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Advanced Core Stability: One Arm RKC Plank

I love the RKC plank ever since learning about it several months ago from my friend Bret Contreras. It's simple to teach, difficult to perform and satisfying in the feel of whole body muscular activation you get with it.  It's one of the only "floor" exercises that gives you the sensation of intense whole body contraction similar to gymnastics open chan movements such as the planche.  As opposed to a regular plank, where whole body tension is often times not very significant and can be held for prolonged periods, an RKC plank relies on developing large amounts of whole body tension and susequent  neuromuscular "irridation", where the whole muscular system becomes a tightly wound spring.

 

 

Credit obvilously goes to Pavel Tatsouline for the genesis of this exercise, which takes a traditional plank and adds "muscle" to it via increased lattissimus, quadriceps, and gluteal contraction.  By doing this, the abdominals are forced to contract more intensly than in a standard plank, with the net effect of increased dynamic stiffness and "pillar stability" around the lumbar spine.  I believe the magic in a properly performed RKC plank is in it's "anti lumbar extension function"- where the force couple of the quadriceps, abdominals and gluteals, along with added isometric tensioning of the latissimus/thoracolumbar fascia really lock down the lumbar spine in an appropriate fashion.  Creating dynamic stiffness and strength in this position transfers nicely to activities on two feet in strength or regular sport.

As I was progressing myself as well as my clients and teams through this exercise, I thought of how I could make a hard exercise even harder.  Not just for the sake of making it harder arbitrarily, but to add another musculoskeletal and performance challenge to the activity; in this case to resist lumbopelvic and trunk rotation.

 

Enter The One Arm RKC Plank

The One Arm RKC plank is a great progression for an already tough exercise.  By removing the support of an arm, you now require your stabilizing musculature of the trunk (internal/external obliques, quadratus lumborum) to work extremely hard to resist falling into rotation.  The natural inclination is to elevate the pelvis to counter the trunk rotation; this is what we are trying to avoid.

Additionally, you will notice a significant overflow of muscular activity of your triceps, as your forearm and fist is the only upper extremity contact with the ground at this point.  In addition, the latissimus fires extremely hard, leading to "tenting" of the thoracolumbar fascia, which further lends to additional lumbar stabilization.

You will find that the quadriceps, gluteals and abdoninals contract even harder than in a traditional RKC plank as a result of the induced instability. This is involuntarily if performed correctly, and another example of "self limiting" exercise. 

 

Setting Up

The one arm RKC plank is performed by first setting up into a traditional two arm plank, then contracting the quadriceps as well as the glutes (into posterior pelvic tilt), which leads to increased abdominal contraction.  When these muscles are set, then "pull" your elbows to your feet isometrically while at the same time isometrically "pull" your toes (your foot contact in the plank position) toward your elbows.  What you will feel is a boatload of whole body tension that we will use to our advantage soon.

Now, while continuing to hold the tension, slowly and deliberately remove one of your forearms from the floor placing your hand palm up in the "small" of your back.This requires an even further intense contraction of the support arm, and can be facilitated by pushing your support elbow and fist into the floor. Intent is everything here-push hard! 

At the same time, you will feel gravity trying to pull your pelvis down on the unsupported side.  This is normal and expected.  To counter this, focus on bracing  your quadriceps and gluteals even tighter on the unsupported side, as well as focusing on keeping a neutral spine position and not allowing your hips to "pike".  At this point, the intensity of whole body muscular contraction increases even further as you fight to keep your trunk and hips parallel to the ground.  This is the crux of the exercise:  Whole body tension from the supporting forearm through the toes, while working hard to keep your pelvis and trunk level.

The video below outlines what you should be striving for in the performance of this exercise:

 

 

 Here is an alternate view of the transverse plane from "top down", again avoiding pelvic and /or trunk hiking:

 

 

Program Placement, Sets and Time

This exercise can be flexible in terms of program placement.  It fits nicely in a warm up/ movement prep, between sets of your main exercises, or at the end of a session.  I have utilized it as a facilatory activity with sprinting and plyometrics, sandwiching a set or two between repetitions as a "potentiation" primer. 

In terms of sets, 4 to 8 sets, lasting from 6-15 seconds/set is a good place to start.  Obviously, you will do an equal number of repetitions on each side, although you will more than likely have a more dominant side with better perfoormance, so adjust set times accordingly.  At least 1-2 minutes rest between repetitions should be taken; more rest may be needed if technical performance suffers.  Of course, technical failure is the end point for this exercise; learning to judge this is important as well. 

 



Exercise of the Week: Advanced Abdominal Brace

A long time favorite in my clinic, this "anti extension" exercise fits the bill for  aggressive abdominal co-contraction, lumbosacral stabilization, and whole body frontal plane stabilization.  It is also a "self limiting exercise", defined by Alwyn Cosgrove and Gray Cook as one that "requires engangement and mindfulness, and provides an automatic yet natural obstacle that prevents you from doing it wrong, or doing an excessive volume".  In this case, the "obstacle" is the neutral spine position itself- you can either sense and hold the correct position or not.  When you lose the position, it becomes very apparent, as it is easy to sense this quickly.  I refer to this feeling as "fatigue extension" and I have never had a patient or trainee not understand how this is sensed.  

Below, I outline two progressions, using an adjustable 45 degree back raise for both.  Equally as useful for the advanced progression is a GHR machine or Roman chair. 

 

PROGRESSION ONE

The first progression here is at 45 degrees.  This allows a shorter lever arm for the trunk musculature to deal with initially, as this exercise is harder than it looks. 

The key to set up is ensuring that appropriate neutral spine is achieved by guiding the trunk position at first using the arms. This is important at first, as a person with weaker abdominals may end up in too much of a lordosis to start.  Once you have the strength and motor control to understand the position, arm guidance isn't as imperative. 

Another important technique note includes appropriate neck positioning.  You can use the "neck pack" position, or just imagine a tennis ball sitting between your sternum and chin (the way I learned it ~20 or so years ago from Beverly Biondi).  This way, you also get great deep neck flexor activity, which in turn helps reflexively reinforce the abdominal activity (which is why you're here in the first place!). 

 

 

 You can also see that the lower quarter is pretty active as well.  This is important, as your shins, and or feet (as we will see below) are the anchor point for the whole technique, and vital if you want the pelvis to stabilize neutrally from "bottom up" (which, obviously, you do). 

When used in a strength and conditioning program, I start with 10 to 15 seconds per set, with 45 seconds to 1 minute of rest between sets.  5 to 10 sets per session are performed.  We progress up to 30 seconds per set before going "arms overhead", and then start back with decreased rep times (10-15 seconds) until 30 seconds can be maintained  for multiple sets.  Dumbells can be added after this, again decreasing time under tension at first, until good lumbopelvic control can be maintained and progressed. You can also choose to perform this activity between sets of your main strength exercises, as it shouldn't interfere with technical performance of your main lifts.

When we use this clinically for our lumbar spine patients, it is always later in their overall program, usually a minimum of 4-6 weeks after treatment has started.  Symptom control, hip and lower quarter mobility, and good understanding of basic abdominal bracing progressions are needed before moving to such an advanced activity.  Sets and reps can be progressed as outlined above.  The lumbar spine patient population is generally good with the first progression, and does not need to move on to the next progression unless their sport or activity level demands it.  

 

PROGRESSION TWO

Here, we are using a "parallel to the ground" position, increasing the lever arm that the abdominals have to deal with in resisting extension.

 

 

 

 Again, I utilize my arms to set up the "neutral spine" position, both entering and exiting the set.  This is even more important in the second progression, as the abdominals have to work ridiculously hard to maintain a neutral position due to the leverage demands.

Other things to consider with this progression:

1)  Set the glutes by squeezing your butt as well as isometrically externally rotating your hips.  Again, this provides a firmer pelvic foundation for the abdominals to work off of.

2)  Notice that my instep is the base of support for my feet vs. the shins.  This is a subtle way to increase the lever arm, making the exercise more challenging.

3)  Arms overhead should be used ONLY after a good, solid repetition can be held for 10-15 seconds over 5-10 sets.  This goes for dumbells in the hands as well.

4)  The set terminates when the lumbar spine falls into fatigue extension.  Trust me when I say this is easy to figure out when this occurs. 

5)  Remember to use your arms to "rescue" yourself from the, as "sitting up" is nasty for lumbar spine shear forces.

 

 



Serratus Anterior Training Progressions

The serratus anterior is like that kid you knew in high school everyone knew: a bit mysterious and misunderstood, who was not necessarily in trouble, but was always around trouble when it happened.

 

Kato Kaelin may be the human equivalent of the serratus anterior

 

It isn't really a muscle that takes a regular beating like the long head of the biceps in a thrower, nor is it "married" to a joint complex like, say the supraspinatus.  However, more often I see it being a problem in people with traumatic neck pain (such as whiplash injuries) in addition to older patients with non-athletic shoulder pathology.

Obviously, overhead athletes (particularly tennis, baseball and swimming) with shoulder pain may have serratus activation/weakness issues, but the big trend I'm noticing is serratus under activation/ weakness in cases of neck pathology, particularly those of a traumatic nature.  This applies again to acceleration injuries such as whiplash, but also to athletes involved in collision sports (football, wrestling, MMA).  This recent study highlights the link between serratus dysfunction, poor muscular activation and cervical/thoracic dysfunction.

Anatomy of the Serratus Anterior

The serratus is definitely an oddly shaped muscle.  The best way to think of the serratus is to think of a hand. The origin(s) of the serratus are shaped like fingers and grasp the superior borders/ outer surfaces of the upper eight or nine ribs (o.k., we don't have nine fingers, but I get a pass on this one).  Your palm is the "body" of the muscle, while the wrist crease is the insertion of the serratus on the medial scapular border.

 

The "classic" anatomy book rendition of the serratus anterior

 

 

Typically what we think of when we see a serratus in a lean individual

 

 

The serratus wholly dissected looks  kind of like this, that is if we had eight or nine fingers

 

Function of the Serratus Anterior

According to Kendal (Muscles Testing and Function, fourth edition), the functions of the serratus anterior are numerous, including letting the glenoid cavity of the scapula (the "socket" of the shoulder joint) rotate upward, as well as holding the medial border of the scapula against the rib cage. Also, the lower fibers may depress the scapula a bit.  I think both clinically and from a performance standpoint that the last two functions are very important. 

First, keeping the scapula held firmly to the rib cage by way of proper serratus function allows properly functioning "anchor points" for the rest of the scapular musculature,  the rotator cuff, as well as the middle and lower trapezius, as well as the levator scapula and upper trapezius.  Secondly, as an end range scapular depressor following the mild  concave contour of the rib cage, I believe we may ultimately help foster qualitatively improved glenohumeral elevation by lessening anterior scapular tilt

The Serratus/Rhomboid Fascial Connection

In "Anatomy Trains", Thomas Myers points out the fascial/septal connection between the serratus anterior and the rhomboids.  We know from Kendall that the rhomboids are antagonistic to the serratus (or as she puts it "direct opponents"). Myers coins the term "rhombo-serratus" muscle,pointing out the two muscles form a myofascial scapular sling, setting up scapular "ballast".  The two muscles appear as "kissing cousins" in these illustrations/ dissections.  So, as the serratus goes, the rhomboids will go (and vice versa), both from a length (short/stiff) issue as well as an activation/contractility issue.

 

Thomas Myers- The "Christopher Columbus" of the Anatomy World

 

These passive, active, and cozy connections provided me with an "a ha" moment when working two patients recently, both who had traumatic neck injuries related to whiplash, and my approach to their treatment.  

Both had multiple issues, including loss of neck and shoulder mobility due to soft tissue injury, and the loss of mobility was due to multiple factors, including segmental tightness at the cervical facet level and posterior shoulder capsule/element tightness.  Obviously these were treated in concert with soft tissue work to the rhomboids (at the point of insertion on the medial scapular border), activation work for the middle and lower trapezius, and postural restoration activities.

 

Weaving the Serratus/ Rhomboid Tapestry

When it came time to train the serratus, I utilized a three phase approach based on 1) supporting still sensitive, sub acute healing  cervical/ thoracic structures 2) gradually decreasing external support as our injured tissues allow 3) giving the rhomboids "equal time" to allow seamless integrated contractility/ activation in conjunction with the serratus.

Phase 1

I use a massage chair for trunk support to dial in what I want the patient to perceive as appropriate serratus function (scapular protraction with shoulder elevation).  The key is to maintian scapular protraction while elevating; retraction during elevation indicates poor serratus function and/ or too heavy a load.

 

 

Phase 2

As the patient gains an understanding of how to activate the serratus and control the scapula, we then move to a seated position to allow/ integrate trunk stability while the serratus does it's job:

 

 

Phase 3

After we have mastered the first two progressions, we then move to a standing position, which integrates further the trunk with the hip.  Again, Thomas Myers notes a fascial/septal connection between the serratus as well as the obliques and tensor fascia lata; standing allows potential stabilization/ integration between these elements:

 

Integrating Rhomboid Activation

The X factor that was missing in the equation for me in the past was addressing rhomboid function.  I had been so focused on not aggravating the upper trapezius/ levator scapula that I avoided rhomboid activation as I felt it encouraged too much "turn on" of the aforementioned groups.  However, with recent patients, careful integration of specific rhomboid work "greases the groove" for the rhombo-serratus anatomy train, and allows appropriate tri-phasic (concentric/isometric/eccentric) interplay in a scapula with great myofascial ballast (courtesy of early and appropriate soft tissue work, joint mobilization and postural restoration).  

Here, we perform a static rhomboid activation, careful to minimize upper trapezius and levator activity:

 

 

Beyond Basics:

After we've got our "new normal" scapular function, we can progress through our preferred  "pushing"upper body exercises.  I am biased toward push up progressions at first, as scapular mobility is encouraged vs. locking the scapula down with a bench press.

My personal favorite test of good serratus function is a handstand hold, as I feel  a real satisfying scapular position on the ribcage with this exercise: 

 

 

 

 

At The End of the Day…

1) The serratus anterior is a tough muscle to wrap your head around from a three dimensional standpoint; however it's function really is a keystone for proper scapular function (and the scapula is a keystone for trunk/ extremity integration, if you really think about it). 

2) Serratus function is an interplay between both the serratus and the rhomboids, both from a passive (shortness/ stiffness) perspective, as well as an active one; both need to be addressed.

3) Strengthening the serratus is more about proper, integrated activation in conjunction with the rhomboids after appropriate positioning/ballast of the scapula has been established through appropriate manual therapy/postural intervention.

4) Advanced upper body push activities should allow free scapular movement, such as push up, dip and pressing pattern progressions as tolerated (remember to pick your candidates carefully for pressing and dipping) 

  



10/5/1: A Simple Starting Point for Youth Strength Training

 A question from a parent who coaches multiple sports teams, ages 13 and under:

"What are some strength training options for  my kids (who participate in 2-3 sports seasons/ year), as well as the kids I coach.  I have a fifth grade boy age 11 who plays football as well as baseball, as well as two seventh grade girls (twins) who play field hockey, basketball and softball.  I coach basketball (in house recreational and travel), baseball and softball.  Thanks!

Training younger athletes is a tricky proposition.  If they are involved in multiple sports, time is tight, as their schedules are already filled.  Combine this with schoolwork and social/ family time, and you find a kid who is going to be pretty resistant to the idea of "strength training". 

 

"Success Stories" like Those Seen in "Major Payne" really only happen in the movies , not on a U14 soccer team…

 

A few questions to ask here are: 1) Do my (my own kids, as well as the athletes I coach) buy in to my "want" for additional training? 2) Are the parents of the athletes I coach on board with additional work outside the regular practice/ game schedule? 3) Is the strength program going to take time away from my practice schedule?

That said, if the answer to the above 3 questions is "yes", a really simple program can be implemented.  The way to do this is to make sure of 3 key points before starting:

 1) The Program is Simple.

Kids and parents don't want more stuff to do, as sports and family demands are already assumed pretty high, as outlined above.  Simple exercises with simple explanations are warranted here.

2)  The Program is Doable

Allowing a young athlete to experience success in performance of a skill is the only way to go in terms having any hope with long term compliance.  Making a kid think the program is easy either in what exercises have to be performed or or much time it will take will enhance your chances of making the program stick.  

3)  The Program is Scalable

Even a simple program will be for naught if a coach/ parent doesn't have the ability to scale the program to each individual athlete.  A 70 lb. 11 year old male swimmer will probably be able to perform a chin up sooner than a 14 year old  female lb. soccer goalie.  Both should be given the tools to succeed.  

 

The  3 Exercises:

1)  Bodyweight Squat– Simple to do, and able to be performed anywhere.

 

2)  Push Up- Again, simple, portable and scalable.

 

 

 

3) Chin Up/Pull Up- The one "challenge" for many young athletes, we will scale this appropriately to allow compliance and success.  If a proper chin up cannot be performed, a flexed arm or dead hang can be performed for a legitimate 10-to 15 second count.

 

 

The Program

Each athlete will perform once daily, a total of:

10 squats 

5 push ups 

1 chin up 

The key to this program is the "daily" part.  Keeping the overall volume low helps fulfill our first 2 requirements- "simple" and "doable" and will be more palatable to a young trainee in maintaining compliance. One chin up (or one flexed/ dead  hang for 10-15 seconds) no big deal to most athletes, but  ten reps might as well be one hundred the same kid  .   Daily compliance allows "greasing the groove" of these basic motor patterns/ activities, which can be progressed in various ways over the athlete's lifetime as they get proficient with the basic movements. I strive for 90% compliance in such programs, so in one year a person can take 37 days off from the program. 

Rounding up to 40 days off  (roughly 3 per month) makes it more palatable to all parties involved (athletes and parents).  In the course of a year, assuming 90% compliance, a young athlete will have performed:

3,250 squats

1,625 push ups

325 chin ups (or over 3,500 seconds worth of flexed/ dead hanging). 

You are simply having the young athlete train a "strength skill" on a daily basis, much like swinging a bat, shooting a free throw, or dribbling a soccer ball.  Not bad, considering the alternative- zero, zero and zero for all three exercises, at ages where establishing great strength specific motor patterns can pay huge dividends.

The Progression

If your young athlete(s) are motivated to do more, there are several options.  You can double the numbers of each exercise, so now the athlete is performing 20 squats, 10 push ups and 2 chin ups (or 2 sets for flexed arm/ dead hang). Another more advanced progression I like to perform after ~3-6 months of consistent (90% compliance) 10/5/1 performance:

30 squats

10 Push Ups

6 Chin Ups

Again, this is a daily progression, shooting for 90% compliance. Laying it out to make it "doable" might look something like this:

15 Squats (1 min. rest) – 2 chin ups (30 seconds rest) – 5 push ups (1 min. rest) – 2 chin ups (30 seconds rest) – 5 push ups (1 min.  rest)  -2 chin ups (30 seconds rest) -15 squats.

Doing the math, our young athlete, in one year would perform:

9,750 squats

3,250 push ups

1,950 chin ups. 

This is pretty significant, especially for a young trainee over the course of a year.  The overzealous parent and/or coach would be wise to see if their athlete can successfully handle the 10/5/1 progression for 1-2 months prior to advancing.

Who This is  Is For:

The young athlete who:1) plays multiple sports, in multiple seasons. 2)  who hasn't really participated in any "formal" strength and conditioning in the past. 3) who would probably be overwhelmed with anything more complicated.

Who This Isn't Probably For: 

A young athlete with significant experience in bodyweight training (i.e. a gymnast or wrestler) may not benefit from this type of program,as basic and advanced bodyweight strength movements are a significant part of these programs.  Also, anyone who is involved in a more formal prolonged  training program with a competent performance coach may not need a daily program.  However, most young athletes don't fall into this category, so daily practice in these basic movements will benefit them greatly.

What Happens After A Year or Two?

Your young athlete(s) will have "greased the groove" for three fundamental strength patterns, and should be ready for more aggressive loading parameters and exercise.  My advice is to first get to the one year mark and see what positive changes have occured in the athletes you coach- they should be stronger and more stable in fundamental stances and quicker with dynamic movements. They should also be more disciplined and confident, as such a program builds a positive kinesthetic habit gradually over time. 

 

 

 

 

 

 

 

 



Teaching the Squat

Filed under: Case Studies,Exercise Instruction,Exercise Progression,Exercise Technique,Squatting — Shon @ 2:16 pm December 6, 2011

An easy way to get a training client or patient to understand the concept of thesquat/  hip hinge is to use a couple of mini hurdles in front of the shins to provide an "environmental constraint" (motor learning speak) to movement.  Maintaining the "vertical shin" position allows more hinge action at the hips, and also lets us cue in good trunk stabilization.  Below are two examples; one unloaded as well as one with a little bit of load:

 

 

Note that I use a dowel to maintain a neutral and stable torso  while hinging at the hips.  Also note the increased box height with and Airex and Nautilus pad to decrease forward lean.  I also use the classic Westside "spread the floor-push out your knees" cueing to maximize gluteal firing posterior chain activation.  This video was taken within the first two or three minutes that the client learned the exercise. 

Below, we add some load with a more experienced (but still new) trainee.  Again, the hurdle placement proves invaluable to keep the shins vertical and knees apart:

 

In this case, this young athlete had been training with me for about three months.  The first progression was with the dowel and hurdles, progressing to bilateral kettlebells/ hurdles, and then the straight bar (with hurdles).  I have loaded her with a front squat as well; this particular day we happened to use a straight bar.

I do eventually abandon the hurdles, but if mechanics "go south" as load increases, I quickly break them out again to get form in line. 

Key Points:

1) The top of the hurdle should be to the level of the tibial tuberosity.  The tibial tuberosity is more sensitive to touch than other parts of the shin, and provides a great tactile cue for the patient/ client.

The tibial tuberosity-a great tactile cue -also hurts pretty bad when you bang it into a coffee table

2) A spotter is needed to place the hurdles when using a bar.  Note in the second video, I have someone take the hurdles away before re-racking.  Walking out a loaded bar while stepping over hurdles is a recipe for disaster along the lines of squatting on a Bosu Ball. 

3) Hurdles are generally parallel to the ASIS of the pelvis, the bar, or both.  I am a fan of symmetry, and straight line hurdles subliminally get the trainee to think "straight/ tight" with technique.

4) A box isn't always needed.  Early in the progression, the box obviously helps teach the hinge, gluteal/ hamstring activation, and proprioception/ depth.  However, like training wheels on a bike, you eventually remove this prop, as the trainee becomes more confident/ capable and comfortable with the technique and load.