Monthly Archives: August 2012

Belt Squats for Lumbar Disc Herniations and Posterior Derangement Syndromes

I am currently working with two other authors to finish a clinical commentary on a rehabilitation program for athletes with lumbar disc herniation. During the time of writing, I had the unfortunate opportunity to have some discogenic flare-ups of my own, but took the experience as an opportunity to play with some exercises which will not be making it into the final print edition. One of these exercises is an old squat exercise called the belt squat which allowed loading of the lower extremity with less loaded involvement of the spine. In recent years, a number of manufacturers have built machines for belt squatting, but from a clinical perspective, you can get a pretty good start with a dip belt, some plates, and two sturdy/stable surfaces to stand on. I have to kick myself for not using this earlier on myself or clients in the past, in particular with posterior lumbar disc herniations and the class of conditions which fall under the MDT posterior derangement syndrome. Beyond simply unloading the spine from above and decreasing the musculature requirements necessary for maintaining spinal extension under load, the belt component may produce a treatment effect during the exercise. MDT practitioners are well aware of the benefits of over pressure in treatments of derangements, and the position of the belt (depending on it’s width) can be generally emphasize on various segmental levels to provide over pressure in the lower lumbar, or to simply facilitate an anterior pelvic tilt, depending on the goal. In addition, the over pressure is now maintained during a “functional” pattern of squatting (I guess this may be considered a Mulligan technique at that point). Clearly they need to be somewhat out of the most acute phase in order to even complete a body weight squat. Also, if they are already in a fairly anterior oriented pelvic tilt asymmetrically, the over pressure from the belt may irritate the involved SI joint.

From my own experience, this has been both psychologically beneficial, as it allowed me to continue to squat while recovering from the flare-up, but also that it assisting in calming down some of my radicular symptoms and low back pain. Your mileage may vary.

I have not had an chance to make my own video for this, so I defer to a great video from AllStrengthTraining.com as an example of the belt squat:

**Update – This guy has a similar setup to my own, everything is homemade. Not a bad option for a low budget clinic if you can make the structure a bit more stable:


Interval Based Dynamic Warm-ups

The discussion about the value of a dynamic warm-up in movement preparation is fairly focused on dynamic stretching these days. If you need a brief primer on pre-exercise dynamic stretching, please visit this old write-up of mine here. Now debates occasionally arise regarding what the “optimal” dynamic warm-up or movement preparation approach is. Tons of articles, books, and even training programs encompass very specific “functional” activities as a part of the warm-up. While I personally think that some degree of specificity is needed for each individual sport, there may be times we get a little excessive in this vein. A recent article from  Sander et al. sparked my interest on this topic. In their study, they took a group of elite youth soccer players (making some limitation of the practicality to 13-18 years olds), split them into two, one with a very generic warm-up (although they did include various running drills which are functionally specific to sprinting) and a second which did the generic warm-up plus additional “functional exercises”.  They found that for linear sprints and change of direction sprints, no significant difference was noted between the two groups. In other words, besides just “getting warmed up”, some of the classic “functional dynamic warm-ups” did not add any additional benefit to the performance of a sprint task. This leaves a great deal of room for argument regarding how this would apply to the broad scope of movements of sports beyond sprinting, but it still shows you don’t have to spend 15-20 minutes doing a complex dynamic warm-up to be able to a physically demanding task such as sprinting.

This was interesting to me because I have been playing around with the use of an intervals for movement preparation in recent months as method of making shorter warm-ups, and the feedback I have received so far has been positive.  Intervals have been extremely popular in recent years for “metabolic training” and fat loss programs based on various interpretations (some grossly inaccurate) of the original Tabata protocol and other historical interval/circuit training research. However, another possible use for intervals are as a generic/semi-specific warm-up.

When performing an interval for a warm-up, the intensity is perceived as high, but the rest intervals, exercise selection, and exercise order prevents early overwork and burn out. Time is saved from the exclusion of a general warm-up, and the movement specific components can be incorporate as a part of the interval model (although more will be necessary if full sport participation is planned).

Currently, I use 30 seconds on, 10 seconds off, for 10-20 rounds  (5-10 mins of actual work) depending on the demands for the session. In these 10-20 rounds I select a matching number of alternating light, moderate, and higher intensity full body exercises which generally involve the primary movers and stabilizers for most sports. Typically, I use a number general low risk contemporary exercises which can be easily graded for intensity, such as heavy ropes, kettlebell deadlifts, hand walk ups on unstable surfaces, farmers walks, etc. If limited equipment is available (on field, etc.) most of the intervals are body weight.

Although I can’t state there are unique physiological benefits from an interval model, theoretically it shares the same benefits of increasing heart rate, blood flow, increased neuromuscular recruitment, provide the ROM demands of the activity, and most importantly, being interesting and challenging enough to get the central nervous system fired up and therefore “wake” the athlete up for training. If I’m honest, it’s not really much different than most dynamic warm-ups except earlier increases in intensity and using a timer rather than reps and sets. But that’s what makes it different from a psychological perspective. Just having the warm-up “be different” is valuable to me, because after nearly 10 years of sets and reps of rather low intensity progressive dynamic warm-ups, sometimes you just want something different, and often times, so do your athletes.

Below is a video of a sample interval warm-up for a small group training session. Since the goal of the warm-up was to prepare for some backyard strength training, no sport specific components were a part of the training session. This session was shorter than what I typically use, consisting of 7 rounds for 3 minutes and 30 seconds of actual work. But it was still more than adequate to warm-up everyone to be able to do what they needed to do in the proceeding training session, showing how the interval model can save quite a bit of time in compressed training sessions.

Sample Interval Breakdown

**Note: With groups, it is more difficult to grade intensity of exercises since an individual starts at any station, so every exercise has to be selected as if it can be tolerated as the athlete’s first exercise if they were “cold”.

  • Weighted stair/box stepping – Hip extension patterning, unilateral & quick heart rate elevation
  • Kettlebell deadlift – Hip extension patterning, requires less spine/hip flexion than tradition DL & much lower load, and some core activation.
  • Floor mover reaches – Scapular/RC activation, some core, and mobility.
  • Floor mover mountain climbers – Quick heart rate elevation, and mobility.
  • Heavy rope battling ropes – Heart rate elevation, scapular/RC activation, and some core activation.
  • Sandbag hand walk-ups – Core activation and scapular/RC activation.
  • Isometric grip strength – This was partially a rest station, but was also to prepare for the gripping components of the training session for the day.

P.S. Yes, I love to keep it classy by shooting these videos in my trashed basement gym. The record has been a small group of 10 victims squeezed in here.