Avoiding the Traditional Pitfalls of Training - Part 1

Without a doubt, the volume of high-quality practical information made available to the fitness/performance industry has exploded exponentially in the past few years. This can only mean great things. However, for new trainers who are perhaps right out of school, it is crucial to attempt to master the BASICS of functional anatomy and mechanics as they apply practically to exercise. Essentially, this must be done PRIOR to the acquisition of an athletically based “elite” clientele and/or the application of any complex or advanced program design(s). This helps to ensure the trainer has at least a basic understanding of what is going on with any given client… underneath the skin. 

It is vital that we always have a science-based rationale and system of progression with our exercise selection. If the fitness/performance professional cannot identify the mechanics and identify the working functional anatomy and follow a logical rationale/progression behind the selection of each and every exercise, the exercise should not be "prescribed." Adhering to these higher standards can only produce increased levels of respect from client to trainer as well as foster a stronger bridge of trust between the medical and fitness/performance industries.

So, let’s get back to basics. Let’s try to understand what’s happening inside the body before we prescribe loaded movements. In this series of articles, I will discuss several “traditional pitfalls” of training (aesthetically, mechanically and functionally) through a focused look at a few specific machines and exercises.

We will begin with the seated hip ab/adduction machines. These two work horses have been residing in our health clubs and gyms around the country for many years. Most have a ridiculously high tachometer readout and have undoubtedly helped to sell countless memberships. Yet ultimately, this is a concern, as chronic use of these two machines can have less than desirable consequences, let alone results.

Let’s begin by talking about exercise selection and goals. The following excerpt by Paul Chek, taken from his Advanced Program Design manual, reminds us all to consider function first and esthetics later:  

Remember, everyone is an athlete! Fitness/performance professionals must design the general health and fitness program and the sports specific program according to the needs of the individual, not your needs or desires as a conditioning specialist. Exercise selection is a topic that seems to trouble even the most elite of conditioning specialists. Today, we are bombarded by advertisements from equipment manufacturers, all claiming that their machine is the best. There are hundreds of magazine articles written by people classed as experts, all stating that their program is the best. Even though there are literally hundreds, even thousands of different exercises, many exercise specialists get stuck in a rut. The most common rut is training your clients like you train yourself. This rut, although comfortable for some, is no different than asking each client to train in your shoes. Undoubtedly, some will get blisters, some will experience acute joint pain and a few will do fine. There is no need to be in a rut! One need only follow these basic guidelines of selecting exercises:

• Correction of posture takes precedence over esthetic, gender driven exercises such as men wanting to do bench press and biceps curls, and women over indulging in abductor and adductor exercises. The only exception to this rule is when training an athlete who is on a strict time line for competition.
• Muscle imbalance findings must influence exercise selection. The alternative is chronic, re-occurring muscle and joint injury
• The sport or activity being performed will serve as the foundation from which your biomechanical assessment determines exercises selected
• Client goals will influence exercise selection but should not be the sole driving force behind the selection process. Always remember that the client is a client because you are the expert, which is why they are paying you! In many instances, a client's goals may not be the best thing for his or her musculoskeletal health. 
• Orthopedic injury will certainly hamper exercise selection. The client presenting incomplete recovery from injury can be very easily re-injured. This is one reason why the client’s goals must not be the only driving force.

That being said, let’s talk about why an individual may or may not want to use the seated hip AB/ADductor machines from esthetic, mechanical and functional perspectives.

ESTHETIC

Unfortunately, there are still many individuals performing hundreds of repetitions on these two machines on a regular basis with the hopes of reducing thigh girth, or the old stand by, “tightening up.” Let’s put the notion of “spot reduction” to rest once and for all! There is no evidence, has never been any evidence, nor will there likely ever be any evidence to support the notion that if one trains thigh muscles, the thigh fat is specifically targeted to be burned. (The same can be said for the abdominals, triceps, etc.) Fat does not turn into muscle nor vice versa.

Burning fat can only be accomplished by increasing (or normalizing, in many cases) the metabolism. The metabolism can be defined ultra-simplistically as the rate at which the body consumes fuel or burns calories. To increase one’s metabolism, there is an increasing volume of research that suggests “supportive eating” for one’s metabolic type in order to maximize metabolism, vitality and overall health. Combine this with regular resistance training (to give priority to building lean muscle tissue, which is ultimately what drives the metabolism, consumes calories and burns fat in the first place), regular moderate cardiovascular exercise and one can build an awesome fat-burning furnace within. 

Concerning resistance training, it is peculiar why one might choose the ab/adductor machines for weight loss. When weight loss is a concern, your best results come from exercises targeting large/major muscle groups. As one can observe from any basic anatomy book, the muscles isolated in the use of these machines are very small and therefore have a minimal training effect with the goals of increased metabolic rate and fat-burning.

MECHANICAL

Just what muscles are we really training here? I have found it particularly fascinating to observe the mysterious abductor “muscle” that runs down the length of the outside of the leg, pictured in the operational diagrams posted on certain brands of this machine (see Figure 1). There are absolutely NO abductor muscle(s) that run laterally down the leg. This is the ITB (Iliotibial Band), and creating restriction here from chronic isolation based training is a common precedent to dysfunction, pain and injury. Remember, muscle fiber alignment as it relates to the direction of resistance will ultimately dictate which muscles are used.

The primary abductors in the upright (anatomical) position are the gluteus medius, gluteus minimus and tensor fasciae latae. These muscles generally lie lateral to the sagittal axis. The main abductor is the gluteus medius. It is mechanically efficient because it is almost perpendicular to its lever arm when in the anatomical position. These actions change considerably when motion is performed out of the anatomical position.

When the hips are flexed, the muscle fiber alignment of the glute medius (as well as the glute minimus) no longer matches the direction of resistance. Hence, it is in a poor position to abduct the hip (see Figure 2, taken from The Physiology of Movement by Slavin).

Please note Figure 3 below. When the hip is neutral in the sagittal plane, the center of gravity lies on the axis and the pelvis is laterally stabilized by the gluteus medius. When the pelvis is tilted forward about 45 degrees (such as in seated hip abduction machines), the piriformis comes into play. As the position of hip flexion increases, the obturator internus becomes involved and, with more flexion, the quadratus femoris. That makes these muscles the primary abductors relative to each position of flexion. The tensor fasciae latae has multiple concentric functions including flexion, internal rotation and abduction, which allow it to maintain an ability to abduct while seated. So ultimately, the piriformis and TFL are being “isolated” (relatively speaking) and loaded on these machines (see Figure 4). 

Figure 3	Figure 4

What’s the problem in Figure 4? To start with, these muscles were never really meant to be regularly-chronically-concentrically-loaded in isolation (common sense tells us this by their small size). 

A primary function of the TFL (as well as the other abductors) is transverse stability of the pelvis. In other words, a major function of the TFL is to eccentrically prevent adduction (i.e., excessive pronation of the lower extremity) during functional movement patterns (walking, running, lunging, squatting, jumping, etc.). 

Primary functions of the piriformis include eccentric deceleration of hip internal rotation as well as working as a major pelvo-femoral stabilizer during functional movements to help maintain stability and proper function of the lumbo-pelvic-hip complex. 

So what can happen when one loads these two small muscles with chronic regularity over time? Extensive research has shown the following takes place: Overuse of and restriction in the TFL can create an anterior pelvic tilt, which then alters the length/tension relationship of the gluteus maximus (essentially weakening the gluteus maximus and preventing it from eccentrically decelerating hip flexion, adduction and internal rotation). The TFL and the gluteus maximus share a resultant of force on the ITB (this has been called the “deltoid” of the hip). When the gluteus maximus becomes long and weak due to the conditions mentioned above, the TFL becomes the dominant force in the resultant, which creates a tight and over active TFL. The ITB then becomes tight and restricted as well due to its direct connection to the TFL. The result of all of this is increased excessive medial rotation of the lower extremity (pronation) as well as increased eccentric load on the lower leg muscles. This in turn can cause iliofemoral joint dysfunction (IFJ), leading to hip joint restriction as well as lateral knee pain.

Overuse of and restriction in the piriformis can lead to the piriformis (as well as other external rotators) becoming synergistically dominant to perform hip extension for the weakened gluteus maximus (caused by the anterior pelvic tilt mentioned above). This in turn can create sacroiliac joint dysfunction (SIJ), leading to lumbar spine dysfunction as well as pain in the posterior thigh, buttocks and sacroiliac joint. Ultimately, this may lead to what has been labeled as “piriformis syndrome,” as a shortened piriformis may compress and irritate the sciatic nerve as it passes through the belly of the piriformis in some cases.

Adductors

The implications of chronic isolation of the adductors, from a postural standpoint, are similar to those of the abductors, and yet, it bears repeating. These primary adductor muscles include the pectineus, adductor brevis, adductor longus, the anterior fibers of the adductor magnus and the gracilis. 

Once again, these muscles have many more important functions than simply isolated-uniplanar-hip flexed-loaded adduction. The adductors work synergistically with gluteus medius, tensor fasciae latae and quadratus lumborum for frontal plane stabilization during stance phase of functional movements as well as assisting in eccentric deceleration of hip extension, external rotation and abduction. The aductors are also heavily involved in concentric hip flexion and extension (relative to the position of the femur to the pelvis) during more extreme gait patterns (sprinting, lunging, etc.).

Overuse of and restriction in the adductor complex increases frontal plane stress at the knee and hip (i.e., increased excessive medial rotation/pronation = KNOCK KNEES), as well as causing excessive reciprocal inhibition of the gluteus medius leading to compensations by the quadratus lumborum and tensor fasciae latae/IT Band for frontal plane stabilization. This can eventually lead to lumbar spine and sacroiliac joint pain and dysfunction as well as knee pain.

Considerations for Females

There are two very important structural and physiological issues to mention specifically when training females: the Q-angle and pre/post natal status. 

Please note Figure 5. The Q-angle is the difference between the straight line from the tibia to the hip joint and the line of muscular action of the quadriceps represented by the angled femur (due to the attachment of the quad on the femur). Because the Q-angle creates tensile stress on the MCL and compression on the lateral joint surface, an excessive Q-angle is likely to worsen with time. Neumann explains:

Different Q-angles exist between the genders: 15.8 degrees in women and 11.2 degrees in men. A Q-angle greater than 15 degrees is often thought to contribute to patellofemoral joint pain, chondromalacia and patellar dislocation. The abnormal kinematic sequence between the tibia and femur may cause an increased Q-angle at the knee and an increased net lateral pull of the quadriceps or iliotibial band on the patella. These situations may predispose the patient to patellofemoral joint dysfunction. Increased Q-angle due to bony malalignment is a possible factor contributing to excessive lateral tracking of the patella. The greater the Q-angle, the greater the lateral bowstringing effect on the patella. Factors that increase the Q-angle also tend to increase genu valgum (knock-knees). Data collected at a large sports medicine clinic showed that recurrent dislocations of the patella accounted for 58.4 percent of all dislocations in women, compared with only 14 percent in men. The greater Q-angle reported in women may partially account for this large disparity. 

Hence, as noted, use of the seated hip ab/adduction machines can feed into a situation of increased excessive pronation of the lower extremity, suggesting serious risks as this relates to the female Q-angle.

During pregnancy, labor and delivery, the hormone “Relaxin” contributes to laxity in the joints, which enables the strong bones and ligaments of the pelvis to stretch as needed. However, it is during this time that these structures also may be more vulnerable to the repercussions of poor training methods. The muscular imbalances and pelvic dysfunction(s) mentioned prior, caused by seated ab/adduction machine use, suggest an obvious red flag with the concern of musculoskeletal health to the trainer of a pre/post natal client.

Postural Implications

Please note Figure 6, taken from the Optimum Performance Training for the Performance Enhancement Specialist by Clark and Russell. There has been extensive research that has revealed specific groups of muscles prone to becoming short (facilitated) and their reciprocals prone to becoming long (inhibited). The muscles discussed in this article are prime examples of a few of these. What this tells us is that by use of these machines, we are encouraging tendencies toward dysfunction that already exist and that we should be trying to discourage.

Essentially, with chronic use of these machines, there is an increase in the likelihood of manifesting what are commonly referred to as "lower crossed" and “pronation distortion” syndrome. This is primarily due to a.) the position of the body (hip flexed), b.) the single plane of motion available (frontal) and c.) the type of contraction emphasized (concentric).

“Lower crossed syndrome” (LC), can be characterized by increased lumbar lordosis and an anterior pelvic tilt (this may be primarily caused by shortened hip flexors [TFL as well as others], IT band and synergistically dominant piriformis). Common injury patterns include hamstring strains, anterior knee pain and low back pain.  

“Pronation distortion syndrome” (PD) can be characterized by excessive foot pronation (flat feet), knee flexion, internal rotation and valgus (knock-kneed) during functional movements (this may be caused by shortened adductors, TFL, IT band and others). Individuals with pronation distortion syndrome develop predictable patterns of injury including: plantar fasciitis, posterior tibialis tendonitis (shin splints), anterior knee pain and low back pain. 

Look around and start noticing the prevalence of LC and PD. From the average client to the elite athletes – most will have some degree of one or both of these. If you aren’t already, it is very worth while conducting a basic transitional flexibility assessment such as an overhead squat with your clients. Observe the frequency of which your clients will excessively ADduct, medially rotate and pronate throughout one or both of the entire lower extremity(s). This should play an enormous role in the decision making process for exercise selection. 

Mechanically speaking, the point is that these muscles are working constantly in all functional movement patterns of the lower extremity (concentrically, isometrically and eccentrically), and there is simply no need to isolate and load them in this manner! 

FUNCTIONAL

From a standpoint of increasing function and/or performance there are several concepts to consider concerning the use of seated AB/ADduction machines – most of which apply to all fixed uniplanar machines in general. 

First, what is function? Function can be defined as integrated, multi-planar movement that involves acceleration, deceleration and stabilization. Machines provide artificial stabilization and only allow isolated, uni-planar training. Therefore, if the body is designed to move in all three planes of motion in an integrated environment, isolated training does little to improve functional ability. This is due to the fact that when training in an isolated, uniplanar, artificially stabilized environment, the kinetic chain (KC) is not being prepared to deal with the imposed demands of normal daily activities (walking stairs, bending over, working out, playing sports, etc.). Clark goes on to explain:

The nervous system is organized in such a way as to optimize the selection of muscle synergies and not the selection of the individual muscles. The nervous system thinks in terms of movement patterns and not isolated muscle function. Isolation and training individual muscles over prolonged periods of time creates artificial sensory feedback, faulty sensorimotor integration and abnormal forces throughout the kinetic chain. This ultimately acts to confuse the nervous system as muscles are being asked to perform a function that the nervous system does not understand. In essence, the muscles are re-programmed to perform:

• A different task. The hamstring performing knee flexion on a hamstring curl machine rather than decelerating knee extension, hip flexion and internal rotation of the tibia and femur.
• At a different speed. Consistently at slow controlled speeds rather than progressing to functionally applicable speeds (power training).
• With a different muscle action. Emphasizing concentric rather than eccentric muscle actions for the hamstrings or concentric rather than isometric (dynamic stabilization) for the hip abductors (outer thigh machines).
• In a different plane of motion. Working in the frontal plane (inner thigh machines) rather than sagittal and/or transverse planes for the adductors.

The point that’s being made here is that chronic use of machines and/or traditional uniplanar free weight exercises tends to create “stupid muscles.” Regardless of what the goal is (esthetic, endurance, speed, etc.), training for cognitive freedom and improved biomotor abilities must be an integral part of the periodization plan. 

ALTERNATIVES

Improving and maintaining optimal function (strength AND flexibility) of the ab/adductors (as well as proper core strength and balance) will ultimately allow for training with greater loads, which in turn increases gains in the rest of the body, enhancing the over all training effect. 

Assessment will determine whether flexibility and/or strength training is required and, likewise, what types. Generally speaking, however, the adductors often need flexibility combined with integrated strength training for the abductors. Remember, the ab/adductors are heavily involved in all single leg movements as well as double leg movements (see list below). All of these can be found in the PTN Exercise Library.

• Multi Planar Tubing Walking (frontal above)
• Single Leg Progressions
• Balance
• Balance with Multi-Planar Leg Reach
• PNF Cable Patterns
• Squats
• Squat Touchdowns
• Romanian Deadlifts
• Single Leg Multi-Planer hops
• Double Leg Progressions
• Multi-Planar Lunges (Bodyweight)
• Multi-Planar Prisoner Squats
• Step-Up Progressions
• Dumbbell Lunges
• Barbell Squats
• Multi-Planar Jump-Ups
• Squat Jumps

CONCLUSION

This article was a roundabout way of suggesting that we stop prescribing/allowing the chronic use of seated hip ab/adduction machines with our clients. Regardless of the goal (i.e., esthetic, mechanical, functional/performance), science has shown that energy here could be put toward a safer and more logical choice of exercise and progression. Good luck, and train safe!  

References:

1. Abrahams, PH; Hutchings, RT; Marks, SC Jr. (1998). McMinn’s Color Atlas of Human Anatomy. (4th Ed.)
2. Chek, P. (1999). Advanced Program Design. (Correspondence Course Manual)
3. Chek, P. (2002). Advances in Functional Stability (live lecture). August 11, 2002.
4. Chek, P. (2002). Train the Movement not the Muscle (live lecture). August 11, 2002.
5. Chek, P. (2001). Flatten Your Abs Forever. Video-Lecture. (book forth-coming)
6. Clark, M. (2001). An Integrated Approach to Human Movement Science. (NASM)
7. Clark, M. (2001). A Scientific Approach to Understanding Kinetic Chain Dysfunction. (NASM)
8. Clark, M; Russell, A. (2001). Optimum Performance Training for the Performance Enhancement Specialist. (NASM)
9. Kendall, McCreary, Provance. (1993). Muscles Testing and Function. (4th Ed.)
10. Lang, Annette. (2000). Training the Pregnant and Postpartum Client. (course manual)
11. Neumann, DA. (2002). Kinesiology of the Musculoskeletal System.
12. Purvis, T; Simon, M. (2001). Resistance Training Specialist Programs.
13. Slavin, M. (1999). The Physiology of Movement.
14. Stoehr, Garen. (2002). A Field Guide to Practical Anatomy. (Course manual). Peak Fitness Consulting.
15. Walthers, DS. (1981). Applied Kinesiology. (Volume 1)
16. Wolcott, W. (2000). The Metabolic Typing Diet.
17. Russell, A. (2002). Performance Enhancement Specialist (live-lecture). May 3-5, 2002. (NASM)