Tuesday, June 14, 2016

Asymmetric Resistance for Trunk Stability

Asymmetric Resistance for Trunk Stability

When training in the gym, we tend to want to train one side of our body exactly the same as the other side, focusing on "symmetry."
If we curl a 25 pound dumbbell with our right arm, we try our best to perform the same number of reps with that same resistance using the left arm.  When it comes to training for trunk stability, however, applying an asymmetric weight to each side may be more realistic and applicable to our everyday activities.  If we are squatting or lunging to pick something up from the ground, many times the weight distribution, especially if it is an irregularly shaped object, may be more to our right or left side.  One example is carrying grocery bags into the house from your car.  You most likely do not weigh the bags and place the exact same amount in each hand.  One hand always ends up carrying more.  When walking with the bags, we still try our best to maintain a stable upright trunk so that we are not leaning toward the right or left.  So why not incorporate this into training from time to time?    It may not be that terrible to train each side with a different amount of weight.  
Instead of Suitcase Dealifting the exact same weight on each side, start off with a heavier weight in one hand for one set, and then switch for the next set.  The focus should be on performing the Deadlift without allowing your trunk to "give in" to the heavier side, but keeping your trunk upright.

Same thing with the Kettlebell Squat.  Try a heavier weight on 1 side.  Then switch sides for the next set

This can be done by just squatting with 1 kettlebell one 1 side, but then switch it up and use 2 different weighted kettlebells in order to apply a higher total amount of weight to your body.

Try a combo movement of a squat press using different weights.  Now you must stabilize your trunk with asymmetric resistance while transitioning from the ground to standing to pressing overhead, all while not allowing your trunk to lose control

This is just another way of introducing various perturbations to your body in order to train it to maintain and maximize its stability

Sunday, April 24, 2016

Piriformis Syndrome or True Sciatica?

Sciatica seems to be the go-to diagnosis provided by a doctor, family member, friend or personal trainer, when someone complains of lower back, hip, or butt pain.  Once diagnosed by your doctor, you may be lucky enough to receive treatment by a Physical Therapist (if your insurance and busy lifestyle allow).  You should be aware of the possible sources of your pain, whether you receive professional attention for your condition or not. 

The sciatic nerve originates from Lumbar Spine, segment L4-5.  As the nerve exits the vertebral foramen, it may be compressed due to inflammation or irritation of the respective lumbar discs.  The bulging disc presses on the L4-5 nerve roots, which causes radiating symptoms down the back of the leg and into the calf, following the path shown in the picture.  Most frequently, the disc will bulge postero-lateral to the left or the right.  If it bulges to the left and presses on the nerve root, you will feel the symptoms down the back of the left leg.  If it bulges right, you will feel the pain in the right leg.  Although this is called Sciatica, it should be treated like any other bulging disc…initially with lumbar extension and neutral activities (avoiding trunk flexion) and trunk stabilization. 

Piriformis Syndrome is often misdiagnosed as Sciatica.  However, the source of the symptoms is not a bulging disc, but is more peripheral at the Piriformis Muscle. 


Due to increased activity level, such as running, the Piriformis Muscle, located at the posterior hip, tightens and compresses the sciatic nerve which runs between the two portions of the muscle.  This causes pain which is mostly felt in the hip/butt region, occasionally travelling down the leg as in Sciatica.  All the lumbar extension activities in the world will do little to reduce the pain.  While sciatica symptoms worsen upon trunk flexion, Piriformis Syndrome symptoms are less affected by this movement.  Acting as a hip abductor and external rotator, a beneficial treatment for Piriformis Syndrome is stretching.  Rest by backing off the causative activity is also a good idea initially.   Besides stretching the piriformis muscle, trigger point work and deep massage may also be helpful.  Below are three progressive levels of self-administering soft tissue mobilization to the Piriformis.


Place a tennis ball at the tender area of your butt where your piriformis muscle is (upper lateral quadrant of your glute).  The least aggressive is lying flat on your back with the ball placed at the muscle.  Place your weight on the ball and either remain still, or gently rock your hips left and right, rolling the muscle over the ball.  Progress to bending the knee on the affected side and slightly dropping the knee towards the other leg (intermal rotation).  This may expose the piriformis more to the surface.  Lastly, progress by bending the unaffected knee, crossing the affected leg’s ankle over the unaffected side’s knee and sitting on the ball.  This applies more body weight to the ball, creating deeper pressure to the muscle.  The figure four position also stretches the Piriformis while it is being massaged.   This is aggressive and not the most pleasant sensations, so go easy.

Click HERE for a video explaining a Piriformis Stretch from the Herniated Disc, Bulging Disc and Spinal Stenosis DVD at www.strengthondemand.com