<This morning I was testing on the 13″ box squat. As I came off the box
about an inch or so? I felt what I believe to be my adductor tear, very
painfull. I dropped the bar on the pins and hit the floor. I thought I might
have to cut the suit off but got it off without ruining it. I had not yet
reached my top set and it did not feel too heavy. I noticed no lapse in
form. It just went. I got a prescription for a muscle relaxer and am taking
Ibupropfen until I can get to the doctor. Also using Ice packs 20 minutes on
and 20 minutes off. So far I do not see any bleeding, bulges or gaps, very
tender to the touch. Have any of you experienced this injury and what might
be ahead. I have not had this particular injury before.>

*** Many years ago, while I was jerking 325lb overhead, my front foot
slipped on baby powder left by a preceding 90kg division lifter on the
platform and I landed in a full ballet splits position. This was one of the
most painful experiences of my life and my adductor magnus was severely
ruptured, as indicated by massive bleeding and bruising that became visible
soon afterwards in all of the area from my groin down the inside of my left
leg and into the hamstring area. I could not adduct my left leg and I
couldn’t do any exercises which involved movement of my left leg for months
afterwards.

Nevertheless, several months later, without surgery, I managed to compete by
using power cleans and push presses (130kg) and power snatches (100kg)
without any sideways movement of my legs – I still don’t know how that was
possible, but you know what one becomes like when the urge to lift overcomes
one’s intelligence! I eventually returned to normal functioning within about
10 months. Since you can still voluntarily move your leg inwards and have no
extensive bleeding into the tissues, it is unlikely that you have
experienced a serious rupture, so you will probably be able to return to
action quite easily.

You may even have experienced a severe spasm, which would be even better news
for you – your medical specialist will have to determine if that is your
problem. Just avoid any loaded or rapid movement for a while, but move
gently over as full a pain-free range as is possible. Continue using ice,
but beware of rubbing DMSO on the inside of your leg, because that area is
easily irritated. Don’t massage the area and don’t use any “hot”
embrocations. You could try large doses of MSM. Vitamin C also plays a role
in connective tissue repair. Remember the old adage: “More haste, less
speed” – don’t try to train with heavier weights too soon, because this
muscle can be very easily reinjured. If you display some intelligent
patience, you will probably return quite happily to where you were before.

Remember, too, that wider powerlifting or sumo squats place great demands on
the leg adductors, so that it would be advisable to use much narrower squats
when you return to leg training. Since adductor magnus also serves as a sort
of adjunct hamstring, be cautious of executing movements which flex the knee
or extend the hip. Whatever you do, simply explore every type of leg
movement in all directions with no added loading and at slow speed before you
even consider adding any weights.

Dr Mel Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

Here are some extracts from an article aimed at teaching people about the
management and prevention of heart disease. As usual, any comments are
welcome.

—————

<http://www.ediets.com/news/article.cfm?article_id=5592>

February is American Heart Month and the prevalence of heart disease in our
society is, at best, heartbreaking.

Heart disease is not just another “disease of the month” — it’s the number
one killer of Americans. The
American Heart Association estimates 60 million Americans suffer heart
disease. That’s 1 in 5! More Americans die of heart disease than of all
types of cancer combined…….

Are You At Risk?

There are two types of risk factors associated with heart disease: those you
can control and those you cannot. The good news: the list of those factors
you can control is much larger!

You cannot control your genetics. If you have a family history of heart
disease you’re at greater risk.

You cannot control your age (too bad!). If you’re over 55 you’re at greater
risk.

You cannot control your gender! If you’re a male, younger than 60, you have a
greater risk for a heart
attack. Women over 60 are equally at risk.

What You Can Control

You can control your smoking, your diet, your weight, your activity and your
stress level (to a certain extent). These major risk factors are what you
need to pay attention to, especially if you have one of the non-controllable
risk factors. The more risk factors you have, the greater your chance of
contracting heart disease.

If you smoke, stop now. Smoking is the number one risk factor for heart
disease. Smoking one pack a
day increases the risk by 70 percent. A two-pack habit hikes your risk by 200
percent!

Other risks (like high blood pressure, high blood cholesterol, high
triglycerides, and type 2 diabetes) have two controllable factors in common:
diet and exercise.

Obesity in itself is not necessarily a risk factor. But obesity is definitely
associated with high blood pressure and high blood cholesterol. Type 2
diabetes is closely associated with obesity. Ninety percent of type 2
diabetics are overweight or obese. Chronic high blood sugar levels increase
the risk for coronary artery disease and high blood pressure. High
cholesterol often accompanies diabetes and these risk actors increase the
incidence of heart disease. Heart disease causes more than 76 percent of
death for diabetics….

Americans, Unite!

Americans: unite against heart disease! Choose to change lifestyle factors
that will keep you healthy. Sixty percent of adult Americans are overweight
or obese, and only about 20 percent of men and women report eating the five
recommended servings of fruit and vegetables daily. More than half of adults
in the U.S. are not exercising the recommended 30 minutes 4 to 6 times weekly
and sedentary lifestyle doubles the risk for heart disease.

Use the Team Approach

When you think healthy, think diet and think exercise… together! Use the
team approach. Separately, diet and exercise each have their benefits.
Together, the benefits are astounding.

Diet counts. Your diet needs modification, not elimination. There are no
“bad” or “good” foods. Remember, portion size counts. A healthy food can
contribute to obesity if you eat too much of it. You need to eat healthy
foods in the portion size that’s right for you as an individual. Your daily
meal plan should include good sources of complex carbohydrates, lean animal
protein and/or good sources of plant-based proteins, such as soy nuts,
legumes and grains. Healthy fats are important sources of good nutrition….

10 Measures That Could Save Your Life

Susan L. Burke, MS, RD/LD, CDE

Here are some tips that will serve you well!

1. Choose healthy fat! A no-fat diet is not necessarily the healthiest diet.
Fat is important for transport of vitamins and minerals in your body, for
hormone function, and for taste. However, avoid saturated fat and
hydrogenated fat in favor of monounsaturated fat in olive oil and canola oil.
Omega-3 fatty acids, plentiful in flaxseed and fatty fish, are beneficial.
Other good sources include wheat germ, walnuts and soybeans.

2. Soy is a healthy food. The Food and Drug Administration now allows a
health claim linking consumption of soy protein to a decreased risk for heart
disease for including at least 25 grams of soy protein in your daily diet,
(the diet should also be low in saturated fat and cholesterol.) Soy is the
only complete plant protein, containing all essential amino acids. It’s a
good source of B vitamins, essential fatty acids, zinc and iron, and it
contains phytochemicals that research suggests are beneficial to women in
lessening the symptoms of PMS and menopause. It’s also very low in saturated
fat. Soy foods have great variety, including tofu, tempeh, textured vegetable
protein, and soy powder.

3. Think green. Dark green leafy vegetables are some of the best sources of
folic acid in food and they can help reduce the level of homocysteine, an
amino acid made in the body and normally found in low levels in the blood. An
elevated homocysteine level predicts heart disease. Research shows that
reducing saturated fat and cholesterol and increasing vegetables and fruit in
your diet reduces homocysteine levels. Dark green leafy vegetables like
collard greens, kale, broccoli and turnip and beet greens are great sources
of folic acid.

4. Think color. When you choose food for health, choose color. That’s because
foods that are colorful — deep green, yellow and orange, red and gold –
have the greatest amounts of antioxidants, vitamins and minerals. Berries are
ounce-for-ounce one of the best foods, full of antioxidant vitamins C, and
have lots of potassium and fiber. Strawberries contain 60 percent more
vitamin C than grapefruit and 8 percent more than whole oranges. Cranberries,
raspberries and strawberries contain ellagic acid, which researchers have
shown to prevent some cancers.

Berries are also low in calories (only 50 to 70 per cup). If you buy canned
fruit, buy water- or juice-packed. Canned cranberry sauce has three times the
calories of fresh cranberries and 86 percent less vitamin C. Buy “in season”
for the freshest fruit. Try some superfruits like guava, papaya, and mango –
all great sources of carotenoids, antioxidants and fiber. Remember other
orange fruits like cantaloupe, apricots and peaches. Any fruit will do. Whole
fruit is still the best source of vitamin C, fiber, and potassium for less
than 100 calories per serving.

5. Think whole. When choosing foods for health, think whole grains, whole
wheat, whole fruits and vegetables. That’s because unprocessed whole foods
have all their important nutrients intact. Whole foods are rich in fiber,
which is important for digestion and elimination. Research has shown that
people who eat high-fiber diets reduce their risk for heart disease and some
cancers.

6. Think food, not pills. Supplements in pills provide you only with the
antioxidant or vitamin on the label. Other micronutrients in food have not
been fully studied. The evidence for using antioxidant vitamins to reduce
your risk for disease is yet unproven in clinical trials, and the correct
dose and long-term risk when taking more than the recommended amount daily
has not been determined. Taking a multivitamin daily for insurance is fine,
but megadosing can be dangerous.

7. Eat your veggies. Studies have shown that people who eat vegetable-rich
diets reduce their risk of colon, lung and bladder cancer. Scientists think
that phytochemicals are responsible, not just the beta-carotene that colors
the veggies. Stroke is less common among people who eat their veggies, which
may be because of the nice amount of potassium. Those who enjoy lots of leafy
greens like spinach, kale and dandelion greens will get a double dose of
lutein, which helps prevent blindness due to macular degeneration.

Of course, the deep yellow- and orange-colored sweet potatoes and carrots
provide top amounts of vitamin C and carotenoids, and the rich green broccoli
and Brussels sprouts are loaded with carotenoids, vitamin C, folate and
fiber, as well has phytochemicals that may prevent cancer. Bright red
tomatoes in tomato sauce contain lycopene, which is a cancer fighter.

All vegetables are superfoods in that they can boast good nutrition and
fiber, and they contain a frugal
number of calories (40 to 60) per serving.

8. Garlic is good. While you’re at it, add some neutral colored garlic,
sautéed a bit to release its DATS, a
compound that cancer researchers say slows human lung-cancer cell growth in
test tubes.

9. Stay active. Reduce your risk of heart disease, diabetes and obesity –
and decrease your stress levels — with regular exercise. Studies have shown
that just 30 minutes of aerobic exercise 4 to 6 times a week can help you
stay healthy. Take a walk. It’s not necessary to join a gym. Get out the door
and go quickly one way for 15 minutes, and then come back. It’s 30 minutes
before you know it. If you can’t get out, then stay in and dance! Put the
radio on and dance around your house or apartment and have some fun. Do what
you like. That way you’ll stay with it.

10. Small changes produce big results. Change what you can, and you can
change a lot! Choose healthy foods, prepared without deep-frying in
hydrogenated fat. Eat fruit and vegetables every day; watch your portion size
with a healthy meal plan as we offer here at eDiets. Stay online and get
support and motivation from your eDiets community and stay active. Do
something at least 4 to 6 times a week to get your heart rate up. Your heart
is a muscle. Make it strong. You can do it!

Did You Know?

One of the largest sources of hydrogenated fat found in most Americans’ diet
comes from crackers. We know that fast food French fries are about 40% trans
fat, while donuts are about 35-40% trans fat. But the typical cookies and
crackers in your grocery store are up to 50% trans fat!

It’s not easy to find out how much trans fat there is in food, because
manufacturers are not required to list it. If the food’s nutritional label
lists the total grams of fat, saturated fat and unsaturated fat, you can
calculate it. Add the grams of saturated and unsaturated fat, subtract from
the total fat, and the result is grams of trans fat. This only works if
saturated fat is listed, which is also not mandated. Read the label and try
to find products that say, “no trans fat added.” …

Dr Mel Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

In response to Dr Mel Siff’s Subluxation Paradox http://www.melsiff.com/12359/subluxation-puzzle-and-paradoxes-by-mel-siff/

Here is some further discussion from another list on my subluxation paradox:

Mel Siff:

< Can you cite any scientific references which definitely relate these small
“disturbances” to any significant pathology? What you are iimplying is that
the spine is critically tuned, displays a very sharply defined range of
efficient functioning and has a negligible “safety factor”, so that even
minor perturbations will cause genuine pathology or pain. This is not a very
efficient way for the body to have developed and evolved, so I have to wonder
about the validity of such an hypothesis.>

Comment:

Your point about the evolution of the system is well taken. As you point out
there must be some safety factor. I am not trying to suggest that it is
negligible, merely susceptible to problems. For example when trunk
stabilization via muscles is especially important in neutral spine postures
due to the inherent low levels of stiffness in the “neutral zone” (a small
range about the mid-position of the joint where little resistance is offered
by passive constraints).

The multifidus has been implicated in providing much of the control in the
neutral zone. Several other mechanisms contribute to trunk stability
including muscle stiffness, co-contraction, and pre-programmed (i.e.
anticipatory contractions) contractions.

Perturbal first maintain posture (primary task) and second, perform voluntary
tasks (secondary task) when the two are presented concurrently. This makes
sense in that without adequate posture, voluntary movements do not happen.

However, the co-demand of voluntary movement and postural control can lead to
a sudden loss of balance, particularly when performing rapidly or under high
loads. Such events have been called “motor errors”. These “errors” can lead
to injury through inappropriate coordination dynamics that require different
functions out of the same muscle(s). An acute injury (eg whiplash) can
instantly impair stabilization due to tissue damage which leads to
subluxation. However, more frequently, authors view repeated motor errors
over the long term as the primary in subluxation. This last statement has
yet to be verified.

Here are a few references:

1. Burns LA. Viscero-somatic and somato-visceral spinal reflexes. J Am
Osteopath Assoc 1907; 7:51.

2. Triano J, Luttges M. Subtle intermittent mechanical irritation of the
sciatic nerves of mice. JMPT 1980; 3(2): 75-80.

3. Winsor, H., Sympathetic Segmental Disturbances- 11. The Evidence of the
Association in Dissected Cadaver of Visceral Disease with Vertebral
Deformities of the Same Sympathetic Segments, Medical Times,49 1-7 Nov. 1921.

4. Gore DR. Roentgenographic findings in the cervical spine in asymptomatic
persons – A ten-year follow-up. Spine 2001; 26: (22) 2463-2466.

5. Dishman RW. Review of the literature supporting a scientific basis for
the chiropractic subluxation complex. J Manipulative Physiol Ther 1985; 8:
163-174.

6. Lantz CA. The vertebral subluxation complex part 1: an introduction to
the model and the kinesiological component. Chiropractic Research Journal
1989; 1(3):23.

7. Rydevik BL. The effects of compression on the physiology of nerve roots.
J Manipulative Physiol Ther 1992; 15(1):62.

8. Kirkaldy-Willis WH. The relationship of structural pathology to the
nerve root. Spine; 9(1): 49-52.

Mel Siff:

< After all, many competitive weightlifters subject the spine to very heavy
loads which surely cause many such small (and even some large) disturbances
in every training exercise and every competition, year after year, yet the
incidence of back pain and dysfunction in this cohort is considerable less
than in the general population which never imposes that magnitude and rate of
loading.>

Comment:

True, but there are studies (eg. Videman T, Battie MC, Gibbons LE, et
al.Lifetime exercise and disk degeneration: an MRI study of monozygotic twins
MED SCI SPORT EXER 29: (10) 1350-1356 OCT 1997) that show higher rates of
disc degeneration which according to ref #4 above will lead to subsequent
symptoms and dysfunction in the future. Besides, the absence of symptoms by
itself is not a good indicator of performance or physiologic function. Also,
are there studies done with weightlifters and controls on coordination
dynamics?

Mel Siff:

<The existence of these well-known structures and processes does not
necessarily suggest that they make pathology more likely. All this means is
that the spinal complex has a very extensive and efficient cybernetic system
which ensures that the spine is well controlled over a wide range of
different conditions in space and time.>

Comment:

AMEN! But when there are problems, it makes it difficult to find the source
of the problems and to find efficient solutions. Overt pathology in many
cases takes a relatively long time to develop (eg heart disease). Sure our
systems are efficient but the trick is finding the inefficiencies (subtle)
and correcting these to prevent future problems.

Dr Mel Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

Someone contacted me privately about methods of training if one has any
injury, weakness or dysfunction of one arm.

These were some of my suggestions – if you have a power rack, you can use
reverse band methods to limit the weight on the bar and control its line of
action while you do bench, inclined press, deadlifts, limited range pulls and
so on. The bands (or bungee cord) are attached to the top of the power rack
and the barbell or dumbbell is suspended from the bands – the amount of
assistance offered depends on the thickness of the bands or cords.

There is no harm in a spotter helping you either to guide you in holding and
moving a dumbbell in a specific exercise pattern – that sort of assisted
lifting (which is a more advanced method of “forced rep” training) is quite
commonly used by physiotherapists. Manual resistance, which constitutes the
basic form of resistance in PNF therapy, may also be used – typical patterns
are illustrated in Ch 7.2 of “Supertraining”. In fact, you can have someone o
ffer manual resistance using wooden sticks and ropes to enable you to execute
most of the exercises that one does in a well-equipped weights gym.

Don’t forget the value of training in water or using light bands for the
injured side. My paraplegic wife’s method of choreographed high speed seated
exercise (she relies on acceleration rather than load to produce force in the
muscles) can also be very useful. Electrical stimulation can also play a
valuable role in training the muscles of your injured side – this is one of
its very legitimate applications.

I am sure there are others who would like to add some more suggestions – over
to you!

Dr Mel Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

Here are a few articles summarising research findings on Alzheimer’s disease:

<http://www.ananova.com/>

The first news item suggests that a substance implicated in the complex web
of causation of heart disease may also be involved in the development of
Alzheimer’s disease.

——————

American scientists find Alzheimer’s link

American scientists have discovered a link between Alzheimer’s disease and a
common substance found in the bloodstream.

The discovery that people with high blood levels of an amino acid called
homocysteine are at a greater risk of developing Alzheimer’s could lead to a
test to identify people most likely to become sufferers. The team of
scientists from Boston University and Tufts University said they could not
show homocysteine is a cause of Alzheimer’s.

The discovery could lead to research to develop a test to find people most at
risk of developing Alzheimer’s, and to advise them on taking steps to reduce
the risk. Homocysteine is a by-product of a normal diet, but its levels are
highest in people whose diet is dominated by meat and lacks fruit and leafy
vegetables.

Scientists say it’s too early to assume that giving people vitamin
supplements would be enough to prevent Alzheimer’s developing. Dr Sudha
Seshardi, a neurologist at Boston University who led the study, said the
study reinforced the need to eat a balanced diet with fruit and vegetables.

The study took eight years and followed 1,092 people aged between 68 and 97
who did not initially have Alzheimer’s, finding that 83 developed the disease.

It found that those who had a level of homocysteine higher than 14 micromoles
per litre of blood had twice the risk of developing the disease.

————–

Other research has suggested that keeping oneself very mentally exercised may
help in reducing the likelihood of developing Alzheimer’s disease.

Crossword puzzles could stave off Alzheimer’s disease

Scientists have found puzzling over a cryptic crossword or reading a
newspaper may help stave off mental decline in the elderly. An American study
of 800 Catholic nuns, priests and monks found that “frequent participation in
cognitively stimulating activities is associated with reduced risk of
Alzheimer’s disease”.

Alzheimer’s is the most common form of senile dementia, causing progressive
memory loss and confusion.

The study, published in the Journal of the American Medical Association,
followed the group for about four-and-a-half years and rated their level of
cognitive activity. None had dementia at the start…..

—————–

Testosterone could be used as a treatment for Alzheimer’s disease.

Researchers who tested the male hormone on rats believe the treatment might
work on humans. They say it prevents a key brain abnormality linked with the
disease.

The treatment was designed by Sozos Papasozomenos and Alikunju Shanavas at
the University of Texas-Houston Medical School, reports New Scientist.

They found testosterone blocks a process called tau hyperphosphorylation
which creates so-called tau tangles.
These bundles of protein are associated with the brains of Alzheimer’s
patients. Oestrogen combined with testosterone – but not oestrogen alone -
also blocked their formation.

The new work suggests maintaining normal levels of testosterone in ageing
men, and adding testosterone to oestrogen supplements for post-menopausal
women, could help reduce the disease risk.

Dr Mel Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

< http://www.t-mag.com/html/body_122back.html >

PART 2

<<Lahad et al concluded that sufficient evidence was unavailable to recommend
the use of mechanical back supports for the prevention of back pain. In
another study conducted by the National Institute for Occupational Safety
and Health, prophylactic use of back belts for healthy workers was not
recommended because of a lack of scientific evidence promoting their
benefit. There are also many other studies indicating belt use provides no
significant improvement in performance or reduction in the user’s chance of
injury. >>

***Virtually all of the studies that Chek quotes to condemn the use of a belt
are drawn from the world of manual labour or research studies with average
volunteers in which belts are worn for prolonged periods. It is
scientifically invalid to extrapolate such findings from the setting of
CHRONIC belt usage to the setting of occasional ACUTE belt usage for very
heavy or maximal competitive lifting.

<<Davis’ Law is demonstrated and well known by physical therapists who treat
neurological injuries; stimulating the surface of the body produces
stimulation of the muscles served by the same nerve root. Therefore,
repeatedly “pushing outward” against the belt, which is encouraged by the
belt through sensory-motor stimulus, is likely to develop and perpetuate
faulty recruitment patterns. >>

***This statement that superficial methods of kineasthetic manipulation
perpetuates faulty motor patterns (see Siff & Verkhoshansky “Supertraining”
1999, Ch is entirely one of personal opinion and not supported by any
quoted research. On the contrary, PNF and neurodevelopmental methods in
physiotherapy rely heavily on manual contacts and touch to teach correct
optimal motor patterns. It is not the stimulation of the surface of the skin
which may elicit faulty patterns, but the inappropriate use of such
stimulation. This sort of remark is grossly misleading and inaccurate, as
any experienced physical therapist and neurologist will tell us.

<<If belts really did improve trunk stability, then the lifter would be able
to use them for a given period of time, remove the belt and experience
improved performance when lifting; THIS IS NOT THE CASE! …..

If indeed belts did improve proprioception, the user would be able to take
the belt off after a period of use and have improved proprioceptive sense or
“position sense” while lifting. This would constitute a learning effect; I
have never experienced this to be the case! Belt users become dependent upon
their belt, making the belt more of a crutch than a training device. >>

***Once again, the same remark may be applied to the wearing of shoes and the
new skintight swimming and cycling outfits which, besides reducing
aerodynamic drag, apparently enhance proprioceptive sensitivity and muscle
activation. Anyway, many lifters who wear belts for maximal lifts have shown
that they are quite capable of lifting the same loads without belts, but
choose to wear belts for attempting new maximal lifts because they consider
that belts may offer enhanced safety under those extreme conditions. It is
very common for athletes in the most demanding situations to use specific
protective or ‘ergogenic’ devices, so why would this be so reprehensible for
competitive lifters?

Remember that the lifting of maximal loads is not undertaken every day or
even every week, but only on occasional maximal training days or training
competitions that are weeks or months apart. As I have written many times
before, it is the manner and duration of belt wearing that may deem it
inappropriate, not simply because belts “weaken” everyone under all
circumstances.

<<The only way to restore function of the deep abdominal wall is to use
various forms of biofeedback (described below)…..

It is very valuable to use other extroceptive (sic) stimuli, such as athletic
tape to improve kinesthetic awareness. As the patient learns, the need for
tape is reduced, and eventually the tape is eliminated. String is also used
as a form of biofeedback during movement training and is particularly useful
in restoration of deep abdominal wall function during functional movement
training.>>

***Here we have a fascinating contradiction! Chek spent a great deal of
space in denouncing the value of a lightly worn belt as a mode of offering
mechanical feedback, but here he is extolling the virtues of using
inextensible tape (a la Jenny McConnell taping etc) to play the same role.

Let us repeat what he said earlier:

<<If indeed belts did improve proprioception, the user would be able to take
the belt off after a period of use and have improved proprioceptive sense or
“position sense” while lifting. This would constitute a learning effect; I
have never experienced this to be the case! Belt users become dependent upon
their belt, making the belt more of a crutch than a training device. >>

So, the use of belts ruins proprioception, but the use of taping does not!
Any jury presented with this blatantly contradictory information would
dismiss his evidence as being unreliable, because he is clearly admitting
that devices like tape (and, by implication, certain types of belt) CAN
improve kinaesthetic awareness. The device being used may be different, but
the underlying principle remains the same. CASE CLOSED!

***Finally, let us reinforce the case a little more strongly – Chek even
quotes the following reference which supports the use of belts. Is this not
another contradiction?

<< 35. Cholewicki J., Juluru K., Radebold A., Panjabi M.M., Magill S.M.
Lumbar spine stability can be augmented with an abdominal belt and/or
increased intra-abdominal pressure. Eur Spine J 1999;8(5): 388-95. >>

So, I reiterate, that, if you are going to use a belt or straps, then just do
so intelligently and selectively! Note that I am not stating that one cannot
lift successfully and safely without a belt or that one cannot develop a very
strong trunk without using a belt – I am simply stressing that sometimes it
may be appropriate or useful to astutely use a belt in a given situation.
What I oppose is any blanket or “allness” statement which creates another
item of dogma in the strength training world.

Dr Mel C Siff

< http://t-mag.com/html/body_121back.html >
< http://www.t-mag.com/html/body_122back.html >

He has not submitted Part 3 of this series, so, if he is still working on it,
it will be interesting to see if my review influences what he submits. These
two article already suggest that he has taken some of our earlier criticisms
to heart, because he is now admitting in this series that breath holding does
indeed stabilise the trunk.

HOW TO BE BACK STRONG & BELTLESS

PART 1

<<Regardless of your opinion about the origin of man, if you believe in God,
you have to wonder why he didn’t provide weight belts as standard-issue
equipment. On second thought, maybe he did, and we just don’t know how to use
them correctly.>>

*** Exactly the same remark may be applied to the wearing of shoes and it is
entirely spurious. We might even have said that we should have retained a
hairy cover all over our bodies to protect us from the sun and other extremes
of climate. Why we should have evolved to lose something that protects us
from our environment is anyone’s guess. A remark like that has been used by
Luddites, the Amish folk, the Taliban and others who reject many
technological advances on a similar basis.

<<Today, our understanding of the stabilizer system is at an all time high,
thanks to the works of people like Richardson, Jull, Hodges, Hydes, Vleeming,
Snidjers and Gracovetsky. >>

*** This is misleading, because no theory of spinal function has been
regarded as pre-eminent over any others. In fact, there is even more
disagreement over spinal function than there has ever been. The number of
theories about spinal action may be at an all-time high, but our
understanding is certainly not yet at an all-time high. It is still highly
theoretical and by no means definitive, though it is very exciting to try and
decode some of the complex biomathematical models (which Chek, unfortunately
is not trained to be able to do).

<<As you are likely aware, when lifting a heavy object or exerting yourself
to throw or move an object such as in work or sports, it is natural to hold
the breath. Holding the breath under load is associated with increased
tension in the diaphragm. …

Practical experimentation in the gym will show that the trunk is stiffer
when filling the lungs as opposed to not filling the lungs with
inhalation….>>

***These remarks are most revealing, because Chek has constantly disagreed
with me and several others (in several Internet exchanges that still exist in
the archives of several user groups) on breath holding as a perfectly natural
concomitant to spinal stabilisation. He has always been vigorously opposed to
breath holding to stabilise the spine. Instead he has placed an exaggerated
emphasis on “pulling the abs in” and trying to voluntarily activate
transversus abdominis (TVA) during all stages of squatting and lifting. It ap
pears as if our criticism of his views may have caused him to change his mind.

<<More recently, it has been shown that IAP does provide a stiffening effect
on the lumbar spine, but that IAP is most effective at stabilizing the spine
when applied in concert with co-activation of the erector spinae muscles…..

Although, as suggested by Gracovetsky, we can not rely on muscles alone
because mathematical modeling shows that Olympic athletes would not be strong
enough to lift the loads they currently are lifting during competition. We
must look to the fascial system of the body for a missing link, the hydraulic
amplifier effect…

It has also been suggested that IAP does not stabilize the spine. Standing
firmly against the notion that IAP provides any significant stabilizing
mechanism for the spine are Gracovetsky and Bogduk…..>>

***Note well that the models of Gracovetsky and others whom he mentions,
though compelling in some respects, are by no means unopposed by other
theorists and researchers, especially some of the world’s most erudite
biomechanists. What Chek has done is a commendable cut-and-paste collage job
of information from various sources, but he has failed to go beyond a
literature retrieval stage of the literature review. A true review retrieves
the necessary information, then compares and analyses it, then, if the author
has specific scientific or research skills, he offers his own views and
models. Anyone can cut and paste from books, articles and Medline, but not
anyone can intelligently analyse the material and go beyond the obvious.

<<The hydraulic amplifier effect, originally theorized by Gracovetsky to
increase the strength of the back muscles, was later proven mathematically to
increase the strength of the back muscles by 30%…. The hydraulic amplifier
mechanism is composed of the TLF (thoracolumbar fasciae) surrounding the back
muscles to create a relatively stable cylinder…. >>

***While Chek has given a reasonable summary of how some of the trunk
musculature can act like an hydraulic lift, he has not shown that he
understands the significance of the “amplifier” part of the spinal model.
This is a very significant omission, because a knowledge of the dynamic
process of mechanical amplification (including amplifier “gain” and feedback
control) is vital to an understanding of lifting, stabilising and injury.

<<What modern researchers have been able to do is more clearly define two
major stabilizer systems of the body, the inner unit and the outer unit. The
stabilizer system considered as our “God-given weight belt” is the inner
unit…..

The Inner Unit serves to stiffen the axial skeleton in preparation for work.
The Inner Unit muscles are A) Transversus Abdominis and the posterior
fibers of obliquus internus, B) Diaphragm, C) Deep Multifidus,
D) Pelvic floor musculature….

The outer unit consists of many muscles such as the obliquus externus,
obliquus internus, erector spinae, latissimus dorsi, gluteus maximus,
adductors and hamstrings working in concert with the inner unit musculature
and fascial systems. …..

A simplified version of the inner/outer unit systems, seen in Figure 9,
depicts a pirate ship’s mast as a human spinal column. While the inner unit
muscles are responsible for developing and maintaining segmental
stiffness, the bigger muscles, shown here as guide wires, are responsible for
creating movement. >>

***The accompanying figure depicted the spine as a system of guy wires
supporting the mast of a ship. Significantly, this model excludes any
transverse members on the sails or the fact that the hull, like the rest of
the human body, does not provide a stable base. This incomplete spinal model
allows us to understand in part why it is nowadays so fashionable to talk
about “core stabilisation”. The latter misleading concept is based upon a
system which excludes the role of peripheral stabilisation (of which I have
written elsewhere) and the systems nature of motor control. One of the
problems with models and analogies is that, in attempts to simplify complex
processes, they can omit details which can lead to some very defective
conclusions.

Division of the muscles of the trunk into “inner” and “outer” systems, while
often being convenient for the sake of simplifying the complexity of the
spine, sometimes proves to be a rather limiting model of trunk functioning.
Interestingly, Chek, while sketching this model in a superficially
attractive way, has not explained if this mast and guy rope depiction of the
spine or Gracovetsky’s model constitutes a frame, truss or machine (recalling
that frames are designed to support loads, whereas machines are designed to
transmit or amplify forces or couples).

Chek, in previous discussions, has always evaded my attempts to make him
understand the difference between moments, couples, force couples and related
mechanical concepts with some entirely irrelevant personal retorts. This
latest article makes it very apparent that he really should have attended to
this deficit in his knowledge base. He might then have come across
biomechanical models of the spine which rely on a systems theoretical
approach which does not regard the spine a system of guy ropes and rigid
members and which do not implicate the fasciae in the role suggested by
Gracovetsky and others.

Other models regard the spine as a cantilever system, while yet others
examine the spine as a suspension system. In these models, there is no
necessity to divide the muscles into inner and outer units, but as an entire
system which stabilises the spine in terms of the least energy principle.

By selecting only one favourite model of the spine, he has been biased to
make some misleading and unjustified conclusions and applications in the rest
of his material, especially the practical applications.

Dr Mel Siff

The next post discusses Part II of Paul Chek’s Article!

This topic of “assistive” or “protective” devices has been discussed at our
ergonomics and some biomechanics conferences for many years, with papers
being presented both supporting and condemning the use of such ‘ergonomic’
devices. Interestingly, it is often these studies which are extrapolated to
the world of weightlifting and powerlfting to make a case for or against the
use of belts and so forth, but it is rarely pointed out that the ergonomic
studies generally have examined the CHRONIC or long term, repeated use of
these devices, whereas among many competitive lifters usage is often reserved
for ACUTE, occasional very heavy or maximal attempts.

Making out of context extrapolations like that is unscientific and
unwarranted. It is similar to comparing the use of shoes in sprints and
marathon running, or even the use of weightlifting and powerlifting shoes
(especially in the deadlift and clean).

So far, no study has been conducted which shows that the occasional and
selective use of belts and wrist straps significantly alters performance or
produces reductions in motor skill, strength, power or speed, so it is highly
misleading to take data from chronic, non-sporting, situations out of context
and apply it to the acute situations of weight training and competitive
lifting. Many lifters will agree that the unnecessary, constant reliance
on belts and straps for every lift, irrespective of weight, may be detrimental
to some aspects of performance, but that sort of usage tends to be confined
to the more aesthetic, bodybuilding-type, fashionable market than serious
weight training and competitive lifting.

Remarks that some of the world’s strongest weightlifters compete without
belts are largely of no consequence, because there are large numbers of top
lifters who lift with belts. In fact, the heaviest weight ever jerked above
the head (266kg) was achieved by the mighty Leonid Taranenko, who was wearing
a belt (I was present when he made that huge attempt). While this may
indicate that it is perfectly possible for many lifters to lift huge weights
without belts, it does not mean that it is detrimental to wear a belt.

Of course, the matter of not wearing belts and wraps is highly questionable
in powerlifting, because performances can be very significantly improved by
wearing these aids while competing. Note that wearing these aids during
competitive lifting does not mean that one wears them for prolonged periods
during training – most powerlifters do not approve of that or follow that
approach.

As usual it is not that a given exercise or given way of using a training
item is harmful in itself; it is the manner and context in which it is used
which may cause problems. To pass a blanket ruling against the use of belts
and wraps in all lifting and training applications is dogmatically excessive,
since there are acute situations or situations involving added security in
which the astute and selective use of belts and other lifting aids can play a
positive role. It is only when one excessively and unselectively relies on
such devices that problems may be introduced.

Remember that there is even more convincing evidence that barefooted running
is more efficient and safer than shod running, so, if we are to be
consistent, we should militate against the use of shoes in all sports. After
all, children and many adults in Africa, India and Indo China can run, play
and carry out the most demanding of physical activities without shoes
(including kicking a soccer ball) – and there is accumulating research which
shows that they have fewer lower extremity problems compared with their
shoe-wearing Western counterparts.

Research has shown that all shoes tend to increase the risks of pronation
injury and sprains to the ankle, plus they slow down the reactive capabilities
of the foot, unless the shoes are expensively modified in an attempt to
imitate the situation which takes place when one is barefooted (e.g. see
texts such as Nigg B ed, “The Biomechanics of Running Shoes”). That alone
should produce a strong case against the chronic use of shoes!

If, as the anti-belt brigade maintain, the body can easily adapt to lifting
without a belt, so can our feet and bodies easily adapt to the stresses of
movement and sport without shoes. The soles of our feet can harden to cope
with frictional and impact loading (and sharp objects), our overall stiffness
and damping ratios can modify to cope with all sorts of loading, we can
develop greater range of movement without shoes and we can develop greater
foot dexterity. This may even tend to make one believe that most shoe
wearing is for fashion and appearance!

The bottom line? If you are going to use a belt or straps, then just do so
intelligently and selectively!

Dr Mel C Siff

<< Causes of my knee problems:

1. I have a hyperlordosis problem that might be related to having tight psoas
2. I seem to have a tendency to round my back at the bottom of the squat
3. There was something to do with my vastus lateralis coming into play
before my vastus medialis while I squat which contributed to my knee
instability ( note that I did not hurt my knee squatting)
4. I think there were some slight rotation problems with my shoulders
5. I think I had a slight tilt that brought my right shoulder up and my left
hip >>

***None of those tests would be considered to be scientifically definitive.
For example, while psoas ‘tightness’ may have something to do with excessive
‘hollowing’ of the lumbar spine, that is one of several possible explanations
for significant lordosis.

Anyway, tightness of psoas would tend to counteract your tendency to round
the back during the squat. Rounding of the lower spine generally has more to
do with limited flexibility in the ankle and knee joints than the psoas. In
addition, it can simply be due to ‘bad’ neuromotor habits accumulated over
prolonged periods of uncorrected training. Very often, the use of a few
hands-on kinaesthetic ‘tricks’ that I mentioned in my last letter, improve
the situation markedly in a few minutes.

If your back tends to round too much near the deepest part of your squat,
then simply squat as far as you can go with good form and gradually increase
the depth of squatting over a period of a few weeks and the rounding problem
quite happily will resolve itself.

How did they ascertain if one of the vastus muscles was ‘firing’ before the
other without using an EMG? How did they conclude that the way in which your
muscles came into play are not appropriate for your individual structure and
characteristics? It is well known that all muscles contribute to different
degrees with different timing, so what a muscle test reveals under static or
short range conditions may be totally irrelevant to what happens under full
range movement in a given sporting action. There is no set universal pattern
which applies to all of us.

Probably what had more effect on your squatting than anything else is the
fact that knee injuries are notorious for producing reflex inhibition of the
quadriceps. The body innately knows that the ability to produce very
forceful contraction, so it somehow activates inhibitory nervous processes
which counteract your ability to contract muscles that operate the injured
joint. Very often, if you have an injured knee, you will tend to become more
of a “back squatter” with a marked forward lean and you will often tilt your
injured knee in such a way as to minimise the stress on it. This will lead
to tilting of the hip, rotation of the trunk and other such problems. No
need to look for mystical causes in vasti , psoas or pyriformis muscles, or
in “muscle imbalance” – the problem may simply lie in reflexive protective
processes.

<<I thought I had been balanced by another therapist, so I’m thinking that
the tilt might have been related to the pain in my knee. >>

***Your diagnosis is probably as accurate as any therapist is going to make -
your intuitive diagnosis agrees with my above analysis based upon a knowledge
of motor control. Far too often, impressive sounding jargon is used to
justify a model of the injury and healing process, when the truth is that the
diagnosticians don’t really know. However, a diagnosis couched in
pseudoscientific language sounds a lot more convincing to the client and the
therapist – remember that both people involved in the healing situation need
to satisfy psychological needs.

The only way in which one can avoid this situation is to list several
possible causes and, by harmless trial and error (guided by movement patterns
and perception of pain), narrow them down to a short list of the most likely
causes. Of course, genuine medical examination such as radiological scans of
the area should be used to rule out the possibility of really serious
pathology, if this may be of any concern.

Dr Mel C Siff

<<I have had problems with knee stabilization. My trainer and therapist
stated that I’d been squatting too deep without doing any quad work and that
my vastus medialis wasn’t firing properly. To solve my problem, I had to
stop squatting and deadlifting for a month and do some extra exercises to
correct for my poor vastus functioning.>>

Mel Siff:

***This is a common sort of plausible-sounding pseudoscientific jargon that
many therapists and quasi-therapists throw into their ‘diagnostic’ analyses
of athletes. It would be fascinating to hear from them what constitutes
“proper” firing of vastus medialis and how they determined without invasive
EMG tests how “improper” the firing actually was.

Firing of nerves depends on numerous factors, including stage of lift,
relative angles between the different joints, velocity of movement, magnitude
of load, rate of load change, pattern of movement, so it is highly misleading
to talk about improper firing as a general problem.

This sort of junk science means almost nothing, though it often serves to
provide some sort of placebo explanation that can assist in the recovery
process. It is well known that drugs tend to work better when the patient
has read about the effectiveness of that drug or had its powers explained by
the doctor.

In fact, some researchers have found evidence that certain regimes of
exercise appear to work more because of their placebo effects than their
direct physical conditioning effects. So, the therapist or trainer gives an
athlete a carefully worked out card of exercises and procedures to
follow like a medical prescription and this formalisation alone can
facilitate a definite part of the healing.

This is wonderful to know, because it means that virtually any plausible
sounding therapist, personal trainer or coach can draw up an impressive
looking training program (which also does contain exercises which DO contain
well-known productive exercises) and help a client make definite progress!
The ideal situation is where one can devise a program which contains
exercises which offer maximal physical and placebo stimulation.

So, when you are devising any program, try to ensure to involve a strong “Faith
Factor” (placebo or what you will effect), so that everything that
you do will allow your mind to augment what your body is doing. In other
words, try to use exercises or ways of using those exercises which you
strongly believe in and avoid ones which you do not believe in – or work at
modifying those exercises which you do not believe in, so that you do learn to
have some faith in them.

<<No squatting and deadlifting for about a month >>

***This was totally unnecessary. If exercises like this are associated with
some movement problem, it usually has far more to do with the technique and
method of using them than the exercises themselves. You could have continued
to use these exercises in a manner that would have enhanced your knee
stability and increased your strength. By the way, knee stability has little
to do directly with the knee or any of its musculature – stability has to do
with voluntary and involuntary (reflex) processes, not simply the strength or
size of the muscles.

<<Do the following exercises:

1. Step ups with the foot rotated outwards slightly and your lower foot’s
toes raised, using dumbbells of 10lbs in each hand.

2. Lunges with rear leg raised with sets of 20 repetitions.

3. Stretches for the psoas muscles >>

*** The reasoning here was that outward rotation of the foot should recruit
vastus medialis more strongly, but research has been very equivocal on this
issue. Moreover, each person in a relaxed stance exhibits different degrees
of hip rotation (not knee rotation), so that a general formula for a specific
type of “knee” rotation is meaningless.

More important than this is that the knee cannot rotate unless it is flexed,
so that there is no such thing as knee rotation or disposition in isolation
of what happens at other joints. If your knees tend to “knock” inwards
during parts of the squat, this is a perfectly normal attempt by the body to
stabilise the lower extremities. It is only when the flexed knee shows
excessive tilt or internal rotation under heavy or ballistic loading that
injury becomes far more likely.

If this happens, there are several strategies to correct this – you can have
someone press gently on the inside of the knees to keep them from going into
valgus (“knock-kneed” position) or have someone keep their hands on the outsides
of your knees for you to push against (sometimes coaches place a band or thin
belt placed around the knees to achieve the same effect). Others may place a
smaller physio ball between the knees to offer the same sort of guidance.
These technique are part of what are called “kinaesthetic manipulation”, a
system that can help impart or correct many exercises techniques in lifting
and other sports (Ch 8 of “Supertraining”, 1999).

Using methods like this, you need not have given up squats or deadlifts,
though there was no harm at all in adding some lunge variations and stretches
of the hip flexors.. However, I would also have added some rotatory slow and
isometric ’stretches’ of the rotators of the hip, because internal and
external mobility of the lower extremity (“leg”) depends largely on these
muscles and the other soft tissues around the hip joint.

Dr Mel C Siff