9S/2
STRENGTH &
SUPPLENESS
Copyright © 2020 Z-Health Performance Solutions, LLC
How Do You
Define
Strength?
Let’s Begin With Neurology Simplified
The Nervous System Does 3 Things
1. Receives Input (Afferent)
2. Decides What the Input Means
and What to Do About It
(Processing)
3. Creates Motor Output (Efferent)
Let’s Begin With Neurology Simplified
1. The Right Cortex Does 2 Things:
• Controls Voluntary Movement on the Left Side of the Body Via
the Motor Cortex
• Sets the “Tone” of the Right Side of the Body Via the PMRF
2. The Left Cortex Does 2 Things:
• Controls Voluntary Movement on the Right Side of the Body Via
the Motor Cortex
• Sets the “Tone” of the Left Side of the Body Via the PMRF
Let’s Begin With Neurology Simplified
All Sensory Input
Eventually Goes to
the Contralateral
Cortex, Except Smell
Strength Neurology Basics
1. Increased Neural Drive
2. Improved Reflexive Tone
Final Common
Pathway of
Movement
1.
2.
3.
4.
5.
6.
7.
Cortex
Basal Nuclei
Thalamus
Midbrain
Pons
Medulla
Cerebellum
Cerebral Cortex
The cerebral cortex decides and implements
voluntary movement. If a ball is coming
toward you the cortex does four things:
1. Has the THOUGHT to catch the ball.
2. DECIDES to perform the movement.
3. CHOOSES the appropriate movement
(Catch it with my hand? Foot? Body?)
4. Chooses the GOAL of the movement.
Basal Nuclei
Many movement theorists refer to the
basal nuclei as the “architect” of voluntary
movement. The basal nuclei:
1. IMPLEMENT the decision made by the
cortex.
2. CONSTRUCT the movement (Contract
the arm, forearm, etc).
3. Develops the SPECIFICITY of the
movement (Contract and relax
individual muscles in a specific way).
4. DELIVER the movement plan back to
the cortex.
Cerebellum
As we have discussed in multiple courses, the
cerebellum is responsible for the ABC’s
(Accuracy, Balance and Coordination) of skilled
movement. On a deeper level you can think of
the cerebellum doing the following:
1. SUPERVISING the movement by checking on
the performance of each muscle, comparing it
to the plan.
2. ALTERATION of the movement is there is a
deviation from the plan.
3. CORRECTION of the movement until the
original goal is achieved or abandoned.
The PMRF
The PMRF
1. Pain - Inhibits pain on
ipsilateral side of the body.
2. Autonomics - Controls
Sympathetic Tone
Ipsilaterally
3. Posture - Inhibits the
ipsilateral anterior muscles
above T6 /Inhibits the
posterior muscles below
T6
4. Muscle Tone – Works with
ipsilateral cerebellum to
set global muscle tone.
1.
4.
2.
3.
Posture and the PMRF
• Located in the brainstem (Pons &
Medulla)
• Part of the descending brain
pathways which cause primary
motor commands to be
combined and layered with
postural controls.
• Especially active during
locomotion and reaching activity.
Remember This!
Approximately 90% of cortical output is
dedicated to activating areas of the brainstem
that contribute to REFLEXIVE CONTROL of
posture, pain and movement!
PMRF Partner #1
The vestibulospinal tracts
contribute to reflexive
stabilization primarily through
the lateral and medial
vestibular nuclei. These are
stimulated by the otolith
organs and the semicircular
canals from within the
vestibular system.
PMRF Partner #2
The tectospinal tract travels from
the superior colliculus, through
the pons and medulla, into the
cervical spinal cord. There it
activates motor neurons of the
cervical musculature to
reflexively affect head and eye
position in response to sudden
stimulus (e.g. the startle reflex).
•
•
•
Corticospinal Tract
Origin– Premotor Cortex,
Motor Cortex, SMA, Primary
& Secondary Somatosensory
Cortex
Lateral = 90% Contralateral
Control of Voluntary, Skilled
Movement
Anterior - 10% Ipsilateral
Control of Neck and Trunk
Muscles
Cortico-PontoCerebellar Tract
•
Origin – Motor Cortex,
Premotor Cortex,
Somatosensory Cortex
•
Distributed Mainly to Lateral
Cerebellum
Motor Planning
Error Detection
Error Correction
•
•
•
Cortico-OlivoCerebellar
• Inputs From Motor Cortex,
Basal Ganglia, Reticular
Formation and Spinal Cord
• Distributed to All Parts of
Cerebellum
• Receives Proprioceptive
Information
• Rhythm and Timing of
Movement
ReticuloCerebellar
• Origin – Brainstem Reticular
Formation
• Distributed Primarily to Vermis
• Involved in Integration of
Visual, Vestibular and
Proprioceptive Inputs
8 Levels of
Performance
Model
Cerebellum
Brainstem
Spinal
Cord
Thalamus
Peripheral
Nerve
Receptors
Insula
Pain &
Performance
Cortex
Strength Training is Threat Modulation
Threat Reduction
Threat Inoculation &
Adaptation
Precise, Specific,
Individualized For
Athlete's Issues
More General Training
Based On Sport
Requirements
Training Variables in the Literature
•
•
•
•
•
•
Intensity
Volume
Exercise Selection
Rest Intervals
Failure/No Failure
Repetition Speed
OB Bench 4 se
ts 5 reps 80%
1 RM 2 / 0 / 4 9 0
Deadlift 3 set
sec
8 reps 85% 1R
M 2/0/0 3 min
Basics
1. Strength, in scientific terms, is the ability to produce force.
2. There are 3 basic mechanisms inside a muscle that affect force
production:
• Length-Tension Relationship – Muscle Fibers Have An Optimal
Length for Force Production
• Force-Velocity Relationship – Muscle Fibers Produce Less Force
During a Faster Contraction
• Force Enhancement During Lengthening – Single Muscle Fibers
Can Produce 150% More Force During Eccentric v. Concentric
Contractions. Overall, We Are 125-130% Stronger When Lowering
A Weight
Strength
Specificity
Research studies have shown that strength is
gained specifically in many different ways:
•
Contraction Mode – Concentric,
Eccentric, Isometric
•
Velocity
•
Joint Angle
•
Load
•
External Load Type – Weight, Elastic
Resistance, Flywheel
•
Force Vector
•
Stability
•
Muscle Group Trained
The Key Principles
1. Strength is the mastery of
creating tension.
2. Suppleness is the mastery of
creating relaxation.
3. All forms of training are
TASK-SPECIFIC.
4. Neurologically, we can state
“The greater the load, the
greater the learning!”
5. Precision Matters.
The Key Principles
Force
Vector
Speed
Endurance
The 3 Exercise Factors
• (Neuro)Mechanical
Tension
• Muscular Damage
• Metabolic
Stress/Hypoxia
Muscular Damage
(Neuro)Mechanical
Tension
Metabolic
Stress/Hypoxia
Strength
Adaptation
Unilateral vs. Bilateral Protocol
Non-Dominant Hand Movements Involve More Bilateral Cortical Activity
Brain Region Activations & Contraction Type
• Parietal – Highest in Eccentric
• Frontal - Highest in Eccentric
• SMA – Con/Ecc & Beginning/Ending of
Isometric
Cortical Activation During Fatigue
• SMA – Highest In Isometric
• Pre-Motor – Highest In Isometric
• Central – Highest for Con/Ecc
• Occipital– Highest for Con/Ecc
• Parietal– Highest for Con/Ecc
Training to Failure
• Middle and Anterior Insular Cortex
Targeting The
Brain With
Strength Training
Assisted
Contractile
Mapping (ACM)
ACM & The ABC’s of Strength
1. The R-Phase of Contraction & Relaxation
2. If Tension = Strength the question is, “Can you tense?”
3. If Tension is the opposite side of relaxation the question is,
“Can you relax?”
4. While we EVENTUALLY want to “train movements, not
muscles” there is great danger in oversimplifying to the
point that you allow & excuse Muscle Contractile SMA.
5. ACM drills are a cornerstone of developing better body
awareness, coordination, mobility and strength.
The Basic ACM/Find the Muscle Protocol
1. Look at a picture of the muscle.
2. Visualize the action from full stretch to
full contraction.
3. Prime the sensory nerve endings of the
entire muscle via skin stimulation or
vibration.
The Basic ACM/Find the Muscle Protocol
4. Palpate both ends of the muscle.
5. Have your client begin by going into the
FULL STRETCH position using an
EXTERNAL TARGET.
6. Next continue palpating at both ends of the
muscle as your athlete performs 2-3
moderate to hard contractions of the target
muscle moving through the full range of the
action. (Make sure they use an external
target each time they move to the full
stretch position.)
The Basic ACM/Find the Muscle Protocol
7. Perform 2-3 more repetitions as you perform a
tactile “search” of the entire length of the muscle:
note areas of high and low tension.
8. Next, have your athlete perform 2-3 near maximal
repetitions, moving through the full range & action
of the target muscle. During these contractions,
you will have your fingers on the O&I of the
muscle. You will give your athlete the verbal
command: “Bring my fingers together!”
9. Finish the drill by performing 2-3 additional
contractions. In this portion of the drill, use your
fingers to facilitate any remaining areas of low
tension in the muscle.
Target Reaching for Suppleness
1. Choose the ROM to be
developed/recovered.
2. Use visual and/or tactile targets to
guide flexibility challenges, making sure
to use different initiation and return-tostart strategies.
ACM Safety Considerations
1. If your client has a history of stroke, carotid
surgeries or significant vascular disease avoid
neck ACM exercises.
2. If your client is on blood thinners also avoid neck
ACM exercises.
3. For complex muscles, use the most basic
movements of the ACM sequence at first.
4. Keep tension levels low – 3 out of 10 intensity –
until the movement becomes comfortable.
5. Add tension to contraction slowly over individual
training sessions – allowing the necessary weeks
or months necessary to perform truly maximal
contractions.
ACM Variations
1. Long-Hold Isometric
a. Internally Generated
b. Yielding
c. Overcoming
2. ACM + Banded Reflexive
Stabilization on Opposite Side of
Body
3. Explosive Isometrics
4. Stabilization/Perturbation ACM
Training Positions:
• Full Contraction
• Mid-Range
• Full Stretch
ACM Dosage
Remember that ACM is primarily for:
1. Maximizing Interoceptive Input
2. Improving the Contractile Map
You MUST FOLLOW ACM with technique practice to
help integrate the interoception and contraction
improvements into other movement patterns!
Assisted Contractile Mapping
Examples
Trapezius
Rhomboids
Post. Deltoid
Ant. Deltoid
Serratus Ant.
Pec. Major
SCM
Suboccipital
Group
Biceps
Triceps
Pronator
Quadratus
Latissimus
Spinalis
Group
Iliocostalis
Group
Gluteus
Maximus
Hamstrings
Tibialis Ant.
FDL - Foot
Loaded Mobility:
Mastering the Art
of Tension During
Movement
Band Basics – Safety First!
1. Allergies - Latex allergies and skin reactions
to bands are not uncommon. You MUST be
certain your athlete can handle skin contact
with the bands.
2. Band Integrity - Check the integrity of the
bands EVERY SESSION.
3. Band Attachments - Attach the band
correctly. Most injuries from bands come
from having them improperly attached or
held.
Band Basics – Attachment Method
Self-Attached - The easiest and
most practical form of band
training uses the athletes own
body as the anchor point for
many exercises.
Band Basics – Attachment Method
Externally Attached - When bands
are available along with solid and
safe anchor points, the usefulness
of bands increases dramatically.
External attachment allows for
multiplanar loading at every joint
and an almost endless variation of
exercises to be performed.
Band Basics – Unique Properties
• Mild Instability – Potentially
increases cerebellar demands.
• Increasing Force Curve – Minimizes
the need for deceleration at end
ranges of motion.
• End ROM Work – Provide a unique
method for safely exploring and
strengthening movement maps in
end ranges of motion that would be
dangerous with other equipment.
Bands – Axial Loading
Unilateral or Bilateral
Loading for Reflexive
Stability Training
Bands – Multiplanar Rotations
Bands – Resisted Groundwork
•
•
•
•
Rolling
Crawling
Kneeling
Ground
Transitions
Bands – R-Phase Drills
Bands – I-Phase Drills
Bands – Practical Applications
Terminal Flicks for
End Range of
Motion Training
and InternallyGenerated Blood
Flow Restriction
Bands – Load Reduction & Perturbation
Perturbation Training Protocol
1. Test an area of decreased AROM or
strength.
2. Identify the side of decreased tone
and balance for the athlete
3. Utilizing bands or hand pressure,
perform perturbation recovery
exercises for 30-90 seconds
4. Retest
Blood Flow Restricted
Exercise (BFRE):
Strength Training
Shortcut #1
The Background - Kaatsu
Originated in Japan over 40
years ago based on the work
of Dr. Yoshiaki Sato.
• He termed it Kaatsu which
translates as “added pressure.”
• Hundreds of research studies
have now been performed
demonstrating profoundly
consistent results.
•
• Large increases in muscular
hypertrophy and strength –
similar or better resutls than
standard high intensity
exercise.
• Sprain, strain and fracture
rehabilitation.
• Acute pain relief
• Increased bone metabolism.
• Faster recovery.
BFRE – How Does It Work?
There are a variety of proposed mechanisms, but a few seem to be the
most prominent. The four mechanisms below appear to act together to
produce an environment that is favorable to muscle growth with low
intensity BFRE training.
1. Fiber Type Recruitment (Fast twitch fiber recruitment)
2. Accumulation of Metabolites (Increased local acidic environment
and increased GH secretion)
3. mTOR pathway activation (Protein synthesis)
4. Cellular Swelling
BFRE – The Concept
Artificially restrict
VENOUS return in a
working limb during
exercise using
appropriately applied
bands or tourniquets.
BFRE Band Placement
1. Bands should be placed as high as
possible on the proximal working
limb.
2. In practice you should adhere to
the recognized teaching
standards of performing BFRE
either on the upper body or lower
body SEPARATELY. Do not place
bands on all four limbs.
3. Bands should be applied over
snug clothing – not directly on
the skin.
BFRE Bands – How Tight?
There are two primary measures for
identifying the ideal band tension:
1. Capillary Refill Time
(CRT Testing)
2. Exercise Response
CRT Testing
1. Test your athletes capillary refill time in the appropriate area prior to placing the
bands.
2. Place the bands and tighten.
3. Wait 20 seconds and then retest the capillary refill time. If it takes more than 3
seconds to see the blood return, the bands are too tight and should be loosened.
If there is no change in the refill time from the first test, add pressure.
4. You can also ask the athlete if they feel a strong or increasing pulsation under the
band. Usually a stronger pulsation is felt the closer you are to an optimal level of
tension.
5. Note – the pressure of the bands should not create any numbness in the working
limb.
6. During training the color of the working limb should be pink or red. It should not
turn white or blue.
CRT Testing – Upper Body
CRT Testing – Lower Body
BFRE - Exercise Response
BFRE, when correctly performed, should create significant fatigue. This can also be
used as a clear indicator of appropriate band tension. General guidelines are:
Perform 3 Sets of Chosen Exercise with 20-40% of 1RM
1. Set 1 should allow the completion of 25-40 repetitions.
• Rest period should be 15-30 seconds.
2. Set 2 should allow the completion of 10-20 repetitions.
• Rest period should be 15-30 seconds.
3. Set 3 should allow only 5-15 repetitions.
• Each set should end at close to or complete muscle failure.
If your athlete is capable of performing 25-30 repetitions in each set then it is likely
the bands are not tight enough.
BFRE - Upper Body Protocol
1. Set a timer for 15 minutes.
2. Prime the Pump – In Kaatsu training a great deal
of emphasis is placed on a priming procedure for
the working limbs prior to beginning the training
session. This is accomplished by tightening the
bands for 20 seconds followed by a 5 second
release for 4-8 cycles. Each tightening of the
band should be progressively more intense.
Conceptually, they believe that this improves
the local venous and capillary tone which
enhances the effect of the exercise.
3. Fully tighten bands to the level described above
based on CRT.
BFRE - Upper Body Protocol
4. Perform 3 sets of biceps curls using a weight equivalent to 20% 1RM.
a. If the bands are correctly tensioned your first set should be 25-40 reps.
b. Rest 15-30 seconds and start set 2.
c. Your rep range should decrease to 10-20.
d. Rest 15-30 seconds and start set 3.
e. Your rep range should decrease to 5-10.
5. Repeat step 4 with elevated or full pushups.
6. Repeat step 4 with dumbbell or band lateral raise.
7. Do not release pressure on the bands until the end of the full training period.
8. Do not leave the bands on for more than 15 minutes.
9. Each set of each exercise should be taken close to or to complete failure for
maximal results.
10.This training program can be performed 3-6 days/week.
11.The exercises can and should be changed to focus on different areas.
BFRE Lower Body Protocol
1.
2.
3.
4.
5.
6.
7.
Set a timer for 20 minutes.
Prime the pump
Fully tighten bands to the level described above.
Perform 3 sets of squats using a weight equivalent to 20% 1RM.
Perform 3 sets calf raises.
Perform 3 sets of toe raises.
Do not release pressure on the bands until the end of the full training
period.
8. Do not leave the bands on for more than 20 minutes.
9. Each set of each exercise should be taken close to or to complete
failure for maximal results.
10.This training program can be performed 3-6 days/week.
11.The exercises can and should be changed to focus on different areas.
BFRE Training Protocol – Rehab
1. Perform BFRE 2x/day (One
session should be less intense –
allowing for 20-30 repetitions
during all 3 sets)
2. Use the hypertrophy protocols
above but focused on muscles
supporting the injured area
3. Make sure to prime the pump
BFRE Training Protocol – Athletes
One unique advantage of BFRE training is
that it can be applied during technical training
drills. For elite or competitive athletes 23x/week consider using BFRE training for 1520 minutes during skill development drills.
Some examples are:
Todd Lodwick - Sochi Flag Bearer and 6X US Olympian
Using BFRE With Z-Health Coach
•
•
•
•
•
•
Sprint Technique
Cutting Drills
Boxing
Kicking
Cycling Technique
Swimming
BFRE Walking Protocol
1. BFRE walking can be a fantastic tool.
2. The protocol is very simple to apply.
You simply follow the initial steps
listed above in the lower body
hypertrophy section.
3. Once the bands are applied and
primed, have the athlete walk for 1520 minutes. This is particularly
effective in individuals who are new to
exercise or are rehabilitating
dysfunctions from disuse.
BFRE – Internally Generated
Protocol #1
1. Perform a mid-range isometric hold of
the lift for 20-60 seconds.
2. Immediately perform a standard set.
3. End with another extended isometric.
4. 1-3 Sets
BFRE – Internally Generated
Protocol #2
1. Perform a 60 second active
stretch of the working muscles.
2. Immediately perform a standard
set.
3. Move immediately back into the
stretch position and hold for
another 60 seconds.
4. Aim for 2-5 Sets.
BFRE– Contraindications
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Coronary Heart Disease
Unstable Hypertension
Vascular Disorders – Deep Vein Thrombosis/Blood Clots
Varicose Veins
Hemophilia
Marfan’s Syndrome
Diabetes/Reduced Peripheral Blood Flow
Prior Stroke/Heart Attack/Aneurysm
Blood Thinner Medications
Medications That Increase Clotting Risk
Pregnancy
Post-Surgical – Do not perform BFRE for 4-6 weeks after any major surgery. After smaller
(arthroscopic) procedures wait 1-2 weeks.
13. History of Rhabdomyolosis
Note: These contraindications apply to External BFRE devices – not necessarily internally
generated occlusion.
BFRE Training Notes
1. It is quite likely that some of your clients
will have petechia form when they first
use BFRE. These look like red pin pricks
below the level of the band and will
typically disappear within 48 hours. This
is an indication of decreased capillary
flexibility which will improve with the
BFRE training.
2. You should warn your clients in advance
that their arms will change color during
the exercise and that this is normal.
BFRE – Explaining To Clients
1. BFRE mimics the effects of high intensity weight training by decreasing
oxygen to the working limbs.
2. This more quickly recruits Type 2 muscle fibers which are usually the
HARDEST fibers to recruit with normal training.
3. The local hypoxia also increases secretion of hormones that are associated
with the positive effects of exercise including: growth hormone, adrenaline
and IGF-1. There is also evidence that BFRE training reduces cortisol levels.
4. Finally, there is also some research that indicates that BFRE can mimic the
effects of high-altitude training and mildly increase hemoglobin levels in the
blood – making for a more efficient cardiovascular system.
5. While you will feel most of the “work” happening locally, the effects of BFRE
are body-wide. This means that you will see effects on the core muscles of
the body as well as the extremities.
BFRE – Potential Dangers
1. Can cause significant increase in
systolic blood pressure during
training.
2. There are case reports of
excessive application of BFRE
causing rhabdomyolisis requiring
hospitalization in a few athletes.
3. Some physicians have raised
concerns about use of BFRE in
clients who have cardiovascular
disease.
BFRE Updates
1.
2.
3.
4.
5.
6.
7.
8.
9.
Use in Rehab Protocols
Walking
Different Band Widths
Pressure and Workload
Interval Training
BFRE with EMS
Improve Strength and Aerobic Capacity at Same Time
Improves VO2Max
Improves 100m Sprinting
BFRE Updates
Current evidence suggests that low-load resistance training with BFR can enhance
muscle hypertrophy and strength in well-trained athletes, who would not normally
benefit from using light loads. For healthy athletes, low-load BFR resistance
training performed in conjunction with normal high-load training may provide an
additional stimulus for muscular development. As low-load BFR resistance
exercise does not appear to cause measureable muscle damage, supplementing
normal high-load training using this novel strategy may elicit beneficial muscular
responses in healthy athletes.
Blood flow restricted exercise for athletes: a review of the available evidence.
Scott, BR, Loenneke, JP, etal. Journal of Science and Medicine in Sport
Volume 19, Issue 5
Read This
Article
Ischemic PreConditioning for
Resistance Training
• 4 Cycles
• 5 Minutes of Occlusion (220 mm Hg)
• 5 Minutes No Occlusion
•
•
•
•
Total Volume Performed
IPC = 46,170 kg
Control = 34,069 kg
Cuff = 36,590 kg
Ischemic PreConditioning for
Exercise Performance
• Better For Healthy
Individuals To Enhance
Performance
• Not As Useful In Elite
Athletes
Ligaments: Anatomy & Neurology
The Ligament
Link
•
One specific type of body tissue that
is of extreme importance in our
discussion of strength and suppleness
are ligaments.
•
Ligaments are tough bands of
connective tissue that generally
connect bones to other bones.
•
They are the largest contributor to
stretch resistance in the human body
and because they are highly
innervated are primary “threat
receptors” in most movements.
•
This makes ligaments excellent
targets for assessment and drills in
order to improve strength and range
of motion as well as reducing pain.
The Ligament
Link
• Found in every joint in the body – usually
several are found around every joint.
• Function as the key restraints and guides to
bone motion providing stability
• Highly responsive to any type of joint
distraction
• Ligaments function as sensory organs
• Provide input to the CNS regarding
sensation
• Contribute to reflexive and
synergistic muscle activation
• Based on ligament shape, different bundles
are recruited at different joint angles.
How Ligaments Work
Solomonow, M. Ligaments: A source of musculoskeletal disorders. 2008
Can You
Strengthen
Ligaments?
• Yes
• They are adaptable to stress –
like other body tissues.
• Moderate exercise with high
numbers of repetitions,
coupled with rest and
recovery have shown that
ligaments can hypertrophy
over time.
Ligament
Neurology
•
•
Mechanoreceptors typically found in ligaments
include:
•
Pacinian (Highest %)
•
Golgi Tendon Organs
•
Ruffini Endings
•
Free Nerve Endings
Research demonstrates that damaged ligaments
can impair:
•
Joint Kinesthesia/Proprioception
•
Reflexive Responses to Joint
Loading
Ligamento-Muscular Reflex
1. First suggested in 1900. Confirmed in
1987.
2. Ligament stimulation can cause
reflexive activation OR inhibition of
muscles surrounding the joint.
3. The goal of this reflexive activation or
inhibition is to preserve joint stability.
4. Newer research indicates that
ligamento-muscular reflexes may also
engage to promote stability at distant
sites (e.g. knee ligaments promoting
maintenance of foot arches)
Ligament Technique - Pinning
1. In most slow movements ligaments are primarily stressed at
their bony insertion points.
2. Because these insertion points are a joining of two different
types of tissues this is the location of greatest tissue
weakness.
3. Neurologically this means that the bony insertion areas of
ligaments are primary sites of threat signals to the CNS.
4. One very helpful process to reduce these threat signals it so
manually “pin” the ends of the ligament, using either your
hands or appropriate tools, to the underlying bone while the
athlete performs the challenging movement.
5. Often, this simple application of pressure will decrease
dysfunction. If this proves successful, the athlete can be
taught how to replicate the procedure at home, or tape and
other tools can be applied
Ligament Technique - Spreading
1. When you evaluate the structure and function of
ligaments, what you will find is that during the
stretch of a ligament it narrows longitudinally.
2. It is this narrowing that causes firing of both
mechanoreceptive and nociceptive nerve endings
within the ligament.
3. As with the technique above, manually
“preventing” the longitudinal narrowing of the
ligament as the athlete moves can also be an
amazing tool for improving results.
4. This process can be performed manually or with
appropriate tools.
Medial Collateral Ligament - Spreading
Lateral Collateral Ligament - Spreading
Calcaneofibular Ligament - Spreading
Deltoid Ligament - Spreading
Deltoid Ligament – With Tools
Coracoclavicular - Spreading
Medial Collateral of Elbow - Spreading
Lateral Collateral of Elbow - Spreading
Copyright 2017 © Z-Health Performance Solutions, LLC All Rights Reserved
Tendon Neuroplastic Training
1. Brain-Based Visuomotor Training
For Tendinopathy
2. Takes Approximately 4 Weeks
3. Focus Is On Corticospinal
Excitability and Inhibition
4. 60 BPM Using Metronome
5. Isometric 4x45 Seconds
6. Isotonic 4 Sets x 8 Reps
• 3 Second Concentric
• 4 Second Eccentric
7. Relatively High Load
8. Test Visual Cues, Auditory Cues
and/or Both
9. Begin Training CONTRALATERAL
To Painful Side
Self Pacing
Does Not
Work In
Research
Tendon Neuroplastic
Training
• Brain-Based Visuomotor
Training For Tendinopathy
• Takes Approximately 4
Weeks
• Focus Is On Corticospinal
Excitability and Inhibition
• Based on Research by Dr.
Ebonie Rio
Effect of
Unilateral
Strength
Training On
Contralateral
Limb
The Performance Continuum
Strength
Suppleness
Suppleness
“The level of joint mobility generally relates strongly to
sporting proficiency. The higher the level of sporting
proficiency, the greater is passive and active flexibility. Static
and passive stretching enhance passive flexibility, but only
moderately improve active joint mobility, which is by far the
most important flexibility quality needed in sport.”
- Mel Siff, Supertraining
Suppleness Defined
Suppleness means that something yields or
changes readily or is adaptable to new
demands. This term was chosen very
specifically in the Z-Health curriculum to
emphasize the quality of movement and NOT
simply flexibility. Traditionally in Z we have
defined suppleness this way:
Maximally efficient motion performed on
demand, in any direction, at any speed,
characterized by smooth transitions between
movements.
Suppleness Demands
1. Excellent Motor Control and Coordination – This requires optimal
functioning of the voluntary and reflexive stability motor loops in the
nervous system.
2. Speed of Movement and Transition Control – These skills are most often a
reflection of strength in the required positions and ranges of motion.
3. Active and Passive Ranges of Motion - Full ranges of motion for required
activities in all directions, which requires a blend of anatomical flexibility
combined with the ability to control muscular tension and relaxation.
Research
Findings on
Muscle
Relaxation
Key Brain Areas
Muscle Relaxation
• Primary Motor Cortex
• Pre-SMA
• SMA
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DLPFC
ACC
Basal Ganglia
Cerebellum
Research Findings on Muscle Relaxation
• Muscle relaxation in one limb (arm)
suppresses muscle activity in the
ipsilateral limb (leg).
• Relaxation and Go/No-Go tasks
appear to partially overlap.
• Use Anti-Saccades and Go/No-Go
Drills to Enhance Relaxation
Competency
Crossbody
Effects of
Relaxation
Identifying Suppleness Deficits
The identification process begins with basic
movement analysis including:
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Gait Analysis
R-Phase Drills
Functional/Athletic Movement Drills
Activities of Daily Living
If you remember the concept of arches vs.
angles from both R-Phase and S-Phase
assessment processes, you already have
the idea because generally where we see
“angles” in movement, we are seeing a lack
of appropriate suppleness.
Fixing Suppleness Deficits
1. Improve motor control and
coordination utilizing appropriate
mobility drills at END RANGES
OF MOTION.
2. Improve strength in the newly
rediscovered ranges of motion or
movement patterns utilizing
isometrics, bands or other low
threat approaches.
3. Apply specific flexibility drills to
areas that are unresponsive to the
above, or in areas where
anatomical tension appears to be
the limiting factor.
Suppleness
Motor Control
and
Coordination
Full ROM
Strength
Neuroanatomic
Flexibility
Neuroanatomic Flexibility Defined
Dynamic Flexibility - Dynamic flexibility (also called kinetic flexibility) is the ability to perform
dynamic (or kinetic) movements of the muscles to bring a limb through its full range of motion
in the joints.
Static-Active Flexibility - Static-active flexibility (also called active flexibility) is the ability to
assume and maintain extended positions using only the tension of the agonists and synergists
while the antagonists are being stretched. For example, lifting the leg and keeping it high
without any external support (other than from your own leg muscles).
Static-Passive Flexibility - Static-passive flexibility (also called passive flexibility) is the ability to
assume extended positions and then maintain them using only your weight, the support of
your limbs, or some other apparatus (such as a chair or a barre). Note that the ability to
maintain the position does not come solely from your muscles, as it does with static-active
flexibility. Being able to perform the splits is an example of static-passive flexibility.
Dynamic Flexibility
Static-Active Flexibility
Static-Passive Flexibility
Neuroanatomic Flexibility
• Dynamic flexibility is the most important form for sports.
• Flexibility is speed and position-specific.
• There is only a 40% correlation between static and dynamic flexibility.
• There is often a very large gap in athletes between their Active and
Passive flexibility, which is called the active flexibility deficit. The
active flexibility deficit is the difference between passive and active
ranges of motion. For example, if an athlete has a passive leg flexion
range of motion of 150 degrees and an active leg flexion range of
motion of 100 degrees, then the active flexibility deficit is 50 degrees.
We call this deficit – THE GAP.
Why Is The Gap Important?
This gap is of concern for several
reasons because the gap represents:
• Range of motion that is
available primarily thru
momentum.
• An active contractile map
deficit or weakness.
• Area of high potential threat
because of sub-optimal
predictive ability.
• Increased injury risk.
Passive ROM
Close The Gap
Active ROM
Neuroanatomic Flexibility Challenges
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The vast majority of research into improving flexibility shows that
there is very limited improvement in pure anatomical flexibility from
most approaches.
The Cochrane Database states that clinical stretching has limited
contribution to the recovery of movement range in many
musculoskeletal conditions:
• Immediate increase in ROM: 3°
• Short-Term increase in ROM: 1°
• Long-Term increase in ROM: 0°
Why Is It So Difficult?
1. The primary reason for this poor
response is that it is very difficult to
ACTUALLY stretch most of the tissues
of the body intensely or long enough in
a typical training environment to create
plastic deformation.
2. The tissues that appear to be the
limiting factors on our anatomical
flexibility are:
a. Joint Capsule 35-47%
b. Muscle
41%
c. Tendon
10%
d. Skin
2-11%
The Good News!
1. Most studies at this point indicate the
majority of improvements in ROM from
stretching is PRIMARILY DUE TO AN
INCREASE IN STRETCH TOLERANCE as
opposed to any significant change in tissue
length.
2. With all of the above in mind it is vital to
consider improving flexibility in a new light
– it needs to be position, speed and
activity-specific and the primary target of
stretching is our PERCEPTION of the
stretch which lives in the brain.
Fixing Neuroanatomic Flexibility Gaps
Use 8 Levels
Model to
Improve Stretch
Tolerance
Strengthen The
New ROM in
Multiple Planes
Apply External
Target Reaching
Strategies
Fixing Flexibility – The 8 Level Model
When an athlete stretches to the point of discomfort
this activates nociceptors in the stretching limb. These
sensations will be carried in the spinothalamic tracts
AKA the anterolateral system to the sensory cortex of
the parietal lobe. Knowing this pathway allows for a
wide array of different stimuli that can be applied JUST
BEFORE OR DURING A STRETCH in order to decrease
the impact of the nociceptive signals. Some examples
are:
• Vibration
• Light Touch
• Deep Pressure
• Visual Stimuli
• Vestibular Stimuli
Fixing Flexibility – Target Reaching
Modern motor learning states that the use of external targets and movement
cues often result in far better outcomes than being internally focused on the
process of any given movement. This holds especially true for stretching.
A simplified range of motion strategy:
1. Choose the ROM to be developed/recovered. The goal here is to actually
PRACTICE the desired movement!
2. Use visual targets to guide flexibility challenges.
3. Use different initiation and return-to-start strategies.
Fixing Flexibility – Target Reaching
Fixing Flexibility: Strengthen the New Range
1. Use other techniques to achieve the
desired new range of motion.
2. Perform multi-planar long-hold
isometrics for 30-90 seconds in each
direction.
a. Flexion
b. Extension
c. Abduction
d. Adduction
e. Internal Rotation
f. External Rotation
3 Critical Factors
Fixing Flexibility – How Much & How Often
Repetition & Overload – A few minutes of general stretching cannot
overcome thousands of limited range of motion movements performed
daily. If your athlete has decreased hip extension on the right during gait –
a few minutes of work on those unruly hip flexors per day is unlikely to
create significant long-term improvement. Practically speaking this means
we need to create opportunities for our athlete to achieve hundreds or
thousands of better steps each day.
Specificity –Based on current research there appears to be little transfer
for stretching techniques and exercises that are dissimilar in goal and
movement characteristic.
Fixing Flexibility – An Example
Walk 3km Keeping Heel of Tight Side Shoe
on the Ground as Long as Possible 25
Reps Per 100 Steps
Task External
Specific Focus
Novel
Suppleness Best Practices
1. Perform daily dynamic joint mobility to maximize motor control and coordination
2. Add daily dynamic stretching to improve athletic ranges of motion. This can be achieved by
maximizing joint ranges of motion in standard R & I-Phase drills.
3. For specific flexibility deficits use:
a. 8 Levels Model to improve stretch tolerance (e.g. Hands-on work, taping, wrapping,
neuromechanics, visual drills, vestibular drills, etc)
b. External targeting to improve ranges of motion
c. Isometrics and/or ACM drills to strengthen and improve stretch tolerance in the new
found range.
4. Add in daily movement practices to achieve high numbers of movement specific
repetitions.
5. Use antagonist isometrics.
6. Interset stretching may improve strength training outcomes.
7. Intermittent/Oscillatory stretching yields better and longer-lasting results in most cases.
Suppleness
Best
Practices
Suppleness
Best
Practices
New Findings on Suppleness
1. Stretching impacts the acute phase of
inflammation by reducing inflammatory
lesion thickness, neutrophil count and
increasing concentrations of inflammation
resolving mediators.
2. Fascia contains cannabinoid 1 and 2
receptors. Stimulation of these receptors
is known to decrease pain and suppress
inflammation.
3. Local vibration applied to the lengthening
muscle enhances flexibility.
4. Stretching combined with vibration may
negate loss of explosive strength in some
athletes.
Rocabado 9-Point Flexibility Index
1. Extend the first finger (2nd digit) over the back of the hand—if 90 degrees or
greater score:
____1 point left
____1 point right
2. Flex the thumb toward the forearm—if the thumb touches the forearm score:
____1 point left
____1 point right
3. Extend the arm—if 10 degrees or more of hyperextension at the elbow score:
____1 point left
____1 point right
4. Extend the leg—if 10 degrees or more of hyperextension at the knee score:
____1 point left
____1 point right
5. Flex at the waist—if you are able to touch your palms to the floor score:
____1 point
Total Points: ____
Results:
1-3 = low flexibility
4-6 = moderate flexibility
7-9 = high flexibility
Recovery – The Goldmine of Training
There is an old bodybuilder
maxim that states that “every
day is kidney day”. What this
little saying means is that
recovery is a full-body process
every day. And, most
importantly from a Z-Health
perspective, we are always
recovering from LIFE – not just
TRAINING.
Recovery – Monitoring Training Loads
There is a massive push around the world currently to quantify and understand
training loads, adaptation and overtraining in athletes and in the general public.
To date, while many methods have been tried there is no single tool or measure
that can guarantee that our athletes are always training with optimal load for
improved results. Based on decades of research and experimentation here is
what we currently recommend:
Daily Physical Assessments
• Gait
• Cerebellar and Brainstem Testing (Include visual and vestibular tests)
• Balance
• Range of Motion
• Strength
Recovery –
Monitoring
Training Loads
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One of the most consistently
successful means of tracking
athletes and their readiness
for load is the chronic use of
a tracking journal.
A good journal will track
multiple physical function
factors as well as the
athlete’s overall energy
levels and mood.
The key piece of using a
journal of this type is
consistency in filling it out
AND in reviewing it on a
daily and weekly basis.
Recovery – Weekly Readiness Tracker
1. Possible scores range from 10 - Worst to 50 - Best.
2. Remember that this is a subjective measurement process so there is no
normative data available indicating an ideal score.
3. Use the tracker as an individualized tracking tool that you CORRELATE with
what you see in training.
4. Some athletes will always give themselves a high score despite what you see in
training and the reverse is also true.
5. As you collect and analyze data over time (usually 2-4 weeks) you will find a
“sweet spot” at which the athlete performs well or where you see performance
degrade.
6. In general, we find that most athletes do relatively well in moderate-to-intense
training with minimum scores of 33-35/50.
Recovery Practices
• Sleep
• Sustenance
• Stress Management
Recovery – Stress Management
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Active Rest
Rehydration
Mobility Work
Music
Sun Exposure
Massage/Bodywork
Saunas
Epsom Salt Baths
Contrast Showers/Baths
Breathing Exercises
Pets
Inspirational Movies/Comedy
Sex
Family Time
Recovery – Getting Practical
Think Big.
Start Small.
Begin Now.
Strength & Suppleness Programming
1. Who are you training?
2. What do they want?
Programming – Client Categories
The 99% =
Non-Competitive
Athletes
The 1% =
Competitive
Athletes
Programming Challenges for the 99%
While everyone is “different”
we know that clients typically
utilize training services for four
basic reasons.
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Look Better (Body
Composition Change)
Feel Better (Pain Relief &
Injury Prevention)
Perform Better
Anytime
Look
Great
99%
Fitness
Anywhat
Anywhere
Programming Challenges for the 99%
1. The real challenge here is
that non-competitive
athletes often want better
bodies – not better skills.
2. They do not understand
that the SAID Principle
means that fitness is task
specific.
99%: Giving Them What They Want & Need
1. The basic rule is: BUILD BETTER MAPS!
2. Focus on General Physical Preparation or GPP.
3. GPP focuses on general conditioning to improve strength, speed, endurance,
flexibility, structure and vital movement skills.
4. GPP performed from a brain-based perspective combined with a better diet will
create:
• A more athletic and fit looking body.
• Improve the ability to create isolated tension and relaxation.
• Improve the ability to create tension and relaxation with movement.
• Increase motor coordination and basic “anytime” athleticism skills.
• Encompass a widely varied and novel movement curriculum that will create
ample opportunities for long-term neuroplastic change – supporting better
overall physical, mental, cognitive and emotional function.
Z-Health Movement GPP
Squatting
Lunging
Vertical Push
Vertical Pull
Horizontal Push
Horizontal Pull
Trunk Rotation
Trunk Flexion
Trunk Extension
Stabilizations (Single Leg, Kneeling,
Bridging, Rolling)
• Moving Over, Under and Around
Obstacles
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Multiplanar Reaching Under Load
Standing to Kneeling
Standing to Prone
Standing to Supine
Standing to Side-Lying
Prone to Stand
Supine to Stand
Side-Lying to Stand
Jumping (Up, Forward, Backward,
Sideways, Rotations)
• Rolling (Forward, Backward, Sideways,
Log Rolling)
• Ground Flow Sequences
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Remember the I-Phase Template!
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Foot Position
Lunge Position
Spine/Trunk Position
Head/Neck Position
Eye Position
Limb Position
Squatting Competency Chart
The Competitive 1%: Athlete Programming
The basic rule is:
Remove Roadblocks!
Competitive Top 1% Roadblocks
1. Injury - Do not let them get hurt! Most elite athletes become elite because
of their ability to show up to practice and competitions day in and day out
for years. Rather than trying to come up with some amazing new program
for them – first focus on decreasing as many movement threats as
possible and moderate their training intensity.
2. Poor Practice Habits/Technique - Teach them how to train and practice
more intelligently using the Deliberate Practice-Play-Flow model.
3. Poor (or No) Intentional Recovery - Help them learn to recover more
deliberately and efficiently.
4. Programming – Once all of the above is in process, analyze their
movement strengths and weaknesses and use ACM, Loaded Mobility,
BFRE and other tools to enhance specific 9S attributes.
Strength/Suppleness Tools
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ACM
Loaded Mobility – SelfAttached
Loaded Mobility – Anchor
Attachment
PNF Techniques
Isometrics – Yielding
(Deceleration)
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Isometrics – Overcoming
(Acceleration)
Position Specific Isometrics
BFRE Training External
BFRE Training Internal
Ligament Technique
Creating Elite Athleticism
Using Z-Health
www.zhealtheducation.com
844.584.2822
info@zhealth.net