Be Careful What You Ask For: Q&A with Paul

Be Careful What you ask for...

Most questions I get come in through email or text, which is great for ensuring the specificity of my answer, but it also means all other readers miss out on the information. So, today will be the first post in my Careful What You Ask For series.

Question:

“What are the safety considerations for performing squats? Specifically, what application does the squat have for runners? And what concerns exist for individuals with arthritis?”

Answer:

Wow – applications and concerns for the squat, known as “the king of all movements!” This could be a pretty involved topic but I’ll do my best to stay on point.  

First off, let’s cover the basics:

The human body is meant to squat.

baby-squat

As soon as we can stand on two legs, we frequently sit in a deep squat position. Whenever we sit down and stand up from a chair, we are squatting. The legs and hips are some of the biggest and strongest muscles in the body not only to carry us long distances, but to offer a safe and powerful base for when we come to a rest and lower into a seated position.

However, like any other movement, the squat can be risky if performed incorrectly.

So, the best place to start is with proper “squat mechanics”

squat

  1. Stand with feet shoulder width apart, toes turned slightly out, weight evenly distributed through the ball of your feet, the pinky toe, and the heel.
  2. Reach hands out in front for counterbalance and push your hips / butt back, keeping your lower back arched in, and shoulders / chest up.
  3. As hips are lowering behind you, actively push knees out to the sides. Keeping the knees wide, and preventing them from caving in, will reduce any load on the knee and ACL.
  4. Keep sitting back and down, almost between your legs, until you reach depth. This is dependent upon specific hip structure, mobility, and experience. Stop descending if your lower back loses its arch and starts to round, if you start to tip / lose your balance, or if any part of your foot leaves the ground.
  5. The squat back up should be identical – knees wide, back arched, chest high and wide – until you are standing up straight, squeezing the butt and keeping the knees “soft” (not forcibly pushing the knees back, creating hyperextension a the knee joint).

A common training wheel of sorts would be to elevate the heels about 1 inch. This will allow you to sit deeper down, without feeling like you’re going to tip over or the extending the knees too far forward.

Next, let’s look at the specific application for runners.


Running is a sport that involves the body moving in one direction, often for many miles, with a great deal of impact. This will develop some muscles while leaving others completely passive and underdeveloped. The most concerning would be the glutes and the hamstrings.

Four-Steps-to-Good-Running-FormAny exercise moving the knee and leg away from the midline of the body will target the glutes and hips…but the squat may be the most effective option because it requires balance and postural awareness, while also engaging the rest of the muscles throughout the body.

My recommendation for a runner would be to become proficient in a bodyweight squat. Once 2 or 3 sets of 20 repetitions can be completed without breaking a sweat, add an elastic band around the knees, hold a dumbbell in front of the chest, or place a bar on the shoulders.

Progressing to barbell squats or a single-leg version would be a perfect goal for runners! If you want to run 26.2 miles without injury, it’s a good idea to first develop the balance, strength, and endurance to perform 20 squats on one leg.  

Remember my favorite quote from Tim Gould, Doctor of Physical Therapy: “Train to run, don’t run to train.”

And finally, does the presence of arthritis contraindicate squats?

Just to clarify, the form of arthritis determines the risks.

Degenerative arthritis is caused by a breaking down of the “padding” between bones. Rheumatoid arthritis is an autoimmune condition where, simply put, offending foods have broken through the stomach lining and are wreaking havoc elsewhere in the body.

I’m going to assume we’re talking about degenerative arthritis since this is affected by activity and movement.

As always, you should consult your doctor first. No matter how cautious and properly a movement is performed, if your body doesn’t have enough cartilage to protect bones from grinding against one another, pain and further deterioration can occur.

Let’s assume that you can load and bend your knee without any pain. If so, performing a controlled squat may actually strengthen the muscles around the joints!

I have had quite a few clients with arthritis, and we usually make the following modifications:

  1. Progress slower, only adding 2 repetitions per set every week.  
  2. Don’t hold any one position too long. Normally, doing a pause squat, where you sit Squat-2and stay tight in the bottom for a count, improves mobility and strength. But the longer you “hang out” in one position, the more likely your muscles will get tired, transferring the load to the bones and joints.
  3. Allow for more recovery and emphasize diet. Degenerative arthritis cannot be cured through diet like rheumatoid, but consuming enough vitamin D & K, magnesium, iron, and collagen (found in gelatin), can help improve bone health.
  4. And finally, never allow one bad repetition! If your knee joint is lacking its natural cushion, we don’t want even a millisecond to be spent in a suboptimal position.

In summary, the inclusion of properly executed squats can help improve running performance, as well as prevent injuries. Squats can also build the strength and stability of soft-tissues around the joints and improve bone density, thereby benefiting those with arthritis.

How you structure your squat training is up to you – some like to heavy barbell squats once a week, while others prefer to complete 20 repetitions of bodyweight squats at random on a daily basis.

If you need any hands-on guidance learning how to squat or developing a safe and effective program, just let me know!

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One Size Fits All

In exercise and fitness training, a “one-size fits all” approach does not work.

This is one of my favorite aspects of being a personal trainer and health coach.

Every single day, I encounter something new. Whether it’s a client’s specific goal, preference, injury, or condition, everyone has different wants and needs. This requires alterations, to say nothing of completely different programming.

My oldest client is 91. My youngest is 13. I have middle-aged clients trying to lose weight. I have young men playing soccer at division 1 colleges. I have new mothers that want to return to their favorite sports. I have seniors reversing rheumatoid arthritis and regaining balance and energy. Some of my clients want to get off a long list of medications. Others just want a fun and challenging workout a few days a week.

These differences between individuals contribute to my hesitation to recommend routines based entirely around weight machines.

Machines allow you to adjust the height of the seat, and sometimes make an adjustment for leg length, but beyond that, you’re pushing or pulling in a pre-determined range of motion. Different people will need to move differently based on their build and body mechanics. And, just as importantly, these types of actions won’t transfer as effectively to real life.

When you pick something up, push a heavy object, or take a very high step up, there is nothing guiding your body through space. Your muscles and joints will be working on their own, free of outside influence.

Machines are useful to isolate a muscle group, and help an individual develop a mind-body connection with that muscle, but they should not be where you spend the majority of your time.

I start most my clients with a series of assessments, performing different movements that are common in everyday life. Their ability to execute these actions, along with the goals they have stated, will specify exactly what we must do together.

These assessments usually consist of a gait analysis, squatting down into a chair and back up, bringing the arms overhead, and holding a plank or pushup position. But, as previously mentioned, I may omit some of these, use alternatives, or do something completely different based on the client.

The same mistake of using a “one-size fits all” approach is apparent in our nations nutritional recommendations. The USDA recommends that everyone consume 45-65% of their calories from carbs, 10 to 30% from protein, and 25 to 35% from fat.

This is akin to recommending that 15% of all calories come from dairy…or that 5% of calories come from peanuts. What if an individual is lactose intolerant or allergic to peanuts?

As evidenced by our current diabetes and obesity rates, most Americans cannot tolerate upwards of 50% of their calories coming from carbs. Through years of trial and error, I’ve learned that if I average more than 40% carbs, more than 4 days a week, I start to gain fat, even in a calorie deficit.

Remember, carbs are fuel for high intensity activity, while dietary fat is truly essential for optimal health. After a lifetime of consuming more carbs than the body can safely store and burn, it loses its “insulin sensitivity”. This means that the sugars last too long in the blood (causing inflammation and cardiovascular disease) and are eventually forced into fat storage.

I work with my clients to find the most sustainable and healthy nutritional path for them. I base my nutritional recommendations not only on their dietary restrictions, activity level, and current conditions, but also their preferences and lifestyle.

I personally cook a few big meals on weekends so I have leftovers available on weekdays. However, I may have to suggest a different approach for clients that don’t have the time to, or interest in, trying this. Some of my clients are vegans or vegetarians that require more vitamin supplementation and creative protein options. If a client has sugar or chocolate cravings, we’ll work to find the healthiest options and optimal timing for indulgences.

Some foods are healthier than others, but I’ve never insisted that a client consume a certain food or avoid another. I merely work within their parameters, to find out what will guarantee them success in the long term.

These examples show the importance of individual personalization. Personal trainers, and health professionals of all kinds, must be able to tailor the theories learned through education, to best serve each client.

No two people are the same, so why should their exercise and diet be the same?

diverse

Unilateral Training

Unilateral training refers to using one limb at a time, as opposed to bilateral training which involves both limbs.

A leg press and seated row are bilateral movements while a single leg press and single-arm dumbbell row are unilateral movements.

Many actions in everyday life require us to use only one limb at a time. Regardless of what specific activity you are training for, unilateral moves help show weaknesses or imbalances within the body. It’s the discovery of these weaknesses, and corrections, that allow us to further improve our health and performance.

I personally love doing full body compound movements, training multiple muscle groups at a time. These are extremely efficient and result in a bigger central nervous system response, thus a better hormonal response, leading to better strength and body composition.

However, I always keep at least one isolation exercise or unilateral movement in my clients (and my own) daily routines. This way, we never allow one dominant muscle group to compensate for a weaker one, thereby exacerbating the imbalance.

If you are just starting to incorporate unilateral training, try a simple dumbbell row – one knee and hand on a bench, back straight, other arm hanging straight holding a dumbbell. “Row” the weight up to about the armpit, trying to pull the arm up and over with the shoulder blade (but don’t twist the torso).

Another simple move to start with would be standing on one leg. This can be done while doing other movements, such a bicep curl or internal shoulder rotation, or it can be treated as its own movement. Standing on one leg will reveal weaknesses at the joints, in the leg or core muscles, or even neurological proprioception issues.

My favorite unilateral movements, as exemplified above, are for the legs and the shoulder blades.
Unilateral training for the legs will reveal weaknesses or incoordination in the lower body, but also instability throughout the core, and may even provide an opportunity for postural analysis. Movements like lunges or single leg dead lifts (SLDLs) are my go to movements for clients trying to increase strength, stability, and function.

Unilateral training for the upper back is useful because it will teach an individual to move the arms in concert with the shoulder blades. If an individual is only using their shoulder muscles, when reaching, lifting, or moving loads, they risk rotator cuff injuries. However, if they can incorporate all the muscles of the upper back, they will have a safer strength potential.

Some advanced movements to work towards would be things like a one-legged squat (pistol squat) or a one-arm pull-up. To achieve either of these, the muscles, stabilizers, joints, and bones throughout the entire body have to be strengthened perfectly.

So, if your workout has stagnated and you’re having trouble adding repetitions or weight to your movements, try incorporating a few unilateral movements to reveal imbalances and weaknesses.

And remember: a personal trainer can help guide you through this process of exercise selection, providing motivation, and finding areas to improve upon safely, guaranteeing long-term improvement!

Weightlifting Belts

I know I’m always talking about controversial topics nutritionally, but today I want to talk about a frequently debated topic in the world of fitness – the use of a weightlifting belt.

Ever since I have started powerlifting, I have worn a weightlifting belt during my primary lift (bench press, squat, deadlift) when I am working over 75% of my maximum. I don’t wear it during warm-up sets, in the 40-50% range, and as soon as I finish my heavy lift for the day, I set it aside.

I think a belt can be a very effective tool but, like many things in the fitness community, it can be easily misused.

The point of a weightlifting belt is to ensure maximum intra-abdominal pressure during maximal lifts.

Injuries in the weight room occur most frequently when an individual is not as “tight” and focused as they should be during a lift…or when they attempt something they can’t properly do.

A thick belt, tightened around the core, can provide a lifter with something to focus on pushing their stomach against, ensuring a full and engaged diaphragm, as well as sufficient tension throughout the rest of the body.

Before I started wearing a belt, I tried incorporating deadlifts into my routine multiple times. Each time, I quickly took them out because I would mess my back up and not be able to stand up properly for multiple days at a time. I have never once had a problem with my back since I started wearing a belt.

However, if a belt is used because an individual simply hasn’t developed proper back or core strength, it can be problematic.  If an individual is using a belt to force a weight to move, that is too heavy for them, this is also problematic.

Very often I will see lifters wearing a belt while doing bicep curls, turning purple in the face, with their eyes bulging. This is a sure way to cause an immediate injury, an overtraining injury, mask weaknesses in the body, or cause cardiac events from blood pressure elevation and lack of oxygen.

I have never told a client that they must wear a belt but, if I am working with a client that is focused primarily on strength, using movements as technical and potentially dangerous as squats or deadlifts, I will certainly discuss the benefits and give them the option of wearing a belt.

In conclusion, I do not believe a weightlifting belt is 100% necessary for powerlifting but, as long as you build a strong core through properly programmed assistance lifts, a belt can aide in one’s lifting long-term.