PreHab Exercise Book for Runners - : Prepare to Perform.

540 Pages·2016·49.132 MB·English

by  Michael Rosengart

PREHAB
EXERCISE
BOOK FOR
RUNNERS
FOURTH EDITION
Michael Rosengart, CPT, CES, CSCS

Prepare to perform.

PreHab Exercises
Hagerstown, MD - USA
© 2016
TABLE OF CONTENTS

By Michael Rosengart, CPT, CES, CSCS
Introduction to PreHab ................................................................................................... 5
Personal Journey: ....................................................................................................... 9
How I found PreHab .................................................................................................... 9
A Foot Perspective .................................................................................................. 13
The Functional Movement Screen .......................................................................... 15
Proper Preparation Techniques .............................................................................. 16
What to Expect from PreHab ................................................................................... 19
A.M.A.S.S. Method .................................................................................................... 21
The Habit of Preparation .......................................................................................... 25
Address Pain First .................................................................................................... 27
Common Injuries for Runners ..................................................................................... 33
Hamstring Pulls ......................................................................................................... 35
Runner’s Knee ........................................................................................................... 38
Iliotibial Band Syndrome (ITBS) .............................................................................. 40
Achilles Tendinitis .................................................................................................... 46
Plantar Fasciitis ........................................................................................................ 49
Shin Splints ............................................................................................................... 53
Ankle Sprains ............................................................................................................ 54
Stress Fracture .......................................................................................................... 55
Strength Training Guidelines ................................................................................... 58
Alignment ...................................................................................................................... 59
What is alignment? .............................................................................................. 59
Living in a Modern World ..................................................................................... 61
Assessing Alignment ............................................................................................... 65
Front View ............................................................................................................ 65
Profile View .......................................................................................................... 67
Plank Alignment ................................................................................................... 69
Movement Evaluations ............................................................................................. 73
MOVEMENT EVALUATION - Kneeling Lunge and Reach .................................. 74
MOVEMENT EVALUATION - Single-Leg Bridge Off Roller ................................ 74
MOVEMENT EVALUATIONS - Single-Leg Box Squat ........................................ 75
The Joint-by-Joint Approach ................................................................................... 79
Mobility .......................................................................................................................... 87
MOBILITY ASSESSMENT: Wall Slide ................................................................ 89
MOBILITY ASSESSMENT: Wall Squat ............................................................... 90
MOBILITY ASSESSMENT: Hip Hinge ................................................................. 91
Mobility Changes ................................................................................................. 92
Soft Tissue Therapy .................................................................................................. 93
Soft Tissue Therapy Techniques ......................................................................... 96
Biotensegrity ............................................................................................................. 99
Foam Rolling ........................................................................................................... 101
PreHab Exercise Book for Runners 1
TABLE OF CONTENTS

Forward Head .......................................................................................................... 111
The Biomechanical Cost .................................................................................... 112
Top Down Rx ..................................................................................................... 113
Thoracic Spine Mobility .......................................................................................... 119
Shoulder Mobility .................................................................................................... 131
Hip Mobility .............................................................................................................. 145
Types of Rollers ................................................................................................. 148
Balling ................................................................................................................ 150
Ankle & Foot Mobility ............................................................................................. 163
A Foot Perspective ............................................................................................ 163
Big Toe Test ...................................................................................................... 164
Posterior Chain Mobility ......................................................................................... 173
Power and Speed .............................................................................................. 173
Supine Mobility Sequence ................................................................................. 181
Combination Exercises for Mobility ...................................................................... 195
Activation Exercises .................................................................................................. 211
Activation Techniques ............................................................................................ 215
Ankle & Foot Activation ......................................................................................... 223
Hip Activation .......................................................................................................... 231
Band Walks ........................................................................................................... 239
Practice Standing ............................................................................................... 244
Core Activation ....................................................................................................... 245
Shoulder Activation ................................................................................................ 253
Shoulder Girdle Activation ..................................................................................... 259
Posterior Chain Activation ..................................................................................... 267
Compensation Strategies .................................................................................. 267
Use the Whole Chain ......................................................................................... 268
Combination Exercises for Activation .................................................................. 289
Stability ........................................................................................................................ 317
STABILITY ASSESSMENT: Single-Leg Heel Lift .............................................. 319
STABILITY ASSESSMENT: Single-Leg Rotation .............................................. 320
STABILITY ASSESSMENT: Hip Hinge ............................................................. 320
STABILITY ASSESSMENT: Single-Leg Box Squat .......................................... 322
STABILITY ASSESSMENT: Lateral Lunge to Single-Leg Balance ................... 323
STABILITY ASSESSMENT: Trunk Stability Push-up ........................................ 324
STABILITY ASSESSMENT: Ipsilateral Rotary Stability Test ............................. 325
Shoulder Stability ................................................................................................... 327
Core Stability ........................................................................................................... 343
One Powerful Lever ........................................................................................... 343
Broken Chain ..................................................................................................... 344
Hip Stability ............................................................................................................. 361
Need for Hip Stability ......................................................................................... 361
HIP STABILITY TEST ........................................................................................ 362
Ankle Stability ......................................................................................................... 371
Eye Test ............................................................................................................. 372
Combination Exercises for Stability ..................................................................... 385
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TABLE OF CONTENTS

Strength Training for Runners .................................................................................. 405
Repetitive Stress ................................................................................................ 405
Perceived Exertion (PE) .................................................................................... 407
Programming ..................................................................................................... 408
Periodization ...................................................................................................... 409
Law of Diminishing Returns ............................................................................... 412
Designing your Program .................................................................................... 413
Strength Exercises ................................................................................................. 417
RUNNING DRILLS ....................................................................................................... 429
Gait Efficiency Drills ............................................................................................... 431
Exercise Progression ......................................................................................... 432
Running Technique ................................................................................................ 445
Improve your Technique .................................................................................... 445
Ground Contact ................................................................................................. 446
Heel Strike - Oh, no! .......................................................................................... 446
Stepping in the Right Direction .......................................................................... 450
Forward Lean ..................................................................................................... 451
Slope and Speed ............................................................................................... 453
PreHab in Sports ............................................................................................... 454
Forefoot Strike ................................................................................................... 454
Mid-Foot Strike .................................................................................................. 456
Form Running Drills ............................................................................................... 458
ANKLE HOP ...................................................................................................... 459
HEEL STRIDE ................................................................................................... 460
LATERAL SHUFFLE ......................................................................................... 461
KNEE TUCK STRIDE (HIGH KNEES) .............................................................. 462
HEEL PULL STRIDE (BUTT KICKERS) ............................................................ 463
STRAIGHT-LEG STRIDE .................................................................................. 464
BACKPEDAL ..................................................................................................... 465
CARIOCA .......................................................................................................... 466
A-SKIP ............................................................................................................... 467
B-SKIP ............................................................................................................... 468
TRIPLE A-SKIP ................................................................................................. 469
ALTERNATING BOUNDING SKIP .................................................................... 470
FORWARD LEAN POSITIONING ..................................................................... 471
Recovery ..................................................................................................................... 473
Yoga ......................................................................................................................... 475
The Practice of Yoga ......................................................................................... 476
Breathing in Yoga .............................................................................................. 477
Breathing to Energize and Calm ........................................................................ 478
Inversions ................................................................................................................ 497
Sleep ........................................................................................................................ 503
INDEX ........................................................................................................................... 505
BASIC ASSESSMENTS AND MOVEMENT EVALUATIONS ..................................... 513

PreHab Exercise Book for Runners 3
Introduction to PreHab

Sun Tzu said that every war is won before it’s ever fought.

PreHab brings that belief alive in your training by physically prepare the body to perform
the best that it can in every workout and run.

How does PreHab bring better results?
The main goal of PreHab is to restore function and integrity to your biomechanics in
order to optimize efficiency in every movement pattern and improve the performance of
each run.

To understand how to use PreHab within the context of your training program, it’s
advantageous to look at where many exercises and techniques come from: Rehab.

Rehab, or rehabilitation to be formal, intentionally aims to restore function to the human
body by realigning a person’s body mechanics, or biomechanics, and optimizing how a
person moves.

Consequentially, the concept of rehab infers that there is a misalignment or dysfunction
in how a person moves, usually associated with an acute injury or chronic stress.

The truth is: everyone will endure faults in their biomechanics.
No one is immune.

Repetitive movements found in sports or exercises as well as your lifestyle will lead to
the distortion of your natural movement patterns. In other words, if you run on a
consistent basis or if you sit at a desk for work all day, these repetitive movements will
slowly warp and distort your natural alignment and biomechanics.

Add some minor injuries, like a sprained wrist or twisted ankle, to a series of random
circumstances, such as helping a friend move, and some not-so-random activities, like
going to the gym or playing basketball, and soon enough your body is changing in a
negative way, and you may not even realize it.

In fact, Katy Bowman, M.S., a well-known biomechanist and author of Alignment
Matters, tells us that our bodies are actually shifting and changing with how we live our
lives – not figuratively, but literally. Our bones reshape themselves and our muscles can
lose their length due to how we live our lives, which is the very reason why we should
look at “how” we physically live our lives.
PreHab Exercise Book for Runners 5
INTRODUCTION

Unless we actively look for it, we will not see how we cheat in the way that we move.
We will not be aware of how we compensate for inefficiencies or weaknesses every
time we move. Yet, we will still compensate one way or another.

PreHab is a way of looking at ‘how’ we move in order to move better. And with better
movement, we can then create better performances in all that we do: whether it’s
running a marathon, playing football, working out to lose weight, or just carrying the
groceries in from the car.

PreHab helps to improve Movement Quality, enhance performance
and prevent injuries.

Tim Ferriss was one of the first people to talk about PreHab in his book, The 4-Hour
Body. Since then, it has steadily crept into the Strength and Conditioning world as
coaches keep looking for better ways to train their athletes and prevent injuries. Now, it
is proliferating through cyber space as people share PreHab exercises and techniques
in podcasts, blogs, and all over YouTube.

But what is PreHab and how do I do it?
Believe it or not, this is an easier question to answer than the first one. Let’s look at the
root word of rehabilitation.

Habilis, in Latin, means to “fit, equip or make skillful.”

Everything you do in PreHab is designed to make you more skillful in the way you move
with your body. From loosening up to strengthening up, anything is PreHab if there is an
intention of making the body move better.

PreHab are those preparatory habits, such as practicing mobility exercises, that
help you achieve specific goals through movement.

Dr. Kelly Starrett, a well-known physical therapist and owner of San Francisco CrossFit,
created his popular Mobility WOD series and his book, Becoming a Supple Leopard, as
a way to help people develop daily maintenance on their bodies and perform better.

Practice daily maintenance as a way to perform better.

Can you accomplish goals without PreHab?
Of course, you can. People are amazingly resilient and adaptable, as Dr. Starrett puts it,
which is a good thing because we strive to accomplish some amazing feats in sports
and in life. Remember when Mary Lou Retton won the gold medal in the 1984 Olympics
on a sprained ankle? When we put our minds to it, we can overcome a lot.
PreHab Exercise Book for Runners 6
INTRODUCTION

The argument for PreHab is best expressed in a combination of thoughts from two men;
Gray Cook, physical therapist and creator of the Functional Movement System and the
philosopher Aristotle.

Cook teaches coaches and trainers to address all dysfunctions in movement first and
foremost because they will eventually lead to an injury or some form a breakdown in the
movement system – it is just a matter of when and not if.

For example, let’s look at a 30-something office worker ready to cross running a
marathon off of his bucket list. For 20-plus years, this person has been spending eight
or more hours a day sitting and developing a limited range of motion in his entire body,
especially his hips. As soon as he starts his marathon training, his body will modify and
change his gait to compensate for the lack of mobility in his body. Strange movement
patterns will appear. And won’t be too long until his body starts breakdown in certain
areas.

Worse off, this man may have the will of Alexander the Great and resolve to finish his
training and compete in a marathon. It’s at this point that his own passion and
determination may become his very own enemy.

One of the goals of PreHab is to prevent future injuries
through addressing dysfunctions in our movement.

Optimizing movement to improve performance and achieve specific results is another
goal of PreHab that can be best expressed through the sentiment laid out in the
following words:

‘We are what we repeatedly do.
Excellence, then, is not an act, but a habit.’
-Aristotle

If we develop a personal system of preparatory habits to performance our best and
avoid injury, we have PreHab.

This book will help create habits that restore biomechanics,
optimize movement and improve performance.

Do you need to do PreHab to run?
No. Running is just putting one foot in front of the other to move through space at an
elevated effort or pace. It’s one of the most primal attributes of the human species.

However, if you are looking to optimize your running in terms of speed and distance,
then keep reading because PreHab will help you.
PreHab Exercise Book for Runners 7
INTRODUCTION

PreHab Exercise Book for Runners 8
INTRODUCTION

Personal Journey:
How I found PreHab

I had a long journey to finding PreHab. And I believe that if certain things didn’t happen
the way that they did, I would never have found PreHab.

Growing up, I was really into sports. I played with all the kids in the neighborhood back
in good old Verona, New Jersey. We were very unorganized. Our sporting events
basically consisted of me calling each person in the morning to meet at Forest Avenue
Elementary School or my backyard, where we would pick teams and play until we were
too tired to play anymore.

I went on to play Little League and Pee-Wee football as well. I don’t recall much
instructing going on in either one, but then again maybe I was just not listening to the
coaches. Regardless, I soon found myself becoming a student of form and technique
because it led to success.

In football, I would pay close attention to my leverage when participating in tackling and
blocking drills. I learned to stay low and I also learned how to be fast out of my stance.
In baseball, I learned to hit by watching the alignment of the pitcher’s shoulder and
elbow. I saw ‘form’ in movement.

Then I got my first gym membership the summer before seventh grade- yes, seventh
grade. I joke to friends that: kids in New Jersey start going to the gym earlier than most
kids. The truth is that the school nurse reported me as obese at the end of sixth grade
and my mother sat me down for a talk. Consequentially, I joined a gym, started Weight
Watchers and lost 30 pounds that one summer.

After losing all that weight, my life was never the same. I kept my gym membership and
slowly began evolving into a ‘gym rat.’ I also assume that one of the reasons this
lifestyle change really took a hold over me was because once I lost weight and started
working out, girls were finally interested in me. And what 13-year-old wouldn’t like that?

So, to keep getting attention from girls, I kept working out and tried to learn more. I
religiously read Muscle & Fitness magazine and watched how other people in the gym
worked out. I thought I knew a lot, and every year I would learn more.

After I graduated from college, I got certified as a personal trainer in a weekend course,
and I thought I was done with “school” forever. Boy, was I wrong.

Personal Training-
I was hired to be a trainer at Equinox Fitness in New York, which was one of the best
things that ever happened to me. At that time, Equinox was one of the only gyms that
had continuing education classes for their trainers – and I loved them!
PreHab Exercise Book for Runners 9
INTRODUCTION

The Equinox Fitness Training Institute was taught by Dr. Paul Juris, who was a very
passionate and creative man. He taught me the principals of periodization and
functional movement, aka functional training. For two years, I sat in the front row,
scribbled down notes and drove Dr. Juris crazy with my questions.

I loved all the work we did in those EFTI classes because I began to understand the
matrix of human movement even more. I would pair exercises in workouts and create
programs for my clients with the same zeal that a kid would have while enjoying putting
together a puzzle. It was thrilling in a way!

In my time with Equinox, I accumulated over 20 different certifications of various
disciplines and emphases. However, the two certifications that left the biggest impact on
my training were:

Certified Strength and Conditioning Specialist
Functional Movement Screen

These two certifications made me realize how little I truly had learned by being a ‘gym
rat,’ reading all those fitness magazines and talking ‘bro-science.’ I had missed out on
how important biomechanics are to movement and performance.

Experience is the Ultimate Teacher
I really set myself up for the biggest lesson of my life when I went back to grad school. I
chose the University in England because I wanted to study abroad. Plus they actually
had an American Football team, and I really wanted to play again.

I was not a star on my high school football team. If anything, I was an unsung hero. I
played tight end on a running team. However, we ran the veer option and did very well
because I was the one setting the edge and designating the option man in the blocking
scheme. I was smart, physical and reliable. Yet, I always believed I had more potential
that I displayed in the game and I longed to prove it – at least to myself.

I got my chance to be a star in England. I helped the University’s team to its first winning
season ever, as well as a playoff berth. I took over as the quarterback half way through
the season, when we were 1-3, and started a winning streak that took us into the
playoffs.

I had such an experience that year with my teammates in England that I choose to stay
one more year and play more football.

‘Greed is Good’- the famous quote from the movie: Wall St.

I enrolled in a Creative Writing class at the University in order to be eligible to play one
more season of football. I figured why not? Would I ever play again? No. I was 30 years
old and everyone else was 19 to 22 years old on average. So, I saw this as a chance in
a lifetime and I took it.
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