Assessing and Improving the Hollow Body Position w/ Dr. CJ DePalma PT, DPT

Intro & Simplified Kendall Leg Lowering Test:

#MondayMusings:
From @the_movement_dr:

This week I teamed up with Doctor of Physical Therapy candidate, CrossFit coach, #CWCC & @clinicalathlete student forum member, @physio.praxis to use the reliable and valid #KendallLegLoweringTest as an objective measure to determine where your athlete or patient is on the #HollowBody spectrum.

Scoring is as follows:

3 - From 90 to 45 degrees: These athletes will compensate through the hip flexors, extending the lumbar spine when asked to hold a hollow just off of the ground. They will build upon dysfunction in an effort to get into appropriate position.

2 - From 45 to 15 degrees: These athletes maintain control throughout most of the movement, but begin to lose that control at the end range of movement - say on a heavy-ish shoulder to overhead or after a few toes to bar.

1 - From 15 to 0 degrees (or to the ground): These athletes exhibit good strength, endurance, and control of the anterior core and are well prepared for loading and dynamic movements.

Here @dani.f.baby would be on the border of 2 & 1. 

Over the next few weeks we will be providing exercise progressions and suggestions to build upon where the athlete currently stands. Keep in mind, core strength and endurance can be subjective—but this system aims to provide a starting point for you, your athlete, and/or your patient. Tune in next Monday for the first progression, or for the full series, follow the link in @praxis.physio's bio! 

Cite:

Staniszewski B, Mozes J, Tippet S. The relationship between modified sphygmomanometer values and biomechanical assessment of pelvic tilt and hip angle during Kendall’s Leg Lowering Test of abdominal muscle strength. Proceedings of the Illinois Chapter of APTA, Fall, 2001.

Level 3 First Progression: Single-Leg Active Leg-Lower:

#MondayMusings:

This test is a good starting point for those athletes who have difficulty getting into the hollow position. By taking a limb out of the equation, we reduce the force demand of the core and the difficulty of the task.

Many athletes make a common fault when “contracting” the deep core, or transverse abdominus (#TrA), where a hyperactive or excessive contraction is produced. This in turn engages the lumbar parapsinals -- creating over extension of the lumbar spine.

Points of Performance:

-Exhale the entire downward motion of the exercise while keeping the lumbar in contact with the ground.

-Once 15 degrees is reached, the athlete will isometrically hold—inhale and exhale—then bring the leg back up to 90 degrees.

-Avoid External Rotation of the leg, focus on keeping the leg linear throughout the full movement.

-Repeat 8-10x

Progressing from Level 3 to 2: Dead Bug Upper Extremity Isometric Variant

#MondayMusings:

The #DeadBug against the wall is a good starting point for those with a score of 2, or as a warm up/ramp up for athletes who score a 1 prior to lifting or gymnastic movements. This variation employs the use of upper extremity isometric firing to light up the central nervous system (#itsLIT), which in turn increases neural firing to the deep core musculature.

Points of Performance:

-Forceful exhale prior to initiating the movement followed by a quick inhale to breathe into the created tension while pressing into the wall or weight.

-Raise the tailbone slightly off of the ground and lower one leg slowly. Make sure that the pelvic positioning is maintained during this eccentric motion

-Repeat for 5-6 breaths per side.

Tune in Monday for the next progression with @the_movement_dr, or head over to #MusingsOfMills -- link in bio. 

Level 2-ish: Plank to Pike on Rower:

#MondayMusings:

Our 3rd installment for the #KendallLegLoweringTest is the Plank to Pike on Rower. This exercise is for those who scored a high-level 2, moving closer to a 1 during the test.

The starting position of this movement is opposite to the starting test position and the previous two exercises. We begin in a bottom up fashion: starting in a plank then working towards a Pike. By doing so, we are able to increase our initial lower core engagement in a concentric fashion.

We need variance to create change, and this movement fulfills just that.

Points of Performance:

- ROM may become an issue, just pike as high as you can and the exercise will still maintain the benefits.

- Exhale as you pike up

- Hold for 1 to 2 seconds at the tope

-Slowly lower the body back down

-Repeat 4-5x 

Levels 2 to 1: Bar-Supported Leg Raise:

#MondayMusings:

In our second to last exercise, again for those on the border of 2 & 1, we use a barbell (or heavy resistance band) to externally cue the athlete (@dani.f.baby) to maintain a #hollowbody position while perform an active leg raise.

Points of Performance:

-Begin by exhaling and elongating your spine, while gently hollowing the low back into the bar or band

-Brace the core, squeezing the feet and quads together synchronously.

-Initiate the movement with your lower abdomen (focusing on engaging the internal obliques and TrA) similar to how you did with the #pike.

-Only lift so high as you can maintain the position without compensation, i.e. beginning position.

-Repeat for 5-6 reps/breaths or until fatigue

This can be paired with a #hollowarch to begin working on the movement specificity needed to perform all #kipping movements, especially if you turn into a #FloppyBaby as soon as you attempt full speed. Tune in next for the final exercise - or visit #MusingsOfMills -- link in bio .  

Level 1: Strict Hollow Body to Arch

#MondayMusings:

For the athletes who have made their way through the progressions or for those who scored a 1.

The Hollow Body to Arch Strict Transitions are the ideal precursor to any kipping Bar or Ring movements.

Focused and controlled transitions will help engage the #Lats and #Trunk in the free-hanging #HollowBody position, as well as improve our bodies kinesthetic awareness as we engage in movement towards an arched position.

Points of Performance:

-Do not swing. Stay as still as possible. Synchronous, co-contraction.

-Keep your body elongated and your feet touching.

-Each transition from Hollow to Arch should take roughly 3-5 seconds

-Repeat 8-10x

     

Improving the Split Jerk: A Self-Case-Study

#MondayMusings:

Ever since tearing my ACL 3 years ago everything that resembles a lunge has given me problems. They feel uncomfortable and weak in comparison to squatting motions, and have since formed a mental block that has always made me nervous to go heavy – especially on the split jerk. Ever since the @cwcseminar, @elisbad7 has been programming them regularly, and I’ve been using what I knew before, along with cue’s and drills that I picked up from both @quinn.henochdpt and @ricky_redus to work towards evening out the weight with my power jerk.

Step one was to incorporate bottoms up kettle bell presses with a focus on maintaining a stacked spine to work on the strength deficits from one shoulder to another, along with a bias towards keeping my core controlled, spine stacked, and rib cage down. Here is a simple progression and self-cue that I find helps facilitate this by both keeping the ribs down and palpating the serratus anterior. I will be piecing together a review of current literature that speaks on current evidence of unstable load training for unilateral strength improvement and as a rehabilitation tool over the next few weeks.   

#MondayMusings:

There are varying opinions amongst researchers on whether or not training with an “unstable load” is effective or not. Some researchers say there is no striking difference in shoulder activation using a #barbell vs. a #dumbbell at the same weight, some say that training with an unstable load offers no additional benefits for force and power production, and some say that co-contraction of the musculature around the joint is always a good thing.

I follow the train of thought that there is a give and take between what the research says and what has been used as an effective tool in varying settings. I have not stumbled upon a prospective study on the ongoing effects that a majority bilateral training program has on the body, but I know #CrossFit has a lot of it. If you are only using an evenly loaded barbell for the majority of your training chances are your strong side is getting stronger, and your weak side is getting weaker.

The Half Kneeling Landmine Press is a unilateral movement, which some would call intrinsically unstable, and has been shown to cause greater recruitment of the local core musculature, specifically the internal obliques and transverse abdominous. I have found that the specificity of training in this position gives a foundational and simple awareness of what you should be feeling in the feet, hips, core, and shoulder during a #splitjerk. Also, try adding in neuromuscular re-ed because your lock-out is slow, soft, and self-limiting. 3x8-12 with a two second pause at the top, 3 seconds on the way down, explode up.

Cites:

Behm D, Colado JC. THE EFFECTIVENESS OF RESISTANCE TRAINING USING UNSTABLE SURFACES AND DEVICES FOR REHABILITATION. International Journal of Sports Physical Therapy. 2012;7(2):226-241.

Kohler J, Flanagan S, Whiting W. Muscle Activation Patterns While Lifting Stable and Unstable Loads on Stable and Unstable Surfaces. Journal of Strength and Conditioning Research. 2010;24(2):313-321. doi:10.1519/jsc.0b013e3181c8655a.

#MondayMusings:

When I was a freshman in high school I remember performing lunges for the first time in an exercise setting, and I hated them. I can picture the trainers face when I said something like, “Yeah, the lunges feel okay, but they really just hurt my big toe.” He seemed bewildered, and stated that in all his years of training, he has never once heard that. It was not until I learned of the Windlass Mechanism that my statement was validated.

Clinicians argue that you need between 45-60 degrees of big toe extension for proper walking mechanics, and 80 degrees for proper running mechanics. When I first goni’d my big toe in PT school I was rocking out at a lackluster 30 degrees, bilaterally. My entire big-toe-life had been a lie. The Windlass Mechanism utilizes the elastic properties of the bottoms of your feet to transfer energy at toe-off during walking and running, and I had utilized virtually none of it for years.

The #WindlassTest is traditionally used as diagnostic tool for ruling in plantar fasciitis, but can also be used to determine hallux rigidus, or a really stiff toe. Here, @djhousebrother and I use it to determine the latter in the first clip.

The stretch performed in the second clip can be utilized both dynamically for a warmup, or held for a prolonged, static stretch. Current evidence suggests that a stretch must be sustained for ~20 minutes to truly add length to the tissue. Tune in Wednesday for exercises and points of performance to solidify positive outcomes. 

#MondayMusings [Extended Edition]:

We’re going to Tarantino this and give you the end first: turn your sound on and listen as @djhousebrother breaks down what your back foot needs to be doing in the #SplitJerk.

If your big toe doesn’t extend, your body will compensate – when walking or running, you may push-off on the outsides of your feet, or your arch will just collapse. In a lunge/split jerk position, that uncomfortable feeling of your big toe slamming into the ground will, in turn, cause the body to move away from that uncomfortable position through compensation – whether that be in the other joints of the foot – or the ankle, knee, and hip. Some can get away with it, others cannot – but if you are not getting into the optimal position, you may not be reaching your maximum potential.

In the second clip, Josh demonstrates a simple Step-1 to gaining motor control in that new range we got from the previous video, all the while focusing on weight bearing through that first ray of the foot. Step-2 increases specificity of the movement in the #lunge – work in a pain-free range as a warm up and work on optimal hip and foot alignment. Then begin to load the movement with 3-4 sets of 10-15 reps, first by increasing depth, then by adding weight to make it a strength training accessory movement. Step-3 is the Bulgarian Split Squat – follow a similar fashion as the lunge by working into depth and tolerance, followed by load, depending on the goal of the athlete.

Clip three, and Step-4 puts it all together in the #JerkBalance – here focus on technique and timing before loading the bar, as the timing of a jerk may be just as beneficial as loading it, especially for beginners. The jerk balance is a great drill to perform between your initial warm up sets to hammer out any inconsistencies.