Major update 1/15/11 Alright, since I've been doing a whole butt load of this shit, and virtually everyone has the same problems, we're going to cover how to fix you up. First off this should cover 80% of guys who do lots of sitting in front of computers (all of OT) or who do too much bench (all guys who go to the gym), but ideally you need to go to a real trainer who knows what the fuck they are talking about to diagnose your specific problems. The PT at your chain gym or your average physical therapist is not going to do it. We'll cover how to find these people at the end. 4 weeks of this work has made a 90% decrease in my shoulder pain. The basic diagnosis for most dudes is something like this: If you're like most guys who've done 3 chest movements for every back movement, your chest is tight, shoulders are pulled forward. When you relax and face a mirror your palms face towards your back rather than your sides. If you sit all day for several years you generally end up with short hamstrings, weak glutes, tight hip flexors, and to much flex in the lower back rather than hips. This causes anterior pelvic tilt (your ass sticks out) back pain, knee pain, hip pain, etc. because you use hamstrings, quads, and your lower back to do work that your glutes should be doing. Trying to stretch the back or directly treat the area that hurts generally doesn't work, because the problem is more systemic. So how do you fix this? You stretch all the stuff that's tight and strengthen all the stuff that's weak. The key thing to understand with a lot of these movements is that you are fixing your brain as much, if not more, than you are fixing your body. You need to learn to use your glutes more than you need to strengthen them. This requires you to concentrate on perfect form and squeezing the right muscles. Slowing down will also help. Do a 3 count on eccentric movements, and even slowing the concentric will help you focus. Step 1: Foam Rolling Go get a foam roller. You can get them at walmart next to the yoga shit or get one online http://su.pr/2UThDL When you first try your foam roller you will think it's too hard. It's not. You'll also need a tennis ball. On a daily basis or at least as part of your warmup for each workout - Roll your feet on a tennis ball for 30 seconds each. Push down, don't be a pussy about it. - Do the same with your calves. Sit on the ground roll your calves on the tennis ball, reposition the ball as needed. - Foam roll the IT band - Foam roll the piriformis - Foam roll the quads - Foam roll/run a rolling pin on the hams (rolling pin is easier to get at) - Foam roll the scapula http://www.youtube.com/watch?v=8caF1Keg2XU&feature=player_embedded As you work your way up you can move on to pvc pipe and from large to small. Step 2: Dynamic Warmup routine - Do this before every workout. It will prevent injury and start moving things in the right direction. Doing a warmup and foam rolling will add 20 minutes to your routine, but it's worth it. If you do nothing else do this. - Glute bridges - Side leg lifts - front leg lifts - groiners - scapula wall slides - finger wall slides - pushup plus - quad stretch Step 3: Routine changes Most of you are probably doing some sort of split routine. I can post up a full routine dedicated to just this, but first we'll cover some basic changes to make to your existing workouts. Chest to back ratio: You back is way more complex than your chest. You should be doing twice as much back work as bench and that's if nothing is wrong. If your shoulder's hurt when you press or incline bench. Stop doing it. Don't think of the back in terms of just rows or pull downs. You need to work all three sets of traps as well as the rear delt, lats, and rotator cuff. Moving the scapula correctly is as important as moving the arms. Variations on your current routine Rows: Go to one arm cable rows ideally in a split step (opposite knee forward). This forces you to squeeze the glutes and core to balance while you pull. You can do these for both horizontal or pull down type movements. Squats and Deadlifts: modified single leg and/or split step These require more stabilizer and glute for balance. Additional exercises you probably aren't doing - face pulls - prone ITY - side and front bridges 2x10 - 5 second hold, 1 second rest - step ups - 2 sets, drive with the heal rather than toes, slow on the way down, squeeze the glutes, can be done weighted - external rotation/rotator cuff - pull throughs: bend the hips rather than squating, keep chest out, but don't hyper extend the lower back. EQI - eccentric quasi-isometrics I'm not the guru on these but they help stretch shit out and they will kick your ass if done right. You basically hold the bottom or mid point of a movement for 2 minutes. If you can do more than 2 minutes up the weight. You should be shitting your paints from the lactic acid at 2 minutes, but you stop if you form goes to hell. Do one set of these at the end of your workout. You will feel an immediate improvement. - Dumbell Fly EQI: hold the bottom of a dumbell fly (should feel light stretch). - Romainain Dead Lift EQI: hold the mid point of a RDL. Knees are only slightly bent, bar is slightly above knees, keep your back straight, slight stretch in the hams/glutes. Pain is your new best friend. Step 5: Lifestyle changes No amount of foam rolling will make up for 12 hour days of sitting hunched over a laptop. Set your computer on a cabinet so you can stand part of the day. Fix your position while sitting down. Save your nickels and buy a herman miller chair if yours sucks. Get up every 20 minutes, drinks some water, pull your shoulders back, move your arms out palms up, neck back, stretch. Foam roll at lunch. Put some tennis balls under your desk. Raise your monitor (phone books are usually easy to find at the office). http://opinionator.blogs.nytimes.com/2010/02/23/stand-up-while-you-read-this/ Ideally just go get a tall desk (above waist height and then get a shelf to mount your monitors at slightly above eye level). Then get a tall bar stool/chair to sit on till you can completely move off of sitting I was able to do this by simply turning my desk around backwards as it has an elevated monitor stand, that is now where my keyboard goes. Work on keeping your head back, chin tucked in, and shoulders back/down, when you're working. Just stay straight. http://trainoutpain.blogspot.com/2008/09/forward-head-posture.html http://trainoutpain.blogspot.com/2009/10/cervical-posture-and-consequences.html Step 6: Diet and supplements An anti-inflammatory diet will do wonders for your joint pain. The two most important components of this are increasing the amount of omega-3 fatty acids you consume, and reducing the amount of processed carbs you consume. Generally most of the things that make you less fat are also things that reduce inflamation and autoimmune response. What works: - Fish oil, get the entric coated kind without salmon - Lots of green vegetables, and foods low in acid - grass fed instead of grain/corn fed animals - meat lower in Arachidonic acid (avoid turkey and limit pork) http://en.wikipedia.org/wiki/Arachidonic_acid - water, obvious but everyone forgets it - fiber Stuff that is supposed to work, but probably doesn't - Flax seed: From what I've seen flax seed isn't readily converted into the stuff you can use - glucosamine chondroitin: mixed reviews, did nothing for me Step 7: Sleep I think we need to add this in here. Quality of sleep has a tremendous effect on inflamation and immune response. If you aren't having relatively fucked up dreams on a regular basis, you're sleep isn't good enough. Lack of dreaming all together is a possible sign of sleep apnea. When I got my sleep squared away, pain went down a lot. - Your room needs to be dark. Put tape over all the stupid lights on your VCR, TV, etc. Buy some heavy curtains. - Maintain air quality. A $20 humidifier goes a long way (get the kind without heat, they don't get as gross). Keep it clean and change the filter regularly. This helps especially for those with sleep apnea. The white noise from the fan also helps block other shit out. - Don't eat buffolo wings and mexican pepperoni's right before bed. - Some carbs before bed will help you sleep. - Buy a new, high quality bed that is the right stiffness for your sleep style....and replace it again when it starts to sag. For me (side sleeper) that was a soft one. If you have sleep apnea, get it taken care of. For me all it took was a daily spray of rhinocort (nasal steroid that opens everything up). For some of you it may take a cpap. But either way, stop being a fat fuck, it's not worth it. Step 8: Stress Easier said than done, but stress controls everything from your cortisol, to your shoulder structure, to your immune (inflammatory) response. Simple example: you're sad/pissed whatever. You look down more as a result, forcing your neck forward, shoulders move forward to compensate. Your ass must then move backwards to counter balance your upper body. What's this? Anterior pelvic tilt because you're having a shitty day, month, year, life. Cortisol, it's made from the same stuff that you eventually make testosterone out of. Being stressed out is keeping you from getting jacked. So my advice, whatever it is that is fucking up your life, fix it now not 10 years from now. Your job sucks, do something about it. Your girlfriend sucks, kick her to the curb. When you have the big things in your life squared away (job, house, relationships, car) you have more freedom to make drastic changes without having a lot of overhead stress distracting your from your goals. Finding a real trainer A lot of these movements require very specific form. A strength coach who is knowledgeable in rehab and corrective exercise is worth their weight in gold. What you want is essentially a physical theropist who can squat 500. They are not easy to find, but they are often surprisingly cheap. I pay $50 a session for one of the best in the country. Start at strenthcoach.com and search around. Find out who the strength coach is at your local division one school or pro sports team and ask them for recommendations. They are usually approachable and these guys often have blogs too. Go to conferences if you need to. Also check out http://www.powerliftingwatch.com/gyms for real gyms in your area. You can follow the basics, but someone who will put you on a table, measure your movement, etc. can give you a routine tailored to your problems. When you start moving correctly your lifts and progress will increase much more dramatically. If you are having regular pain, take a break from trying to add strength and focus on getting your movement right. Reference materials and articles http://www.tmuscle.com/free_online_...performance_repair/neanderthal_no_more_part_i http://www.tmuscle.com/free_online_...erformance_repair/neanderthal_no_more_part_ii http://www.tmuscle.com/free_online_...ng_performance_repair/neanderthal_no_more_iii http://www.tmuscle.com/free_online_...erformance_repair/neanderthal_no_more_part_iv http://www.tmuscle.com/free_online_...performance_repair/neanderthal_no_more_part_v http://www.synergyclinic.net/lowercrosssyndrome http://stronglifts.com/how-to-improve-your-ankle-mobility/ http://stronglifts.com/7-dynamic-stretches-to-improve-your-hip-mobility/ http://stronglifts.com/how-to-optimize-posterior-chain-power-glute-activation/ Blogs http://ericcressey.com/ robertsontrainingsystems.com http://trainoutpain.blogspot.com/ Videos worth subscribing to http://www.youtube.com/user/PerformanceU http://www.youtube.com/user/CampbellStrength http://www.youtube.com/user/RobTrainSystems The OT Generic Corrective Workout Since we have so many people with jacked backs, who can’t bench comfortably, here’s a generic corrective workout that will address the most common problems. It’s no substitute for a proper assessment, but it should work for most people. Note that you can get very strong doing this and you shouldn’t think of this as a temporary thing. Most of these movements should be included in any decent workout and will keep you lifting healthy for longer. Each day includes a main compound lift, some complimentary accessories, oblique work, and some shoulder correction. Upper back to chest volume is 2/1. Generally you will perform the first compound movement by itself (bench excluded) and then accessory work can be done as super sets of 2-3 exercises. Sets/Reps can be performed however you want. If you are not well trained, have significant issues, you’re fat, or are restarting after a long break, shoot for 3 months at high reps 8-12 low number of sets (2-3). After you’ve gotten used to some consistent volume drop it down to 5-8 reps for compound movements (ie 5x5). If you want to get strong, then use 5/3/1 for compound lifts, and 6-8 for accessory lifts. Shoulder work, particularly rotator cuff, should always be done at high reps. Do a deload week every 4th week, dropping both sets and reps, then re-evaluate your rep scheme. This will significantly increase your gains. All leg movements should be performed with knees no farther forward than mid foot (split squats, step ups). This may require you to move way down in weight (body weight in many cases). The purpose of this program is to build up your glutes, hams, obliques, etc. to straighten out your posture and take some pressure off your shoulders and knees. All upper body work is generally performed with shoulders locked back and down. Fix your form and get some mobility before you add load to bad movement (reinforcing it). Energy systems should be performed post workout if you need/want it. Suggestions: Prowler sprints Sled drags Battling ropes Kettlebell swings or snatches 20-45 seconds on off 30-90 seconds off for 3-10 sets depending on how much difficulty you want. Bare Minimum Dynamic warm-up (every day) Foam roll (upper back, IT band, glutes, quads) Clams Glute bridge Hip flexor stretch (back foot elevated, split stance) 30 seconds x 3 Pushup plus (just retract scapula in a pushup position) Thoracic Rotation 3 Day Split (bench, squat, deadlift) “Bench Day” Flat bench or whatever variant hurts least, swiss bar, floor press, close grip are all fine. If you can’t bench at all single arm grappler shoulder press is probably your best option. (Lock shoulders back and down.) Between bench sets: Band pull-a-parts (reverse fly’s if you don’t have a band) Single arm row variant (3 point, two point, cable in a split stance, or chest supported) Lift Chop Shoulder external rotation (rotator cuff) Finish with dumbell fly EQI (stretch) for time (failure at 1-2 minutes) “Squat day” Front Squats (alternatively safety bar or zercher) RDL GHR (alternatively ball leg curls) Planks (Start with regular planks for time, move to lifting one arm off the ground as you get more advanced) ITY (thumbs towards the sky, can be done on an incline bench, flat bench, or ground depending on how much difficulty you want) “Deadlift Day” Deadlift variant - Total noobs: cable pull throughs - Most of you: Trap bar deadlift - After 6 months: sumo or conventional deadlift Chin Variant (band or machine assisted if you need it, neutral grip if possible) Step ups (keep knee behind toe, focus on front leg glute, land with the heel) Split squats (Keep front knee back, sit up tall, move straight up and down, use rear glute for most of the work) Face Pulls Pallof Press 4th day/off day If you need/want another day, do some warmup and shoulder correction and light energy systems. I use this day to stay loose and help recovery. This usually works best between deadlift and squat days to give you more time to recover. Suggestions: Facepulls Curls Tricep variant Pallof Press ITY Not included anywhere in this workout for good reason: shrugs, shoulder press variants, crunches. Give all that a break and see if you feel more awesome.