by Bret Contreras March 14, 2011
A couple of weeks ago Dean interviewed me on his site. I thought it would be a kind gesture to return the favor. I admire Dean for being a hard-working guy who isn’t afraid to speak his mind. Enjoy!
1. Hey Dean, introduce yourself to my readers. Please include your qualifications.
First, let me say a big thank you for taking the time to ask me a few questions. It’s always humbling to know that there are big names out there paying attention to some of the things I’m doing, and it’s definitely an empowering thing to form a network with like-minded greats like yourself.
I’ve been a personal trainer for the past 8 years and developed a niche specialization in injury post-rehabilitation. Over 80% of my clientele have been referred from medical sources to help fix nagging injuries or prepare them for or recover from surgery, as well as help manage complex medical conditions. I’m the director of Medical & Post-Rehabilitation Training for World Health Club, a chain of clubs across Alberta, Canada, and organize all the medical referrals coming into and out of the clubs for the personal trainers. I graduated from University of Alberta with a BSc in kinesiology, completed a CSCS certification from the NSCA, a Medical Exercise Specialist designation from the AAHFRP, and am completing a Certified Exercise Physiologist designation this summer through the Canadian Society of Exercise Physiologists. To top it off, I also train 30-50 sessions a week, so I try to walk my talk as much as possible.
2. Dean, new clients show up onto our doorsteps with all sorts of issues. Why is everyone so beat up, and what are three of the most common issues you see with the general population?
3 simple reasons: We eat shit, we move shit, and we think shit
The quality of food in North America (and probably around the world) has decreased so drastically with the addition of chemical fertilization, genetic modification, hormone injections, radiation treatment, soil depletion, drought, hybrid seeds, and preservatives that we can’t even call it food any more. I built a garden in my back yard last year and started growing my own vegetables. It’s not ideal in the winter, but it’s better than shelling out $5 for a bunch of carrots that taste like wet cardboard and farts because of the chemical cocktail they’ve been brined in. Let alone the high fructose corn syrup that’s in everything and no one knows why it’s there, artificial sweeteners that cause cancers and surprisingly weight gain, and our reluctance to move away from a starch-based diet that worked well for our grandparents when they were growing up in the industrial revolution or the great depression and they needed the carbs to keep them active while they worked physical 12-16 hour days to keep a roof over their families heads. I’ll admit, if you’re a roofer or a contractor working 12 hour physical days, you can have an extra scoop of potatoes, but if the only kind of sweaty you get is playing World Of Warcraft, eat a freakin tomato instead!!!
People on average spend less than 30 minutes per day simply weight bearing. This means the most activity the majority of the population gets is while leaning on the shopping cart to get their groceries, which we already know are crap!! Sitting in a chair is pushing us into the flexed-posture positions of neck, shoulder, lumbar, pelvic, knee, and ankle issues that are plaguing our society. More people come to me with shoulder injuries because of a stupid chair and desk design and setup that’s causing their scapulae to slip across their ribs and pinch the hell out of anything in the way.
People are also quick to find reasons why they can’t fix their situations. Somehow, they lost control of their own lives, and someone else is to blame for all their problems. “It’s not you, it’s your metabolism.” Are you kidding me?? If your metabolism isn’t you, I don’t know what the hell is!! No one’s going to squat for you to get the benefits, just like no one else is going to gain weight if you eat that powdered glazed donut, just you, so put it down, grab some weights, run a mile or ten, and work it out. This is the information era, and if you want something there are literally millions of ways you can get all the assistance, advice, information or resources necessary to make the life you want, build the body you want, and have the relationships you want to have with the people you want to have them with. Take ownership, do something about it, and run your life like it’s YOUR life.
3. How do you get people to hinge at the hips properly, and why is this so important?
This is a fantastic question. The hip hinge is the main movement within the vast majority of strength, power, postural and endurance movements, so pretty much everything. Every core muscle and leg muscle, as well as some of the main shoulder muscles, have attachment points to the pelvis, which makes its ability to move well extremely important to performance, health and rehabilitation.
Teaching a pelvic hinge has to come back to understanding why there may be a problem in the movement pattern. Is it the result of structural problems or supportive problems? In other words, are the joint and bone structures limiting the movement, as would be the case in osteoarthritis or tight capsules, or is it a case of muscular malfunction from improper conditioning or movement patterns over the course of decades? Is it because of another joint being injured and the mobility of the hip being affected?
Movement assessment and manual testing of involved muscles can help to reveal where the problem is coming from, and once it’s determined whether the problem is joint stiffness versus muscle weakness, we can begin to train the movement.
I use a pretty simple progression to get people performing a hip hinge. The first step is to create lumbar stability during hip flexion and extension to ensure there is minimal compensation. I use a leg raise with a blood pressure cuff feedback to maintain neutral spine during the movement. This can be done with a single leg raise in the case of some people with much weaker cores.
The goal of this exercise is to have the cuff inflated under your lumbar spine, and exert a constant pressure on the cuff throughout the movement. If your spine goes into extension, your reading will go down, and if your back presses down into the cuff going into flexion, the reading will go up. Maintaining a constant pressure is the goal.
With this, I will also try to get the person to passively move their hips through flexion and extension, again limiting the lumbar spine involvement. A hip rock is one of the best ways to do this to ensure minimal compensation and zero spinal loading.
Once they can master these movements and have a stable core, we can progress to standing movements like deadlift variations from supports, partial squats, and of course hip bridging.
If the person can by-pass the first two stages because they have good movement capabilities and strong cores, two of the best movements I’ve used to get the hip hinge working are the wall facing squat and the wall butt touch. These two give immediate feedback and don’t allow the person to cheat whatsoever.
Once these movements are strong, mobile and stable, we can start adding load to the movements. There are some people who may never get past the basics, so we can start to add load occasionally, but only if the hips are performing the movement.
4. What are the essential components to an individual’s routine that is looking to improve his health and physique (not an athlete, just a general gym-goer)?
I’d have to say the first thing is to simply drink more water. The majority of the population could be considered dehydrated, and the addition of a bunch of high-sugar, caffeinated and carbonated beverages only dry out the tissues even more. Most people don’t even get a litre of water in them, despite the fact that the average person who isn’t exercising needs about 3 litres a day just to keep healthy, and if they sweat they need even more. Fat can’t metabolize in a dry environment, and tissues can’t heal or reduce scar tissue formation if the tissues aren’t well hydrated.
Next up is mobility. I don’t care how much you can lift if you can’t touch your toes. As most people sit for the vast majority of their day, their muscles and joints, as well as fascial tissue and nerve tissue will shrink and shorten, making movement restricted and the potential of the muscle to grow and move much less than it should be. Think of someone trying to do a bicep curl without letting the weight come below 90 degrees of the elbow. Pretty much everyone would say “FULL EXTENSION!!!” Yet let someone do a partial squat and load the hell out of them with a few plates on their spine, and the trainer would say they’re doing great.
The third big component is posture. If I can get someone to stand up straight and learn how to move their pelvis to change their lumbar curve into a more favourable position, I’ll reduce their risk of injury throughout their body dramatically. Most people have some degree of kyphosis from riding the cubicle all day as a desk jockey, a position I call the “Mr. Burns Syndrome,” and as a result are stuck with every joint in flexion. Getting them to extend and move in three planes of action can make them function and feel better.
Last, make it simple and something that can become a part of their daily life. More than half the population doesn’t even walk for a half hour each day, combined!!! We need to re-evaluate our priorities as a society and get people moving again.
5. What do you do to get client’s glutes functioning better, and when are you “satisfied” in terms of their gluteal prowess?
To quote Chaz Michael Michaels from Blades of Glory: “I am NEVER satisfied. It’s a curse.” I’ve had to sometimes spend up to five sessions working on JUST getting clients to use their glutes instead of compensating and relying on their spines or hamstrings. They’re just that important.
Depending on why they hinge or not is going to dictate what I do to train their glutes. If they hinge at their spine and there’s an obvious buckling deformity, we’re going to work on spinal stability with femoral flexion/extension without loading to try to groove the pattern, or else they’re going to just keep buckling at their spine. If the hips are stiff, we’re going to spend a lot of time foam rolling and performing mobilization movements and activation movements. As both Gray Cook and Mike Boyle have shown, without mobility we can’t create strength or performance improvements without increasing the risk of injury. As most of my clients are already injured, going backwards is absolutely not an option.
Once they’re able to create stability through their spines and engage some mobility through their hips, we can start loading them. I’m pretty strict when it comes to positional specificity, and I want to make sure perfection is the goal with most exercises before we add loads. If the hip can’t get past neutral into extension in a passive movement, it’s definitely not going to do it actively or with a barbell across the hips, so we’ll have to start slowly and build up until the client has that foundational skill to be able to handle something more and get some sort of optimal benefit out of it. Pretty much every movement you list out in your glute book is in my rotation in some way or another. Seriously, that thing should be on every trainer’s book shelf, dog-eared and scribbled in, sworn at, accepted and utilized repeatedly. I’ve talked a lot about some of the mobility and stability patterns on Muscle Imbalances Revealed, the webinar series I co-authored with Rick Kaselj, Mike Robertson, Bill Hartman, Eric Beard and Kevin Yates. It’s pretty redicul-awesome, if I do say so myself.
6. Tell me your favourite 3 exercises for each movement pattern:
quad dominant: Barbell front squats, standing or walking lunges regardless of resistance, and one-leg squats or step-ups
hip dominant: Glute hip press (hip thrust), deadlifts (sumo preferred with lumbar issues, conventional the rest of the time), and a 90 degree turning side lunge & press with a cable system
horizontal press: There’s going to be a lot of hatred out there for this one, but I think the conventional bench press isn’t that great of a movement, simply because of the risk of sub-acromial impingement being so high with a fixed bar placement. I much rather prefer a dumbbell chest press with a slight external rotation at the bottom, and rotating the hands so that the pinkie fingers are facing each other at the top. It gives a much deeper contraction and a safer position for the sub-acromial region. On top of that, pushups in any pattern, and medicine ball throws from a chest pass style or side arm style
horizontal pull: standing cable rows, seated cable rows, as well as any rotator cuff or scap stabilization exercises.
vertical press: I don’t really involve a lot of vertical pressing movements with my clients, as the risk of injury to the shoulder girdle and neck are way too high for most of them. If I’m trying to get someone’s rotator cuff to settle down and get stronger, AND they present with thoracic kyphosis and anterior cervical positioning, there’s no way in hell they’re going to be lifting their arms overhead, unless they are stretching against a wall.
That being said, to prevent injuries while still being able to perform some overhead movements, I try to avoid performing any type of concentric/eccentric action, but will allow some people to do a snatch movement, as it doesn’t allow the deltoid to compete with the rotator cuff for force distribution, and allows the humerus to move a little more freely through the range of motion. As the arm starts hanging low with a high degree of rotator cuff involvement for stabilization, and as the power comes from the hips and legs with the arms guiding the movement, I would rather do this than a pressing movement. The 180 twist in the following video is just for show, so enjoy it.
vertical pull: No question, narrow grip pull-ups are king, but for those who can’t lift body weight, a lat pulldown will work well. On top of this, dumbbell rows, with a heavy emphasis on proper scapular mechanics in the row, trying to ensure the shoulder blade slides along the ribs towards the opposite back pocket. Additionally, bicep curls are fantastic. One feature I like about them, aside from making the person look like they have lifted a weight in their life, is that it promotes scapular positioning when done right, and also provides a degree of anterior glenohumeral stability, as the long head of the biceps attaches above the joint at the coracoids process.
sagittal core: I don’t mind crunches, when they are done with regard to the specific clients needs. I’m not going to get a client with disc issues performing them, but in many instances I will get a client with weak core muscles to perform crunch variations in order to build the strength of the rectus specifically. In any instances, we have to isolate to be able to integrate, especially in cases of injury or mechanical pathology. Dr. Stuart McGill gives a great variation in his book Low Back Disorders, and I use it quite a bit. Active leg raises with spinal stability, and TRX straight arm extensions are probably two of the best sagittal core movements you can do.
lateral/rotary core: I try to do more rotational stability or anti-rotational work, especially as most of my clients have some form of spinal issue and rotation can increase the shear force on the spine and discs. That being said, some anti-rotation exercises are a cable 1-arm fly:
Stability ball stir the pot:
I call this one a reverse screaming eagle, because that seems to be the noise that comes out of most people when they do it on the first go. Just ignore Pete in the background yelling “plank” like Matt Damon from Team America World Police:
7. Thanks for the interview Dean! Where can my readers go to follow you?
I write a fantastic almost-daily blog about all things fitness, and a few things loosely related, at www.deansomerset.com. On top of that, you can add me on Facebook to see what else I’m talking about. Additionally, if you’re ever in Edmonton, give me a shout and we can train or talk shop. My email is email@example.com if anyone has anything specific they want to talk about.
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