The purpose of this article is to provide some basic information about the importance of understanding the role posture and function have in pain, injury, and movement dysfunction. The hope is that you will gain an understanding of why your chiropractor or therapist must evaluate and bring into consideration issues that may not seem related to your pain.
Patients come to us with symptoms and we want to get to the source of their symptoms. In addition to providing relief through manipulative therapy and treating muscular adhesions, it can prove to be incredibly valuable to identify the source of their symptoms. In my experience, the source of a client or patient’s symptoms is often found in painless dysfunction of the motor system.

All too common, providers become reductionist in their evaluation and treatment of the motor (aka musculoskeletal) system. In order to provide long-term solutions and minimize reoccurrences, a holistic or global approach to evaluating functional capacity is needed to identify what is driving pathology in the motor system. This concept is of critical importance when you understand that the majority of motor system pathologies exist because the demands of activity exceed the individual’s capacity. If the demands upon the motor system are at a high level, then capacity must be even higher. Even if demands are relatively low, capacity still must exceed the level of the demand. If there is a capacity “shortage”, the result is a higher injury risk. In musculoskeletal care, one of the greatest challenges is identifying functional capacity “shortages” and how to address them during the course of conservative treatment to provide both immediate and sustainable results.

Professor Vladimir Janda and Dr. Karel Lewit pioneered the process of identifying functional pathology within the motor system. The model is in contrast to the traditional North American orthopedic model, which focuses on structural pathology (ex: disc herniations, rotator cuff injury, labral tears, etc.) as the reason for pain and impairment. But simply focusing on structural pathology can take your eyes away from identifying key reasons as to why they developed in the first place.

Outside of structural pathologies, the functional approach to managing motor system pathologies includes identifying joint dysfunction, muscular imbalances, trigger points, and faulty movement patterns. Faulty movement patterns are protective movements that form in response to pain or the anticipation of pain. These are often the hidden causes of injury, the reasons why many structural pathologies occur. Czech physician Vladimir Janda likened musculoskeletal pain and dysfunction as a chain reaction, thus stressing the importance of looking beyond the site of pain for the source of pain. Janda observed that due to the interactions of the skeletal system, muscular system, and central nervous system (CNS), dysfunction at any one joint or muscle is reflected in the quality and function of joints/muscles throughout the entire body. This opens the door to the possibility that the source of pain may be distant from the site of pain.

Janda also recognized that muscle and connective tissue are common to several joint segments; therefore, movement and pain are never isolated to a single joint. He often spoke of “muscular slings” or groups of functionally interrelated muscles. Muscles must disperse load among joints and provide stabilization for movement, making no movement truly isolated. This ultimately is the reason why many providers within physical medicine are catching onto the saying, “Stop chasing pain.” Chasing pain and other symptoms (ex: tightness, stiffness, restricted movement) may provide short-term relief, but are you providing long-term results?

A common intervention in the rehabilitation of motor system pathology is therapeutic exercise and resistance training. These exercises are used to help restore any number of neuromuscular qualities, such as endurance, strength, and motor control. But often, even in a rehab setting, exercises fail to progress a patient in the recovery process. Sometimes, the application of exercise can make a patient's condition worse. Similarly, many people with the intention of being healthy and wanting to help their body “feel better” will use resistance training in their exercise regimen. Working out, exercising, strength training should improve our state of muscle balance, right? Sure they get the cardiovascular, endocrine, and psychological benefits of exercise, but they start to wonder why all their exercising is only making certain areas of their body feel worse. This is why it’s important to learn that unless exercising occurs in a thoughtful manner, based on a functional evaluation of movement and capacity, the benefits of reducing injury risk, improving posture, enhancing motor control, and restoring muscular balance will be difficult to achieve.

For example, what Janda discovered is the tendency for certain muscles within the body to become tight and overactive, while others have the tendency to become weak and underactive. So if someone is performing general exercises, the brain will select the muscles that are already tight to perform the majority of the work. This is a phenomenon knows as “compensation” or “substitution”. Muscles that are already chronically overused will continue to be overused, leading to greater risk of an overload injury. The muscles that are “weak” have developed a sensory-motor amnesia that will not correct itself unless the exercise is carefully selected and tailored to activate these dormant muscles. Such exercises emphasis the quality of the movement pattern over any prescribed number of sets or reps. The eye of the provider can’t be focused on isolated impairments, but on finding the motor control error. Finding the hidden causes of injury or motor system dysfunction.

Remember, what enhances performance also reduces injury. Finding the solutions to enhancing performance will often address hidden motor system dysfunctions. If you are training for athletic performance, you must build functionally specific or sport-specific capacity. If you are recovering from injury, you must build function rather than solely focusing on palliative measures and treating the site of symptoms. In either scenario, you are building a better athlete and fast tracking the rehabilitation process by taking a functional approach to motor system dysfunction.

More related reading:

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/the-importance-of-functional-evaluation/

The emphasis of many athletic development programs is typically rooted in developing the physical qualities needed in the sport of competition. Physical qualities usually emphasized are endurance/work capacity, strength, body awareness, agility, quickness, speed, and explosive power. Improvements made in any of the previously mentioned physical qualities can certainly improve an athlete’s fitness and physical preparedness for competition. But great athletes are rarely defined by their level of fitness and how ‘in-shape’ they are. They are defined by their ability to play the game and perform the skills of the sport. Great coaches and trainers understand this, being able to take an athlete’s newly developed physical qualities and transfer them to into improved skill execution or technical mastery of sport related movements.

This is accomplished by specificity of training.

In order to ensure specificity of training, it is first necessary to determine the exact physical qualities an athlete is in greatest need of. Many coaches and trainers refer to this as ‘identifying the deficiency’. Once the deficiency is identified and an understanding is developed as to how the deficiency is limiting on-field performance, the deficiency can be trained appropriately.

To identify deficiencies, the majority of coaches and trainers utilize tests to determine an athlete’s level of strength, endurance, explosiveness, and even flexibility. While these tests are often necessary and provide quantitative information that will help assess how an athlete stacks up in comparison to others, what these tests fail to indicate is how efficiently an athlete can perform sport-specific skills or maneuvers.

Physical performance tests fail to indicate an athlete’s needs in relation to game performance. To ensure transfer of training into improved sport performance, identifying an athlete’s developmental needs must take into account an analysis of all components involved in successful competition. Often, this involves a complete biomechanical analysis of movements related to sport-skill execution.

For example, the deep squat is often a staple of many strength and conditioning programs. It can be a tremendous exercise for building hip strength and power and for a variety of other reasons. But when you examine the sport-related movements of many athletes, one can come to the determination that the need to deep squat is not a priority for many athletes. Consider hockey and basketball players. These sports require hip external rotation strength and power to execute sport-specific movements (skating, lateral cuts, change of direction, etc.). Rather than placing greater and greater emphasis on improving strength in the deep squat, these athletes will be better served in developing hip external rotation through other exercises which more closely mimic the external rotation demands of the hips in competition.

Again, great athletes are rarely the strongest or the fittest. There are studies that demonstrate Olympic-level athletes and World Record holders are not the strongest athletes (with the exception being in strength sports such as powerlifting and Olympic weightlifting). Athletes on the highest levels of performance do not lift the greatest amount of weight in commonly used exercises, such as the clean, squat, bench, or deadlift.

More commonly, athletes will fall in the midrange of strength numbers. What this is demonstrating is a ‘point of diminishing returns’. Many athletes reach a point at which increases in strength or other physical qualities do not always equate to improved sport performance.

Successful athletes must be able to execute sport skills with technical mastery and precision. Regardless if you are a hockey, football, soccer, lacrosse, baseball, tennis or track athlete, you need great acceleration, speed, agility (ability to change direction quickly), and the ability to jump high (which also requires explosive power). But arguably most important is the ability to perform all sport skills with mastery and precision of movement.

An athlete will never be successful if they do not have the ability to execute sport skills successfully. This is why technique must be closely analyzed and why the training of physical qualities must directly enhance the performance of sport-specific skill execution.

Analyzing an athlete’s sport skill technique and the demands of game play becomes a necessary first step to determine exactly what their training program should consist of. Often to correct and/or enhance technique, special strength exercises are implemented to develop the specific strength an athlete needs to execute movements more efficiently.

We addressed special strength exercises in this article. Special strength exercises are intended to replicate the exact neuromuscular pathways utilized in the execution of specific sport skills.

With proper analysis and identifying the ‘deficiency’ of the athlete, it enables the training program to have greater transfer into sport performance. The training program is continually adjusted as improvements in strength, speed, agility, and explosive power are integrated into technical mastery of skill execution.

Related Articles:

Training for Elite Athletes
Common Mistakes in Developing Young Athletes

High-intensity interval training (HIIT) is a system of training characterized by high-intensity resistance or metabolic training with short/incomplete rest periods in between working sets. An example of HIIT is often advocated by Crossfit WODs (workout of the day) and other similar programs.

According to the American College of Sports Medicine, HIIT is now the most popular fitness trend. HIIT has tremendous appeal to those looking to shed unwanted body fat and ‘lean up’ or ‘get in shape’ quickly because of its ability to burn body fat more efficiently. HIIT has been shown to produce greater improvements in both aerobic and anaerobic capacity with less overall training volume when compared to individuals who only perform steady-state aerobic exercise. In the public eye, a huge upside to these workouts is they typically take less than 30 minutes to complete. Sounds too good to be true, right?

However, what is rarely if ever mentioned, is the number of injuries sustained by participants.

In my opinion and experience, which may be similar to what others are also observing, the number of injuries associated with HIIT appears to be on the rise. What is especially significant to note is that these injuries are often debilitating in nature.

Not only is HIIT growing in popularity among the general population, but it also seems to be a growing trend among athletes. The point of this article is to discuss why HIIT is not an appropriate training program for athletes and provide some insight into why athletes should avoid programs that advocate high-frequency application of HIIT methods.

Why Athletes Should Avoid HIIT
First and foremost, when training with heavy weights or performing complex motor skills (i.e. jumps, throws, sprints) it is highly critical that proper technique is learned during the initial stages of training. This is the key to not only continual development in regard to strength and all other physical abilities, but is fundamental to injury prevention.

Proper technique is the key to ensuring that strength developed becomes more useful not just in athletic skills, but also in everyday activities. For athletes, proper technique serves as the foundation for efficient execution of sport-related movement skills.

So why does HIIT fail athletes?

What appears to be most important in HIIT is overcoming a prescribed amount of resistance or finishing a prescribed number of reps in a designated amount of time, regardless of how it is done. From the start, HIIT does not place technique as the number one priority. For your viewing pleasure, Youtube provides numerous examples of this. I can recall watching a Crossfit workout during which a young female participant is doing her best to finish an overhead press. She had to contort her body in every way imaginable in her attempt to get the bar locked out overhead. Needless to say, I did not like what I saw.

What was even more disturbing to me was hearing the other members of the class cheering her on and applauding her when she finally locked out the bar overhead. They were encouraging her effort with absolutely no attention or care about her technique and safety. This is just one example of many that indicates how overcoming the weight was more important than how the lift was performed.
Other daily workouts may prescribe high-intensity metabolic conditioning that often requires participants to train to the point of exhaustion and, sometimes, to the point of throwing up. The mindset and main objective is primarily focused on overcoming a specific quantity of work as opposed to expressing quality in the work.
It is this mentality that can be detrimental to athletes and the general fitness population as well. There is a reason why physical therapists and chiropractors love Crossfit and other HIIT programs. HIIT programs are pretty good at producing patients.

Another unwanted factor associated with HIIT is the high degree of fatigue and lactate training loads. For athletes, how can they master movement and skill execution or build speed and strength in a fatigued state? The answer is they cannot. This is something the majority of coaches and trainers must understand. Lactate-based training is widely over-utilized and misplaced. This ultimately cuts into more productive training methods and increases the need for recovery. When it comes to HIIT programs, recovery is often not sufficient and will potentially push participants into a chronic state of fatigue or create an over-trained individual. Keep in mind, injuries are more likely to occur in a fatigued or over-trained state.

When it comes to HIIT, training principles regarding periodization, progressive overload, mastery of technique, specificity of training, and individualization of training are completely ignored. These principles, among others, are highly important when it comes to the safety and effectiveness of training athletes. They have been proven to be foundational in producing the most effective results from any training program.

Final Words
Training and sport science tells us that HIIT programs or any randomized high-intensity program is not conducive for efficient training and development of athletes in regards to strength, speed, power, and other physical abilities. Sure it may be trendy, but ask yourself does the program or exercise routine provide the development you want? Remember, development is always specific to your training demands. Also, ask yourself if your current training methods are more likely to make you a better athlete or a patient.

Related Articles:

Interval/Sprint Training vs Cardio: Which is Better for Fat Loss and Physique Development?
Training Hard vs Training Smart
Have You Mastered Your Movement?
2 Reasons For Your Lack of Results
Training for Elite Athletes

It seems almost routine now that we come across parents who are curious about what type of ‘training’ their child should be doing to become a better athlete. Ultimately, the majority of parents are concerned about their child lifting weights. Typically their child is 12-15 years of age and the parents feel that weight training at that age is inappropriate and could be potentially dangerous (e.g., stunt their child’s growth). Since this idea is so widespread, we felt it would be valuable to address the topic and the determining factors of whether weight training is suitable for a young athlete.

To start, let’s set the stage for our discussion by simply stating that weight training is one form of ‘resistance’ training. There are plenty of ways to apply ‘resistance’ to the body. From bands to weighted vests to body weight exercises, they are all considered resistance training. If you asked most parents if they had a problem with their child doing push-ups or walking lunges, the majority of them would likely reply, “No”. Lifting weights, at times, can provide less resistance than common body weight exercises yet lifting weights is somehow deemed more dangerous.

Why?

The majority of parents are primarily concerned about the risk of growth plate fracture and the possible result of stunted growth.

To address these concerns, the National Strength and Conditioning Association (NSCA) published a position statement. They determined that resistance training is safe, even for children as young as 6, and that the risk of growth plate fracture and stunted growth is completely unsupported. Simply put, it does not happen and weight training is safe with appropriate coaching and progression. Additionally, research has demonstrated significantly higher injury rates in youth sports (football, basketball, soccer, baseball, hockey, etc.) when compared to weightlifting.
When it comes to coaching and progression, this is where considerations from Long-Term Athletic Development (LTAD) models become invaluable in helping to understand sensitive “windows” during an athlete’s development. These windows identify when to capitalize on certain physical qualities. Looking at LTAD models, children around 12 years old are in a critical window for their speed development. This means that while they can improve in all athletic attributes (balance, coordination, rhythm/timing, relaxation, strength), speed development will experience faster rates of improvement. Speed simply comes down to putting a lot of force into the ground quickly. Explosive movement requires high power output and this relies on your “fast twitch” muscle fibers. Resistance training is one method to efficiently train “fast twitch” muscle. In this context, certain exercises aren’t always what they appear to be. For example, a young athlete performing squats may not be simply performing squats, but rather “speed training” because it’s a tool to teach them to produce force quickly and utilize their muscles in an explosive manner. Improve an athlete’s ability to produce force and they will get faster. Force production is directly controlled by the nervous system. Neural development is very sensitive for children 12-13 years of age. This means that the nervous system, which coordinates all movement, is primed for learning and improving efficiency of complex movements. This is one reason why resistance training is appropriate for athletes during this time period; it can capitalize on a sensitive period of neural development to help kids move with improved body awareness AND coordination, thus resulting in increases in qualities such as strength, power, and speed.
Concluding Thoughts
There are many factors to consider when it comes to “appropriate training” for young athletes. While there are safety concerns, age-appropriate and developmentally specific training methods can be extremely effective. For young athletes, weight training is a safe and effective means to develop body control/awareness and improve athletic qualities, such as speed. Weight training, as part of an athletic development program, should follow a structured approach under the supervision of a knowledgeable and qualified coach.

To ensure the highest quality outcomes and safety, GP understands and utilizes LTAD models in the training of their young athletes.

Related Articles:

Success or Failure: What Are You Setting Your Young Athlete Up For?
Don't Fall for the Speed Trap
Identifying Strength Needs for Athletes

Lack of progress or results in any training or fitness program is a common frustration for many athletes and individuals. Let's take a look at two of the more common reasons why people fail to see results from their training efforts.

#1 – You Aren’t Training Correctly

“I don’t get it. I workout hard. I eat right. I follow advice. I feel like I’m doing everything right, but I just can’t seem to (plug your goal in here)”

• Was an assessment performed to understand if my body is prepared for the training ahead?
• Is my injury history accounted for and understood?
• Is this training program tailored to reach my goals?
• Am I going to learn proper lifting technique to minimize my injury risk?

What you need to know:

• Many endurance athletes have exhausted their means of improvement with traditional training.
• Training deficiencies, such as strength, can take your endurance capacity to new levels.

• Maintain and/or promote the building of muscle mass. This is a huge benefit because endurance training negatively impacts muscle mass, meaning many athletes lose precious muscle.
• Strengthen the endocrine and immune systems. Yet another big plus since chronic endurance training has a negative impact on both these systems.
• Promote adequate bone density. The importance of this should speak for itself, but this will be of special importance to runners when you consider the risk of stress fracture.

• Triathlete trained is one of the head researchers for PowerBar, has a PhD in nutrition.
• 8-10 lifts were performed per month in the 90-95% range of her 1RM (rep max)
• Special exercises performed were box squats, special deadlifts, good mornings, and a similar variety of pressing movements for upper body.
• No high repetition work was performed to avoid soreness and a high degree of effect on her traditional triathlon training.  Also, very little time is spent training in this manner.
• She was amazed at the results this training was giving her. She said that she “could now look at any hill, use muscles she never had, and was able to dig deeper than ever before, and have a posture that was solid as stone,” which made her much less fatigued at the end of the run. She had shaved 1/2 hour off of her Iron man, and did about 4 hours less work per week of traditional training.  She had gained 2lbs of weight from the beginning as she trained this way for 8 months. Her bodyfat went down about 2%, and she no longer had back pain, neck pain, and less nagging training injuries and setbacks.

"Training is efficient if the highest sport result is achieved with the least expense of time and energy".