Kevin at The FitCast has been reminding me every week that I haven't updated my blog in months. Even Tony called me out for not updating, and he's the guy that hangs out at Lord of the Rings festivals...allegedly.
I've been hard at work with my Orthopedic Residency at the University of Delaware, but unfortunately my 60-70 hour work weeks leave me little time for much more than recording the show once/week and updating my Facebook page. The good news is that I'm learning a lot, so it will definitely be worth all of the long hours, sleepless nights...and dusty blog posts.
With all of that going on, I did get the chance to unwind with one of my favorite movies, 1999's groundbreaking instant classic, The Matrix. Taking cues and inspiration from religion, classic literature, modern cyber-culture, Hong Kong martial arts and Japanese anime films, and even a healthy dose of Alice in Wonderland, The Matrix redefined how we create television and cinema.
Neo, the protagonist of the film, transforms from a simple 9-5 computer programmer and hacker into a modern-day super hero capable of amazing abilities, learning how to move faster than a speeding bullet and leap tall buildings in a single bound. But just like a certain blue-and-red suited crusader for Truth, Justice and the American Way, Neo didn't need to work hard for years and years in order to perfect his skills and abilities: all he really needed to do was plug himself in and download the information! I can't think of anything easier than that...except maybe just stepping outside and being able to fly Under a Yellow Sun.
The idea of achieving an amazing life without an equally amazing dedication towards achieving it is littered throughout our culture, unfortunately. We play the lottery so that we can become instant millionaires and we cram the night before an exam so that we can pass a test.
The fitness field is rampant with "Instant E-Gurus" that announce themselves as experts, producing sloppy YouTube videos and e-books in order to make a fast buck without the slightest bit of education or experience (insert Tracy Anderson joke here). In turn, they feed into our own "something for nothing" instincts by promising the world for as little as 10 minutes a day and 2 low payments of $39.95
And you won't even get bulky!
As you might have guessed, the solution to any problem is rarely as simple as this, and it usually only works in the movies for people named Morpheus and Trinity. By feeding into these impulses, we often end up wasting more energy and time by not achieving our goals than had we simply dedicated ourselves to performing the hard work that we should have done in the first place. It's almost always better to do something rather than nothing, and if you can dedicate yourself to even 10 minutes of exercise each day, I'd much rather see that you do; however, if you're just making excuses to yourself and trying to "cheat the system," at the end of the day you're likely to end up with exactly what you've put in: excuses.
In the last three months, I've averaged 65 hours/week at the clinic. I've worked as much as 17 hours in one day, and average 13-14 hours each day. In the end, I will have learned an enormous amount of information, acquired a huge amount of experience and become a better therapist because of it...and that's why I wanted to do this. When it's done, I will be applying for Fellowship training in manual physical therapy, another year of advanced training and education. When I say that I want to be "the best," I mean it. But unlike Neo, I know that if you want something, you have to work for it. Sometimes, you really have to work for it. But if you do, good things will come of it, too.
Whatever your goals are, keep at them. Resist the temptation to take the easy way out or the quick fix. Earn your results through your efforts and your dedication, and you will be better for the experience.
Mike and I talked about physical therapy and sports performance settings, what I learned from Bill Hartman, what strength coaches can learn from PT's, what MMA fighters, from beginners to advanced, need to focus on to improve...not to mention just what I've been up to for the past two months!
It's always awesome to catch up with Mike, and we had some great discussions. Have a listen and enjoy it!
Q: I'm a brand new personal trainer. I don't want to be an average fitness professional, but my background is geology; I studied at home for the NSCA-CPT and passed, and have been working in a pretty decent gym for a year now, while I was studying, but that's it for my background. What are the biggest things you've learned (to do or not to do) as a trainer?
A: Congratulations on the start of your new career, Giz!
Beginning a new profession can be fairly intimidating, especially a career as dynamic and detailed as health & fitness. The truth is, I continue to learn more and more every day. Rather than try and give you a giant list of do's and dont's, here are my top three areas to focus on as a new trainer:
1. Anatomy is the lyrics written to the music of kinesiology that we sing to our clients.
If you're still reading this post, that's good. If you were able to tolerate my horribly corny analogy, you should have the mental fortitude to dedicate the hours of study required in order to know your anatomy and kinesiology expertly. Studying anatomy can be pretty dry at times, and kinesiology can be fairly intimidating to the uninitiated, but these subjects are the basis of everything that we do as trainers. Without a firm grasp of these sciences, you're going to have a difficult time truly understanding anything else in your job description.
Always remember: the client exercises his/her muscles; the trainer understands the muscles.
You've got your ubulus muscle, which connects to the upper dorsimus. Its boring, but its part of my life.
2. Don't fall in love with only one "method"...be a swinger!
When I first began training clients, I generally used one approach with everyone, which had been taught to me during my first certification coursework. The truth is, it worked well enough and my clients got leaner and stronger. But that was really all that I knew. Programming for performance enhancement, weight loss, increased strength...it was basically all the same! As I developed and learned more about training, exercise and the science behind them, I started incorporating different methods and techniques into my "bag of tricks," while at the same time removing some of the things that I felt were no longer effective.
So while you search to find your own niche, discovering what works for you and within your particular skill-set, don't be afraid to venture out at times, observing others and incorporating different methods to make you a more well-rounded and more effective trainer! A few great places to start might be podcasts such as The FitCast or Mike Robertson's new podcast newsletter, In the Trenches Fitness, as well as excellent resources such as Mark Rippetoe's "Starting Strength" (you didn't think that I made up the title of this blog by myself, did you?) or the growing collection of free information at places like FLZine (where, if you search hard enough, you might even find an interview with yours truly!).
Leigh and I sit down for a little quality time at FLZine.com
3. Be good at what you do, but know your limits.
It can be pretty overwhelming when you're a new trainer, especially when you don't have a background in exercise science. At first, it might seem that you're woefully under-prepared or unfit for the job. But the truth is, you are prepared. Are you as good now as you might be in another 5 years with more experience and education? Of course not. But that doesn't mean that you aren't able to help your clients and make a positive impact on someone's life right now.
Even with 50 years of experience, you'll never know everything. No one does (except maybe William Kraemer,PhD). So focus your efforts on getting really good at a few things, but don't get caught up in trying to figure out everything, especially when it's a subject outside of your scope of practice as a personal trainer.
For instance, I'd like to think that I have a fairly decent grasp of the basics of nutrition. I've even dedicated a few blog posts to questions about eating healthy. However, I'm far from being an expert like my friends Cassandra Forsythe and Leigh Peele are, and I always turn to them when I need information about diets and nutrition. Conversely, both Leigh and Cass are excellent trainers as well as experts in nutrition; however, when they face an issue in training or rehab that they're unfamiliar with, I'll happily return the favor and try to help them with their training question (and if I don't know the answer, I just ask Bill Hartman!).
Sure, all three of us could dedicate ourselves to actively learning more about other fitness-related areas such as nutriton (for myself) or rehabilitation (for Cassandra and Leigh), but that wouldn't make much sense, either. We are all good at what we do because we chose to be good at those particular things. Too much "Career ADD" won't make you particularly good at anything, even if you feel like you're expected to know everything as a new trainer.
Wait, where was I going again?
I hope that this gave you a good place to start in your new career. Best of luck!
The blog just got a major facelift thanks to my friends at Local Wisdom, and I have to admit that it's a significant upgrade! The brilliant minds at LW have been my go-to computer experts since I started, and without them, I would barely know how to turn my laptop on.
Teh coMput3rz maiks my heAd hurTz
I think the blog looks great, and I hope that you do too. Let me know your opinion in the comments!
Last weekend I took the drive up the NJ Turnpike all of the way to the Mass Turnpike and attended Mike Boyle's 3rd Annual Winter Seminar (yes, it was Valentine's Day: my Jenny is a very understanding woman!). I had a great time, and the presentations were varied and full of great information. I met a lot of talented coaches and trainers this weekend, and a few listeners of The FitCast too (thanks for coming by and saying hi, guys!).
I have this question that I have been pondering. It's about shoulder internal rotation and range of motion. First of all, we've got two ways of assessing it, right? Abducted shoulder internal rotation and back scratch test.
With the back scratch test I've not yet seen a clear classification of what arm position corresponds to what range of motion. General classification is : if your arm goes horizontal - that's a good start; if you can't get horizontal - bad; if you can go above horizontal - you have good flexibility. Always look for the inferior border of the scapulae and scapular winging - the easiest way to cheat the test. Other ways are shoulder abduction and thoracic lateral bend.
That one's fine with me, if you say that it's a good test.
The one that's bothering me is the abducted arm internal rotation test. Here's the thing - I can rarely get anyone to go into internal rotation without scapular elevation and/or anterior tilting.
What Eric Cressey is showing in his pictures usually corresponds with my observation - on most of the pictures he post, he allows people to hike the shoulder up and get more ROM. Now don't get me wrong - he's a really smart guy, but is that ok with you?
Best of wishes. TS
A: In general, we've got definite ROMs that we would use for shoulder internal/external rotation that we consider to be "accurate" (90 & 70 degrees, respectively, by goniometric measure according to the American Academy of Orthopeadic Surgeons). Personally, I prefer the supine position (the subject remains on his/her back with the arm brought out 90 degrees), but any position is fine relative to patient needs (from a clinical standpoint, there may be a reason that the patient can't get into the position that you need them to, so you have to use different strategies). That can include the arm held at the side or with the shoulder abducted to 90 degrees, etc. The scratch test is fine too, but it's more of a gross movement test vs. a single, isolated movement test and you won't get a "pure" number corresponding to just one movement. In the gym, this is fine. In the clinic, this may or may not be ok...it just depends on the case.
If we're interested in the technical word of law, then no: you shouldn't allow any additional movements such as scapular tilting (or any other compensation) when taking the ROM of the shoulder. However, it probably isn't that important in a non-pathological shoulder, which is what you're likely to see in a gym client.
In terms of "real world" function, observing compensations by allowing gross movement can be extremely valuable, so I understand why Eric would say that. I generally do the same thing for a non-pathological client, too. I would just add that if there's a difference, you probably need to break down the movement into it's constituents (IR, extension, elbow flexion, etc) and see what's really going on.
Which leads to the last point: how do you measure things in the "real world" outside of goniometers and the AAOS? Compare both sides: it's more important that a client is symmetrical then if they have the appropriate ROM in most (if not all) cases. Problems will occur if there is a difference between limbs, and that's what you should be looking for.
Yes, if a client presents with bilaterally short hip flexors, for instance, you would probably look to address that through various stretching and mobility work, but if you have the case of one hip flexor being significantly stiffer or shorter than the other, that's where you will see non-symmetric, unilateral alterations to the kinetic chain, which can cause major problems over time. That's like driving with one flat tire: eventually, your car's alignment will also need fixing, too.