Do You Paleo?

    Warning: if you like Paleo or think you are a true follower of the lifestyle, think again. Alan Aragon is one of my absolute favorites in the research and training field. He holds no punches and preaches the truth with a huge sense of humor. While this particular article does not have much of his funny wit, it is chock full of knowledge bombs. Prepare to learn and change how you percieve Paleo...

Interview with Alan Aragon Paleo Critic

20 Sep 2013 by Karen Pendergrass in Interviews

Alan Aragon is a nutrition expert and renowned Paleo critic that writes research reviews on the latest nutrition publications, writes a monthly column in Men’s Health Magazine, and is also a continuing education provider for several organizations, including the Commission on Dietetic Registration, National Academy of Sports Medicine, and the National Strength & Conditioning Association.
Aragon has been openly criticizing the Paleo Diet for over a decade, so I asked him a few questions about his background and opinion of the Paleo Diet and Paleo Movement in general to gain some insight and clarity to his oppositional stance.

1. Alan, tell us a little about your background and what you do. 

I’ve spent the majority of my career in nutritional counseling, but as of the past few years, I’ve been progressively more involved in research and conference lectures. My areas of concentration are the integration of training and nutrition for altering body composition or enhancing exercise performance (my latest publication is here). I have two primary research projects in the works and one secondary research project that should make it past peer review hopefully before the year is over. I’m also working on a book for the lay audience, and at this point I’m not too sure how much I can divulge about that. The speaking road will lead me to London and Canada before the year is up, in addition to my regular speaking spots at the Fitness Summit and the NSCA. My formal bio can be seen here.

2. What is AARP?

Are you trying to tell me I’m over the hill? If that’s the case…then I can’t argue with you on that. In all seriousness though, AARR (Alan Aragon’s Research Review) is a monthly review of the scientific literature related to nutrition, training, and supplementation. It’s what I do to stay on top of the current research, and help other health/fitness professionals and enthusiasts do the same. It’s an outlet for me to pour out my nerdy obsessions, when you really boil it down. Both the theoretical and practical sides are covered. I also have various guest contributors from all corners of the allied health fields, so it’s pretty diverse in terms its scope of content.

3. Many proponents of the Paleo Diet believe that post-Agricultural Revolution foods that weren’t eaten by our prehistoric ancestors should be avoided under that pretense. What is your response to this assertion? 

It’s logically faulty to just assume that pre-agricultural times were optimal in terms of nutritional circumstances, and general health circumstances, for that matter. Some of the most significant technological breakthroughs for improving human health and preventing/treating disease occurred within roughly the last century. The march of technology can be both good and bad, but let’s not dismiss or ignore the enormous amount of good. But beyond that, many whole foods (both plant & animal) of the present day did not exist in the Paleolithic period; they are products of modern-day farming and food engineering, so that virtually kills the objective right there. The best practical move we can make as modern-day humans is to predominate our diet with whole and minimally refined foods, while judiciously moderating the “naughty” stuff. One thing that really bugged me was seeing potatoes (a whole, nutrient-dense food) on the list of banned foods set forth by pioneering Paleo diet researcher Loren Cordain. Talk about going full-potato!

4. Are there some populations of people that you believe are extremely maladapted to Neolithic diets and therefore should avoid grains and legumes altogether?

I don’t think it’s practical or even accurate to assume population-wide extreme intolerance to grains and legumes. The issue with grains inevitably boils down to some level of gluten intolerance. The most current estimates of celiac disease prevalence fall below 1% of the population. As far as non-celiac gluten sensitivity (NCGS) goes, a very recent study led by Daniel DiGiacomo of the Celiac Disease Center at Columbia University estimated that the national prevalence of NCGS is a smidge over 0.5%, which is about half the prevalence of celiac disease. I’ve seen higher gluten sensitivity prevalence estimates in less reliable literature, but the bottom line is that the gluten-tolerant faction of the population is likely to be well over 90% of us. So, it simply makes no sense to view gluten-containing foods as universally “bad.” Adding to the illogic of banning foods that are tolerable by the vast majority of the population, the traditional Paleo diet doctrine selectively ignores the fact that ‘Paleo-approved’ foods (i.e., nuts, fish, and shellfish), have a combined prevalence of allergenicity comparable to – and by some estimates even greater  than that of gluten-containing grains. Another amusing fact is that 4 of the 8 “major food allergens” designated by the Food Allergen Labeling and Consumer Protection Act are Paleo-approved.

5. Are Paleo Diet adherents missing important health benefits from eschewing grains, legumes, and dairy?

If you include taste enjoyment as an indirect benefit to health, then I’d say yes, that applies to all of those foods. Anyone who can tolerate a given food, and truly enjoys the food, should not force the avoidance of it. This rigid, all-or-nothing approach to dieting is a recipe for disordered eating in susceptible individuals. Speaking of the foods from a nutritional standpoint, I’d also say yes. Every species of food has its own unique nutrient profile – and I’m not just talking about essential vitamins and minerals. There are a plethora of phytonutrients (& zoonutrients) in those foods that may act individually or synergistically to promote health and/or inhibit disease. Let’s take oats, for example. There is a substantive body of research pointing to multiple beneficial effects attributed to the beta-glucan content, and other non-essential components of oats. These benefits range from appetite control (as indicated by increases in peptide Y-Y) to enhanced immune response, and improvements in blood lipid profile and glucose control. The list goes on. As for dairy, I pity the poor soul who can digestively tolerate dairy just fine, truly enjoys it, yet avoids it just because it breaks Paleo rules. I’ll quote research by Rafferty & Heaney on the nutritional profile of milk:
“NHANES 1999–2000 and CSFII 1994–1996 analyses of food sources of calcium, vitamin D, protein, phosphorus, and potassium reveal milk to be the number 1 single food contributor of each of these bone-related nutrients with the exception of protein in all age groups of both sexes…”
Regarding legumes, the aforementioned principles apply. Furthermore, I’ve repeatedly challenged folks to show me research indicating the adverse effects of whole legume consumption (not soy protein isolate by the bucketload) in healthy humans. Invariably, I hear crickets. In contrast, the scientific literature (in both observational and controlled studies) on the health benefits of legume consumption is substantial. Peanuts are legumes, and peanut butter (especially combined with chocolate) has been known to impart magical powers. Your mileage may vary on this. An interesting bit of information that folks ignore or overlook is that legumes are common staples of some of the healthiest populations in the world. In fact, Dan Buettner (of Blue Zone research fame) reported that beans, including fava, black, soy, and lentils, are the cornerstone of most centenarian diets. Of course, this is observational data with many potential confounding variables. Nonetheless, it warrants caution against the assumption that legumes are the bad guys. I’ve recently made the point that traditional Mediterranean populations have intakes that violate every food restriction rule of the Paleo diet, but they’re busy being too healthy to give a damn.

 6. While it is almost universally recognized that Celiac’s Disease is a gluten-mediated condition, do you suggest that people with Autoimmune Conditions consume grains?

For those who enjoy grains, yes. I am a big believer in respecting you own personal taste preference, and letting that override the rules and formalities of any given fad diet. If grains don’t suit your personal taste, then by all means don’t eat them. It’s the idea of banning them universally despite a lack of supporting evidence that I take issue with. For those who DO have the desire to eat grains but have issues with gluten intolerance, the good news is that commercially available gluten-free grains outnumber gluten-containing grains by at least 2 to 1 (complete resource here).

7. If a client of yours presents with IBS, what dietary recommendations do you make to improve GI function?

Well, right off the bat, I wouldn’t do a knee-jerk recommendation to avoid all grains, legumes, and dairy. The British Dietetic Association recently published evidence-based guidelines for the management of irritable bowel syndrome (IBS). In summary, lowering the intake of fermentable carbohydrates is recommended. Also, avoiding or minimizing gluten-containing foods may be necessary, but let me reiterate that there’s still a fair range of gluten-free grain foods available to choose from if the person likes grains. Lactose-containing foods can be problematic, so their minimization or elimination should be considered as well (note that low & no-lactose dairy products are abundant). A high consumption of fructose has also been implicated in exacerbating IBS, so this should be moderated as well. Indiscriminately having an IBS patient “go Paleo” can potentially lead to problems since there are Paleo-approved foods are high in fructose, fructans, and polyols suspected to aggravate IBS. However, I would concede that as a quick-and-dirty shotgun solution to managing IBS, the Paleo diet model is actually quite a good approach. I would also encourage screening and treatment by a gastroenterologist (or similar qualified medical specialist), since many times the treatments for digestive disorders are beyond the scope of nutritional modulation alone.

8. Is the fear of a skewed off, greater than 1:1 Omega-6, Omega-3 ratio, irrational and unfounded?

Yes, it is unfounded. There’s no objective evidence demonstrating the optimality of a 1:1 ratio of dietary omega-6 to omega-3 fatty acids. It’s all speculation without a solid research basis. For example, the ratio of omega-6 to omega 3 in coconut oil (a Paleo fetishist favorite) is almost 4000 to 1, yet the weight of the evidence does not indict coconut oil as an agent of adverse effects. Most commercially available land animals’ fatty acid composition has omega-6 content that’s many times greater than its omega-3 content. So, if we were to strive for a 1:1 ratio in the diet, we’d have to minimize the consumption of beef, chicken, pork, etc. It’s just silly. In line with this, the higher proportion of omega-6 fats in whole foods of plant origin such as nuts is not a concern. The evidence of omega-3 consumption’s beneficial effect on health indexes is abundant, so I would recommend keeping fatty marine foods in rotation in the weekly menu in order to reap these benefits. For those really worried about it, omega-3 supplementation is always an option.

9. Is our ‘fear’ of sugar unfounded?

It depends. I’d say in rational, health-conscious, physically active adults, the fear of sugar is indeed unfounded. In children and adolescents (who are mostly clueless about health, lets’ face it), sugar consumption is often unbridled & combined with physical inactivity, so yeah – the concern is there. The crux of sugarphobia centers around fructose, which is an almost unavoidable component of commercially available sugar-sweetened products. Table sugar itself (sucrose) is half glucose, half fructose, and high-fructose corn syrup (HFCS) which is ubiquitous in soft drinks and packaged sweets has a slightly but inconsequentially higher proportion of fructose. Many are familiar with Robert Lustig’s campaign against sugar, and his emphasis on the evils of fructose. What often fails to be addressed is that dose and context make all the difference in the world. The research indicting fructose as an inherent agent of harm uses artificially high doses that are many times greater than typical human intakes. Much of this research is rodent-based, and rodents’ capacity to convert dietary carbohydrate to fat is roughly ten-fold that of humans. There are several diligent scientific reviews that have been done on this topic, which I would encourage everyone to read, since the full text is publicly available. To quote a recent review by Salwa Rizkalla:
“Despite the epidemiological parallel between the marked increase of obesity and fructose consumption, there is no direct evidence linking obesity to the consumption of physiological amounts of fructose in humans (≤ 100g/day). A moderate dose (≤ 50g/day) of added fructose has no deleterious effect on fasting and postprandial triglycerides, glucose control and insulin resistance.”
I would also encourage everyone to read John White’s recent review challenging the fructose hypothesis, whose key points are quoteworthy:
“In considering the volume of contemporary literature on fructose, 1 conclusion stands clear: fructose is safe at typical intake levels but can produce adverse metabolic effects when abused—as is true of most nutrients. It turns out that the largest abusers of fructose are not American consumers, but research scientists. [...] It is only when researchers hyperdose human and animal subjects with fructose in amounts that exceed the 95th percentile by 1.5- to 3- and 4- to 5-fold, respectively, that adverse effects are provoked.”
The way I see it, the practical take-away for the general population would be to keep added sugar (as opposed to intrinsic sugar in milk or whole fruit) limited to roughly 10% of total calories. This will allow for moderation & sane dietary practices while also hedging your bets away from the adverse potential of excess intake. Certain athletes involved in high-volume endurance competition (and other highly physically active folks) can safely exceed this in order to meet the demands of their sport.

10. What are your biggest gripes with the Paleo Movement as a whole? What do you appreciate about the Paleo Movement as a whole?

My biggest gripes with the Paleo Movement is the extreme-ism and absolute-ism that some folks apply to food avoidance despite a lack of supporting research evidence. And even the “Primal” model of going 80% Paleo while leaving 20% for the non-Paleo stuff is rather humorous. For example, in the context of a typical 2500 kcal diet, 20% of those calories coming from grains & dairy would constitute 500 kcal – which is the capacity for a typical bowl of cereal. So, if a bowl of cereal (or 2 cups of pasta, or 4 slices of bread) every day qualifies as Primal, then it sounds a lot like conventional eating to me. It’s just difficult to tolerate the lack of logic there. I generally can’t stand the labeling or branding aspect of a diet, or the universalization of diet rules. This is because individuals have vastly different preferences, tolerances, and goals for the function of their eating habits.
As for what I appreciate about the Paleo movement, the push toward consuming more whole foods is definitely a positive thing. I appreciate guys like Robb Wolf & Mat Lalonde who are much more flexible and objective in their approach & philosophies than the majority I’ve communicated with in the Paleo sphere. Last but not least, I like the CrossFit training attire.

11. Are there any questions that I failed to ask you that you feel merits answering?

Not that can think of at the moment, this should be plenty to get people thinking. I want give you thanks and credit for being the first Paleo-focused publication to reach outside the box and interview me.

Alan Aragon Paleo Critic interview conducted by Karen Pendergrass. To learn more about Alan Aragon, visit his website here.

To Belt or Not to Belt?

  Weight belts are weak, much like gloves, wrist straps and carrying the entire tub of protein powder to the gym ( do not get me started). Do we really need them, or are they just an accessory to make us look 'bro-tastic'? Three coaches give their insights and opinions. My opinion? I haven't owned a belt since 1990 and have used one fewer than ten times since...

Do You Really Need a Lifting Belt?

by Mike Robertson – 6/20/2013

Here's what you need to know...

• The typical trainee has a weak core. Using a weight belt masks this problem.

• Strength athletes can use a belt, but only for sets above 85% of 1RM and not with all lifts. Never wear a belt when performing an exercise that has you sitting or lying down.

• If you're an athlete and you don't wear a belt in your sport, then wear a belt sparingly, if at all.

• There's a specific way to wear a belt – don't just slap it on.

---

Weight belts seem to be making a big comeback. Are they must-have accessories for every lifter?

Some lifters are never seen without their beat-up old leather belts, while others go their entire careers without ever putting one on.
Four coaches took aim at lifting's most common fashion accessory – the weight belt.

Mike Robertson

An athlete doesn't get anything out of using a belt.

Only those who are trying to compete in a strength sport (Olympic lifters, powerlifters, strongmen, etc.) should be wearing a belt when they lift.
When we assess our clients, they almost universally come in with a weak or underdeveloped core. As such, we have to rebuild this over time with smart coaching and exercise progressions.
If someone is constantly using a belt to "hide" a weak core (relative to their hips/legs), this is a problem we need to address.
An athlete really doesn't get anything out of using a belt. And many times it works against them because the goal is to build a balanced body that works as a functional unit.
For strength athletes, it's a different story – you're judged on your ability to move weight. However, the bulk of the training time should still be done raw, only using a belt when in the 85%+ range of lifting.
To effectively use a belt, there's a lot more to it than simply "pushing your abs out." In fact, this is detrimental as it slams your lower back into extension.
Instead, put the belt on and exhale slightly, allowing the ribs to come down. Now with the ribs down, take another deep breath in – you should feel pressure to the front, sides, and back of the belt.
This is true, circumferential, core stability in all directions. You'll not only be more stable, but move more weight as a result.

Tim Henriques

Over-reliance on belts weaken the core.

Lifting belts can increase intra-abdominal pressure. This intra-abdominal pressure is good in that it increases spine and core stability. It's bad in that it shoots up blood pressure and can aggravate hernias and other injuries.
Lifting belts can help performance on big lifts involving the lower back. If a lifter is squatting heavy or pulling big, a belt may be able to increase performance on those lifts.
However, if the exercise really doesn't stress the lower back/core that much – leg presses, triceps pushdowns, etc. – wearing a belt is unnecessary (apart from making your waist look smaller and your shoulders look bigger).
Over-reliance on lifting belts might also weaken the core musculature. Think of a belt like a crutch – use it too much and the muscles don't respond because the belt is there.
That being said, folks like Louie Simmons advocate pushing your abs against the belt, in which case belt work might actually make your core stronger because you have some resistance – the belt – to push against.
But if you're an athlete and you don't wear a belt in your sport, then I would wear a belt sparingly.
So my answer to the belt question is this: First, don't wear it on stuff that doesn't involve the lower back much, and definitely don't be one of those dudes that puts the belt on in the locker room and doesn't take it off until he's changing out of his workout clothes.
Second, save the belt for the big sets, whatever that means to you. For warm-up sets and light work sets it's generally unnecessary to wear one, but for the big stuff put it on.
Finally, you need to learn how to use the belt. I like to do a core bracing exercise in which I put the belt on, get into lifting position, and then brace my core really hard.
Sometimes I'll have lifters put their fingers in between the belt and their core. When they brace they should feel considerable pressure on their fingers. This is harder than it seems, and if it is for you then regress the movement in the following way:
Start in a normal standing position with a slight arch in the lower back and learn how to brace there. Then move into more lifting-specific positions. Hold the brace for about 5 seconds and do a few sets of this.
If you have an injury and you feel the belt protects it, wear it. It's easy to brace the core hard in spinal flexion, but while lifting we want to mimic our lifting position which is usually with a slight spinal extension.
When it comes to types of belts, I'm partial to the Inzer Forever Belt with a Lever. I've had the same belt for 17 years and still love it.

Dan Trink

The answer lies in the middle.

About 400 years ago, when I first set foot in the gym, everyone wore a weight belt. It didn't matter if you were squatting, bench pressing, or taking a step aerobics class, a cinched weight belt was as much a part of the gym uniform as leg warmers or Zubaz pants.
Then, about 15 years ago, guys like Paul Chek came out against weight belts saying how they stunted the development of the transverse abdominus and other core musculature. At that point, unless your name was Sven and you were lifting a 400-pound atlas stone at the World's Strongest Man competition, you wouldn't be caught dead in a belt.
As with most things, the right answer lies somewhere in the middle. The majority of people shouldn't be wearing lifting belts the majority of the time.
However, if you're going for a maximal or near-maximal squat or deadlift, and the weight on the bar is hovering around 2x bodyweight, a belt will certainly help you complete the lift by providing more support to your abs and lower back as well as keep your spine from crumbling into a pile of dust.
I've also noticed a lot more Olympic weightlifters wearing thin belts with a Velcro closure during near-max attempts. This is also a good idea as anything that can keep you safer and training longer and harder will be beneficial in the long run. And given the way a lot of these athletes train and the massive loads they're able to lift, these belts are probably necessary.
While you want your lifting belt to be tight, the goal is to be able to get a belly full of air and brace your abs against the belt. So if you're cinching your belt so tight that you can't get in a full, deep breath, you may want to back it off a notch.
You can actually use a weight belt as a proprioceptive tool to help teach an abdominal brace by getting air into your abdomen and bracing against the belt. I usually do this by placing my hands around a client's waist, but if training alone the belt does a great job.
And never wear a belt when performing an exercise that has you sitting or lying down. Ever.
Bottom line, if you're an experienced lifter about to do a near-max effort single or double, then pop on a lifting belt. However, if you're cranking out sets of 8 to 10 at 70%, then put the weight belt back in the closet with your string tank top.

Todd Bumgardner

Belts are for experienced lifters and big weights.

I'm absolutely an advocate for using weight belts to promote strength.
It's an easy argument – intra-abdominal pressure that provides spinal stability leads to greater force output. Like any other training tool, however, use is situational.
While belts are a useful tool, they should be saved for the big lifts and Olympic lifts, and for efforts at 75 percent or greater of one-rep max. Sorry, but screaming, parachute pant biceps curls aren't belt worthy.
Sure, it's efficacious to use a belt for lifts at lower percentages – you're going to improve force output. But building core strength and coordination is advantageous for building lasting strength. Consider the lower-percentage lifts to be the core builders, while belts are showtime ergogenic aids.
Belts are also reserved for those with at least a few years of lifting experience – young lifters, and those young in training age, need to learn how to breathe and how to brace with their lats, abs, and supporting core musculature before they slap a belt on.
We actually came out of the womb with a solid belt – lifters need to master using it before they turn to external assistance.
Do you know how to get your air low into your belly? Have you mastered lat tension? Can you breathe behind the shield? If you've answered no to even one of these questions, forget about using a belt.
If you're belt ready, use it well. Align it so the bottom of the belt is just above the crests of your hip bones. Make sure the front of the belt covers your belly button.
Also, make sure the belt is used to reinforce a solid, diaphragmatic breath. Don't just push your abs out against the belt. This means that you shouldn't have the belt so tight that your belly can't expand into it.
As you take in a breath, you should feel your trunk fill with air and put pressure on the belt in 360 degrees. Your belly should press into the belt, as should your back. Your obliques should press into the belt just above your iliac crests. If you're doing it right you'll feel like a marshmallow stuffed into a wedding band.
Make sure the belt isn't a crutch for shitty positioning. Lock your form in, and then use the belt as assistance for holding good position – long spine and low breath.

Wrap Up

Weight belts are a tool – in the right context they're indispensable, while in the majority of cases (and in the majority of lifters) they're useless at best.
Learn proper form, learn how to brace your core, and focus on getting strong with as little "gear" as possible. The fun tools will be waiting for you when you have the need for them.

The Beauty of Complexes

 If you can not stand to walk on the treadmill, if running is too boring, and if you are too uncoordinated to ride a bike, try complexes. These are truly made to test your mettle, as you may think your lungs may burst mercifully before you pass out. Some of the best coaches torture their athletes with these; they save time and will have you on the floor in a matter of minutes. But don't let that scare you, give them a shot! This snippet comes to you from an old T-Nation article. Enjoy.





Complexes: Not So Complex
Quick review: A complex is where you pick up a barbell, perform several reps of an exercise with it, then move right into another exercise, then another, and another, and maybe one or two more. Then you see black spots, get all ripped 'n shit, and bang swimsuit models.
Okay, okay, Coach Dan John has a much better definition: "A complex is a series of lifts performed back to back where you finish the reps of one lift before moving on to the next lift. The bar only leaves your hands or touches the floor after all of the lifts are completed."
Alwyn Cosgrove is even more concise: "A complex is a circuit using one piece of equipment, one load, and one space."
So maybe you perform front squats for 8 reps, then push presses for 8 reps, then bent-over rows for 8, and finally back squats for 8 — all without putting the damn bar down.
It's brutal. Better still, it's brutally effective for fat loss and improving all the physical qualities I listed in my snazzy intro.
But the best thing? You can't do it while talking on the fucking cell phone or otherwise "going through the motions." It requires focus, discipline, hard work, and quite possibly a touch of insanity.
Make no mistake, if anyone says this is easy you can bet they've never actually tried it.

So When Do You Use Complexes?

• As a replacement for boring-ass cardio during fat loss phases
• As a conditioning tool for sports
• As an off-day "bonus" workout if you just feel like going to the gym when you're not scheduled to (OCD, anyone?)
• As part of an unloading/deloading week.

 

 

 

Poor guy. Even puppies get tired from complexes...

 

 

 

 

 

 

Shoulder Pain? Fix This!

This is an older article that I still refer to. It was one that really opened my eyes to the importance of shoulder health. If you are having issues with your shoulders, chest tightening, or just generally sit at a computer all day, use some of these tips to correct yourself before you wreck yourself. Sorry, couldn't help myself. Enjoy!

Push-Ups, Face Pulls, and Shrugs
...for Strong and Healthy Shoulders!
by Bill Hartman and Mike Robertson

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Screw the Rotator Cuff!

That's right, screw it. Seriously, it's about as over-hyped as Kevin Federline's big "debut." We think the rotator cuff gets way too much attention. Whenever shoulder pain creeps up, what's the first thing that everyone brings up? The rotator cuff, of course. (Or for those of you from Indiana, that would be your "rotary cup").

"My shoulder hurts when I bench press."

"Well, you need to strengthen your rotator cuff."

"It hurts when I reach overhead or do barbell presses."

"You're probably impinging your rotator cuff."

"I hurt my shoulder pitching and now I can't collect my million dollar performance bonus."

"Sounds like you tore your rotator cuff."

We've had it up to our shoulders with the rotator cuff! While the rotator gets all the chicks, all the glamour, and all the attention, the real star of the show is forced to the background. In fact, it never even gets any mirror time at the gym, unless you're picking at your backne. (We've seen you do it).
Allow us to introduce the real star of the show: the scapula!

Our Favorite Bone

The scapula is our favorite bone and we're not afraid to admit it. (Insert way-too-easy penis joke here.) No other bone in your body functions like the scapula, nor does any have so complex or important a job. Without the scapula, your shoulder is nothing!
When you really examine the scapulae (plural for scapula), one of the first things you'll notice is that it's position on the body, and it's function, are almost entirely determined by the function of the muscles attached to it. If it weren't for your tiny acromioclavicular (AC) joint and a couple of ligaments, your scapulae wouldn't have any bony attachments to the rest of the bony skeleton.
Since the scapula is half of the glenohumeral joint (the shoulder joint) and is essentially the foundation of the shoulder, this becomes an important point. Any altered scapular muscle function, weakness, or inability to position the scapula and then stabilize it results in a direct affect on the shoulder joint with dire consequences. These include glenohumeral instability leading to arthritis, impingement, rotator cuff tendonitis/tendinosis, rotator cuff tears, labrum injuries, and so on.
Rather than blindly give you a series of exercises and a program, we think it's important that you have at least a rudimentary understanding of how the scapula functions.

Functional Anatomy Surrounding the Scapulae

We live in a 3-D world, so the scapulae function in three dimensions. The scapulae tilt forward and backward, rotate inward and outward, and rotate upward and downward.
Through the combined efforts of some 17 muscles it can also protract and retract as well as elevate (shrug) and depress.
Of the typical 180 degrees of overhead reach in a healthy shoulder, the scapulae's upward rotation is responsible for about 60 degrees of it. It does so through the synergistic efforts of the "upward" rotators: the upper trapezius, the lower trapezius, and serratus anterior.
Now imagine what would happen if you were unable, for whatever reason, to get that necessary movement from the scapulae. What would happen then? In all likelihood, when one (or all) of our scapular upward rotators are weak, inhibited, or simply not able to control and produce movement like they should, impingement syndromes develop and your rotator cuff is at a significantly increased risk of injury.
Contrast this with our downward rotators comprised of the levator scapulae and rhomboids. In her text Diagnosis and Treatment of Movement Impairment Syndromes, Shirley Sahrmann discusses a phenomenon called scapular downward rotation syndrome. In essence, due to poor training, behavioral demands and flat-out poor posture, our scapular downward rotators have a tendency to become short and stiff.
Class, what does all this mean? Let's use a simple math equation to put the pieces together:
Lack of proper training for the upward rotators + excessive training and postural demands placed on the downward rotators = a recipe for rotator cuff injury!
But as bad as that sounds, it gets worse before it gets better. Let's delve even further into the matrix, looking at how the majority of us develop our training programs.

Flawed Programming

Flaw #1: Focus on external/internal rotation movements only vs. role as a humeral depression
At the risk of sounding heretical, we've got to tell you that all those internal and external rotations aren't bad, but they're not doing as much for you as you'd like to think. This is even more true if your only goal is to have a jacked physique or push around heavy iron.
Specific muscles of the rotator cuff do promote certain movements (e.g. the subscapularis promotes internal rotation, the teres minor and infraspinatus promote external rotation, etc.), but there's a bigger, more functional role that's very rarely discussed. That role is humeral depression.
Go back to our example of upward rotation — as you move your arm upward, the scapula rotates upward as well. If your rotator cuff is working appropriately, it will exert a downward pull on the humeral head, which keeps it from impinging on the acromion. If the rotator cuff is weak or inhibited, it can't exert this downward pull, and again we're left with impingement.
Luckily for you, a lot of the exercises we've included focus on the stabilizing role of the rotator cuff. But don't skip ahead just yet, there's more to learn!

Flaw #2: Ignoring the effect of the thoracic spine on the scapula and shoulder
The scapula will talk to you if you listen. It will tell you when it's SICK (yes, there really is a condition called a SICK scapula), it will tell you where you're strong, and it'll tell you where you're weak simply based on its resting position on the ribcage and how it moves, or doesn't move, when you do.
Because the scapula rests on the ribcage forming the scapulothoracic joint, the shape of the ribcage will also determine the resting position and the mobility of the scapula. In turn, the shape of the ribcage is determined by the postural alignment of the thoracic spine (upper back). This is also why we spend so much time focusing on proper alignment of the thoracic spine in our Inside-Out product line.
This makes your scapula the middleman between the spine and the rotator cuff. We already know that poor scapular mobility or stability can compromise the strength, function, and health of the rotator cuff. Therefore, to assure optimal shoulder function we must develop the relationship from the spine (inside), to the scapula, to the rotator cuff (out).
Let's look at one example of how the thoracic spine posture affects your shoulder. In a normal thoracic spine/scapular relationship, as you reach upward, the scapula tilts backwards (posterior tilt) to make space in the shoulder joint for the rotator cuff. In a case of thoracic kyphosis (rounded forward upper back), the scapula is unable to tilt backward.
The result is a closing of the gap between the upper arm bone (humerus) and the acromion and impingement of the rotator cuff. In the photos below, you can see how the athlete compensates for an inability to tilt the scapula posteriorly and fully elevate the arms by arching in the lower back. To achieve full elevation, he's most likely impinging the rotator cuff.
As spine mobility and upper back posture improved (check out the shape of the ribcage), the scapula was free to tilt backward, restore overhead reach, and reduce compensation and impingement.

Day 1	3 months	6 months

Flaw #3: Attempting to balance bench presses with rows
If you read the interview with Bill, you remember that he laid out what the basic movement pattern relationships should be based on the function of the scapulae and rotator cuff. It looks like this:

Abduction/scapular upward rotation to adduction/scapular downward rotation:

• Vertical push to vertical pull
• 0.85-0.95 to 1 (almost 1 to 1)

Protraction to retraction:

• Horizontal push to horizontal pull
• 1 to 1

For the rotator cuff:

• Internal rotation to external rotation
• 1 to 0.75

We all know that we should balance our pushes and pulls, especially with regards to our bench pressing and rowing, right? But what if it's not so simple a relationship? Do we have your attention?
In essence, what we're looking at here is balancing our ability to protract and retract the scapulae. Bench pressing is a horizontal pushing movement that you'd think normally produces protraction (forward movement of the scapula around the ribcage) and trains the muscle that cause protraction, a.k.a. the serratus anterior. The logical opposing movement would be a row of some sort. Balanced, right? Wrong.

Question: What's the most effective scapular position to maximize bench press performance?

Answer: Retraction and depression

Question: What scapular position is achieved in the contracted phase of a rowing movement?

Answer: Retraction and depression
Balanced? Nope.
Get it? What looks good on the outside, feeds an imbalance on the inside. Serratus anterior becomes ineffective as a protractor, stabilizer, and upward rotator. Then there's an added bonus. But first a quick anatomy lesson.
Next time you're cutting on a cadaver (What? Doesn't everyone?), check out the serratus anterior and the rhomboid. What you'll find is that because of the fascia that covers everything in the body, they're essentially the same muscle with the scapula kinda stuck in the middle.
So if the serratus anterior isn't fully effective at producing an upward rotation force and the rhomboid (a downward rotator) is getting trained with both pushes and pulls, then guess who wins the tug-o-war with the scapula.
Correct! The rhomboids and downward rotation. This means you're more likely to experience shoulder impingement. But that's not all!
Remember how the thoracic kyphosis limited posterior tilt of the scapula with elevation of your arm? The kyphosis will also promote an anterior tilt of the scapula at rest. Over time, the pec minor (which attaches to the front of the scapula) will stiffen or shorten and the scapula gets "stuck" in an anterior tilt.
This will also result in weakness of the serratus anterior, lower trapezius, and the upper trapezius. These, as you now know, are the upward rotators. Weakness in the upward rotators will then allow the downward rotators to become the dominant force on the scapula. If you need to figure out what happens next, please reread the scapular equation in section two of this article.
So whether you're a truck driver or a powerlifter, you can end up with the same shoulder dysfunctions.

Truck Driver	Powerlifter

The bottom line? Crappy scapular position leads to crappy scapular stability which leads to crappy rotator cuff function! As Matt Damon's character in Good Will Hunting would say, "How you like them apples?"
So what's the fix?

Long Live the Push-Up!

The push-up has been used for centuries to help everyone from cromagnon man to the ancient Greeks, to guys and gals like yourself, with one goal in mind — to achieve a jacked physique! And why not? It's an amazingly simple exercise that anyone can perform anywhere.
Unfortunately, in recent years, the push-up seems to have fallen out of favor in a lot of circles. For those who like excessively detailed programs, it's just not "complex" enough. For others, it's only for the "bodyweight" guys. And lastly, some just don't know how to fit it into their program and progress it correctly.
Before we get onto the push-up and its progressions, let's look at some of the research that's been done regarding push-ups. Obviously, our first goal of performing push-ups is to recruit and strengthen the serratus anterior. So how can we do that?
Lear and Gross determined that push-ups performed with the feet on an elevated surface (in this case the feet were elevated 45.7 cm) significantly increased the activation of the serratus anterior compared to traditional push-up variations. If it's been a while since you performed traditional push-ups, it would be a good idea to start with basic variations, but elevating the feet is a viable progression if your primary goal is improved serratus function.
Another common question when performing push-ups is, "Where should my hands go?" Cogley et al. wondered this as well, and examined subjects to see how various hand positions affected EMG activity of the pecs and triceps. Researchers looked at three hand positions: shoulder width, hands together, and wide (approximately 90/90 position). The EMG for all trials showed that EMG was highest in the hands together position, which makes perfect sense — this is the position of least mechanical advantage, and therefore more musculature must be recruited to perform the movement.
Adding an unstable surface to the mix can also change which muscles are most heavily recruited. When push-ups were performed with the participant's hands on a physioball, there was a significant increase in both activation of both the triceps and rectus abdominus. It appears as though the unstable surface increases the activity of the triceps as a shoulder stabilizer, and it also increases the demands of the rectus abdominus to produce stability.
Here's where things get interesting. It seems the more weight you put on the upper extremity, the higher activation levels you get in the surrounding musculature as well. Uhl et al. examined multiple push-up positions that progressively increased loading on the upper extremity. Researchers started with patients in an all-fours position, and progressively moved them into more loaded positions such as push-up position, push-up position with feet elevated, and even single-arm push-up position.
As you can imagine, the one-arm push-up produced a significant increase in recruitment of shoulder stabilizers such as the supraspinatus, infraspinatus, and posterior deltoid over all the other conditions. It appears as though there are many ways to progressively increase the difficulty and function of the push-up, whether you're elevating the feet, performing the exercise on an unstable surface, or performing single-arm variants, we're going to give you a ton of options in the following section.
Hopefully you're starting to see that whether you're rehabbing a shoulder injury or just concerned with keeping your shoulders healthy, push-ups are an excellent and undervalued exercise. It should also be stated that just because it's a great exercise, there's also a correct way to perform it, and the basic principles of progression should be followed.
In other words, if you're rehabbing a rotator cuff injury, don't jump into the most difficult progression right away. As well, if you're a strong and healthy individual, don't mess around with the "on-knees" version — get right into something you can do correctly and that challenges you!

Performing the Push-Up

To correctly perform a push-up, lay face down on the floor with your toes pointed, hands and elbows at a 90 degree angle to the shoulders, and stomach tight. Press up to the starting position, making sure to keep the stomach tight throughout, and then lower under control to a point where the chest touches the ground. As you're lowering, tuck the elbows such that the angle between your upper arm and torso is approximately 45 degrees.
One aspect that we can't emphasize enough is to use a full range of motion. Be sure to lower under control, and at the top think of pushing your body as far away from the floor as possible. This extra "push" at the end will emphasize proper serratus function.
At this stage in the game, the powerlifters in the group are screaming, "We need more weight!" Trust us, we're all for progression; we don't want you using bodyweight resistance for the rest of your life. The easiest progression you can use in this case is a weighted vest such as an Xvest. If you need additional instruction on how to perform push-ups with an Xvest, maybe you shouldn't be lifting weights at all.

Push-Ups with Bands and Chains

That's not it though; let's look at some other ways we can perform the push-up to increase the intensity of the exercise.
Using bands is another option when we want to increase the loading of our push-ups. Again, the progression is simple — once you've mastered one band for the desired number of sets and reps, bump it up to the next level. It's that simple!
To perform push-ups with bands, you're going to take the band behind your back and place your hands in the ends of the bands such that the band is in the palm of your hand.
As you can see in the picture, you have to make an ëX' with the band. Simply twist the band, put it behind your back, and you're ready to rock!
Still not enough variation? You can also drape chains over your back.
If one chain isn't enough, either move up to the next size of chain or drape multiple chains over your back. The band and chain variations are also excellent for powerlifters looking to improve the lockout of their bench press.
We've included two variations of the chain push-up. The first version you cross the chains in a diagonal fashion over your back as in the picture above.
The behind-the-neck version is even tougher; moving the weight further up toward your shoulders will increase the activation of the rotator cuff and make the exercise a lot harder.
Finally, please note that getting the chains on your own back is a pain in the ass. Get a partner to help you out if possible.
Once you've mastered the basic push-up variations, feel free to move on to some of the following variations. They're not only great for strengthening, but they also jack-up the rotator cuff involvement and force your body to stabilize the shoulder in a more dynamic environment.

Med Ball Push-Ups

The medicine ball push-up is a great variation, as it increases activation of the rotator cuff due to the unstable surface. There are multiple variations you can use here.
Start off using a small med ball under one hand, with the other hand pushing off the ground. This will limit the instability to some degree and allow you to learn the exercise. We shouldn't have to say this, but make sure you're switching hands either in-between sets or at the midpoint of every set.
If that isn't enough challenge, move on to the double med-ball version. Place a small med ball under each hand and perform the exercise. As you increase the instability, not only will you recruit more shoulder stabilizing musculature, but you'll also force your core to increase its stiffness as well. Just try these variations with a soft-tummy; we dare you!

Blast Strap Push-Ups

The blast strap push-up is very similar to the med ball push-up, so we're not going to continue harping on the topic. Regardless, this is another effective variation you can use.

Enter the Face Pull: The Most Underrated Exercise!

The face pull may be the most underrated exercise in all of strength training. It falls into the horizontal pull category, but where rows potentially promote a downward scapular rotation syndrome and internal rotation of the shoulder joint, the face pull can do just the opposite.
Because the shoulder is either flexed or abducted 90 degrees throughout the face pull, the scapula is in upward rotation to some degree. Right away this gives us greater activation of the upward rotators, especially the upper and lower trapezius. The upward rotation offsets the pull of the downward rotators and helps prevent the development of the downward rotation dominant imbalance.
Now let's look at face pull performance. Traditionally, the face pull is performed with a rope handle or strap and a pronated grip.
In the contracted position, the pronated grip limits the degree of external rotation of the shoulder.
In thinking about movement pattern balance, we know that the internal rotators of the shoulder tend to be at least 25-33% stronger than the external rotators. We also tend to find that from a postural perspective, internal rotation of the humerus is quite common. Using the traditional pronated grip for the face pull can then potentially feed a rotation imbalance in the shoulder.
To remedy this situation, we recommend the use of a neutral grip. This allows you to pull the rope or strap past your face with the humerus in much greater external rotation and promotes shoulder rotational balance.
To further increase loading the external rotators, the lever arm can be altered by increasing the angle at the elbow. Make sure to adjust the weight accordingly; this is the second version that's shown in the above video.
Remember those short or stiff pec minors? You can make your face pull more effective by taking advantage of the acute effects of stretching the pec minor for about 20 seconds on each side. You can do this effectively by placing the front of your shoulder against a door jam and leaning your body weight forward and simultaneously pulling the scapula backward.

Diagnosis Via Face Pull

In cases where the rotator cuff is known to be weak relative to the deltoid, the posterior deltoid can overtake the rotator cuff as the primary external rotator.
This will show up in the face pull as the humerus (upper arm bone) hyperabducts relative to the scapula. In other words, as you pull horizontally, the scapula stops moving and the upper arm bone continues to be pulled back along the horizontal plane. Rather than the upper arm bone and the scapula ending up in the same plane during the contracted phase of the face pull, the upper arm bone and scapula form an angle. The dead giveaway is a dent or a dimple that forms between the posterior deltoid and the infraspinatus.
If this is the case, your shoulder program would be better served by working on some isolated strengthening to the rotator.

The Only Shrugs You Haven't Done Before!

One of the common findings in a downwardly rotated scapula is a lengthened upper trapezius. In this situation, the excessive length makes the upper trap weak and a less than effective upward rotator of the scapula. Ineffective upward rotation of the scapula, especially with overhead movements, is a recipe for rotator cuff injury.
The obvious fix would be to address the weakness with some form of shrugging movement to strengthen the upper trapezius and improve the upward rotation function. There's just one catch: the typical barbell or dumbbell shrug may make the situation worse.
A shrug with the arms at the sides will certainly activate the upper trapezius, however it also strongly recruits the levator scapulae and the rhomboids, the downward scapular rotators. This feeds the imbalance causing the downward scapular rotation dominance.
The answer is to perform a shrugging movement with the scapulae in an upwardly rotated position with the overhead shrug.
Now if you have or have had shoulder problems resulting in pain, the overhead shrug may be problematic. In this case, the next best exercise is scaption with a shrug.
Scaption is essentially a thumb-side up, dumbbell lateral raise in the plane of the scapula. The plane of the scapula is about 30 degrees or so in front of a lateral raise performed straight out to the side of the body.

Summary

Proper training and injury prevention go hand in hand. You can't have one without the other.
As you can see, we've presented one scenario where dysfunction, and potential injury, may exist that can't be "fixed" with a few sets of external rotations for the rotator cuff. A lack of attention to proper daily postures and less than optimal exercise selection can, given enough time, be a recipe for rotator cuff injury and lost training time or worse.
So what does it take to assure a healthy rotator cuff? If we had to boil it all down to three principles it would be this:

1. Maintain adequate mobility and posture of the upper back to allow for adequate mobility of the scapulae.

2. Maintain optimal balance of the muscles around the scapulae and the shoulder joint.

3. Proper exercise selection with compound movements can correct and maintain those optimal relationships that not only improve performance but also prevent injury.

Sometimes an isolation exercise like external rotations may be an answer, but that's an article for another time.

About the Authors

Bill Hartman is a physical therapist and strength and conditioning coach in Indianapolis, Indiana. You can sign-up for his upcoming Performance Training Journal at www.billhartman.net.
Mike Robertson, M.S., C.S.C.S., U.S.A.W., is the Director of Custom Athletics and President of Robertson Training Systems in Indianapolis, Indiana. Mike received his Masters in Sports Biomechanics from the Human Performance Lab at Ball State University, and has been a competitive powerlifter for the last 6 years. To contact Mike or sign-up for his free newsletter, check out his web page at http://www.RobertsonTrainingSystems.com.

Need Some Speed?

  Here is an exerpt from an Eric Cressey article that addresses the numerous ways to incorporate speed work into your routines. As in all sports, speed kills. There has never been a coach in any sport ever who has uttered the words, "I really need you to get slower and fatter. You know, for the good of the team." And speed equals less body fat, which equals sexification, which leads to helloooo ladies. Even a 42-year-old incredibly handsome ( I prefer 'Hunky') soccer player such as myself has benefitted from the speed element in my training. Just sayin'.

Ten Ways to Train Speed in Your Strength Training Program
A lot of folks get stuck in a rut when it comes to training speed in the context of strength and conditioning. It seems like everyone's all about just doing box squats and bench presses – but there really are a number of other options.

• Sprinting: No equipment needed. It might not carry over perfectly from a specificity standpoint, but running fast will never make you less athletic. In terms of resisted sprinting, I've never been a fan of sprinting with parachutes, but we will use sprinting with sleds.
• Box Jumps: You go up, but don't come down – so the pounding on the body is minimized. I've read of quite a few high-level deadlifters who have utilized box jumps with outstanding success.
• Countermovement (Vertical) and Broad Jumps: You can do these with body weight only, or against added resistance. Band-resisted broad jumps are arguably my favorite exercise for training posterior chain power.
• Medicine Ball Drills: These might not carry over from a specificity standpoint, but frankly, people spend too much time in the sagittal plane – and power training is no different. Plus, it's fun as hell to try to smash medicine balls. You can do overhead, rotational, and scoop variations. I'd also put sledgehammer swings against tires in this category.

• Non-Sagittal Plane Plyos: Like medicine ball drills, they aren't necessarily "specific" to lifting, but there will be carryover, and you'll certainly move better on the whole. We utilize many different variations of heidens with our athletes.

• Olympic lifts: As noted earlier, assuming you learn proper technique and you have the adequate mobility to perform them correctly, you can't go wrong with Olympic lifts if you're trying to improve universal bar speed. Cleans, snatches, high pulls, jerks, you name it; if you're slow, they can help.
• Squat Variations: Following the percentage variations I noted above, you have loads of options for variations: different bars (straight bar, giant cambered bar, safety squat bar), free squats, box squats, Anderson squats (from pins or chains), and different forms of accommodating resistances (chains and bands).
• Deadlift Variations: I increased my deadlift from 510 to 628 in just under a year, and I'm convinced that it had to do with the fact that my programs included speed deadlift variations twice a week for that entire period. You can do conventional, sumo, trap bar, and snatch grip variations.
• Bench Press Variations: As with the last two examples, variety is easy to include. You can vary grip width, change bars (straight bar, multipurpose bar, thick bar), perform the movement with or without a pause at the bottom, and implement different accommodating resistances.
• Plyometric or Clap Push-ups: These can be a good change of pace for those who are bored with speed benching – and they can be great exercises to take on the road if you don't have a lot of equipment at your fingertips.


How to Pick the Right Speed Exercises for You


Several factors influence which of the above modalities you choose, but the foremost of these factors are a) your goal and b) your current training experience.
If your goal is to deadlift a Buick, then you need to go with specific options. I'd use speed deadlift variations almost exclusively, and perhaps just use some broad/box jump variations and a bit of hip dominant squatting for speed as variety. Specificity will always rule if lifting heavier weights is the only goal.
If you're just an Average Joe trying to get more athletic with some solid carryover to your strength training program, I'd rotate my "speed work" on a monthly basis. Each month, in both the upper and lower body, I'd do one movement with minimal external loading (jumping variation, sprinting, medicine ball work) and another with more appreciable loading (speed box squats, speed deadlifts, or Olympic lifts).
If you have two upper-body and two lower-body training sessions in each week, you could simply do one in each as the first movement of each session. I'm in this category, and I tend to do one day of speed benches and one day of speed squats or deadlifts per week, then supplement it with a bit of sprinting and some medicine ball throws. In other words, I get some general, and some specific.
If you've got decent speed already, chances are that you can get away with just once a week in both the upper and lower body.
As you can probably tell, I don't see any reason to devote specific training sessions, weeks, or entire blocks specifically to training speed. Rather, I see it as one component of a comprehensive program – and something that can be trained alongside other strength qualities in each training block. You might do more of it at certain times than others, but that doesn't mean it should be performed to the exclusion of everything else; heavy lifting and rep work definitely still has its place!



When to Include Speed Work


Most of the time, the best place to put your speed drills is first thing in your strength training session, right after the warm-up. In other words, it'd be your "A1." There are, however, a few exceptions to the rule.
I've often done my speed deadlifting as my "B1" exercise after heavy squatting.
We'll also integrate complex training, in which a speed exercise is preceded by a heavier load. In other words, you might do a heavy set of 2-4 reps on a front squat, and then do a set of five countermovement (vertical) jumps within 20-30 seconds.
You'd rest 2-3 minutes, and then repeat the process. Through a principle known as post-activation potentiation, the heavy loading of the front squat increases neural drive and recruitment of high-threshold motor units, which in turn allows for greater power output on the subsequent task. It can work great, but if you do it all the time, you can burn athletes out.
Finally, in certain cases, it might be necessary to do a separate speed session altogether. Sprinting and medicine ball work, for instance, may need to take place in a separate location than lifting, so for sake of convenience, you'd just perform those exercises on their own.
Basically, the idea is to train speed when you're fresh. Doing a bunch of box jumps at the end of a heavy lower body training session isn't just unproductive; it's dangerous!

Funny Gym Etiquette. Watch it. Now.

Lower Body Flexibility For Weightlifting

  Here is an outstanding video from Coach Glenn Pendlay addressing lower-body flexibility. This is an area that we all need to improve, as tight hips and weak lower backs are the norm in our society. Though he is a powerlifting coach, his message applies to us all. Give this a try and let me know what you think!