Regressing Training: Learning From Client

I currently train one client in the early morning 3-4x/week and it has been and continues to be a great learning experience.  When we first started out, we did all the basic patterns you would typically think of for a beginner program.  This client particularly has poor t-spine mobility, shoulder mobility (issues with shoulder pain), and complaints with low back pain. We started out with…

  • Push : only push ups or elbow push-ups (could not do any form of pressing with DB’s because of pain)
  • Pull (low pulley row/1-arm standing cable rows)
  • Knee Dominant (Split squats, reverse lunges)
  • Hip Dominant (1-leg DB SLDL, slideboard hamstring curls, glute bridges)
  • Core: front planks, side planks, light farmer walks, belly presses
  • Conditioning would either be elliptical/bike intervals or sled drags
  • Soft-tissue and stretching is everyday

For awhile we were making progress (strength and weight loss wise) but on certain days upon waking he almost always seemed to have some degree of low back pain.  It would also only happen on certain days… (more on this later).  Up until this past month he had reoccurring back pain at least 2-3x/week, sometimes which would keep him out of training.  How could a basic program possibly be causing his pain?  For one, we cannot always cure everything in the weightroom when athletes or clients have 23 hours outside of our facility.  Secondly, they have to do their homework (FMS corrections, PRI breathing stuff, stretching).  These routines will help get our people out of the bad postures, breathing patterns, or stiffnesses that may be hindering their performance.

He typically would get back pain from standing (if he did all day for work) or running.  Compound this with having a little belly and you may notice how that cranks of the low-back (living in anterior pelvic tilt).  For one it made me question my coaching (am I really focusing  on the small stuff) and what can I do to regress the  program accordingly.  Typically, with the average person you are going to get some sort of lower crossed/upper crossed syndrome (don’t we all have some sort!)

  • Lower crossed: overactive hip flexors & low back, weak abdominals & glutes
  • Upper crossed: overactive pectoral group/upper trap, weak deep neck flexors & scapular stabilizers, retractors and depressors

Because of this I made some of these changes…

  • True hip extension is really poor after making him posteriorly tilt pelvis before glute bridges (good assessment idea)..the entire time it looked like it was relatively normal with slideboard hamstring curls, but definitely was compensating with low back. All glute bridges start with a posterior pelvic tilt then lift
  • Take out slideboard hamstring curls : Slideboard Reverse Lunges, Glute Bridges (on foam roller or on floor with miniband), backward monster walks, and forward sled drags are our “hip dominant” movements
  • Knee dominant (or so-called more knee dominant) exercises are split squat holds and reverse lunges (also do reverse lunges with 3s pause at bottom)
  • Push: Incline push ups (1-leg), elbow push ups, and DB Floor presses are all we do pressing wise (he has got up to 70s with floor presses and no pain)
  • Pulling: all rows are a go (1-arm cable rows, low pulley, chest supported, wall slides,face pulls are options)
  • Core: basically his ribs were flared so bad that any breathing we tried never seemed to get the rib cage down.  I count his push ups as core and we do supine balloon breathing  to try to facilitate depressing th ribcage down as a filler exercise (this is a filler exercise everyday)
  • Conditioning is bike or elliptical intervals

For the past 3 weeks he has felt awesome and is progressing very nicely.  It is motivating to notice that progressing to regress can do a lot.  It certainly helped me realize to start basic even more so and to not assume.

During the first week and a half I had him only do reverse lunges and slideboard reverse lunges with a dowel to make him realize how he should be in the bottom position (he pitched forward more than I thought).  An example of his program looks like this

A1) Slideboard Reverse Lunge 3 x 6-8/side (other day will either have 3s pauses at bottom or normal reverse lunges)

**W/ PVC at first (still hard for him to keep vertical tibia but its ok with me for now)

Goblet- It is ok to have slight forward lean but I use the PVC as feeback and he looks much smoother than what it used to be

A2) 1-leg Incline Push Ups 3 x 6-8/side

A3) Supine Balloon Breathing

B1) Forward Sled Drag 3 x 25 yards

B2) Chest Supported Row 3 x 10

B3) Glute Bridge 3 x (3x 10s)

CON) Bike Ride (Level 15)  4-5 miles-finish as fast as possible : jot down HR at finish and how long it took.

Cheers,

Matt



Categories: Conditioning, Core Training, Injury Prevention, Strength Training

Tags: , , ,

2 replies

  1. Look at you learning!!! Excellent stuff.

    Monday… in or out????

    Ant

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