Exercise Tool Kit

Distance Running & Strength Training

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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.1,2 Strength training is an effective way to improve running economy.

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

Johnson et al. (1997)4 demonstrated 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)5 determined that explosive strength training (plyometrics) was associated with improvements in running economy.

Millet et al. (2002)6 found 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)5 found 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)7 showed 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)

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
Leg Press: 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 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.

______________________________________________________________________________________________________________
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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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.

Health Benefits of Strength Training

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Strength training is not just for bodybuilders and athletes. A wide variety of people participate in this activity.1,2 Unfortunately, only a minority of the U.S. population strength train.1 The American College of Sports Medicine (ACSM) and American Heart Association (AHA) consider this activity to be one of the core recommendations for the health of the adult population.3 ALL healthy adults between the ages of 18 and 65 should participate in order to promote and maintain their health, as well as reduce the risk of chronic disease or premature death.3,4

Strength Training

Strength Training

What Are Some of the Potential Health Benefits? 2,4

  • Prevent osteoporosis
  • Prevent age-related muscle loss
  • Reduce incidence of disabling low back pain
  • Decrease high-normal blood pressure to normal levels
  • Increases metabolic rate
  • Decrease central obesity (abdominal fat around the organs)
  • Reduce anxiety symptoms in healthy adults
  • Improve cognition among older adults
  • Improve self-esteem 

How to Gain These Benefits

For adults to gain health benefits, the ACSM recommends:5

  • Training each major muscle group 2-3 days a week with a variety of exercises
  • Performing two to four sets of each exercise
  • Doing 8-12 repetitions for each exercise to improve strength and power.  People who are middle aged or older can improve strength and power using 10-15 repetitions.
  • Older adults and those who were previously sedentary should start with low intensity
  • Waiting at least 48 hours between resistance-training sessions.

These recommendations to access the health benefits of strength training are not for bodybuilding or athletic purposes. I believe it is important to seek guidance in individualizing a strength program and ensuring exercises are performed appropriately.  A physical therapist can help facilitate the process.

______________________________________________________________________________________________________________
Author: Christopher (C.J.) Eberley, PT, DPT
Board Certified Orthopedic Physical Therapist
_______
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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References

1. Chevan J. Demographic determinants of participation in strength training activities among U.S. adults. J Strength Cond Res 2008;22:553–558.
2. O’Connor P, Herring M, Caravalho A. Mental health benefits of strength training
in adults. Am J Lifestyle Med. 2010;4: 377-397.
3. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A 2007 Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116:1081–1093
4. Winnett RA, Carpinelli RN. Potential health-related benefits of resistance training. Prev Med. 2001;33:503–513.
5. ACSM Guidelines http://www.acsm.org/AM/Template.cfm?Sehttp://www.acsm.org/about-acsm/media-room/news-releases/2011/08/01/acsm-issues-new-recommendations-on-quantity-and-quality-of-exercise Accessed 3/23/2013

 

Weight training for the Athlete

Imagine improving your ability to run, jump, sprint and throw while bridging the gap between an okay performance and optimal performance.  Weight training can help with all of the above. Through increases in strength and power the athlete improves their ability to move their body and other objects through space.  The more effectively we move the better we can compete in athletics and go about our daily lives.

In addition to improvements in strength and power the athlete can also increase muscle mass through weight training. This benefit may serve to be very useful in sports such as football where body size can be a factor.  Enlargement of the muscle cells or hypertrophy is the reason for increases in muscle size and also adds to the ability of the muscle to increase force.

A weight program is a necessity for optimizing performance in most athletes. Three ways that weight training may benefit the athlete include hypertrophy, strength and power.  I give below very basic examples of how the athlete can train for each one of these benefits.

Hypertrophy-  Hypertrophy is the enlargement of muscle fibers which leads to increased muscle size. If the athlete desires to effect a change in body composition with addition of fat free mass and subsequent decrease in body fat percentage, hypertrophy training is often recommended. A program aimed to encourage hypertrophy would typically consist of moderate loads, high volume and short to moderate rest periods.  Training in this fashion can also serve as a way to provide good general conditioning to the muscles of the body.

As an example, a football player may perform 3-6 sets of 6-12 repetitions of the front squat.  The sets performed would typically not include warm-ups. Rest periods between sets may be between 30 seconds to 1.5 minutes.  In the case of a football player, hypertrophy training may serve as preparation for the strength and power phase of the athlete’s sport performance program as well as increasing body mass.

Strength-  Strength is important for a variety of athletes from football linemen who must physically move other players to the cross country runner who may desire to maintain an increased stride length throughout the last 100 meters of a race.  If an athlete intends to increase strength, high loads, moderate to low volume and longer rest periods tend to be recommended.

An example may include 5 repetitions of the back squat performed for 3 sets by a cross country athlete.  A foundation of overall strength is important for a majority if not all athletes.

Power- If the athlete desires to increase power or explosiveness variable intensity and low volume exercise with longer rest periods are advocated.  This type of training aims to increase the amount of work which is performed under a smaller period of time.  For a shot putter this would equate to a shot being put with increased force more rapidly.

An example of power training for a shot putter may include performing 1-2 repetitions of the power clean for 1-3 sets.  The sets performed would typically not include warm-ups.  Rest periods between efforts are typically 2-3 minutes.

In addition to a foundation of weight training, the athlete should incorporate components of aerobic conditioning, agility and flexibility training.  The type of training should be tailored to meet the needs of each individual athlete.  Before beginning weight training the athlete should be cleared by a physician and ideally a coach or professional trained in strength and conditioning should oversee the program.  If an injury needs to be worked around the skill and knowledge of a physical therapist or athletic trainer may be of benefit.

Building Muscle: Hypertrophy Training (An Introduction)

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Increasing muscle size for appearance or performance is a common motivation to weight train. Increased muscle mass is associated with increased muscular strength, which can enhance the performance of power and strength athletes such as American football players and powerlifters.1 Another important benefit of building muscle is to stave off the effects of age-related muscle loss. This article aims to give a basic introduction on how to increase muscle size.

How Do Our Muscles Get Bigger?

Our muscles get bigger or hypertrophy when they are subjected to an overload stimulus (physical stress), which results in microscopic muscle-building events. This process leads to an increase in size and amount of the contractile elements of muscle fibers. The cumulative increase in size of many individual muscle fibers leads to a greater cross-sectional area of the actual muscle.

Hypertrophy is also associated with increased fluid and sugar (glycogen) stores in the muscles.2 This does not contribute directly to muscle force production but adds additional size.

Weight Trainer (Me)

Weight training is an effective way to stimulate anabolic (muscle-building) cellular pathways and potentially magnify the anabolic effect of hormones on muscle.

To optimize weight training as a tool for hypertrophy we need to apply sufficient stress on the muscle. The weight trainer must pay attention to several factors including frequency, intensity, volume, exercise selection, rest interval, muscular failure and repetition speed.2,3

Traditionally, it is believed that significant hypertrophy does not begin until after the first 6-7 weeks of weight training; however, significant increases in muscle volume can be realized as early as 2-5 weeks.3 In my experience noticeable size changes take time (6-8 weeks).

Frequency

To optimize hypertrophy in beginners evidence suggests that, 2-3 exercise sessions a week should be performed for each muscle group.3 Although a variety of frequencies have been shown to induce hypertrophy, I have not found an agreed upon standard for the advanced trainer.4 In my experience, 1-2 times a week seems to be sufficient.

Keep in mind that in many training programs, muscles such as the shoulders are being stimulated not only on “shoulder day” but also on “chest day”.

Intensity

Generally 75-80% of 1-repetition max (1RM) or 6-12 repetitions is suggested for hypertrophy training.2,3 Other rep ranges can result in hypertrophy but may not maximize gains.4

Volume

Higher volume (sets and reps) is ideal for building muscle size.2 Greater physical stress is realized from increased volume, but over-training can be a problem. Programming in 1-6 sets a session per muscle group would be effective for muscle gain.3 This could be tapered up and down, depending on a host of factors such as recovery, sleep and nutrition.

Exercise Selection

Both multi-joint and single-joint exercises should be used.2,4 An example of a multi-joint exercise would be the squat, and a single joint exercise would be the knee extension. The squat involves a large number of muscles, but certain muscles may not be adequately stimulated.  By using single-joint exercises, underrepresented muscles can be developed further.

Training the muscles from a variety of angles could be important as certain portions of muscles may be more active at different angles. For example, the lower portion of the chest is involved to a greater extent in the decline bench press than the incline.6

Rest Intervals

Rest intervals can be divided into several categories: short (<30 seconds), moderate (60-90seconds) and long (>3 minutes).2 Shorter rest periods are good for inducing metabolic stress, which is what we want to stimulate hypertrophy.2,7 The problem is that it may not be long enough to allow for strength to recover between sets. It takes around a minute to recover most of our strength capacity.2 A moderate rest period would allow a balance between hypertrophy-inducing metabolic stress and recovery of strength. Longer rest periods allow for full recovery of strength capacity but decreased metabolic stress.8

Muscular Failure

An example of training to muscular failure would be when a weight trainer is no longer able to lift a load. For instance, having lifted nine reps, the trainer cannot lift the tenth, and a spotter must help. This type of training is probably good to use in moderation.  When training to failure, more muscle fibers are stimulated and increased metabolic stress likely leads to an increased hypertrophic response.2

Repetition Speed 

When we lift a weight there are two basic phases of the lift. There is a concentric lift (think pushing the barbell up in a bench press) and the eccentric lift (think lowering the barbell). The speed at which we lift the weight may have an effect on hypertrophy.

Lifting a weight too slowly in repetition lifting may not be optimal for muscle gain; on the other hand, lifting too quickly may not provide enough stress to the muscles. During the lifting/concentric phase of the contraction, a fast to moderate speed is probably ideal.2,3 The lowering/eccentric phase should be slower, as this is associated with greater muscle trauma and muscle-building cellular events.2

A suitable repetition speed may be 1-2 seconds for concentric/lifting and 2-4 seconds for the eccentric/lowering contraction.

Example Shoulder Workout

Barbell Overhead Press 2 x 6-12 repetitions (1-2 seconds concentric/2-4 seconds eccentric)
Side Raises 2 x 6-12 repetitions (1-2 seconds concentric/2-4 seconds eccentric)
Cable Rear Raises 2 x 6-12 repetitions (1-2 seconds concentric/2-4 seconds eccentric)

To maximize hypertrophy shoulders may be trained 2-3 times a week, with changes and substitution of exercises, grips, and angles of pull. Rest between sets would be 60-90 seconds. It would also be a good idea to work in some sets to failure, depending on your recovery abilities.

How to use this Information

Muscle building can be worked into a strength-building program, a program aimed at aesthetics, or a way to decrease muscle loss as we get older. A man/woman who wants to have rounder, more shapely shoulders may want to perform the sample shoulder program provided. A football player or powerlifter may add this type of training to their strength/power program knowing that increased muscle size is associated with increased strength. Somebody over the age of 35 may just want to limit muscle loss as they age.

Please be mindful that this is meant only as an introduction to the basics of muscle building. Many factors play a role in how an individual responds to training.

In most instances, hypertrophy training is best utilized to complement focused strength building.

______________________________________________________________________________________________________________
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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References

1. Maughan, R. J., J. S. Watson, and J. Weir. “Strength and cross-sectional area of human skeletal muscle.” The Journal of physiology 338.1 (1983): 37-49.
2. Schoenfeld, Brad J. “The mechanisms of muscle hypertrophy and their application to resistance training.” The Journal of Strength & Conditioning Research 24.10 (2010): 2857-2872.
3. Wernbom, Mathias, Jesper Augustsson, and Roland Thomeé. “The influence of frequency, intensity, volume and mode of strength training on whole muscle cross-sectional area in humans.” Sports Medicine 37.3 (2007): 225-264.
4. Kraemer, W. J., Adams, K., Cafarelli, E., Dudley, G. A., Dooly, C., Feigenbaum, M. S., … & Triplett-McBride, T. (2002). American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Medicine and science in sports and exercise, 34(2), 364.
5. Garfinkel, S., and E. Cafarelli. “Relative changes in maximal force, EMG, and muscle cross-sectional area after isometric training.” Medicine and science in sports and exercise 24.11 (1992): 1220.
6. Glass, Stephen C., and Ty Armstrong. “Electromyographical activity of the pectoralis muscle during incline and decline bench presses.” Journal of Strength and Conditioning Research 11 (1997): 163-167.
7. Goto, Kazushige, et al. “Muscular adaptations to combinations of high-and low-intensity resistance exercises.” Journal of Strength and Conditioning Research18 (2004): 730-737.
8. Miranda, Humberto, et al. “Effect of two different rest period lengths on the number of repetitions performed during resistance training.” Journal of Strength and Conditioning Research 21.4 (2007): 1032.

Beyond Mirror Muscles: Lower Trapezius

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I would wager that people who strength train are universally aware of the upper trapezius muscles. When developed, these are the impressive-looking neck muscles that shrug the shoulders. The “traps” do not end at the shoulders. The trapezius muscles continue down the spine, transitioning from the middle trapezius to the lower fibers ending just above the lower back.

What function does the lower trapezius serve?

The lower fibers are referred to as the lower trapezius, and are responsible for helping rotate the shoulder blade upward as well as drawing the shoulder blades down. They may also play a role in tilting and rotating the shoulder blade when reaching overhead.1 When the lower trapezius functions “properly,” this may decrease the risk associated with shoulder impingement.2

Is this muscle being addressed in your conditioning program?

A study that investigated a group of bodybuilders found that this population has proportionally weaker lower trapezius muscles.3 I find it rare when any individual has good strength of this muscle.

Why They May be Neglected

Issue 1 The weight trainer may not be focusing enough on the muscles of the back.  The lower trapezius can be activated during exercises such as the pull-down and row.  Specific exercises for the lower trapezius may also not be incorporated in the training program.

If these exercises are ignored, particularly in favor of chest, “trap,” and anterior deltoid exercises, strength deficits in the lower trapezius can occur.

Issue 2 The weight trainer may not be performing exercises such as cable rows in a way that effectively targets the lower trapezius. Although these movements are traditionally used to train the latissimus and rhomboid muscles, upper trap involvement may be proportionately high and lower trap involvement low.

Solution

Begin using exercises that help activate the lower trapezius.4

Y’s

The following exercise should be performed with little or no weight. As the exercise becomes more rigorous more upper trap activity occurs.5 There is nothing wrong with going heavier, but lower trap involvement decreases in relation to the other scapular musculature.6

Y’s

 

This exercise can be performed on the side of a bed, bench treatment table, etc.. To perform the exercise, lift the arm from a hanging position with the thumb up. Both arms may be raised to form a Y. It is common to perform these for repetitions or for static holds.

Modified Prone Cobra

Retract the shoulder blades and draw them down while lifting the chest off the floor. Rotate the arm out and down at the shoulder. Although not depicted in the picture, rotating the arm so the thumbs are up may help ensure that the humerus (upper arm bone) is rotated appropriately. Ten repetitions with 10-second holds should be sufficient in most cases.7

 

 Ensure rows and other back exercises do not have an upper trap emphasis.

DO NOT

DO

 

 

 

 

 

 

 

 

 

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When rowing or performing other pulling exercises be sure to draw the scapula down and in during the exercise motion.5 This is how I recommend performing most back exercises to engage the lower trapezius. Be mindful not to shrug the shoulders up while pulling.8 Sometimes, particularly during heavy training, the upper trapezius may come into play, taking focus away from the lower trapezius.

Conclusion

Those who weight train may have a proportionally weaker lower trapezius, which may be associated with issues such as shoulder impingement.  I have described simple exercises that may help the strength trainer ensure these muscles are being stimulated. Ensuring there is not excessive upper trap emphasis during pulling exercises may also help ensure the lower trapezius are being sufficiently worked in relation to the upper trapezius.

______________________________________________________________________________________________________________
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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References

1. Ludewig, Paula M., and Thomas M. Cook. “Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement.” Physical therapy 80.3 (2000): 276-291.
2. Cook, Thomas M., and P. M. Ludewig. “Three-dimensional scapular orientation and muscle activity at selected positions of humeral elevation.” Journal of Orthopaedic Sports Physical Therapy 24.2 (1996): 57.
3. Barlow, JOSHUA C., et al. “Shoulder strength and range-of-motion characteristics in bodybuilders.” Journal of Strength and Conditioning Research16.3 (2002): 367-372.
4. Reinold, Michael M., R. F. Escamilla, and Kevin E. Wilk. “Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature.” J Orthop Sports Phys Ther 39.2 (2009): 105-117.
5. Andersen, Christoffer H., et al. “Scapular Muscle Activity from Selected Strengthening Exercises Performed at Low and High Intensities.” The Journal of Strength & Conditioning Research 26.9 (2012): 2408-2416.
6. Arlotta, Melissa, Gina LoVasco, and Linda McLean. “Selective recruitment of the lower fibers of the trapezius muscle.” Journal of Electromyography and Kinesiology 21.3 (2011): 403-410.
7. Arlotta, Melissa, Gina LoVasco, and Linda McLean. “Selective recruitment of the lower fibers of the trapezius muscle.” Journal of Electromyography and Kinesiology 21.3 (2011): 403-410.
8. Lantz, Jason, Shawn McNamara, and Georgia Locust Grove. “Modifying the latissimus pull-down exercise for athletes with shoulder injury.” Strength Cond. J 25.6 (2003): 67-69.

Beyond Mirror Muscles: Serratus Anterior

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This article will focus on one of the shoulder blade stabilizer muscles called the serratus anterior (SA), and why these muscles may not be getting sufficient attention in a conditioning program.

What is the purpose of the serratus anterior?

The SA helps provide stability to the shoulder blade and helps move the shoulder blade forward (protract) and rotate it upward. These actions are important for the shoulder to function optimally. Relative weakness of this muscle is associated with shoulder conditions such as impingement.1

Is this muscle being addressed in your conditioning program?

Most resistance trainers are familiar with exercises such as the bench press, and its variations and shrugs. These exercises focus on muscles that can be visualized in the mirror, such as the chest, upper trapezius “traps,” and anterior deltoids. These exercises are effective, and although they are useful in many training programs, they may be over-used at the expense of training smaller muscles, such as the SA.

Issues that may be encountered with this type of training.

Issue 1. When performing a bench press or its variations, the weight trainer is typically taught to pull the shoulder blades down and in.  This is how the most proficient bench pressers I know perform the exercise. Remember, the SA brings the shoulder blade forward and upwardly rotates.  When doing the bench press we are consciously doing the exact opposite by pulling the shoulder blades down and in while driving the upper back against the bench.  This creates an “unnaturally” fixed position and leaves the SA without much work to do. With this style of pressing we miss out on really working the SA.

Issue 2. The upper trapezius is worked extensively during shoulder shrugs and exercises such as the deadlift.  The serratus anterior and upper trapezius are important stabilizers of the shoulder blades but decreased serratus activity and increased upper trapezius activity can be associated with shoulder injury.1 Proportionately more upper trap work has the potential to lead to relative weakness of the SA in comparison with the upper trapezius.

Possible Solution

To offset this type of training it makes sense to do some type of focused work on the SA. Improving the strength of the SA compared to the upper trapezius and other scapular stabilizers may also help decrease the possibility of shoulder injury.

Serratus Punch

The following video demonstrates the free weight version of the serratus punch.2 Lying on a bench with the arm extended at shoulder level punch arm toward the ceiling. This can be treated like any other exercise, but I recommend initially starting with lighter weight and higher repetitions.

_

Conclusion

Weakness of the SA is associated with shoulder issues. Your strength and conditioning program may not be adequately addressing this muscle. The serratus punch is an effective exercise to help ensure this muscle gets addressed.

______________________________________________________________________________________________________________
Author: Christopher (C.J.) Eberley, PT, DPT
Board Certified Orthopedic Physical Therapist
_______
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.
_______

References

1. Ludewig, PM and Cook, TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther 80: 276-291, 2000.
2. Decker MJ, Hintermeister RA, Faber KJ, et al: Serratus anterior muscle activity during selected rehabilitation exercises. Am J Sports Med 27: 784–791, 1999

 

Beyond Mirror Muscles: Rotator Cuff 1

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A balanced shoulder maintains stability of the joint and neutralizes undesirable joint movement. When the rotator cuff is fit and healthy, it helps serve both of these functions.

The muscles we don’t necessarily see in the mirror, but which should probably be working.

The Rotator Cuff (RTC)

  • Supraspinatus (most commonly affected in RTC tears 4,5)
  • Infraspinatus
  • Teres Minor
  • Subscapularis

Scapular Stabilizers (Muscles that help stabilize the shoulder blades)

When trained, these muscles can help provide stability to the shoulder. The following are two exercises that can help address shoulder muscles needing attention in a strength program.
 _________________________________________________________________________________
Standing Shoulder External Rotation At Side
C.J. Eberley

Standing External Rotation: Start

Standing External Rotation: Finish

Using a band or cable, rotate the shoulder out away from the body.  Imagine rotating the shoulder as if a steel rod is going through the shoulder and out of the elbow.
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Good for working:1
Infraspinatus
Teres Minor
Subscapularis (co-contract)
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No Money

No Money

No Money is very similar to the first exercise.  The exception is that both arms are rotated out while the shoulder blades are squeezed together and down. This may be performed in a door-frame so the shoulder blades are squeezing in toward the frame while the arms rotate out.
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Good for working:1,6
The shoulder blades
Lower trapezius
Infraspinatus
Teres Minor
Subscapularis (co-contract)
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These exercises are typically performed with light weights for high repetitions. For example, 2-3 sets of 20 reps would be appropriate. I think an argument can be made with heavier weights, but I believe this needs to be worked into a program very purposefully.
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In the future, I will highlight more exercises to address the RTC and scapular stabilizers.
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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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References
1. Escamilla R, Yamashiro K, Paulos L, Andrews J. Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med 2009;39:663-85.
2. Armfield D, Stickle RL, Robertson DD, Towers JD, Debski RE. Biomechanical basis of common shoulder problems. Semin Musculoskelet Radiol 2003;7:5–18
3. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80:276–91.
4.Clark JM, Harryman DT, 2nd. Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic anatomy. J Bone Joint Surg Am. 1992;74:713-725.
5. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop. 1990;64-74.
6. Reinold, M.M., Escamilla, R., & Wilk, K.E. (2009). Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature.Journal of Orthopaedic & Sports Physical Therapy, 39(2), 105-117.

3 Basic Core Stabilization Exercises

The muscles supporting the lumbar spine or “core” are so important that without them we would not be able to support ourselves!  It makes sense that the spine must be able to efficiently handle forces put on it for us to perform optimally.  The core must have the strength and endurance to continually maintain spinal stability and prevent excessive movement of spinal segments.  Excessive movement of the spine could cause tissues to become irritated or even result in injury 1.

Relatively speaking, maintaining “sufficient stability” of the spine during daily activities does not require a great deal of strength1.  We DO need to maintain adequate amounts of strength for extended periods of time.  Not surprisingly, increased levels of muscle endurance have shown to have a potentially protective effect2 .

What can be done to improve the endurance of the core?

The following are 3 basic stabilization exercises that can be utilized to improve endurance.

Curl-Up

One leg is bent to help preserve the neutral lumbar curve.  Start with head and shoulders on the ground and lift shoulders as shown while tightening the abdominal muscles.  This exercise can be performed in a variety of rep ranges with higher repetitions or increased sets being used to improve endurance.

Curl-Up

Curl-Up

 

Side Bridge

Side Bridge (Knees Bent)

Side Bridge (Knees Bent)

Side Bridge

Side Bridge

 

 

 

 

 

 

 

 

To perform this exercise prop up on your forearm and elbow.  I often recommend this be performed while tightening the abdominal muscles as if you will be hit lightly with a punch to the abdomen. This can be progressed from knees bent to legs straight.  Progressively increasing sets of 5-10 second counts should be sufficient for improving endurance 3.

Average endurance times while performing the side bridge is approximately 95 seconds for men and 75 seconds for women 4.

Bird-dog

Bird-dog

Bird-dog

While on your hands and knees lift your arm and opposite leg until level with your body.  Hold for a 5-10 second count while tightening your abdominal muscles.  Perform 10 repetitions increasing the number of sets to improve endurance.

These exercises can be performed daily or worked into a strength and conditioning program to improve and maintain endurance strength of the core musculature.

 

References

1. McGill SM. Low back stability: from formal description to issues for performance and rehabilitation. Exerc Sport Sci Rev 2001;29: 26-31

2. Biering-Sorensen, F. Physical measurements as risk indicators for low back trouble over a one year period. Spine. 9:106 –119, 1984.

3. McGill S. Core training: Evidence translating to better performance and injury prevention. Strength Cond J. 2010;32(3):33-46.

4. MCGILL, S. M., A. CHILDS, and C. LIEBERMAN. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch. Phys. Med. Rehabil. 80:941–944, 1999.