Fighting Fit in Pregnancy & Beyond: Part 2 Exercise in the Second Trimester

Having felt rather normal in the first trimester there had been little impact to my fitness regime but now in the second trimester I knew how important it was to ensure my fitness regime was appropriate.  My first priority is to ensure the health and safety of my baby, but my second priority is to ensure my own health and happiness.  I am a firm believer that keeping myself fit and strong can only benefit my baby both during the pregnancy and in the post natal period where I will need plenty of energy and strength to tackle my new job as mum.  In addition to staying fit and strong I want to also ensure that I am limiting the physical damage to my body to ensure I am not left with a legacy of musculoskeletal and pelvic floor problems in the years to come.

Continue reading Fighting Fit in Pregnancy & Beyond: Part 2 Exercise in the Second Trimester

Dynamic Stretching: Miguel Angel Jimenez, Mad Man or Genius?

After a thoroughly enjoyable weekend of golf watching, I thought I would take inspiration from The Masters for this week’s blog.  The subject of this tale I hear you ask?  Miguel Angel Jimenez or “The Mechanic” as he is fondly known.  Whether it is his tumbling red curly hair or the cigar smoking he is undoubtedly one of the most lovable characters on tour, but for me it is warm up routine that shows me there is more to this man than his caricatured outer persona.

Miguels Magic Warm Up
Watch Miguels Warm Up Tips here:  

It may elect laughter from some of the tour pro’s and spectators on the warm up range but what they may not know is that Miguel’s stretching routine is dynamically releasing muscle after muscle, fascial layer after layer to allow him to start his round with optimal power and flexibility.  Is this why at 50 years of age he is still able to win on tour and finish 4th at Augusta this week?
So what is Dynamic Stretching?  We are all used to getting a muscle into a stretched position and holding it for 20-30 seconds.  This is called ‘static stretching’ and is what most people have been doing as part of their warm up for a long time.  Over the last few years there has been a real movement towards stretching by moving into a position, moving some more, then returning to the start.  The difference here is that yes the muscle is getting a stretch but because you are moving the tendons, ligaments and muscles have to contract and work while you do this which has the added benefit of giving greater levels of functional ability and strength in doing so.  It doesn’t take a genius to realise that this must lead to a better warm up as not only are you stretched but your muscles are fired up and ready to go!
And finally there is the Fascia.  So what is it and why is it important?  Our body consists of many organs, muscles, circulatory systems and nerves that work together to make us human.  What holds them all together and ensures they work together harmoniously so we move as one strong being is Fascia.  A connective collagenous tissue that is multi-directional allowing movement in all planes while keeping everything connected but free to move.  Now imagine your muscles are loosened up and ready to go but your fascia is stuck, adhered, knotted.  How freely can the muscles move if they are pinned down by this restriction?  And what is more if this fascia connects everything so that our muscles work together as opposed to independently if we have not stretched the fascia itself how can the whole body work freely to deliver power and movement? 
A closer look shows the genius of Miguels warm up.

First it starts with the wrists, twisting from right to left, left to right golf club in hand, loosening up the wrist flexors, extensors, supinators, pronators, right up to the upper arm and into the shoulder.  Right side, then left side. The use of the golf club adding some overpressure to stretch the muscles further than with movement alone.

Next he moves into the stretching the superficial back line, using the golf clubs as a stretching pole to reach the arms out and away from the body stretching the muscles of the shoulders, neck and spine.  Flexing forward, stretching the hamstrings, bending the knees and squatting down into the ankles releasing the calves.  Every part of the back line opening up and releasing

Moving on Miguel opens up the Superficial front line, reaching the clubs over his head, opening his chest, extending the body upwards and backwards opening the neck flexors, abdominals and hip flexors.

Next, comes the spiral lines, the most important lines for golf.  From the ankles to the knees up to hips, he rotates them in, rotates them out.  Briefly moving up to the triceps and the chest again, the harder parts to stretch to ensure that nothing remains untouched.

The lateral line comes next, side-bending right, opening up the hip abductors, the QL, the obliques, then mirroring these moves to the left. Again the use of the clubs to add overpressure and additional stretch while challenging the muscles to work, contract to fire.

And finally the swing.  With everything in place its time to stretch into the movement itself, preparing the body to fire and move for the sport in hand.  Again the genius flows through, Miguel swings right to left, right to left, but power comes from movement and if we cannot move from left to right our power is diminished…. so of course he repeats the movement left to right, left to right.

What part of the body remains unstretched? Unmoved?  Unworked? Nothing.  The perfect dynamic warm up. Genius.
So now you know the science behind the madness why don’t you give ‘The Mechanics’ warm up a go before your next round and just feel the power you release?

Related Links:
Interested in Fascia? Watch this video:

Carl Watts – The Experient Session 2

It had been a week since I saw Carl and I was keen to get a little deeper in this session so we can start making headway in his realignment.    Our priority in today’s session is to continue work on correcting the upper and lower cross syndrome we identified but firstly I will start with reassessing Carl to get a clear picture of where his body is following a week of rehabilitation.  In addition to reassessment there were a couple of other tests I wanted to perform:

1)      Glute Firing Pattern

Given the degree of anterior tilt in Carl’s pelvis and also the fact that it is likely to have been in this position for a long time there is a risk that the Glute muscles have been inhibited – in simpler terms ‘turned off’.  This is due to the process within the body which involves the muscles working in antagonistic pairs i.e. when the muscles on one side of joint contract, the muscles on the opposite side relax to allow ease of movement.  Given Carl’s hip flexors have been contracting hard for so long it is possible that the Glutes have been constantly receiving messages to relax which over a sustained period of time have left them lethargic and lazy letting the hamstrings do all the work.

      2)      Thoracic Rotation

This is a key movement in the golf swing.  In order to get the amount of torso rotation required in the golf swing it is not enough to simply rotate at the lumbar spine as this only gives you about 40 degrees on average.  The thoracic spine can rotate up to 30 degrees so it is vital that we have good range of motion in this part of the spine to get maximum rotation and therefore power into the golf swing.  Given Carl’s lack of movement in the thoracic region in our tests last week I am keen to test the rotational aspect today.               

Firstly I started with reassessment of Carl’s hips which showed a real change, both hips are now aligned relative to each other, i.e. no rotation and in addition the degree of anterior tilt has reduced by about 30%.  On discussion with Carl he described how he can physically feel this change, his abs feel like they are ‘on’ and he feels them engaging in his day to day activities where he had not felt them before.     I then moved on to test Carl’s Glute firing pattern.  On both the right and left side it was evident that the Glutes are not acting as the main hip extensor – something we need to correct as soon as possible.

Next we moved on to the upper body where on assessment of Carl’s cervical spine/neck there is still a level of restriction and his head is still sitting slightly forward although Carl has reported some improvement in his neck stiffness which is a start.

Carl’s shoulder girdle is still of concern and this is something I plan to work more deeply on today. In addition to his Pectoralis (Pec) Major and Minor being overly short and tight his Biceps are so contracted that his elbows are slightly flexed when in a relaxed position.  Although not a primary function of the Biceps Brachii muscle, it can impact on the Shoulders range of movement given its attachment to the scapula.  In Carl’s case I see this as an additional layer of dysfunction causing the rounding of his shoulders and the lack of scapula control we have seen so this is something we need to address to fully balance out his upper body.

Finally, I move on to assess the amount of rotation in Carl’s Thoracic Spine.  What I see is that Carl’s does appear to rotate to quite a degree, but on closer inspection what I see is that his shoulder blades are responsible for most of this rotation, by bringing his shoulders forward on the side he is rotating it appears he has rotated fully, but while focusing on the thoracic vertebrae themselves you can see that the movement is quite restricted.  I found a simple but interesting article on why stiffness in this region may cause lower back and neck pain both of which Carl experiences:

Treatment Plan Session 2
Today I will continue to work on releasing Carl’s Hip flexors & lower back using a variety of soft tissue and neuromuscular techniques.  In addition I have also included some proprioceptive/retraining  work on the Glute muscle group to help kick start Carl’s training and homecare to get more stability in his hips.

Moving on to the upper body we will open up Carl’s chest and release his neck to restore normal range of motion.  Today we will also focus on some retraining techniques on his lower and mid trapezius to start getting more control into his scapula.  Thoracic rotation is something we will address in a later session as until we get more balance through the chest, neck and back I think we will make little headway.

Finally I ended today’s session by applying a functional Kinesio taping to Carl’s shoulder to bring it into a neutral position.  This is not a therapeutic taping but will give Carl a sense of where his shoulders should be, and will also help over the next 3-4 days as he starts his homecare.  I don’t want Carl to rely on this taping but I think it will be interesting to see how it feels to him and also how it felt while hitting balls given he is going straight to a coaching session today.

Home Care
I want Carl to continue with his three exercises from session 1 as they are clearly yielding good results.  In addition there are three aspects to work on over the next 4 weeks until our next session:

·         New Exercises:
  •         Glute strengthening/hip stabilisation exercises
  •        Rhomboid & mid/lower Trapezius strengthening
  •        Pectoral & Bicep stretching

·         Previous Exercises to Continue:
  •        Hip flexor stretching, in particular Rectus Femoris
  •        Lower back stretching
  •        Breathing rehabilitation exercises

Training Considerations
Given Carl can already feel physical changes within his body we discussed what this means for his golf game.  It is important that Carl continues to train through these changes as there is a risk that his game will appear to get worse as his body starts to react to these changes.  The compensating actions that he has been doing to make his swing work we will no longer be required but he will have to relearn how to hit the ball with his more balanced, stronger body. Carl agreed that he would be continuing to work on his swing with Andy Traynor through our period of body work.

Our next session is in January, in the meantime Carl is going to continue to progress with the homecare and I am hoping to see a marked difference in the new year.

Read Andy and Carls Blogs here:

Carl Watts – The Experiment Session 1

Today I met Carl Watts for the first time and what a treat that was!  Carl is a friendly, enthusiastic man who is truly motivated to achieve his goal on getting that tour card back.

We started with a full bio-mechanical assessment. I try to assess each client as if I didn’t know what sport they played as not every golfer fits the stereotype. It’s important to look at each person with fresh eyes rather than jump to the ‘things’ you would expect to find.

Top to Bottom Summary of Findings in Session 1

On initial view of Carl in a resting standing posture there is a clear imbalance between right and left.  His right shoulder drops down and this follows through the rest of his body resulting in a rotation towards the left.  Another point of interest is that Carl’s breathing seems very shallow and is very much so an upper body breath with little use of the diaphragm and abdominals.

Upper Body

  • Carl has a posture summarised by Janda as Upper Cross Syndrome, see illustration below from, resulting in restricted range of motion (ROM) in his neck.
  • What is more unusual is that this is more pronounced on this right side but is still present on the left to a lesser degree.  This also translates to the lack of scapular control Carl exhibits on his right hand side compared with the left.

  • Another deviation from the Janda model is that Carl’s head is less forward but points upwards as if trying to correct itself in some way but leading to even more tension on the back of his neck which is common complaint on discussion with Carl.
  • Shoulder ROM restricted range of motion.
  • Full Range of motion in wrists.

Lower Body

  • Carl has another condition summarised by Janda – Lower Cross Syndrome. This is quite commonly seen alongside upper cross syndrome resulting in an ‘S’ posture.
  • Again this is more pronounced on the right side and Carl complains of pain in his right knee when doing hip flexor strengthening.  This also correlates to the rotation we see through Carl’s torso, although the left hip is not in a posterior tilt, it is dropped back compared with the right.
  • On assessment Carl’s Rectus Femoris muscle is tighter than his Psoas so we will start here.
  • Carl’s lower back is stiff and lacks movement.  This lack of movement is evident through the lower and more so into the mid thoracic spine.  On flexion of his trunk there is little to no movement in this region.
  • Hip flexion is restricted and hamstrings are taut but not short, the anterior pelvis tilt is likely to be causing this apparent lack of flexibility.
  • In addition Carl’s hips are both laterally rotated and his ankle range of movement is very restricted particularly in dorsi flexion.

On discussion with Andy Traynor, Carl’s coach, my findings match up nicely with what Andy is seeing in Carl’s swing.  His lack of hip stability and flexibility  is manifesting itself in a loss of power in Carl’s downswing as his body moves to compensate/re-balance in spite of his restricted movement.

The number one priority for Carl will be getting his core and hips stable, strong and flexible and his home care reflects this.  I also feel that this restoration of balance in the hips may resolve some of the lower and upper body issues we are seeing.

Treatment Plan Session 1

The main focus of today’s treatment is to begin work on correcting Carl’s hip alignment.  I used a variety of techniques to release the hip flexors and lower back.  I also started work on engaging Carl’s diaphragm and abdominals to encourage a full and complete breathing pattern, this will be followed up by home care to start training Carl to use his core when breathing which will also help to start to correct some of the upper body issues we identified today.
Home Care
  • Hip flexor stretching, in particular Rectus Femoris
  • Lower back stretching
  • Introduce Yoga to training regime
  • Breathing rehabilitation exercises

Remarks for Next Session

  • Test Glute Strength/Firing Pattern
  • Test Thoracic Rotation
  • Retest Hip Alignment
  • Continue treatment for hips and start upper body treatment
Check out Andy and Carl’s blog to find out how ‘The Experiment’ is going!

Recommended Links

Carl Watts – The Experiment

1997 BMW Open: European Tour Record -24

I am very excited to have been asked to take part in The Experiment with Carl Watts.  This is a challenge to get Carl Watts a European Tour Card in 2014 after 13 years of retirement from professional competition.

Carl will be working with Andy Traynor PGA fellow from a coaching point of view and I will be working with both Andy and Carl to understand what is going in Carl’s body and how it is manifesting itself in his golf game.  We will then together devise a treatment and training plan to get Carls body into balance to give him greater distance and accuracy.

Over the next 12 months you can follow my findings here at PAMO Fit but you can also follow Carl’s personal experience on his blog.  Andy will also be detailing Carl’s journey from a coaches point of view.