Five stages to build the ultimate back:

1. Build Motion Patterns, Motor Patterns, and develop appropriate corrective exercises:
   • Identify patterns of movement that cause issues
   • Build basic movement patterns through to complex activity specific patterns
   • Create basic balance challenges to more complex ones
2. Build Stability
   • Build stability while sparing the joints
   • Sufficient stability proportionate to the task
3. Build Endurance
   • Perform basic endurance training to build foundation for eventual strength
   • Transition to activity-specific endurance, paying attention to duration and intensity
4. Build Strength
   • Learn to create “strength” pulses
5. Develop Speed, power and agility

• For a painful back, the exercise dosage needed to stimulate adaptation is very close to the load that will make them worse
• Ideal training occurs when both tolerance – load of work before tissue breakage occurs, and capacity – sum of all total of activities over a period of time perhaps during an exercise session, a day or a week, are increased together with perfecting form and ultimately performance
• Do not waste precious capacity on poor standing and sitting postures
• Current Low Back Disorder Myths:
  • Stretching:
    • Flexibility in the shoulder, and hips is more important for performance than stretching the back
    • Stretching the back can cause injuries
    • Many world-classt athletes have very stiff backs that they’re considered disabled by the definition of American Medical association
    • Stretching can serve a functional purpose if one side of the body is more tight than the other
    • Not everyone needs stretching
    • Flexibility without motor control and flexibility is useless
    • Look for opportunities to train motion and build an appropriate motor pattern to ensure ultimate performance throughout the range, as opposed to blindly stretch at joint-end range.
  • Rehabilitation vs training for performance
    • Power (Force times velocity) should come from the hips. The risk rises when power comes from the spine
      • Weightlifters develop enormous hip power but virtually no spine power cz spine is locked into a static position while high velocity angular motion is provided by the hips
  • Pain inhibits optimal motor patterns
    • “no pain, no gain” does not work for backs
    • Exercise must be pain free
    • The presence of pain prevents the re-establishment of “healthy” motor patterns required for performance
    • Rehabilitation objectives are very different from performance objectives
  • Getting stronger always makes better athlete
    • Not true. Pushing to get stronger increases the risk of injury
    • Depending ont he sport, the definition of strength may differ and also more muscle stiffness may compromise performance in sports such as running
    • You need to develop sufficient strength
  • Rebhabilitation for a bad back is for pain reduction and health enhancement – period.
    • Establishign motor and motion patterns with no pain, and building function for daily activity, while building tissue and avoiding further injury are the objectives
    • In contrast, performance training demands that risks be taken, that the body systems be overloaded into the razor-thin zone brinking on failure.
  • Many body building principles such as isolating a muscle during training, the basic design of repts and set were designed for muscle hypertrophy. Training the whole-body motion involves balance of force throughout the linkage
  • The strength and skill of the body, when combined with the strength and the skill of hte mind, make for a third strength and skill far in excess of the sum of the two.
  • Islolating a muscle about a joint and training it with progressive overload is purely a body building hypertrophy approach. Functional training incorporates the goal of enhancing strength throughout the body segment linkage.
    • functional training emphasizes strengthening muscles in a way that mimics real-world movements and involves multiple muscle groups working together. It trains the body’s movement patterns rather than isolating individual muscles.It enhances strength throughout body segment linkage, meaning it improves the way muscles coordinate with each other across joints. Exercises like squats, deadlifts, push-ups, and kettlebell swings engage multiple muscle groups, stabilizers, and joints at once.This approach promotes better mobility, balance, and overall strength that can be applied to daily activities or sports. Functional training often uses compound movements to improve the body’s kinetic chain.
      Train movement, not muscle
  • Designing a training program starts with establishing the motor and motion patterns, then develop endurance all of which occurs prior to specific efforts to build strength. Next, you build endurance with greater volume of work but low intensity, then progress to decreasing volume and increasing intensity
  • Ligaments, Passive Tissues and Joints
    • Ligaments: fibrous tissues. Connect bone to bone and provide stability by limiting excessive movement limiting range
    • Passive Tissues
    • Joints: they are the point of connection between two bones. Can be of two types
      • The ones that connect the skull bones: rigid and does not allow movement
      • Vertebrate discs: allow limited movements
      • There is the type exemplified by the knee joint which has several components allowing for movement

• Concept of the moment: Moment equals force multiplied by distance, the perpendicular distance between force and rotation axis. This is why the further away an object is from the body, the heavier will be the load on your spine if you were to lift it off the ground

• Russian Training Principles:
  • Education: Comprehensive education about physiology, mechanics of movement, psychology, etc. All to have the athlete develop awareness
  • all-round development: Endurance, speed, coordination, strength, and mental toughness
  • consecutiveness: operationalized at two levels: during a training session you first ramp up and down – decrease the number of reps as you progress with the sets, and the overall increase in the challenge as the training program progresses.
    During static postures, tissues at the joint interface accumulate micro demoframtions. A well-designed wary up slowly introduces motion as these tissues regain their normal confirmation, preventing destructive stress concentrations
  • Repetition: first you perfrect motor and skill ability such that it becomes second-hand nature. From there, you can add strength and challenge
  • Visualization: the ability for the athlete to visualize the movement at many levels: how the joints move and motor patterns in different areas of the body
  • Individualization
  • Strctured training: Session typically begins wtih warmup with specific effort directed to tissue-joint and physiological systems warm-up. Then, proceed to perfecting technical and tactically skill, then ability and speed, then strength, and finally endurance. Second level is planned cycles of training
  • Strength and Posture: Internal biomechanics ( muscle, joint architecture, body segment variables) together with external biomechanical variables ( projected force vectors from the floor through various joints, distance from external loads to various joints) is all impacted by posture. Strength is affected by spine, neck and shoulder posture. Neck needs to be stacked on top of shoulders which need to be stacked on top of hips. slouched postures impact capacity
• Plyometric Training:
  • Requires a lot of prep before you get to it. You need to avoid the injuries associated with such ballistic forces during this type of training
• Strength and Posture: strong people cannot have a slouched posture dueto both mechanical and biological reaosns
• Propreception Training: Exercises can be performed with the eyes closed to focus on kinematic patterns
• The Science of Flexibility:
  • Blindly increasing the range of motion rationalized by the belief it’s beneficial is problematic
  • No relationship between static joint flexibility and dynamic performance
  • Negative correlations between increased back flexibility and higher back troubles, at least for occupational athletes
  • A joint that has lost some passive stiffness requires more muscle contraction to maintain stability
  • The concept of “Active Flexibility” is more important for performance, where muscular force is produced through a range of motion
  • Active flexibility about the spine (Shoulders, hips and knees) is emphasized but not always justifiable in the spine itself
  • General guidelines for stretching techniques:
  • Static Stretching for the sake of just extending the range of motion for as much as possible is not a good idea. It leads to loss of stiffness in joints that might not be needed for the range of motion that is needed for the daily activities and sports performed.
  • Dynamic Stretching yields better results as it focuses on ensuring full range of motion for the daily activities and sports performed
  • Joint Range of Motion is impacted by several factors including joint muscles ability to stretch, tendon and ligaments ability to stretch too, neuromuscular functions
  • Any stretching should be accompanied by appropriate strength training to ensure that stability of the joint is not compromised.
  • Specificity: The required repeated activity dictates the subsequent range of motion needed. Eg: if you require range of motion about the hips, and if you have history of back trouble, cycling would not be a wise choice for aerobic activity
    • Hip is in restricted range
    • Cyclists show hamstring dominant patttern during hip extension
    • Evidence shows that training for flexbiility with the range of motion is more important than static stretching
    • Athletes who require explosive movements such as runners and lifters, do not need stretching beyond their range of competitive motion
      • Stretching beyond their ROM would alter the muscle structure, compromising performance and increasing the risk of injury
      • Dynamic stretching which means performing movements within range of motion that is required for the sport
      • Competitive range of motion: it is the range of motion required for the athlete to perform their sport effectively. For runners and lifters, this range is generally less than what might be required for activities like gymnastics or dance
      • Muscles and tendons act like springs, storing and releasing energy efficiently
      • excessive stretching can lead to hypermobility, increasing the risk for joint instability and injury and sprains
      • Dynamic stretches that prepare the muscles and tendons for the specific demands of the sport
  • Children and Athleticism:
    • Focus on ingraining motion and motor patterns in a safe way. Best developed 3-9
    • There will be more specific training 13-14 for most sports, increasing intensity and duration appropriately
  • Olympic lifts:
    • eg: Power clean.
      • They build strength but at a very high cost
      • Require specific body segment proportions, natural speed and flexibility
      • There is less focus out there on speed and repetitions with very low weights than needed
      • Very few will survive the cumulative toll on the body of this very demanding event to survive for a necessary amount of time
      • Skiller power lifters sustained lower back loads than their less skilled competitors. They were able to obtain a body posture that spared their joints but the posture itself demands joint positions at the extreme range of the population continuum
      • Some fitness programs incorporate olympic lifts to fatigue and then some burpees. Burpees soften the collagen matrix of the discs making them more susceptible to delamination when exposed to the loading of the olympic lifts. Further, with fatigue the lifting form breaks, substantially elevating spine loads
• Training with Machines: Concerns include the following
  • You are not training in a functional way. These machines have you assume positions – often sitting, that do not correspond to activities that you’ll do daily or in sports
  • They can give a false sense of safety in that they limit speed of joint motion, magnitude of resistance and motion in adjacent joints, and stopping a load from falling onto a person. Yet, training in a propreoceptively deprived environment does not challenge the system needed to ensure no single tissue experiences damaging overload.
  • They can force you to flex your spine, overload your knees
  • They can place joints into weak and vulnerable biomechanical positions – eg: seated military press
• The best training is one that focuses on the needs of the activity. This means focusing on the motion, the areas of the body where muscles generate the greatest force, the rate of force production and regimen of muscular work. Eg: a sprinter may train hip extension with corresponding hip flexion about the other hip – lungs, birddog, etc
• Injury results from an accident during training, undertraining, or overtraining
• Warm-up: A good warm up regimen should be 10-15mins, involve all body parts, and has two phases: general and activity-specific.
  • General – easy walking, progresing to easy jogging and calisthenic exercise -8 to 10 reps to achieve neuromuscular preparation. Think Biomechanic
  • Specific – meet the physical demand of the exercise. Eg: lifters may begin by lifting an unloaded bar and progress to heavy exertions
  • Spine mobilization may be achieved in the most spine sparing way with the cat-camel exercise performed on all 4. After that, spine mobility exercises are highly sport specific
  • Consider the following components of a warm up: biomechanical – mobilize joints, physiological – activate various systems, and neurological – potentiate the nueor muscular system for rapid activation/deactivation in desirable patterns
• Low back pain is associated more with back muscles that do not have a good level of endurance than strength. A stable spine requires endurable muscles, not necessarily strong muscles
• Generating high strength is much safer with a back that is not bending. The goal of most movement technique designed to save the back is to ensure that power is developed about the hips and that lowe spine power is maintained
• Balancing Stability with Mobility: This is achieved through dynamic stabilization while maintaining functional mobility
  • Stability is to ensure that the spine structure or function does not change under varying loads and movements. This does not mean rigid immobility but rather controlled stability and no excessive motion at one segment. Stability exercises can include: Bird dog, deadbug and modified curl
  • Mobility: ensures that the spine can move to accommodate activities without stiffness or pain. adequate mobility means that the spine can bend or twist without too much stress on any single segment. Eg of exercises that can help with this: cat-camel stretch, later walk with a resistance band
  • Functional movements like squats, deadlifts and lunges allow combining mobility with stability when done correctly.
• Spine Power: The goal of any rehab or performance program is to spare the back by maintaining low spine power. Your spine is made of vertebrae. When back muscle change their lengths – either by twisting or bending, they apply rotational forces on the vertebraes. If the movement happens quickly, you’ll be generating power in your back, and you want to keep that as low as possible.
• Motor Patterns: an example of a poor motor pattern would be failing to maintain core stiffness to maintain sufficient spine stiffness while breathing. Same when it comes to gluteal activation.
• The spine has a loading memory. This means that a prior activity can determine the biomechanics of the spine in a subsequent activity. If you sit slouched long enough, this causes ligament laxity and disc creep, and this residual laxity lasts over half an hour in some cases when you stand. If a spine if flexed in one maneuver, it probably to neutral or extension in the next.
• Begin exercising with spine-stabilization exercises.
• Best to establish motion/motor patterns at the beginning of exercise session – called neuromuscular activation. Neuromuscular activation is simply put when your brain tells your muscles to move, it’s like a message from the nerves to the muscles. Motion pattern is the sequence of movements your body does when it performs an activity. Motor patterns is the sequence of muscle movements that your body learns over time to perform actions efficiently. So motor patterns is how the muscle execute a motion pattern.
• Avoid exercises that bend the spine in the first hours of waking up as discs are most hydrated and most vulnerable at this time of day
• Develop a breathing pattern that creates independent diaphragm movement from stiff core musclesn
• Rehabilitative exercise guidelines for people with back troubles:
  • Exercise Daily: low back exercises are most beneficial when performed 6 days of the week
  • Stop any exercise that causes pain: the no-pain, no-gain axiom never works with backpain
  • Add walking to the routine
  • Focus on building endurance and core muscle stiffness. Favor more reptitions than building strength
  • Do the core-strengthening exercises daily
  • Avoid spine bending after rising from bed
  • Be patient and stick with the program: success can take time
• Process of injury: occupational and athletic injury Involves cumulative trauma from repetitive subfailure loads. In this case, injury occurs either by repetitive application of relatively low load, or a sustained load for a long duration. A slow degradation of failure tolerance is experienced. A cyclist might not heavy weights but by keeping a fully flexed lumbar spine for long durations, he is loading the posterior passive tissues. The objective of injury prevention and training strategies is to ensure that tissue adaptation stimulated from exposure to loads keeps pace with and ideally exceeds the accumulated tissue damage. Rest periods allow the healging/adapation process to gradually increase the failure tolerance to a higher level.
  • Prevention efforts should not be focused on culminating events – think of the culminating event as the hair that broke the camel’s back
• There is no single ideal sitting position as any position would ultimately cause the back tissues to reach their capacity because of stress build. Instead, vartaion of the sitting posture is recommended, use of lumbar support and taking breaks
• Backpacks are superior to weight vests for those with back troubles. The weight is behind the spine rather than on top of it with a vest. Try wearing a backpack with about 10kg place in the backpack
• Sitting prior to exertion is an example where spinal memory can increase injury risk and decrease performance
• Pain:
• Often felt in the muscles but when the muscles are in pain they are often acting in “sympathy” as the pain is often due to underlying pathology
• Pain is due to overuse of weak link – poor technique makes the back the weak link
• The approach is to remove the cause of the pain. This involves changing the mechanical load exposure of the painful tissues in ALL aspects of life, including postural components and training efforts
• Sciatic symptoms: stretching is bad for them. two approaches to dealing with them:
  • Spine sparing motion to avoid end-range of motion and associated nerve tension, and reduce possible disc pulling
  • Nerve flossing
• Optimal health of spine comes from optimum of loading – not too little and not too much. Too much bed rest for example can stress the spine. Consider the following
• You cannot fight your way through pain, if it is tissue pain. The nervous system becomes sensitized, meaning it becomes better at detecting the pain. The approach to break this type of cycle is to accommodate pain free motion – winding down the nervous system. As you desensitize the nervous system and the back you can slowly start adding more challenging tasks.
• The foundation of athletic performance has 4 components;
  • Proximal stiffness creates distal athleticism
  • A muscular guy wire system is needed for the flexible spine to successfully bear load
  • Muscular co-activation creates stiffness to eliminate micromovements in the joints that lead to pain
  • Abdominal armor from stiffness is necessary for some occupational, combative and impact athletes
• Back injury causes joint laxity. Eg: injury to the disc causes it to lose height allowing aberrant micro-movements. The micro movements irritates the nerves resulting in back and radiating pain.
• Principles for optimizing performance
  • Proximal stiffness creates distal mobility and limb athletecisim. Consider the example of a punch. Force needs to be developed through forearm and arm segments. Torso needs to be stiff to facilitate transition of forces from the lower body to the arm. Stiffining the arm is essential so that the forces developed higher in the linkage are not lost.
  • Production of linear impulse: The impulse formula is duration of time multiplied by force applied. It represents the total amount of moment transferred to an object. Examples include: when a sprinter pushes off the ground, they generate an impulse through their leg muscles acting on the ground for a brief moment. This causes them to move upward
  • Direction of force application: If you want to jump to spike a volleyball, then forces applied to the ground that have horizontal component are wasted. In static situations, the force is applied to the ground when you are trying to control balance during resistance training. But, when running, the force is applicate to “corral” the center of mas and bring it back within a base of support.
  • Principle of Stability: Body stability is determined through the position of body center of mass CofM within the base of support. More stability in martial arts is achieved by widening the base of support while hinging about the hips and knees. This won’t work for sprinters who create a base of support with the hands and feet on the ground.
  • Summation of segment velocities: forward velocity of the hand at the time of release of a baseball at impact determines travel distance for ball. This is a process produced by all contributing links in the chain rather than velocity being produced at the instant in time when the ball was thrown
  • Production of angular impulse: consider the diver who creates a force on the springboard well behind the CofM. Knockout blow in boxing occurs because of angular punch to the jaw: the brain remains stationary int he skull while the skull rotates around it – damaging tissues and concussing the brain.
  • Conservation of momentum: Volleyball striker should create rotational forces in the striking arm. These forces should cause the body to react with rotation in the opposite direction
  • Manipulation of moment of intertia: for springboard divers, a tighter tuck position causes faster rotation of rotation already exists.
  • Elimination of Energy leaks: motion in lumbar spine during spriting woulbe an example of an energy leak.
  • Minimization of tissue stress: taking breaks by standing up and stretching arms straight above head then inhaling is an example of reducing tissue stress to prevent back troubles. Warm-up is also a consideration to minimize tissue stress. Consider athele who may stand for a period of time, creating a dent in the knee cartridge. If forceful motion is suddenly applied, huge stress develop at the edges of the dent and cartridge is destroyed. This is prevented with a warm-up consistent of gentle motion slowly progressing in vigor. Same with the viscous discs in the spine which need to have gentle mothin to make subsequent motion less stressful.
  • A process for first client-consultant meeting
    • Identify training objectives: The difference between performance training and rehabilitation training is important. Someone wanting to prepare for gymnastics strength training but has back issues need to adjust their objective to first minimize the back problem. Failure to pay the “back gods” causes trouble to linger with compromised performance
    • Consider Athlete’s age and general conditions: Younger people tend to have more discogenic problems
    • Note sporting specific and lifestyle details: Inquire about the athele’s daily routines – exercise habits, meal habits, daily routine and double-click on areas of concern. eg: if a person reports sitting for two hours to watch tv, inquire about the posture, the type of chair used, etc. Discogenic troubles are linked with prolonged sitting and repeated torso flexion.
    • consider injury history and mechnic of injury: careful questioning about events leading to injury provides clues about mechanism of injury
    • Have the athlete describe perceived pain exacerbators: movements should lead you to understand what tissues have been irritated or loaded. These tissues should be spared in exercise/therapy training
    • Have the athele describe type of pain, location, whether it is radiating: deep, boring, scratchy, sizzling, at a point, generally over the back region, continually changing. Direct pressure can indicate a unilateral disc bulge or end-plate fracture with a lost in disc height
    • Observe basic movements: observe hip and spine motion during sitting and standing and rising from sitting to standing. Look for spine hinges where excessive local motion occurs together with stiff regions.
    • Perform provocative tests
    • Box Squat: Sit “back” to the box, not “down on” the box. No spine motion permitted while seated. The key is to keep the spine controller din a neutral posture and stabilized with isometric torso muscle contraction. So, the spine the and torso are not relaxed, only the hips. The hips generate the explosive drive.
    • Every strength program should have elements of pulls, pushes, lifts and carries
    • Training programs that challenge the back in all planes should begin by training the back in the sagittal plane – picture a vertical line dividing your body into two halfs: left and right, at the center. Movements in this plane are typically forward and backward. Examples include walking, bicep curls, and nodding head, then proceed to Frontal plane – vertical line diving the body into front and back. This includes abduction, adduction and moving the body sideways, jumping jacks, side leg raises, and tilting the head to the shoulder, and then torsional plane – horizontal line dividing the body at the hips. This includes rotational movement around the axis such as twisting the hips, head, or limbs. It also includes horizontal abductal and adductal movements such as raising a leg horizontally towards the body midline. One way to avoid this is by locking rip cage to plevis and rotate about hips and feet.
    • Training for speed and explosiveness while doing strength produces superior results. Even if speed is only perceived, it will still produce benefits as the athlete is focused on sensing body segment movements, speed and speed, the more effective they’ll be.
    • Considerations for developing general progressions in a training program:
      • Peak and Taper according to competition schedule
      • Establish basic motion and motor patterns to stability/mobility to endurance to strength to speed to power
      • Body weight to external resistance
      • stable surfaces to labile surfaces to labile loads
      • Combine fast and slow exercise sessions not heavy and light
      • Resist building programs around areas of the body, rather think of a push, pull, carry, life and perhaps an anti-rotation (stop twist)
  • Components to transition to optimal performance:
    • proximal stiffness creates distal athleticism: core stiffness creates more forceful and faster limb action
    • Rapid contraction and relaxation of muscle: The neuromuscular system must be trained for rapid muscle contraction and also relaxation. One way to improve rapid contraction/relaxation is to rapidly release an isometric contraction with a rapid motion such as with a strike
    • Tuning of the muscles: pre-contraction of the muscle prior to the loading phase is extremely important. Start first by stiffening the core, and then optimize distal joints.
  • Muscular binding and weaving: you activate all the muscles at a joint to create superstiffness where the whole is greater than the sum of the individual muscle stiffness. Rectus abdominis, obliques, and transverse abdominis form a composite when activated together – similar to a composite of plywood where one layer has the wood grain running north and south while the second east and west and glue connects them in between. The suggestion here is to contract all layers of the abdominal wall or all components of back extensors
  • Directing neuronal overflow: if you shake someone else’s hand firmly, and repeat the same task but grip the floor with your feet, preactivate the glueteal muscles, stiffen the core and make a fist with the other while co-contracing the other arm. You will experience a much more robust contraction
  • Eliminate energy leaks: when a coach yells to an athlete “stay tight!”, this means to maintain stiffness. Consider an expensive bicycle frame: as you push on the pedal, the forces are transmitted to the wheel. A compliant frame allows flex which results in energy losses with each foot exertion. Efficient transmission of forces through linkage requires stiffness. Pavel Tsatsouline would prod looking for sot area when performing a pushup by using a stick to whack and prod.
    consider the leaper in basketball. the planting foot is flat on the ground and hte power source is primarily the hip. the hip is so powerful in rapid extension that if the foot plant was on the ball of the foot, the foot would be forced flat to the floor and the ankle extensors forced into eccentric contraction, resulting in energy loss.
    This scenario highlights efficient transmission of energy from hips to foot when the entire foot is in contact with the grounds. This way, there is no energy being spent on extending the calf muscle if you were to just plant the forefoot, the ball of the foot, into the ground when jumping.
    when you plant just the ball of the foot, the powerful extension of the hip can force the foot from a toe-down position to a flat position. This causes the calf muscle to undergo eccentric contraction under tension. Eccentric contractions are less efficient at energy transmission than concentric contractions
  • Get through the “sticking points”: Superstiffening the entire body helps get through the midpoint of the lift in a bench press
  • Optimize passive connective tissue system: Elite runners run to a large extent on passive tissue not muscle. They are kangaroos! they can stiffent their passive tissues further with muscle activation given the many ligamentous and fascial connections. This ability is compromised with Stretching. Thus, a general guideline is to never stretch a runner beyond the joint angles utilized in running. Keep them tight to engage the springs with each stride. Stretching should only be considered to correct asymmetries between right and left sides of the body.
  • Create shockwaves: in a one arm military press, you can use a weight that is simply too heavy to lift it up. Then, with the hips and the knee create a rapid but very small amplitude dip. This initiates the shockwave. The body must be very stiff to transmit the wave upwards to the load. Engage your entire body to create a stable and rigid structure, slightly bend your knees and hips to lower your center of gravity, followed by an immediate upward push
  • When it comes to squats, the basic motion is to squat “back” and not “down”. this means that the trajectory of the hips is along a line that is about 45 degrees from vertical. The trick is to keep the bar over the hips