Monday, June 25, 2012

Fixing the Endurance Athlete, Part II: Cyclists

In part I, I went into some detail about the main points to consider when training/fixing a runner. In part II I'm going to talk about what to do with a cyclist. Biking is nearly as popular as running in Boston (No idea why, though; have you ever ridden a bike in this city? It's like playing Russian Roulette.) and quite a few of my clients partake in this activity on a regular basis. It's, again, not my first choice of ways to stay active, but you do your thing and I'll do mine.

The biggest thing to consider when dealing with someone who rides a lot is their posture. I am specifically speaking about people who spend a lot of time on road bikes with aero bars right now. Mountain bike and hybrid-bike position is much different; it's not exactly ideal, but it's not nearly as bad as a road bike with aero bars. First things first, let's takes a look at what I'm talking about.

If we take a look at this guy piece by piece, we will notice a few things. Hips flexed, lumbar spine in flexion, thoracic spine in flexion, humerus is internally rotated/adducted and his cervical spine is hyper-extended. Those things on his shoes also look a little silly. Does this positioning remind you of anything?

Hips flexed, lumbar and t-spine in flexion, cervical spine in hyper-extension and arms are internally rotated and adducted. Only difference is that this guy isn't getting Bike posture is, in my opinion, even more of a concern than a runners posture. Again, we have an issue where someone spends 8-10 hours at work sitting in a shitty postural position at their desk, then will go home and hit an easy 25-mile ride on their bike in the same position. Talk about ingraining a movement pattern!

So, what can we do to take of these issues when we get a client who rides a lot? Let's start at the top and work our way to the bottom.

1) Cervical Hyper-extension: Listen to Charlie Weingroff and make sure that you are packing in the neck during every applicable movement (you should be doing this already). If your athlete is going to spend all of their "competing" time in one particular bad position, you want to make sure to reinforce the good position as much as you can. Make sure you are cueing them to pack their chin down into their throat; I find that telling clients to make a double-chin often helps them visualize it. Make sure they aren't just tilting their head forward, but actively pushing their head back into the right position. Cue this during all deadlift variations, as well as all rowing, overhead pressing and loaded carry variations. Actually, cue them to do this all the time. Brushing their teeth, driving the car, cooking dinner...a good drill to ingrain this is the hip hinge with a broomstick.

2) Internally Rotated and ADducted humerus: This position is part of what leads to Janda's Upper Crossed Syndrome. Spending hours in this position leads to tight pectorals, which pull your shoulders in. Having your shoulders pulled forward by your pecs causes the upper-middle back muscles to stay in a shortened/weakened state.

These factors all work together to leave you looking like Quasimodo, and this doesn't help with the ladies. What do we do to fix this? Step one is soft-tissue work: let's get out a lax ball and mash the shit out of your internal rotators (just below your collar bone). Now that you've loosened up the tissue a bit, go ahead and ingrain the correct movement pattern and do some doorway slides. Another useful drill is the Resistance Band Shoulder Distraction and it comes from Kelly Starret. As Eric Cressey is fond of saying "there's no such thing as a contraindicated exercise, just contraindicated lifters". The contraindicated exercise I'm referencing with these athletes is any variation of overhead pressing. I'd be hard pressed to find a lot of cyclists that I'd be dying to put stuff overhead with; you'd be better off spending your time on horizontal and vertical pulling exercises.

3) Thoracic Spine Flexion: A flexed thoracic spine isn't an intrinsically bad thing; the t-spine is made to flex forward. However, it's not intended to spend the majority of the day in this position. This is part of what leads to that really poor posture that none of us want to have. Add to this the tight internal rotators and you have a recipe for awful posture. What can we do to help solve this? Lot's actually! First off, foam roll your upper back. You can take it a step further and use this trick that K.Star shows us. (FYI it feels miserable/amazing.) I personally think that, for a lot of people, soft tissue restrictions are a piece of the puzzle that prevent them from getting back their thoracic range of motion. For this, I would suggest seeking out a reputable soft-tissue therapist such as a masseuse or licensed ART practitioner. There are literally dozens of drills to employ when trying to restore T-spine ROM, so do a Google search and start trying them out. To go along with your new thoracic extension, you're going want to reinforce the position by doing lots of horizontal rowing exercises, making sure to get a full scapular retraction when doing so. I would start off by doing variations with a vertical torso: seated row, standing 1-arm cable rows and face/neck pulls are very effective. From there I would progress to horizontal rowing with an angled/supported torso: chest-supported row, head-supported row, and batwings.

The final progression is to horizontal rowing with the torso parallel to the floor; the "classic" rowing exercises: barbell row, Pendlay row, 3-point dumbbell row and the t-bar row. I place these exercises as the last progression because using them too early would result in the cyclist wanting to put their back into its most comfortable position (rounded), which would defeat the purpose. Build a solid base of strength and allow them to get comfortable with the positioning.

4) Lumbar Flexion: This is the dangerous one. If the athlete tries to return to a lumbar flexed position during any heavy lift, they run the risk of hurting themselves pretty badly. It's of the utmost importance to the athlete and coach that pelvic control and hip mobility is restored before starting with any axial loading of the spine. Starting off the athlete with glute activate exercises and stretches/mobilizations for the anterior aspect of the hip will be necessary. Since they spend a lot of their time with their hips "tucked under", their glutes will tend to be inefficient and their hips will be tight. Trying to load this athlete up with a deadlift on day 1 would be a poor decision. After they've demonstrated the ability to achieve a lordotic spine, ingrain the proper movement patterns with simple exercises like goblet squats and Romanian deadlifts. You'd also want to perform some solid anti-flexion exercises with this athlete: planks, various isometric Palloff presses and loaded carries. Just like with the upper body, these athletes usually flirt with what's known as Janda's Lower Crossed Syndrome.

To help restore glute function you're going to want to spend your time on glute bridges, x-band walks and slideboard hamstring/body curls. Progress them to all deadlift variations, glute ham raises and 45 degree back extensions (done properly, of course). I would start off deadlifting these athletes since they tend to be very quad dominant but squatting will, of course, be in order. However, I would tend to keep the bar off of their backs; chances are good they will have poor external rotation of the humerus and will probably experience some discomfort when trying to do a barbell back squat or a good morning. Use the front squat or a speciality bar.

5) Hip Flexion: The flexed hips position will tend to exacerbate the flexed lumbar position. Everyone who sits often (read: everyone) will have shortened hip flexors, so these drills are very applicable. Use the K.Star couch stretch or the ubiquitous rocking hip flexor mob. I have found a few of Kelly Starret's banded joint distractions to be extremely useful in my own training to help restore some good hip mobility. Here are the ones that I personally used the most often:

Well, shit. That was a lot. This post was fueled by Dave Matthews Band and Stella Artois. I hope someone out there finds something here useful! Whether you train cyclists, are a cyclist, or just happen to sit a lot, there's something here for everyone. If you take one thing away from this, then I succeeded. Take care, and go lift something heavy!

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