Personal Training Scenario

[Cburylax]

Well, I got LM to respond to my training scenario in the Amino Acid Thread and I figure it can lead to some productive discussion, as well as avoid hijacking that thread complely. I encourage everyone to offer their possible ideas and explanation and I'll offer up my own opinion. Lets try to keep this productive, I know a few people could learn something from this. Here goes...

Training Scenario 1

"During squats, my right leg tends to externally rotate and I can feel my bodyweight shift laterally to the left on the eccentric movement. I'm trying to increase my 5 rep max by 50lbs and I have 9 weeks to do it. Can you tell why my leg is moving and why my body is shifting. What can you recommend for me to increase the weight?"



LM's response:
I'd say weak abductors, toes are too boxed up and should be pointed out more so as to take strain of the knee and prevent it from buckling, also there is a possible imbalance between right and left legs. It is also quite likely that depending on where the shift is occuring that there may be an imbalance between quads and hamstrings/glutes. I'd say drop the weight, focus on technique (this will also serve to deload your CNS which may be necessary to increase your max) and do more hamstring/glute work. Also since there may be an imbalance between the legs it is necessary to push with the right and left leg evenly instead of pushing more with the right, this can be fixed with concentration and possible overcompensation of the left leg with a lower weight to build up the left leg to correct the strength imbalance.

[LiquidMercury16]

What are your opinions on it cbury?

[Cburylax]

I want to wait until we get a few more responses and they we can walk through it together.

[Diesel4958]

Rotating due to -Weak adductors, possibly a strain from over training.
weight shift due to- weak right leg, needs left leg to compensate.
Left leg is stronger so I sould suggest get away from squats completely do some single leg work to correct leg to leg imbalance.

I have some questions for you C to add to my response in how to train them. What stance do they use, where are the weakest from? Lockout, hole, 2 inches above parallel?

[Lax.53]

are you wearing shoes when you squat? perhaps pronation of the foot.

[LiquidMercury16]

Could also be that some moron put too much weight on one side and the guy doesn't realize it heh. Possibly imbalances between lateralis and medialsis on legs pushing on either left or right leg. On right leg would be overcompensating medialsis and on left leg would be overcompensating lateralis, or could be a combo of both.

[LiquidMercury16]

Rotating due to -Weak adductors, possibly a strain from over training.
weight shift due to- weak right leg, needs left leg to compensate.
Left leg is stronger so I sould suggest get away from squats completely do some single leg work to correct leg to leg imbalance.



Well if you do single leg work you could be doing single leg squats (hard as a mofo). This will stimulate all the leg muscle required for squatting not just the quads as would be if you were doing single leg extentions. Could also try doing 1 legged leg press or hack squat.

[Diesel4958]

Well if you do single leg work you could be doing single leg squats (hard as a mofo). This will stimulate all the leg muscle required for squatting not just the quads as would be if you were doing single leg extentions. Could also try doing 1 legged leg press or hack squat.
Yea. lunges as well. all variations. I don't like machines. I would have them doing lunges, split squats, and even some stability work on a bosu ball.

[LiquidMercury16]

eh screw bosu ball, overated crap in my opinion

[bigDman]

weak adductors, maybe bad form. Tight hips is a common problem now a days with all the sitting in front of computers. Id do some serious mobility work. Id do some SMR of the leg muscles. Some glute activation. Make sure the form on the squat is perfect. Do some extra adductor strengthening exercises

[LiquidMercury16]

Possibly has pelvic tilt which in turn may have caused imbalance between hams/glutes/quads and caused all sorts of problems. I know I've got some pelvic tilt that I'm trying to correct and if I don't focus on my form I'll sometimes have bodyweight leaning one way or another.

Good to see you're still on here bigD, I took a hiatous of about 2 years and all these youngins have taking over haha.

[Cburylax]

Sweet....I like the thought process here. Anyways, here goes.

The first thing I would do when posed with a question like this or any other is wait to give any advice before I can do a postural assessment. Guessing is strike one in my book and most trainers feel the need to offer some kind of advice on the spot. Bad pie.

Like some of you pointed out, it could be as simple as wearing the wrong shoes, a previous injury, or simple just doing it wrong. But, for the sake of discussion, lets say its not that and is in fact an imbalance of some kind.

Since we're talking about the squat, it would make sense to perform a simple bodyweight overhead squat assessment. Basically, have the guy stand barefoot, raise his hands above his head, and tell him to squat. I usually don't offer any other instruction. You can usually gain a lot of insight into a person by how they think a squat should be performed.

I take a look from the front, back, and each side and look at the following bodyparts in this order.

1. Feet
2. Knees
3. Hips
4. Shoulders
5. Head

What happens here will give you a good indication for kinetic chain imbalances. Kinetic chain meaning skeletal, muscular, and nervous system interaction. Anyone have any ideas as to what to look for?

[LiquidMercury16]

How the balance is shifting, where they may be slowing down or having possible stalls. Speed of eccentric motion. Depth of concentric. If their feet are arching or if they are rocking on the heels or onto the toes. Where their hips are in relationship to their knees and feet. If the head is pointed up, looking around, so on so forth. I know I didn't look at that in the order as going from low to high but that's pretty much everything I can think of. I'd also say check spinal curvature, if its concave or convex.

[Cburylax]

You can also breakdown the deviations into three categories, ie Upper Cross Syndrome, Lower Cross Syndrome, and Pronation Distortion. Anyone heard of these?

LM, you're definitely on the right track.

[Cburylax]

Since I work from the feet up when I do an assessment, the Pronation Distortion Syndrome can be seen with the following:

1. Increased pronation of the feet
2. Internal rotation and/or adduction during the squat
3. Heal raising from the ground

From here you can tell what muscles are tight or overactive and what muscles are weak and/or inhibited.

I'll continue this a little later when I get back from dinner.

[LiquidMercury16]

Yes I've heard of all three of those and have suffered from upper cross syndrome (8 years of rowing) and always am having to watch my posture and sit up straight.

[Cburylax]

Ok...back to Pronation Distortion. In this scenario, the client says his right leg rotates outward during the squat and his weight shifts to the left.

(For this example, lets say we don't know if his feet flatten or his heels raise, and he doesn't have any previous injuries that might cause this).

That being the case, we need to identify the tight and overactive muscles, the weak muscles, and then come up with some exercises and flexibility work to address the imbalances. Any ideas? We need to know

1.What muscles could be responsible for external rotation of the leg?
2. What are the antagonists of the external rotators?
3. What muscles stabilize the pelvis in the frontal plane preventing lateral movement?

[bigDman]

How the balance is shifting, where they may be slowing down or having possible stalls. Speed of eccentric motion. Depth of concentric. If their feet are arching or if they are rocking on the heels or onto the toes. Where their hips are in relationship to their knees and feet. If the head is pointed up, looking around, so on so forth. I know I didn't look at that in the order as going from low to high but that's pretty much everything I can think of. I'd also say check spinal curvature, if its concave or convex.

in addition to this heels rising up knee position in relationship to the toe if the feet move at all during the squat. If the clients arches fall. what breaks first when squating hips or knees

[lowrollincaddy]

Are you right handed? Not joking here, because everyone has one leg that is stronger naturally. Think about if you were going to run and go for a lay up in basketball, would you prefer going to the right side of the basket (where you would push off of your left leg) or to the left (where you push off of the right leg)? Also think about how you would start a sprint, right leg or left leg forward? I bet you go to the right side of the basket and put your left leg forward. This is natural and what your body thinks is easiest.

So translating to your squat, you lean over your left leg because it is naturally stronger than your right. To help compensate for this you should try some single leg squats which will work the total leg and hip flexors a little more, and its ok to use a bench or chair to put your hand on while you do it, it takes most people awhile before they can do a single leg squat without assistance.

Your right leg is rotating out for the same reason. The rotating out allows your body to adjust to the extra weight om your left leg.

As for remedies for these problems I would suggest single leg squats, snatch squat (hold the bar only above your head with as wide a grip as you can, sit down like your doing a squat, do this slow and deliberate, it helps to have a mirror in front of you. I would warm up with these, 3 sets of 5) also working on all your core muscles.

As for increasing the weight 50lbs in 9 weeks. You should keep track of your weights and add a 2.5lb weight to each side of the bar every week, you will barely notice the difference but soon enough you will be at your goal.

[Cburylax]

in addition to this heels rising up knee position in relationship to the toe if the feet move at all during the squat. If the clients arches fall. what breaks first when squating hips or knees

Definitely things to look for.

Are you right handed? Not joking here, because everyone has one leg that is stronger naturally.

True, this can and does affect the kinetic chain. I don't really have any idea just how quantitative it can be but I'm sure it plays a part.

To help compensate for this you should try some single leg squats which will work the total leg and hip flexors a little more, and its ok to use a bench or chair to put your hand on while you do it, it takes most people awhile before they can do a single leg squat without assistance.

I'll agree that single leg squats are one of the ideal exercises here, but its only part of the solution.

Your right leg is rotating out for the same reason. The rotating out allows your body to adjust to the extra weight om your left leg.

Perhaps, however my experience says the external rotation is most likely the result of the overactive external rotators, ie piriformis, biceps femoris and an inhibited glute medius. A tight IT band is usually found here as well.

As for remedies for these problems I would suggest single leg squats, snatch squat (hold the bar only above your head with as wide a grip as you can, sit down like your doing a squat, do this slow and deliberate, it helps to have a mirror in front of you. I would warm up with these, 3 sets of 5) also working on all your core muscles.

I'm curious to know why you prescribed these exercises for this deviation? I would use them myself but I'd like to know your reasons.

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Continuing the Pronation Distortion concept, I'll need to also bring up the Lower Cross Syndrome (you know the song....cause the thigh bone is connected to the hip bone) since they are so interconnected, especially in the deviation scenario we're talking about.

The primary external rotators of the leg are the psoas major, Iliacus, Sartorius, Glute max, gemellus complex, piriformis, and glute medius.

The antagonists are obviously the internal rotators including the glute min and anterior glute medius, tensor fascia lata, adductor longus and brevis, and part of the hamstring.
source: http://www.ccptr.org/KDC/balancing_hips.htm

Regarding the lateral movement at the hip during the squat, the primary hip stablizers are the glute complex, specifically the glute medius, and the piriformis among others. Since the shift is happening to the left, it would seem that the left leg hip stablizers are weak or inhibited, correct?


So now that we've figured out the muscles that may be responsible for this, what strength and flexibility exercises should be recommended? What muscles are inhibited and how can this be addressed? Why is this important?

[bigDman]

As i stated before. Stretching of the hips and foam rolling of the whole leg espically the IT band. Id have the client do an extensive warmup with many glute activating exercises and dynamic stretching. with the weights a copious amount of one legged work,squats and deadlifts.

[Cburylax]

Ok...back from vacation in Napa Valley. To continue...

As i stated before. Stretching of the hips and foam rolling of the whole leg espically the IT band. Id have the client do an extensive warmup with many glute activating exercises and dynamic stretching. with the weights a copious amount of one legged work,squats and deadlifts.


I agree that stretching the hips, ie hip flexors and rolling the IT Band are necessary. What kind of glute activating exercises would you recommend? What other muscles would you suggest rolling? Anyone?

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Note: Rolling or Self Myofascial Release is explained here
http://www.performbetter.com/catalog/matriarch/MultiPiecePage.asp_Q_PageID_E_91_A_PageName_E_Arti cleMyofacialRelease
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[LiquidMercury16]

I'd roll thorax spine and abductors. As far as ham activation probably reverse weighted hypers, regular weighted hypers, bulgarian split squats, and possible good mornings, upright sled works, low-cable pull throughs. All are great for hip/glute activation. I prefer bulgarian split squats or low-cable pull throughts the most though.