Sunday, September 26, 2010

From Discectomy to Deadlift - A True Underdog Story

Ryan Binge is 23 years old, he can deadlift 195kg, snatch 90kg and clean and jerk 110kg. But only four years ago he could lift zero kilos due to debilitating back pain.

This is a story of how someone can come back from injury and multiple surgeries. How they can go from sitting at home in pain to running, progressing to half ironman triathlon and eventually lifting heavy things over head Olympic style.

It begins in a tree – surgery no.1.

At 18 years old Ryan was a full time tree surgeon. A physical job that involves lifting objects in awkward positions, climbing, and looking cool while holding a chainsaw.

Chainsaw - the main reason people become tree surgeons

Six months in, he started to get lower back pain. He toughed it out but the pain gradually got worse, until eventually Ryan sort help. The back consultant diagnosed disc prolapses at L3 and L4. Surgery was proposed, and a micro discectomy was performed on L4. And after just 12 months, Ryan’s tree surgery career was over.

Things get worse – surgery no.2.

Unable to work, Ryan sat at home in pain, in his own words

 “Feeling sorry for himself.”

While off work, he was continuing to receive physiotherapy for his back as he still had a significant amount of pain. During one of the physio sessions the therapist lifted his knee in a simple mobility exercise, Ryan experienced immediate searing pain, pins and needles shot down his leg.

Ryan was referred back to the consultant. This resulted in another discectomy being performed on L3, a mere 6 months after the first one. He had undergone two spinal surgeries before he was even 20 years old. Things were not looking good. Ryan stopped physiotherapy. All in all Ryan says he basically sat at home for one and a half years.

Micro discectomy - how its done
Micro discectomy - with part of disc removed

Tree surgery was no longer an option. Realising he had to do something about the rut he had found himself in, he started to look for a way forward. He decided to do a lifeguarding course and things began to change. He still had back pain, but sitting at home for the rest of his life just wasn’t an option anymore.

Lifeguarding, Running, Triathlon and shin splints.

After completing his lifeguarding course running secured a full time job. Realising he needed to get his fitness back Ryan started running.

Then a strange thing happened, Ryan says

 “Running made my back better, I was in less pain”

Buoyed by his new found fitness and confidence, he started to enter some races and completed his first half marathon two years after his first back surgery.

He then decided to try triathlon, bought a bike and added in swim training. His work ethic and diligence soon saw him promoted to duty manager, and he applied the same principles to his training. Unlike some people who spend more time talking about training than doing it, Ryan just got on with it.

He soon completed sprint distance, Olympic distance and at 21 years old he completed a half ironman triathlon.

In 2009 his shins started to hurt. Like a lot of endurance athlete he continued to run with pain. Also during this time he was probably in a state of overtraining. The term overtraining is banded about too much by weight trainers who think hitting their chest more than once every 7 days is going to be too much. But endurance athletes can end up hammering their bodies everyday; with no deload weeks or periodisation. The demands of triathlon can mean multiple training sessions per day, for several hours, and most triathletes have to fit this around a full time job.

Being proactive about his training and always keen to learn more and how to fix himself, Ryan went to a see a sports physiotherapist and local sports medicine doctor who has worked with professional and Olympic level athletes. He also got a professional gait analysis, and adopted a series of corrective exercises and moved his running style from a severe heel strike to more of a forefoot style.

However, the pain continued and probably wasn’t helped by a reluctance to rest while training for the half ironman. In October 2009 after the half ironman, Ryan stopped running.

Surgery no.3 - weights to the rescue.

During this period he was also starting to get pain in his shoulder, mainly during swim sessions and it was restricting his ability to do swim training. This is not uncommon for swimmers and triathletes engaged in hours of training, after all there is a condition called ‘swimmers shoulder'.

At this point he started a standard bodybuilding split routine in the gym. Around about this time I also showed him how to do the Olympic lifts.

In January 2010 Ryan had a diagnostic arthroscopy on his right shoulder which showed there was no impingement. He was given rotator cuff band exercises to do and stopped swimming.

He believes strength training has helped his shoulder. He now avoids movements like lateral raised and wide grip bench press. But thinks the Olympic snatch has helped his shoulder – as it has increased his shoulder strength, stability and mobility.

Around this time he started to focus more and more on the Olympic lifts. As flexibility and mobility were a weak point for him, he really worked on them as much as he could, as well as building up his strength in the deadlift.

Ryan practising the overhead squat - he's really had to work on his mobility

Now, I have to point out that I take no credit for Ryan’s increase in strength and improvement in his back pain. Even though I teach evidence based exercises for chronic lower back pain I didn’t actually show him any of these. I coached him on his Olympic lifting technique and how to keep a neutral spine while deadlifting, and that’s about it. All the credit goes to him.

Back to the woods

Ryan had decided that his back was now strong enough to go back to tree surgery. He wanted to be back in the outdoors and not stuck staring at a swimming pool. He could now deadlift 195kg and clean and jerk 110kg overhead with no pain, both feats that he couldn’t do when he was originally a tree surgeon. His strength had never been better, and his back felt stronger than before.

In June 2010 he returned to tree surgery. He still has numbness behind his left knee and hamstring after the original disc prolapse but otherwise has no problems. His back aches sometimes after a hard day, but then so does everyone’s, and he now sees the tree surgery as functional training.

The future is unwritten

Ryan is looking to compete in an Olympic lifting competition in December. His goal is to snatch 100kg and clean and jerk 125kg. He has recently gone through a bodybuilding type phase, training 5 x week, but is now focusing on the Olympic lifts for December.

He is also looking to join the armed forces within the next year.

And he wants to complete an ironman distance triathlon within five years, ideally the ‘forest man’ in the New Forest.

Weak points and 20/20 hindsight.

When I asked Ryan if he would have done anything differently. He says without hesitation

 “I would have gone to exercise quicker.”

 And when he first started triathlon he would have

“had more rest days or light days and paid a triathlon coach from the start”

This is an interesting point, so many people think they can train themselves and don’t need any help. However, every pro athlete has a coach in some form. A coach can save you years of trial and error and keep you on track.

Ryan says his weakest point is his nutrition; he needs to work on food preparation and increasing protein intake.

Flexibility has always been an issue, and Olympic lifting mobility drills have helped. (See the videos where  Ryan is in the overhead squat position, this was slightly unfair as I asked him to demonstrate these exercises with minimal warm up, also note that he is wearing Nike frees in these videos and not Olympic lifting shoes and with no bumper plates he has to control the weight down).

Wrap up

This story shows that spinal surgery doesn’t have to hold you back. Am I suggesting everyone with back pain start Olympic lifting? Of course not, this was Ryan’s choice. However, don’t be afraid to start moving your body. Exercise works for back pain, I have a whole bunch of testimonials from people who attended our 8 week chronic back pain course and it transformed their lives, using evidence based exercises and back sparring strategies for everyday living.

I have no doubt Ryan will reach his goals. He’s one of those guys who doesn’t moan or complain, he gets on with it. He’s unassuming, one of those genuinely nice guys (and he’s single ladies!) but deep down has that competitive streak. The desire to push himself to his limits, compete and see how far he can go, like all successful athletes.

There are inspirational people around us all the time you just have to look for them. They’re not in the media, they’re not famous and they don’t have PR companies promoting everything they do. They’re just out there doing it. And it may be a truism, but all you have to do is start, take that first step – it’s always the hardest one. Don’t be afraid to admit you can’t do it by yourself, seek the help of those who have already made that journey, the ones with a proven track record. This doesn’t mean the journey will be easy but you’ll get their quicker and with a lot less diversions along the way.

I’ll keep you posted on Ryan’s Olympic lifting numbers and competition in December.

Sunday, September 19, 2010

Take responsibility - stop lying to yourself

People want to blame. They want to blame everyone except themselves for their failures. If they didn't reach their goal it was because the program wasn't good enough, no one told them what to eat, the gym wasn't open when they wanted it to be, they didn't have enough time, no one told them what to do, blah blah.

This is another way of saying they lied to themselves. And it's surprising how many people think I am lying to them on a daily basis, when I'm not. Maybe it's because they've been lied to their whole lives, the government lied to them, big corporations lied to them, the media lied to them, reality TV shows lied to them (chances are you're not going to be a famous singer), the medical profession lied to them, their teachers and lecturers lied to them, the guy on the end of the phone at the call centre lied to them. There's a good chance their parents lied to them, sometimes with the best of intentions.

Their teachers and parents may have told them do this and this, go to this university and you'll be successful. Then they leave university or school and life slaps them in the face. Then the media tells them to buy this house, buy this car, buy this product and you'll be happy, but they're not. And they get depressed, so the medical profession gives them some pills, which are mean to help, but they don't. Most people live lives of quiet desperation in a sea of mediocrity punctuated by fleeting moments of vitality.

And they go to gym, and after a few weeks of training twice a week they don't lose any weight, so they think the fitness industry lied to them. And in a way, it did.

And maybe it's me, or maybe it's the economy, but people seem to be getting angrier and more frustrated, I think it was Sandra Bullocks character in Crash that said "every day I wake up angry". And people realise there's nothing they can do about the big lies, they feel impotent in the face of government lies and wars and  collapsing economies; where those responsible accept no blame and everyone else has to accept the pain.

We've become a nation of complainers and whiners, quick to apportion blame, but rarely looking to ourselves. Refusing to accept that we are complicit in many of the big lies. So people start to focus on the things within their sphere of influence, people who are forced to listen them, the woman at the supermarket they can complain to, the person in traffic who pulls out in front of them and the person who was meant help them lose weight.

And the fitness professional who was meant to help them lose weight, it must be their fault why i didn't lose weight or get fitter or failed to attract more members of the opposite sex. Because no one wants to blame themselves. And the reason most people think everyone is lying to them is because they lie to themselves on a daily basis. You ask them what they eat, of course, they don't eat biscuits or cakes, they only ever eat lean protein and organic veg, yeah right. And yes, they exercise every day but somehow don't get any stronger or lose any weight. So it must be the program.

The people I've seen who were successful at weight loss or strength training or sport didn't do anything magical or secret, in fact some of them followed what I would consider sub optimal programs. But, they were consistent, they didn't miss training sessions, they put weight on the bar, they pushed themselves, they pushed away the dessert and the alcohol until they had reached their goals. They worked hard.

But people don't want to work hard, they want someone else to do it. As Morpheus from The Matrix said  "I can only show you the door, you must walk through it". So they go to self help gurus, who tell them to visualise themselves thin, and they 'deserve it' and they are 'special', because who wants to be normal. And it doesn't work, and they search for meaning and direction and latch on to the latest fads or trends.

And then you tell them doing steady state cardio twice a week isn't probably gonna do shit for weight loss, and they think you're lying, because no none ever told them that before.

How to tell I'm not lying to you

It is surprising how many people think I am lying to them or telling untruths. Here's how to tell if I am lying or not. If I have nothing to gain from what I've said, if there is no financial reason for me to say it, then I'm probably telling you what I believe. If it was actually easier for me to sell the status quo and tell you what everyone else has, then don't you think I would do it? If I'm telling you something that could actually make me look bad, why would I say it? And if I say something that goes against what most people are doing, then it's probably true. (caveat to this: this doesn't hold true for everything, lots of people believe in conspiracy theories and new age crap like waving crystals around, this doesn't make these things true, see the next point).

And what I say can be supported by research and evidence. People like to bash science these days, you often here that in relation to nutrition and exercise in the media, you here comments like "You don't know who to believe, one day somethings good for you and one day something is bad, so I carry on the same".

Some people like to blame the messenger. It's the messengers fault for telling them the truth and not sugar coating it. It's surprising how many people ask questions they already know the answer to, or think they know the answer to, they don't actually want you to answer the question, they want you to agree with them, to validate their belief in what they should be doing. And if you give the 'wrong answer' they go and find a trainer who gives them the right answer, which matches what they want to hear.

Too much information, not enough knowledge

There is more information than ever before, but true wisdom and knowledge has become lost in the deluge. Educate yourself, think for yourself, use critical thinking, seek out real experts, people with a proven track record who aren't just trying to sell you something

If you fail no one cares, if you succeed no one cares.

If you don't reach your goal, guess what happens? Nothing, the world carries on the same. If you do reach your goal, guess what happens? Nothing, the world carries on the same, except you changed. Make yourself accountable, no one is going to do this for you, you could have the best personal trainer in the world, a personal chef and a PhD in exercise science, but if you don't get off your arse nothing is going to change. You are the only person who really cares about your goal. Others can help you, but you have to live and breathe it.

If you failed, you failed yourself. And I'm not going to sell you some self help shit, chances are you aren't going to get half the things you want, however hard you try, some people make money, some don't, some business's fail and some don't, some marriages fail, some don't; and the reasons are complex. And some people have got the talent and piss it away, and some people have below average talent but never let go and 'get lucky'.It's a fine line between success and failure, and sometimes the reasons why some people succeed are purely random (see the book The Drunkard's Walk to find out why ). Life is not black & white.

There is no correlation between financial and career success and life success. Some people have jobs they love and make money from, they are in the minority. Some people have jobs they don't really like to make some money to live a life they don't really like, they are in the majority. And some people have jobs that are a means to an end, they live a life outside of their work, their live is given meaning by other things like family or meeting goals.

There are school caretakers in their seventies running ultra-marathons, there are postman working to save money to climb 8000m metre peaks, and there are millionaires sitting at home watching TV.

Living a life of quality, that is authentic is the only way forward.

Not everyone is going to be a millionaire, not everyone is going to have a job they love.

But exercising 3 or 4 hours a week is achievable right now, without question.

Eating less junk, is achievable right now, without question.

Doing 5-10 minutes mobility and stretching while watching TV is achievable right now.

Fates right hand

Now, of course, there are things out of your control, if a tsunami hits your house then the random chaos of the universe has slapped you in the face. And maybe you'll get struck by lightning or win the lottery, but don't waste your life waiting for destiny. There's nothing you can do about entropy and chaos, but you can control your reaction to it, assuming you survived.

All too often people want to blame fate or in the case of exercise and disease they blame genetics. Yes, the reason you had a heart attack was because of genetics, but in the majority of cases you could see it like a slow train a comin'.  Of course, it wasn't because you were sedentary, a smoker, had a poor diet, didn't eat omega 3's or vegetables, and your homocysteine levels were through the roof. And don't think your doctor is doing any better than you, they have access to years of medical training, the latest journals, constant visits from pharmaceutical reps, do you think their life expectancy is any higher than yours?

You must educate yourself, and arm yourself with knowledge and the right tools to succeed.

Upton Sinclair said
"It is difficult to get a man to understand something when his salary depends upon his not understanding it."
To paraphrase, it is also difficult to get a person to understand something when them staying in their comfort zone is dependant on them not understanding it. Doing nothing is easy, action requires risk and uncertainty.

I think it was Charles Staley who said something along these lines. Look at what most people do in the gym, most of them stay the same year after year. That don't change shape but continue to do the same workout. Therefore, do the opposite to what most people do.

Take responsibility for your actions, realise when you're lying to yourself. Don't blame others for your failures, and to quote Donny Shankle

"Go maximum, everyday!"

Go on, do 20 press ups right now. You know you want to, what's stopping you; and who are you going to blame when you don't? Live life like you mean it!

Gym with escalator - who are you going to blame when you fail?

Saturday, September 11, 2010

Are the people who work in the fitness industry fit (or even healthy)?

Some gym members and PT clients are under the impression that you must be super healthy and superfit if you work in the fitness industry. They’re under the impression you knock out a 20k run, deadlift 200kg and then go home and eat an organic chicken you raised yourself and some quinoa from your own personal vegetable patch. And if you enter an event, they expect you to just be able to ‘do it’ because you’re a trainer.

The truth doesn’t always match reality. I’m not talking about the occasional cheat meal or someone who is following John Berardi's 90/10% rule, eating well 90% of the time and for the other 10% having the occasional snickers or glass of red wine or missing a training session when on holiday.

I’m talking about people who are the very opposite of what the public would expect. And it not only applies to the fitness instructors & personal trainers in a health club or centre but even more so to the managers, duty managers, receptionists, lifeguards and studio/class teachers. Also, I should point out that this doesn’t only apply to where I work now but is common in other companies I have worked, clubs I have been a member of and trainers I have met who work elsewhere.

Fitness Instructors

I’ve met several fitness instructors who smoke, and even met a manager who though smoking was ok in moderation, you know, like the occasional glass of red wine, and not a cancer stick.

More common is instructors who binge drink, now this could be because they tend to be younger or it could be something to do with British culture, either way it’s seen as acceptable.

And when it comes to junk food, only the other day an instructor was eating the left over domino’s pizza from the night before for lunch (you know who you are!). On the plus side, most fitness staff tend to workout and train in some way, but some don’t.

Personal trainers

This group can be worse than fitness instructors for working out. They have clients that are spread throughout the day, so the trainer spends a lot of time sitting in their car driving to appointments while snacking on the go – hoping their natural ‘awesomeness’ will pull them through, because hey, back in the day they could deadlift 250kg and run 100m in 10.5, but they can’t do it now because of that pesky knee injury and not because they don’t do any exercise and live off energy drinks. And in between working 12 hour days, getting their hair highlighted on a weekly basis and buying industrial amounts of hair gel & wax they just don't have time to train. Of course, I also know trainers who put there money where their mouth is, and live the life, they live and breathe fitness & nutrition 24/7.

Managers, lifeguards

In all my time in the industry I’ve rarely seen a club manager actually use the gym facilities or go to a class (and some of them don’t even come out of their office when they are actually working and you know, actually talk to their customers, but that’s a whole other story). Now some of these people may have been training outside or participating in a sport. And I’d be the first to admit you don’t need fancy facilities or equipment to train. But these guys weren’t training at home or doing a sport, they weren’t doing anything.

I know managers and lifeguards who have regular cigarette breaks throughout the day and don’t eat any proper food or snack from the vending machine (more on this later) or don't eat anything in an 8 hour shift.

The dark side

Studio instructors can be someone of the most compulsive about exercise but some of the worst eaters. It’s not unusual to see then have a pre workout coffee and then a post workout coffee, living of the adrenaline and caffeine. And I’ve known studio instructors whose idea of a big meal was a piece of broccoli and half an apple. Some are easily doing 15-20 hours a week of classes, mostly not lifting a weight heavier than a shuttlecock. They end up with that skinny fat, studio instructor look, high fat %, no muscle. This is what Charles Poliquin calls the 'chunky aerobic instructor syndrome'. Their paranoia about putting on weight and their addiction to cardio exercise can sometimes push them over the edge. This is the group in the fitness industry most likely to suffer from eating disorders. Now this is a minority,  but I would like to see some research on this to see how much of a problem this is, and how we can address it.

And I’ve seen studio instructors do an exhibition class at a fitness conference and then go round the back of the stage and have a cigarette!

Pre workout & post workout meal for some studio instructors


Many people in fitness work shifts, or weird hours, and sometimes duty managers can’t leave the building. And they end up making poor food choices, now most of this is due to bad planning and meal preparation, as in they don’t have a plan.

You may be surprised to find out the food choices on offer in the average health club/ leisure centre are rubbish.

For dinner I will be having A3 and B6

They still have vending machines, and cafes with muffins, cakes and basically no healthy choices apart from the occasional protein bar or shake. Managers & staff on shift can end up living off the vending machine.

Sugar & Fat - all the colours of the rainbow

Also, on a side note, I’ve seen parents taking their kids to the vending machine after various swim lessons and clubs and buying junk or buying a donut in the café

The argument seems to be that we should give the customer what they want and not what they need. But all these cakes and sweets are available elsewhere, in fact, nearly everywhere, they are pervasive. Maybe, we should provide the alternative.

Right now, Jamie Oliver is crying into his homemade ravioli.

Only the other day I saw a fitness instructor/ trainer who happens to be diabetic, and also runs weight loss classes, drinking a bottle of coke and eating a bag of crisps ( potato chips if you’re American) for lunch. Now, I’m no expert on diabetic nutrition but I’m thinking this is not the best choice. And then to go into a weight management class and say one thing and then do the other, ever feel you’ve been lied to? So if the people preaching the message of healthy eating aren't doing it, it's no surprise that some parents & kids are having a hard time following it.

Members are fitter

We’re in the situation where a lot of the members and clients of our clubs are training more and eating healthier than the very people running the health & fitness business.

I’m going to sell you a car that I wouldn’t drive

Can you imagine going to a car dealership and the sales person trying to sell you a car, but then saying ‘Of course, I wouldn’t drive this car myself’ or going into a restaurant and the staff saying ‘I wouldn’t eat here’, err, then neither will I.

But this is happening everyday in fitness. Many of the staff who work in a centre or club have free access to the facilities but never use them! And I wouldn’t mind if they were going for the occasional walk or bicycle ride outside, but they’re not.

Of course, if you work in a place all day it’s the last place you want to spend your leisure time. But this doesn’t hold up, because the people who use the gym the most are the fitness staff, who are in there all day, and some of the other staff don’t set foot in the gym all day.

If we can’t even get our own staff to use our gyms and classes, how can we expect to get the public in?

Currently, the penetration of the UK fitness market is about 10%, add in all the people who do personal training and bootcamps outside and maybe you’ve got 11% of the UK population exercising. That means about 90% of people don't go anywhere near a gym, health club or leisure centre. But most our staff don’t use our facilities or believe in the product, so why should the general public?!

To find out why the public don’t exercise, all we have to do first is ask our staff why they don’t. And not only why do our staff not exercise, but why are so many of them smoking, binge drinking and eating junk. Is it a cultural thing or human nature?

Now I should finish by saying not everyone in the industry is like this, I know lifeguards, receptionists, café staff and sales staff and even some managers who attend classes or the gym on a regular basis or participate in sport and eat healthily; and some teach classes as well. But I would go as far as to say they are in the minority.

And I’m not saying I’m perfect, I have the occasional beer or dessert. And I’ll admit right now I like to have one cappuccino a day ( ahh, sweet caffeine, okay sometimes 2, but normally on a really bad day, and as long as I drink green tea that okay, right? ) but I generally eat healthily 90% of the time and exercise on a regular basis

And again, I’m not saying you have to be superfit, but you need to be a role model to a certain extent and be fit and healthy to prove the product works. If we don’t believe in our product, who else is going to?

Wednesday, September 8, 2010

Diagonal Cable Pulldown (for the lats & teres major)

I don't really see anyone else doing this exercise, so I thought i'd post it. I used to give this exercise out a fair amount about 8 or 9 years ago, but then stopped doing it, mainly because I didn't have access to the 'old skool' cable crossover machine.  This exercise doesn't seem to work on the narrower dual cable pulley machines, the angles are wrong  and the tension gets lost at the top of the movement. But recently, I've had access to the cable crossover again, and have been giving this exercise out more & more, and I'm liking it more & more as well. Here's why.

Latissimus Dorsi - notice the angle of the fibres

What do the lats & teres major do?

 The main actions of the latissimus dorsi are  – extension, adduction and medial rotation of the humerus. And the teres major assists with these actions. This means they basically bring your upper arm down to your side, extend your arm behind you and internally rotate the shoulder

Teres Major - notice the diagonal angle it pulls at

Most people don’t think of adducting or extending at the shoulder when they do a latpulldown ( and by the way it's not called a lateral pulldown, for all those people who keep using that name, the reason why should be obvious!) or pull up. They kind of just pull themselves up or pull the bar down to their chest or worse behind the head. Most of the time they're struggling to get their chin over the bar and not thinking what the muscle are actually doing.

But if you focus the movement on pulling the upper arms into the side of the body and slightly behind you can target these muscles more effectively.

What I also like about this exercise now is how it mimics the action of the scapula wall slide, but it's weighted. In fact one way I cue clients is to think of it as a scapula wall slide. This way they focus on puffing the chest out and pulling the arms into their sides. So much like the wall slide we’re also helping to set the shoulder blades down and activate the lower trapezius muscles.

Now, to be pedantic we can see that both the lats & teres major help with internal rotation of the humerus, so you could theoretically get more muscle action by internally rotating the upper arms at the end of the movement. But seeing as most people are already chronically rotated and have the janda ‘upper cross syndrome’ of tight pecs and under active muscles in the middle back I would avoid this.

If you're in to anatomy trains you can see the line of pull for the diagonal pulldown matches the upper section of the back functional line.

How to do it

1.    take a tall kneeling position in the middle of the cable crossover, with space between the knees
2.    brace abs, neutral spine, and try and set the shoulder blades down
3.    pull the upper arms down in to your side and even think of the elbows going slightly behind the body to extend the humerus
4.    avoid collapsing into the chest or rotating the arms forward or trying to cheat the final part of the movement with the wrists bending
5.    keep tall & keep the chest puffed out like a scapula wall slide

Simple as that. Do this as part of your upper back corrective work or as an accessory back exercise. It should complement your pull ups & chins and help improve your technique when you do these exercises. And it's going to hit your lats in a slightly different way. Go try it!