Strength | Exercise Tool Kit

Case Study: General Strength Improvement

Posted on 07.30.14

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This is a brief review of a general strength training case.

History

The trainee is an apparently healthy 20 year old male Kinesiology intern, with several years of strength-training experience. His strength has been at a plateau for at least 12 months and he would like to improve general strength and gain body weight. He mentioned an uneven barbell path during the bench press and would like to correct this.

The trainee does not report any significant life stressors and does not anticipate high levels of stress or obstacles that would interfere with training over the next eight weeks. He will be able to train with a partner of somewhat comparable strength.

The trainee has high motivation to train and is confident using free weights. He has had success with pre-workout supplements (caffeine) in the past and is willing to get “adequate” sleep and eat a caloric surplus. Although he participates in intra-mural basketball, he does not care much if his performance or vertical jump improves. Basketball will not begin for another five to six weeks from the start of the program.

Examination

Max Strength Testing (Post)

Height/Weight
6’1″ 165 lbs.

Maximal Strength
Bench Press – 215 lbs. for a 1 repetition maximum (1RM)
Parallel Squat – 225 lbs. for a 3 RM / Estimated 1 RM 240 lbs.
Deadlift – 275lbs. for a 3 RM / Estimated 1 RM 290 lbs.

Uneven barbell path during the bench press noted.

Peak Power Estimated From Vertical Jump
Vertical Jump – 20.5″
Peak Power (PP) – 4,644.7 watts (W)
Peak Power estimate based on vertical jump and body weight (Amonette et al.)

Evaluation

The trainee’s strength levels are intermediate, with the bench press being his most dominant lift. We reviewed his previous training program and mutually agreed that the training volume was excessive and there was too much emphasis on accessory lifts.

Decreasing volume and emphasizing compound lifts such as the squat and deadlift will help contribute to improved maximal strength. Taking an evidence-based approach to his strength training will help maximize his gains. An evidence-based approach considers the trainees preferences and experience, my expertise, and the best available research evidence.

Prognosticating strength improvements can be challenging due to the many variables, and we agreed it was best he did not know my opinion. If I had underestimated his potential, and he knew of my expectations, it might have had a negative effect on his outcome. I was confident he would have a good overall outcome, a sentiment I expressed.

Intervention

The program was to last seven weeks, but was completed over eight weeks, as he needed a week off after the first two weeks due to a vacation. The first four weeks was focused on hypertrophy, and leaned toward strength over the last three weeks. The principles used to structure the program are described in the hypertrophy and strength-training articles on this site.

Training primarily consisted of barbell and dumbbell workouts, which were performed five days a week (Monday through Friday), with weekends off. Each bodypart was trained twice a week. It was decided to include specific accessory exercises to help correct bar path deviations during the bench press.

We reviewed the nutrition and supplementation guidelines for strength athletes. He decided to supplement his program with creatine and a pre-workout drink with caffeine as an active ingredient. We said caution should be exercised in taking supplements, as an amphetamine analogue had recently been identified in a popular pre-workout supplement.

Outcome

Height/Weight
6’1″ 183 lbs.

Maximal Strength
Bench Press – 240# for a 1RM
Parallel Squat – 275# for a 3 RM / Estimated 1 RM 290#
Deadlift – 340# for a 3 RM / Estimated 1 RM 360#

Peak Power Estimated From Vertical Jump
Vertical Jump – 24″
Peak Power – 5,574.7 W

Discussion

The trainee was pleased with the results. I was particularly impressed with the improvements in bodyweight, deadlift, vertical jump, and PP. The vertical jump was not specifically trained for, but there was a meaningful improvement, even with a significant body weight increase. I attribute much of the body weight improvement to potential water retention from the creatine supplementation and glycogen retention from surplus eating. It is reasonable to assume some increase in size was due to increased contractile tissue as well. We did not assess body fat but it appeared he gained little, if any, fat mass relative to fat-free mass. I anticipate further improvement if he follows the same program or a similar one for another seven weeks after a week of recovery.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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Disclaimer: The views discussed on this website are for educational purposes only. Should you have any questions please consult your physician or physical therapist. Copyright© Kinesis Physical Therapy. All Rights Reserved.

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Resistance Training Periodization: An Introduction

Posted on 07.5.14

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Resistance training programs are often undertaken to maintain or improve physical strength. Strength can be built by systematically increasing stress on the body through exercise.¹This is termed progressive overload and can be accomplished by manipulating several training variables. These include:

Intensity (load)- The load that is lifted may be expressed as the percentage of a 1 repetition maximum or as a unit such as pounds/kilograms.
Repetitions- The number of repetitions (reps) of a given load may be increased to provide progressively greater stress on the body. The repetition speed and tempo may also be manipulated, depending on the trainee’s goals, e.g., maximum strength, hypertrophy, or power.
Rest intervals- Rest periods between sets may be manipulated, depending on the desired outcome. Shorter rest periods may help increase the metabolic stress associated with hypertrophy and longer rest periods may be ideal for improvements in strength/power.
Volume- The amount or volume of work done can also be increased or decreased gradually. Volume is represented by the product of the sets, reps and weight lifted. For example, 3 sets x 8 reps of 225# would represent less volume than 2 sets x 8 reps of 225#.

Periodization

Periodization is the “systematic process of altering one or more program variable(s) over time to allow for the training stimulus to remain challenging and effective.”¹

Stress

The concept of periodization is influenced by the idea that the human body adapts to stress. In theory, once the body adapts to a training variable, progress slows or stops. To ensure progress there must be changes to one or more of the program variable(s).

What is the evidence for this style of training in practice? The training literature suggests that periodized strength and power programs are more effective than non-periodized programs.²

Models of Periodization

Increasing weight when the load becomes “easy” for a set number of reps often provides enough progressive overload to allow for strength improvement in the beginner. Strength gains may continue for up to six months without a formal periodized plan. Once strength reaches a plateau it is advisable to convert to a more formal periodized plan to progress. The following are three models of strength training periodization.

Classical Periodization- This model traditionally starts with high volume and low intensity and gradually progresses over weeks or months to lower volume and higher intensity. As an example: If the goal is to increase maximum strength of the bench press, the trainee may start a program with a greater number of pressing exercises, lower relative load, and higher repetitions (8-12). Over the course of several months the trainee may decrease the number of pressing exercises and, repetitions and increase load. This would allow the trainee to peak for a 1-repetition maximum in the bench press.

Reverse Periodization- The classical model is simply reversed. Higher intensity, lower volume workouts are progressed over time to higher volume, lower intensity workouts. This is a useful method for improving endurance strength.³

Undulating Periodization- This model of periodization allows for variation in load and volume throughout the training cycle. During a single week, load and volume may be increased or decreased, depending on goals. In a classical model, several weeks may be devoted to a specific strength quality, while in this model various strength qualities may be targeted in as short a time as a single week. The idea is that this style of training will maintain and contribute to a greater overall performance of multiple strength qualities.

To effectively create a periodized program it is important to understand how variables such as intensity and volume relate to:

It is not unusual for a periodized program to progress from phases of hypertrophy to strength and finally to a more specific strength quality such as reactive strength.

Bottom Line

A beginner can improve strength by progressively increasing load. When progress begins to stall and variables other than load need to be manipulated, programs that include periodization offer value.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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References

1.American College of Sports Medicine. “American College of Sports Medicine position stand. Progression models in resistance training for healthy adults.Medicine and science in sports and exercise” 41.3 (2009): 687.
2. Rhea, Matthew R., and Brandon L. Alderman. “A meta-analysis of periodized versus nonperiodized strength and power training programs.” Research quarterly for exercise and sport 75.4 (2004): 413-422.
3. RHEA, MATTHEW R., et al. “A comparison of linear and daily undulating periodized programs with equated volume and intensity for local muscular endurance.” The Journal of Strength & Conditioning Research 17.1 (2003): 82-87.

Soccer: Strength Expectations

Posted on 01.3.14

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To be competitive in a sport such as soccer, the management of a number of fitness qualities is almost a necessity. One of these qualities is physical strength. Adequate strength serves as a foundation for injury prevention, and when developed results in improved markers of athletic performance. Some of the improved markers of performance gained through strength training include: ^1,2

Improved Sprint Performance
Increased Vertical Jump Height
Improved Change of Direction

These are a few of the reasons that many soccer players wisely employ strength training.

Strength development takes time and is typically worked into a long term training plan. If the athlete is aiming to compete at a high level the physical strength that elite players possess may be reasonable long term goals.

What are reasonable strength expectations for high level soccer?

Calculations to determine reasonable strength expectations of elite adult male and female soccer players have been proposed.³The following are the results of calculations for men weighing between 140-200 pounds and women between 100 and 180 pounds. The women’s calculations are less specific.

Bench Press and Squat Expectations for Men:

Body weight: 140 lbs. Bench Press: 195 lbs. Squat: 390 lbs.
Body weight: 150 lbs. Bench Press: 205 lbs. Squat: 410 lbs.
Body weight: 160 lbs Bench Press: 215 lbs. Squat: 430 lbs.
Body weight: 170 lbs. Bench Press: 220 lbs. Squat: 445 lbs.
Body weight: 180 lbs. Bench Press: 230 lbs. Squat: 460 lbs.
Body weight: 190 lbs. Bench Press: 240 lbs. Squat: 480 lbs
Body weight: 200 lbs. Bench Press: 250 lbs. Squat: 495 lbs

Bench Press and Squat Expectations for Women:

Body weight: 100 lbs. Bench Press: 70-85 lbs. Squat: 165-240 lbs.
Body weight: 110 lbs. Bench Press: 70-85 lbs. Squat: 175-255 lbs.
Body weight: 120 lbs. Bench Press: 75-95 lbs. Squat: 185-270 lbs.
Body weight: 130 lbs. Bench Press: 80-100 lbs. Squat: 196-284 lbs.
Body weight: 140 lbs. Bench Press: 85-105 lbs. Squat: 207-300 lbs.
Body weight: 150 lbs. Bench Press: 90-110 lbs. Squat: 215-313 lbs.
Body weight: 160 lbs. Bench Press: 95-115 lbs. Squat: 225-325 lbs.
Body weight: 170 lbs. Bench Press: 95-120 lbs. Squat: 235-340 lbs.
Body weight: 180 lbs. Bench Press: 100-125 lbs. Squat: 244-355 lbs

The values given for the squat are for the half squat. For details on the depth of the half squat please see: The Squat: An Introduction.

Bottom Line

Strength training for Soccer may be useful for improving performance. Strength expectations of high level soccer players may serve as good long term strength goals for competitive players.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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References

1. Wisløff, U., et al. “Strong correlation of maximal squat strength with sprint performance and vertical jump height in elite soccer players.” British journal of sports medicine 38.3 (2004): 285-288.The
2. Keiner, M., et al. “Long term strength training effects on change-of-direction sprint performance.” Journal of strength and conditioning research/National Strength & Conditioning Association (2013).
3. Stølen, Tomas, et al. “Physiology of soccer.” Sports medicine 35.6 (2005): 501-536.

Strength Qualities

Posted on 11.6.13

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Intelligently designed programs based on traditional strength and power training result in improved markers of performance. However, there are more specific pieces to the strength puzzle, and in many cases more decisions to be made. Performance gains may be further enhanced by purposefully addressing specific qualities of strength, particularly in more advanced athletes.

Strength Qualities

The strength qualities described in this article are specific to performance requiring one to a few maximum efforts. Example are, the shot put, long jump and individual portions of activities that last longer, such as the sprint.

While there are other strength qualities and different ways of describing them, we intend to focus on the six measurable qualities described by Newton and Dugen.¹I believe that considering these six strength variables enhances program design. Although higher-level athletes tend be ideal for program design involving specific strength qualities, this does not mean the rehabilitation patient confined to a wheelchair cannot also benefit.

1. Maximum Strength- This is the maximum amount of force that can be generated during a relatively “slow” voluntary muscular contraction. Think of traditional resistance training. Typically high levels of force are generated but not a great deal of speed. A 1-repetition maximum (RM) in the deadlift, squat or bench press would be a display of maximal strength.

This is important because we know maximum strength is associated with markers of athletic performance.

As an example, in the recreational athlete ~23% change in squat 1 RM results in a significant increase in sprint time.²This association between improvement in squat strength 1 RM and sprint performance indicates that maximum strength may be an important quality in recreational athletes.

Decision Making: If a recreational athlete wishes to increase sprint speed, then working to improve maximum strength may be of benefit.

2. High-Load Speed-Strength- High-load speed-strength is the highest force that can be produced as quickly as possibly using relatively heavy loads (>30% of maximum effort). A perfect example would be a javelin thrower performing 30%to 100% of their 1 RM in the power clean. The power clean is a good representation of high-load speed strength as it can be loaded up to 100% of the athlete’s 1 RM.

Kari Ihalainen who is the national Korean javelin coach, compiled data of strength norms among varying levels of javelin throwers. His data demonstrate that an increase in the power clean 1 RM among other lifts is associated with a distance improvement in the javelin throw. Women who power clean ~ 130 pounds tend to throw ~ 130 feet and those that clean ~250 pounds tend to throw ~ 240 feet.³This association seems to indicate that high-load speed-strength is an important attribute for javelin throwers to develop.

Decision Making: Based on data of strength norms among female javelin throwers, greater levels of high-load speed-strength (among other strength qualities) seem to be associated with increased javelin throw distance. If a national-level javelin thrower’s power clean is relatively weak, perhaps improving this high-load speed strength lift will result in improved performance.

3. Low-Load Speed Strength- Low-load speed strength is the highest force that can be produced as quickly as possible using relatively light loads (<30% of maximum effort). The shot put event is a demonstration of low-load speed strength. Putting a shot of varying weights or performing light bench press throws are options to improve low-load speed strength in the upper body.

Decision Making: If distance in the shot put continues to improve with implement training and low-load speed strength exercises, then that athlete should probably continue focusing on training this strength quality. If shot distance is plateauing, then the athlete will likely need to look closely at other strength qualities that may have weak points such as maximal strength.

4. Rate of Force Development (RFD)- This is the development of maximal force in minimal time.⁵ Think of muscular force that is generated during the initiation of a movement (0-200ms).⁴The more rapidly force increases, the quicker you will be able to get out of a chair or lift an object or your body from the ground.

There is a correlation between vertical jump performance and RFD.⁵A high jumper working on increasing vertical jump height might want to work on training that improves RFD. This type of training may involve heavy explosive strength training and cueing to lift “fast”.^6,7

Decision Making: A high jumper looking to increase RFD may want to focus on heavy explosive weight training. This means weights >85% of 1 RM ~ 5 repetition sets and longer rest periods. Repetitions would be performed fast.

High jumpers tend to be rather slender. The jumper must be mindful not to add unnecessary muscle size. In theory, training with low repetitions in an explosive manner should not create excessive hypertrophy in most people.

5. Reactive Strength- The ability to change direction from a lengthening muscle contraction (eccentric) to a rapid shortening muscle contraction (concentric). Reactive strength is important for sports such as basketball that requires players to change direction often.

A good way to generically assess reactive strength of the lower body would be to compare vertical jump performance to the depth jump. Somebody with reasonably good reactive strength should have a depth jump that is higher than his or her vertical jump.¹Be mindful that the depth jump is not appropriate for everyone and a coach or exercise professional should be consulted to determine if it if suitable for the individual.

Decision Making: If the depth jump is not higher than the vertical jump then reactive strength may be lacking. Plyometric exercise including the depth jump may be helpful for improving reactive strength.

6. Skill Performance- This is the ability of the motor control system to put together the other five strength qualities, and it can be assessed by actually performing the skill e.g. shot-put/high jump.

Decision Making: Analyze skill performance and attempt to distinguish which strength quality may need fine tuning to improve performance.

Bottom Line
There is more to performance preparation than just generic strength and power training. Strength qualities such as the six described in this article can be important for improving performance of activities requiring one or a few maximum efforts.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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References

1. Newton, Robert U., and Eric Dugan. “Application of strength diagnosis.”Strength & Conditioning Journal 24.5 (2002): 50-59.4. McBride, Jeffrey M., et al. “Relationship between maximal squat strength and five, ten, and forty yard sprint times.” The Journal of Strength & Conditioning Research 23.6 (2009): 1633-1636.
2.Cronin, John, et al. “Does Increasing Maximal Strength Improve Sprint Running Performance?.” Strength & Conditioning Journal 29.3 (2007): 86-95.-95.
3. http://www.speerschule.ch/docs/doc_ihal-tabellen.pdf (accessed 11/06/2013)
4.Aagaard, Per, et al. “Increased rate of force development and neural drive of human skeletal muscle following resistance training.” Journal of applied physiology 93.4 (2002): 1318-1326.7. McLellan, Christopher P., Dale I. Lovell, and
5.Gregory C. Gass. “The role of rate of force development on vertical jump performance.” The Journal of Strength & Conditioning Research 25.2 (2011): 379-385.5. Sahaly, R., et al.
6.”Maximal voluntary force and rate of force development in humans–importance of instruction.” European journal of applied physiology85.3-4 (2001): 345-350.
7. Heggelund, Jørn, et al. “Maximal strength training improves work economy, rate of force development and maximal strength more than conventional strength training.” European journal of applied physiology (2013): 1-9.

Strength Training (An Introduction)

Posted on 09.14.13

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We all need to be strong enough to optimize the performance of activities we enjoy. The level of strength an individual requires can vary widely, from lifting groceries to dunking a basketball. The focus of this article is not to review the health benefits of strength training but to introduce the reader to strength training as it relates to performance. So, what can be expected from a strength-training program?

An appropriately designed strength training program can result in: ^1,2

Improved strength, power, speed, acceleration, and running economy (how efficiently a runner utilizes resources such as, oxygen)
Increased vertical jump height
Muscular hypertrophy (increased muscle size)

How Do We Get Stronger?

When our bodies are subjected to sufficient amounts of resistance, they will adapt and become stronger. During the initial phases of a strength program, gains are due primarily to the nervous system becoming more efficient.³ Our nervous system gets better at activating muscle fibers that need to be called upon and decreasing the activation of muscle fibers that hinder the desired movement. This results in a net improvement in strength.

When starting a strength-training program we also get better at performing strength movements. Practicing movements such as the squat allows us to learn how to detect where the body is in space and to exploit the best biomechanical positions that allow the best expression of strength.³Learning how to optimize the performance of strength movements allows us to lift more.

Aside from the initial neurological adaptations that are expected from weight training, we eventually begin to realize hypertrophic changes of the muscles. As the size of the muscle increases, the ability to produce muscle force also increases.⁴

Frequency

Evidence suggests that the best way for a beginner to increase strength is to train each major muscle group 3x’s a week.⁵When deciding on training frequency it is important to keep in mind that each exercise session can affect the subsequent session.

Optimal training frequency can vary depending on the individual’s ability to recover and factors such as volume and intensity of training sessions. After working a major muscle group, we recommend 48 to 72 hours of recovery before working that muscle group again. Support for waiting at least 48 hours has been demonstrated in a study of novice female resistance trainers who had not fully recovered (94%) their lower body strength two days after a lower body workout.⁶

In the case of the advanced trainee/athlete evidence suggests that training up to 6x’s a week is acceptable but training each major muscle group only 2x’s a week seems to result in the greatest strength gains ⁷. Training each major muscle group 2x’s a week over 6 sessions is possible when employing a split routine e.g. arms trained on one day, chest on another etc..

Intensity

Training with as little as 60% of a 1 repetition max (1RM) or ~15 repetitions is sufficient to maximize strength gains in the beginner.^4,5,7Performing 8-12 repetitions when 15 could be performed may be recommended. The beginner would perform an “easy” 8-12 repetitions for his or her sets.

In order to maximize strength in more advanced trainees utilizing 85% of 1- repetition max (1RM) or 5-6 repetitions is advisable.⁷While these repetition ranges seem to optimize strength gains, a variety of rep ranges may need to be used to maximize strength.

Sets

For beginners, the optimal number of sets during a training session seems to be 4 per muscle group and up to 8 for advanced trainees.^5,7Be mindful that the untrained individual may time to adapt to multiple set training, and much of the benefit from the sets and reps may be from learning the strength movements.

Exercise Selection

Both multi-joint and single-joint exercises are effective for gaining strength. Multi-joint exercises such as the squat, bench press and deadlift are generally regarded as the best choices for overall strength.⁶Single-joint exercises such as the knee extension are also effective strength builders, as are cables, bands, and other strength-training accessories.

Rest Interval

When developing strength, rest intervals of 3-5 minutes allow for less performance decrements than shorter rest intervals.⁶In theory, this would allow the resistance trainer the ability to handle heavier weights during subsequent sets, resulting in greater strength gains.

Muscular Failure

Training to muscular failure is training to a point at which the strength trainer is no longer able to lift a load. As an example, an individual may be able to lift five reps but can’t get the sixth, and a spotter must help. This type of training is probably good to use in moderation. When training to failure, more muscle fibers may be stimulated, leading to greater strength gains.

Repetition Speed

Moderate to slow repetition speed is recommended; however, as the strength trainer becomes more advanced a variety of speeds may be utilized.⁴

Repetition speed should be dependent on the individual’s. When working on a strength quality such as speed-strength (power,fast strength) repetition speed would be faster.

Example of a Beginner Workout

Bench Press 2-4 x 8-12 repetitions (controlled rep speed)
Deadlift 2-4 x 8-12 repetitions (controlled rep speed)
Back Squat 2-4 x 8-12 repetitions (controlled rep speed)

Example of an Advanced Split Routine Workout (Chest Focus)

Incline Bench Press 2×5 repetition max
Weighted Dip Machine 2×5 repetition max
Bench Press 2×5 repetition max

Certain aspects of a strength program will need to be manipulated to maximize strength. Aspects of manipulating volume/intensity are touched on in an introduction to periodization.

How to use this Information

Strength building is important for those wishing to improve performance for a wide variety of activities. The information presented is meant to outline aspects of a basic strength training program. There are many training variables that can be manipulated, depending on the individual’s goals. Strength training complements and overlaps both hypertrophy training and power-training styles.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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References

1. McGuigan, Michael R., Glenn A. Wright, and Steven J. Fleck. “Strength training for athletes: does it really help sports performance?.” International journal of sports physiology and performance 7.1 (2012): 2.
2. Paavolainen, Leena, et al. “Explosive-strength training improves 5-km running time by improving running economy and muscle power.” Journal of Applied Physiology 86.5 (1999): 1527-1533.
3.Haug, William B. “Predictors in Strength Gains in Untrained Men Over 9 Months of Training.” (2011).
4.”American College of Sports Medicine position stand. Progression models in resistance training for healthy adults.” Medicine & Science in Sports & Exercise. 41(3):687-708, March 2009.
5. Rhea, Matthew R., et al. “A meta-analysis to determine the dose response for strength development.” Medicine and science in sports and exercise 35.3 (2003): 456-464.3.
6. Kraemer, WILLIAM J., and NICHOLAS A. Ratamess. “Fundamentals of resistance training: progression and exercise prescription.” Medicine and science in sports and exercise 36.4 (2004): 674-688.
7. Peterson, Mark D., Matthew R. Rhea, and Brent A. Alvar. “Maximizing strength development in athletes: a meta-analysis to determine the dose-response relationship.” The Journal of Strength & Conditioning Research 18.2 (2004): 377-382.

Romanian Deadlift

Posted on 09.1.13

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The Romanian deadlift (RDL) may be a useful exercise for strengthening and developing the gluteal muscles and hamstrings.¹This exercise is specific to maximal speed sprinting and useful as an accessory lift to the traditional deadlift and squat.²The RDL is a hip hinging exercise, and I have found it useful for the rehabilitation of a variety of injuries.

How to Perform

Stand with a barbell held at arm’s length in front of the body.
Feet should be approximately hip width apart and feet facing forward or slightly toed out
Hinge at the hip while maintaining the natural curve in the lumbar spine. As an internal cue think of pushing the buttocks toward the wall behind you.
There should be a slight bend in the knees during the lift.
The hamstrings limit the range of motion of this exercise.
When the end range has been reached, return to the starting position by contracting the glutes and hamstrings.

Romanian Deadlift Start

Romanian Deadlift End

Application of This Exercise

Cosmetic – The RDL is useful for developing the hamstrings and glutes.

Performance – If progressive resistance is used, this may translate into improvements in the performance of activities involving hip extensions, such as sprinting or jumping.

Make sure you are able to hinge properly at the hip before adding resistance. Most experienced trainees tend to handle fairly heavy weights.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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References

1. Fisher, James, Stewart Bruce-Low, and Dave Smith. “A randomized trial to consider the effect of romanian deadlift exercise on the development of lumbar extension strength.” Physical Therapy in Sport (2012).
2. Young, Warren, Dean Benton, and MHSci John Pryor. “Resistance training for short sprints and maximum-speed sprints.” Strength & Conditioning Journal23.2 (2001): 7.

Hip Hinge

Posted on 08.31.13

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Bending or lifting with a rounded low back can be unsafe, particularly when lifting heavy weights. In order to keep the spine in a neutral position when picking up an object or pulling a weight from the ground there must be some level of hinging at the hips. Keeping the hips bent, while maintaining a relatively neutral spine, is referred to as a hip hinge.

Why is the Hip Hinge Important?

Hinging at the hips while maintaining a neutral spine (as opposed to a flexed posture) helps to decrease stress on the discs and ligaments of the spine.¹Hip hinging is integral to performing many exercises including the the following:

It can also be employed during simple tasks such as picking up and re-racking weights.

How to Perform

To ensure that you are carrying out this exercise correctly, you will need a rod. To perform the hip hinge:

Start with feet shoulder width apart
The rod should be held in contact with your sacrum, between your shoulder blades and the back of the head
Initiate a bend at the hips pushing hips toward the wall behind you
End when you feel a slight pull in the back of the thighs or begin to break at the knees

Hip Hinge (Start)

Hip Hinge (Finish)

Bottom Line

This is a basic movement that should be second nature to anyone using free weights. There is also real-world application when performing activities such as lifting from the ground or rising from a chair.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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Reference

1. McGill, Stuart M. “Low back exercises: evidence for improving exercise regimens.” Physical Therapy 78.7 (1998): 754-765.

Hip Hinge

Posted on 08.31.13

Why is the Hip Hinge Important?

It can also be employed during simple tasks such as picking up and re-racking weights.

How to Perform

To ensure that you are carrying out this exercise correctly, you will need a rod. To perform the hip hinge:

Start with feet shoulder width apart
The rod should be held in contact with your sacrum, between your shoulder blades and the back of the head
Initiate a bend at the hips pushing hips toward the wall behind you
End when you feel a slight pull in the back of the thighs or begin to break at the knees

Hip Hinge (Start)

Hip Hinge (Finish)

Bottom Line

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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Reference

1. McGill, Stuart M. “Low back exercises: evidence for improving exercise regimens.” Physical Therapy 78.7 (1998): 754-765.

The Squat: An Introduction

Posted on 07.1.13

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The squat is integral in many exercise programs focusing on health, rehabilitation, injury prevention, and performance. So why is this exercise valuable?

Benefits of the Squat

Strengthens and builds the muscles of the ankle, knee, hip, and “core” (with enough resistance as many as 200 muscles may be strengthened).¹Use at least 50% of your maximum squat to strengthen your core effectively.^²
Improves mobility/flexibility (see Deep Squat)
May help improve vertical jump (stronger athletes tend to jump higher).^3,4,5
Improves sprint speed. In recreational athletes, a 23% increase in squat strength may significantly improve sprint time. ^{^3,6}
May contribute to improved running economy.^⁷Running economy is how efficiently a runner utilizes resources, i.e., oxygen.
May improve bone density when sufficient resistance is applied (see Health Benefits of Strength Training). In 2000, a study was published that assessed the bone density of the then current world record holder in the squat. This athlete demonstrated the highest known bone density at the time.⁸
Directly specific to many of our daily activities (e.g., getting out of a chair or lifting an object from the ground).
Squatting properly is a basic prerequisite for many ACL prevention programs and integral in the rehabilitation of ACL and patellofemoral injuries.^9,10
Useful for combating the effects of knee arthritis.¹¹

Learning the Squat

It may take minutes to learn a bodyweight squat and in some cases weeks to properly learn a barbell back squat. It is not uncommon to have to work through flexibility issues, and in some cases strength deficits before performing the exercise optimally. Barriers to some common performance problems will be addressed in another article.

There are many variations of the squat. My intention is to focus on introducing the reader to the traditional bodyweight squat and barbell back squat.

The Hip Hinge

In my experience, untrained individuals tend to initiate the squat at the knees. This may create a scenario in which the thigh muscles increase in activity while the muscles of the hips are not “optimally” engaged.¹²

Squat Initiated at the Knees

In most instances, the hip should break slightly before the knees. If there is difficulty initiating the movement at the hips, practicing the hip hinge may be helpful.

To perform the hip hinge:

Start with feet shoulder width apart
A rod should be held in contact with the sacrum, between the shoulder blades and the back of the head
Initiate a bend at the hips pushing the hips back
End when you feel a slight pull at the back of the thighs or begin to break at the knees

Hip Hinge (Start)

Hip Hinge (Finish)

Traditional Squat (Body Weight)

Downward Phase

Stand with feet parallel
Feet should be approximately shoulder width apart or wider, with toes pointing out slightly
Chest is held up and out
Gaze should be forward or slightly up while performing the squat
Arms should be held at chest level
“Sit Back” on heels while initiating a hip hinge and breaking at the knees
Knees should track in line with the toes
Squat to desired depth, ensuring that the natural curve in the lower back is maintained

Upward Phase

Straighten hips and knees at the same rate, while keeping heels on the floor
Keep the natural curve of the back. Think of how the back is held during the hip hinge.

Squat Depth

Language on squat depth is not standardized. Weight training magazines, the Internet, peer-reviewed journals, and gym goers all seem to use a variety of different terminology when talking about squat depth. For the purpose of this article:

Partial squat = approximately 45-degree angle at the knee
Half squat = approximately 90 to 100-degree angle at the knee
Deep Squat = greater than a 100-degree knee angle (A squat with the thighs parallel to the floor is considered a deep squat as the knee angle is >100 degrees).

Partial Squat (~45-degree)

Half Squat (~90-degree) This is slightly shallower than 90 degrees

Deep Squat

Regarding sport – Depth will likely change, depending on where the athlete is in their training cycle, but most athletes will benefit from focusing primarily on the deep squat.

Regarding pathology – Those with posterior cruciate ligament (PCL) injuries may need to restrict themselves to partial squats (<60 degrees) to decrease excessive posterior shear force.¹The greater the knee angle during squatting, the more compressive forces are placed on the meniscus and articular cartilage of the knee.¹Someone with an ACL injury may not be off the hook as the meniscus is often damaged along with the ACL. In many cases it is advisable that squatters dealing with a knee pathology limit themselves to a half or partial squat.

Regarding those with healthy knees – For those with healthy knees the optimal squat depth to minimize the risk of injury and ensure maximum activation of the leg muscles has been proposed to be the deep squat (115 to 125 degree knee angle).¹²

Squat depth should be individualized, even in those who are healthy, based on factors such as the individual’s goals and physical status (e.g., flexibility,coordination).

Aesthetics – This is an effective exercise for developing the lower body. If the idea is to develop the glutes then a deeper squat may be optimal for reaching this goal.¹³

Barbell Back Squat

In order to gain optimal benefit from the squat, weight must be added. The barbell is a convenient way to do this and is commonly placed in the high or low bar position:

High Bar position – The barbell sits at the base of the neck on a “shelf” created by the contracted upper trapezius
Low Bar Position – The bar sits on a “shelf” created by the contraction of the upper/middle trapezius and posterior shoulder.

High Bar

Low Bar

Styles of the Barbell Back Squat

Traditionally the squat is performed in a fairly upright position; however, in powerlifting a more angled torso is common. The powerlifting squat typically utilizes a low bar position, and the traditional squat tends toward the high bar position.

Traditional

Powerlifting

Considerations – When comparing squat styles, the more traditional upright squat is associated with more stress on the knees, while the powerlifting squat creates more stress at the hips.¹⁴A tremendous amount of stress is placed on the spine during the heavy back squat. In order to minimize stress on the lumbar spine it is important to keep a natural lumbar curve during the entire movement.¹

What if Hip or Groin Pain is Experienced?

Get the source of pain diagnosed by your physician. If the hip joint is the problem (e.g., labral tear, impingement, arthritis) consult with your physician or physical therapist to determine if the squat is an appropriate exercise.

Bottom Line

The squat is an unbelievably useful tool for almost anyone wanting to improve themselves physically. The exercise needs to be individualized. It is best to consult with your physical therapist so he or she can consider your individual mobility, strength, medical history, and goals.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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References

1. Schoenfeld, Brad J. “Squatting kinematics and kinetics and their application to exercise performance.” The Journal of Strength & Conditioning Research 24.12 (2010): 3497-3506.
2. Clark, Dave R., Mike I. Lambert, and Angus M. Hunter. “Muscle activation in the loaded free barbell squat: A brief review.” The Journal of Strength & Conditioning Research 26.4 (2012): 1169.
3. Wisløff, U., et al. “Strong correlation of maximal squat strength with sprint performance and vertical jump height in elite soccer players.” British journal of sports medicine 38.3 (2004): 285-288.
4. Baker, Daniel. “Improving vertical jump performance through general, special, and specific strength training: A brief review.” The Journal of Strength & Conditioning Research 10.2 (1996): 131-136.
5. Kraska, Jenna M., et al. “Relationship between strength characteristics and unweighted and weighted vertical jump height.” Int J Sports Physiol Performance 4 (2009): 461-73.
6. Cronin, John, et al. “Does Increasing Maximal Strength Improve Sprint Running Performance?.” Strength & Conditioning Journal 29.3 (2007): 86-95.
7. Millet, GREGOIRE P., et al. “Effects of concurrent endurance and strength training on running economy and VO~ 2 kinetics.” Medicine and science in sports and exercise 34.8 (2002): 1351-1359.
8. Dickerman, R. D., R. Pertusi, and G. H. Smith. “The upper range of lumbar spine bone mineral density? An examination of the current world record holder in the squat lift.” International journal of sports medicine 21.07 (2000): 469-470.
9. Gagnier, Joel J., Hal Morgenstern, and Laura Chess. “Interventions Designed to Prevent Anterior Cruciate Ligament Injuries in Adolescents and Adults A Systematic Review and Meta-analysis.” The American Journal of Sports Medicine (2012).
10. Kibler, W. Ben, and Beven Livingston. “Closed-chain rehabilitation for upper and lower extremities.” Journal of the American Academy of Orthopaedic Surgeons 9.6 (2001): 412-421.
11. Deyle, Gail D., et al. “Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program.”Physical therapy 85.12 (2005): 1301-1317.
12. Comfort, Paul, and Peter Kasim. “Optimizing squat technique.” Strength & Conditioning Journal 29.6 (2007): 10.
13. Caterisano, Anthony, et al. “The effect of back squat depth on the EMG activity of 4 superficial hip and thigh muscles.” The Journal of Strength & Conditioning Research 16.3 (2002): 428-432.
14. Fry, Andrew C., J. Chadwick Smith, and Brian K. Schilling. “Effect of knee position on hip and knee torques during the barbell squat.” The Journal of Strength & Conditioning Research 17.4 (2003): 629-633.

Distance Running & Strength Training

Posted on 04.28.13

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Many people prepare to run 5km for health, while others prepare in earnest to win marathons. Many programs have been designed to train for these events. These programs naturally include running, but often a strength training component is missing. My intention is to persuade runners to consider incorporating strength training into their program to realize health or performance benefits.

Why Resistance Training is Important to Distance Runners

Running Economy – With all things being equal those with good running economy use less energy and less oxygen than those with poor running economy. The runner who requires less oxygen will perceive running to be easier and will be able to run at a faster pace before feeling fatigue. Even small improvements in running economy can have profound effects on performance.^1,2Strength training is an effective way to improve running economy.

Supporting Literature
Storin et al. (2008)³found that in well-trained distance runners, an 8% increase in running economy occurred following a period of resistance training.

Johnson et al. (1997)⁴demonstrated that female runners who had been strength trained had improved running economy significantly more than a control group (running only) that had not.

Paavlainen et al.(1999)⁵determined that explosive strength training (plyometrics) was associated with improvements in running economy.

Millet et al. (2002)⁶found that in a group of well-trained triathletes a strength training program resulted in improved running economy.

Improved Race Times
If strength and explosive strength training have the potential to make running feel easier, then there should be evidence supporting improved race times.

Supporting Literature
Paavlainen et al. (1999)⁵found that not only did running economy improve with explosive strength training, but 5km time improved significantly in a resistance training group of experienced athletes. This makes the results that much more remarkable, as more experienced athletes can have difficulty experiencing meaningful improvements.

Spurrs et al. (2003)⁷showed significant improvements in 3km running times with the addition of explosive strength training (jump training/plyometrics).

Applying This Information

Health
If you are running to improve or maintain health, consider performing basic resistance training along with your distance work. This would involve training all the major muscle groups 2-3x’s a week, performing 2-4 sets per exercise, and 8-12 repetitions per set. This will at least help you expereince the health benefits of resistance training as a runner, and will likely also help your performance. You might need to cut back on mileage, as throwing more exercise volume at your body may not be the best idea, particularly if you are health conscious.

Performance
If you are training competitively, I would recommend a certain number of weeks focusing on periodized strength training to build a strength base, then work into explosive strength (jump/plyometric) training. Concurrent run training would be appropriate in most/all cases. Unfortunately, this is about as specific as I can get without considering a large number of variables. A well-designed program may have training blocks planned for a year or more.

Sample Program (Adapted from Millet et al.)

As a very general example, this is an adaptation of what Millet et al. did in their work with experienced triathletes. The expected result from training this way would be improved running economy.

General Training (14 weeks)
This is the period during which the athlete is not actively competing. The training is primarily aerobic (70% Vo2max). In the Millet study, the athletes swam approximately 11 miles a week, cycled approximately 137 miles a week, and ran approximately 30 miles a week. They also stretched approximately 1.6 hours a week.

Strength Training (9 weeks)
Continue with endurance training and add in concurrent strength training. Lower-limb muscles were trained heavily twice a week. Exercises included hamstring curls, leg press, seated press, parallel squat, leg extension, and heel raise.

Initial 3 Weeks (3 sets to failure of 3-5 repetitions)

Sample Week
Day 1
Parallel Squat: 2 warm-up sets then 1 x 3-5 repetitions to failure
Hamstring Curl: 2 warm-up sets then 1×3-5 repetitions to failure
Knee Extension: 2 warm-up sets then 1×3-5 repetitions to failure

Day 2
Leg Press: 2 warm-up sets then 1×3-5 repetitions to failure
Heel Raise: 2 warm-up sets the 1×3-5 repetitions to failure
Parallel Squat: 2warm-up sets then 1×3-5 repetitions to failure

Second 3 Weeks (4 sets to failure of 3-5 repetitions)

Sample Week
Day 1
Parallel Squat: 2 warm-up sets then 1×3-5 repetitions to failure
Hamstring Curl: 2 warm-up sets then 1×3-5 repetitions to failure
Knee Extension: 2 warm-up sets then 1×3-5 repetitions to failure
Heel Raise: 2 warm-up sets the 1×3-5 repetitions to failure

Day 2
Leg Press: 2 warm-up sets then 1×3-5 repetitions to failure
Heel Raise: 2 warm-up sets the 1×3-5 repetitions to failure
Parallel Squat: 2warm-up sets then 1×3-5 repetitions to failure
Hamstring Curl OR Knee Eextension 2 warm-up sets the 1×3-5 repetitions to failure

Final 3 Weeks (5 sets to failure of 3-5 repetitions)

Day 2
Leg press: 2 warm-up sets then 1×3-5 repetitions to failure
Heel Raise: 2 warm-up sets then 1×3-5 repetitions to failure
Parallel Squat: 2 warm-up sets then 1×3-5 repetitions to failure
Hamstring Curl or Knee Extension: 2 warm-up sets then 1×3-5 repetitions to failure

This is an example only. For competitive runners we encourage consulting with someone who has experience developing strength programs for distance runners.

Bottom Line
Strength training can have a positive effect on running economy and distance running performance.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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References

1. Karp, Jason R. “An In-Depth Look At Running Economy.” Track Coach 182 (2008): 5801-5806.
2. Jung, Alan P. “The impact of resistance training on distance running performance.” Sports Medicine 33.7 (2003): 539-552.
3. Storen, Oyvind, et al. “Maximal strength training improves running economy in distance runners.” Medicine and science in sports and exercise 40.6 (2008): 1087.
4. Johnson, Ronald E., et al. “Strength training in female distance runners: impact on running economy.” The Journal of Strength & Conditioning Research 11.4 (1997): 224-229.
5. Paavolainen, Leena, et al. “Explosive-strength training improves 5-km running time by improving running economy and muscle power.” Journal of Applied Physiology 86.5 (1999): 1527-1533.
6. Millet, GREGOIRE P., et al. “Effects of concurrent endurance and strength training on running economy and VO~ 2 kinetics.” Medicine and science in sports and exercise 34.8 (2002): 1351-1359.
7. Spurrs, Robert W., Aron J. Murphy, and Mark L. Watsford. “The effect of plyometric training on distance running performance.” European journal of applied physiology 89.1 (2003): 1-7.