Anatomy Lesson: The Spine

Next stop in our anatomy lessons in the ever important spine.  Check out the previous editions - Foot/Ankle, Knee, Hip/Pelvis

We all know how important our spine is for our overall function, movement, and health.  It's the chassis the makes our upright gait unique and what separates us from all other animals.  Spine health is extremely important and most of us will experience some sort of spinal pain at some point of our lives, and those of us that have experienced it will tell how debilitating it can be.  While everybody knows just how important the spine is and the role is plays, most do not know the basic anatomy and specific functions it plays, so let's take a deeper look 

The spine can be broken down into 4 main sections

• Lumbar Spine - The lumbar spine is the lowest part of the spine and consists of 5 vertebrae.  The lumbar vertebrae are the biggest and thickest vertebrae due to the fact that they bear the most amount of weight.  The lumbar spine are numbered top-to-bottom L1-L5 and naturally form lordosis or an inward curvature.

• Thoracic Spine - The thoracic spine is the middle portion of the spine and consists of 12 vertebrae.  The thoracic spine is numbered top-to-bottom T1-T12, with each progressing vertebrae, moving up the spine, getting a little smaller and thinner than the previous.  The thoracic spine naturally forms kyphosis or an outward curvature.

• Cervical Spine - The cervical spine is the upper part of the spine and consists of 7 vertebrae.  Like the lumbar and thoracic spine, the cervical is numbered top-to-bottom C1-C7.  What's unique about the cervical spine is the top 2 cervical spine vertebrae are called the axis and atlas.  These two help form the spine to the skull, and are specialized in their shapes to allow for greater movements and freedom.  Your head can move in all those different directions because of the axis and atlas.  The cervical spine naturally forms lordosis or an inward curvature. 

• Sacrum -  The sacrum connects to the lumbar spine and is situated right between the two pelvis halves.  The sacrum consists of 5 fused bones and is a wedge shape with more width at the top and it gets skinnier as it does down.  In women the sacrum is wider, and this is a big reason for the having wider hips than males.  The sacrum is naturally kyphosis or curving outward.  At the bottom of the sacrum, lies the coccyx or better known as your tailbone.

For those of you counting, that makes 24 bones articular bone - Lumbar through Cervical - and if you include the sacrum and the coccyx (together usually 9 fused bones) it makes a grand total of 33 bones.



Look at the natural curves

 
 Vertebrae Anatomy

As you can see below, here is what a typical vertebrae looks like.  The picture is a lumbar vertebrae, and as each vertebrae you follow up the spine, it becomes a little smaller and thinner.  Some main points of attention include

• Vertebral Foramen - The hole in the middle of each spine is for... you guessed it your spinal cord.

• Spinous Process - This is what gives the spine its' name.  The process or protrusion points outward and is what can be seen and felt on your spine when looking at it from behind.  It serves as a very important attachment point for many muscles and ligaments. 

• Vertebral Body - The body of the vertebrae is the largest portion of the spine, and is set inward within the body.  The body and how each proceeding and preceding vertebrae lie help it bear the brunt of the spines weight. 

• Spinal Discs - Spinal discs lie between each vertebrae and act similar to a ligament, holding the vertebrae together and providing movement and cushioning.

• Joint Facets - Joint facets are on the posterior side of the spine and act as a hinge connection between each vertebrae.  Joint facets help control movement of the spine.  

All vertebrae from L5-C3 will carry a similar structure of what was just described.  The axis and atlas carry slightly different structure, as seen below.  Like mentioned before, the unique structures of the axis and atlas provide the great ROM abilities of your head.

 

Problems

There are many problems seen at the spine, in fact 80% of people will experience back pain at one point or another.  Most of this is acute pain, but plenty suffer from chronic back pain.  The biggest culprit of spine back occurs at the lumbar spine.  Just by looking at it's position on the spine it's understandable that it often bears the brunt of problems. 

The cervical spine also incurs a lot of pain.  With this section of the spine being let's say a little more fragile, compounded by our constant poor posture, the cervical spine often recieves pain.  Your head weights between 10-12 pounds, and for every inch forward your head posture is, that put an additional 10 pounds of force on your spine!  Now take a look at someone and look how far their ears are in front of their shoulders.  For many this may be 2-4 inches, that an additional 20-40 pounds constantly being put on your cervical spine, any question while your neck hurts?

There are a ton of injuries and problems we could include with the spine, but instead we're gonna focus on two "syndromes" that most of the population has in some form of fashion.  These syndromes are often at the root of many spinal problems, so fixing them will often help with many back problems.

Upper and Lower Crossed Syndromes

Dr. Vladimir Yanda created the Upper and Lower Crossed Syndromes through his observations of patients throughout his career.  In the most basic terms he found that joint dysfunction often results in certain patterns of muscle stiffness and weakness.  These patterns of stiffness and weakness strongly correlate with postural problems and joint dysfunctions.  The whole Crossed Syndromes can be argued with the chicken or the egg debate - does joint dysfunction cause these muscular patterns or vice versa, but the reality is these patterns can indicate potential pain and injury. 

Upper-Crossed Syndrome

The upper-crossed syndromes (UCS) refers to the upper region of the spine, and while it may not directly involve the spine, it does have a tremendous impact on spinal posture and health.  UCS is characterized by a crossing pattern of weakness and stiffness. 

So for weakness in the UCS, we tend to see weak cervical/neck flexors on the anterior aspect and crossing to the posterior side we tend to see weak lower traps and rhomboids. 

For stiffness or tightness we start with the pectoralis group on the anterior aspect and crossing over to the posterior side we see tight upper traps and scapular levators. 

Just by taking a look at the picture above, what sticks out?  Obviously the posture is poor, but if you really think about it, this is the posture many of us are in for the majority of the day.  Hunched over your computer, in your car, watching TV, or eating food.  This is the position most of us take during those activities.  Not only that but when people tend to workout, what do they do?  Watch anybody at the gym and they'll most likely be doing a thousand different variations of bench while doing little to no pulling exercises.  So our daily life and what we tend to do at the gym, over time, can lead to creating the upper-crossed syndrome. 

This creates a posture of excessive forward head position, internal rotation of the shoulder, protracted, elevated, and winging scaps, excessive thoracic kyphosis, and cervical lordosis.  There are many reasons to fix this - increased risk of neck pain, joint dysfunction especially at the C4-C5 and T4-T5 regions, reduced glenohumeral stability, and half joking but half serious, trust us we when say this is not the best way to attract members of the opposite sex.

Just take a look at how one thing can lead to another in the UCS, taken directly from Janda himself

These postural changes decrease

glenohumeral stability as the glenoid fossa becomes

more vertical due to serratus anterior weakness leading to

abduction, rotation, and winging of the scapulae. This loss of

stability requires the levator scapula and upper trapezius

to increase activation to maintain glenohumeral centration

The moral of the story is weakness or tightness in one area, for whatever reason that may be, can lead to problems elsewhere.  Remember Janda and many other clinicians have seen these same common patterns in thousands of patients, and the incidence is on the rise do to many of the lifestyles common today - more sitting, less activity, improper training.

Lower-Crossed Syndrome

Moving down to the lower region of the spine and hips is the lower-crossed syndrome (LCS).  Just like the UCS, the LCS involves criss-crossing areas of weakness and tightness. 

For weakness in the LCS we see the glutes and anterior abs lacking strength. 

For tightness we see the illiopsoas/hip flexors on the anterior side and the lumbar spine/thoracolumbar/erectors on the posterior side.



(photo: www.muscleimbalancesyndromes.com)

This pattern creates an excessive anterior pelvic tilt, excessive lumbar lordosis or hyperextension, SI Joint problems (touched upon this in hip/pelvis anatomy lesson), joint dysfunctions especially at L4-L5 and L5-S1, and even moving down the chain causing knee hyperextension.

Not only that but LCS is a major culprit in hamstring strains.  How?  With LCS you get an anterior pelvic tilt due to the glutes and anterior core is weak (and this is very common) and the hip flexors and erector spine becoming tight to help stabilize the pelvis.  This anterior tilt puts an extra stretch on the hamstrings (lengthens the origin attachment point), and because the glutes are weak, the hamstrings help to pick up their slack.  So the hammies are pulling double duty - they are over worked and constantly lengthened.  Now compound this with the fact that most will stretch their hammies because they feel "tight", when in reality this is the worst thing you can do.  Next thing you know - pop! A hamstring strain, and once you have one of those suckers they linger around forever.

Joint-By-Joint

Using the joint-by-joint as a guide we see a couple of things with the spine

• The Lumbar Spine favors stability - The lumbar does need adequate mobility and as we age we often lose that mobility, but more important than mobility for this region is stability.  Remember the lumbar spine is only 5 thick vertebrae that have to withstand the weight of the whole upper body.  It needs to provide stability and control.  Problems occur when people take the lumbar spine into end-ranges of motion over and over again.  We've all heard how someone say, "use your legs not your back".  Lifting heavy weights with a hyper-flexed or extended lumbar position is asking for trouble.  Some people can get away with it due to great amounts of co-activation from surrounding muscles, but those people have usually been training for years and are super strong.  Also things like crunches or sit-ups, thousands of reps - done day after day - for years also puts a tremendous amount of stress on your lumbar spine.

• The Thoracic Spine favors mobility - With 12 vertebrae, the thoracic spine makes up a big portion of your spine, and needs mobility.  This is an extremely important area for mobility and one that is often lacking.  This lack of range of motion will be compensated for elsewhere - lumbar spine, rib cage, shoulder, etc.  While, in our opinion, everybody could use more thoracic mobility, stability at the t-spine is still very important.  Anybody who has buckled under a heavy squat, deadlift, or Olympic lift knows the thoracic spine is often the first place to give out.  Also as touched upon in the UCS, muscles surrounding the thoracic area are often weak, and this can lead to t-spine weakness or sloppiness.   

• The Cervical Spine favors stability - Look at the make-up of the cervical vertebrae and understand they are the smallest and weakest vertebrae.  They need to be stable and controlled yet many lack that strength and control.  Again lack of adequate pulling exercises and living in cervical flexion contribute to this. 

• The Axis and Atlas favor mobility - The joint are designed for freedom and movement, yet most of the time they are "glued" down.  Try this, clench your teeth together and try touching your chin to your chest.  You SHOULD be able to do this with clenched teeth, if not you definitely have lost ROM.  Hand in hand with this is loss of rotation of the head as well.  Watch how many adults cannot even turn their heads to look out their rear view window or blind spot without having to turn their whole body.  Again you should be able to turn your head so your chin is over your shoulder without having to rotate your whole body. 

Fixes

The fixes for the crossed syndromes are pretty self-explanatory - Do the opposite of what describes the syndrome.  Pair this along with continuing to relate your training to the joint-by-joint approach and your pretty set.  So let's go over some guidelines

• Upper Body Pulls - Most programs need an overhaul of pulling movements and if you aren't keeping track of the volume of pulls to pushes, your doing yourself a dis-service.  For most people a 2:1 or even 3:1 pull to push ratio will do wonders to help correct imbalances, posture problems, performance, and pain (say those p words 5 times fast).  This means adding in more rows variations and pull-up type movements.  One of the best and easiest ways to get more pulls into your life is to do 100 band pull-aparts everyday.  This advice has been around for a long time and it's priceless.  Add in some work specific to your lower traps like OH shrugs or wall slides and your set.  So to recap more rows, pull-ups, band pull-aparts, face pulls, OH shrugs, and wall slides.  Less bench replace that shiz with push-ups

• Booty Booty Booty Rockin Everywhere - Having weak glutes ain't cool, hell glutes are the new biceps.  Not only are they great for athletic performance and keeping your body safe and strong, but everybody, guy and girl, looks for a nice pairs of buns on someone.  Hit your backside from a barrage of angles with hip thrusts, deadlifts, squats, reverse lunges, back extensions, and sprints.  Also don't forget about the ever important glute med with band walks, naughty dogs, clams, and side planks.  Hey, was your dad a baker?  Because you've got some nice buns!

• Set a Foundation - This piggy backs strengthening your glutes, and it's strengthening your "core"  What's you core exactly, well we'd say everything between your butt and chest.  While some may argue the existence of an actual core, it's hard to argue that this region does not to be strong and stable.  With the core, by our definition, including everything from the rectus abs, obliques, TVA, multifidus, pelvic floor, diaphragm, QL, serratus, glutes, psoas - you can see how many different pieces of the puzzle there are and all the connections they each will branch off to.  So there is no doubt the impact this region plays on strength, posture, and health.  Attack this region with anti-movement exercises such as planks, carry variations, pallof presses, roll-outs, and bird-dogs; then target on improving your breathing patterns; and finally connect everything together with turkish get-ups, animal walks, chops/lifts, and your core lifts.

          Check out our core collection articles for a few ideas.

• Open Your Front-side - A timeless piece of advice that will never go old says this - strengthen your non-mirror muscles and lengthen your mirror muscles.  Translation, strengthen your backside, open up your front-side.  You can never go wrong with doing extra mobility/flexibility work on your quads, hip flexors, or pecs.  While parts of your backside do need to be mobile, especially the thoracic spine, it's probably best in most situations to start with specific front-side openers. 

Conclusion

We understand there is a heck of a lot more going on at the spine than just upper and lower crossed syndromes, but it's real messy getting into disc problems, facet joint problems, and degeneration.  No body really knows how to deal with those things and research is murky on what works and what doesn't work.  So for simplicity sake, we chose to stick to the crossed syndromes.  If you can work to fix and correct those problems you'll more than likely improve your situation.  And because we're of particular interest in athletes, these fixes are imperative for improved sport performance. 

Overall we want to work on improving movement patterns, body positions, and then getting strong as hell afterwards.  Hope you learned something, and until we meet again Go Get 'Em!

Anatomy Lesson: Hip/Pelvis

Up next in our series of Anatomy Lessons is the Hip and Pelvis.  Let's first set the story straight by saying these two areas are about as complicated as they come.  The hips and pelvis essentially connect the lower body and the upper body.  There is a whole mess of things going on in this area, and it's pretty dang easy to get lost.  It's like those super highway interchanges in huge cities, on and off ramps going in every which direction. 

Basically The Hip and Pelvis
(photo: myclipta.blogspot.com)

But we're gonna try and take you through some of the basics of the hip and pelvis, and hopefully leave you with a better understanding of this area.  Don't get discouraged, this is tough stuff, and even the best out there often times need a quick reminder of these things.  So let's start this crazy adventure!

Bones

• Femur - Your big thigh bone.  At the superior (top) end of the bone is the head of the femur which fits into the acetabulum of the pelvis.

       - The femur has aspects that are also very important in the anatomy and function of the hip.  One of these includes the greater trochanter, which acts as a very important place for muscle attachments. 

• Pelvis - Comprised of the ilium, pubis, and ischium.  These bones are separate from birth until puberty when they are fused together to form the pelvis.  The pubis consists of the medial aspects, the ilium consists of the upper/superior aspects, and the ischium consists of the lower, lateral aspects.  The pelvis actually consists of two haves that connect together.

• Sacrum - This isn't really part of the hip or pelvis (technically part of the spine), but it connects the two halves of the pelvis together.  It sits on the posterior side of the pelvis fitting right between the two pelvic halves.

• Coccyx - Your tailbone, bottom portion of sacrum

• Pubic Symphysis - Not a bone, but cartilaginous joint that connects the two halves of the pelvis together

(photo: thankyourbody.com)

Muscles - The hip and pelvis are crossed by a ton of muscles.  The hip/pelvis basically connects the lower body to the upper body, so many muscles from both the lower and upper bodies play significant roles in the function of this area. So without getting way to in-depth we are going to just touch upon a few of these major muscles.

• Glutes - This includes the glute maximus, medius, and minimus.  This group is responsible for hip extension, abduction, and external rotation; as well as playing a key stabilization role.  The glutes for simplicity sake connect from different parts of the illium to different parts of the femur - this connection may not be direct, but through connective tissues or other muscles.

• Illiopsoas - The group consists of the illiacus and psoas (major and minor).  This group is grouped together because they attach the anterior part of the femur to the pelvis, with the exception of the psoas which connects to the first 5 lumbar spine.  They mainly act to flex and externally rotate the hip, but also act as pelvic stabilizers and pelvic alignment.

• Outer Abdomen - There are numerous abdomen muscles that interplay with the pelvis.  The rectus abdominus, oblique complex, erector spinae, and QL all play a role in the pelvis

• Inner Abdominal Group - This consists of the transverse abdominus (TVA), pelvic floor, diaphragm, and multifidus.  They form a cylinder shape structure with the TVA providing anterior support, the pelvic floor supporting from the bottom, the multifidus acting posteriorly, and the diaphragm supporting from the top.  These boys are instrumental in respiration function as well as pelvic/spinal stabilization and control. 

• Piriformis - The piriformis runs laterally from the sacrum to the femur.  The piriformis laterally rotates the femur with hip extension and abducts the femur with hip flexion  

• Latissimus Dorsi - The lats also connect to the iliac crest.  This connection is often through thoracolumbar fascia, but it' role on the pelvis is often under-stated.  

• Quads/Hammies - As you know from Anatomy Lesson of the Knee - These muscles groups also greatly effect the hip.  Simply the quads on the anterior side of the femur act to flex the the hip, while the hamstrings act to extend the hip.  They also act as stabilizers and help control flexion and extension eccentrically at different times.   

• Adductor Group - These are the muscles on the inside portion of your leg, better known as your groin complex.  This group mainly acts to adduct the leg. 

• Reproductive Organs - Our respective reproductive organs also play a role in pelvic structure, and provide support to the bottom aspects of the pelvis

(photo: crossfitforglory.com)

(photo: www2.ma.psu.edu)

(photo: physiodetective.com)

Movements/Alignments

• Flexion - Bringing knee towards the chest or vise versa
• Extension - Straightening leg or pulling chest away from the lower body
• Adduction - Bringing the leg towards the midline or crossing over the midline
• Abduction - Pulling the leg away from the midline
• External Rotation - Rotating the femur head away from the midline.  Can also be done by keeping a fixed leg and rotating pelvis inward
• Internal Rotation - Rotating the femur head towards the midline.  Can also be done by keeping a fixed leg and rotating the pelvis outward
• Anterior Pelvic Tilt - When the top of the pelvis tilts forward.  Think about pushing your butt out to give that Baby Got Back look
• Posterior Pelvic Tilt - Top of the pelvis tilts backwards.  Think about tucking your butt under, giving you the ever dreaded flat butt syndrome.
• Lateral Pelvic Tilt - The pelvis also has the ability to tilt or rotate laterally

(photo: joegambina.wordpress.com)

Problems

• Mobility - Going by the joint-by-joint theory, the hip favors mobility, and this is true.  The hip is a very mobile joint with the ability to move in many different planes and directions.  Problems occur when we lose ROM in our hips.  It differs in everyone, but there is a good chance you are missing mobility in some movement or another. Here are some common ROM standards you should be able to achieve

• Extension - 15-20 degrees
• Flexion - 120-130 degrees
• Adduction - 30+ degrees
• Abduction - 45+ degrees
• Internal Rotation - 45+ degrees
• External Rotation - 45-50 degrees

These are normal ranges of motion, and a loss of ability to reach these ranges could lead to increased chances of injury, dysfunction, or sub-optimal performance.  But on the same token, too much ROM, could mean some joint laxity and lack of stability, which is also not optimal.  It's the whole, more is NOT necessarily better.

• Stability - While the joint-by-joint suggests the hips favor mobility, you can easily argue it needs just as much stability.  Poor control and stability at the hip will often lead to pain or increased chance of injury elsewhere.  The hips are the power house of the body, and they need to provide strength and power.  Lack of adequate strength and stability will lead to energy leaks everywhere, and will sprinkle up and down the chain and increase chance of knee and back pain/injury

• Sacroiliac (SI) Joint - The SI joint is the joint between the sacrum and the ilium.  Remember that the sacrum is sandwiched between the two halves of the pelvis, and this means there is an SIJ on each side of the sacrum.  As you can imagine, this area requires a lot of mobility and stability, as it really connects the posterior lower body to the posterior upper body.  So despite the SIJ being joined by really strong ligaments, it can often be "pulled" by so many different demands and forces that go through the joint.  The SIJ needs a great ability to move while at other times it needs to create stability.  The SIJ can be effected by the erectors spinae, glute max, thoracolumbar fascia, TVA, lats, pelvic floor, piriformis, and biceps femoris.  So as you can see, many different muscles can affect the tension and forces on the SIJ.

• Femoral Acetabular Impingement (FAI) -  FAI is an impingement of the femur with the acetabulum, caused by irregular bone formation resulting in abnormal rub or movement in the joint.  FAI results in a limitation of hip flexion, usually limiting flexion to around 90 degrees before pain or restriction occurs.  There are 3 types of FAI (compliments of Kevin Neeld and learn more here)

1. CAM impingement - Excess bone formation around the ball of the femur. Hip flexion is limited by the bony overgrowth butting up against the top of the acetabulum.
2. Pincer impingement - An over extension or growth of the acetabular hood. The femoral neck contacts the overgrowth at a lower degree of hip flexion.
3. Mixed impingement - A combination of the CAM and pincer structural deviations.

Fixes

• Mobility - A good place to start any hip program should be to work on improving ROM in all directions.  Hip mobility is absolutely vital when it comes to knee and low back health, as well as proper function of the hips. If your hips can't move properly, then your low back and knee may compensate. Everybody is different and there is a great variance in loss of ROM from individual to individual.  Have someone qualified test to see how you fair in each range of motion so you can find out which movements may be restricted.  

I've mentioned it here before, but Kelly Starrett and his MobilityWod's are one of the best      resources around.  Doing soft tissue work, to really get in and straighten some of those tissues out also works great.  Areas like the glute max and med, piriformis, psoas, and QL/thoracolumbar fascia often respond very well to dedicated soft tissue work.  Also check out articles under the Mobility Movement Tab for ideas.  Also check out these links for some other of our favorites

Quads
Extension and Internal Rotation
Adductors

• Strength - To go along with mobility, we need to be sure to add strength and stability on top of it.  No good hip program can exist without strength work of some form.  The hip and pelvis is the connection point for the upper and lower bodies, and it oftens needs great control in order for movements to move smoothly and efficiently.  As we touched upon last time in Anatomy Lesson of the Knee, the knee follows the path set by the hip.  If the hip has poor control and sets a poor path, the knee will follow and be put at an increase risk of injury.

A good start is to add "activation" or strength exercises during warm-ups or between sets, such as naughty dogs, bird-dogs, glute bridges, band walks, prone hip extension, clams, variations of farmers walks/carries, variations of chops/lifts, and animal walks.  From there your exercise program should include a good dosage of compound lifts, such as squats, deadlifts, hip thrusts, Olympic variations, single leg variations (BSS, squat, RDL).  These exercises target the strong and powerful hip musculature from different angles or vectors, this will strengthen the hips in all areas and movements.

• Core Stability - Core stability goes hand in hand with hip and pelvis stability.  Like it's been shown above, many "core" muscle interact at the pelvis and hip.  These muscles will often assist in pelvic and hip control, and keep pelvic tilt in a good position.  The preferred method of strengthening these muscles is through forms of anti-movement instead of repetitive lengthening and shortening ie crunches/sit-ups.  So things like bird-dogs, farmer walks/carries, chop/lift variations, planks, stir the pot, landmines, turkish get-ups are all great options.  Check out articles under the Core Collection Tab to get a few ideas.

• Breathing - Like most things, breathing patterns can affect the hip and pelvis.  We talked about the inner "abs" playing a key role in pelvic stability and orientation.  The diaphragm and pelvic floor (heck it's got pelvic in it's name) are respiratory muscles and often highly dysfunctional.  To go along with the above mentioned core work, which will help strengthen the other 2 inner core muscles - TVA and multifidus, direct breathing exercises can go along way in helping function at the hip and pelvis.  Remember we take 20,000+ breaths each day, that's a huge opportunity to make giant positive changes, but on the other hand, if kept unchecked, you're just putting yourself further and further behind the 8-ball.  Good overview by Paul Ingraham here

Conclusion

Whew!  There you have it, a brief overview of the hip and pelvis.  Believe us when we say we don't fully grasp everything going on at the hip and pelvis.  There are PT's and Dr's who specifically specialize in this area, and they could tell you just how complex it is.  But we gave you the basics here today, and this info should set you straight with about 80% of the stuff happening at the Hip and Pelvis. 

If you missed the first two in this series, check them out here - Foot/Ankle and Knee
Also be sure to sign-up for BBA updates on our home page and like our Building Better Athletes Facebook page so you can stay up to date with everything going on here at BBA.  So until next time Go Get 'Em!

Anatomy Lesson: The Knee

Time for another installment of Anatomy Lessons.  Last week we went over the Foot/Ankle, now we're moving up the chain to the knee.  When you think about the knee in sports, the first thing that pops into most heads is injury; and not just a little ding but season ending injuries.

The knee is susceptible to injury because of the nature of certain sports, and the because the knee is often left helplessly to follow the hip and/or left to compensate for the foot/ankle.  The knee is stuck between two joints who often leave crap behind, and the knee is forced to take much of that crap. 

"The knee is a dumb joint, the foot/ankle and hip dictate not only the position of the knee, but what it's capable of doing as well". - Mike Robertson

So while the knee is often the joint that gets injured, it's usually a result of problems seen elsewhere in the body.  But for now let's find out the nitty gritty of the knee!

Bones: Four bones make up the knee joint.

• Tibia - Shin bone
• Fibula - Smaller lower leg bone running parallel to the tibia
• Femur - Thigh bone
• Patella - Knee cap

Muscles: 

• Quadriceps - The quads are the group of muscles on the front side of your thigh.  The quad group is made up of 4 muscles - rectus femoris, vastus lateralis, vastus medialis, vastus intermedius. The quads work to extend the knee joint as well as provide stabilization.  
• Hamstrings - The hamstrings are the group of muscles on the backside of your thigh.  The hammy group is comprised of 3 muscles, biceps femoris, semitendinosus, semimembranosus.  The hamstrings work to flex the knee joint as well as provide stabalization.
• Popliteus - This muscle runs on the backside of the knee joint.  It is often thought to unlock the knee from extension during walking/running.  The popliteus assists in flexion, but also provides a rotational component to the knee.  It will rotate the tibia and femur inward during certain situations or positions. 
• Lower Leg - We're bunching these all into 1 group for simplicity sake.  The calves (gastrocnemius and soleus) and tibialis anterior also have some influence on the knee.  Aiding in flexion and extension respectively, but far far less in comparison to the quads and hammies. 

Ligaments: Ligaments connect bone to bone. They are key in stabilization of the knee

• Medial Collateral Ligament (MCL) - The MCL runs on the inside (medial) aspect knee attaching to the femur and tibia.  It prevents excessive inward movements or valgus forces.  A typical injury to the MCL will be caused by a force acting on the outside of the knee, forcing the knee inward.
• Lateral Collateral Ligament (LCL) - The LCL runs on the outside (lateral) aspect knee attaching to the femur and fibula.  It prevents excessive outward movements or varus forces.  A typical injury to the LCL occurs when a force occurs on the inside of the knee, forcing the knee outward.
• Posterior Cruciate Ligament (PCL) - The PCL is the strongest ligament in the knee, and is deep inside the knee joint behind the ACL.  Cruciate ligaments cross in the middle of the knee joint, and the PCL travels from the posterior surface of the tibia to the anterior surface of the femur.  It prevents backward motion of the knee.
• Anterior Cruciate Ligament (ACL) - The most well known, and "infamous" knee joint.  The ACL runs from the anterior surface of the tibia, to the posterior surface of the femur.  It prevents the tibia of moving forward.  Injury to the ACL is severe and can cause a recovery period of 9-15 months. 

Cartilage/Tendons: Cartilage is a connective tissue that cover the ends of the knee joint bones to help bones more freely against each other.  Tendons attach muscle to bone.

• Menisci - The lateral and medial menisci attach to the tibia on the respective outside or inside portions of the knee.  These menisci act as shock absorbers and help distribute forces evenly through the knee.  Menisci also aid in keeping the knee stable.
• Articular Cartilage (AC) - Articular cartilage is on the ends of all bones, in any joint.  So in the knee joint, AC covers the ends of the femur, tibia, and back of the patella.  AC is lubricated by synovial fluid, synovial fluid and AC create a slippery, lubricant that is 3 times more slippery than ice and even more impressive, 5 times more slippery than the road runner is to the coyote.  This combination allows the bones to move against each other freely and without pain or resistance. 
• Quadriceps Tendon - Connects the quad muscle to the patella.  It helps assist in knee extension and provides stability of the patella. 
• Patella Tendon/Ligament - The patella tendon connects the patella to the tibia, so in reality it is a ligament, but most people know it at as the patella tendon.  The patella tendon assists in knee extension and works to keep the patella stable

Common Issues

Stability + Mobility - In the joint-by-joint theory it is stated that the knee joint prefers and needs stability.  The knee is often thought as a hinge joint, with only flexion and extension movement, but the knee does have rotational components.  So while the knee does lean towards needing stability, it also needs adequate mobility. 
We definitely want to see full extension from the knee joint - a quick easy test for this is to sit on the ground with your legs extended flat.  From there, extend your knee and see if you can get your heel to come off the ground - without flexing your hip!  Essentially seeing if you can go beyond 180 degrees of extension or not.  If you can't then you A. lack knee extension ROM and/or B. lack some quad/extension strength.  Both are very important for knee health.

Stuck in the Middle - The knee is between the hip and ankle joints, and often receives the brunt of bad news if these two joints are not working optimally.  The knee often just follows suit with what occurs up at the hips.  The knee is in a position that forces it to just follow the path set by the hips and pelvis.  So while the knee may be perfectly happy and healthy, it can get pulled down by problems at the hip or ankle.

Ligament Injuries - We all know the horrible effects that a ACL or some other kind of ligament injury can have.  During a surveillance study on 100 high school from 2005-2001

• 15% of all athletic injuries were knee injuries
• Half of these knee injuries were ligamentous
• MCL was the most common injury
• Over 21% of all knee injuries were treated with injury
• Occurrence rate were higher for games than practice
• Occurrence rate for females was higher than male

Many of these are contact type injuries, where avoidance is hard to prevent.  On the other hand, we also see many non-contact ligament injuries, and these can be prevented.  Many will say these occur from an "un-stable" knee, but this is far to simplistic. The occurrence of a knee actually being "un-stable" or lax is not very common. This "un-stableness" is more likely a result of weakness or lack of mobility at the hip, ankle, or surrounding muscles. Training or continuing to allow poor knee mechanics, even if they are rooted elsewhere, is a major No-No. 

Valgus Knee Collapse - Valgus knee collapse is the term given the knees "buckle" inwards.  This collapse is a break in proper knee mechanics and puts a ton of stress on the knee joint and has been associated with MCL and ACL injuries, patellofemoral pain, IT band pain, and tibial stress fractures.  This is seen in so many athletes, and work to correct valgus knee collapse needs to be essential in injury prevention and sport performance programs.

Fixes

Hip/Pelvis Strength - Like we touched upon, the knee is often helpless to the actions and control of the hip/pelvis.  If the hip and pelvis is strong and stable and gives a good path, the knee will follow.  But if the they are weak and present a poor path, the knees can't really help but follow.  This is when bad things occur.  The knee often will see great benefits from better strength and control of the pelvis/hip and work targeted to the glute max, glute medius, diaphragm, core, hip rotators, psoas, and QL.

Ankle Mobility - Like we touched upon in the Foot/Ankle Anatomy Lesson, problems in ROM at the foot/ankle will often lead to compensations at the knee.  This might contribute to a valgus knee, or a tibial torsion, or some other compensations at the knee.

Strengthen the Quads and Hamstrings - Adequate strength and balance between the quads and hamstrings help influence stability, control, and distribution of forces among the knee.  Weakness or an imbalance between the quads and hams can alter the stability and control of the knee in certain directions or actions.  This can increase the stress seen in certain parts of the knee and over time this can add up, and lead to injury or altered mechanics.

Motor Control - Proper knee mechanics and tracking need to be taught.  Often times valgus or other compensations occur because the person is lazy or just developed poor motor control.  With young people, often just telling them to correct their mechanics is all that is needed.  They just need to know the proper technique. 

When looking at the knee from the side view, you should see the hip, knee, and ankle in a single line.  Next view from the front, it should show a relatively stacked position of the hip, knee, and ankle as well.  Depending on body types (more the case with females) you might have a natural medial alignment of the knee in comparison to the hip, but ideally the closer to stacked the better. This alignment is a great start in improving knee function and health. 

Knee ROM - Despite the tendency for the knee to be stable, we also need to make sure it has adequate ROM.  In flexion, you should be able to get your heel to your butt.  If you cannot then you are leaving performance potential on the table, as many track and field coaches have stated that if one cannot cycle their leg through close to thier butt, they will not run at their full potential.
Along with knee flexion, we need to see full extension, past 180 degrees.  Lack of extension is a major cause of concern for future dysfunction.  Check these out by KStarr and get it fixed!

Conclusion

If you take away one thing from this today, it's that problems at the knee are usually rooted elsewhere.  Whether that be the hips or ankle or pelvis or spine.  Don't always think a knee injury or problem is directly caused by the knee, mostly it's rooted elsewhere.  The knee is a conformist, it just follows what other body parts are doing.  Fix them and make them all cool and dandy, and the knee will follow suit and become part of the cool crowd. 

Well that's all we got for you today.  Hope you enjoyed, if you did be sure to sign-up for BBA updates to keep up with us here at BBA.  Until next time Go Get 'Em!


Related
Anatomy Lession: Foot/Ankle

Weekly Recap - 4/21/13

Hey, Hey BBA Nation!  Another Sunday means another Weekly Recap.  Have a lot of great stuff for you today, so settle in a enjoy!  Also be sure to check out this weeks post

Anatomy Lesson - Foot and Ankle

Also check-out the article we had posted at Tabata Times - Early Specialization?  Think Again!

Ok, enjoy!

If I Knew Then What I Know Now: Middle of the Road - Harry Selkow

A Lion In Iron: What Are You Afraid Of - Alexander Cortes

The Individualization of Team Training - James Smith

Conditioning: You're Doing It Wrong - Molly Galbraith

Considerations of Olympic Style Training on Athletic Performance - Rob Panariello

Anterior Pelvic Tilt and Lumbosacral Pain As It Relates To The Hip Thrust and Glute Bridge - Dr. Conrad Stalheim

Not Your Average BS Core Training - Ben Bruno

Fascinating Facts About Sleeping - TC

Your Job Makes You Sit? Fix It With MobilityWod

Strongkid.com - Great site for youth athletes.  Run by researcher Dr. Avery Faigenbaum, he provides great info on how youth athletes should be trained and progressed.  Check it out!

Safegaurd Your Shoulders - Keith Scott

10 Things to Stop Saying to Your Kids - Tessa Miller

10 Eating Styles Explained - Ashley Fleming

The Three H's - Morrill Performance

Knowledge and Nonsense: Food Like and Dislikes - Jamie Hale

Zero Drop: Think Before You Drop - Gait Guys

37 Ways to be a Badass - Chris McCombs

Bridging the Gap Between Yoga and Movement - Amanda Patti

Book of the Week - How to Win Friends and Influence People - Dale Carnegie - Many of you have probably heard of this book, as it is one of the all-time best sellers in literature history.  Written over 70 years ago by Dale Carnegie, it is essentially the first book on success and the information in this book still rings true today.  In a nutshell it goes over
   - 3 ways to handle people
   - 6 way to make people like you
   - 12 ways to win people into your way of thinking
   - 9 ways to be a great leader
Simply this book is a must for anybody who is in the business of working with people.  It will help you influence and impact your career in a number of ways.  Check it out!

Video of the Week - Try Something New For 30 Days - Matt Cutts

Alright have a great weekend and be sure to sign-up for BBA Updates!  As always Go Get 'Em!

Anatomy Lesson: The Foot and Ankle

What do Star Wars, Lord of the Rings, or the ever awesome Scary Movie's (hint of sarcasm) have in common?  They're all series', so if you like that kind of stuff, you should like this. 

We are going to do a series of Anatomy lessons for you, so you can get a better understanding of the human body.  We are going to go joint by joint through the body, and point out some keys structures, movements, and jobs of each joint.  Then probably go over some common problems we see, and how to fix them.  Maybe some more info, but I don't know if we'll have enough time, we have a lot of busy days at the Home Debot planned ahead.

So were starting from the ground up, with the foot and ankle.  Your tootsies (as it's known in the playground) bear a huge brunt of your everyday activity, but do you ever really pay attention to them?  Doubt it.  These poor pups get used and abused, and never get shown any love.  Well that changes today, time to give the foot and ankle some much deserved TLC.   

So enjoy!

Bones - The foot and ankle contain 28 bones (including the tibia and fibula).  All together the foot and ankle contain over 25% of the total bones in the human body!  That's right, these two little structure that don't even take up 10% of your bodies area or weight, contain over 25% of the total bones.  Why again do we never show the feet any love?  Hmmm

Ankle

• Tibia and Fibula - Two lower leg bones.  Tibia is the "shin" bone, it is much larger than the fibula, which runs laterally to the tibia.
• Calcaneous - Heel Bone
• Talus - Joins the foot to the shin.  Sits on top of the calcaneous

Foot

• Cuneiforms - Medial, Intermediate, Lateral - Articulate with the 1st-3rd metatarsals
• Cuboid - Articulates with the calcaneous and the 4th-5th metatarsals
• Navicular - Between the talus and cuneiforms
• Metatarsals - 1st-5th
• Phalanges - 5 proximal, 4 middle (2nd-4th toes), 5 distal

(photo:visual.merriam-webster.com)

Muscles - The foot and ankle contain over 100 muscles, mostly small in length and cross-sectional area, but many very important.  The main functions of these muscles are to dorsiflex, plantar flex, evert, invert, extend the toes, and flex the of toes, as well as pronate and supinate the foot.

Ankle

• Gastrocnemius - Aka your calve aka your baby cows.  Action - Plantarflexion
• Tibialis Anterior - Aka your shin muscle aka where most will feel it when they get shin splints. Actions - Dorsiflexion, inversion (supination)
• Tibialis posterior - inversion (supination)
• Peroneals - Run down the lateral aspect of the ankle/foot - eversion

Foot

• Flexor Hallucis Brevis - Flexion of great toe
• Flexor Digitorum Brevis - Flexion of 2nd-4th toes
• Flexor Hallucis Longus - Flexion of great toe, plantar flexion
• Flexor Digitorum Longus - Flexion of 2nd-5th toes
• Extensor Digitorum Brevis - Extension of 2nd-4th toes
• Extensor Hallucis Brevis - Extension of great toe
• Extensor Digitorum Longus - Extension of 2nd-5th toes, dorsiflexion, inversion
• Extensor Hallucis Longus - Extension of great toe, dorsiflexion, eversion, inversion

(photo: angelopodiatry.com)

Joints/ Tendons/ Ligaments - The foot also has 33 joints, and hundreds of tendons and ligaments.  Not to mention huge amounts of proprioception receptions in these joints, tissues, and skin to give feedback to the body.
          (remember proprioception refers to awareness of ones position, orientation, activation, and movements.  Like your hands, the foot is filled with sensory feedback receptors to communicate tons of information with the CNS about what it is feeling and sensing, and what potential actions to take)


Common Issues

Ankle Sprain - The ankle sprain is the most common lower leg injury, and if you participate in sports, you'll more than likely suffer from an ankle sprain at one point in time.  There are many different types of ankle sprains and different levels of severity.  Know that a sprain refers to injury to a ligament, and there are typically 3 grades.

   Grade 1 - Least severe.  Refers to a small tear in the ligament
   Grade 2 - Refers to a moderate amount of tear in the ligament
   Grade 3 - Most severe.  Refers to a complete tear in the ligament

Lateral Ankle Sprain - The most common type of ankle sprain, this occurs when the foot inverts (gets twisted inwards) and results in spraining of the lateral ligaments.  The most common ligaments sprain during lateral ankle sprains are the anterior talofibular, calcaneofibular, and posterior talofibular ligaments.

Medial Ankle Sprain - The medial ankle sprain is seen when the foot gets everted (twisted outward) beyond it's ROM.  The deltoid (no not the shoulder) ligament bears the burden from medial ankle sprains.

High Ankle Sprain - High ankle sprains occur to the syndesmotic ligaments that connect the tibia and fibula to the lower leg, and hence is often referred to as syndesmosis.  High ankle sprains most typically occur from a combination of excessive external rotation, eversion, and dorsiflexion of the foot and ankle.

(photo: mkillustrations.com)

Plantar Fasciitis - Plantar Fasciitis (great hangman word) is inflammation in the connective tissues of the arch or sole of the foot.  This part of your foot is heavily influenced by connective tissues such as fascia, ligaments, and tendons.  These all work together to support your foot and give it stability through your everyday movements.  Problems occur when the arch becomes weak, strained, over-worked, tight, or inhibited. 

Turf Toe - Turf toes refers to a sprain of the connective tissues of the 1st metatarsophalangeal joint (big toe).  This occurs when the big toes dorsiflexes (pulled upward) too far and the ligaments of the metatarsophalangeal tear.  This is an excruciating injury and doesn't allow the individual to roll up on to their big toe.  Obviously this will greatly impair gait as the big toe is where we want to finish our gait cycle as it is the biggest, strongest, and has the most tendon, fascia, elastic components. 

Varus - Varus basically refers to a body part turned inward or towards the midline.  In the foot, two common dysfunctions are forefoot and rearfoot varus

   Forefoot Varus - this occurs when the forefoot is turned inwards compared to the rearfoot.  This leads to contact during walking/running on the lateral aspect of the foot.  This forces the foot to go a further distance to reach the big toe for toe off, and because of this further distance, it leads to increased pronation and increased knee collapse.  Both of these resultants are not optimal for energy transfer and can increase risk of injury.

   Rearfoot Varus - this occurs when the rearfoot is turned inwards compared to the tibia/fibula.  This is by far the most prominent dysfunction seen in the foot.  This again results in a more lateral landing of the foot, and again more distance for the forefoot to travel to reach the big toe.  This causes an increase in the speed to pronation, which will put a lot of stress on the arch or cause the forefoot to adapt a more valgus position.  Because this varus is seen in the rarefoot, it will often be accompanied with a bow legged knee position. 

Valgus - Opposite of varus, valgus refers to a body part turned outward or away from the midline

   Forefoot Valgus - this occurs when the forefoot is turned slightly outward compared to the rearfoot. Like with touched on, this is often paired with rearfoot varus, as a compensation to better use the forefoot and big toe.  People with forefoot valgus are have higher arches and a more rigid arch.

Usable Information

So we've covered a bunch of anatomical information, which might sound like a bunch of mumbo jumbo, so let's take this info and give you use applicable info.

Fascial Work - Of all the areas of the body, in our opinion, the foot responds the best to fascial work or message.  Hopefully you're not on your ass all day, and get in some quality movement time.  This means your foot will be doing a lot of work and often times it gets beat up.  Take a PVC pipe, tennis ball, lacrosse ball, or golf ball and spend 3-5 quality minutes rolling the bottom of your feet each day.  This will greatly help with the health, quality, and proprioception of your feet.  This is also great for plantar fasciitis.  Just think, your foot has 33 joints, over 100 muscles, and numerous more connective tissues in your size 10 feet.  That's a lot of business going on in a small space, give it some love and roll those puppies out.  

Plus rolling out the bottom of your feet can lead to positive changes up the chain.  If you spend some quality time working on your feet, we can almost guarantee when you pop off you'll have increased hamstring flexibility, which may lead to decreased back pain or poor pelvic alignment.  The role off fascia is fascinating and it's potential influences throughout the body are pretty cool, so while research hasn't made any definite conclusions about myofascial release, we like to keep our feet happy. 

Take your shoes off - Take your shoes off more!  It's so easy.  Get your foot butt naked, and give them the experience of walking on different surfaces and let them breath.  While some might argue the efficacy of barefoot training to improving performance; they cannot deny the benefits of enhanced proprioception, increased sensory stimuli, and a chance for greater movements and ranges of motions of the foot when it isn't confined to a strict shoe. 

Learn Tri-Pod - Foot tri-pod refers to the position your foot is most stable and most desires.  It's contact with your heel, the head of your big toe, and the head of your pinky toe.  These 3 points form a tri-pod of optimal stability and position for your foot. 

Feel this position by lifting your toes off the ground and adjusting your foot to feel those 3-points of contact.  Notice how when you lift your toes, your arch become stiff and stable, this is called the windlass mechanism.  Lower your toes back to the ground, but maintain the arch position.  This is an ideal position for your foot.  Try feeling this tri-pod and windlass mechanism position when performing squats, deadlifts, or single leg movements.  This will strengthen your arch and teach your foot how to maintain a stable base and not collapse or become weak when performing dynamic movements.  

 

Ankle Mobility - Walking requires between 4-10 degrees (past 90) of ankle dorsiflexion, while running can need 10-20 degrees (past 90) of dorsiflexion, yet many cannot even achieve 90 degrees of ankle dorsiflexion.  If we do not have the appropriate range of dorsiflexion, the body will compensate in other areas.  This might mean the foot will develop a varus or valgus position, the arch will collapse, the knees will collapse, the tibia might develop excessive internal rotation, the hip might compensate, the back might compensate, etc.  It's hard to keep a stable foot position if ankle mobility is lost.  Work on improving your ankle mobility and you could potentially see problems in your foot, knees, hip, and back improve, as well as your performance. 

Joint-by-Joint -  The JBJ has been popularized by Mike Boyle and Gray Cook.  It basically states that joints in the body alternate between leaning towards stability or mobility.  In the JBJ, the first metatarsophalangeal joint leans towards mobility, the foot leans towards stability, and the ankle mobility.  While the JBJ does have exceptions and is a little simplistic, it does provide a good guideline for what each joint would prefer and how to structure training to each joint.  So like the above tips touched upon, work on creating a mobile big toe, a stable foot/arch, and a mobile ankle joint.  

     (a note of exception - also work on foot mobility.  Get back some ROM from those stiff connective tissues and open those feet up.  This makes it much easier and beneficial for the proceeding stability work)

Conclusion

Your foot and ankle are often times neglected for whatever reasons.  But in just about all movements, your ankle and feet have the final say about what goes into the ground.  You can have the strongest hips in the world, but if your feet cannot transfer that force, then all is lost.  Your feet take a pounding, so take the time to understand they need to be taken care of and strengthened like the rest of your body. 

So we hope you enjoyed and learned a little something about those things you call your feet.  Until next time 

Go Get 'Em!



Also be sure to sign-up for BBA updates.  By doing so you'll receive 2 Free Ebooks -
   10 Tips to Improve Your Vertical
   10 Tips to Improve Your Acceleration and Sprinting Speed  


Resources
The Gait Guys - Go here for all things gait and feet.  The best resource out there!

http://www.eorthopod.com/content/ankle-anatomy

Physio Blogger - Has a ton of articles of foot functions

Weekly Recap - 4/12/13

Posting this Week's Recap a little earlier than usual, because we have a busy weekend.  So get prepped for the weekend with this list of great reads. 

Spring weather is turning around, suns starting to pop out, oh it's a great time of the year!  So get some vitamin D and get some knowledge with these links below and be sure to check out our 2 articles from this week

Interview with Paul Fabritz
11 Random Knowledge Bombs

Also be sure to subscribe to BBA updates, so you're always up to date with the happenings here at BBA. 
Plus you get 2-free Ebooks
     - 10 Tips to Improve Your Vertical Jump
     - 10 Tips to Improve Your Acceleration and Sprinting Speed

Ok let's kick it off!  Enjoy!

Derby City Crossfit - I've talked about Derby Crossfit before, but thought I should bring them up once again.  If you haven't been to their site, then go NOW!  DCC is quickly becoming a site I go to everyday, I always need to check out the 4-6 articles they link; they always cover diverse topics and articles from sources I would never find on my own.  Not only that they put together daily WOD's, with appropriate scales or progressions for the varying levels of the athlete.  I have never been to their gym to see how it runs first hand, but I can tell you if I lived in the Louisville, Kentucky area I would make sure to head over to their gym.

Yoga and Fitness Classes For Girls - Girls on Target - Want to change a young girls life?  Then watch this video on how Girls on Target is slowly changing the scope on youth girls fitness.  Spread this message, and build a generation of strong, fit, united women.

Conditioning: Are You Doing It Wrong - Molly Galbraith - Awesome overview of conditioning and energy systems.  If you are an athlete, this is a must.

The FMS and It's Relevance in Sports Performance - XL Athlete

How to Stay Consistent - Scrawny to Brawny

Girls Who Play Sports Are More Successful - Natasha Hawkins

Why Breakfast Is Nothing But A Scam - Dangerously Hardcore

Reflections on Reflections: Mirrors - Frank Forencich

13 Harsh Reasons Why You Aren't Succeeding - Joel

10 Articles for Expecting Moms: How to Exercise During Pregnancy - Breaking Muscle

Surprising and Substantial Effects of Peppermint on Exercise - Breaking Muscle

Hamstring Mechanics During Sprinting: Insights - Breaking Muscle

10 Nutrition Tips You Should Be Following: Part 1 - Molly Galbraith

Considerations in Olympic Style Weightlifting - Rob Panariello

Quick and Easy Ways to Move Better - Greg Robins

How to Build an Awesome Gym Culture - Mark Fisher

11 Random Knowledge Bombs

1.  70% of the Immune System is in your gut

That's right 70%, that a whole heck of a lot.  If you want to stay healthy, then keep your gut healthy.

How?

Consider taking a pro or prebiotic or start adding more probiotic rich foods.  Probiotics are bacteria aka "good bacteria".  You have roughly 100 TRILLION living bacteria in that old dumpster you call your stomach, and the more good bacteria you have the better your health.

So consider eating more foods such as greek yogurt, kefir, sauerkraut or other fermented foods, and dark chocolate (were talking 80% cocoa plus).  When I lived in Austria, it presented me with the opportunity to eat a lot of 'Kraut (as it's known in the ghetto), and I freekin love that stuff.  If you've only ever had 'Kraut on a brat or hotdog, you're missing out, that stuff is good with any meat and is also good to throw on eggs, pizza, or just as a side dish.

2.  20% of energy expenditure during exercise is spent on brain activity

This means, do things that challenge yourself and in return you will challenge your brain.  Challenge your position, your movements, your speeds, your proprioception, your asymmetries.  Your brain is learning about itself during exercise, so teach it something!

While on this topic, please read this article on the importance of Physical Education and Physical Activity in Schools.  If you're in the fitness field/ PE educator, work with youth kids, or are a parent, then this topic is important, and this information needs to be spread.

3.  We are naturally asymmetrical

Everybody and their mother talks about how we need to balance out asymmetries, but we are naturally asymmetrical beings

     - We have a heart in our left upper chest cavity but nothing on the right
     - We have three lobes on our right lung and only two on the left
     - Our right diaphragm is 2/3's larger than the left and is supported by the liver.
     - Speaking of the liver, I don't believe there is one on our left side :)
     - Each hemisphere of the brain is responsible for different functions, and they are not identical
     - Most of us are left or right side (hand, foot, brain) dominant, not ambidextrous 
     - My left bicep is 14.31456 inches and my right is 14.52301 - OMG! I need to fix this NOW!!!

(photo: happehtheory.com)

Many programs are set on finding and curing our asymmetries, but they never take a second to consider that some asymmetries are good and needed.  We must understand we will never be perfectly symmetrical and many of our asymmetries are necessary for athletic success and actually help us in sports.

So while it may important to close the gap between major asymmetries, we need to look and consider why some of the smaller asymmetries developed.  Most likely it's do to an adaptation to a sport, and that small asymmetry is benefiting performance, and you might do more harm than good in trying to correct that 3% difference between sides.

4.  Breathing is Important

Breathing is becoming a prominent training tool, and a point of attention to evaluate.  Diaphragmatic breathing is so important because of all it's connections and implications elsewhere in the body.  If the diaphragm doesn't do it's job properly the thoracic, lumbo-pelvic, cervical, so on and so forth will bear a brunt of the abuse from this loss in function.

In fact, we take between 20,000-22,000 breaths each day.  That's 20,000+ reps each day, and each rep plays a role in how the rest of our body functions and moves.  Imagine doing 20,000+ reps of squats!  You better believe the squat pattern is going to get engrained and how difficult breaking a poor squat pattern would be, plus your legs would be like sequoia tree trunks.  The same goes for your breath, you need to consciously think about activating the diaphragm and using your pelvic floor to get a full, deep belly breath.

Here are just a few ways breathing effects the body, and believe me, trying to wrap my brain around just how powerful proper breathing can be, is extremely difficult and I still don't understand it all.  Gonna need to take a PRI course and really learn more

• If you’re locked into thoracic flexion, the odds of your breathing being affected is pretty high
• If you don’t open your lungs adequately, your ability to extend your thoracic spine will be inhibited, which will affect scapular mechanics, shoulder mechanics, neck mechanics, and probably lead to some form of an upper body injury or another.
• If your diaphragm isn’t working properly, it can affect your entire core stability, which could lead to low back injuries.  This lack of diaphragm function that doesn't allow your core to work optimally may not allow your hips to fire properly and thus limiting your strength/power (NOOO!!!)
• Clavicular breathing is related and can actually increase stress.  It can also lead to tightness and inhibition of your neck, scalenes, and cervical spine.
• If you can't breath right, who won't move right - I'm really sorry not being able to remember who I heard this from, but it hits the nail of the head

5.  80/20 Rule

Twenty percent of the things you do, account for 80 percent of the results.  Don't forget that!  Stick the the basics and be great at them.  This applies to in the weight room, nutrition, and life; save the gimics for the wannabe's.

6.  Play Multiple Sports

Kids need to play multiple sports.  I was going to go into greater detail about this, but decided to keep it simple.  Don't specialize before high school (and truly don't specialize in High School either), and play as many different sports as you can.  There is a whole bunch of research showing specialization at younger ages is leading to injury, overuse, burnout, decreased performance with age, and a higher percentage of drop-out.

7.  De-Clutter

This hits home for me right now, living in a foreign country with about 5 pairs of clothing, 3 pairs of shoes, no TV, no car, no couch, no living room, no desk, no smart phone, no microwave, no oven, limited language comprehension, and no junk.  Everything I'm living with fit into one suitcase and a small backpack, that's it.

You'd be amazed at how little you really need.  Here are two challenges for you

   1.  Go through your clothes and turn all your hangers the opposite direction (so the open end is facing you).  When you use a piece of clothing, put it back on the hanger but turn the hanger the normal way now (open end facing away from you).  After 6 months, take all the clothes on the hangers that haven't been switched and give them away or sell them. 

   2.  One day a week go without facebook, twitter, TV, email, or your phone (can keep it on you just in case of emergency).  You'll probably learn you are addicted to that stuff.  What can you do instead - read, go to a museum, explore the city you live in, exercise, write, play a board game, etc.  Get out and see the world a little bit, all that other stuff will still be there don't worry.

Here's a neat little TED video, oh by the way TED is awesome, start watching them!

8.  Daily Stress is Equivalent to Smoking 5 Cigarettes a Day

You need to find ways to reduce and relieve stress.  Everybody is different, so experiment with different approaches.  Movies, meditation, spend time with family, friends, be around young people, be around old people, exercise, walk your dog, do yoga, learn how to breath, cook, go to the gun range and get all Bruce Willis on that targets ass, etc.  These are all simple thing you can do to lower your stress.

9. Sitting Might Be Slowly Killing You

More and more research is starting to confirm what many coaches have preached for years, sitting is really bad for you. How about this little factoid
On average in the United States, people are sitting 9.3 hours a day as compared to sleeping only 7.7!

Some studies have shown that after 1 hour of sitting, enzymes that burn fat are reduced by 90%.  Prolonged sitting is being correlated with many health risks and shortend life span.  Basically what it boils down to is that sitting is an indication of exercise.  The more you sit, the less likely you are exercising; the less you exercise, the increased risk of health problems, and on and on.

Check out this Sitting Visual

So what can you do, MOVE!  Try kneeling instead of sitting, maybe get a stand-up desk, or a great tip from Dan John is to sit on the floor more.  By sitting on the floor you will naturally take up different positions and move more often.  Also research is showing that the ability to get off the ground is a key indication of life expectancy.  Sitting on the floor forces you to get off the ground to stand up instead of just off the couch.  And as you know, getting up off the ground from a seated or lying position is a great strength, core, mobility, and stability exercise  As Kelly Starrett has said, "Your butt is NOT a weight bearing muscle!"

Go Get 'Em!