Case Studies – Nerves

The human body is incredibly complicated. I’ve been through various anatomy, physiology, and biomechanics classes that have given me an appreciation of the body, but being able to study on cadavers was life changing. It was amazing to hold a human heart in my hands knowing that it belonged to a living, breathing person who had hopes, dreams, aspirations, a family, children…a life. To hold that person’s heart, one of the most important organs yet a symbol of vitality and love, was something I’ll never forget.

More to the point, the musculoskeletal system was fascinating. Instead of looking at bones or models of bones and muscles, I could see them right in front of me. The rectus femoris attaches on the anterior inferior iliac spine and travels down to integrate with the other three parts of the quadriceps to a common tendon that attach to the patella, which shifts into a ligament that attaches on the tibial tuberosity on the anterior side of the proximal tibia. God damn it, isn’t it beautiful? Seeing it gave me an immense appreciation for the complexity of life and how it evolved to be that way.

I love and appreciate this kind of shit, and I love and appreciate teaching people to optimally train their bodies to perform and be as healthy as possible. There’s a lot going on when we train, eat, sleep, or experience life. It takes effort to keep things on track, yet there’s a lot that can easily go wrong. I’m often surprised that some people have made it as far as they have; the crack addict still breathes years after being addicted and the ignorant guy who deadlifts with a horribly flexed lumbar still hasn’t blown out a disc. Humans are a hardy species.

I have two friends that have had nerve issues to the point that it has effected their training. Shawn has made his way through law school and still manages to train about four times a week. “Mace” is a soldier who has been blown up and shot. They have very different backgrounds and different nerve related issues that they have either fixed or improved.

I want to point out that I’m not a medical doctor. I’ve had several medical doctors comment that I know anatomy better than they do, but I think they were just being nice. Anything I say should not be taken for medical advice; when in doubt, go see a doctor. But let’s face it, some times we — people who train regularly — do not have the resources to see a doctor. Does this mean you should try adjusting your vertebral segments on your own? Absolutely not. But there are ways that you can work on your body to improve your ailments (it’s the premise behind MobilityWOD). Most of us can handle the minor repairs in our house; it’s only when there is a major issue (a flooded basement, the hot water heater craps out, etc.) that we’ll get ‘professional help’. Our bodies should be no different. Let’s look at how we addressed some nerve related issues.

Shawn

Earlier this year Shawn started noticing that his left hand was feeling numb. Specifically it was his pinky finger and half of his ring finger. When he pressed, he noticed that his wrist felt extremely unstable, especially at the top half of the range of motion. He felt as if he had no sensory feedback, kind of like when your foot falls asleep. Shawn can deadlift close to 405, but when he was doing 315 one day it felt hard, and the bar just fell out of his hand halfway up. He realized something was wrong and had it looked at. He was told he had carpal tunnel.

To me, that’s a bullshit over simplification. The pinky and ring finger are precisely where the ulnar nerve travels to. That tells me there is something occluding or impinging his ulnar nerve, but the question is where? After being told he had carpal tunnel, Shawn was conscious of his wrist position when typing (he was working at a law firm while finishing his degree), yet the issue never went away. That told me it didn’t have much to do with the wrist.

I started thinking about three other places: the elbow, shoulder and neck. If someone is particularly tight in their internal rotators of the shoulder, I could see that pinching down on the brachial plexus and causing issues, but I’d sort of expect there to be some shoulder or inner biceps pain. There wasn’t really any of that, but file that info away. I started asking Shawn about what his elbow was doing when he is sitting. He primarily sits in class, at work, in his truck commuting, or at his desk at home. It turns out that his medial elbow was often mashed down on the arm rest of his chairs or the door of his truck (you know, the “I’m a big guy and my elbow is sticking out my window” style of driving a truck).

I collected all of this data and created a non-invasive prescription for Shawn.

1. Stop sitting with the medial elbow in contact with surfaces.

2. Complete nerve flossing 4x/day (more on this below).

3. Stretch the internal rotators of the shoulder and tie in the neck 2x/day.

By not impinging the nerve, we should free up that medial elbow and allow the nerve signal to pass through the area. By stretching the shoulder and neck, we could account for any possible tightness in the area that could impinge on cervical or brachial nerves. Lastly, the nerve flossing seems to be significant in treating the issue. To perform it, a person would reach their arm out laterally from their side so that their whole arm is horizontal. The palm is up, which supinates the forearm and slightly externally rotates the shoulder. They then look forward with good spinal posture and gently laterally flex their neck away from the outstretched arm. They would hold for a count, and then return their head to neutral position.

Kinda like this, but keep the wrist straight and laterally flex the head away from the arm. Click picture for source.

Within a week or so, Shawn noticed improvement in his numb fingers. His wrist felt more stable when training, and his grip strength returned. His fingers became sensitive to regular temperatures of water; they would feel like extreme hot or cold on the pinky and half of ring finger while the rest of the hand felt a moderate temperature. My guess is that because his fingers had lost innervation for several weeks, his body adapted to not feeling anything. When the neural innervation returned, his sensitivity was heightened to the temperatures. Now, several months later Shawn doesn’t have any issues with his fingers or wrist.

“Mace”

This guy is a crazy asshole in the Army who has made a really solid effort on getting killed in or out of combat. When his humvee was blown up by an IED, it started a series of issues that eventually resulted in two herniated discs in his back that cause localized and sciatic pain. When he was trying to jump off of a building to avoid an RPG, the explosion took his feet out from under him and he dislocated his left shoulder and tore his labrum. At least the grazing AK round on his leg didn’t leave any lingering damage.

Mace’s issue is in his right shoulder. He noticed that his right deltoid was just not being innervated, and this resulted in a lop-sided press. “Brute force and ignorance” didn’t seem to help, so we started collecting info on his situation. Unlike Shawn, who had no history of cervical injury, Mace probably has some kind of cervical issue that could be causing this. He could have a brachial plexus issue. Who knows? He’d have to wait to wait a bit to see a military doc, so I figured we might as well try:

1. Nerve flossing, same thing as what Shawn did.

2. Working on shoulder mobility, especially internal rotation stuff.

Before trying this treatment, Mace’s deltoid simply wouldn’t innervate properly (he sent me a video, it’s weird). He found that if he did the neural flossing at home, it would help innervate his deltoid and he’d get a decent press workout. He found that if he did it as part of his warm-up at the gym that he would still favor his right shoulder. Regardless, he still does it at the end of his training session. Despite our efforts that improved the issue slightly, his “shit is still fucked up”. He will see a neurologist soon and hopefully they can shed some light on where his issue originates and whether or not he can do basic treatments to keep him operational.

Recap

Nerve issues are not incredibly common in the training world. Hopefully this post gives you two perspectives. In Shawn’s case, we were able to identify what caused his issue, created an effective rehab program, and completely eradicated the problem. In Mace’s case, he has some more serious stuff going on that is going to require actual medical attention. We can discern the difference through collecting data on our “patients”. I was quickly able to identify what was probably causing Shawn’s problem by critically thinking with anatomical knowledge. I knew Mace’s issue was going to require “proper medical attention” since there wasn’t really one cause we could point to, but I still thought we could improve it to some degree (we did).

In either case, the assessment and “prescription” were derived from a knowledge of anatomy and physiology. I’ve explained in the past why anatomy is important for people who coach or train, but took it to a different level here. Coaches, trainers, or “fitness professionals” owe it to their clients to continuously learn about the human body. That doesn’t mean they should have to take bullshit continuing education credits on stupid pieces of equipment, coaching, or nutrition, but should focus on the hard sciences applied to relevant scenarios. I didn’t do anything special here; PT’s or chiros may have better solutions. Yet I was able to eliminate or improve serious problems that hampered two friends’ training.

And it all starts with anatomy and physiology.

 

New England Women of Strength

Monday’s are devoted to women and training, and this is a guest post from Gina Melnik, one of the women who helps run the New England Women of Strength (N.E.W.S.)

New England Women of Strength (N.E.W.S.) is a community of female strongman athletes.  N.E.W.S. provides its members an opportunity to share passion for the sport of strongman and build a pathway to help other strong women become Strongwomen.  As a relatively new organization, one of our first major activities was holding a workshop to help introduce women to the sport of strongman.

The idea came about because many of us in N.E.W.S. kept finding women that were excited by the idea of heavy lifting and trying strongman, but needed some support and the right environment to help them feel comfortable exploring the sport.  We knew based on our own collective experiences that a learning environment constructed and run by strongwoman athletes would be approachable and empowering for novice female lifters beyond anything that other strongman or strength training resources could provide.  We started talking about the possibility of a strongman workshop for beginners and there was immediate excitement from prospective workshop takers.  Three of N.E.W.S.’s more experienced strongman competitors – Gina Cravedi, Kim Berg and me (Gina Melnik) — decided to make it happen and formed a coaching team for the workshop.

The workshop was geared toward women that were already strength training, but new to strongman.  The coaching team’s goal was to lay out a basic foundation for learning the sport – the kind that we wished we had when we were beginning.  After a seminar-style discussion, we moved on to events.  As anyone familiar with strongman knows, contest events are constantly changing.  There was no way to cover all the possible events in strongman; we wanted to give the participants the experience of an event-based training day and provide some initial instruction.  The coaching team considered a range of factors and ended up selecting Viking press, tire flipping, car deadlifting (with the apparatus weighted with heavy tires), and farmer’s walks.  It was fun to watch the participants rally around supporting each and pushing through on hard sets.  We then wrapped up the day with more discussion and Q&A.  This second discussion session was one of my favorite parts of the workshop because everyone’s initial nerves had dissipated and it really felt like what N.E.W.S. is — a community of athletes exploring their potential together.

The women that attended were wonderful to work with — they showed up enthusiastic, and ready and willing to step out of their comfort zones.  I know that some of them had hesitations about being ready to step up into something like this and it was fun for our coaching team to show them that they were.  As one of my coaching mentors is fond of saying, “ready is willing and willing is ready.”

Participants loved that this workshop was not just for women, but also taught by strongwoman athletes.  All of us on the coaching team have full-time jobs outside the fitness industry showing that everyday women can do this.  And because we vary in size and build, it helps illustrate that this sport can be accessible to anyone.  In a number of ways, the participants could relate to us.  Additionally, there is something about having experienced strong women present, modeling strength, and sharing their own accomplishment in the sport that is uniquely motivating to other female athletes.  On the instructor side, our coaching team was able to reflect back on our own past experience as novice strongwomen and use that as a guide to provide the right atmosphere, tone and support.  We could relate to them and where they’re at this stage of exploring the sport.

It was a wildly successful endeavor and I think all of us – both athlete participants and coaches — are still feeling energized and looking forward to what’s next.

You can learn more about N.E.W.S. through their Facebook page.

—–

I think that one of the most important things that the N.E.W.S. instructors do is show that anyone can participate and compete in this sport. By setting the example AND providing an avenue for beginners, they make it accessible and fun. What do you think? Are there any other women lifting groups out there?

 

Q&A – 33

PR Friday

Join the fun and post your training PR’s and updates to the comments. I PR’d by driving 2,000 miles across the country (4 days of driving) — I do not recommend this. If there was ever a time to learn a lesson from Justin doing something stupid, it is now. Pay someone else to move yo’ shit. It continued to destroy my lifting (travelling and GoRuck Challenge started that), reduced my food intake, ruined my sleeping ability, and annihilated my mobility. Pay someone else to move your stuff, trust me.

Weekly Challenge

Last week’s challenge called you to help a stranger by lifting something heavy and declining compensation. Did you get a chance to do so? That’s nice, Leroy.

Next Week’s Challenge:

Don’t let this be you in your training:

Week In Review

Last weekend the site theme was updated. This was long over due and something I have been working off-and-on. Thanks to Nick and Lucas (readers of the site) at Nytrix Media. If you have web design needs, then hit these fellas up. There will be a few more modifications, but the main updates are a better menu system and threaded comments. The threaded comments will allow for more seamless conversations.

Monday was a quick post on Beverly Crawford’s big squatting ability, but she also pulls some heavy weight. Tuesday was a quick post I wrote at 3AM (was travelling) about some of the concepts I teach at the seminars about belts, and it turned out to be a hot little number. Wednesday was the 4th of July, and I posted the Declaration of Independence (mandatory reading). Thursday was a blast from the past; I put up a story Jacob Cloud wrote in 2009 to which he responded, “Aww shucks. Thanks, Justin. Nice to look back a couple years and see that, though older, I’m hairier, leaner, stronger, and oh yeah, I have more hair. Heck, Floyd even has a new engine, but is still tickin’. Unfortunately, the jorts ripped in half long ago.”

Q&A

Continue reading

An Adventure

I haven’t had internet access for several days so I decided to pull this post out of the archives for all of the newer readers. Jacob Cloud sent me this email in 2009 and I read it before going to bed every night.

———-

Justin,

For the month of May, I have rocked a rockin’ mustache. I thank the 70sbig contest for this. So naturally, I felt it would be only appropriate to go out on the last day of the month and snag some pictures to try and capture the awesomeness that is my ‘stache, and to share them with you. I did not expect to have a story…it just sorta happened. Hope you’re bored.

After a full day of lifting at the gym, setting PRs, and tossing around a few tons of sand and bricks while helping a friend build a patio, I drove over to a buddy’s place. I’m going to help my friend look for a custom decks company to upgrade his patio. If you’re also planning to build custom decks on your home, you may view this ipe decking cost Georgia to know how much this type of material will cost you.

After another quick workout in his garage gym, we grabbed the camera gear out of the truck and I went inside to change. This is when things began to go “wtf.” My phone fell out of my bag of crap, directly into a drainage ditch. This is not cool, because without my phone, I can’t play solitaire between sets at the gym. Naturally, I ripped off the manhole cover, dove in after it, and recovered the stupid thing.

I had to make sure the damn phone worked before I felt it deserved to stay out of the sewers, so I made a few calls to some hot 70sbig-friendly ladies. The phone worked, though I was a little upset none of them answered.

The phone survived the fall, and subsequent recovery, but unfortunately, my evening light was fading quickly. Angry as hell, I decided to toss my truck in the air as a back-off set for my awesome day. Donning my lifting belt and grunting loudly enough to scare the neighbors, I proceeded. Naturally, my roommate grabbed her camera and captured this amazing feat of strength.

However, tossing a truck in the air isn’t exactly kind to its exterior, which had already seen its share of wear and tear. Here, truck covers could definitely help in keeping my ride a bit more protected in the future, especially after enduring rough days like this. Not only would a quality cover shield the truck from the elements and unexpected incidents, but it would also add an extra layer of durability for the occasional rough handling.

In hindsight, maybe I should have thought about these little protective measures before my airborne feat—though there’s a certain satisfaction in knowing my truck is tough enough to withstand just about anything, even a lift-off or two.

My buddy captured this shot as well on another camera.

Satisfied with my conquests, I was much happier. I shared the moment with Floyd, my truck, and it was such a beautiful moment that the skies opened up and photoshopped a photo worthy of a magazine cover as we pondered our next conquests.

I became immensely hungry, and thirsty for beer, so I decided that Floyd and I would go hunt down some grub.

Given our good looks, charm, and my mustache, it should be no surprise that we picked up a little filly to join us. The fact that it was my roommate is immaterial. I insisted on telling her about the time I threw a football “over those mountains.” She was, of course, impressed.

The end. I hope you enjoyed my story, and pictures. I know it’s probably too late for the contest, but I was entertained enough that I thought I’d send these your way. Don’t care if they make it to the site, just have a good laugh, and keep lifting heavy shit. I’m gonna keep rocking this fucking stache, that’s all I know.

Independence Day

As you celebrate traditions with friends and family, take a few minutes to reflect on the impact of this day. It’s more than just historical significance; it represents the foundation of our liberty, our freedom. Many complain about the state or future of our country, yet the United States of America is a wonderful place to live. Read The Declaration of Independence below, reflect, and then enjoy your day.

IN CONGRESS, July 4, 1776.

The unanimous Declaration of the thirteen united States of America, When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation. We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.–That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, –That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.–Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.

He has refused his Assent to Laws, the most wholesome and necessary for the public good. He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them. He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only. He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository of their public Records, for the sole purpose of fatiguing them into compliance with his measures. He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people. He has refused for a long time, after such dissolutions, to cause others to be elected; whereby the Legislative powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within. He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations hither, and raising the conditions of new Appropriations of Lands. He has obstructed the Administration of Justice, by refusing his Assent to Laws for establishing Judiciary powers. He has made Judges dependent on his Will alone, for the tenure of their offices, and the amount and payment of their salaries. He has erected a multitude of New Offices, and sent hither swarms of Officers to harrass our people, and eat out their substance. He has kept among us, in times of peace, Standing Armies without the Consent of our legislatures. He has affected to render the Military independent of and superior to the Civil power. He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation: For Quartering large bodies of armed troops among us: For protecting them, by a mock Trial, from punishment for any Murders which they should commit on the Inhabitants of these States: For cutting off our Trade with all parts of the world: For imposing Taxes on us without our Consent: For depriving us in many cases, of the benefits of Trial by Jury: For transporting us beyond Seas to be tried for pretended offences For abolishing the free System of English Laws in a neighbouring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies: For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the Forms of our Governments: For suspending our own Legislatures, and declaring themselves invested with power to legislate for us in all cases whatsoever. He has abdicated Government here, by declaring us out of his Protection and waging War against us. He has plundered our seas, ravaged our Coasts, burnt our towns, and destroyed the lives of our people. He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation and tyranny, already begun with circumstances of Cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation. He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands. He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.

In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people. Nor have We been wanting in attentions to our Brittish brethren. We have warned them from time to time of attempts by their legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the circumstances of our emigration and settlement here. We have appealed to their native justice and magnanimity, and we have conjured them by the ties of our common kindred to disavow these usurpations, which, would inevitably interrupt our connections and correspondence. They too have been deaf to the voice of justice and of consanguinity. We must, therefore, acquiesce in the necessity, which denounces our Separation, and hold them, as we hold the rest of mankind, Enemies in War, in Peace Friends. We, therefore, the Representatives of the united States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.