“Hey bro, we’ve been stretching for an hour, can we start lifting now?” “Yeah right! We’ve only stretched our quads so far. It’s time for the hammies!”
Conversations like this happen between gym buddies everyday across the iron kingdom, but luckily I’ve never been part of one.
In fact, many people in the gym have noticed I don’t stretch much, and asked what my mobility routine is.
I’ve touted the benefits of a daily short yoga routine, but beyond that, I don’t do any stretching in the gym.
This may be surprising, because over the past decade or so, mobility work has become all the rage for lifestyle bodybuilders, powerlifters, professional athletes, and Crossfitters alike. Some people spend half their time in the gym just preparing to lift.
Why is it so popular? Is it really necessary?
To help explore the benefits of mobility work and find out what it can (and can’t) do, I’ve invited Sam Visnic onto the podcast.
Who is Sam, you ask?
He’s a certified massage therapist, expert on corrective exercise, and the founder of Release Muscle Therapy, where he specializes in helping people become pain-free through movement evaluations, techniques to re-learn proper movement patterns, massage, stretching, and more.
In this episode, Sam and I chat about . . .
- How do you get started with a mobility routine (and whether you need to)
- How and why people became obsessive about mobility
- Finding balance between mobility work and training
- How mobility can improve nagging aches and pains and why pain might not be caused by lack of range of motion
- Common pain problems and causes with the squat, deadlift, and bench press
- How to test your ankle mobility
- Foam rollers, massage guns, and other gizmos
- And more . . .
So, if you want to learn all about mobility work and how you can start nipping aches and pains in the bud, listen to this episode!
7:05 – What are your thoughts on mobility work?
12:47 – What is your approach and how do you find a balance between gaining muscle and attaining mobility?
38:29 – What are some of the exercises that tend to create the most common problems?
41:38 – How can someone determine their ankle mobility?
45:21 – How about the bench press and its relation to shoulder pain?
47:41 – What are your thoughts on rotator cuff exercises?
56:22 – What are your thoughts on massage guns and foam rollers?
1:09:44 – Where can people find you and your work?
Mentioned on The Show:
What did you think of this episode? Have anything else to share? Let me know in the comments below!
Mike: Hello there, and welcome to another episode of Muscle Life. I’m your host, Mike Matthews. Thank you for joining me today to learn about mobility work, which has become all the rage these days for gym goers and athletes of all stripes, lifestyle bodybuilders like me and probably you, power lifters, professional athletes, CrossFitters, and so on.
I don’t know what your gym is like, but in my gym there are always at least one or two people who seem to be spending at least half of their time there getting ready. To lift weights, doing mobility work, massaging, massage, gunning, stretching, using bands, balls and so forth. How useful is all of that stuff, though?
Why is it so popular? Is it necessary? Should you be including some mobility work in your routine? Well, to help answer those questions, I invited Sam Vinik on the podcast, who is a massage therapist, an expert on corrective exercise, and the founder of Release Muscle Therapy, where he specializes in helping people become pain free through movement evaluations, techniques to relearn proper movement patterns, massage, stretching and more.
And in this episode, Sam and I chat about how to get started. With mobility work, how to create a mobility routine that actually makes sense, and whether you need to or not, because not everybody needs to be doing this stuff. We also talk about how to find the right balance between mobility work and actual training and some of the common problems that cause issues with the squat, the deadlift, and the bench press, and how to correct them.
We talk about foam rollers, massage guns, and other gizmos and more. So if you want to hear a good overview of mobility, Exercise and mobility techniques, and if you wanna learn how you can use them to maybe get rid of some aches and pains or improve your performance in the gym, then I think you’re gonna like this episode.
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Hey, Sam, welcome to my podcast.
Sam: Hey, Mike. Thanks for having me here. I’m, uh, I’m pretty excited.
Mike: Yeah, yeah. Thanks for taking the time. I was just saying, you know, off air that this is a discussion that I was looking forward to because it’s something that I haven’t beaten to death. I’m always looking for new nooks and crannies of health and fitness that are interesting to me, and that I think will resonate with my crowd because, I mean, I would say this applies, this is true for me and probably for many people listening, if we were looking at it purely through the lens of, all right, what do we need to know to get what we really want or what we most want out of this stuff, which is just gonna be a body that looks good, that feels good, that functions well free of disease, and that is gonna allow us to live a, a long, enjoyable life.
I mean, I certainly know more than I would ever need to know just for that. And a lot of people also, you know, you don’t need to know that much, at least the fundamentals. So I’m always looking for other interesting things that fit into, maybe they’re not part of the 20% that gives you 80%, but. Maybe they’re part of the, all the stuff out there that can provide the last maybe 20% of additional muscle or, you know, strength gain or health and vitality or whatever it is that we’re talking about in relation to wellness.
And so, in your case, I, I’m looking forward to talking about mobility. It’s very much a trend that’s been the case for years now. It’s something that I have written and spoken about a bit here and there. I would not consider myself much of an expert on it, but I do know some stuff and I, and I do have a fair amount of experience with it firsthand and working with other people.
And also talk about dealing with pain, especially chronic pain, which is gonna be, I mean, that’s just part and parcel. Lifting heavy weights consistently over a long period of time. I, I do think that you can avoid major injuries. I mean, I’ve avoided, I’ve had a couple minor injuries, but nothing that has done more than maybe prevent me from squatting or deadlifting for a couple of weeks while my back got back to normal or something like that.
But RSIs, you know, repetitive stress injuries are kind of part of the game. It can be hard to avoid that. And I’m sure many people listening are dealing with at least aches and pains, at least little nagging problems that don’t fully go away. Or maybe they’ve sustained injuries in the past or had problems in the past that they’re trying to prevent from returning.
And so, as these are a couple of topics that you not only know a lot about, I mean, this is what you do for a living is help people deal with these things. Here we are, and I’m looking forward to hearing your take on mobility, on dealing with pain and preventing pain. And then we can also, if we have some time, talk a little bit about some of the popular gizmos, like.
Massage guns and vibrating foam rollers and stuff like that. Yeah,
Sam: I, I absolutely don’t mind diving into the weeds with you on this stuff, especially when it comes to actual practice, and that’s kind of my specialty.
Mike: Yeah, so let’s start with mobility. Since I’ve been active in the fitness space as a quote unquote professional, I guess the book is becoming a supple leopard, right?
And many people have asked me, they’ve gotten the book, and they’ve reached out to me over the years asking like, okay, there’s a lot of stuff in here, and there are a lot of big words. What do I do? How do I just put together a routine? Makes sense for me. Do I even need to be doing any of this? What are your thoughts about mobility work, as many people
Sam: understand it?
Well, this kind of goes back, if you want to think about how this all kind of has started, it helps to kind of get a big picture view. A lot of this kind of changes in the strength training or the fitness community started happening around the mid to late nineties. None of this stuff existed. There was no functional training, these sorts of things.
A lot of it was just going to the gym and lifting weights, right? That’s what people did. And you, you did exercise with a full range of motion and you stretched, you know, these sorts of things. And something started to happen out of the, into the mid to late nineties, which is there started to become this kind of merging of the physical therapy realm with fitness.
And I was around when this first happened. I remember in about 99, 2000 when I was working at one of the big fitness chains, national Academy of Sports Medicine was coming in. And, you know, they were teaching us about postural dysfunction and how you have to correct, you know, uh, muscle imbalances and this is why people were getting injured and this whole thing.
So we started this process of looking at posture and movement saying that someone’s shoulders rounded forward, these are the muscles you need to stretch, these are the muscles you need to train, et cetera. And what started to get lost in all of this, and this is still kind of what we’re trying to figure out today, is that, you know, these corrective processes of whether you’re trying to, you know, address a shoulder problem or postural issue, muscle imbalances, were always there to, as a means to supplementing what somebody was trying to do with their fitness, right?
Which was, you know, the person needs to just improve their aerobic endurance or cardiovascular endurance. They need to get stronger, do basics. They need to be able to do pushup, squats and so forth. So these corrective kind of activities, if we can call them that. The goal on these was to support being able to do those regular fitness goals.
But somewhere along the lines, what happened is, is that all of those corrective kind of activities started to kind of become the sole focus of someone’s program. And admittedly, you know, when I was into this, I became lost in this as well. It was. You know when somebody came in, we were starting right off the bat with doing movement evaluations, and even when people didn’t have problems, you know, they didn’t have a back problem or an knee problem.
Here we are showing them that they had all of these issues. You have hip flex or tightness. You know, this is gonna predispose you to back issues and so forth. And it really just started kind of implanting these ideas to into people’s heads that they needed. They had, there were something wrong with them, first of all, and two, that you needed to do all of these things to fix them cuz otherwise they were gonna be at risk.
And you know, over time that functional movement and that paradigm started kind of bleeding into athletics and sports and there was a lot of functional training that, you know, that started to basically pull athletes away from doing training, like regular strength training that was actually preparing them for their sport and making their central nervous system stronger.
So there seemed to be kind of like this backlash against this because athletes were oftentimes getting weaker and so forth because it was spending too much time doing this stuff.
Mike: Mark Rippetoe has been on my show to rant about that several times, and I know Dan John has Oh yeah. Similar positions about, you know, D one level strength and conditioning, quote unquote, when it, it’s more like hopping around with bosu balls and, and doing a lot of, it’s like combining six or seven different modalities into one as if that makes for a better athlete.
Sam: that’s been a huge problem and it’s still an issue, you know, and a lot of us who have been really in the thick of this has kind of grown out of that, especially when you’ve been involved more with strength coaches. You know, one of my mentors was Paul Che. I originally did some of my initial exercise certification work with him, and funny enough, how Paul’s gotten a reputation for being like an excessive corrective exercise guy, but Paul’s not really like that.
He tells you to deadlift, to squat. I mean, he’s doing the big stuff, but in his educational information, it’s almost all the kind of therapeutic kind of element. So people kind of misinterpret that. So, but again, that’s kind of like where there’s, it leads to a lot of confusion. So here we are, as the years have gone by and these two kind of differences of opinions have really split the industry.
You’ve got this more corrective, you know, constantly fixing everything physical therapy approach. And on the other end you’ve got the guys saying, that stuff’s useless. We just need to get stronger and these things will work themselves. Whereas usual, you know the truth and the best approach is somewhere in the middle of those things.
And that’s where it becomes kind of challenging when you get a new thing that comes out, like Kelly Star came out with his book and Supple Leopard, which is, is very mechanically oriented, you know, and that came out in CrossFit where you have this big group of the population that is now doing these kinds of routines that might be a little bit more advanced than what they’re prepared for.
Maybe they don’t know how to power clean squat now they’re doing all this stuff. They’re starting to get injured a lot more. And now, you know, he came in at the right time in the CrossFit community as a physical therapist and say, Hey, you know, you’ve gotta keep up with all of this stuff and these things might be the reasons why you’re having issues.
And so then it became like this thing where, It was like a reemergence of this mechanical model in a different way, . So I, I think it definitely has gotten people aware of, of the scope of things that you can do with your body to improve range of motion and mobility and joints get you to squat better and so forth.
But it’s also kind of like led further a little bit down that path of people becoming excessively focused on that stuff or just
Mike: overwhelmed and confused. I mean, I hear from a lot of those people again, I still do, but over the years I’ve heard from many, many people who there are just so many things. I mean, in that book in particular, it’s encyclopedic and it’s very technical.
And even if they are not afraid of doing some experimentation and doing the work, they’re just trying to go about it as efficiently as possible. Okay, so yeah, my shoulder could be a little bit better and I have like 14 different things to choose from. Should I just like start doing them randomly or how do I go about it?
And so what’s your approach and how do you recommend people find that balance between the lifting, the getting bigger or getting more developed? In the case of, of women, they don’t necessarily think about trying to get bigger, but gaining more muscle definition, gaining more strength, working on their physique, so to speak, and then supporting that.
With maintaining, I guess there’s different ways that you could look at it. It could be maintaining structurally sound joints or maintaining good tissue mobility. Make sure everything is moving the way that it should. And at some point I’ll jump in and share my own little anecdote with this type of thing.
And what I’ve worked out for me, that actually did make a difference in my training because I had tried many things previously that just didn’t really make a difference. I didn’t mind taking the time if there was gonna be a benefit, but I couldn’t tell myself that I really noticed any difference. So a lot of it just kind of fell by the
Yeah, and you know, I’d say that in putting this in the context of pain, because for me, most people are not coming to me for just optimization. That’s not really my market. Every once in a while I have some people ask me about that, but most of the time they’re coming in because they’re saying, I got this acre pain.
You know, again, let’s say in the athletic active population where their primary problem is, my back is hurting all the time and I can’t do anything. Okay? So that’s not that person. Let’s say we’re saying, Sam, I’m active, I’m going to the gym on a regular basis and I have these goals, but you know, I’ve got this back problem or this shoulder problem and it’s really hindering my ability to do something.
So, and that’s the context in which I will kind of go forward with this discussion. So the first thing is, is that we have a. Right. We have mobility work or we have, you know, whatever else that we’re gonna use. The tool’s job is to get us from point A to point B, right? So it’s a transition or a bridge. So doing mobility work for the sake of mobility work, again, for me is kind of almost pointless.
My question is, what are you trying to accomplish with this? So let’s say, you know, we have to look at everything. First of all with looking at someone’s training program is, what is the outcome and what do you actually want to do with this? So look, we could separate this into two camps and make it easy.
Number one, let’s say this, the goal is more recreational weekend lifters. You just want to get some gains, put some size on, be lean. So let’s say there’s some general aesthetic goals. So let’s say hypertrophy, right? So when it comes to hypertrophy, we have a certain set of recommendations that are gonna go with achieving that outcome, right?
We probably want to pick some big exercises to include as much muscle mass as we possibly can, repetition ranges and so forth that are gonna go with that. On the other hand, let’s say we’re gonna look at something like it’s a a very specific performance goal. So let’s say for example, we got a lifter that comes in who wants to improve his squat, right?
So this is a different goal as it require a different set of parameters to achieve that goal when one of the key defining factors is gonna be like, what types of movements do we have to select to achieve that goal? In the hypertrophy realm, we have a lot more flexibility. We know that we can do a lot of different exercises and exercise variations, a lot more repetition ranges.
We can get away with a lot more to achieve that hypertrophy goal. Versus like when we’re trying to increase the squat, you increase the squat, you have to squat, right? So if somebody has pain in the squat, let’s say they have back pain. You’re gonna have to do certain things that are a lot more specific to that because you can’t not do that lift because that lift is the goal.
So you know, in hypertrophy, if somebody’s gonna come in with that and they’ve got pain when they bench press or something else like that, oftentimes it’s about what do we need to do here? Is the bench press itself vital for increasing your hypertrophy? And in most cases, I would say probably not. We can pick some alternative exercises or modify that exercise in particular so that we don’t aggravate or sensitize those already sensitized nerve tissues that are actually giving you pain.
So it’s easier to modify that. So that way we’re gonna do a little bit more of exercise and movement modification. And there might be less direct mobility drills associated with that, and there might be more corrective exercises that we might use in that circumstance, but certainly some mobility work might work on the other end.
Again, with the squat, let’s say, you know, I’m having a problem getting depth into my squat. Let’s say there’s ankle range of motion limitation. We’ve got mobility problems in the hips, then there’s gonna be some very direct mobility things that are gonna need to be done in order to free up those movements in order to do that.
So again, when somebody comes in and say, what’s the goal here and what can we get away with? Because the reason why we do this is because people oftentimes get very carried away with, again, going too much mobility work where their entire session ends up looking like a physical therapy session and they’re not actually doing any work.
Mike: 20 minutes of rolling around and stretching before they get into the barbell kind
Sam: of thing. That’s right. And it’s unnecessary, especially again, if somebody comes in and the goal is they’ve got aches and pains associated with certain movements, and the goal is hypertrophy. And I’m like, look, let’s get all this mobility stuff outta here that you don’t need.
Let’s get it down to the basics so that maybe the goal is to eventually get more pressing activity in here with less problems with your shoulders. So you might only need two or three things here. Let’s modify the exercises, get the pain levels to go down, work on this. And then we’re good to go. Versus that person with that real specific lift, we might spend a good chunk more time on mobility things that are necessary to fix that individual lift.
So again, you know, you’ve gotta look at the goal here in the context of the situation, and that gives you an idea of how much of that mobility work you’re really gonna need to do.
Mike: And you had mentioned that if somebody is not experiencing, let’s say, any pain or movement restrictions, then if Youer programming their training, it sounds like you wouldn’t include any mobility specific work in the program.
Is that more accurate than inaccurate? Like that can be generally more the case than not. Yeah, and here’s
Sam: how I would do this. And we always thought you think about mobility as somehow like stretching or isolation movements, but I think about it as movement. And remember, mobility has a lot to do with range of motion and joint motion can be accomplished with exercises.
And one of the things that, again, is probably an annoyance to me, is how much time people tend to stretch their hamstrings in particular. And again, it’s like, look, if your back hurts and you can’t do certain exercises or movements, it’s kind of in the acute inflammatory phase, and you like to lay down in your back and stretch your hamstrings, that’s probably valuable.
Although I don’t even me in my practice, I hardly ever give that to people. But once I can move their exercise progressions into the realm of being able to do a Romanian deadlift, for example, the Romanian deadlift is an exercise in a mobility drill. It’s a stretch. So when you’re doing mo, you know, uh, Romanian deadlifts in a program, you’re actively stretching those hamstrings under load.
Then you’re getting that in there. What’s the need to, again, also do separate hamstring stretching and mobility work? You know, we may not need to do
Mike: that. I’ve had that discussion many times over the years with people in my, I guess in a professional capacity, but also just people in the gym who would ask me, they just notice that I don’t really do any stretching or any, any of the, especially.
mobility work. I mean, I guess it may be still, it may still be quite a thing. It’s just I work out at an empty gym essentially when I go, so I don’t see much of what’s going on. I’m happy for you. Yeah, no, I actually, I had to change because I was going at like the noon slot and it got real busy. There were probably 40 plus people.
It’s not that big of a gym. I was waiting for equipment and I was like, okay, it’s time to change. But anyway, I would show people when they would ask me, oh, so like, what’s your mobility routine like? And at the time I was like, well, you know, I squat I, I deadlift, I do good mornings, R dls bench press and, and then show that I have pretty good flexibility.
Like, you know, and I maintained that through doing these exercises. And at the time I was also playing a fair amount of golf. And so people were surprised that I’m not a, I’m not a huge guy, but I’m definitely bigger than the average guy yet. Quite flexible. able to get into the right positions you need to get into for the golf swing and stuff.
And that was only through just proper range of motion and not getting hurt really.
Sam: Yeah. And you’re gonna find that some people don’t need to do anything at all. Like we’re talk about this in a second here, but it is a key piece is that the natural level of kind of flexibility and mobility people have, there’s two camps.
You know, we can use that hyper mobility spectrum, which is basically how naturally flexible and mobile people are. Someone like me and they never need to stretch. You know, maybe every once in a while I’ll do some cash stretching or maybe some quad stretching when I’m doing a lot of quad work, but I never stretch and they have, I can pass every orthopedic test and range of motion.
So that person is not gonna need a lot of mobility work. What they need is controlled range of motion strengthening through end range of motion, and then they’re gonna be able to be stronger in those positions. But, There’s this lack of kind of like, I guess knowingness or awareness of what normal range of motion is and what it could be.
And a lot of times you get this with people, um, you know, not picking on them, but who do yoga for example. Yoga tends to attract a lot of people have a lot of range of motion because we tend to gravitate toward doing the things that we like to do because we’re naturally kind of good at them cuz it’s not too hard for us.
So you have a lot of flexibility and then you have people in there that don’t have a lot of mobility and flexibility who end up showing up to these classes. And now there’s this norm that you look around that everybody has that is really probably not even attainable for you. But now in your mind you have this mentality of how, um, immobile you are and how unflexible you are against that standard.
Whereas again, most people when I come in, believe it or not, in testing orthopedic range of motion, you know, a good chunk of people, and this may surprise some of your listeners out there who have chronic pain, have normal orthopedic range of motion and passed all the numbers in the textbooks. So like I look at ’em and it’s like I don’t even use, oftentimes use a goniometer to measure this stuff anymore because I can eyeball it.
And most of the time it’s normal. More often than not, I find people with too much range of motion and flexibility that I would call them Madeira, use this word unstable. Unstable just basically means to me that they’re not strong through that range of motion. Right? And that may be limited range of motion of what they’re capable of, but it also could be they have excess flexibility and in that situation they’re weak and that’s gonna a relative instability problem.
And yet there they are continuing to chase doing these mobility programs and I have to pull them out of that thought process. And teach them, Hey you, you need to get stronger. And funny enough, you’ll feel more mobile when you’re stronger through those ranges
Mike: of motion and pain can mysteriously go away too through weightlifting or Paul Ingram was talking about that from pain science that of course there’s a lot we don’t understand about pain, but if I remember correctly, researchers think that it may be related to the threshold for pain can just go up with regular and and intense training.
There’s still, whatever’s going on in your back is still going on. You’re just not aware of it like you were before and hey, if it works,
Sam: it works. . Yeah, exactly. And what you know, essentially what I think we’re doing here is in those situations is those receptors in the tissue are too hypersensitive to low threshold, the stimulation.
So for example, a small mechanical loaded end range is triggering threat and you’re getting. . But let’s say, you know, just as simple as a fly, a lot of people come in with these weird kind of situations where their pecks are very sensitized and they feel it a lot when they do bench dresses and stuff. But you know, you take that range and let’s say as we open up into a chest fly and they start to feel that pulling sensation in the peck, and that for whatever reason is sending signals and information to the brain that something bad is going to happen, a tear or a strain.
And again, the way to work with that is, is always, you know, we call it um, calm stuff down, build stuff up. So at that range, we reduce the loading on the tissue. We start to learn how to put the brakes on toward that strain position, and then start to learn how to feel safe moving in and out of that position.
And gradually at load those receptors are now going to down-regulate the amount of activity or that oversensitivity, because they’re now less threatened to that activity. And therefore there’s a greater capacity for tolerance and therefore you’re not triggering. Alarm because those receptors aren’t hyperactive.
So again, that’s kind of the scope of that. The kind of work that we’re doing here and mobility kind of activity is to some degree, when it works for pain is doing the same thing. It’s reducing threat, improving control in the tissues and desensitizing those nerve receptors. But then there’s also that kind of longer term goal of somebody trying to actually like legitly increase the range of motion in their joint mobilizing a joint capsule or something like that.
And that’s just more consistently doing that work gradually over time to improve that tissue extensibility. So again, it depends on, you know, what the outcome is. You see a lot of these things tend to overlap as well, cuz again, I find that a lot of people who are doing this mobility work and so much. For pain or under the mistaken concept that their lack of flexibility or mobility that they perceive that they need to have is the reason why they’re actually having pain.
And that’s not actually the case.
Mike: You know, I have, like I had mentioned earlier, a little anecdote to share on this point. Be curious as to your take. So for a while, a long time, for many years, I just focused on lifting weights and again, no major injuries. A minor injury si joint dead lifting and some biceps tendonitis.
That was pretty annoying. So I had. Some rsi and in the case of my SI joint, it was probably a bit of hypermobility actually. Like I’ve kind of felt my hips shift at the top of a deadlift and I was like, oh, that’s not good. And then had some pain for a couple of weeks. But, and I’ve told this story several times in the podcast, so I’ll just go through it very quickly.
Basically what I found is that my hips were a little bit out of whack, so on my left side, my external rotation was quite good, my internal rotation quite bad. And then the other way around on the right side. So I, my internal was okay, my external was quite bad and I mean, maybe I’m exaggerating a little bit, but they were noticeably asymmetrical, like the external mobility on the left side, I was able to get.
Knee, basically down to the floor, several inches from the floor on my right side. And by working on that, by particularly improving the internal rotation on my left side by, that’s kind of hard to explain. I still do it. I still do a couple of these little stretches. It’s a couple stretches, a couple little yoga poses every day to address some specific structural issues that I’ve had in the past.
But what I did is this simple internal rotation, little stretch, sitting on a bench, basically putting my heel next to me and just kind of sinking into my butt cheek and trying to get, I mean, initially I couldn’t sit it down to onto the bench, like I had to just kind of hover above the bench a little bit and.
just work on it. And like you were saying, just get my body used to that range of motion, get my brain to understand like it’s okay, you can go down. It took a couple of months to start to balance those things out. But what I noticed is that si joint injury that I sustained on my left side, it would flare up every couple of months very randomly.
Usually it wasn’t when I was lifting heavy weights, it was usually when I was warming up. Like I remember warming up with 2 25 on the deadlift and I was just being kind of sloppy with it cuz it’s 2 25 and that tweaked it and then I wasn’t able to deadlift for, you know, I don’t know, a week or two weeks.
I remember warming up on a squat with 180 5 and uh, just up there it goes. And after correcting that internal rotation imbalance, that was the end of it. And my understanding, and I came across this afterward actually, that there is. A relationship in the literature like it has been established that si joint dysfunction and internal hip rotation, those dysfunctions go together and the anatomy makes sense.
I just didn’t know about it. And so it’s just kind of interesting in that that was a problem that I probably had for a long time. And if I would’ve known that and I would’ve done that, want to call it mobility or just simple stretching, if I would’ve done that beforehand and corrected the imbalance in my hips, I may not have hurt my SI joint in the first place.
Maybe I would’ve. But it is pretty telling that since correcting that, I’ve yet to have it return. Sometimes I have a little bit of discomfort. But Is that just though, is it that, or is it just because I deadlifted a lot of weight and you know, that’s what, that’s kind of what happens sometimes. But you know, I’m back up to, you know, a one RM and of probably low mid fours on the deadlift and I’m, you know, doing sets of two and stuff and everything’s been good for quite some time now.
I was just curious as to your thoughts about that. Cuz you know, unless I would’ve done some sort of screen or known to look for that, I would never have thought to do some bizarre internal rotation stretch,
Sam: you know? Well, I mean, so there’s a couple of ways to break that down and this is where you start to come into and see conflicts in the field between what the research says and what kind of like the more pain advocates or who are less, again, moving away from the biomechanics type say there’s an arguments in there.
So, you know, when you look at my actual work, if you came in and you saw what I do, I do an A to Z mechanical assessment, I look at people and I’m looking for general asymmetrical positioning because I want to know what that person’s tendencies are. And that way when I give them an exercise program or a corrective program, I’m oftentimes giving them the mirror opposite because I want to, or antagonize the asymmetries to see how their body responds to that.
So, but you know, you’re gonna see that these types of patterns are going to exist. The question is whether or not they will lead to. or be able to predict pain or injury. And as you can see with a lot of research to talk about out there, looking at the F M S, the functional movement screen and so forth, there’s not a lot of evidence that this can prevent anything.
Now in, in athletics, the problem is of course, there’s lots of different reasons and ways you can get injured in athletics. You know, you can have a wrong step when you’re running or whatever, or get pushed. You know, these sorts of things are kind of more random. You know, you’re not gonna be able to predict that.
And certainly it’s easy to imagine. If you pass a movement screen and you know you perform well in a controlled environment, like in the gym, that that’s 100% gonna transfer to non-injury on the field. Okay, so that’s a bit more complicated. But in the average gym goer, it’s a lot more telling. Like for example, it’s very, very common.
And you’re right with what the, the literature shows with the sacc or the Ilios Sacro mechanics is a lack of ir, internal rotation in particular, which occurs on the left, which is natural to the human body. By the way, our design then, what that’s gonna lead to is we have external rotation in the left hip, the pelvis is gonna turn to the right.
That means that the right hip is gonna go into internal rotation by predisposition. And human beings tend to lean on our right side because we are right growing. We love to use our right adductors. So in this case, you’re already kind of predestined to go that direction. So when you start to lift, and you’ll see this with a lot of lifters, and you’ll see a classic pattern of which way they tend to shift, either number one is a result of fatigue, or number two, due to load percentage of one rm.
They’re gonna tend to shift to the
Mike: right. I still fight with that. I still consciously have to fight that when I get deeper into a satter, and especially when it’s heavy.
Sam: Again, that’s completely normal. And why? Because the right AARs are dominant and the right oblique and the abdominal wall is dominant.
So you’re gonna go to the position of strength. That’s normal. It’s like knees collapsing when you’re squatting intensely. The problem is that that should not be happening at lower percentages of one rm. If it does, I almost have an explanation of like, why? You know, you pulled 2 25. It’s no big deal. It’s like your nervous system doesn’t take it seriously.
You know, you watch the guy who you know, who’s deadlifting or squatting 500, you watch him go pick up a 45 pound plate, you know, he’s standing on one leg, half Ben talking to someone else, he doesn’t even care. He’s not threatened by that 45 pounds. But that’s also the position where that little tweak or that hypersensitivity in the nerve can lock up, you know, the lumbar rectors in that position because you just weren’t paying attention.
You didn’t take it seriously, you know, and then you have this tweak. So when we do these corrective, I mean absolutely for sure we don’t throw the baby out with a bath water. The key is if you have asymmetrical imbalances and your right side dominant, and you cannot load your left side well at all. You know, these are gonna be things that are gonna probably predispose you when you get fatigued or when you start to push toward a higher percentage of one rm.
Or again, like I said, when you’re not taking things seriously, you may be more likely to get these tweaks and these aggravations and so forth. So I certainly pay attention to those things. You’re never gonna be as good on one side as you are on the other. If you’re right-handed, you’re never gonna write as well as you can with your left.
But the point is, is to try to improve that asymmetric. imbalance a little bit so that your body has options. And to me, when somebody has chronic pain, meaning that the pain is just constantly going, especially when it’s being triggered by mechanical inputs, we call that nociception, like, you know, positions or movements, oftentimes what we find that when you put them into the alternating opposite position, meaning putting them into that dysfunction on the other side of the body, they actually cannot do it.
They don’t have enough strength, endurance, coordination, et cetera. So what’s happening is the body is always defaulting to that same pattern. And so you actually have to break that by number one, relaxing and releasing that tissue. But you have to actually be able to get people to facilitate and learn how to use the opposite pattern.
And that way the nervous system when it kind of figures this out says, oh, again, I don’t have threat and I can use this because this side feels stable. You’re probably gonna get a greater chance for actually sharing that load when you’re squatting your fatiguing, et cetera. Could you give a couple specific examples of that?
Okay. So let’s say that for example, somebody walks in with that same kind of issue that you had your deadlifting and say, say my back went out on the left. You know, the acute phase is over, but this still things kind of nagging me. And when I squat, I put the bar on my back. I’m still filling this in my left SI joint.
So what I’m gonna do is, let’s say I assess that and I say this is a right side dominance right-handed person. So what I’ve got here is that classic pattern I find of some pelvis positioned forward. It’s anteriorly tilted more on the left. So the body weight’s going to the right. I find a tight right addict.
So my mobility work’s gonna go after this. I’m gonna say, all right, can this left hip internally rotate? If it cannot, what’s restricting it? Do I have soft tissue restriction? Do I have joint mobility? Maybe that joint capsule’s not rotating as well. And so what I’m gonna do is I’m probably gonna initiate left internal rotation mobilization.
So I’m gonna do what you did. We’re gonna mobilize that left hip into intro to rotation. Once we do that, this is the key piece. The key piece is you have to do exercises to facilitate those muscles in that new position. This is where people make the mistake. When you increase mobility, you’re gonna increase range of motion and a joint or whatever, and you see this a lot when somebody gets a chiropractic adjustment or whatever.
There’s a rapid alteration in that neurophysiology where range of motion can increase really rapidly and improve. The problem is, is that the nervous system doesn’t become competent in that. And learn how to use the muscles in that position, it’s gonna default back to what it was doing. So again, we see this a lot.
Also, again, another quick example before I move on here. Rear deltoid exercises. So for example, if you slouch when you do rear delta exercises, right? You’re training mostly this kind of mid-range. Let’s say if you’re doing the rear del machine, it’s kind of that mid-range where most of the load is happening and there’s not a load happening at end range where the shoulder blades are fully together.
So if somebody starts working that end range and they’re using that, you know, same amount of weight, they oftentimes the next day are like, my Rambos are wrecked. And it’s a Yeah, because you’re always training mid-range and now when you train end range, you realize you are not good at that. Yeah, yeah.
Mike: you switch to some dumbbells and all of a sudden it’s a lot harder at the
Sam: top. Yeah. So then the person’s gonna default to the position where there’s the greatest degree of facilitation. So anyway, so there’s the point. So you gotta mobilize the left hip into internal rotation, then you gotta stabilize it with exercises and teach the muscles how to be competent.
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And how does that look? I’m just curious cuz I’m thinking through with my own experience. I mean, I improved the mobility through just brute force. I mean, not that I had to kind of grid it out, but I just found a stretch. I was like, that doesn’t feel very good. I’ll just keep doing this. And, and slowly but surely I was able to, you know, get it to at least about the same as on the right side.
And as for strengthening, I didn’t know this point, so I didn’t have anything specifically in mind. I just kept on lifting. And so that meant doing some sort of hip hinge, uh, some sort of deadlift regularly. I like to alternate between trap bar and, and conventional and of course squatting and so forth.
And again, I was able to progress better without any of the pain issues.
Sam: Yeah. And that can happen. And again, it’s just like sometimes you throw a wrench in the wheel and things work fine. I think that tends to also occur a lot. With people that, number one is just have a behavioral problem, like the tissue just keeps doing the same thing or the joints and it never gets interrupted, and sometimes when you interrupt it, the system will default into some pattern that is corrective on its own.
In psychology, I look at this too, like if you’re gonna. Take a behavior away from somebody like biting their nails. Okay? You can interrupt the biting the nails habit. But the question is, that’s under the assumption that if I just interrupt that the nervous system has a default program behind that, that it’s gonna go to, that’s better than the biting the nails pattern.
But if the person’s biting their nails, you interrupt them and the nervous system doesn’t have an alternate routine or something else to do to achieve the same outcome, you know, then it’s gonna go back to doing that, that same thing again. So you actually have to, I don’t want you to do this, but I want you to do this.
So sometimes, again, it’ll correct itself, and that’s cool and that happens that if it doesn’t, we have to build that pattern in to teach the nervous system what to do. So in that case, What are the muscles that internally rotate the hip? You know, predominantly we’re looking at the groin, the adductor musculature, and second, we’re looking at the anterior portion of the glued muscle, which is an internal rotator.
So you have to get these two muscles to work together. Without that bastard that always gets in the way, which is the T ffl muscle. The T F L is always hyperactive for the most part, especially in that situation on the. . So you’ll oftentimes get, when people start trying to do internal rotation exercises on the left side, it oftentimes doesn’t work because they keep recruiting the T F L.
And so you’ll see almost all hip syndrome problems have that key facet of left T F L over activity. And people oftentimes assume, again, that’s a tight IT band or whatever, but really what we’re talking about is we’ve gotta give exercises to help teach internally, rotate that hip and without T F L recruitment.
And we’ll try to do those things For me when I do them is in pure isolation, like a level one, activate that muscle and try to gain control over it. And then once they can do that, then I’ll progress them upright and more complicated exercises without getting that T ffl to trigger, they can train that hip in a neutral position.
Mike: Interesting. Transitioning to a bit more about pain and chronic pain, what are some of the exercises that tend to create the most common? Problems with your clients? Like what movements are you constantly having to address with people? That
Sam: depends a lot on where they’re coming from. You know, you get people that come in who are doing, you know, CrossFit or a lot of functional training exercises, they’re, it may be a little different, well,
Mike: let’s say a lot of the listeners are just kind of, they’re gonna be weightlifters, they’re gonna be doing, uh, a lot of strength training, probably some body building stuff in addition to that.
But, you know, squatting, deadlifting, bench pressing, overhead pressing, and then some isolation or accessory work for bringing all the other little muscles up. You know, I’ll
Sam: see a lot of, I think the first thing that will always come in is problems with the squat, the back squat in particular. So there’s always, you know, some kind of story that comes in.
Usually when we look at, somebody will say, when I back squat, my low back hurts, or my mid back, my mid upper lumbar spinal. But funny enough, when I front squat, I have no pain. So we’ll get that sort of thing. And there’s also, which is almost a different kind of problem than when somebody comes in and they say, you know what, Sam?
Like I can back squat, I can front squat. I know a problem, but when I deadlift, I got a problem. And then from there you’ll sub classify that as you gotta a sumo problem or a conventional stance problem, cuz those are all slightly different as well. But almost always when it comes to those patterns, you know you have to address range of motion.
A lot of times you’ll see in the back squat in part. For all the talk about, you know, hip mobility and so forth. I think the fundamental problem you see most of the time in the back squat for the most part is people have poor ankle mobility and range of motion. So the knee can’t go forward and the knee can’t go forward.
Then the person sits back further and then their tailbone tends to tuck under, so they tend to round their low back. Right. So we see that a lot. And then the compensation for that is to keep opening the stance. If you follow some experts in, in the, uh, fitness industry, you see a lot of this too, where they bend it basically their back squats look like good mornings and that’s a common problem.
Yeah. Real wide stance. Not that there’s anything wrong with that, but it’s like, it’s just a, a way of working around it, you know? Versus, you know, trying to improve the ankle range of motion and mobility to the best that you can to get that torso a little bit more vertical and that torso goes vertical.
You get a little bit more load sharing and that tends to remedy that problem.
Mike: How can someone determine their level of ink mobility? Is there like a simple way that they can do that? Just right now if somebody’s wondering like, oh, maybe I wonder if I have that problem, how can they know if they have sufficient in ankle mobility?
Sam: Probably one of the easiest ways, and you can find this test online, is where if you position yourself, uh, let’s say your foot, your toes, about five inches from a wall in front of you, so you put your foot down on the ground, your foot has to be completely flat. Heel has to stay on the ground. and then you’re in kind of in half kneeling position.
You know, one leg forward, one leg back, and you try to take your knee and push it all the way forward to touch the wall. Right? So can you get about four or five inches in front of the toes? And that’s a good ankle mobility test
Mike: while keeping your heel on the ground.
Sam: Right? That’s the, exactly. And a lot of people will get stuck in their knee, can’t even, even actually go past their toe.
So you can imagine what happens in that position if they’re standing and start squatting and the knee can’t go past the toe at all. You know, it should go right. As always, the devil, your knees are gonna blow up. If that happens, , we’ll leave that one for another podcast. But, but when they start to descend, depending on the depth of their squat, you know, and now today there’s so much like, you know, so much pressure to have these deep, deep, super squats and if you squat anything, you know, above parallel, then you’re a loser.
Which is not the case by the way. But, you know, trying to exceed range of motion and then they’re getting down there and starting to have problems with that. So I think that’s a pretty good test. And then you. If you elevate your heels with a couple of 10 pound plates and then all of a sudden all of these issues clear up, I, I think that’s a pretty good signal that you’ve got some ankle mobility problems.
Mike: Or if, uh, squat shoes make a big difference in this regard. Right. So, oh,
Sam: yeah. You know, and outside of that, I would say that again, with deadlifts, the primary problem with the deadlift for the most part, is just having overly sensitized lower lumbar extensor muscles. That could be multiple things, but, uh, I oftentimes find that when people don’t know actually how to leverage and use their glutes and their hamstrings during the deadlift, they tend to be lifting up to the sky with their back rather than pushing their hips forward.
And in those cases, my strategy might be teaching them how to do glute bridges, hip thrusts, and so forth via, you know, Brett Contreras, this type of. Which is teaching them how to actually accelerate that movement is pushing the hips forward rather than lifting themselves up through the lumbar spine.
They’re initiating the movement from the lumbar extensors, which is oftentimes kind of starting to sensitize that area, whether or not that’s the muscles or the, or the joint segments in receptors that are feeling threatened by that
Mike: activity. Yeah. Yeah. That’s a great cue. That’s one I’ve shared many times of just trying to push your hips into the bar as opposed to trying to squat the weight up.
Some people think about it that way, or like you’re saying, really relying on the low back muscles to just kinda lever the weight up. And then usually what we see there, right, is the hips shoot up and then the back is just used as a, again, as a lever to try to get the weight up. And that’s not the exercise.
And when the weight starts to get heavy, that’s when. Eventually you just hit a brick wall.
Sam: Yeah. We always, you know, tell people, Hey, your ass muscles are built that size for a reason. You gotta use ’em. You know, the , there’s a lot of surface area there and you’re not getting everything out of it. And you’re trying to use your string bean, spinal erectors to actually lift that weight.
They’re really not that capable of
Mike: doing it. Yeah, and I guess if somebody is feeling a lot of soreness in their lower back, for example, after they deadlift and not feeling much in their glutes or their hamstrings, that may also be an indicator, right, of what they’re doing. Yeah, and
Sam: it’s, you know, it’s kind of rare.
I think a lot of people, it’s pretty tough to get sore lumbar extensors from training unless you’re actually deliberately flexing and extending your spine, like when you’re doing 45 degree back extensions. I mean, I can’t even tell you the last time I’ve had sore rectors. I mean, most of ‘
Mike: em really, I still get it a little bit from deadlifting.
Maybe. Maybe I have something to
Sam: work on. . That’s interesting. Well, there might be some movement there. Again, I don’t know. I’d love to see it, but a lot of times when you look at it, it looks fine. You know, we never know how much strain is going into that tissue though. But again, it is funny having sore Rectors feels, it’s, it’s very hard to distinguish from your back feeling, quote unquote locked up, isn’t it?
It’s almost the same. .
Mike: Yeah. Maybe it’s mild then if we’re talking about those types of terms, but there’s certainly, after heavy deadlifting, I’ll often feel a little something like, it’s the level of soreness that’s actually kind of nice. You know, when you get into lifting weights, there’s too much, like my legs were too much actually from the last workout.
I hadn’t done good mornings in a while. I think I had a little bit zealous on it and I was like, Hey, one of those, well, this feels easy. And then I was having trouble walking two days later. Usually I’ll feel it a a little bit and it’s nice in, in my back. But to your point, I would say that over the years, yeah, from deadlifting, I’ve had a lot more soreness in my glutes, in my hamstrings than my back, or my lower back in particular.
Sam: Oh yeah. Yeah. And especially as lumber extensors are kind of like forearms and so forth, they tend to just thicken it and toughen up, you know? And I think over time it’s like, again, that’s another one. It’s like, unless you. Out of grip training and stuff for a while, it’s pretty hard to get sore forearms unless you’re really going after them on purpose.
Mike: that’s true. Talk to us about the bench press and of course, shoulder issues. That’s the common thing I hear about.
Sam: Well, I mean, I’d say that probably be a good chunk of the problems with bench pressing is ultimately come back to two things, is number one is, you know, almost always it’s in the horizontal abduction position.
That’s where your arms are out to the side classic bench press, right? So a lot of people are getting impingement syndrome, rotator cuff problems, and so forth. A could of course be due to shoddy technique or bouncing off the chest, not controlling the range at the very end. But a lot of people, I do feel, to some degree from a mobility perspective, or maybe in just the way that they’re designed, are not really built to do flat bench pressing.
You know, they’d probably be better served by and in these people picking up the angle of the bench by 20, 30 degrees and all of a sudden a lot of these issues tend to disappear because that clears the space in the shoulder, gives a more range of. I’m a huge advocate, first of all, of using more close grip bench presses.
If you watch any of Louis, yeah, I was
Mike: gonna mention close grip two is often
Sam: a workaround. Watch Louis Simmons, I, I learned a ton. Now, considering all this corrective work that I do, I spent a good amount of time listening to high level strength coaches and seeing the kind of work that they do. If you ever wanna see, you know, at least to some degree, if you’re not at power lifting, you watch some of the stuff these guys do.
How do they stay lifting heavy for so long? It’s because they learn how to kind of work their way around stuff. And it’s worth kind of watching what they do. And Louie will talk about most of your bench press is based on, you know, the long head of the tricep. The thicker piece of the tricep toward the elbow is the bench press.
So the more of you work on the close grip based work, your wide grip gets better. So there’s even a more entertaining part, which is somebody has pain doing arms out to the side bench presses, and yet they also have weak tricep development and you switch ’em to closed script number one. They have less problem.
And then number two, they actually get stronger. They go back to the bench and they perform better with less pain. I always switch to incline, first of all, and at least I don’t like really starting off as something like a 45 degree high incline. I usually move people to 30 degrees, and I also teach them basically how to keep their shoulder blades kind of slightly down and back and down in the sockets because they don’t know how to use their lats and really drill the shoulders down into the sockets when they press.
So I like the power leaking versions from the corrective standpoint because it’s a real quick win to get people to be able to bench without too much discomfort while you work on cleaning up all the other shoulder imbalances, like dealing with their sarus muscle and their, and their rotator cuff muscles, which are a little bit slower to kind of build.
That way you can keep people in the gym and keep ’em training with modifications without literally, again, turning their whole program into a physical therapy regime for their shoulders.
Mike: Yeah, makes sense. What are your thought on rotator cuff exercises? I know that was, it may not be as much of a thing now as it was a couple of years ago, but I remember a lot of people asking about, there definitely was a wave, I guess, of advice that if you’re not doing rotator cuffs, some of these rotational exercises, you’re just asking for a, a
Well, I mean, this is where it gets complicated with the shoulder because there’s a lot of moving pieces with this. I mean, you have to realize that probably I believe in most people, a lot of the problems are, is that they’re external rotator cuff muscles. Those are the ones that were always associated with strengthening.
You grab a tubing or an exercise cable and start rotating your arm outward. Yeah, that those muscles are oftentimes overactive in particular because of the faulty positioning of the shoulder itself. So we beat on these things and we see like, well, the rotator cuff muscle is not strong. You ever done rotator cuff exercises?
What’s the most you’re gonna be using on the stack? 40 pounds. You know, maybe most of the time these muscles are just hyperactive trying to stabilize the shoulder because the other muscle groups are either not any a good biomechanical position, or they’re weak as well. So on the right side, and this kind of goes in with that asymmetrical pattern, which at some point we should nail out and we’ll walk you through it.
But what tends to happen is with that left side hip problem, you go up to the right shoulder with a right arm handed person is you see an overactive pec minor. When that pectoralis miner, which dumps that shoulder forward, now that shoulder blade is starting to tilt down and forward. And now you’ve got a shoulder that’s deleverage and biomechanically, non positioned really well.
You’re gonna get a lot of strain on that rotator cuff. So here you are with a shoulder that’s propping down and forward, right? And because of that peck miner tension and it’s stuck in that position, and here we are just beaten on the external rotator cuff muscles to get them stronger, that’s not gonna work very well.
So I actually find that more often than not, just correcting the primary positioning of the shoulder by, uh, stretching out the peck miner and teaching people how to get their shoulders back in the right position, that deloads, that external rotator cuff, those trigger points tend to kind of quiet down a little bit back there if they have them.
And then from there, just teaching them functionally how to do those lifts. Again, you can shoulder press, you know, front press with the shoulders in the right position, or again, mid incline shoulder presses we’re oftentimes able to do that, that rotator cuff muscles. Are working during those activities.
The problem is, are they working in a faulty overall shoulder position? And that’s just gonna keep exacerbating the preexisting problem. So again, there’s, it’s not like I have to peel somebody out. I mean, I do give people, let’s say I’ve got somebody with frozen shoulder or something, I’m gonna do some isolation external rotator cuff activities.
It depends on the circumstance, but again, I like to leapfrog, meaning by the end of my program, My goal is to get people to be able to do basic gym exercises with no problems, because that becomes the therapy regime for them. And these kind of simple mobility or isolation exercises are only initial or interim exercises to bridge the gap to those key lifts.
Mike: Yeah, yeah, that makes sense. It’s interesting that, uh, you mentioned that asymmetrical point and how it can kind of cascade up in that example where you have in, you have issues in the lower body and then, and then that can cause issues all the way up. And I just think of, so I’ve had the SI joint issue on my left side and.
For whatever it’s worth correcting that internal rotation seemed to put that to bed, so that’s nice. And then on my right side, I had this biceps tendonitis, bici groove, just aggravation in there and it never got too bad. I stopped being stubborn about it and got off of the exercises that were pissing it off and saw a physical therapist and worked on, if I remember correctly, let’s see, subscap was super tight.
That was part of the issue. And then I believe it was also, oh, this was years ago, so it might have been in infraspinatus, but I still have a tendency to. Piss off my in infraspinatus and the biceps tendonitis hasn’t turned back on. But what has helped keep it at bay and I haven’t been able to do this much since Covid because I had an office here in Virginia.
We some people, then we had an office in Florida, we got rid of those offices. Now were all remote. But one of the guys who worked with me in the office in Virginia, he would take the massage gun and there were just a couple trigger points that we would hit on my right side of my back. There was a trigger point in the longissimus muscles.
There was a trigger point, uh, in the infraspinatus near the scapula. And by just working a couple of these points and just desensitizing them, I noticed an immediate improvement in this bi groove, which at the time was getting a little bit irritated. Again, I would feel it when I would bench press. And so that’s just a, an ongoing.
Thing that that I have to deal with. And it sounds like it has something to do with some of these natural, asymmetrical aspects of the musculoskeletal
Sam: system. And that’s the thing too, is that we tend to focus on where the area where the problem is, which is obviously completely logical, you know, is a fixing and cleaning up the imbalances in the right shoulder.
But we have to remember that everything in the body is reflexive and relatable to other areas. So if your pelvis, let’s say, for example, turns to the right, then that’s gonna turn the spine at the lower portion to the right. You have to counter by turning the upper body to the opposite direction and then your shoulders gotta go.
Right? That’s how it works. I’d have people in the past who would come in, I’d say a lot because outta the years, I don’t even remember how many, but I almost always start at the torso, at the midline because oftentimes get the most potent effects. So I never start working with somebody with a shoulder problem or a neck problem at the shoulder level.
I always start with the rib. Because the ribcage, when it’s positioned off or asymmetrical, alters the accessory muscle activation. So you’re using muscles to move your ribs, but what sits on top of that is your shoulder girdle. And the only thing that connects your shoulder girdle to your body is the two joints that your clavicles connect to on the front.
Everything else is muscular, so it’s gonna be very responsive or reactive to rib cages that are rotated to one direction. So a lot of times, again, when the first rib area is not expanding really well, oftentimes because that peck miner is tight on the right, we don’t appropriately breathe into our upper chest wall on the right, and that’s gonna trigger inappropriate.
Or overactive muscles in the respiratory cycle that don’t need to be doing that activity. So point is, is that if you reposition some of these elements lower down in the chain, some of those upper portions will actually reset or relax themselves because now they’re responsibly or reflexively not having to do that compensatory activity.
So that way when you do an exercise or you do a stretcher, a mobility drill, you get this magical release and it’s really because you fixed or you readdress the things that were below the chain before you did that, versus again, fighting with the shoulder when that shoulder’s positioning is only reflexive to something below the chain.
So the body is, is smart enough to know. Yeah, that’s great. This feels better for five seconds, but I still have to go back to doing my job again. And we fight with that as if the nervous system doesn’t know what it’s doing, when really we just don’t know how to interpret why it’s doing that. And that’s kind of the key that over time in my career, it’s more like, yeah, for looking at posture mechanics, that’s stuff I knew a long time ago.
A lot more of this work now is just trying to figure out the relationships of these things and understanding why that behavior makes the most sense to that person’s nervous system. And if you can figure that out, then you can create magic much
Mike: faster. Makes sense. Makes sense. And yeah, that was my experience on working on some of these muscles.
And then that was it for the, for the bi groove issue. And again, so long as I don’t get too. Sensitized in the Subscap and infraspinatus. I mean, it’s hard to say if it’s that or Terry’s minor. It’s right in there. So long as I can keep those touched semi-regularly, it just seems to make the bench pressing.
Okay. And the overhead pressing.
Sam: Okay. Yeah, we basically just do what we can. We don’t always know, I don’t want to put it out there that I know how to fix every single thing, but the point is like how you can always do more with it, the more you figure out what’s going on. But at least at defaults what we do is we maintain things and we keep things healthy with the things that we know how to do and the things that work.
And a lot of times that’s good enough. As long as you don’t do things to keep aggravating it, then you can move forward with your goals. And that kind of circles back to what we talked about, which is how far do you go with this stuff? Well, that depends on what you need. You know, is it good enough to keep you active in doing the things that you love, then great, we’re
Yep. And that’s really where I’m at. Even though I take my fitness pretty seriously, like I understand that there’s not much muscle and strength left for me to gain. I do enjoy working out. I like pushing myself. I like lifting, but I’m in a a maintenance mode for the rest of my life really. So if I can just do that, I’m happy.
If I can maybe make little bits of progress here and there, enjoy my workouts, not get hurt, not have any major pain issues, then I’m happy. So that’s it. That’s my
Sam: Right. Exactly. And it’s like, well if you can’t bench press and you’re reconsidering, you know whether life is worth living because you can’t bench press, that’s a different kind of goal and you’re gonna spend a lot of time.
You know, going after that. But that’s probably not the case for most people. Yeah.
Mike: Let’s talk about gadgets. What do you think about massage guns? Those are obviously very popular right now. Vibrating things like foam rollers and little balls and uh, those are the ones I get asked the most about foam rollers, including some of the fancier ones and the
Sam: percussion guns.
I’m not gonna lie, I love gizmos, you know, it’s my thing. And I feel like I’m a little bit of an early adopter though, cuz I’m gonna throw that out there. Um, my first percussion machine when I started doing this work. I think I’ve had it for almost 18 years. So for a long time I’ve been using percussion in the company that was called, uh, Viper.
Cusser was using, it was a chiropractic tool. So, you know, percussion therapy has been around for a long time. Dr. Robert Fulford, I think it was the first one, he was a osteopathic doctor like in the sixties I think, or something like that, was using percussion. But you know, it’s so that you can imagine was kind of odd when you see this now, like every single person that you go to Best Buy and there’s percuss.
Devices being sold. It’s kind of interesting considering be using it for so long. That’s the case
Mike: with so many things. Well, a lot of marketers do. I mean, intentionally they go back cuz they know that with generational shifts, you know what I mean? They know that they’re looking intentionally back. Yeah.
Fifties, sixties, I’d say forties through the sixties for things. That were once popular and that proved that there was something there that resonated with people and that you have a whole new market for that You can introduce it as breakthrough, I
Sam: believe that’s, you know, where we’re at with the keto raw milk and uh, cod liver oil.
Right. , what was the last one? Cod liver
Mike: oil. Oh, cod liver oil. Yes, yes,
Sam: yes, yes. So the holistic health, you know, practitioner from the seventies, probably yapping about that all the time. But it was funny to see, you know, talk to people how some of these things make these comebacks. Does it work? Yes, it does.
If you set proper expectations for it, you understand what you’re using it for. I mean, it’s, all of these things we have to remember are just kind of fit into the category to me of what I say is a sensory stimulation. It’s input into the system and we’re just trying to give the nervous system. We have hardware, you know, and we have software.
We have the hardware, which is our joints, muscles. You can think about it like that. But then you have the software, which is the brain, you know, that updates how it’s responding and dealing with these different components of our body. And you know, we figure things out and we make sense of the world around us through sensory input.
So if we use something like, for example, a percussion massager, it’s gonna hit certain receptors in the tissue, it’s gonna flood those receptors with information. I mean, the brain is gonna have to figure out what to do with that information. And either it’s gonna have a negative response. I mean, I’ve had clients that tell me, Hey, Sam, can I pay you an extra $25 this visit to not use that percussion on me , uh, because they hate it.
They don’t like the feeling. And then there are other people that will literally like, can I pay you to just do this over my entire body for an hour? People have different responses to sensory input, and also it’s how you’re using them under what context. So I find that for me, for example, Percussion, a lot of the ways that it’s being used generally out there.
Not that it’s wrong, but I just don’t think that there’s that much you get out of it. So, for example, first of all, I, and you did a, a marvelous job covering this on your podcast when you went through the research on the tools and so forth, and it was, it was really great. I learned a lot of stuff from that
So, you know, I don’t dive into the research on some of this stuff because for me, I kind of already am like, all right, this is sensory input and I just kind of move on. But every once in a while I do take a look at that stuff. So, great that you did the homework
Mike: for me. Yeah. Again, it was something I was just getting asked about so much.
I was like, okay. All the time, right. ? I have the companies reaching out to me. They want me to promote their trinkets and Yeah, and I’m
Sam: not above that. And I’ll tell ’em I say you. No, no, no. I actually, I’m
Mike: gonna add to, I don’t know exactly when, because there are just more important things that my developers are working on.
But I want to bring back this recommendations section that I had on my previous website, which was Muscle For Life, which I merged into Legion and just gave Legion all of the content. I should have done that a long time ago. Finally got around to it, but I had a section on Muscle for Life of just recommendations.
And of course there was fitness stuff in there. Like what shoes do I like to squat in? What shoes do I like to deadlift in? Uh, usually the same, but sometimes I just prefer a flat soul for the deadlifting. What straps do I like? You know, it’s just things that people would ask me about. And then other random things too, because I would just get asked for book recommendations and oh, in that one picture, what jeans are you wearing?
So I would just throw stuff that I like in there, and I’m gonna bring that back over at Legion. And I do like using the precusor. I don’t spend too much time and I have my little spots that I hit and I just do it in accordance with what I discussed in that I think it was a q and a or whatever in that podcast, when I have that section of the website up, sure.
I’ll reach out to the companies and say, Hey, I’m gonna promote your stuff cuz I like it. Do you have an affiliate program? Cuz I might as well. If I’m gonna make them money, I might as well earn a commission. I’ll be open about that, but I’m not gonna promote anything. I don’t really care about the commission.
It’s just if I’m. Send a bunch of people their way, why not make a little bit of money? That’s how I think about it at least. Yeah, and
Sam: I’ll do the same thing, but I’ll tell ’em that my two rules are is that number one, I’m gonna be honest in my review. Yes. So if I tell you that I don’t think that this stuff is good for this, then I’m not gonna value tarnish my reputation.
Mike: I honestly don’t even want to bother doing reviews. Yeah. Like I just get stuff, I’ll pay for it, and then when I like it, then , I’ll put it up and I’ll reach out. Like I don’t even want to commit to, okay, I’m gonna go through the whole process and do a review. I would rather, okay. My compromise would be if I want something and I can get the company to send it to me, I will do the review if I end up liking it and using it.
Otherwise, I’ll just send it back to them and I don’t even want to bother with it at all. . Oh yeah, totally.
Sam: And you know, the other rule of thumb is, is that, um, and again, I I’m not gonna hawk your narrative if I don’t believe in it, because again, we know that there’s just like these massagers are not probably releasing fascia.
They’re not doing none of this stuff. And I wrote an article on my website would talk about that, which is, there’s just no, there’s no recent evidence. That really supports that we can re do anything meaningful with fascia, especially in the short run. You know, in the long run maybe who knows? But it’s not really, really relevant to us.
It’s, this is altering neurophysiological behavior and that that is good enough, you know, and amount of people do we, we care that it works, but you know, we gotta ditch some of the stories on this stuff. So I think that with that, you know, you, you use these tools and it doesn’t matter what it is. I have a lot of different gadgets and gizmos.
You know, you’re really like vibrating foam rulers and so forth. But I am a fan of certain things that I like. I probably have about five different percussion massagers. Some of them are really expensive in the three grand range and they just do different things. I use them for different body parts. And probably for a different number of different reasons.
But I would say this, just as my general disclaimer, hands-on therapy when you’re in the hands of a good therapist, is far superior to anything that any of these tools can do. My experience,
Mike: just to interject quickly, is a good massage therapist is far better. Like I will take a good massage therapist over anything I can do myself,
Absolutely. And if you’re in Canada or in the UK or whatever, if you find yourself a good manual osteopath, I mean, it’s completely different, you know? But when you’re self-treating, it’s different. You get the sources of sensory stimuli. I do find that in some cases, these tools may. Have the advantage, and in one in particular, I use a, a tool that has high speed vibration.
It’s very superficial and it’s basically an anesthetizing tool. It numbs an area pretty quickly, and I will use this on nerves that are, I’d say superficial nerve entrapment at the skin level. Scar tissue, it will desensitize it very quickly. These tools are superior in that regard, but you could also use cupping and stretching the skin and so forth.
It just takes longer. A lot of time in my sessions when I got 55 minutes with a client, the goal is to how much therapy can I get done in, in that amount of time? Yeah. So I’m not gonna camp out in an area for 10 minutes with a tool when I don’t have time for that. So I have to get things done faster and pick and choose what I use, and that’s where I’ll have so many tools and I might use one for a couple minutes.
but people go, well, you need use percussion on me. And sometimes, you know, again, it’s like three minute treatment. It’s maybe that much because I’m gonna move on to hands-on. But again, so like to me, I don’t like camping out on muscle groups with percussion. I’ve used a lot of it. I mean it does work, but it, to me it’s takes a lot of time.
But most of the time I’ll add sensory input while moving. Mm-hmm. . So for example, I’ll put cups on and then move people. I’ll put percussion on and move them because what this source of stimuli is doing is just flooding those nerve receptors with new information. And in particular it can block out the sensory input, the input that you’re getting from other sources.
It can disrupt, you know, the signals that the nerve system is getting through, for example, stretch receptors or pain tissues that are generating that pain experience. So if I turn my neck to the left, and I only get about 20 degrees range of motion because I’m feeling a pulling sensation on the right side of my neck if I put that percussion unit on that area.
Provided, of course, as your listeners, be careful, you don’t wanna put the, uh, percussion on your neck in certain areas, but if you put it on in a certain area where that sensory stimuli is telling your brain to create a threat, if I put it on there and I start to turn my head repetitively to the left, my brain is getting flooded with information of both from the percussion, but also from those stretch receptors.
It may inhibit them to some degree where my neck range of motion may immediately improve. And, and that’s going to be useful because it’ll drown, regulate some of that sensitivity. It can immediately cause changes and also, show the person that their neck is not, you know, stuck because of, uh, some kind of scar tissue adhesion or whatever.
But instead, because of the behavior of the nerve receptors, I can show people very rapidly how quickly things can change. And then it’s just a matter of solidifying those changes with doing exercises and follow-up movements. So certainly it has value just by putting it somewhere, but with movement is oftentimes quite a bit more powerful.
And it’s also a great distraction unit. So, for example, people oftentimes have apprehension to do a manual therapy. You have to learn how to be a good manual therapy recipient. Not everybody gets the best results on day one. You see a, a new therapist, they’re taking your shoulder through a new range of motion that feels threatening.
You know, you put that percussion on there. It’s a nice welcome distrac. From that sensory input that might make you feel threatened. So it oftentimes adds to the ability to go to a good therapeutic effect, especially when I’m doing passive movement just by flooding those nerve receptors. It’s like magician working their hands.
That’s right. It’s a, it’s a slight of hand and, and it works really well. And again, I tell people that I’m doing it like I don’t rest on the placebo effect. It’s just this is how your physiology and your neurology works, and we’re gonna leverage. To get the job done. And
Mike: for anybody wondering what I do with the massage gun, again, I think it was a q and a probably back summer of last year, but I, I just have found a couple of, I go looking for little trigger points basically, and I just use the massage gun to desensitize them.
And I, I understand this is an understudied thing and many experts don’t agree on what these trigger points are, what causes them, but I can just vouch for how it has. It’s, um, ever had some issues with my quads. It’s helped with, with my hamstrings. It’s helped with and it doesn’t take much time. The devices aren’t very expensive and I’ve had the same one for years, so it looks like they last a long time.
And so for me it’s just one of those, not exactly sure why this works, but it seems to help. So why not? I’m sitting in my infrared sauna in the morning anyway. I bring it in. I do my little, I have a little bit of a, an entrapped nerve also on my left shin area, which I don’t, I dunno if it’s been like that for a long time.
So I do that, which was interesting, the anesthetizing effect. Obviously what I have is not what you have, but it does desensitize it. And so I just have my little spots and it seems to help. And that’s it. That’s what I do. I don’t read too much into it. . Yeah. And
Sam: if something works, you just kind of go with it.
And I guess that’s the difference. And you read too much and you know, for. Discussions for another time, but I’m very cautious of spending too much time reading what other people are saying. Especially when people are too research oriented too, too, too much because they’re in this field is far too complicated.
It’s not that black and white, you know, you do things in practice that really work. And again, to me, I think it’s perfectly acceptable. You ditch in a narrative. But you’re saying that these things, saying that they don’t work as I think is a ridiculous statement because anybody who is actually doing this stuff in practice knows that they’re helpful when they work, they work really well.
When they don’t work, you just move on to something else. You don’t build your entire practice around one source of sensory stimuli, . It’s not. It’s just not. It’s not how
Mike: it works. Makes sense. See, I found the percussion gun more useful than foam rolling for me. I know some people like foam rolling. I know there’s some evidence to support it, but I just got better results from the percussion gun and faster.
And I can, again, I can stack the habit, so to speak, with my, I’m already in the go in the sauna and then I’m reading on my phone while I’m gunning myself. It works.
Sam: Yeah. , right? Right. And certain things just feel better for you and your nervous system responds to them. I mean, I think that’s the part that’s, we always have to remember when it comes to these kinds of sources of stimuli is that you know what’s fantastic and allows someone to relax and zone out and their nervous system just soaks it all in is a repulsive stimuli to other people.
You know, there’s, that’s a. Some people hate massage. I know. I was
Mike: just gonna say that I love massage. A good massage really makes me feel good, but I know people who hate it. They refuse to get a massage, and I’m like, how? How does that not make you feel it? They do not like it. Oh
Sam: yeah. Oh yeah. It’s just the sensory stimulation and the way that it is and the context of the environment’s no good.
And they’re gonna have a bad response to that. You know, I say one of the metaphors, you use my clients and I’m like, look, how do we know what’s gonna work for you? I don’t. I know a direction to go. And as a. But let’s put it this way, if you were line up a hundred people in a row and I put a spider in my hand, you know I might be 20 feet away from those people.
Half of ’em are gonna be running for the hills. Other people are gonna be wanting to come up and touch it. You know, you had a nervous system, you present it with a stimuli, you’re gonna have a lot of varied responses, and it’s human beings are not that predictable. Where every single time source of stimulation is gonna be, make them relax, make them feel good, whatever.
We respond differently based on our programming and our, and what we’ve got on the.
Mike: Yeah. Well hey Sam, this was a great discussion. I really appreciate you taking the time. And why don’t we wrap up with where people can find you, your work, if they wanna reach out to you, is there a good way for them to get in touch with you?
Is there anything in particular you want them to know about a specific product or service if something you’ve said has resonated with them and they want to and they want to get
Sam: more help from you? Yeah, certainly. You know, I see clients in particular in my Santa Monica office. Pretty soon I’ll probably be seeing in another area, which I’ll, I’ll announce as well, but my website’s release muscle therapy.com.
There’s a lot of content there on the blogs to check out, and I got two resources on there to check out. Number one is my digital book. I pulled together all the research on chronic pain and what everything currently says now. It’s, uh, work in progress to continue expanding as I find more research out there, talk about posture and, you know, different types of pain and gives you an idea of the principles by which I, I promote and I do my work, very evidence-based of course.
And two is my insiders group and which I put a lot of free in resources and so forth in there to check out programs, corrective drills. You know, these sorts of things, but grab the book, check out the insider’s area, get on my list and pumping out a lot of good content here Pretty soon. You wanna keep following me.
Mike: Awesome. And then you also are on Instagram, right? It seems like you’re fairly active there.
Sam: Fairly active. You know, when I get busy I start seeing a lot of clients. That’s when I love in my passion, but uh, working on getting more social content out there as well. Yeah, that’s on a release muscle therapy, you can find that there too.
Mike: Awesome. Well, hey, this was great again, thanks for taking the time.
Sam: Awesome. Thanks Mike. Really appreciate it.
Mike: All right. Well, that’s it for this episode. I hope you enjoyed it and found it interesting and helpful. And if you did and you don’t mind doing me a favor, please do leave a quick review on iTunes or wherever you’re listening to me from in whichever app you’re listening to me in.
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