Author: Bill

  • Announcement: The Intensive – July 26-29

    Mentorship typically consists of two people working for the betterment of one.

    How about six with the goal to better each other?

    In 1972, Eldredge and Gould presented their theory on evolution referred to as punctuated equilibrium. In simple terms, their view is that evolution occurs with periods of rapid change between periods of little or no change.

    The goal of this intensive is to create a period such as that. Rapid change.

    The When and Where

    July 26-29 at IFAST (and Casa de Hartman) in Indianapolis, Indiana. We start at 8pm Thursday the 26th (unless you can make dinner at 6:30 at my favorite Mexican restaurant). We go until Sunday July 29th at about noon. When we get hungry, we eat. When we get tired, we sleep.

    The Who

    Six (6) professionals (It is NOT for students) who:

    Are comfortable with contributing ideas, asking, and answering questions.

    Have an understanding of foundational movement-based anatomy and exercise/training concepts.

    Want to challenge and help others professionals improve.

    Understand the value of a coach and seek a learning network of individuals with common concerns, interests, and goals but different backgrounds.

    Selfishly, it’s for me. I enjoy what I do, and I enjoy sharing and interacting with bright, motivated people from whom I too can learn.

    The What

    A fun, open, engaging, and challenging environment

    Guided, focused effort over three days

    Develop a principles-based approach

    Examining a model of human movement from micro to macro

    Assessment processes from a passive to a dynamic environment

    Cuing, coaching, decision-making, intervention strategies, and programming

    Ongoing discussion and conversation over dinner at Casa de Hartman

    Enhance and evolve your personal information capture and learning system

    Share knowledge as part of an ongoing professional network

    Follow-up mentorship to assure ongoing progress

    Train at IFAST

    The six individuals will be selected via the application process as quickly as possible. Attendees will be notified by June 21st.

    How Much?

    Attendees are responsible for travel to The Intensive and accommodations while in Indianapolis.

    There is no fee for The Intensive. Only presence, time, and effort are required.

    The application process is now closed. You can still join the mentorship list below.

  • The Patient is Their Own Experiment

    Treatment typically occurs within the domain of complexity. There are always unknowns. How do you deal with them?

    Here’s a brief discussion with a Padawan about how the patient becomes their own experiment using a within-subjects design.

  • Dessert at the funny farm – Willpower and Cravings

    Dessert at the funny farm – Willpower and Cravings

    The brain works in interesting ways.

    Have you ever had the best intentions to stick to your eating plan, and then suddenly, you choose to eat something so far off your plan that you thought you’d never recover?

    Here’s what I mean.

    You’re out with friends for dinner.

    You look over the menu to create a meal that fits your intended macros and calories.

    You actually get excited that you can have a great time with friends AND achieve your behavior of eating to support your health and fitness goals.

    The next thing your know your just told your waiter that you’ll have the giant bowl of pasta with some sort of creamy sauce with enough calories to feed a small village of 500 people. It’s as if someone took over your brain and made a bad choice for you.

    What just happened?

    In her book, The Willpower Instinct, Dr. Kelly McGonical outlines just such a scenario.

    It seems that you can get so excited about the fact that you can stick to your goal, your brain substitutes that feeling for actually achieving your goal. Having just achieved your goal (at least seeming to do so), immediate pleasure takes over and you make a bad choice.

    The fact that this can happen makes me think that we can actually use this fact to our advantage.

    I call it Imaginary Dessert.

    Call me kooky but I’ve actually use this method to overcome some of my cravings (Dr. Mike will vouch). It’s an interesting mental exercise.

    Chances are that whatever you’re craving, you’ve eaten before. You know what it should taste like, so you have mental “image” that you can use.

    Just imagine eating whatever you crave in the greatest possible detail. Don’t rush. Take your time. It gives you a pause to let your craving pass and feel the experience as if you’ve really eaten dessert.

    You 1, Brain 0.

     

  • Incorporating research into treatment and using a sense-making framework

    How do I incorporate research into my current treatment model of n = 1?  How does it influence the effect of knowns and unknowns in regard to patient care?

     

  • What is good posture?

    What is good posture?

    My second grade teacher, Mrs. Krewson, was rather militant about sitting at one’s desk with “good posture.”

    One was to sit on the front half of the chair, feet flat on the floor, spine upright, and fingers interlaced with palms and forearms down on the desk. (Oh, yeah… 45 years later and I STILL can’t get it out of my head)

    I was also lovingly flipped on the back of the head by my father on more that one occasion as a reminder to “correct” my more primitive posture and stand up straight.

    I’ve read through a few blogs, and I’ve gotten a healthy dose of references to “neutral spine” although a consistent and useful definition is difficult to pin down.

    I appreciate what everyone has been trying to do.

    Mrs. Krewson wanted discipline and good behavior.

    Dad probably agreed with Mrs. Krewson having been a product of military high school, but he also didn’t want me judged as a loser, slacker teenager based on my posturing.

    And a broad spectrum of fitness and rehab professionals want to do what is best for their clients and patients to keep them safe, pain-free, and successful.

    The problem with all of these attempts at an optimal of sorts are that they are most likely (highly likely) futile.

    Why you ask?

    Well, for one, we’re probably not very good at determining a standard for what is good posture, best posture, neutral posture, or whatever you want to call the perceived and understood optimal.

    296 physiotherapists from Ireland, England, Germany, and the Netherlands did not agree to an optimal although the majority narrowed it down to two very different sitting postures. (Manual Therapy 17 (2012) 432-437)

    Interestingly, there was a single physiotherapist in the group specifically from Ireland (I have no idea why this person was identified specifically by nationality) who stated that all of the postures evaluated were acceptable. I really like the way this person thinks and would gladly buy them a beer.

    Secondly, there probably isn’t even a singular optimal posture or spinal position that is possible.

    According to Gracovetsky (The Spinal Engine. Springer-Verlag/Wein. 1988. Pg. 145), “…there is no unique optimal lordosis for all tasks. Rather, a subject adjusts his lordosis according to the angle of flexion and the task to be executed.”

    Finally, we probably can’t really tell what the spine is doing anyway.

    Even though you may coach a client performing back squats to maintain a lordosis or a “neutral spine,” they may not be able to as a by-product of the exercise.

    “The current research has shown that as soon as the 50% BW load is placed across the shoulders, the lumbar curve flattens and becomes slightly kyphotic before the subject commences the descent. This change of lumbar curve is marginal, and we suggest it would be difficult to view with the naked eye [Bill:  my bold]. Coaches using the change in lumbar curve, or lumbar flexion angle, as a determining factor, or teaching cue for good squat technique may in fact be interfering with normal lumbar movement behavior. Further, the point at which the subject loses the lumbar curve cannot be used as a cue to determine when a person should cease the descent.We suggest that kyphosis of the lumbar spine in deep squatting is a natural part of the squat movement when using loads equal to 50% BW and coaches should not prevent experienced squatters from allowing this to happen to the small extent shown in this research.” (McKean, MR, Dunn, PK, and Burkett, BJ. The lumbar and sacrum movement pattern during the back squat exercise. J Strength Cond Res 24(10): 2731–2741, 2010)

    Does this mean I don’t think spinal position matters? No, that is not what that means. It simply means that there are no absolutes and what is ideal may be entirely specific to a context and the individual or it remains  an unknown. It does appear that based on Gracovetsky and the quote above that the body will adapt and choose (self-organize) what is best based on the demands of the task at hand assuming sufficient adaptability of the body in question.

    I thought about quitting here. Quite the cliffhanger, eh?

    How about some strategy? What do we do with this information?

    If you train yourself

    Observe the 15th Commandment. Thou shalt not be stupid.

    There is not one way, there are many. While this is in reference to postures, position, techniques and exercises, this also accounts for your movement capabilities. Your goal is to be capable of many different postures. The greater your movement options, the less likely any one posture will be more influential than another.

    If you don’t move comfortably or lack effective movement during an exercise, you are loading your body at your own risk.

    If you’re goal is to look and feel better and gain health, you have a nearly infinite choice of activities that will provide the stimulus your body needs to change for the better. Select exercises that are within your movement capabilities and non painful during or after a workout (that is excluding the normal, generalized discomfort associated with effective exercise including delayed-onset muscle soreness which should never be debilitating).

    Coax progress. Do not force it. Small consistent gains over time will add up.

    Consider hiring a competent professional to determine your movement needs and guide your progress at least initially. While exercising effectively is not like doing your own dental work, professional guidance may be safer and accelerate your progress.

    If you’re a health or fitness professional

    Just because you’ve read this blog, don’t throw out everything you’ve been doing (has anyone ever really said… Wow, that blog changed my life?).

    Understand the limitations of your current model and processes. Recognize that there are probably many more considerations than any of us can know. That means no one has all the answers, and there are still unknowns.

    Become an intern, apprentice, protégé, mentee, or volunteer to work with an experienced coach. Reading and two-day courses only provide a limited scope and perhaps inspire you to look more deeply at a topic. Day-to-day work with real people under the guidance of an experienced practitioner is the best way to learn. Spend time with other professionals at and above your current level of understanding. It is the fastest route to expanding your model.

    Whether you are just starting a career or are a seasoned veteran, we all have a representation of what is acceptable in regard to position, posture, and technique for any exercise. Your model of acceptable performance, including postures, positions, and technique, will evolve but always err on the side of safety and caution.

    Program for the client. Don’t try to fit the client into a restrictive model to which they cannot adapt. Appreciate that every exercise becomes an assessment of your client’s capabilities.

    Promote adaptability, not a singular rigidity.