12):  1907-1912, December 2002)

Ever see an ACL injury prevention training program?  They emphasize proper landing mechanics, posterior chain strengthening, force absorption and plyometric training, etc.

Looks a lot like a performance enhancement program.

Train your athletes for improved performance, and they’re less likely to be injured.

Bill

Q: Bill, I love your blog. I wish you had time to post more often. I had a question. I have never been able to do a lot of push ups. My chest gets fatiqued after about 25-30 now matter what I do. I hear people talk about doing 50 push-ups at a time. Do you have any advice that will help me be able to do more push-ups?” Thanks.

A:  Thanks for the question.

If you really have your heart set on setting a PR (personal record) for push-ups there’s a number of factors that contribute to your performance.

1.  Stability

If you lack trunk or scapular stability, your prime movers at the shoulder girdle and upper extremity will be limited in their ability to produce force.

The Fix:  Perform long duration planks and isometric holds in the lowered position of the push-up.  Be sure to actively depress and stabilize the scapula.

2.  Maximal strength

When doing a regular push-up on the floor, you’re lifting about 2/3 of your body weight.  If you can increase maximal strength of those muscle groups involved, your 2/3 body weight becomes a lesser percentage of your maximals strength and theoretically your maximal number of push-ups performed should increase.

The fix:  Loaded push-ups with a weighted vest, push-ups with chains, push-ups with bands, asymmetrical and unilateral push-up variations, partial range of motion push-ups, and even bench pressing.

3.  Strength-endurance

High rep sets of push-ups are a test of your strength-endurance, so in essence, doing more push-ups will help.

The fix:  Try this progression.  1-2x/week start by performing the maximal number of push-ups that you can do in a row while timing the duration of this first set.  Rest the same amount of time that it took to complete the set.  Repeat this process until your complete the desired number of repetitions.  As strength-endurance improves, it should take fewer and fewer sets to complete the desired number of repetitions.

Bill

I was doing my food prep last night while my wife was watching “60 minutes.”  Most of the time I’d have ignored the TV, but they were talking about the science of sleep and it’s impact on health so my ears perked up.

Here’s some highlights:

After 6 nights of sleep deprivation, subjects of one study were found to be pre-diabetic…6 nights!

Leptin hormone concentrations are altered by sleep deprivation such that you become hungrier and consume more calories.  This kind of makes sense that I you’re awake more you would eat more, but these calories may be in excess of your daily requirements and increase fat storage.

A lack of deep sleep may be risk factor in most of the major cardiovascular diseases.

As we age, we spend less time in deep sleep.

Sleep is not just a primary recovery tool as part of your training (see http://billhartman.net/blog/2007/06/22/restoration/), but it’s also an important component of overall health.

One little piece of advice:  Try to go to sleep and wake at the same times each day.  Otherwise, it’s like constantly changing time zones which makes it harder to get restorative sleep.

Here’s a link to the 60 minutes segment:

http://www.cbsnews.com/stories/2008/03/14/60minutes/main3939721.shtml

Bill