November 2005 archives

Paternity leave amounts to 18 days. It can be taken during maternity or parental leave in up to four stages. The paternity leave can be extended by 1-12 weekdays if the father takes the last 12 weekdays of the parental leave. The extension must be taken in a single period immediately following the parental leave.
Ministry of Social Affairs and Health

Say no more. Introduced in 2003 in Finland based on Swedish and Norwegian models, the extended parental leave is something I have been looking way forward to. Waaay forward to. From the outset, it has been very clear that we will take every opportunity to prioritize family even in the face of much reduced income. Incidentally, reduced income is cited as the prime reason why only seven percent of all Finnish fathers take the opportunity to stay home for a month with their nine-month olds. The research also shows that the lower the family income and education level, the less likely fathers are to take advantage of the extra parental leave. We should be grateful that we are in a position to do so. Sanna took a leave off work as well to allow the whole family to spend the month of November together at home with Rufus.

Tuesday, 1 November 2005: Bench

Tested the close-grip bench max, but 100 kg/221 lbs was not even close. I still have some catching up to do before I regain whatever strength I had before the latest back pain episode. Also experimented with an extremely high pad height on the GHR, but even with seven holes showing it did not feel markedly heavier than the usual three holes.

Friday, 4 November 2005: Squat

Spent a sizable part of Thursday watching the WPC World’s Open Men competition on location here in Helsinki. I took a lot of notes and some video, something I hope to return to a bit later. All the hours of sitting in a plastic chair has taken its toll on my lower back. A measly 70 kg/155 lbs deep manta ray squat was enough to send it into a small cramp. I should probably have stopped there, but went on to the GHR, this time working up to a violet band, then followed with a whole array of midsection exercises. Turns out doing roman chair sit-ups with a miniband is a good way to get an extended sick leave if not very careful…

Sunday, 6 November 2005: Bench assistance

Almost forgot to include this workout done after spending the day following the last WPO event, the heavyweight semifinals (again, something to get back to later, suffice it to say that there were some HUGE lifts). Nothing to say big words about, but am slowly starting to think about actually following some kind of routine. Direct shoulder work definitively needs to be phased back in. Definitively lost a bit here as well since my previous behind the neck pressing session in August.

Wednesday, 9 November 2005: Squat

Last week’s WPC/WPO powerlifting competitions provided a lot of mental delight, but also took its toll on the back. I was a little stiff going into the gym and decided to just work up to whatever felt good on the camber bar squat. Since only 70 kg/155 lbs on the manta ray squat last week was enough to produce a cramp, I did not expect “feel good” to equal “heavy”. Nevertheless, I worked up to a decent 90 kg/199 lbs single without undue strain. Learned a valuable lesson about camber bars and monolifts in the process: unloading 30 kg/66 lbs from one side of the bar is enough to send the other end flying into the floor… Wrapped up with the standard core and calf work. Tried the GHR with a plate pressed against the forehead. Let me tell you, a meager 5 kg/11 lbs in that position is worse than a violet band. A 10 kg/22 lbs plate was too much. Much too much. Imagine that, such a small plate.

Saturday, 12 November 2005: Bench

Really sore back now. The only thinkable max effort bench movement was floor presses. Again had to conclude that I am not yet back to full strength as two wheels a side defied my hearty efforts.

Wednesday, 16 November 2005: Squat

Only did accessory work. Too stiff back to do much else, even standing cable crunches turned out to be too much.

Saturday, 19 November 2005: Accessory bench

Following the month off, I have not had much structure to my bench training. I have coasted along for long enough now, time to put in another push for a bigger bench. The concoction is a 5x5 program focused on old-school full-range pressing movements with one max effort movement. The details will follow, but today was an abbreviated accessory day where I tried to get a feel for what weights to use.

…or a 5x5 / WSB hybrid with an old-school mentality. Call it what you will, here is my new bench program. This pulls together much of the things I hold dear. The full details are posted in the routines section. Almost forgot I had a routines section.

Max Effort Day

Accessory Day

Monday, 21 November 2005: Squat

Man down. Did Manta Ray squats again, but had to call it quits at 70 kg/155 lbs. Small cramp again.

Wednesday, 23 November 2005: Max effort bench

There something fishy about the incline. The second time around, I easily, very easily, put up the current 80 kg/177 lbs PR, but then found 85 kg/188 lbs barely get off the chest. Hopefully all the heavy incline shelling on the accessory day will take care of that. This was the first max effort session on the new raw bench routine. Went very light on the speed bench to get a flying start and found the 31 kg/69 lbs bells very doable for 5x5 on the dumbell bench. A good start, save for the incline hazard.

To say that training is going well may be a slight overstatement. Two years have passed since the notorious back injury, but the pain is still with me. I have gone through two major cycles of lumbago characterized by a major cramp that pulls the hip out of alignment followed by rehab and brief glimmers of hope. After being able to pull off a few decent squat workouts, I seem to be getting worse again. This time around a visit to the back clinic appears futile; I know the diagnosis, I know how to rehabilitate it… I also know it will come back. I don’t doubt their expertise, but am starting to question whether it is adequate for whackos like myself who load their spine with limit weights and call it a hobby. I might never be able to reach my goal of putting up some decent numbers on the squat and deadlift, but I am not ready to give up any time soon. Only another whacko will understand why.

As I was pondering where I could find a physical therapist with some knowledge of powerlifting, it finally dawned on me that Elite Fitness Systems has a question and answer section dedicated to rehabilitation of powerlifting injuries. They have an impressive staff manning it too. It took me a while to formulate a good synthesis of my problem within the narrow constraints of the allowed number of characters, but it was more than worth it. Within a day or so, I had received an encouraging answer from Michael Hope, a physical therapist currently practicing at the Summit Physical Therapy in Syracuse, New York. I have taken the liberty of inserting relevant hyperlinks.

Kris: Rehab Q: Two years ago (Dec 2003) I sustained a good morning injury (felt like something “rolled down” the middle of the low back, slight bruising, impossible to sit for the next few days). I continued benching while treating the injury with RICE, painkillers and very light accessory work. 3 months later, a chiro adjusted me after sub-max squats caused the left side of my back to stiffen up. I also treated myself for gluteal trigger points.

In May 2004, I got my first full-blown lumbago (severely drooping right shoulder) after light squatting. Got muscle relaxants and painkillers. A back specialist put me on the McKenzie extension protocol, neural mobilization and a core training program (swiss balls, balance boards). He told me the right side of my lower back was not fully contracting. After 3 months of religious rehab work, I got another bout of lumbago after light box squats (ok’d by therapist); continued the same treatment.

In March 2005, 15 months after the initial injury, I was finally doing regular ME squat/dead work. Everything was fine until I got another case of lumbago in August 2005 after decline benching. The back specialist could find nothing structurally or neurologically wrong with my back. Apparently, the lumbago is triggered by compression of the spine which causes the nucleus to spill over and irritate the nerve roots. Am now focusing on strengthening my midsection (reverse hypers, side bends, abs…), while carefully regulating heavier SQ/DL work. Sleeping and sitting long hours can also trigger a mild case of lumbago (always tilted to the right). The recurrent pain is not too bad, but zero SQ/DL progress over the last two years is no fun. Giving up is not an option.

I would HIGHLY appreciate any suggestions. Am also curious whether this is a common injury scenario in powerlifting. I lift raw but could reluctantly consider equipment if that could help keep me under the bar. I live in Europe and am 30 years old. Thanks for your time!

Michael Hope: If you get a tilt to the right you present as a lateral shift. You need to perform lateral procedures before you do extension procedures per McKenzie

The sitting for prolonged periods of time may be a sustained flexion load. Produces posterior and lateral disc migration.

Did you notice it always takes three months for you to get better. This is how long it takes people to get better if they do nothing at all.

If you’re not getting worse with activity( lifting) but are getting worse with inactivity(sleep and sitting) then try to fix these postures.

You have a poor internal mechanism( weak annulus) With bad postures this will get loaded and weakened and more likely to injury with minor tasks.

Ironically the spine is quite resistent to herniation with compression. Brinkmen(research) cut a disc trying to create a herniation with compression loads… it could not happen however as soon as flexion was introduced the disc herniated.

You must remember that reverse hypers are a crushing compression force with a flexion component.

Can you currently squat?
Can you currently deadlift from a high pin position?

Why do you think you are weak in “core”?
The combination of heavy compression and heavy core training may be too much…

You may try to re-estblish squatting with minimal assistance training(core training)

If squatting is out of the question, then try single leg exercises. I have found these to be tolerated by individuals who can not tolerate heavy squatting.

Michael Hope

I received another cosmically significant answer a few days later to my follow-up questions. For increased readability, I have matched question to answer on this one.

Kris: Dr. Hope, thanks for the very insightful answer (11/21/2005)! Too much compression in the gym appears to be the main stressor, several days of sitting/sleeping extensively can be nearly as bad. I did extensions with feet out to the left while tilted to the right, then switched to regular McKenzie, would this qualify as a proper lateral procedure? Squatting in the 60-70% range usually works, if not stiff I can max out without causing lumbago. Cannot go very heavy on high pin pulls unless totally pain-free. I hear you about posture, will seek advice, thanks.

Michael Hope: Glad too see you are resolving.

Ironically I just read an e mail from Vinnie 11/25/05 he was lifting and got injured what he describes is a lateral shift like yourself. I recently treated a SWAT officer with a lateral shift. Shifts are not common problems.

Some of his guidelines may help you in the future. I corrected his shift on day one. He did shift corrections for one day and was placed in a CASH orthosis. This brace does not allow him to flex. On day two his shift was corrected and he began extension procedures. He was to perform one side glide every hour to make sure he had no obstruction to side gliding. Once he was pain free for five days to test his stability I had him perform standing flexion 50x and sit slouched for twenty minutes. This produced no pain and created no obstructions to movement. His condition was resolved.

If down the road he developes low back pain he will perform sidegliding and extension to see if his motion is obstructed If it is he resumes his exercises 10x every one to two hours.

Before I answer your questions remember I try to to give what I believe are safe exercises based on science. I have been asked about RDL, Good mornings and GH raises. They are not rehabilitation exercises. I had a conversation about this approach with Stuart McGill a few years ago and he is in agreement about this point. He has testified in court against therpist who decided to use high compression strong muscle activation exercises for spinal rehabilitation. He had science on his side they had it was a good exercise on theirs.

Kris: Sorry for the long list, but this is the first time I am getting any help from someone who understands PLing and I am eager to work out a plan of attack. Any advice would be much appreciated. Thanks for helping me out!

Should I consider the Ironmind Super Squats Hip belt as a way of rebuilding some strength in the legs while lowering compression?

Michael Hope: Yes this would be a good place to start
would use a wide stance.

Kris: Can spinal compression build over time, i.e. the spine get progressively more compressed week after week? Am thinking in terms of doing a couple of weeks of reasonable loading (using first occurance of minor lateral shift as an indicator) followed by 1-2 deload/decompression weeks (perhaps only hip belt work here).

Michael Hope: spinal compression does not build up like you stated. It is increased with positions then reduced with others. This is known as creep and hysteresis. Using periods with safer exercises ( delaoding is probable a good thing) every other group gets some time off why not the spinal muscles.

Kris: Should I ditch the reverse hypers altogether?

Michael Hope: The revers hyper is a very good exercise to improve posterior chain strength and is necessary to have a heavy squat. You may try limiting how far the feet come under you. I would limit the arc to the point where you can keep the lordosis. There is no value of rounding your spine. Trying to generate a major contraction of the spinal musculature and hips from the flexed posture is not a good idea.

Kris: Does a stronger core equal less compression at all (my reason for focusing more on abs and the posterior chain)?

Michael Hope: Core training and improved compression is necessary to have a stable base from which to move from. The delimma that arises is how much stability is necessary. Power lifters are unique in that they are alwyas trying to lift greater loads which require greater support.

Athletes are not the same. In some cases less compression exercises will keep them playing. Training is used to bring up weaknesses, work on high risk areas of injury and selecting exercises that will improve their strength while minimizing injury during training.

Kris: What would be good ways to relieve compression, how frequently should they be used?

Michael Hope: Most spinal compression is produced with sustained flexion( poor posture) and repeated bending. This again goes back to creep and hystersis. Good sitting posture more than bad is a good place to start. Implement extension or overhead reaching during the day to offset flexion forces.

Kris: Would you say my weak annulus will stop me from becoming competetive in the SQ/DL or is this something that might be resolved long-term with proper rehab and posture correction?

Michael Hope: As the nuclues dries out and becomes fibrous,it is less able to exert fluid pressure, Thus the nucleus is less able to exert radial pressure on the annulus fibrosus. Consequenly, the annulus is subject to greater stresses Nucleus breakdwon is a normal painless process. There is science to suppport that not all changes are age realted, some are active metabolic responses to change in the internal stresses of the annulus( changes in Type 1&2 collagen.

If you continue to have frequent episodes of lateral shifting then you are continually weakening the structure so the disc material will take the path of least resistance.

Most athletes will have back pain like yours and think it is a muscle… So they stretch it out usually more flexion and greater chance of injury. They sit slouched on a bench between sets more chance of injury( plus hysteresis). Those pains in my opinion are early warning signs and it aint muscle sending those messages. It is the disc. 50% of the time it is the disc that is causing pain.

Kris: Would using equipment help at all in lessening compression? Currently raw, not even using a belt.

Michael Hope: The belt is not favoured by some exercise specialist because they read the research that belts dont help prevent low back pain and may lessen the muscles ability to supprot the spine. This assumption can not be made with heavy lifting. This information came from back pain suffers. Not guys squatting 700 lbs. I would say with heavy squatting use a belt it will act as a counterforce to the abdominal pushing out.

Kris: Would you recommend any specific supplementary activities (swimming, sled dragging…) for keeping my spine active without undue strain?

Michael Hope: James Smith and I have had this conversation we are both in agreement that you should pick something that has diffrent movement patterns and loading patterns.

Because of my back ground i like heavy bag training work both punching and kicking. Remember No one said you had to be good at something to like it. Your body is forced to move out of the sagital plane. this is the moving pattern that all squatting and deadlift are done in as well as benching.

Remember if you can’t perform low level compresssion exercises safely most likely the big ones will be worse.

Exercise selection is misunderstood when treating low back pain. Good exercises for strengthening need to be put into the program when appropriate. No one would tell a torn ACL afer four weeks to begin depth drop jumps on to a single leg if they have never done loaded lunges with out buckling or pain.

One more consideration science is realizing that resolved low back pain athletes still have firing latencies. This may mean they are still suspect when it comes to protective movements.

what a long answer,
Michael Hope

Looks like I have been going about it the wrong way. Whenever I have had encountered renewed back pain, I have strived to counter it by lessening the amount of heavy loading (squats, deadlifts…) while increasing the amount of core work (stability balls, abdominal exercises…). This makes perfect sense if high levels of spinal compression is taken as the sole culprit. Turns out the equation was missing one vital piece, flexion (forward bending). The research Michael cites is in agreement with that of Mr. Spine, Stuart McGill:

A couple of years ago we sought the most potent mechanism leading to disc herniation. Given that it was critical to create a homogeneous cohort of specimens, we chose a pig spine model, controlling diet, physical activity, genetic makeup, disc degeneration, and so forth. We found that repeated flexion motion under simultaneous compressive loading was the easiest way to ensure herniation. In fact, it turned out that the number of cycles of flexion motion were more important than the actual magnitude of compressive load. [..] The herniated disc appears to result from cumulative trauma: even though we have crushed well over 400 vertebral motion segments, we have only once or twice observed a herniation without concomitant flexion cycles. Note that we are including both frank herniation and visible disc bulges under this category of injury mechanism. [..] [H]erniation of the disc seems almost impossible without full flexion. This has implications for exercise prescription particularly for flexion stretching and sit-ups or for activities such as prolonged sitting, all of which are characterized by a flexed spine. Some resistance exercise machines that take the spine to full flexion repeatedly must be reconsidered for those interested in sparing the posterior annulus portions of their discs.
McGill, Stuart (2002): Low Back Disorders, Human Kinetics: pp. 55-56. My emphasis.

Spinal compression caused by bending is the problem, not compression per se. Hence Michael Hope suggests I do the precise opposite to what I’ve done so far: minimize bending exercises (abs, full range reverse hypers and so on) and focus on re-establishing squatting, an activity where the load is transfered to a fairly neutral spine. At the risk of restating the obvious, heavy squatting is not the problem, all those “light” core exercises are. If this is indeed so, it is easy to see why it would take me a full three months to heal up. Simply put, many of the exercises I did in the name of rehabilitation (reverse hypers, standing cable crunch, side bends…) were themselves major sources of compression caused by flexion.

My new plan of attack:

• Focus on squatting, drop or minimize all exercises with a flexion component for now. Use a belt on all heavy squats.
• Start to do reverse hypers with a shorter range of motion to keep the back from rounding (no more swinging!).
• Purchase a squat hip belt.
• Subject the spine to a different loading pattern through heavy bag work done before every workout.
• Continue to relieve compression by paying attention to sitting posture and time, and by doing frequent overhead reaching.

Whether this is a first step to a viable solution or just another brief glimmer of hope remains to be seen. Mood: optimistic. Thanks to Michael Hope for taking the time to answer and to Elite Fitness Systems for providing this service!

Hell-bent on following Michael Hope’s rehab recommendations to a T, I dutifully pounded the heavy bag for fifteen minutes before today’s workout. This brought back many memories of my former life as an avid martial artist. I got interested in martial arts when my age was in the single digits. Back in those days of the colorful 1980s, Ninja movies were found in great quantities at any rental store, even when nothing more than a tiny video corner in a tiny neighborhood kiosk. With all respect to the American Ninja series, Sho Kosugi was the man who shook not only my world, but that of millions worldwide. I can no longer recall when I started watching those flicks together with a friend whose parents were of the permissive kind (not necessarily a good thing), but little by little we knew which brand of martial arts we wanted to get into. Meanwhile, we started practicing kicking and the so frequently seen nunchaku (homemade…) on our own. Flying kicks and jumps off high places, including the roof of my friend’s house (don’t attempt this at home), together with a lot of somersault training in the winter also played an integral part of our spare time. This picture taken of me flying off a huge rock at about age 12 is one of my most fond memories, it brings it all back to me.

To make a throwing star laden history short, shortly thereafter Måns appeared in my class at school. At age 14, we finally found a ninjutsu instructor who was willing to have us tag along for training (ironically, my childhood ninjabuddy never got around to it). As it turned out, the real deal, Bujinkan Budo Taijutsu, was nothing like the movies. A serious martial arts consisting of nine different schools, three of which are true ninja lineages, it quickly erased all traces of my dream world ninja childhood (haven’t touched a nunchaku since). The next thing I knew, I was training several times a day, sometimes at 6am in the woods before school together with Måns, in addition to attending formal training five to six times a week. All the hard work paid off as I got my black belt in 1993, just after I turned 18. The flip side of this borderline (?) fanaticism was that both of us slowly but surely started becoming burned out and losing our appetite. Måns got his black belt and we both taught for some time, but within a couple of years we found ourselves more and more at the gym and less and less in the dojo. Soon enough, less had dwindled to nothing. My interest for Asia remained strong however, and I started majoring in sinology (Chinese language and culture) at the University of Helsinki.

Taking a right off memory lane now, we are back at Metal Gym in November 2005. I felt like a white belt all over again as I drove my punches and kicks into the bag. The body dynamic I acquired during my martial arts days will probably accompany me all the way to the grave, but I felt a bit rusty, not the least in the flexibility arena - imagine that I used to be able to do front and side splits… cold. The movement pattern of Bujinkan Budo Taijutsu also doesn’t lend itself very well to a heavy bag with its odd strikes and kicks designed to hit specific targets of the human body that seldomly resemble a heavy bag. Bujinkan dakentaijutsu (striking and kicking) relies heavily on transfering the bodyweight into the target which in turn has more to do with the kness than the hips. Even on kicks, the bodyweight will be down on the supporting leg and the foot will remain put during the whole kick. Taijutsu kicks are generally close-range affairs of a stomping nature that will seldomly fully extend the knee and will often land with the heel. This is more akin to Wing Chun kicks than the long-range snap kicks of karate and taekwondo that leverage primarily hip torque to generate force which, especially on roundhouse and side kicks, allows the supporting leg to move against the ground. Ironic or not, I focused mostly on precisely the latter kind of kicks because they force the back to twist around and generally be more active. Wonder when I last attempted spinning back kicks…? In the same spirit, my punches were boxing like because the front foot or back foot pivots to allow maximal force to be generated from the hip. Probably time to dig out the old 80s Panther Productions tapes by legends Bill “Superfoot” Wallace and Benny “The Jet” Urquidez for some more ideas on how to get the back to twist along nicely. Rest assured that the bag will continue to receive its share of stomp kicks and finger knuckle strikes too though. Will also not use gloves. Never forget your roots, even for the sake of “rehabilitation”.

Wrapped up with some light flexion-free accessory work. The back pain is too acute for me to squat just yet. Will give it a rest and start squatting at the first opportunity. Cowabunga!