Both the upper body rolling pattern and the thoracic spine rotations are ground-based patterns designed to unwind stiff and tight tissue, improve multi-segmental movement to the spine; as well as to calm and restore the body’s natural to breath deeply (which in turn helps to improve the relaxation response).

Why is rolling important?

Upper body rolling pattern is the first pattern performed in neurodevelopment. For example as infants, when we hear mommy, but can’t see her we discover that we can roll around and move from one side and the other. Our heads and eyes direct where our body naturally wants to go and it’s how we get from our back to our front. This of course then leads into getting from A to B – crawling and walking.

The upper body-rolling pattern becomes the first time we learn to truly use our inner unit/core as infants. We stabilize our center of gravity and learn how to rotationally get around. As adults, this pattern is often forgotten, when addressing lack of mobility in the thoracic spine, and tight tissues of the chest and back it can be used as a great tool. The soft rolling patterns can be used as mobility drills, but they also require a certain level of motor control. If the thoracic spine is very limited, this will be hard to achieve without compensation. This is where the thoracic spine rotations come in to play.


Mobility before stability

Adequate mobility is first and foremost when addresses movement dysfunction and in restoring movement competency. Yet, as adults through the invention of the chair, long bouts of sitting through school, work, driving and bipedal motion, we naturally lose the ability to properly move segmentally in our spine optimally. We may feel a dull ache in the lower back, strain the neck, or feel heavy in the mid section due to compressive forces of not being able to move freely.

One of the pre requisites for the upper body-rolling pattern is ensuring there is adequate mobility in the thoracic spine. Most often this area needs a little restoring so that the muscles and connective tissue of the thorax, ribcage, deep spinal muscles can effectively rotate, move and extend.


Form and Function of the T-Spine Rotation:

This T-spine rotation series features 3 progressions, designed to re open and re connect with the breath while encouraging 3 specific vectors of force (1) hip stabilization (2) thoracic mobility and (3) fascia opening of the superficial front and deep arm lines.

This video series presented focuses on three self-managed exercises designed to improve thoracic mobility, scapular gliding and opening of the breath. These can be used together as a sequence or independently for movement preparation and decompression post workout.

For all three progressions there are 3 distinct focuses:

(1) ensure there is downward activation of the knee; the knee should drive down into the foam roller to ensure lumbar lock and limit extension.

(2) ensure there is downward activation of the shoulder in contact with the floor. This ensure stabilization of the thorax.

(3) as you open your wing, ensure your head and eyes move to the direction of the arm. Your head is an extension of your spine.

T Spine Rotations

Video reference here:


Form and Function of the Upper Body Rolling Pattern:

Flexion Pattern:
Ensure when starting this drill you lay on your back in supine with feet and arms shoulder width apart and the head in contact with the floor. The lower body should remain motionless until the upper body pulls the lower body over. Think of flexing the nose into armpit, as the arm rotates across, pull from the back and ribcage through the exhale.

Extension Pattern:
Ensure when starting this drill you begin by laying on the floor prone with the feet and arms shoulder width apart and the forehead on the floor. Much like the flexion pattern, start by moving your eyes and neck into extension, look behind as the arm follows pulling the lower body across.

upper body rolling pattern flexion2

Video reference here:

Watch the videos for specific movement and cues on how to perform these two corrective exercises. To know more about whether these drills are right for you, consider getting a functional screen first to assess your needs and mechanics stressors.

Happy Rolling!

Stabilize Your “Wings”

Stabilize Your “Wings”

When we think of the word “chicken” in the gym, we naturally think of the term “chicken legs;” but how often do you think about your “chicken wings?”

By this I mean the muscles that promote good posture, the muscles that help to stabilize the shoulder girdle; and help to assist with breathing. Many of these important muscles, are often small, neglected and overlooked when discussing corrective exercise prescription. These muscles are the Serratus Anterior and Serratus Posterior groups.

Lets look at their basic anatomy and function.


Anatomy Breakdown of the Serratus Anterior:

The Serratus Anterior is a muscle that originates on the surface of the 1st to 8th ribs at the side of the chest cavity and inserts along the entire anterior length of the medial border of the scapula. Apart from the shoulder blade it also attaches to the thoracic segment of the spine. It’s main function is to act as a scapular stabilizer; in other words, when we do shoulder movements, particularly reaching over head, the scapula must get locked into place against the t-cage, allowing unimpeded movement, yet many people find this significantly challenging.

When this particular muscle becomes hypertonic it can cause the scapula to wing out, rolling the shoulders forward and can further cause unnecessary stress to the thoracic spine.
Anatomy Breakdown of the Serratus Posterior:

The Serratus Posterior superior muscle connects the bottom two neck vertebrae and the top two upper back vertebrae to the 2nd – 5th ribs and helps to raise the 2nd – 5th ribs to assist in inhalation. It’s primary function is to help in breathing mechanics, especially when we are forced to inspire (breathing hard).

Like all muscles, the attachment sites of Serratus Posterior Inferior determine its function. Its serrated strips connect from the spinous processes (the jagged topography of your spine felt through the skin of your back) of vertebrae T11-L2, and reach upward and outward to ribs #9-#12. It’s function is to anchor ribs #9-#12 downward toward its attachment on the spinous processes; to ensure that the ribs don’t elevate during the first phase of a complete inhalation.


When this particular muscle becomes hypertonic it can promote forward head carriage and rounded shoulders. It can also cause our breath to weaken in overall capacity. It is often a trigger point for hands on treatment.

Corrective Exercise Rx:


Most of us only use 25% of our lung capacity, and many have apical breathing (chest breathing); which weakens the diaphragm from its reflexive nature. A complete inhalation takes place in two phases to maximize lung capacity. Phase one secures the rib cage (enter Serratus Posterior Inferior). As the belly swells until the lungs are about 75% full. In phase two, we can “top up” the breath lifting the rib cage to upward, filling the lungs the remaining 25% of the way.

This is often taught in Yoga classes and in aiding to correct breathing dysfunctions. This rib expansion is also assisted by the diaphragm’s attachments to the ribs and thus allows you to expand the intercostals of the ribcage horizontally and laterally.

It is here we can see the importance of the Serratus Posterior Inferior and it’s role in bracing the ribcage to encourage a deeper release of the diaphragm.

Improve Your Posture:

They help us move our arms multi-dimensionally and with great speed. We may not necessarily rely on them for bipedal locomotion, but they help us move forward by increasing our arm’s distance from danger, keeping predators at an arm’s length away or drawing an imaginary boundary.

They also are a crucial scapular stabilizer in almost every inversion and arm balance and can help to reduce tension and stiffness in the neck and upper back by re aligning the relationship between the scapula to thoracic region of the upper quadrant.

The exercise I like to use is a floor press, or a wall press. I teach this exercise prior to a push up or a scapular pushups, because it reinforces the idea of the shoulder blades packing down into the back pockets. For those clients with neck or shoulder pain, it can be difficult to hold a push up position without additional stress on the neck; therefore a floor press is a great place to start.

The actual movement is called protraction of the shoulders, which is the exact opposite of retraction (pulling the shoulders back).

Wall Press:

Stand facing a wall, arm distance length, with palms shoulder height on wall. Lean forward with your torso toward the wall, without bending your arms, feeling the shoulder blades come closer together at the spine. Ensure that your pelvis is slightly tucked to encourage the core to also engage.

Floor Press:

Progression 1: Dandasana: start with legs extended out with  both sit bones on the floor. Place hands beside the hips on the floor. Create positive tension in the legs by squeezing them together, big toes touching, flexed up. Then press into the floor, as if creating space between your hips and the floor. Hold for a count of 4.

Cue: Think about placing your shoulder blades into your back pockets, and keep head neutral over the spine.

Progression 2: Cross Legged Floor Press: Sit on the floor, legs crossed. Place your palms on the floor by your hips, with arms straight. Press you body away from the floor, till you can feel space between your hips and floor. Hold here for a count of four and gently release. For those who have limited flexion in the spine and being seated on the floor is difficult, you can also use a set of kettlebells or a bench. This offers you more space to work with. Much like the start position for a trice dip, you either hold the horns of the bells or the edge of the bench, directly beside your hips, and then press down, ensure your “get tall” through the spine. Keep knees bent and in line with the hips, feet rooted to the ground. Hold for a count of 4.

Cues: Think about placing your shoulder blades into the back pocket, and ensure you keep your head AND hips in line with the spine. Your hips should “dangle” off the floor. if this is too challenging, using a blocks under each hand can offer your spine the space to stay long.

This will help encourage better posture, reduce stiffness and tone in the neck and mid back, as well as strengthen the stabilizers of your shoulder girdle.

Happy Pressing!

Clubbell Yoga Comes to Vancouver

Clubbell Yoga Comes to Vancouver

Yoga means Union, to yoke. The Clubbell Yoga practice is a modern expression of the yoking of two very effective ancient systems, eastern Club swinging and Hatha Yoga. Yoga means many different things to many different people, and many ‘yogis’ follow a specific lineage that resonates with them. We recognize that Yoga can be a spiritual practice, it can be a devotional practice, and it can be a physical practice that leads to other intellectual studies.” – Orgins, of Clubbell Yoga, Summer Huntington

 CBY 7

Clubbell Yoga:

Clubbell Yoga is a fusion of strength and intelligent movement. For those of you who are new to Clubbells it is a tool relatively new to the Canadian market, yet well distributed in the USA, Europe, and abroad. I had the opportunity to chat with Summer Hunington, Co-founder of Clubbell Yoga to learn more about this workshop coming to Vancouver BC, this January.

Clubbells are a unique tool, which require precision, stabilization, and  a good deal of articulation under load. What makes the clubbell unique ,is its design, in that the majority of the weight is distributed above the handle, creating a longer lever to control under load. When held upright it requires more muscle activation and motor control in the shoulder complex, postural muscles and trunk stabilization to keep it steady and to transition from movement to movement, while maintaining breath and flow. Drawing from Summer’s experience as an adjunct teacher in Kinesiology,  a leader in the community of Yoga, and as a head CST coach, she is paving the way for movement culture.

CST is the “flagship” professional certification course at RMAX International pioneered by Scott Sonnon, a refined, coherent, cohesive and comprehensive approach to the industry of movement culture. CST has rapidly emerged as a leader among the premier training modalities in the health / fitness and strength / conditioning arenas.

How is Clubbell Yoga compliment traditional fields of conditioning?

One of the greatest myths of our time is that “hardcore” trainers tend to not have a background in yoga, nor do they see the benefits. Those who “lift;” don’t do yoga and vicer versa; that yogis don’t have much knowledge in training for power and don’t life. This is a misconception, and it has left many “lifters” injured due to lack of dynamic mobility and “yogis” injured from overuse and improper alignment.

Clubbell Yoga aims to bridge the gaps between these two groups and reeducate the benefit of integrating both into a seamless practice.

Who Can Benefit?

Both of these disciplines compliment each-other, and are designed to build from the ground up. This means you do not have to be experienced in either discipline; this workshop is designed for all levels in both fields of study.; especially for active professionals involved in sport. You can be a beginner or you can be experienced. The glorious thing about both disciplines is that you can go at your pace. There is an introduction to both modalities; which can have endless benefits for both body and mind.


Vancouver Workshop: Clubbell Yoga & Anatomy Breakdowns

Come learn about glute activation and core with Accupuncturist and NKT specialist Carolyn Watson and Summer Huntington, co-creator of Clubbell Yoga. They are both very dynamic teachers who will improve your understanding of yoga poses involving glutes, give you anatomy breakdowns and hold discussions and breakout sessions. Yogis, trainers, pilates instructors and everyone in between are invited to this workshop in the heart of Vancouver, BC.

Click on this link to REGISTER

VIP Registration – $99
(Register before December 15th, 2014)
Early* Registration – $129
(Register before January 16th, 2015)
Registration paid in Full – $150
(*VIP and Early registrants can borrow clubbell at event)

About the Co Founders:

Summer Huntington:

Summer Huntington is a Head Coach at RMAX International, co-creator of Clubbell Yoga and owner of Fit Body Wellness. Her primary objective is to help bridge the gap between strength training and yoga by infusing weighted Clubbells into traditional vinyasa classes. She holds an undergraduate and masters degree in Kinesiology: Human Movement & Performance, is an adjunct professor and is an experienced yoga teacher.

Summer practices and teaches vinyasa flow yoga and Clubbell Yoga with an emphasis on alignment, thoughtful sequencing and cultivating a soothing meditation through movement. Summer has been a longtime student of Scott Sonnon, founder of the Circular Strength Training (CST) method, which is mind-body exercise using a Clubbell. Her joint-mobility, Prasara yoga and Flow Fit background allow her to help students to unlock bound areas and allows for training of the nervous system.

Scott Sonnon:

Scott is the founder of RMAX International, CST and Tacfit. Scott has now taken his success in martial art, fitness and yoga off the mat and into the classrooms, as an international speaker advocating for children and adults facing labels of learning difficulties, facing the ravages of obesity, the trials of post-traumatic stress, the dangers of bullyism and the challenges of accelerated aging in joints and soft tissue.

For more information please visit the following website:

Clubbell Yoga –

Primal 12 –

Can Creativity Be Learned?

Can Creativity Be Learned?


Is creativity and intelligence the same thing? How does our brain process thoughts, feelings, ideas, questions and answers? Can creativity be learned and if so how? The study of “thinking” and “creativity” has been an area of study by the science community for some time, and over the last decade or so has gained significant traction.

As a movement coach, my professional focus is aimed at the knowledge and application of biomechanics, addressing movement compensation and approaching the health-first model with corrective prescription. With that being said we know, that movement is a behaviour; therefore I spend a great deal of my study in the arena of human behaviour and behaviour modification. What we also know is that can be re shaped; with another growing field of study called neuroplasticity. It all boils down to adaptation and the right stimulus. How we approach thinking is first and foremost.

Dr. Jung, an assistant research professor in the department of neurosurgery at the University of New Mexico, explains; “The brain appears to be an efficient superhighway that gets you from Point A to Point B” when it comes to intelligence. But in the regions of the brain related to creativity, there appears to be lots of little side roads with interesting detours, and meandering little byways.”

Although intelligence and skill are generally associated with the fast and efficient firing of neurons, many studies have shown that subjects who tested high in creativity had thinner white matter and connecting axons that have the effect of slowing nerve traffic in the brain. This slowdown in the left frontal cortex, a region where emotional and cognitive abilities are integrated, some believe might allow for the linkage of more out of the box thinking ideas, novelty and creativity. Creativity seems to take a more meandering path to a specific decision, where intelligence looks for the most efficient and readily available answer.

Contextually we can look at the thought process as one highway or another; meaning either “convergent or linear thinking” vs. “divergent or lateral” thinking – a fork in the road. “Convergent” and “divergent” thinking represent two different ways of looking at the world, but what’s the difference?


Convergent is a form of the word “converging” meaning to “come together.” A convergent thinker sees a limited, predetermined number of options; a set number of options predetermined from their previous education and experience of the world. Convergent thinking is what you engage in when you answer a multiple choice question (although, in real life, we often only see two choices). This style of thinking is known as linear thinking.

Example of Convergent Thinking:

What rhymes with brick?

  1. Lead
  2. Treat
  3. Stick
  4. Iron

The most logical answer is the correct answer.

By contrast, divergent means “developing in different directions;” therefore, divergent thinking offers you the available to open your mind to alternate possibility in different directions. It leads you to look for options that aren’t necessarily apparent at first. A divergent thinker is looking for options as opposed to choosing among predetermined ones.

Divergent or lateral thinking, is the ability to think creatively, or “outside the box;” which sometimes involves discarding the obvious, leaving behind traditional modes of thought, and throwing away preconceptions.
Example of Divergent Thinking:

Grab a timer and set it for one minute. Now list as many creative uses for a brick as you can imagine. Go.

The question is part of a classic test for creativity, a quality that scientists are trying for the first time to track in the brain. They hope to figure out precisely which biochemicals, electrical impulses and regions were used.

Over the past 30 years, Dr. Jung has relied on a common definition of creativity: the ability to combine novelty and usefulness in a particular social context. While I.Q. tests, though controversial, are still considered a reliable test of at least a certain kind of intelligence, there is no equivalent when it comes to creativity.

Creativity is a complex concept; it’s not a single thing, and most researchers can agree that no single measure for creativity exists. Creativity is a collection of different processes that work in different areas of the brain.

In New Mexico, using M.R.I. technology, researchers are monitoring what goes on inside a person’s brain while he or she engages in a creative task. Taking into consideration the biochemical, neurological, biological, and breakdown of nerve firing into parts and patterns. The findings are that the images of signals flashing across frontal lobes have pushed scientists to re-examine the very way creativity is measured in a laboratory. Creativity not only involves coming up with something new, but also with shutting down the brain’s habitual response, or letting go of conventional solutions. Leading us into the direction of unconventional solutions.

Ironically, in my line of work – the health and wellness industry – we have seen a surge of coaches and businesses leaning towards unconventional means of training, vs. the traditional strength and conditioning models. It seems almost serendipitous.

As a Movement Coach and Corrective Specialist, screening a client and building a baseline is key to any client’s success. On the macro level, I have to be somewhat linear in my approach; I must be organized, data driven, and adhere to a standard operating system, so that inter-rater reliability is upheld and a baseline is set for each client. However, on the micro level when addressing goals, performance metrics or corrective strategy I prefer to think outside the box and be creative. I have more opportunity to think unconventionally so that each client has the ability to use their brain to absorb information from our eyes, ears, and other senses – all of which, directly relate to changing movement and behavior.

Sources of Inspiration:

Win a Lifetime Membership to Yogi Surprise!

Win a Lifetime Membership to Yogi Surprise!

Attention all yogis and yoginis! A new company called ‘Yogi Surprise‘ is set to launch very soon. It’s a monthly care package designed to complement the active yogi’s lifestyle! Think of it as a mini yoga retreat delivered to your doorstep. Each month, Yogi Surprise will send its members 6-8 full size products ranging from items like unique yoga accessories and natural beauty items to herbal tonics, organic snacks, super food essentials and more! Sounds fabulous doesn’t it? And best of all, here’s your chance to win a lifetime membership:


“Happy Feet” The Importance of Foot Mechanics

“Happy Feet” The Importance of Foot Mechanics

Your feet are the foundation of every stride you take. Nowhere is the miracle of the foot more clear than watching the human body in locomotion. It is something to be marveled. The combination of 26 bones, 33 joints, 112 ligaments, and a network of tendons, nerves, our fascia matrix and blood vessels all work together to establish the graceful synergy that allows us to get from A to B. The balance, support, and propulsion of our body all depend on the foot. But before entering a fitness regimen that includes jogging, don’t forget to make certain your body’s connection with the ground is in proper working order.

So why is it that so few runners give their feet proper care? We stretch our hamstrings, tighten our stomachs and carbo-load our muscles, but barely pay any attention at all to our feet.

Which is especially misguided when you consider that, after the knee, the foot is the most frequently injured body part.

foot 1

How’s Your Gait?

Many health professionals now use gait analysis as a critical part of their assessment and screening protocol. A comprehensive analysis will look at the foot mechanics in several focuses: a non-weight bearing state, standing, walking, running at pace (i.e. endurance vs. sprint) and after fatigue. A well rounded analysis will also take into consideration more than the foot — you must look at the knee, pelvis and low back, and what’s most forgotten, the reciprocal relationship of the arm mechanics in static posture, and in swing.

Biomechanics in a non-weight bearing foot boils down to the functionality of the multiple joints of the foot and how they interact, particularly in a dynamic state. Is your foot rigid, flexible, flat or high-arched? Does your big toe have the motion it needs for push-off? Is the main ankle joint (talocrural joint) moving correctly? What changes when the foot bears weight in standing, walking or running? What happens if we load the structure, how does balance and coordination shift?

When running, foot strike location in relation to the body position is a major factor in efficiency and effectiveness. If foot contact with the ground is made in front of the line of the body, regardless of where on the foot the contact happens, the foot will act as a break in motion. Ideal foot contact should be under the body to allow forward momentum to continue unimpeded.

What does this mean for the average runner? Think more about where your foot is landing and less about which part of your foot lands first.

The Big Toe “This Little Piggy Went to Market”

The toes (especially the great toe) play a vital role in normal arch functioning, both in the shock absorption and propulsion phases. In normal stride cycle the toes are flexed up on landing so the foot lands with the arch high like a shock absorber at full extension. Then the toes lower and the arch flattens dissipating shock in a controlled manner. As stride moves forward the heel lifts up, flexing the toes up, and lifting the arch-turning it into a rigid lever for an energy efficient push-off. this “Windlass Mechanism” requires free movement of the toes and plantar fascia ligament for proper shock absorption and propulsion.

The great toe being able to stabilize the arch in midstance and takeoff is critical for a funcional gait and normal arch functioning. Remember an arch is supported by its ends- this is the front end and a heel flat and balanced with the forefoot is the other end. When medical patients lose their great toe due to injury or infection they are left with a foot that is very unstable, with no ability to absorb shock, and with limited to no propulsive properties. Not surprisingly, many of these patients often end up with severe disabilities and higher amputations as they traumatize other foot structures.

The big toe must be properly aligned and the flexor hallucis longus and brevis allowed to perform normal stabilizing functions.

foot 2

You Gotta Have the Right “Sole”
Proper shoe selection is vital to foot health–not merely the shoe brand and model, but the fit. “Bad shoe fit can cause a multitude of problems for your feet, everything from numbness and burning to blisters and painful calluses. Shoes that are too short can cause black toenails. Shoes that are too narrow in the forefoot can cause pinched-nerve pain, bunions, corns or calluses. Shoes that are too wide allow the foot to slide around, which causes undue friction, which in turn can lead to blisters. And so on. Just like Goldilocks and the 3 bears, you have to try a few on before making a decision. Most shoe stores these days have experts in this field, so seek out a pedorthist and ask for guidance.

Once you purchase shoes with the right fit, you then need to maintain them and replace them when they’re worn out. The average life of most running shoes is 350-500 miles, but if you’re a heavier or taller runner, or if your gait isn’t smooth, you may need new shoes sooner.

Think Patterns of Running, Not Parts

Efficiency is affected by hip stability and mobility, trunk stability and thoracic mobility, shoulder mobility and head posture.

Runners with a mid-foot strike will translate much of that energy into up and down motion – rather than forward motion — will be less efficient than a heel striker who sends all the energy forward.

Things to think about when taking the piggies out to the market.


Next week we will address the corrective strategies for addressing re stabilization for the foot and mobilization of the lower limb mechanics.




Incision and closure of the abdominal wall is one of the most frequently performed; yet least discussed, of surgical procedures. Another often over looked topic is; understanding the rehabilitation process and post surgical care. Placing the power in the clients hands and arming them with the knowledge to self manage the healing process can significantly reduce movement dysfunction caused by scar tissue or change in posture habits and inactivity; as well as, a basic understanding of the timeline for wound healing and wound health.

The structural integrity of the anterior abdominal wall depends upon the rectus abdominis muscles, the muscles of the flank, and the conjoined tendons of the flank muscles that combine to form the rectus sheath. These terms, the anatomy and function were introduced in length in my last article. The rectus abdominis muscle is found on either side of the midline with the pyramidalis muscle lying superficial to the rectus muscle just above the pubis.

Factoring in connective tissue; we mentioned the rectus sheath also forms and intertwines with the superfiscial front line and the deep front lines of the fascia matrix. However, two notable structures are often overlooked when discussing abdominal wall surgery and post surgical care. They are the pyramidalis and the transversalis fasica.


abdominal wall 1

The Pyramidalis:

One important muscular structure that is often not discussed in re training/ re patterning post-surgical rehabilitation is the pyramidalis.

The pyramidalis muscles arise from the pubic bones and insert into the linea alba in an area several centimeters above the symphysis pubis. Normally, the precise function of the pyramidalis muscle is unclear and considered to be of no value in the human structure. That is until abdominal incisions are made along the linea alba and near the umbilicus. The function this muscle acts to contact the linea alba, as well as stabilize the pelvis.

Therefore, if scar tissue or adhesion builds up, as it naturally will due to cutting through the abdominal wall and connective tissue, the innervation and nerve response could be diminished. In many patients, I have worked with I have seen Si joint dysfunction and low back pain that was not present prior to surgery. Something to consider in rehabilitation.

Transversalis Fascia 

Deep to the muscular layers, and superficial to the peritoneum, lies a layer of fibrous tissue called the transversalis fascia, which lines the abdominal cavity. It is visible during abdominal incisions as the layer just underneath the rectus abdominis muscles.

It’s importance lies in the nature of it’s structure. The transversalis fascia in its entirety is second in importance perhaps only to the peritoneum as an encasing membrane of the abdominal contents. It acts to reinforce and stabilize the spine, as well as regulate intra abdominal pressure. Where function demands, it thickens and develops its strong elastic fibers to a protective perfection. When there are multiple incisions necessary for surgery, like a laparoscopic appendectomy this wall is perforated and comprised for several weeks to months. Tissue strength is a integral concern and factor in corrective rehabilitation; as well as wound healing.


Understanding the fundamental processes that are responsible for these functions is necessary to best create and close an abdominal incision and limit the risk of inflection, as well as to understand the complex process of healing post surgery.

Inflection is the first major risk; or failure of the healing process to synthesize adequate quantities of collagen to restore abdominal wall strength.

Psychoneuroimmunology (PNI):  (Pyschological + Neurological + Immunology)

The wound-healing process is a balance between the amount of damage done to the tissue during an operation, and the ability of the body to decontaminate and repair its function.

With any incision, there is exposure of blood and platelets to connective tissue; which ultimately begins the inflammatory response that will sterilize and heal the wound. Psychoneuroimmunology (PNI) plays a critical role in both healing and immune function at the biological and biochemical levels. PNI is the study of the interaction between psychological processes,  the nervous and immune systems of the human body.  Recent work in psychoneuroimmunology (PNI) has demonstrated that stress delays wound healing; which is directly related to the pre and post surgical anxiety and nervousness a patient will ultimately feel.

Greater fear or distress prior to surgery is associated with a slower and more complicated postoperative recovery because anxiety presumably interferes with recuperation through both behavioral and physiological mechanisms. Seems logical enough.

Listening to mindful music for an hour every day can reduce chronic pain by up to 21% and depression by up to 25%, but I will leave that stat for another article.

Our body’s nature inflammatory response

During the initial phases of this process, the small vessels in the region of the injury become permeable to both molecular and cellular mediators of the inflammatory response. First, healing is under the direction of the inflammatory response, as this is essential to eliminating bacteria; as well as immunology. Every person has a unique biological and biochemical healing process; which should be taken into account.

After this initial phase, the polymorphonuclear neutrophils (PMNNs) and wandering tissue macrophages begin their work of digesting damaged tissue, killing bacteria, and synthesizing the chemotactic factors that direct wound repair. These cells lay the groundwork for the later appearance of the fibroblast that will reestablish wound strength.

The next critical factor in proper healing is the amount of necrotic tissue created. Actual repair must begin from healthy tissue. Healing must then begin from the uninjured tissue behind the area of damage.

Collagen & Tissue Strength

The re-establishment of abdominal wall strength depends upon the synthesis of new connective tissue. This is accomplished by fibroblasts and requires, not only the protein precursors for collagen synthesis, but also occurs most rapidly in a normally oxygenated environment where the enzymes and cofactors needed for collagen synthesis are present.

Collagen, the primary structural protein of the body, is synthesized by the fibroblast. It begins to appear in the wound on the second day, as an amorphous gel devoid of strength. Maximum collagen synthesis occurs around the fifth day. It depends especially upon the presence of oxygen, vitamin C, and amino acid precursors.

Maximum strength development does not occur for several months and depends upon the interconnection of the collagen subunits. Approximately 80% of original strength is reached in about 6 weeks; therefore it is recommended that light activity building up to moderate activity are only encouraged after 6 weeks and as long as there is no pain or discomfort.

It is important to recognize that perfusion of the wound is the most important factor in wound healing. Integrity of the microvasculature and flow is responsible for the oxygenation needed for cellular metabolism. Damage to tissue that impairs the delivery of oxygen to the wound increases the number of wound infections and the likelihood of herniation or infection. Which could complicate and impair movement quality in the future.


Empower the patient is first and foremost. Education each client on the complex healing process and concerns moving forward with post surgical care is crucial to not only the healing process but self management on behalf of the client. Understanding tissue strength and the body’s healing process from the inside out is of equal importance when re entering sport, play and or professionals that require manual labor.


  • Milloy FJ, Anson BJ, McAfee DK: The rectus abdominus muscle and the epigastric arteries. Surg Gynecol Obstet 110: 293, 1960
  • Cruse PJE, Ford R: The epidemiology of wound infection: A 10-year prospective study of 62,939 wounds. Surg Clin North Am 60: 27, 1980
  • Cherney LS: A modified transverse incision for low abdominal operations. Surg Gynecol Obstet 72: 92, 1941
  • Surgical anatomy of the transversus abdominis and transversalis fascia. Ann Surg. Jan 1971; 173(1): 1–5.



Getting to the “CORE” of the Abdominal Wall Post Surgery

Getting to the “CORE” of the Abdominal Wall Post Surgery



The abdominal wall encloses the abdominal cavity, which holds the bulk of the gastrointestinal viscera. A topic I have grown quite font of over the last couple of weeks, post appendectomy.

It’s structure and function can be broken down into these key areas:

  • Forms a firm, flexible wall which keeps the abdominal viscera in the abdominal cavity
  • Protects the abdominal viscera from injury
  • Maintains the anatomical position of abdominal viscera against gravity
  • Assists in forceful expiration by pushing the abdominal viscera upwards
  • Involved in any action (coughing, vomiting) that increases intra-abdominal pressure

Its structure is complex, yet in most cases we think of the abdomen as merely the “six pack.” When it comes to rehabilitation of abdominal injuries like an appendectomy we should consider this two fold: (1) The Rectus Sheath and (2) The Abdominal Sheath and the Superficial and Deep Front Lines.


The Rectus Sheath:Abdominal-Muscles-Rectus-Abdominis

The rectus sheath is formed by the aponeuroses of the three flat muscles, and encloses the rectus abdominus and pyramidalis muscles. It has an anterior and posterior wall for most of its length:

  • The anterior wall is formed by the aponeuroses of the external oblique, and of half of the internal oblique.
  • The posterior wall is formed by the aponeuroses of half the internal oblique and of the transversus abdominus.

But what about the front line connective tissue? Should that not be included when discussing the complexity of the abdominal cavity and strength of the front line connective tissue? Yes!

The Abdominal Sheath & The Superficial and Deep Front Lines:

If we include the superficial front line to the integral working of “the abdominal sheath,” we can see that the entire structure starts at the feet, then travels up the front of the body and all the way to the neck and skull. The Superficial Front Line acts to contract the front of the bod.

The Deep Front Line makes up our myofascial “axial core.” This means that out of all the myofascial meridians, it is the deepest and has the function of maintaining our core alignment and core stability.

The orientation of fibers in the muscles of the left and right abdominal wall; give it strength and flexibility of movement in many directions. By contrast, the fibers of the rectus sheath are oriented for flexing the trunk.

The anterior wall is reinforced by the tough rectus sheath and one muscle. Since the sheath is composed of aponeuroses anchored at the midline, the lateral muscles oppose one another to make the trunk of the body rigid when they contract (for structural support or to increase intra-abdominal pressure).

One other notable fact is that the anterior rectus sheath is complete, but the posterior sheath is deficient (absent) below the arcuate line (linea alba).


The layers of the abdominal wall consist of (external to internal):

  1. Skin
  2. Superficial fascia (or subcutaneous tissue)
  3. Muscles and associated fascia
  4. Parietal peritoneum



“The Core” of An Appendectomy:

What is the appendix?

The appendix produces a bacteria destroying protein called immunoglobulins which help fight infection in the body. Its function, however, is not essential; however there is some evidence to suggest it play a role in maintaining a healthy gut. People who have had appendectomies do not have an increased risk toward infection. Other organs in the body take over this function once the appendix has been removed.

Laparoscopic Surgery:

In most laparoscopic appendectomies, surgeons operate through 3 small incisions (each ¼ to ½ inch) while watching an enlarged image of the patient’s internal organs on a television monitor. In some cases, one of the small openings may be lengthened to 2 or 3 inches to complete the procedure. The notable factor here, is one of those incisions (for me) is directly above my belly button.

How can the incisions affect the function of the superficial fascia?

The superficial fascia consists of fatty connective tissue. The composition of this layer depends on its location:

  • Above the umbilicus: A single sheet of connective tissue. This continuous with the superficial fascia in other regions of the body.
  • Below the umbilicus: It is divided into two layers; the fatty superficial layer (Camper’s fascia) and the membranous deep layer (Scarpa’s fascia). Superficial vessels and nerves run between these two layers of fascia.

The umbilicus is the most visible structure of the abdominal wall, and is the scar of the site of attachment of the umbilical cord. It is usually midway between the xiphoid process and the pubis symphysis.

The linea alba is poorly vascularised, so blood loss is minimal, and major nerves are avoided. All can be used in any procedure that requires access to the abdominal cavity. This is a common site for incision because it can leave minimal scar tissue.


Understanding the nature and complexity of the human structure can aid in supporting your rehabilitation program. Fiber composition, the body natural inflammatory response, and the body’s ability to compensation post op is equally important to reduce the impact of surgery, as well as reduce the risk of tissue restrictions and movement dysfunction.

When there are alterations made to our structure, even the smallest of cuts changes the way our body moves, adapts and responds. Our viscera is the gateway to our nervous system and when recovering from surgery we must take this into account and begin to rebuild from the inside out.

Regarding rehabilitation, understanding that the tissue around the incision is only 60% repaired for the first 4 weeks after surgery means you should take care when re entering your sport or hitting the gym. Hernia’s are the biggest consideration when returning back to work or sport after an appendectomy. Make sure to consult with your surgeon or GP prior to engaging in physical activity post surgery. Use this as a time to nurture and honor other priorities in your life so that when you do get back to your sport, you are 100% and ready to pick up where you left off.

Next week, we will look at rehabilitation and corrective movement to reduce the risk of movement dysfunction in post operative patients appendectomy.


Anatomy Trains

University of Michigan Medical School – Clinical Case, Abdominal Wall

Instant anatomy – Anatomy lecture made easy – Anterior abdominal wall

Sleep, Chronic Pain and Our Biological Clock

Sleep, Chronic Pain and Our Biological Clock


SleepDeprivation_0Pain and sleep are integrally connected. A person’s quality of life and health can be disrupted due to many different reasons; like diet, activity level, and stress. However, one important, yet underestimated cause of a person’s reduction in quality of life, can be contributed to sleep loss or not enough restorative recovery.

Over the course of the last several decades, the modern worlds working hours have been consistently increased, along with an emphasis on active leisure, and “more” is typically seen as being better.

Depending on your profession, in some designations, people face sleep restriction. Professions; such as health care, emergency response and security and transportation require working varied shifts and often rounds of night work. In these fields, the effect of acute total sleep deprivation (SD) on performance is crucial and possibly life threatening. Furthermore, on average, in almost every profession, people tend to stretch their capacity and compromise their nightly sleep, thus becoming chronically sleep deprived. On a neurological level, this changes a persons biochemical, biological and psychological health. Thus, increasing risk for mental illness, chronic pain and disease.

What The Stats Tell Us:

In the adult population, about 15% of those surveyed report experiencing chronic pain. Nearly 50% of older adults have insomnia, have difficulty in getting to sleep, early awakening, and/or feeling unrefreshed upon waking. As we age, several changes occur that can place one at risk for insomnia, and less than restorative sleep; including age-related changes in various circadian rhythms, environmental and lifestyle changes, and decreased nutrients intake, absorption, retention, and utilization.

In all age groups, those who suffer from insomnia and consistently achieve less than restorative sleep show memory weakness, increased reaction time, decreased fine motor skills, short-term memory problems, and lowered efficacy levels.

A lack of sleep and restorative recovery can be more problematic in elderly subjects, because it puts them at higher risk for falling, cognitive impairments, weak physical function, and mortality. Not to mention, not getting enough sleep takes time off our life span. There’s a reason, our body tells us when it needs a time out to re boot, filter and process daily existence.

Minerals Count:

In order to have a restorative sleep, we must have the right percentage of calcium and magnesium present in our system. This directly relates to cell formation and re generation, as well as key processes in our body.

Magnesium: Plays an essential role in ion channels conductivity, such as N-Methyl-D-aspartic acid (NMDA) receptor, and unilateral entrance of potassium channels. Therefore, magnesium as a natural antagonist of NMDA and agonist of GABA is critical in sleep regulation.

Magnesium is the fourth most abundant cation in the body and the second most abundant intracellular cation. It is involved in more than 300 biochemical reactions of the body.  Magnesium is an essential cofactor for many enzymatic reactions, especially those that are involved in energy metabolism and neurotransmitter synthesis. It contributes to teeth and bones as well as activating enzymes, contributing to energy production, and helps regulate calcium, copper, zinc, potassium, vitamin D, and other important nutrients.

Calcium: Does not work alone in your body. It requires vitamin D, parathyroid hormone and healthy saturated fat in order to be utilized for strong bones, teeth and muscles. Nerve cells have calcium channels that act like gates in their membranes, regulating calcium flow in and out, triggering each cell to take action.

Bone health not only requires calcium, but an array of other vitamins, minerals and hormones to complete that process.  Another notable amino acid in sleep regulation is Tryptophan; which your brain uses to make serotonin and melatonin. These two substances are neurotransmitters that slow down nerve transmissions, relaxing your brain and body and encouraging deep sleep.


Sleep & Chronic Pain

Pain triggers poor sleep; we shift around, can’t get comfortable, and thus can’t fall or stay asleep. For instance, someone experiencing lower back pain may experience several intense microarousals (a change in the sleep state to a lighter stage of sleep) per each hour of sleep, which lead to awakenings.

Pain is a serious intrusion to sleep. Charles Bae, MD, a neurologist in the Sleep Disorders Center at the Cleveland Clinic in Ohio, puts it this way: “Pain can be the main reason that someone wakes up multiple times a night, and this results in a decrease in sleep quantity and quality, and on the flip side, sleep deprivation can lower your pain threshold and pain tolerance and make existing pain feel worse.”

The body’s has a built-in circadian clock, which is located at the center in the hypothalamus in the brain. This is the main mechanism that controls the timing of sleep, and is independent of the amount of preceding sleep or wakefulness. Therefore, it is no wonder that people who experience chronic pain, adrenal fatigue or other auto immune diseases have trouble sleeping. The Hypothalamus is one of the most important organs related to regulation of body systems and re generation of cell formation.

Circadian Rhythm & Sleep:

When considering the effects of sleep loss, the distinction between total and partial SD is important. The need for sleep varies considerably between individuals; averaging sleep length is between 7 and 8.5 h per day. Sleep is regulated by a two-part process that adjusts to the body’s needs every day. This two-part process is known as the homeostatic debt and the phase of your circadian rhythm.

The homeostatic process depends on sleep and wakefulness; the need for sleep increases as wakefulness continues. This homeostatic debt increases as a function of how long you have been awake and decreases as you sleep.

The second process that greatly influences the onset, of sleep and the duration, and quality of your sleep is the phase of your circadian rhythm. This phase is governed by your biological clock, whose rhythm is endogenous but is reset regularly by daylight, but deeply affected with inadequate amount of sleep. Studies show, that the circadian rhythm dips and rises at different times of the day. In adults, the strongest sleep drive generally occurs between 2:00-4:00 am and in the afternoon between 1:00-3:00 pm

The interaction of these two processes determines the sleep/wake cycle of a person and can be used to describe fluctuations in alertness, performance, energy levels and cognitive functions.

To perform at your best, achieve your dreams and reach your goals, ensure sleep is restorative recovery is part of your daily optimal well being plan.

Mobility vs. Flexibility

Mobility vs. Flexibility


Mobility training seems to be all the rage these days and has been widely accepted by both ends of the movement, sport and performance spectrum. However, as a growing trend, the word “mobility” is more and more often being used interchangeably with terms, such as; “flexibility,” and “stretching.”

For instance, many clients come to me and say they have been told they are tight, and need to stretch. Some of these clients have been prescribed Yoga classes or been given “stretching” exercises, but isolated stretching or classes that encourage improved flexibility will not address, nor fix a mobility dysfunction problem.

Understanding the “why” we prescribe and the “how” are key to, not only a client’s success, but in their understanding of how to self manage their health. Let’s start by defining the three terms:

Flexibility is the ability of a muscle or group of muscles to lengthen passively through a range of motion. It is specific to that particular “part or parts.” Notice the word passively. During screening, one must assess tissue extensibility and length to determine if the dysfunction is a true muscle tissue issue, or, a joint issue.

Mobility is the ability to move a joint actively through a range of motion. Mobility is all encompassing and takes into account the joint, the joint capsule (ligaments), the muscles crossing the joint and the nervous system (motor control). This requires movement can control. Notice the word actively. This speaks to a clients ability to control movement. Screening mobility should also address mobility dysfunctions and or tissue extensibility dysfunctions.


Joints vs. Tissues:

As an industry too often we merely think of “flexibility” or “mobility” as being solely just tissue related, but what about the joints? Mobility dysfunctions are seldom differentiated appropriately because we need to screen them separately. We need to determine patterns vs. parts. This should be a two pronged process to differentiate mobility dysfunctions; further into either joint mobility or tissue extensibility dysfunctions. Joint pain, unlike muscle soreness, is a legitimate, bonified red flag, much like tight and overly toned tissue restrictions is a legitimate yellow flag. I say yellow because even if there is no pain yet, if not addressed, there could be.

Patterns vs. Parts:

In corrective movement, we focus much of our attention to “training patterns,” not parts.” This means that when a client is prescribed an exercise, it needs to address a pattern of movement, not just a part of the body. If there is an action to one part, there will be an equal reaction to surrounding parts AND to the pattern. As part of my overall screening I ensure “mobility (patterns) is optimal first,” which includes screening “tissue length” (parts) if needed, so that I can address and identify risk, but also ensure I am not just treating the symptom of a larger problem.

After screening or assessment, stretching may be one tool needed if there is a true flexibility issue; but even the word “stretching” has a vast spectrum of meaning. Stretching could apply to, passive, active, dynamic, facilitated, contract/relax etc. As a coach, clarity to the client is key.

Stretching is a form of physical exercise in which a specific muscle or tendon (or muscle group) is deliberately flexed or stretched in order to improve the muscle’s felt elasticity and achieve comfortable muscle tone. The result is a feeling of increased muscle control, flexibility and range of motion. Stretching is also used therapeutically to alleviate cramps.

Here’s an example of screening both for mobility and tissue extensibility (aka flexibility):

In the active straight leg raise screen, we are looking to identify the active mobility of the flexed hip, but also addressing the available hip extension on the alternate hip. We can also add in addressing lumbar and core/trunk stability.

In this screen, we ask a client to actively flex at the hip and raise the leg up straight (no bend in the knee). If the client cannot reach adequate flexion with a straight leg (which is around 70 degrees for leg flexion in this particular screen) we then move into screening the flexed hip through passive range. If the client still cannot reach optimal range, we could define this as requiring more “flexibility” in the hamstring group.

Does the screening process stop here? No…

If a client has movement dysfunction, the tissue length of the hamstring is merely one piece of the overall puzzle. When I screen, I also take into account the mobility of the joints at the hip, knee and ankle. Therefore, breaking this down to include screening the muscles in hip extension; as well as internal and external rotation at the hip, along with screening dorsi flexion at the ankle, would be next on my list to determine the full pattern. And down the rabbit hole we go. If I find other limitations I may take the client to seated and standing and further screen their toe touch to ensure this is a bonified “hip mobility” dysfunction. For the sake of this article, I merely wish to point out the difference between “flexibility” and “mobility” related to both screening and program exercise selection.

Prescribing Flexibility:

Soft Tissue release, we addressed in our 2 part series on myo fascia release. . Muscle soreness, tightness or tone usually changes when an appropriate warm-up, myo fascia release techniques are administered and or flexibility efforts are performed. This is where styles of stretching can be beneficial. Movement is the best remedy for maintaining both adequate flexibility of tissue, and adequate mobility of the surrounding joints.

Static stretching and proprioceptive neuromuscular facilitation (PNF) stretching are the two most common ways to stretch short, tight muscles. Static stretching usually involves using stretches that hold the target muscle in a lengthened position. Through autogenic inhibition, this method allows for increases in passive range of motion. Once we have achieved this, we can then move onto active range, and joint disassociation drills.

Prescribing Mobility:

Mobility should always be addressed proactively, rather than on a reactionary basis. Do not wait until there is problem, dysfunction will manifest if compensation is present. If you see compensatory movement – address it right away. Mobility comes before stability and stability comes before strength.

Tight tissues are red flags for risk. Mobility drills address the elements that limit movement and performance; they take into account short and tight tissue, soft tissue restrictions, joint capsule limitations, joint range and motor control faults – the pattern, not just the part. Mobility includes, flexibility if needed, but for instance, if a client has a tight chest, tight shoulders, and a tight upper neck, I would look to screen their thoracic spine. Most often mobility exercises; like the rib pull or trunk rotations can clear up limitations in the shoulder, neck and upper girdle. Merely stretching the pecs or lats will not clear up dysfunction.

Mobility should be performed by globally addressing movement above and below the limitation to help weed out performance and movement problems.

Just keep in mind that when you add mobility to a joint, you also increase risk. Stability needs to be earned and applied before you apply strength. Movement and control are the key when mobility is added to a client’s program.

321 Method: A List Training for Body, Mind and Spirit Comes to Vancouver May 4th, 2014

321 Method: A List Training for Body, Mind and Spirit Comes to Vancouver May 4th, 2014


Most people know Ramona Braganza as a global fitness expert and celebrity trainer. Her client roster and list of Hollywood clients have included (and are not limited to) Jessica Alba, Halle Berry, Kate Beckinsale, Anne Hathaway, Amanda Seyfried, Scarlett Johansson, Eva Mendez, Dania Ramirez, Zac Efron, Ryan Reynolds, Tom Welling, Michael Weatherly, along with the entire cast of the movie “The A Team” – Jessica Biel, Bradley Cooper, Liam Neeson and Sharlto Copley.

And that’s a big part of who she is and what she’s does, but that’s only a small portion of her story and her success.

I met Ramona in 2005; while working at Stude55, a boutique style health club located in the beautiful downtown city of Vancouver. Upon our first meeting, tit was obvious to me that this woman was a leader, and more importantly, a woman who defied all odds; born in Germany and growing up in Ontario, the Canadian native left home, around the same time most young adults contemplate which University to go to, to make a name for herself in the big city of LA. A city that is no short of trainers, health club owners – all trying to climb the corporate ladder in industry success. That did not deter her from her dream; and that drive and determination has been the direct result of who she is and what she loves to do.

Ramona has spent a lifetime in fitness; not just coaching and training clients, but she speaks from a place of experience. Her accomplishments are many, such as; a competitive gymnast, NFL cheerleader, fitness contestant, model and wellness coach. Her true passion is guiding all walks of people toward a better life – body, mind and spirit.

The 321 Philosophy

The same training philosophy and methods she uses with her Hollywood clients can be found here. Originally designed for movie shoots on location where time and equipment were limited, 321 Training Method contains the proven combination of core, cardio and circuit exercises to get you in the best shape of your life.

The 321 Philosophy focuses on the integration of body, mind and spirit, where people can tackle anything life throws at them because they’ll have wellness for the mind, fitness for the body, and peace for the spirit. It’s design is focused on the ability to get you ready mentally, get set physically and go forward emotionally to reach your goals.

There are hundreds of videos and products out there; but very few that actually result in improving one’s lifestyle. Ramona’s products are not your regular run of the mill products! After sitting down with Ramona, I was able to get a deeper perspective on the operating system of 321 works and why I believe it has great potential in our industry for the niche market of weight-loss, body sculpting and those who want to train like the stars do – it’s simple – it is well rounded. It takes into account the biopsychosocial model of a client’s well-being; their physical, mental and emotional well-being. It also ensures that any trainer who wants to add onto their current scope of practice the ability to not only learn the program design and exercises, but the business model itself, and how to improve your own business.


Take The Workshop or Get Certified: The 321 Training Method in Vancouver May 4

As a newly accredited course (with canfitpro), this program gives you the opportunity to become a qualified instructor in Canada so that you too can follow and enjoy the same workout as the top LA celebrities.

The 321 Training Method Level 1 is a workshop and is suitable for gym instructors and personal trainers who want to learn new ways to help clients achieve great results. This massively successful programme, now available in Canada, is accredited by canfitpro and will earn you 2 CEC credits towards your annual CEC quota.

Once you have completed Level 1, you can register for the Level 2 certification course, as this will also earn you 2 CEC credits. Register for both in the same day and save!

In just a couple weeks, Ramona teaches this revolutionary workshop and certification course here in Vancouver, at APT South in Kits (4255 Arbutus Village) for more information on how to register please visit her website here:

Ramona Goes Global:


mobile_appAt your fingertips, with minimal to no equipment, wherever you are, her 321 Method is ready when you are. This highly effective combination of 3 Cardio, 2 Circuits of Strength training and 1 Core segment will get you burning fat fast, losing the weight and building lean muscle tissue immediately!

It come with a 12 week transformational program that progresses you safely through beginner, to intermediate then advanced. Unlike other programs that give you the same workout everyday the 3-2-1 Training Method includes a variety of exercises, daily workouts and top training techniques she uses with her stars to keep motivation high and the body challenged!

There’s even a built in calendar, with bi-weekly fitness assessments and the ability to customize the length of your daily training sessions, whether you have 20, 30, 45 or 60 minutes, will keep you on track! Download it from iTunes today!

So what are you waiting for!

Find her here:

Twitter:@ramonabraganza  / Facebook Page / Website 

A Corrective Approach to the Turkish Get Up

A Corrective Approach to the Turkish Get Up

The TGU is a flow state drill that targets 7 specific movements and requires not only mobility and stability, but strength and endurance, built from the ground up; which makes it an effective drill for strength and corrective coaches alike.  We can classify it as; corrective, functional and a competent way to lift. It can help restore movement patterns and build strength. As a corrective tool, I most often use the half get up to improve shoulder or thoracic spine dysfunction and I use the half get down to improve hip and thoracic stability, as well as rotational compensation.

The 7 Stages in the Get Up:

Much like neurodevelopment, the TGU is built from the ground up, moving the human structure through primitive postures, to foundational ones. Breaking down the stages will ensure your client’s success, as well as understanding of the benefits the TGU can provide.

(1) Fetal Position to Press, (2) Press to Elbow Position (3) Elbow Post to Hand Post (4) Post to High Pelvis (5) High Pelvis to Hip Hinge Bend (6) Hip Hinge Bend to Half Kneeling, (7) Half Kneeling to Standing.

From the Agatsu E Book Series

From the Agatsu E Book Series

From Movement to Mastery, the benefits include:

  • Improved shoulder stabilization and neuromuscular control
  • Improved thoracic mobility
  • Improved multi segmental stabilization of the spine
  • Improved hip stability , in supine, half kneeling and standing neurodevelopment postures
  • Improved reflexive lumbo pelvic control
  • Improves balanced symmetry between right and left sides, as well as upper and lower quadrants
  • The TGU can be used for critical postural feedback and mechanical awareness


Remembering that a screen is not an assessment, always use your best judgement; if there is pain or a red flag for potential risk, the client is not ready to perform the TGU. We know that from the joint by joint approach, problems with the neck could mean problems stemming from a different area of the body altogether. Problems in the shoulders, could mean sloppiness in the cervical spine or stiffness in the thoracic spine.

Let’s presume you have already performed the full FMS screen and have been working on your clients prerequisites for the TGU. This would include soft rolling upper and lower body patterns, and ensuring that you re screen that major patterns within the complex make up of the Turkish get up or get down. This would include:

From the Functional Movement Screen:

  • The shoulder mobility screen – which we know showcases not only the shoulders, but active flexion and extension in the thoracic spine.
  • The active straight leg raise screen – as this will showcase a client’s ability to perform flexion and extension at the hips, as well as lumbo pelvic control and hip disassociation.

Selective Screens:

  • Screen breathing patterns in both unloaded/relaxed, and performance breath – breathing patterns places emphasis on the diaphragm and significant load to the thorax.
  • Thoracic Spine Screen– screening the thoracic spine is critical, as this is required for proper packing of the shoulders and rotational stability coming from standing to half kneeling, as well as getting up to half kneeling with load. You can perform this right after the breathing. If you have not screen the prone press up and TSPU you can move into this easily through this sequenced screen.
  • Cervical Spine screen – to ensure there are no pre risks in the upper neck or tissue supporting the head.
  • Screen your client’s grip.  Grip strength can determine neurological restrictions in the hand related to the shoulder and ability to pack and move around the load in the get up.


A Corrective Approach to the TGU:

As movement prep, I warm my clients up with a little foam rolling to rehydrate and warm tissue. From there we review upper and lower body rolling patterns, working in biofeedback tools where necessary. From there a set of open and closed chain joint mobility sequences to help promote flow state movement and breath. The tool or type of equipment also matters. A dumbbell or power block doesn’t can wobble; whereas using a kettlbell will offer you more because of the nature of its design. The handle and offset center of gravity helps to pull the body into vertical, because of the placement of load. When the weight hangs from your hand, within that vector of gravity means less risk and more stabilization.   Reviewing where needed; the hip hinge, coassack lunge or shibox progressions depending on which style if TGU I may use (RKC vs EKG).

The Arm Bar & Ceiling Reach:

When we look at the structural anatomy and physiology of the shoulder we can deduce that it does two things; (1) compresses (as in the arm bar and TGU) and (2) it distracts (as in a single arm deadlift or snatch). The TGU focuses on compression of the joints. Both of these drills ask us to practice vertical placement of weight through the shoulder blade. Shoulder packing requires the shoulder girdle, the breath and the body to support load. Getting the joint stable and centered, so the client can work on the proprioceptive vertical. One addition to this drill to ask the client to rotate the load in the ceiling reach until they find a spot that feels stable. Adding onto this, we can then ask the cline, still in supine to rotate the head (cervical spine) from side to side; which helps build their ability to disassociate between their neck and shoulders, while at the same time improving movement and proprioception. Moving onto the hip drive in the arm bar,  you can teach the client to connect the vertical compression and shoulder packing to the initial hip drive required to start distributing load in the first stage of the get up. Teaching the client to drive from the hip, transferring that load to the shoulders encouraged clients to understand the connection between the shoulders and the hips. Practice stacking the shoulders in the finish position and driving the floor away (turning on as much tissue as they can). This is a whole body exercise right from the beginning, to the end.

Half Get Up:

The half Get-Up is an excellent exercise for those who have dysfunction or compensatory movement in the shoulders, and thoracic spine. For those who require motor control and stability in the upper quadrant, this drill can be incorporated with neck and shoulder rotations, just like we performed in the arm bar and ceiling reach; which require total body engagement.  Learning this first part of the Get-Up places a high priority on breathing, as opposed to powering through the movement; therefore, cues like “bringing the sternum forward, driving out of the posted elbow will all help the client connect to the ability to expand in breath.  The aid of the kettle bell intertwines the grip, breathing, and core to pack the shoulder and display balance under a load. It is at this point you, as the coach, can further explore restrictions that can then be cleaned up as you slow this process down. One cue I use often for clients to “move your body around the kettlbell,” when you start keep your eye on the bell, move your body around the bell vs moving the bell to match your body. This prevents the athlete from pushing the bell forward, when they move from underneath the bell, it becomes an extension of their body. The half get up down slowly, allows us to provide the structure with a sensory rich environment to explore greater awareness and stabilization.

Pay attention to the Grip:

Most often the grip is practically ignored in today’s training. Yet, we know from primitive patterning; strong hands lead to a strong body.  The hands also fire neurons to the brain, when you make a fist and your body recognizes fight or flight and will naturally pack the shoulder. The hands tie into the neurological system, as do our feet. They are the two most neglected sensory feedback tools we own and are a central nervous fatigue marker.  Practice exercises in the vertical and horizontal positions to strengthen your grip. Once you have mastered this, then move into practicing static holds, bottoms up in half kneeling, as this will also start to improve more hip stability needed to hinge in the half way position prior to loading into standing.

Leaders in the evolution of the TGU:

The Turkish Get Up is one of the oldest known lifts, which requires a great deal of both mobility in the joints, extensibility in the tissues and stability in movement to endure moving from the ground up. I have found that a hybrid between the traditional TGU and the integration of the shin box bridge in the Evolution Kettlebell Groundwork series, as well as the attention to mobility and preparing tissue to move in Agatsu Kettle bell Trainings can significantly increase a client’s success and awareness towards the flow of this movement. It connect each stage as well as the breath. The links to these can be found below.

Next week we look at the other half of the TGU from the perspective of top down, vs ground up.


Part 2: Foam Rolling FOR “Tissue” Release! Say What?!

Part 2: Foam Rolling FOR “Tissue” Release! Say What?!

fasciaLast week,  we featured “Part 1: Foam Rolling NOT Myo Fascia Release” where we looked one end of the debate regarding foam rolling for myo fascia release; where our focus was to look who foam rolling should be applied based on a client’s particual tissue make up. Meaning, the difference between tissue tone or muscle knots vs tissue fibrosis and scar tissue.

Foam rolling is a form of self-myofascial release that is commonly used by fitness and health professionals across the globe. However, it is still a relatively new field of research.  The study of  the areas of fascia, myofascial release, self-myofascial release and myofascial trigger points are also still young and quickly developing; therefore depending on how, what, when and where you apply these techniques are up for discussion. As I mentioned in my previous post, it really boils down to the the understanding of both tissue composition and the “WHY.”

Why are you prescribing these tools? Do you understand the difference between tone, tightness, tension and fibrotic tissue/scar tissue? Have you considered manual therapy over self release techniques? If a client has tone and you are looking to prepare the clients tissue for movement, the roller can be effective, but has temporary lasting effects. If the client has significant mobility and tissue adhesions the roller will not be enough to break down fibrotic tissue and thus you will get the results you want, nor will your client.

Any discussion of self-myofascial release first has to present some background to research into fascia and the vast interconnected matrix.  The purpose of today’s post is to look at how foam rolling, can indeed by beneficial to a client’s tissue health, when used appropriately.

First, let’s jus review the fascia system; fascia is connective tissue that wraps around all of our muscles and is heavily interconnected with muscular function, communication and our nervous system. It has 3 integral layers (visceral, deep and superficial) putting it in it’s simplest terms.  It is also a continuous sheet all around the body, which means when we alter it’s composition in one area, it can effect movement in other areas of the body.

Tight fascia  and fibrotic tissue affects the whole organism. Structural imbalance causes overall and specific increased rates of nervous stimulation. These cause increased muscle tonicity, trigger points and somatic-visceral referrals into the organs.

Myofascial trigger points are more usually defined as “tender spots in discrete, taut bands of hardened muscle that produce local and referred pain” (Bron, 2012). A commonly-held hypothesis about myofascial trigger points is that they are caused when motor endplates release excessive acetylcholine, leading to localized sarcomere shortening and consequently very short muscle fibers in one particular area (e.g. Hong, 1998).

fascai 2

According to the standard definition provided by the Journal of Bodywork and Movement Therapies (LeMoon, 2008), fascia is responsible for:

  • Maintaining structural integrity
  • Providing support and protection
  • Acting as a shock absorber
  • Plays a role in hemodynamic and biochemical processes
  • Provides the matrix permitting intercellular communication
  • Functions as the body’s first line of defense against pathogenic agents and infections
  • Creates an environment for tissue repair post-injury

How Can Self Myo Fascial Release(SMR) Benefit Tissue:

In general, a myofascial release technique is intended to address localized tension and tone , but most people describe it as “fascia rlease” when in actuality a better way to educate clients, is to use “tissue release,” because we are affecting more than just the fascia itself.  SMR traditionally focuses on the neural and fascial systems in the body that can be negatively influenced by poor posture, repetitive motions, or dysfunctional movements.

There is research that explains that these mechanically stressful actions are recognized as an injury by the body, initiating a repair process called the Cumulative Injury Cycle. This cycle follows a path of inflammation, muscle spasm, and the development of soft tissue adhesions that can lead to altered neuromuscular control and muscle imbalance. The adhesions reduce the elasticity of the soft tissues and can eventually cause a permanent change in the soft tissue structure, referred to as Davis’s Law. SMR focuses on alleviating these adhesions (also known as “trigger points” or “knots”) to restore optimal muscle motion and function.

Literature often seems to me to be slightly confusing regarding whether muscle tissue, fascia itself or a combination of both is being treated by the various techniques. I tend to lean towards “tissue release,” vs “fascia release.”  Most often we prescribe these tools not only to “release fascia,” but to prep muscles to improve mobility in a joint, or perhaps extensibility in muscle tissue (called tightness).


Let’s Talk Hydration:

Outside of blood, connective tissue houses the majority of our fluid state. Other, more intricate and vastly important systems (nervous, vascular, and circulatory, etc…) rely on the fluid in this system to function efficiently. If the Extracellular Matrix (ECM), which is the fluids and it’s components of connective tissue that support, protect, and connect all of the cells it surrounds loses even 2% of its water content, it would cause every cell, structure, and system it surrounds to lose efficiency. This exhausts the body, makes it work harder daily and ultimately taps out your energy, ages you faster, and is the catalyst for most chronic pain.If we become dehydrated the body will prioritorize so that essential organs will remain hydrated.

Connective tissue (fascia) will be one of the first to dehydrate leading to adhesions and fixotrophia. For example, researchers have noted that since 67% of the volume of fascial tissues is made up of water and that the application of load squeezes water out of the structures, fascia may therefore lack water in certain areas. The application of external force may therefore be required in order to redistribute water and rehydrate the tissues. Using tools like the roller , the magic stick and slow, application of pressure can improve translation of nutrients and water into and out of tissue.  

James Oshman Phd. in his book ‘Energy Medicine’ cites research which shows that a 10% increase in hydration will result in a million -fold increase in conduction of impulses through the tissues such as collagen. This means our work could potentially be a whole lot more effective if we could get our clients more hydrated.

Gil Hedley, who is renowned for his work with cadavers and fascia mentions quite frequently in his Integral Anatomy Series,  that using myo fascia tools and manual therapy are important to movement and the pliability of tissue to maintain the sliding properties of fascia and muscle.

My Conclusion:

The discussion is new, our fields of research in these areas are new, and there still so much we do not know about the fascia, tissue and this interconnected matrix.

KISS Principle: Keep it simple…

  • SMR & Foam Rolling Techniques: good for reduces tone, improving hydration and temporary release of tense “tissue.” (notice I did not say just fasica, let’s think tissue – fascia and muscle)
  • For Fibrotic Tissue, Scar Tissue and Acute Adhesions: for best results, seek hands on professional treatment for long-term sustainable effects.  Offer client’s self management tools to empower them to manage their health, but ensure they recognize the difference and benefits, to both used together.



  •  The Concise Book of Neuromuscular Therapy: A Trigger Point Manual – By John Sharkey
  •  NASM Essentials of Corrective Exercise Training – edited by Micheal Clark, Scott Lucett, National Academy of Sports Medicine
  •  Integral Anatomy Series – Gil Hedley
  • MELT Method –
  • Energy Medicine – by  James Oshman Phd
  • John Forsyth – RMT, Central Lonsdale Massage Therapy Clinic & Massage and Therapy Center Vancouver
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