Why Your Training Sucks and You Keep Getting Hurt

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Part I: Beltless Training is NOT Core Training

Alright, fellow lifters of heavy things…I’m back! After a long hiatus from writing for LBEB due to the demands of life and residency, Dr. Meathead’s clinic is now open again for business, and I’ve returned with a very important message: your training program is bad, and that’s why you feel bad. Now don’t be offended; this may not be entirely your fault! In the era of Instagram coaches with little to no education and even less real-world experience, e-books with zero biomechanical background research, and cookie-cutter programs that don’t take anatomical interactions or recovery processes into account, it has become increasingly easy to get sucked down the rabbit hole of BS.  I’m here to drag you, kicking and screaming, towards the light.

I know, guys. Your coach is amazing. He or she is better than all the others. “He competed in that Olympic weightlifting meet that one time and has a B.S. kinesiology.” “She did 2 bikini competitions AND powerlifts, bro.” “His gym has 1.6k followers on the ‘gram.”  It pains me that I’m not joking. These are the people offering online coaching these days. They aren’t all like this, but the percentages are less than favorable. Maybe you’re one of the few with a coach who has an impressive competitive resume. Unfortunately, even that isn’t a qualification for a true understanding of human movement. “But I never would have gotten where I am without them!” You might be right about that last part, which is why you’re weak, beat to shit, and reading this article. In the upcoming series, I will be breaking down a few common mistakes often seen in programming, how they can result in pain or injury, and most importantly, how to implement simple interventions to mitigate and ultimately solve these problems. And of course, injury prevention is only one benefit. Improved performance is the goal of all athletes, and is the major outcome of addressing the aforementioned problems.

In Part I, we are going to delve into the truth and lies about “core training” (for the record, I hate that term, but it’s commonly used and that horse has been beaten enough, so I’ll use it in this article). Before we start with the basic anatomy and biomechanics behind trunk stabilization, let’s get something out of the way: THE ABILITY TO PERFORM HEAVY COMPOUND MOVEMENTS BELTLESS WITHOUT SHOOTING YOUR SPINE OUT OF YOUR BUTT DOES NOT MEAN YOU HAVE A STRONG OR STABLE CORE.  That’s right. Your beltless training is NOT sufficient core training. I will go into more detail later, but I cannot be any clearer on this point. Now, as always, we will start with a quick anatomy lesson (and don’t forget to review your anatomic terms beforehand if needed: https://en.wikipedia.org/wiki/Anatomical_terms_of_location).

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The abdomen is of course, a hollow cavity that contains many of your vital organs. It also a three-dimensional structure that if properly utilized, can provide immense amounts of stability for the axial spine and limbs via intra-abdominal pressure (IAP). It is bordered by the abdominal wall anteriorly, the lumbar spine and associated muscles posteriorly, your diaphragm superiorly, and your pelvic floor inferiorly. Each of these borders must work in conjunction with the others for optimal performance and effective injury prevention. There are multiple layers that encase the abdominal cavity, but for our purposes we will focus on only the muscular layers, as those are the ones we can actively improve in the gym.

The first layer worth mentioning is the most anterior and superficial, composed of the rectus abdominis within the rectus sheath. These are your “six pack” abs (or in most of the readers’ cases, the abs protected by your power bellies). While the rectus may be the money maker in Hollywood and on the bodybuilding stage, from a performance standpoint, it isn’t terribly important. Its primary function is to flex the trunk, with some small action in stabilization and anti-rotation. Although it is lower on the totem pole of stability and functionality, this does not mean the rectus should not be trained, as we will discuss below. Remember, the muscles of the trunk are a unit! Extending laterally from the rectus are the external obliques with the internal obliques deep to them. These muscles provide a tremendous amount of rotational and lateral stability, acting as side-benders, rotators, and anti-rotators. This last function of the obliques, anti-rotation, is arguably the most crucial to performance. By preventing excessive rotation of the trunk under load, the entire structure of the body is more stable and can exert force in a singular vector. More on that later. The last of the commonly discussed “core” muscles is the transversus abdominis, which is the deepest muscular layer of the anterior abdominal wall and meets up with the fascia of the psoas and quadratus lumborum posteriorly. The action of the transversus is to compress the abdominal cavity, which means this is one of our big guns when it comes to creating that IAP that all us lifters love so much.

Moving on to the posterior abdominal muscles, we have the quadratus lumborum (or QL), the illiacus, and the psoas. The QL is a multifunctional muscle, as it can side-bend the spine, extend the spine, elevate the hip, and fix the 12th rib during exhalation. You can likely understand why all of these are important to stabilizing the trunk. The illacus and the psoas come together distally as the illiopsoas and act primarily as hip flexors, but also aid in trunk flexion. Now if you’re thinking that these don’t sound like direct core stabilization actions, you’re correct. However, because the psoas originates in the lumbar spine, when it is tight (and likely weak), it pulls the lumbar spine anteriorly. This results in a weakening of the overall trunk stability as the transversus must now overcome this anterior force when trying to compress inward and generate IAP. Couple this with the likely anterior pelvic tilt that nearly always results from psoas hypertonicity, and you’ll be in the fast lane towards missed lifts and low back pain before you know it.

If you thought we’d be done using fancy terms of location and talking about force vectors now that the anatomy class is over, you’re wrong. Don’t worry though, because now it’s time to actually apply all the BS I just spouted off to make myself seem credible. Wait, did I say that out loud? Anyways, now that we’ve laid down some groundwork, I can explain why trunk stabilization is among the most important things you can train as a strength athlete, and why it needs direct attention in every training program.  Let’s take your average intermediate powerlifter. He’s done a few meets and has a few years of lifting under his well-worn lever belt. He’s starting to push some bigger and bigger numbers, but he can’t seem to stay healthy.  He hurts his shoulder, then his back, then his knee. What gives? He’s doing all the mobility work he can find, his technique is pretty solid, and he hits his accessory lifts hard. He also likes to post videos of himself deadlifting without a belt and “#thisismycoretraining” in the caption. He can pull 500lb with no belt and his back doesn’t tweak during the movement, so doesn’t he have a strong and stable trunk? Let’s unpack this a little bit. His bench technique is excellent and he stays away from low-bar squatting too far out from meets, and his shoulder hurts. His back never rounds when he pulls or squats, but it still aches. His knees never cave on squats, but they feel beat up.  Some would say that it’s just the ravages of the sport, but does it need to be?  Wouldn’t it be better if the forces from his lifts could be absorbed by stronger, larger areas of his body than the fragile joints of the knee, shoulder, and spine? That’s where trunk stability comes in.  The trunk is the platform off of which we push or pull, regardless of the movement. It is where our exertion of force on the bar starts, and where the majority of the opposing force ends. If that platform is unstable and can’t absorb all of those external forces, they have to go somewhere. That rotation, flexion, or extension that the trunk musculature isn’t stopping will wind up happening in a smaller, more injury prone joint.  For better or for worse, the human body is a phenomenal compensator.

Take my long-time nemesis, the overhead press, for example.  If you need me to explain why stability from the ground up is needed for pressing a heavy implement overhead, you might be hopeless, but I’ll take you through a rep anyways. With the bar resting on the deltoids, you take a deep inhale and set your transversus abdominis to establish that IAP. Now you’ve got your internal weight belt on. It’s a good thing you’ve got strong and stretched illipsoas muscles, because you didn’t have to work as hard to get set. You start your press, and like all of us, one arm is slightly stronger than the other, so that side goes up a little bit quicker. You feel your hips start to shift and your trunk start to side-bend, but you can’t really stop it because you don’t train your obliques. Of course, because they are “mirror muscles” and you’re “not a bodybuilder.” Now you’re not going to miss this lift, so you keep powering through, even though the bar is now uneven. Your scapulae start to shift awkwardly and you feel your weaker arm lagging even further. All of the sudden, there’s a pop and you drop the bar. Congrats, you just tore your rotator cuff, and it had nothing to do with your shoulders being weak or immobile. Due to a lack of trunk stability, the body overcompensated for the slightly diagonal shift in force vector, placing the stress on a small structure not designed to support that kind of load.  The same types of issues occur in the squat and deadlift, leading to knee, back, and hip injuries. We are all slightly unbalanced, but when we don’t have the oblique strength to stop rotation or side-bending, the psoas strength and flexibility to diminish anterior tilt, or the QL strength to reduce unwanted spinal flexion, this lack of balance can result in significant long-term morbidity.  Even the poor rectus, demonized by so many modern strength coaches needs to be strong enough to handle its share of the load. Simply doing a few extra sets without a belt on doesn’t provide enough stimulus to effectively strengthen any of these muscles (never mind the fact that a weight belt is a tool for increasing numbers, NOT for preventing injury in the first place). When all of these muscles are working in concert, heavy weights are bound to be lifted.

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So what are we going to do about your weak trunk? What’s step one to make your training suck less so that you can actually make it through a training cycle and perform effectively in competition?  Unlucky for you, I’m not going to give you some one-size fits all, magic mobility movement to rid you of imbalances, poor strength ratios, and limb length discrepancies. You are not a lithesome lion or any other type of well-stretched feline. But lucky for you, it’s actually simpler than all that. We just have to approach it systematically and address each action of the trunk musculature individually. Don’t forget, however, that like any other muscle group, the trunk needs recovery too, so don’t just throw core work in at the end of each session and expect to make optimal progress. Adding in a few of the following exercises two to three session per week (maximum) should be sufficient. Leave them for the end of your workout so a fatigued core doesn’t compromise your heavy work and put you at risk for injury.

Let’s start with the rectus and trunk flexion. I know, flexion = bad and extension = good, but that isn’t always the case. You can have too much of a good thing, so in an effort to help you maintain a neutral spine, I suggest you train your rectus. It gets hit by a number of common exercises, but arguably the best bang for your buck is the ab rollout. This movement is easily scalable (knees to standing, changes in tempo, adding a weighted vest), doesn’t require much teaching, and needs little equipment. You can do it with an ab roller or a barbell, but I prefer the ab roller as it allows you to change directions and move diagonally to hit the obliques. Due to the stabilization aspect of the movement, it performs a similar function to the plank as well. It is essentially both a dynamic and static core movement because of this, and trains the rectus, obliques, transversus, and even the posterior core musculature due to the load placed on the spine. It also helps with thoracic stabilization due to the movement of your upper back. A word of caution, however: be sure to scale the movement to your ability and control it at the end of the range of motion. It doesn’t take much to hyperextend your lumbar spine in that position and wind up creating more business for me. Other good rectus exercises are Stir-the-Pots (courtesy of the man himself, Dr. Stu McGill), dead bugs, hanging leg raises, and GHD situps (especially if your sport puts these in WODs). Just don’t do any crunches. Please.

The obliques are up next, and in addition to tweaking the ab rollout like I mentioned in the previous paragraph, there are a few other great movements to improve your ability to rotate, anti-rotate, and side-bend. One is the Pallof press, a favorite of physical therapists that also has benefits for shoulder stability. Simply take a band, wrap it around a rack, and grab it with your shoulders parallel to the direction of the band (your hand holding the band should be the one closest to the rack, with your other hand over it). Your hands should be in the center of your chest with the band stretched tight away from the rack. Now press the band out in front of you without rotating your body at all. You will feel your obliques hard to prevent rotation. Conversely, the contralateral oblique is also working to rotate your trunk, so you’re hitting both of these movements. To work on the side-bending aspect, you can move the band up or down on the rack as well.  This is another easily scale-able movement, as you can always get a heavier band. Try it in a half kneeling position if you want to take your legs out of it and provide an extra challenge. Other movements I like for the obliques are Stir-the-Pots, Turkish get-ups, windmills, rotational medicine ball slams/throws, side planks, and sunrise planks.

Speaking of planks, let’s talk about the transversus. This is both an easy and a difficult muscle to train, and does actually get some real benefit from beltless training. However, it should get some direct work as well. Planks are good way to go about this, but I’ve found that too many people graduate from planks too quickly. Adding a movement component like in a sunrise plank or gator walk can help make it more difficult, but I’d argue the plank isn’t as optimal a core exercise for strength athletes as some others. However, it’s easy to add into your training and doesn’t tax your recovery systems much, so if you like them, go for it. If you’re really interested in ramping up your trunk stability though, Stir-the-Pots are where it’s at. You’ll need a Swiss ball/stability ball for this (Oh, the horror!). Simply put your elbows on the ball as if you were in a plank position, and rotate them around like you’d stir a pot of stew. It’s a good bit harder than it sounds, and I highly recommend watching some Youtube videos beforehand. Actually, you should probably do that for all these new exercises so you don’t hurt yourself and make me feel like a jerk.

                Training the posterior core should already be a major part of your training as a strength athlete. Your illiopsoas and QL both take a beating from squats, deadlifts, and their accessory lifts, so I wouldn’t stress them too much. They will also get some love from these new movements you’re adding in. Don’t forget to keep your hip flexors loose though. For those of us that spend a lot of time behind desks, keeping on point with your mobility will help keep your illiopsoas from becoming a problem.

I would be remiss if I didn’t give the diaphragm itself some love when it comes to trunk and specifically, deep spine stabilization. If you aren’t already doing 90/90 diaphragmatic breathing exercises, you should be. You’re probably breathing wrong. That is a topic that requires its own article, and has already been discussed in depth by biomechanists more skilled and more knowledgeable than myself. Look it up as soon as you finish reading this.

Now my strong(wo)men and functional fitness athletes out there are probably saying, “Who the heck is this guy? He just spent 4 pages talking about trunk stabilization and didn’t even mention how awesome loaded carries are!” Cool your jets, Turbo. Of course loaded carries are great. They stress a level of dynamic core stability that is hard to match. However, they can also be very taxing on your recovery systems, especially if done with heavy loads. Ever try to have a good training session the day after doing heavy yoke walks? Not happening. Performing light carries, especially overhead or with a bottoms-up kettlebell, to close out your training session is a much better way to add them in. But if you’re a strong(wo)man or functional fitness athlete and carries are already part of your normal training, I wouldn’t recommend adding any more. That’s where the direct core training movements I mentioned before can be useful.

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So now that you’re armed with knowledge, hopefully you can implement some of what we’ve discussed and suck a little bit less. Remember, the best athletes are the ones that stay healthy the longest, and the road to mediocrity is paved with injuries.  A strong and stable trunk is a good step towards preventing them and improving your performance. Be on the look out for Part II of this series, focusing on the shoulder, coming soon.  Stay strong and healthy, my friends. And try not to suck.

 

DISCLAIMER: None of this article is intended to be taken as medical advice. If you have any questions or health concerns, please contact your primary care physician. Always consult a physician before starting any diet or exercise program. These statements have been made by a private citizen and do not reflect the views or policies of the United States Navy.

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Dr. Seth Larsen is a Doctor of Osteopathic Medicine and resident physician in family medicine with an area of focus in musculoskeletal and sports medicine. He is also a former NCAA football player who now competes as a nationally-qualified lightweight (<200lb) strongman, elite-level deadlifter, and amateur highland games athlete.

 

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