Ultimate Back Fitness and Performance (6th Edition-2017)

Acknowledgments (pg 1)
Preface (pg 3)

Part I Scientific Foundation

Chapter 1 – Laying the foundation – Why we need a different approach (pg 9)

• • The Ultimate approach
    • The concept of tolerance and capacity
  • Current low back disorder myths
    • The myths associated with stretching
    • The myths associated with strengthening – rehabilitation vs training for performance
    • Motion and motor changes from back injury – pain inhibits optimal motor patterns
    • What distinguishes the best athletes?
    • Another Myth: Getting stronger always makes a better athlete
  • Misdirected clinical effort
    • Focusing on multifidus, or transverse abdominis or any other single muscle
    • The confusion between rehabilitation and performance training
    • The pollution of body building approaches in low back training
    • Athletic painful backs: Dealing with the cause and the role of prevention The mind and performance
    • The doctor says the pain is in your head – don’t believe it!
    • Each person is an individual – there are no approaches that work with all Are back troubles a life sentence?
  • How we obtain the evidence to improve back training – Our unique approach
    • In-vitro lab The in vivo lab
    • Clinical Research and Field Trials
  • References for the modeling process
  • References

Chapter 2 – Exercise science and the back – Removing the confusion (pg 27)

• Introduction
• Training affects all systems
• Preliminary issues for designing a program
  • Strength
  • Factors that limit training outcome Biomechanics and training The concept of the moment
  • Muscle mechanics
  • The Russian philosophy of training
  • Competent coaching matters
  • A note on Plyometrics
  • Strength and posture
  • Proprioception training
  • The science of flexibility
  • Progression of a program with younger athletes
  • Training balance
  • The popularity of the Olympic lifts: Justifiable or misdirected Training with machines – a discussion
  • The principle of dynamic correspondence
  • Safety Issues – a generic discussion
  • Principles for designing a good warm-up
• Specific Considerations for Rehabilitative Back Exercise
  • Back Flexibility
  • Strength and Endurance
  • Spine Power – integration of flexibility and strength discussions Motor patterns
  • Eliciting volitional movement
  • Aerobic exercise
  • Studies on the connection between fitness and injury disability Order of exercises within a session
  • Establishing grooved patterns (Movement Engrams) Breathing
  • Time of day for exercise
  • Clinical Relevance for the Rehabilitative Exercise
• The process of injury: Tissue response to mechanical load
• References

Chapter 3 – Helpful Facts: Anatomy, Injury Mechanisms and Effective Training (pg 61)

• Some anatomically based facts
• Basic neural structure – activating back muscles
  • Are you a master of your motor control domain?
• The full spine
• The vertebrae
  • Vertebral endplate fractures
  • Posterior elements of the vertebrae and neural arch fracture
• Optimizing health of the intervertebral disc
  • Avoiding disc herniation
• Muscles
  • The proprioceptive function of the small rotators and the intertransversarii
  • The back extensors have several important roles: Longissimus, iliocostalis and multifidus Latissimus dorsi is a critical performance muscle
  • Abdominal muscles
  • Abdominal fascia
  • Rectus abdominis
  • Abdominal wall – Obliques and transverse abdominis
  • Psoas
  • Quadratus lumborum
  • Ligaments
• The pelvis and hips and related musculature are important considerations for the back
  • The great ones train the hips
• References

Chapter 4 – Normal Back Function and Changes Following Injury (pg 85)

• How you stand is important
• Lumbo-Pelvic rhythm, bending, performance and injury risk
• Additional thoughts on spine bending
• General muscle activity amplitudes
• Mechanics of specific activities
  • Loads on the low back during lifting
  • Consider sitting to be a dynamic task
  • The mechanics and implications of walking
  • Elliptical machines
  • Pulling and pushing technique is critical
  • Loads on the low back during flexion exercises
  • Loads on the low back during various push-up exercises
  • Loads on the low back during extension exercises
  • Pulling patterns for the posterior chain:
  • Sled drag and mini bands – Integrating the hips
  • On backpack carriage and training
  • Bedrest, back pain and exercise
• Other facts that assist performance
  • Spinal memory
  • Confusion over twisting
  • What about back belts
  • Guidelines for serious athletes
  • Nature’s back belt – the abdominal hoop and the Lumbodorsal fascia Pain Pain
  • Predominant pain generating mechanisms in athletes
  • Sciatic symptoms
  • Sacroiliac pain – Is it from the joint?
  • Staying within the “Biomechanical envelope”
• Biomechanical, Physiological and Motor Changes Following Injury
  • Pain and central sensitization
  • Motor control changes
  • The crossed-pelvis syndrome and gluteal amnesia
  • Other lingering deficits following injury
  • A commentary on the new “Pain Science”
• References

Chapter 5 – Enhancing Lumbar Spine Stability (pg 113)

• Why spine stiffness/stability is essential
• Finding about spine stability can be summarized as follows:
• A few crucial issues to enhance fitness and stability training
  • A classic- viewing instability and injury
  • Illustrating the important conditions for stability
  • Stability myths, facts, and clinical implications
  • Ensuring sufficient stability usually only needs modest levels of muscle activation
  • The special case of transverse abdominis
  • Abdominal bracing vs. hollowing
  • Breathing and stability
  • Why do athletes “Grunt?”
  • The hammer and the stone
  • Summary: The lesson for athletes
• References

Part II Individualizing Programs

Chapter 6 – Fundamental principles of movement and causes of movement error (pg 127)

• Section 1. Identifying the fundamental movement patterns
• Section 2. Identifying movement errors and correcting their cause
  • Finding optimal movement and performance techniques
  • Movement error checklist
  • Principles for optimizing performance
  • Summation and continuity of joint forces and moments
  • Production of linear impulse
  • Direction of force application
  • Principle of stability
  • Summation of segment velocities
  • Production of angular impulse (rotational motion)
  • Conservation of momentum
  • Manipulation of moment of inertia
  • Eliminate energy leaks
  • Principles for safety
  • Minimization of tissue stress
  • Optimal joint positioning
  • Minimization of fatigue
  • Qualitative biomechanics to analyze the movement – putting the principles together
  • Final thoughts: Control feedback and proprioception
• Section 3. Understanding the stages of motor skill development to better teach motor skills

Chapter 7 – Injury prevention and injury proofing (pg 141)

• Preparing the athlete
• The importance of spine hygiene throughout the day
• Reducing the risk in athletes – guidelines
• What coaches need to know
• References

Chapter 8 – Evaluating and qualifying the Athlete/Client (pg 155)

• The first consultant-athlete (with back symptoms) meeting
  • So what have we learned?
• The first meeting for those without back troubles
• Some additional performance-specific tests
  • Assess posture
• Basic Movement – The squat
• Basic Movement – The squat – Choosing optimal hip and foot width
  • Looking for spine “hinges”
• Poor control in torsional tasks
  • Stable patterns during challenged breathing
  • Endurance Testing
  • Specific movement screens
• A philosophical approach for selecting specific tests, and designing the program
  • Step 1. What are the demands of the sport/activity?
  • Step 2. What are the capabilities of the athlete – together with current deficits
  • Step 3. Designing the program
• A final note on qualifying the athlete for specific training exercises References

Part III Building the ultimate performer – Putting it all together

Chapter 9 – Developing the Program (pg 177)

• Some preliminary matters
  • Some notes for the chronic back
  • Keeping a journal of daily activities
  • Ensure continual improvement
  • How long should each stage be?
  • Training with labile surfaces underneath the athlete
  • Training harder and longer is not always better
  • Some final thoughts on reps, sets and sessions
• Stages of athlete progression References

Chapter 10 – Stage 1: Eng rain motion/motor patterns and corrective exercise (pg 183)

• • A note on the training environment
  • Awareness of spine position and muscle contraction
    • Lumbar spine proprioception training
    • Corrective standing approaches
  • Corrective walking approaches
  • A convincing demonstration of the influence of posture on strength
  • Distinguishing hip flexion from lumbar flexion – Teaching the motion pattern
  • Perfecting the “hip hinge”
  • A note on spine stability, spine motion and control
  • Locking the rib cage onto the pelvis
  • Mental imagery
  • Steps of mental imagery
  • Other imagery exercises to develop motion/motor awareness
  • Important abdominal patterns
  • Abdominal hollowing is dysfunctional – Abdominal brace instead
  • Teaching abdominal bracing
  • A note on fascial raking
  • Building squat patterns
  • Re-training the gluteal complex
    • Learning to activate gluteus medius
    • Learning to activate gluteus maximus
    • Beginning basic squat patterns
    • Star exercises
  • Active flexibility and stretching for back performance
    • Active flexibility for the back
  • Sparing the back while stretching the hips and knees

Chapter 11 – Stage 2: Building whole body and spine stability (pg 215)

• • • Whole body balance
    • Balance training examples that progress from less demanding to more demanding for the back
    • Specific exercises to develop whole body balance
      • Soft hands
      • Japanese stick
    • Exercises for training the stabilizing muscles
    • Training the stabilizers of the lumbar spine: The “Big Three”
      • The Curl-up
      • A trick to alleviate neck symptoms
      • Isometric exercises for the neck
      • Curl-up progressions
      • More on the abdominal progression
    • The side bridge
    • Training spine stability during high physiological work rates
    • The Birddog
      • Advanced motor patterns with the Birddog
      • Building the stabilization program
      • Safe progressions of back exercises
    • References

Chapter 12 – Stage 3: Endurance (pg 233)

• • • The reverse pyramid for endurance training
    • Training for endurance events
    • Breathing mechanics
    • References

Chapter 13 – Stage 4: Developing Ultimate Strength (pg 237)

• • • Stage 4. Strength training considerations
      • Qualifying the athlete
      • Training motor units
    • Body weight resistive exercises and surrounding the dragon
    • Dumbells vs barbells
    • Cables: For multidimensional strength
      • Choosing the cable load
    • Bands Chains
    • Abdominal Strength
    • Training hip flexion strength and power
    • Building squat performance
    • Building more hip and back extension strength and performance
      • Training to power squat
      • What about box squats?
    • Don’t forget hip external rotation
    • Quadratus lumborum – essential for functional strength
    • Building torsional strength capabilities
    • References

Chapter 14 – Stage 5: Ultimate performance with speed, power, and agility (pg 269)

• • • A note about the dead lift
    • Speed strength
      • Tips for speed strength
    • Agility
    • Progressing into plyometrics
    • Some final thoughts on program design References

Chapter 15 – Final transitional training – Ultimate performance with the techniques of Super Stiffness, and other tricks (pg 279)

• • • Principle #1 Proximal stiffness enhances distal athleticism
    • Principle #2 Rapid contraction and then relaxation of muscle
    • Principle #3 Tuning of the muscles
    • Principle #4 Muscular binding and weaving
    • Principle #5 Directing neuronal overflow
    • Principle #6 Eliminate energy leaks
    • Principle #7 Get through the “sticking points”
    • Principle #8 Optimize the passive connective tissue system
    • Principle #9 Create shockwaves
    • References

Chapter 16 Putting it all together – Case Studies (pg 291)

• • • Enhancing the agility of a soccer goalkeeper
    • Re-grooving the chronic back of an elite golfer
    • The rower who had to continue
    • The washed-up baseball catcher
    • The CEO who had painful “midnight movement”
    • Building the power lifter
    • Rebuilding a power lifting beast
    • A sprint kayaker broken with an endurance warmup
    • Pelvic and S.I. pain in an elite sprinter: squat vs spit-squat
    • Jiu Jitsu: Bucking tradition to rebuild a career
    • Body builder with underperforming core
    • Pro footballer with sleeping challenges
    • The misguided football lineman
    • Training a sprinter
    • Back troubles in the long distance runner
    • The Rock Climber
    • The champion squash player
    • The dancer building to the arabesque
    • Two former gymnasts and the spine instability legacy
    • Sciatic case-flossing
    • The “Strongman” competitor unable to conquer the sticking points
    • Blending speed, stiffness, strength and compliance for the martial artist
    • A Squat “Clinic”
    • A comment on forensic cases

Epilogue: Becoming the Elite Builder of Ultimate Backs (pg 317)
lndex (pg 321)
About the Author (pg 331)