Considerations for Overhead Training

Overhead pressing is an effective way of strengthening your shoulders. With that said, it is important to respect the complexity of your shoulder joint to avoid provoking pain down the line. As your arm (humerus) elevates, the shoulder blade (scapula) must follow with an upward rotation and shrug at the top. This creates a stable base for your shoulder to withstand resistance overhead. If your shoulder blade does not move through a full range of motion, the deep structures in your shoulder may impinge (⬆️migration of the humeral head, ➡️⬅️subacromial space). The ideal range for your arm to get above your head is ~180 degrees, from your hip, without compromising your spine or rib cage. However, this alone does not prevent shoulder pain from occuring. Instead, this should be viewed as a prerequisite before adding progressive resistance overhead. If you participate in a sport that requires a lot of throwing or you are currently dealing with shoulder pain (other possible pathologies), you will need further evaluation.

Ligament Tears in the Knee

Ligaments are strong connective tissues that bind your bones together. In your knee joint, four ligaments work to keep your upper leg (femur) and lower leg (tibia and fibula) connected as your knee bends and extends. These ligaments are located on the inside and outside of your knee (tibial collateral ligament [MCL] and fibular collateral ligament [LCL]) and crossed-formed deep within your knee joint (anterior cruciate ligament [ACL] and posterior cruciate ligament [PCL]). In sports consisting of multi-directional movement or repetitive impact to the lower body, these ligaments are challenged to maintain proper knee alignment. In fact, many of the knee injuries that occur in a variety of sports come from ligaments being pulled passed their capacity and torn, often from an inward collapse of the knee (ACL and MCL tears). If you participate in a sport, it is wise to take the time to learn to decelerate, change direction, and land without compromising the knee joint. Doing so may help you avoid experiencing an injury during a competitive event. Regardless, some may be at a higher risk than others due to structural and biomechancial differences (size and shape of the femoral notch, degree of tibial torsion and femoral anteversion, joint laxity, etc).

Delayed Onset Muscle Soreness

Delayed onset muscle soreness (DOMS) is currently understood as unaccustomed eccentric training that results in peak muscle soreness ~1-2 days after a training session. When you begin a new workout program or make changes to an existing one, the high levels of eccentric, or lengthened, contractions temporarily damages the actin and myosin cross-bridges in the sarcomere. Many theorize this new stimulus causes an inflammatory response, leading to the tenderness and discomfort felt hours later (↗️ bradykinin, prostaglandins, and leukotrienes ⬆️ NGF 🚨 nociception ➡️ mechanical hyperalgesia). However, there may be other possible mechanisms (connective tissue damage, free radicals, nitric oxides, etc). Further, muscle soreness should only be experienced in moderation and not a common occurrence. When soreness does occur, supplementing caffeine, omega 3 fatty acid, taurine, or polyphenol may help alleviate the effects.


Caffeine and Adenosine

Caffeine and adenosine are very similar in chemical structure. In short, caffeine is used to increase levels of adrenaline (epinephrine) and adenosine causes drowsiness. Adenosine is a neurotransmitter that binds to receptor sites, slows neural activity, and later causes us to fall asleep. Caffeine, a psychoactive substance, interrupts this process by removing adenosine, taking its place, and blocking further accumulation. Adenosine, at that point, is no longer available to slow neural drive, thus creating the opposite effect: central nervous system stimulation. This is beneficial when adenosine signals a “rest and digest” (parasympathetic) response but we prefer a “fight or flight” (sympathetic) response. The effects of caffeine peaks after ~1 hour of ingestion and has a half-life of ~6 hours. This means, if you consume 200 milligrams of caffeine at 6am, ~100 milligrams will still be in your system by 12pm.

Ground Reaction Force

Acceleration sprints are a great form of improving your overall athleticism. The ability to effectively accelerate with mechanical efficiency is an important quality to possess in a variety of sports and/or recreational activities. Although acceleration involves the use of many muscle groups working together, your hip extensors play a significant role in sprint acceleration performance. The more force your foot exerts against the ground, the faster your body moves (Newton’s Third Law).

Aiding Osteoporosis

On a physiological level, the aging process is difficult to fully generalize. Physical activity, dietary choices, skeletal blood flow, and endocrine function helps dictate how rapidly you experience the effects of aging. Bone density typically peaks around 30 years old. However, bones adapt to the stresses that you placed upon them. For example, astronauts often show a decrease in bone mineral density and tensile strength due to periods of zero gravity. This puts into perceptive the importance of following a well-designed resistance training program to improve bone mineral content. Training for strength, therefore, is invaluable for the maintenance and improvement of bone health.

Reducing the Risk of Iliotibial Band Syndrome

The IT Band (Iliotibial Band) is a thick fascia and tendon-like structure that runs down the side of the thigh. Pain on the lateral aspect of the knee (lateral femoral epicondyle) is common in sports involving endurance, both competitive and recreational. Often, this comes from the IT Band uncomfortably rubbing against the side of the thigh bone (femur). This may be due to altered running mechanics, weak hip abductors, muscular imbalance or muscular tension around the hips and knees. Some proactive measures in reducing the risk of lateral knee pain include: an adequate assessment of running mechanics, frequent updates to footwear, and proper training progressions.

Limited Dorsiflexion and Knee Injuries

If you were to walk on your tippy-toes, your ankle joint (talocrural region) would be in what is called plantarflexion. Alternatively, if you were to walk on your heels, your ankle joint would be in what is called dorsiflexion. Limited range of motion in ankle dorsiflexion is an important component in altered knee biomechanics. So, if you are dealing with knee pain, the source the pain may not be in the knee itself, but instead the ankle. The ideal range of ankle dorsiflexion is 0-20 degrees. Limitions in this range of motion can alter neutral knee alignment (often valgus) and increase risk factors of ligament and cartilage tears (ACL, MCL, Meniscus), patellofemoral pain, and knee osteoarthritis. So, if you identify limitations in the ankle and are currently dealing with knee pain, increasing ankle range of motion may be an important contribution in reducing the risk of knee injury.

Meal Frequency and Metabolism

Based on our current understanding of the topic, meal frequency does not appear to influence metabolism or body composition. If you are looking to develop healthy eating habits, you will gain the same benefit eating 2 meals a day, 3 meals a day, 6 meals a day, etc. Multiple meals may be beneficial during periods of caloric restriction to aid hunger and preserve lean muscle mass, however it is not necessary to eat ~6 meals a day to “stoke the metabolic rate”. The number of meals you choose to have in a 24 hour period is a matter of preference.

Humeral Anterior Glide Syndrome

In horizontal push and pull exercises, the top of the arm (head of the humerus) should stay secured in the shoulder (glenoid fossa) throughout the entire range of motion. The top of the arm may translate forward (relative to the acromion) as the elbows pass behind the hip, which can be a contributing factor in future shoulder pain. This may be brought upon by an excessively rounded (kyphotic) spine and/or forward tipping of the shoulder blade (scapular dyskinesis). However, if the back and shoulder blade are not compromised, you can self-correct by simply monitoring and avoiding this glide. You will often see this at the bottom of a bench press or top of a bent over row.