IronMan

IronMan
How to be Injury Free for Life
with Keith Scott
Copyright 2008 by Jason Ferruggia
All rights reserved. No part of this manual may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without the expressed written permission from Jason Ferruggia.

_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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Recently I had the chance to sit down and grill my friend and colleague, Keith Scott, about all aspects of injury prevention and rehab. Keith is the one guy I go to when I have questions about rehab or injury prevention for me or any of my clients. He knows the subject inside and out and never lets me down. Since Keith is one of the masters when it comes to this topic, I consider this information invaluable and hope you will use it wisely. Enjoy Question: Are there any specific tests or evaluations that you like to perform before training someone? Answer: Absolutely. I am an assessor by nature. I always like to do a full body ortho screen or evaluation before I start working with someone. This may be very involved or a quick run through, all depending on the person and their history. I will usually do a range of motion assessment at all of the major joints followed with a posture screen. This information can tell a lot about the person and what you are dealing with. I routinely find things that doctors and physical therapists neglect to see. This saves me and the client a lot of future grief. From there depending on whether I am dealing with an athlete or not, I may throw in some actual testsFor example, if I find a possible shoulder problem, I will do some individual tests to find out if there is an impingement, or an instability somewhere, for example. Question: What are some simple tests that trainers can easily learn to perform on clients or that training partners can perform on each other? Answer: I think that range of motion tests are some of the easiest and tell us the most. Trainers can easily learn to do basic range of motion test for the major joints in the body. Before you start, know the rules. (A.) Always compare both sides. If one side is very different from the other side, a warning signal should go off in your head. (B.) Know what is considered a normal range before you get started. You can find a list of joint range of motion in many books or on the net quite easyily. Once you know the normal ranges, you can start to perform some tests on the client. Start with the ankle then move up into the knee, hip, low back, shoulder, and neck. Dont leave out the arms and wrists either. (C) Ask the client to move through the range,
_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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and then you can move them through the range once they are relaxed. If you find something that is obviously not normal or right, you need to address that either with a follow up with a professional, like a physician, certified athletic trainer, or physical therapist. Other than range of motion, basic strength tests can be done. I like to use break tests on clients. You ask the client to lock out their joint and hold it as hard as they can. You then try to break them, or push through their resistance. You will compare both sides. If both are very strong, they pass at that joint. If you find that both sides are abnormally weak, or one side is much weaker than the other, you then know there is work to be done. Question: What if you train alone? Are there any tests or evaluations that people can administer themselves? Answer: Sure, but it is much more difficult to get a good evaluation in, but it can be done. Here are some things I like to teach people when they dont really have a pro around to evaluate them: Observation. Look at yourself in the mirror or have someone look at you, take pictures or video you. Here is the check list: 1. Feet Look at your feet and see if they are rotated in (toes pointing toward one another) or out (toes pointing away from one another) excessively, or are they neutral? Do they seem to turn in from the weight of your body (bottoms of the feet more facing one another) or do they turn more outward (bottoms of the feet more facing away from one another)? Have your friend or family member take pictures of the back of your feet and ankles. Observe how your feet sit from the back view. See if your achilles tendons point in or out. Based on this quick look at your feet and ankles, you can better understand if you might need some additional stretching or strengthening and in what areas. 2. Knees Look at your knee caps. Are they pointing straight ahead, or do they seem to point inward? Do you notice any thickness or swelling around one knee vs. the other? Do both knees seem to be alike? If not, what is different about it? With the pictures that your friend or family member takes, observe if your knees hyperextend. Look to see if your knees turn inward or
_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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turn outward. Finally, see if you can tell whether you are knocked kneed or bowlegged. 3. Hips Pull your shorts down just a little so your hips are exposed. See if you can tell if one is hiked up higher than the other. Are they even? 4. Shoulders Look to see of you can tell if one shoulder is hiked up higher than the other? Do they sit even to one another? Are your shoulders rounded, meaning do they have an inward rounded appearance to them? In contrast, do they seem to sit way back? Get pictures taken of the upper back and shoulders and observe whether your scapula (shoulder blades) are winging or sticking out. Look to see if your arms touch the sides of your body naturally, or do they want to stay away from the sides of your body. 5. Neck - Does your neck tend to tilt to one side? Does it turn to one side? Does it jet out forward? If you find anything out of the ordinary, get a second opinion from a professional. Question: Are there any circumstances (such as scoliosis) that prevent certain people from performing certain exercises? Answer: Yeah, actually a few come to mind. First of all if you dont have the proper range of motion in certain joints, some exercises should be avoided until you gain some mobility/flexibility around that joint. For example, if you have terrible dorsiflexion in your ankles, meaning you cannot move your foot upward very far at the ankle joint, squats will be difficult for you. Actually they could be dangerous to do. Lack of dorsi-flexion at the ankle joint will force you to flex more at the hip, which will place a lot more pressure over your knees and low back. Beginners will just tend to attempt to squat by raising their heels off of the ground. Not a good start. Ankles, and hips need to be mobile enough to do certain movements. If not, I spend time getting those areas mobile. This doesnt mean we scrap the leg workthere are plenty of other ways to still perform some of those movements and get a good training session in.

_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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Another example is wrist flexibility for people trying to front squat or overhead press. These people have a tough time holding onto the bar without being in a huge amount of pain. So again, we work around it until we get that flexibility that we need. I have worked with a lot of people with scoliosis and other spine issues. Some bad cases dont allow us to load the spine, so we dont. Single leg work, hack squats, DB work can be great replacements for people like this. Of course you have to take past history and surgeries into account with people. Some people have surgical limitations that will never be undone. So you train around them. But you still train. Question: What kind of prehab or injury prevention work do you recommend that everyone do either once in a while or on a regular basis to keep themselves healthy and injury free? Answer: I always preach and practice injury prevention and reduction strategies. So most of my athletes and clients will ALWAYS do some sort of prehab work. With that said, I think some trainers out there over do it. I split prehab into two categoriesGeneral and Specific. General prehab is what I think most everyone should be doing somewhere in their program at the least once a week. This kind of prehab covers the areas where I have seen the most problems over the years. Not too many people out there are perfect and as a matter of fact most of us need to constantly work on the following areas: Shoulder/Scapula work - Scapula stabilization exercises. Not only will these prevent injuries, but they will improve your performance, yes in the weight room that means you will be able to lift more in a sense. Things I always include with almost everyone: Push ups Regular and Scap push ups External Rotation work Rotator cuff Pulling Face pulls, Low band rows, DB Rows, Overhead Band Pulls Stick ups

The other area I always work on in the general category is the hip complex. Most of the lower extremity injuries that I have seen come from people having messed up hips. This could mean lack of mobility, lack of strength, imbalances, etc Get the

_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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hips right, the rest will fall into place. Besides, If you have bad hips, your squats and deadlifts will suck. Things I include here: Straight leg Band walks (lateral) Psoas Activation Psoas Stretching Hip Rotation (internal and external) stretching Glute activation

The specific prehab all depends on the person and their history. For example, JayI know you have messed up your wrist in the past. If you were my client, I would include specific prehab work for your hand, wrist, forearm, elbow and shoulder. All effect one another and all would be part of your plan. That kind of work would keep you healthy and your performance would improve as well. Question: Are there any specific injury prone muscles or areas that you believe should be warmed up before training? Answer: Muscles? Not really. We all are different. I have seen pulled muscles in just about every area of the body, but nothing that stands out as the muscle if you know what I mean. With that said, I do see some patterns in joints and the muscle/tendons that surround those joints. Again, the shoulder being a big one. I think the shoulder complex needs to be warmed up well. That means more that just some arm circles too. I see a lot of rotator cuff problems that I feel could be prevented with good warm ups. This would involved some muscle activation work. Getting the whole cuff fired up, for example would help stabilize the shoulder joint a lotleading to a decreased chance of injury and once again, better performance. The other areas that stand out involve the hip joint. Groin pull, hamstring pulls, and hip flexor pulls are the big three that I have treated the most. All due to bad hips. Like I mentioned earlier, fix the hip, most of these problems go away. Question: What do you say to people who say that squatting or dead lifting is dangerous and damages the knees and spine?

_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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Answer: I say Dont believe the hype! Seriously a ridiculous statement. We squat and dead lift every single day in our daily lives. Every time we sit on and get up from the toilet, car seat, dinner tablewe squat. Every time we pick something up off of the floor, we dead lift. The problem is this JayPeople who dead lift and squat the WRONG way damage their back and knees. If you are coached the proper way, or have learned the right way to do both of these movements, you will never have problems. That includes proper technique, warm ups, progressions, etc Most of the people I have worked with over the years have stronger and healthier knees and backs because they dead lift and squat. The people that have problems are the people that keep doing nothingIts not the squatting that leads to bad knees, its the lack of strength around the joints. People that claim this have it all backwards. Besides, who says you need to load 500 pounds on your back each time you squat? There are plenty of ways to squat. Here is another interesting example: I have new mothers squatting and dead lifting as soon as they start training again after they have their baby. They will be squatting up and down all day with that baby for many years to come. Further, they will be doing all kinds of dead lifts with that baby too (straight leg, bent knee, one legged) without even knowing it. Every time they pick their baby up with or without that car seat, they dead lift. As the baby gets bigger they need to get stronger. They need to be ready for this. These movements protect the knees and back, they dont injure them if done properly. Question: Where do you stand on overhead pressing? Some experts claim it is the key to healthy shoulder development, others believe it will destroy your shoulders. What is the real truth? Answer: If done correctly and you have the stability to do it, I think it is one of the best ways to work, strengthen and develop your shoulders. I have nothing bad to say about overhead shoulder work. In my 15 plus years in this field, I have had just about every single athlete of mine do overhead shoulder work. I have rarely had a problem. That is thousandss of athletes. I said this in another interview recently and I will say it again here; if your joint is not ready to handle the load given to it, meaning you lack the stability for that load, you have no business doing that movement. Well that holds true to the overhead press or anything like it. Problem is that too many people jump the weight up before they have the proper stability to handle the weight. Injuries from overhead pressing come from stability issues, not
_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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strength issues. Get stable and you will get big time strong. If you already have bad shoulders or issues then you might need to consult with someone in the know or rethink how you go about doing overhead anything. But please, dont avoid this great exercise because some people say its bad. Its not. Question: Is spinal flexion in an abdominal exercise dangerous? What about rotation? Answer: Flexion? It can be. Mostly because people over load before they are ready to. I am not going to sit here and tell you that you should never do a crunch againcrunches are not evil exercises. I do however think there are better and more effective ways to strengthen and develop the abs. These happen to be a little better for the spine too. Listen, we flex our spine all day longno way around it. Better to be stronger in all muscle groups and movements. So I have no problem including some flexion work for abs. You just have to progress the proper way and at the same time dont over do it. I see people doing hundreds of crunches a day, everyday. That is overkill. You could train those abs in half the time and keep things cool with your back and neck. Resisted rotation work is great for ab development and is working the abs the way they were meant to workby stabilizing the spine. Traditional movements will get the abs big time if done right. Weighed chins/pull ups, cleans, deads, squats, are all great ab exercises. I rarely do abs when I am doing core movements like I just mentionedno need to. Rotation is another matter. I know there is a lot of controversy over whether rotation is good or bad right now. I tend to think it may be worse than people think, only because it is overdone and usually nothing is done to counter act that kind of stress. I think we need much less lumbar rotation and much more thoracic rotation. I have dealt with way too many back problems over the years many because of over rotation of the lumbar spine. We need to train the abs to support the lumbar spine while getting the thoracic spine to move more. We would have much less problems. With all of that said, you are still going to rotate in life, and yea, rotate in the lumbar area. Just have your body ready for it. Question: Are there any other exercises that you see causing a lot of problems that you think should be avoided? Or do you believe that there are
_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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no dangerous exercises, only dangerous coaches? Or does the answer lie somewhere in between? Answer: Thats a loaded question, but one I would be glad to answer. I feel strongly that some coaches tend to throw an exercise out totally because they had a few bad experiences with it or read too much into potential risks. In my line of work I have always had to be very careful, so you would think I would be ultra conservative, but I am really not. I think most exercises are fairly safe if they are (a) done correctly and (b) if your body can and is ready to handle them. If you have an anatomical issue, some exercises should be avoided. As I mentioned already, if your joints are not ready to handle the movement in question, avoid it until they are. A few exercises that come to mind: Dips. I love dips. I know a lot of well respected coaches that will never do another dip with their clients or with themselves ever again. I have been doing dips all of my training life and have most of my clients do them I have never had a problem. I have had some clients that could not handle them, so we stopped doing them and things were fine. Dips can be problematic for some, for others not so much. Again, its an exercise that I believe is avoided too fast by some coaches. If you have anatomical impingement issues, its probably best to avoid them, if notstabilize those shoulders through good solid prehab work and go for it. We already covered overhead presses, dead lifts, and squats. I mention them again because these are the exercises that I hear about giving people the most problems and these are the exercises that people will avoid because of fear. I will throw one more out there that may get me some death threats and a possible hit put out on methe barbell bench press. Yeah, I said it but let me explain. I have had more people have problems with their shoulders from performing the barbell bench press then any other exercise. Do I think its a dangerous exercise that should be avoided at all costs? No! But I do think it can cause a lot of problems. To be fair, I have to say the same thing as above; you need to be ready to do this exercise i.e. your shoulders have to have a good deal of stability and strength first before you get into this. Dumbbell bench is a great alternative for beginners and others that cannot do or are not ready for the traditional barbell bench press. But lets get into the meat of my argument: What is the most overdone exercise in gyms across the world? Probably the bench press. Every guy benches. Its usually the first thing that is done each week. So you have a lot more people doing this one, and most people do it
_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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totally wrong. So up the numbers of people doing it (and the amount of volume), up the so called importance of it, and add in that most do it all wrong, and you have problems. I personally dont bench anymore, but still do dumbbell bench variations all of the time. Question: Besides post workout nutrition, can you give us some of your unique recovery methods that will keep people healthy and ensure that they keep making consistent progress? Answer: I come from an old school traditional sports medicine background so I still utilize some methods that many may call outdated, but that work very well. I still like using an ice bag when you are done with a heavy or stressful training session. Ice does wonders and can help cut inflammation a lot. Once you control that, you control pain and the injury cycle slows down. You can start recovering nicely after that. Static Stretching I like to implement some static stretching after a big training session. Hold each stretch for about 20 seconds, and go through the whole body. I also like to use elevation of the legs after a big leg day. Go home lie down, and prop your legs upway up, for about 15-20 minutes. When you are finished you will feel a lot better. Soft Tissue work: Long before the foam rolling fad hit the streets, we were using soft tissue work with our athletes. We didnt have foam rollers, but we used other methods to get the same results. I love foam rollers, therapeutic massage, or whatever you can find to dig into your muscles and soft tissue. This is one of the BEST ways to recover and ensure progress and decrease injury. Question: What are the benefits of these methods and why should they be utilized? Answer: Increased blood flow, which will help with recovery by bringing in tons of good nutrients and helps get rid of the crap.

_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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Tissue extensibility this ensures that you dont get locked down with adhesions, spasms and contractures that most of us have. Tissue work and stretching are big here. Pain management The more pain you are in, the more you are going to lock up. Once that happens the cycle gets worse and you wont be feeling so well physically the next day. Regeneration Muscles need to heal and regenerate. Increase blood flow, lack of blockages, increase lymph flow, etc.. all help the areas regenerate faster. You would be stupid NOT to do these things. If you are training, and get by without doing some or all of these, I would have to say that you are not training very hard, or you are not making the gains that you could. Question: From the neck down to the ankles, could you give us a list of the most common injuries, ways to prevent them (if you didnt cover that already in an above question) and what to do to rehab them if you do sustain an injury? Answer: Neck strains, spasms Hard to prevent, but easy to get rid of (sometimes). This is where I swear by soft tissue work. Find someone that can massage the knots out, or use a tennis ball. Lie on the ball and dig the knots out yourself. Whether it is a strain or just a spasm, you will have knots. Once the knots are gone, you will get your range of motion back. Moist heat works wonders here too. The best way to prevent neck issues is to find a high quality pillow when you sleep, since most neck problems come from sleeping. Also get regular soft tissue work, especially if you are upper trap dominant and train that area a lot. You will certainly have neck issues. Shoulder Joint Impingement - get your scap area right. Work on the external rotators, serratus anterior muscle and do plenty of
_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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pulls. Stay away from benching for a while until you figure it out. Keep the rest of the movements under 90 degrees. See a professional if you can. These dont always go away on their own. Rotator Cuff strains, tears REST!!! You need rest here. No way around it. Once you start healing, you can work on slowly strengthening those areas that I just mentioned above. Labrum tears See a professional. I see most of these in the weight room when someone tries to overhead press, bench, or incline bench way more than their shoulder joint is ready to handle. I already talked about stability of the joints first. Biceps/Triceps Triceps Tendonosis Overhead extensions (i.e. Skull crushers) are the number one culprits of this condition. Be careful here. I have watched this condition knock someone out of any kind of heavy lifting for almost a year. Once you start feeling a strain in the back of your elbow, back off. Rest, ice, stretch, and stay away from triceps extension for a while. Biceps Strains dont see much of these, but they do happen. If it is in the muscle belly itself, take a week or 2 off and you should be good to go. If it is in the tendon, down by the elbow, you need to really take it easy for a while. These will take sometime to heal and could make your life miserable. Forearm / Wrist / Thumb Wrist Sprains/Strains Heavy bars, weak wrists overhead presses, front squats, and power cleans.these are the lifts where I see this. Stretching the wrists out before and after can help, but getting into the load in a progressive manner is
_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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the best way to prevent this problem. What I mean is that you should do some good warm ups with lighter weight first, get the wrists stretched and ready before you start, work your way up. What about tape? It can help, but it can also screw your form up and not allow the correct motion. In the long run, tape could make things worse. However, its a good thing to do if you are in a crunch.

Abdominals Strains TIME. In other words, you need to take some time off and rest. Make sure its not a hernia (see a professional) and once you rule that out, you need some rest. Ab strains can and will happen a lot when you are moving heavy stuff. Once they do, you have no choice but to rest it. They will get worse if you dont. Since you need your abs for just about everything you do in the weight room and in life, its a good idea to rest it and let it heal. Low Back Strains Stretch your hamstrings here as long as it doesnt make the back hurt worse. If not, stretch them, statically. Hold each for 20 seconds and do about 8 of them on each side. When you are done, see how the back feels. I am going to bet it will help to some degree. This doesnt mean you are healed, only that you are helping the back calm down enough to be comfortable. This is another injury that will need to be rested. How you prevent a low back strain? Tough to do, but it all comes down to having great technique in your lifts and a very strong core. Disk injuries See a professional before you do anything.

_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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Hips Strains Groin, hamstrings, hip flexors Rest, rest, rest. Groins and hip flexors take months to heal sometimes. You dont want to mess around with them. That doesnt mean you cannot train, just that you should stay away from things that bother the area as much as possible. Once you are healed, make sure you get your hips mobile in all directions and also that you have glutes that fire. Knees Tendonosis Patellar, Quad HIPS!! Most knee overuse injuries can be blamed on the hips. Get your hips mobile, and you will take the stress off of the knees. If you do have some overuse stuff going on with your tendons, which many of you will, ice after each session will be a great start. However, you need to get the knee better. I have found that eccentric loading, believe it or not, will do wonders. Try doing the negative portion of a lunge. It will hurt a bit, but in a week or so, tendonosis all gone! Lower Leg / Ankle / Foot Shin Splints Arch support. Number one way to get rid of shin splits is to get some good arch support. Insoles, or tape will do. Ice those shins every single day before and after you train. Calf Strains, Spasms gentle stretch and foam roll. Achilles tendonosis Ice, eccentric loads like the knee. Go into a toe raise, and come down slow.

_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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IronMan About Keith Scott

Keith is a Certified Athletic Trainer (ATC) through the National Athletic Trainer's Association (www.nata.org) and also a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association ( www.nscalift.org). He has recently received his certification as a Performance Enhancement Specialist (PES) through the National Academy of Sports Medicine (www.nasm.org). Keith received his Master's Degree in Exercise and Sports Science with a concentration in Sports Medicine from the University of Arizona. During his 13 years in Tucson, he had the pleasure and opportunity to work with hundreds of athletes each year in the youth, high school and college levels. Keith focused on injury recognition and prevention, post surgical/injury rehabilitation, and Strength and Conditioning. He worked extensively with athletes of all levels and many different sports. Keith also holds a Bachelor's Degree in Athletic Training from the East Stroudsburg University. With over 17 years working directly with athletes in the trenches, Keith's goals are to continue to assist athletes of all levels reach their athletic potential, help them maintain or regain their optimal physical health, and be an excellent source of knowledge for anyone looking to improve their overall fitness, health and nutritional goals. While he has mainly focused on athletes most of his career, Keith thrives in working with non-athletes as well. Corrective Therapy, weight management, body composition and post injury rehabilitation are some of the many areas on which Keith likes to focus. To learn more about Keith, go to KeithScottTraining.com.

_________________________________________________________________________________ Copyright 2008 Jason Ferruggia. All rights reserved. http://www.MuscleGainingSecrets.com/

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