Below, a short clip, featuring yours truly, from our local news.  I think they did a nice job presenting a balanced approach.  I find it funny what they chose to use out of a 45 minute interview, but I agree with their conclusion that Crossfit should likely entered into with caution like training for a marathon rather than as a general exercise program.

A nice piece by Katherine Underwood: Crossfit Controversy

Points I wish made the video:

• We have a sedentary, obese society that needs to sit less and move more.  By motivating people to get moving in some ways Crossfit has it right.  They have also done well removing seated exercise machines and motivating people to perform a variety of more functional activities.
• Crossfit can be extremely fun, motivating and exciting.  (This is one of their great achievements but it can also compromise judgment.)
• One of the main flaws in training is the value of quantity over quality.
• Big picture goals should be as follows: For athletes: Long Term Athletic Development.  For adults: Long Term Athletic Participation.
• It is very easy to make exercise hard.  Do more reps, add more weight, do it faster.  It is very hard to make exercise challenging. This is where the exercise remains under control, but just on the edge of someone’s capabilities.  The difference is HUGE.  Challenge leads to adaptation and improvement.  Exercising hard leads to injury and failure.
• Health care providers have a duty to at least “DO NO HARM”.  Fitness trainers should adhere to this same concept.  
• Professor Stuart McGill reminds us that, “There is no good or bad exercise” only ones that are inappropriately applied.  Group exercise classes do not allow individualization which creates problems.  In other forms of group training there are also problems, yoga, pilates, etc… however with these other forms of group training there is more of an environment that it is acceptable that an exercise or activity may not be for you and an encouragement to ‘listen to your body’.  Crossfit adopts a mantra closer to ‘no pain, no gain’.
• Each person should be screened pre-participation.  Screening should include cardiovascular assessment, but also a movement based assessment such as the FMS looking for movement limitations & common injury mechanisms.  It is also essential that screening is implemented using corrective exercise and modification of the routine.

Some blog reviews: of Crossfit:
http://impact-pt.com/fitness/what-crossfit-is-and-isnt/

http://boddickerperformance.com/?p=295

http://justinlevine03.blogspot.com/2012/01/crossfit-is-it-safe-program.html

I was excited before, but found out from some Facebook friends that there is a water slide and some fun to be had at the resort.  Resort fun is a distant second, but a nice perk to what will be a fantastic seminar.

Seminar Flyer

Registration

For those who haven’t purchase the book yet (available on the Newton Biomechanics website), read this paragraph from the preface.  Tom, “had me at hello”.

“Using the latest technologies, modern researchers are proving what practitioners experienced in conservative interventions have known for decades: hands-on manual therapy, orthotics, and rehabilitative exercises provide inexpensive, effective, long-term solutions for the majority of gait-related injuries.”

The book begins with a fascinating history of the evolution of bipedal walking and gait.  Laced with details that I’d never considered, it’s a fascinating read.  For example, “An extreme important by product of Homo rudolfensis’s habitual bipedality is that it decoupled the process of breathing from locomotion.  As noted by Carrier, running quadrupeds time their respiration with their strides…. the coupled patterns locks the breathing cycle during quadrupedal locomotion to the stride rate.”  I guess I haven’t spent enough time analyzing my dogs breathing pattern while he’s running.   This evolutionary detail reminded me of the common conversation of timing breathing with exercise. Considering the essential nature of respiration in spine stability, with the diaphragm serving as the dynamic lid of our pressurized canister, we must always have controlled breathing to have adequate spine stability.  The argument is often when to inhale and exhale during exercise and I think this point in Dr. Michaud’s book lends itself to what I’ve always believed the answer to be.  One of our evolutionary advantages is that we can inhale and exhale whenever we like, completely separate from gait or physical activity.  This evolutionary advance is something we should not give back by training specific inhale or specific exhales during exercise.  (exceptions for extreme performance such as Olympic power lifting are acknowledged)

This text continues with analysis of biomechanics, evaluation of gait cycle (ideal & abnormal), exams, orthotics, shoes, and ends with treatment protocols.  It includes a very insightful discussion of the risks and benefits of the barefoot running trend.   I enjoyed this particularly as a part-time, rational, minimalist runner.  For those interested in this specific topic see also Barefoot in Boston by Art Horne.

I’ve found myself using the book as a reference for lower quarter problems that I’ve been treating and taking some pearls away from Dr. Michaud’s text to add to my clinical toolbox.   This is a great read that shouldn’t be missed.  For other info and reviews of the book, see below:

AUDIO INTERVIEW @ SPORTSREHABEXPERT.COM (view the sample articles if you’re not a member)

During the interview Dr. Michaud covers a variety of topics.  One is the growing body of research that pre-competition stretching does not change injury rates.  He recalls a story of Rob De Castella in his clinic after winning the Boston Marathon and notes that he had a 4″ ASLR raise.  In discussion Rob explained, “when I run that’s as far forward as my leg goes so that’s as far as I want it to go”.  Dr. Michaud discusses the athletic value of ‘tightness’ and the clinical presentations which warrant stretching.  He also discusses barefoot running, treatment of plantar fasciitis, the role of hip stability and proprioception, reasons for recurrent hamstring strains in runners, and shows his ownership of the research which is so evident in his book.   To listen to the audio interview with Dr. Michaud go to sportsrehabexpert.com (membership to the site may be necessary): Dr. Tom Michaud audio interview

Still not convinced…. Read a great review and blog post by Patrick Ward about Human Locomotion.

Dr. Tom Michaud, author Human Locomotion

To see the actual work, read some samples from the text and see the Table of Contents @ www.newtonbiomechanics.com/pages/contents

Can you see the stabilizing, connecting architecture.

We know that no muscle works in isolation and the brain thinks in terms of movement, not muscles.  So I think the title of these videos (and articles) may be misleading for those who are not familiar with the paradigm and principles that support it.  Despite calling it QL training, you will notice very quickly that Dr. Liebenson & Chad Waterbury are training patterns and functional whole body exercises, not working to isolate an individual muscle.  Keep in mind our common movement patterns as you review this and realize how neglected that lateral direction or transverse plane can be.  So far today I’ve spent 95+% of my time moving forward on level surfaces.  My activation of the lateral stabilizers has been minimal.  Our modern society and common training exercises necessitate evaluation of this plane and likely incorporation of these exercises into most routines.

A great introduction, now see how it’s done.

Some addition reading: on Dr. Liebenson’s blog  & Chad Waterbury’s blog.
Also a previous post by Dr. Cubos on Gluteus Medius activation which includes the role of the QL.

We must assess all planes and all movements.  Treatment is the applied to the worst, pain-free pattern (treat the abnormal motor control that improves the mechanical sensitivity).

• in your activity level
• in your career
• in your sport/training
• in your relationships

… perhaps you didn’t watch closely enough?
This is SIMPLE but not EASY.  Just like so many treatments for my patients.  Simple, but not easy, exercises.  Simple, but not easy, changes in diet.  Simple, but not easy, changes in perspective and lifestyle.  Best luck to everyone to FORCE themselves to make the simple decisions.

I first viewed this on: SB Coaches College

As this has carried forward we see widespread  examples of how this concept of quantity over quality has gone wrong.  Quantity over quality  has corrupted society.  We are saturated in low quality abundance.

• Calories over nutritional content.
• White bread everywhere vs. whole grains.
• American cheese food vs. actual cheese.
• Processed, packaged foods full of preservatives.
• ALL LEAD TO: Obesity & disease

• Exercise fads, the quick easy, this is for everyone approach.
• 3 sets of 10 mentality.
• Lift more weight.
• Add balance challenges to anything.
• No pain, no gain mantra.
• LEADS TO:  hypertrophy, compensatory pattern, accumulation of stress/strain, failure to meet goals, frustration, injury,…… inactivity.  (Stronger, but no healthier.)

We now know that quality of exercise is more important than quantity.  The same holds true in nutrition, quality foods (whole foods, organic foods) are more valuable than quantity.
Systems have been developed to access quality of movement.  Functional assessment or evaluation of movement quality have been around for some time and were championed by Vladamir Janda.

• Janda & Prague School teachings including Dynamic Neuromuscular Stability.
• FMS /SFMA
• Liebenson’s Mag 7

These methods are not always used as we rely on traditional orthopedic testing (which has it’s place in examination, but also has it’s limitations) and diagnostic imaging.  Imaging such as x-ray, MRI, CT also has it’s utility, but is frequently over utilized and often muddles the clinical picture as it does not show function or pain.  Evaluation of structural change has poor correlation to pain and function, it can be misleading.  To combine the concepts, below are some examples of imaging (flouroscopy) during poor quality and then high quality movement patterns.  After watching them which is more important, the # of repetitions you do, or the quality of the repetitions?  Would you prefer 3 sets of 10 with bad form? Or one set of 4 with good form?

Abduction of the shoulder, first with a shrugged, decentrated, elevated scapula; then repeated with proper packing/stabilization.

original posting @ http://irontamerblog.com/packing-the-shoulder/

Which shoulder exercise would you like to see in your patients?  In your own exercise?

The days of quantity have passed.  The emphasis needs to return to QUALITY.   Once we achieve quality, quantities of quality exercise can be used to increase capacity.