New Workouts

AMRAP 15 minutes:
21 lunge jumps
15 toes to bar
9 Dead Lifts
6 Burpees
3 Handstand push-ups

Total rounds complete: 3 + 21 lunges/15 toes to bar/9 DL

I had a sore back from this for two days but it is going away.

Then today did another AMRAP-20
5 pull ups
10 push ups
15 air squats
Total complete: 10 x with 3 minutes left stopped the clock.

We'll see how I feel tomorrow.

Run

Ran today. 6.7 miles with some hills. Stopped to stretch at 35 minutes into the run because the view of the beach and sunrise was spectacular. Said hi to people as I passed by them on the run. People in Santa Barbara actually respond. Knee pain began at 35 minutes into the run, but didn't change or get worse, so I continued to run. Walked a total of 4 minutes, especially on the downhills. I found out that I enjoy running uphill.  1 hour almost exactly. Off to work!

Interesting Patients

The A-typical typical postural dyfunctional patient.

Since I have been working with many triathletes, I have seen all too many people who's glutes are inhibited to the max. Too much running forward, not enough using their bottoms to get them moving leading to too many problems. This compiled with the fact that we sit too much, drive too much, spend too much time with poor posture and leaning forward, our hip flexors get toooo tight.

That's not what this is about. What I am writing about is the patient who comes in for a hamstring strain. But rather than the hamstrings predominantly firing first when the glutes are too weak as hip extensors, in this case, the patient's glutes are strong. Strong as can be. 5/5 Manual muscle testing: I cannot break her. Hmmm. I was thrown for loop one. Test the hip flexors: Not tight. Hmmm another loop. Test the hamstrings: ouch. Ok, I won't do that again. Length test the hamstrings: those puppies are better than average. Damn another loop. Fine, 3 loops and I'm dizzy. So I step back and rethink.

Looking at her posture: this girl has relatively good posture. Except that she is slightly hyperlordotic (increased lumbar [low back] curves), exacerbated by her anterior pelvic tilt: greater than 20 degrees bilaterally. What would that do for her hamstrings and how does that relate? What haven't I tested that I could be missing? Let's look at a picture

As you can see in this picture, with an anteior pelvic tilt, the quads (on the right bottom arrow) become tight and shortened. The hamstrings become long and "weakened", the abdominals are also weak and lengthened, and the low back muscles are tight and shortened. So thinking about this cross pattern of muscle balance I test out some of these muscles. I already saw that her hamstrings were longer than the expected "normal" person. So I put her into the Thomas test position.

The back of her thigh touches the table easily, but WOAH! her knee is almost straight. And comparing the right to the left, the right has a degree of external rotation. She is a kickball player and prefers to kick balls with her right foot. What that means is her quadriceps are super tight and her sartorius on the right side is tight too. Next, I test the strength of her abdominals using a simple plank test. Palpating her spine, her spine begins to dip down at 30seconds of holding the position and she is shaking like a 9.6 on the richter scale. She manages to hold the position for 60 seconds but collapses when I tell her she's finished. That was hard for her.

Conclusion: "Weaker/inhibited" hamstrings are having to try to overpower her tight quads leading to a hamstring strain.
Solution: Stretch out the quadriceps, stretch out the low back musculature/glutes, strengthen the abdominals, and strengthen the hamstrings.

Final thought: Correcting postural deformities based on individual variations is very important. Don't treat everyone the same. Don't do what other people do, simply because their hamstrings also hurt at one point in their life. Talk to a professional orthopedic physical therapist and get yourself evaluated. Make sure they find the root cause of the problem and not just treat the problem. Stretch and strengthen by cross training and staying active.

Aloha,
Eli M Kase, DPT

Thursday Run

Woke up at 6am and hit the snooze for 15 min. I never do that. Motivating myself to get up this morning was difficult. But once I got in my workout clothes, I was ready to go. Walked up the street to Elings park and started running up one of the bike paths. Ran up to the glider port, then got lost following a water trail. Turned around and headed back down the loop at the top of Elings park. At that point it was less than two miles and I wanted to do more. I ran down Elings park street and found a trail at the bottom that followed Las Positas toward Cliff. After running into many spiderwebs, I got to Cliff. There even was a little area with oak trees and what I believe to be Poison oak. Ran up cliff then left at FloraVista. Stopped at Escondido park to stretch and do one set of tap downs. Then walked home. Finished in 45min. 3.89 miles (3.51 of running).

Wednesday

Did not do crossfit today but did my own workout for core and scapular stabilizers.
3 sets
Prone on ball: Y, T, A 2# x15
Front plank hold 1min
Bird dog rows 15x 20#
Advanced Side plank with ER 2# x15
Plank up/downs Rx5, Lx5
Wunda chair pikeups x30
Military Push ups x10
Turkish get ups Rx3, Lx3 17.6#

Found my baseline workout from crossfit: 5:26
500M Row
40 Squats
30 situps
20 push ups
10 pull ups
Felt good, but almost puked. Might have gone out to hard on 500 M row. These were done as dead hang pull ups.

Wednesday

3 rounds max effort bench press: 115#, ring dips blue, pullups. 1 min rest

Tuesday:

1 deadlift every 30 second for 10 min. 185#.
AMRAP 10 VUps, 10 Double Unders, 20 VUps, 20 Double Unders, 30 VUps, 30 Double Unders etc...
7 min: 3 rounds+40+17