Blackout!!!

Blacking Out With Heavy Lifts

 



Many of you may have seen this video before: BLACKOUT!!!
This is pretty common with heavy lifts and max exertions.  Why did he blackout? 
Upon intense exertions, your blood pressure in the cranial vessels rises to extreme levels.  This causes a large pressure gradient between the vessels of the brain and the Central Nervous System/Cerebral Spinal Fluid (CSF) pressure that is in the spine and surrounding the brain.  If the gradient is large enough, you may black out.  To reduce this pressure gradient, you will want to increase the pressure of the Central Nervous System.  In order to accomplish this, the Valsalva Technique may be used.  The Valsalva Technique is basically holding your breath, which along with abdominal bracing, not only increases the CNS pressure, but also increases intra-abdominal pressure, further stabilizing your spine for the heavy lift.  The Valsalva Technique is not recommended for rehabilitation clients due to the possibility of other medical conditions, as it has the possibility of leading to aneurysms or stroke.  However, for athletes performing these extraordinary lifts, the statistics of the Valsalva causing stroke or death are very low.  The Valsalva Technique increases the CNS fluid pressure, decreasing the pressure gradient between the cranial nerves and the CNS, which then reduces the load on the blood vessels.   Performed properly, this will help prevent blackouts.  However, sometimes it just is not enough.

Spine CPM Unit

Spinal CPM

 

Following a Total Knee Replacement, many surgeons will immediately place their patient's leg into a CPM or Continuous Passive Motion Unit in order to 'get the knee moving' so that functional range of motion may be reached as soon as possible.  Some surgeons are advocates of the CPM, while others avoid it.  As it is very common to see a knee or even a shoulder CPM unit, for me years ago it was not so common to see a Spine CPM unit.  However, the clinic I had worked for purchased one for more than $50,000 and used it for many of the patients suffering from lower back pain.  I initially used it but did not notice much of an improvement in my patients' progress.  Many of them actually felt worse.  As I studied more about treating lower back pain, I learned that although many of these patients have limited trunk range of motion, my goal should be to stabilize and strengthen their spine in the neutral position, while maximizing hip and knee mobility, rather than attempting to maximize their spinal flexibility.  Once the patient has progressed through stabilization and into endurance and strength training, then trunk flexibility may be focused on.  However, this is not the main focus and many studies even show that increasing spinal flexibility does not predict whether a patient will or will not have recurring back trouble.  My take home message is that for clients suffering from lower back pain, I must first work on trunk stabilization in the neutral position, and not be so concerned about their spinal flexibility. 

 

Check out this video on the Spine Six Biomotion Unit and let me know if you have had successful or unsuccessful experiences with it: Spine Six Biomotion.  You may also recognize the picture below, which is similar in concept, but was being sold to households.

Side Plank Reverse Pyramid

Side Plank Reverse Pyramid

 

To build endurance of the trunk muscles in order to maintain stability for long periods of time, your focus should not be to fatigue the muscles over extended work times, but to allow short rest periods in order for the muscle oxygen levels to be restored.  One popular trunk stability exercise is the Side Plank.

Many times I see people holding the Side Plank for 30-60 seconds until their entire body is shaking and their form deteriorates.  Instead, hold each plank repetition for 5-7 seconds and then rest for a few seconds.  Then repeat.  You can use the Reverse Pyramid Russian Method, starting with 5 repetitions on the right side, then 5 on the left, then rest.  Then do 4 on each side, followed by rest, and then 3 on each side.  As you go through the pyramid, you are more likely to maintain proper form because although you are fatiguing the muscles, the reps are decreasing so you are not training to failure.    

Battling Ropes and Neurogrips

Battling Ropes and Neurogrips

 

 

The Battling Ropes Training System was developed by John Brookfield and has become quite popular in the fitness industry.  Common rope thicknesses are 1.5" and 2", yet some may be introduced to this training with the 1" thick rope.  Rope lengths vary from 25ft to 50ft to even 100ft.  It is obvious that with the length being equal, the thicker the rope, the heavier it is to undulate (make waves). 

2" rope on top; 1.5" rope in middle; 1" rope on bottom

 

As you progress your Battling Ropes training, you may feel that the 1" thick rope no longer challenges you the way it used to and would like to move up to a thicker rope in order to train your grip (thicker rope means the hand and forearm work harder).  However, the thicker rope may be too heavy, and tires you out too quickly.  To increase the grip challenge, while keeping the weight of the rope the same, try using Neurogrips while rope training.   

Pic 1 shows bare hand grip of 1" rope; Pic 2 shows Neurogrip with 1" rope - compare the difference in finger overlap - Neurogrips clearly adds thickness to the rope diameter

 

Pic 1 shows bare hand grip of 1.5" rope; Pic 2 shows Neurogrip with 1.5" rope - compare the difference in finger overlap

Pic 1 shows bare hand grip of 2" rope; Pic 2 shows Neurogrip with 2" rope - compare the difference in finger overlap

 

Neurogrips transform the 1" thick rope into a 2" thick rope, the 1.5" thick rope into a 2.5" thick rope, and the 2" thick rope into a 3" thick rope in a matter of seconds.  You can do one set with the Neurogrips and the next set without the Neurogrips to feel the difference.  This will work with any fitness device that can be gripped with your bare hand!

 

 

 

 



Tips For Neurogrips

Tips For Neurogrips

 

 

Here are some things to keep in mind when using Neurogrips.

 

1)

Neurogrips are not used alone like the traditional hand grip trainers, but are used with other pieces of fitness equipment, both standard and non-standard that can be gripped with your bare hands.  These include barbells, dumbells, cable attachments, therapy tubing, kettlebells, Indian Clubs, Persian Mil, sledgehammers, ropes, suspension trainers, sleds, etc....  

 

2)

Once you put on the Neurogrips, the finger webbing is used simply to keep the grips attached to your hands for comfort and for the convenience of decreasing the chance of losing them while moving from one exercise to the next.  As everyone's hand may be a different size, the Neurogrips only need to span the gripping area between the hand and the handle that you are attempting to grip in order to increase the thickness/diameter by approximately 1 inch. 

 

3)

 

Straight out of the packaging, Neurogrips may feel slightly stiff.  But as was stated above, they are not meant to be used alone like hand grippers.  You do not put them on and try to squeeze them in order to train your grip.  You put them on, then place your hands with the Neurogrips onto the handle of the fitness device that you are going to lift.  By doing this, Neurogrips will easily wrap around the handle, and you must "CRUSH" the Neurogrips on the handle to truly feel the grip benefits.  This is true functional grip training. 

4)

No open hand or false grip if you want to maximize your grip.   You will still be challenged with your grip, but you want to include your thumbs.

 

 For the full benefit, make sure you include your thumbs when gripping the device

  

Because Neurogrips are compressible, it allows you to adjust your grip throughout each repetition, particularly during explosive exercises like the kettlebell Snatch so that you can control the speed of the kettlebell as it moves around your wrist.  Just like bare hand training, once you place your hand on the handle, you may want to make adjustments to your hand until you feel comfortable enough to make the lift.  When using Neurogrips, you may want to make the same minor adjustments to the Neurogrips prior to crushing the handle and making the lift.  The more you train with the Neurogrips, the more they will contour to your hand and the less adjustments you will feel the need to make during your training.  They will become an extension of your hand. 

You can see in the following pictures, that although there is a specific "thumb" region of the Neurogrips, when gripping a particular device, your hand/thumbs may not exactly match up with that area of the Neurogrips.  This does not matter, as the Neurogrips encompass the entire handle of the device.  No matter where your thumb lies, you will be compressing a larger diameter/thickness handle. 

 

In the picture below, I exaggerate the position of my thumb to be completely off the "thumb section" of the Neurogrips.  But because the Neurogrips encompass the handle, I still must use my thumb to compress the larger diameter.  The grip challenge created by Neurogrips remains, no matter where the thumb is (unless you use a false or open hand grip) 

 

 

Like any other new training technique, you may initially want to slowly add Neurogrips into your program.  As is with anything, if you are not used to doing something, and you all of a sudden do it repetitively, you may feel sore.  I advise trying one set with Neurogrips and the next without them so that you can feel the difference.  You will notice that the set without Neurogrips is much easier than when using Neurogrips, and in time what was once a challenge to lift bare-handed, will seem much  easier. 

Bottoms Up Kettlebell Bicep Curls Using Neurogrips

Bottoms Up Kettlebell Bicep Curls Using Neurogrips

 

 

To properly perform the bicep curl, you must initiate the movement by retracting your scapulae so that your shoulders are in correct alignment.  If using a dumbbell, grip the handle tightly and flex your elbow.  Maintaining your shoulders/scapulae in proper position while performing the bicep curl helps train scapula stabilizers (isometrically), which will act as the foundation for the upper extremity movement.  With a dumbbell, the weight is distributed evenly in your hand.  However, if using a kettlebell in the bottoms up position, the weight of the bell is offset in relation to the handle that you are gripping, so the lever you are attempting to move is longer and therefore more difficult to lift.  Because of the awkward weight distribution and shape of the kettlebell, when performing the Bottoms Up Kettlebell Curl, it is much more demanding on your hand grip and forearm strength as you are trying to curl the weight, while at the same time preventing the kettlebell from moving your wrist into flexion, extension, radial/ulnar deviation, pronation or supination.   You are constantly making adjustments to your grip to control the movement of the Kettlebell.  To make it even more challenging, try this same exercise with Neurogrips.   

 

 In the images above, you can see how Neurogrips add thickness/diameter to the kettlebell handle.  In the picture on the left, the thumb overlaps the index finger.  In picture on the right, the thumb does not come close to the index finger.  The goal here is to control the kettlebell by "crushing" the Neurogrips around the handle.

Below is the Kettlebell Bottoms Up Curl with Neurogrips.  To initiate the curl, the shoulders/scapulae must be "set" isometrically.  Then as you curl the kettlebell, you must avoid trunk sidebending towards the side of the kettlebell as well as losing control of the "set" scapulae.  Do not let your shoulders drop or protract (roll forward).

  

The Turkish Get-Up: Broken Down, Modified and Applied for Rehab

The Turkish Get-Up: Broken Down, Modified and Applied for Rehab

 

Many of today's multi-joint, complex fitness techniques are more beneficial than we may realize.  For example, the Turkish Get-Up requires scapula and trunk stabilization, rotational strength, grip, balance and motor coordination to correctly transition from the supine position (lying on your back) to sitting, kneeling, lunging, standing and the reverse.  This is a great activity for overall stability, balance and strength as well as cardio.  However, if used properly, it can benefit even those who have neurological conditions such as stroke, cerebellar dysfunction and ataxia.  We just have to modify the movement and avoid training our clients with a narrow mind-set. 

 

The Turkish Get-Up is a popular kettlebell exercise, but if we only applied it to our fittest clients, I feel we (and they) are missing out.  Below is a video of a client with a neurological condition causing ataxia.  He suffers from balance issues, frequently falling backward, and has a difficult time recovering from the fall.   He is an awesome client, as he is willing to try anything that may make his life easier.  Here is the Turkish Get-Up customized for his needs...Turkish Get-Up RehaBELLitation