S1:E4 - Why Most Physio Never Get Results - An Interview with World Renowned Physiotherapist, Andrew Lock

Hey, hey folks, it's Mark Ottobre here and welcome to the show that punches you in the face, but with information in a good way. It's the Enterprise Fitness Podcast, proudly brought to you by the good people at Enterprise Fitness. To transform your body, increase performance, or compete, make sure you speak to the great coaches at Enterprise Fitness. Email us today at info@enterprisefitness.com. Enterprisefitness.com.au. Today's guest is a longtime friend of Enterprise Fitness, and that is the world's greatest physiotherapist, Andrew Lock. Andrew Lock is the stuff that genius is made of, let me make that clear. His thoughts and ideas around strength training, rehab, bodybuilding, powerlifting are quite frankly prolific, and really he brings together so many elements that are often in separate camps. He brings them into, into the one camp and really uses things as tools rather than, you know, isolating, this has to be a bodybuilding exercise or a powerlifting exercise, but really seeing the unique shades of gray and then culminating into a system that really works and really getting the best from his clients. So personal story on that, you know, I was on a, I was doing quite an aggressive program of loading, and it was quite a lot of bench press. I was using shoulders almost every single day and included some Olympic lifting. And from overuse, I really tweaked my right shoulder. And what Andrew actually did to help me rehab my shoulder was to bench press every day. That's right, you heard that right, folks. Most people, most physios would tell you, well, you've hurt your shoulder, stay away from bench press. But in fact, Andrew got me to bench press every single day And my shoulder, you know, within I think it was about 3 weeks, was right as rain. It was perfect. So Andrew, as I said, has a very unique approach to often common conditions or injuries, and really quite genius in the approach that he takes.

And he gets it.

He's, you know, powerlifter, bodybuilder, and been elite at both of those. And he's a very, very switched-on man and physiotherapist, and he really gets it when people aren't You go into the average physiotherapist and they'll say, yeah, look, just take 4 weeks off and don't train, or do these remedial exercises. Where with Andrew, it's really how can we get you back to training? Not only training, but get you back to better than you ever were. And, you know, it's that approach that I think really gives him the world-class success that he's come to be known for. So Andrew is obviously a sought-after physiotherapist and the only physiotherapist we recommend here at Enterprise Fitness. So And other things to mention about Andrew, he's also a judge for the IFBB Pro League, judging such competitions as the Arnold Classic, and has been doing so for about 20 years. So it's my pleasure to introduce the show. The show's obviously with your host, master Enterprise Fitness coach, Reece Adams. He's gonna take over. I'll speak to you guys on the other side of this podcast.

Enjoy. Welcome to the Enterprise Fitness Podcast, Andrew.

Oh, thanks Reece. Wonderful to be here, man.

Thank you for taking the time out today to chat to us. Can you please give us an insight into what you do and what your job title is?

Well, what I do— what I am officially is a physiotherapist. So in Australia, that's physiotherapist. In the US, it's a physical therapist. So that would be my official title as I'm registered under. What I do, I do what other physiotherapists have yet to learn to do. Which is basically combining real resistance training to strength athletes, mostly fitness athletes. And my practice is pretty much solely based around working the rehab on these sort of athletes.

Yeah, you're currently working with Luke Shembury as well. I see he's having some good success.

Yeah, wonderful Luke, an IFBB pro, and he's presenting some fantastic challenges. He's really coming through well, and there's going to be a huge year ahead for him.

How did you get into physiotherapy?

Well, originally I thought there was two career paths— there's a career path I wanted to follow, and I always thought ending up on TV yelling and screaming, great idea. So I actually thought I might become a— either you've got to end up being either a TV televangelist or a professional wrestler. So I decided to become a professional wrestler. While I was training to do those sorts of things, I got injured, and that injury made me reevaluate what I was doing. And I decided that maybe being a physio after having been injured would be a good way to be. The guys dressed pretty well who were treating me. I thought, they look pretty sharp, I should do that for a career.

What, what injury did you get, Andrew?

Um, a lower back injury at that point. Yeah, it's nothing like trying to do that extra rep with a weight that might be a little bit too heavy. Prior to that, I played baseball for Australia as a junior, and I'd been selected to the high school Australian cricket team. So I sort of had a lot of work around different sports, and I'd seen a lot of physios for different injuries over the years since I was about 14 onwards. And after that injury, while being planned to be a pro wrestler, It brought me back to thinking, be a little bit safe and get a career that I could always work with. Yeah, absolutely.

Do you still wrestle at all?

Only with hard tasks and questions like you answer— you ask me.

Good answer. What do you think separates you from other physios?

Usually a crowbar. No, actually, when it really comes down to it, It's experience and love of what I do because I've always loved lifting heavy things and always worked with people who lift heavy things. So my science background enabled me to start to apply my rationale, how I approach things using physiotherapy science to figure out how we solve the injuries that stronger and more fit people in our sort of industry get. So I started off life probably more as a shoulder specialist because I first of all graduated and got a job with Sports Medicine Victoria as a shoulder person for them. I was just very lucky that I got to work under a magnificent diagnostician and there was fantastic surgeons there. So they really brought me up to having to be the best I could be on shoulders. But there was nobody who understood bench press shoulders. In fact, I don't think there was probably anyone who actually even knew what a bench press was really, as far as professionals were. And you'll probably find that too, is when you talk to professionals and they say don't squat, you gotta say, what type? You talking Olympic squatting, powerlifting squatting, bodybuilding squatting, front squatting? What sort of squat are you talking about? You ask a professional that question and they'll probably look quite blank and not realize that there are different forms of squatting. So I've refined my work pretty much down to working with athlete to understand there are all these variations in different movements that we have to perform. And once you do that, you can, um, you can really start to see how it all comes together. The science of anatomy and physiology and applied resistance.

Yeah, would you say that it's, uh, it's common that most physios are of the belief that it takes 4 weeks for an injury to heal, and with that said, we'll get the patient to do exercises that don't further injure them but don't necessarily address the underlying issue, resulting in them normally re-injuring themselves? Within 12 weeks. Would you say— what's your opinion on this?

I could see it being an easy thing to occur. I wouldn't know how those other ones would operate, but often one of the most important things you ever learn is that the human body is trying to heal itself, and in the main, it's going to heal itself as long as you don't impede the process with something inappropriate as far as an intervention goes. And one of the things I do is I tend to get a lot more people who have longer-term problems. So what I do is when I take a history, I certainly am looking for that thing which is retarding their process of their body getting better. And that's probably one of the biggest things that you'll tend to find is injuries do get better because the body's trying to heal, but there are certain ones that at certain times are not getting better. And what you've got to look for Is that habit, that posture, that position, that thing that they're doing which may be contributing to the length of this injury's process?

Yeah, whether they're doing something that's continuously aggravating the issue or coming away from it and let the body do its job.

It can be quite unconscious, and that's the thing. What I love, what Professor McGill says when he looks at a person who's sitting in poor posture He'll say, you deserve your pain.

He's so right. I actually listened to a podcast with him on it, and he was saying that there was other back rehab people who were basically assessing this one person. And when she stood up and walked towards him, he goes, okay, I've already got my diagnosis. And the other ones were like, but you haven't even done anything.

Well, I get that all the time. It's quite amusing. I had a very good athlete came to see me recently, and he'd had problems squatting for about 12 months. And his coach had got quite a few eminent people to come and see him and figure out, and they all said he was squatting quite fine. They couldn't see a reason for his pain. And in the end, they came up with this wonderful diagnosis that it was something to do with his adrenal glands. I saw his video that he showed me of his squat and I picked it up probably within 2 seconds. It was incredibly clear to somebody who knows how human beings move to see where problems are. But if you don't know how to see people move, I've treated probably, I was sort of figuring the other day, probably close to 50,000 people. When you've seen that many people and you see how people move, you can make clinical decisions before you even realize how you got to that point of seeing it. And then most of your work from there will be hypothesis testing. You're testing your, your belief. You challenge yourself about what you've decided the problem could be. And at the end of it, you'll either have disproved it and have to go on to another hypothesis, or you've got rid of all the things that you thought may have been there, but you needed to test. So yeah, it's a thing. There's a book called Blink. It's about expertise. And it talks about how experts can see things incredibly fast and the unconscious processing that takes you there. So as you are in the fitness industry, as you'll notice every year that goes by, you'll pick up things faster and faster. And sometimes you'll ask yourself, how did I actually see that? And that's what comes with experience. So I can have somebody put a bar on their back and the first movement, within the first couple of degrees of movement, something will tick and I'll see where the problem is it started.

With that guy, what was it in particular that was causing it?

Um, it was a knee break, a too early knee break, and he was an incredibly good athlete and he was an incredibly powerful person, but he was basically knee breaking too early.

How did you address that, if you don't mind me asking?

Uh, got him to start on box squats.

Okay, so just keep teaching him to start from the hip.

Yep, just put the calf muscles onto a box so they had some kinesthetic and proprioceptive feedback, and then the instruction would be to leave those calves so they didn't move from the box and to sit back onto the box. And because this person's probably done hundreds of thousands of good squats in their life, the underlying movement pattern was already there. All he had to do was find it again.

It only takes one bad movement to cause an injury, doesn't it?

Certainly does, yes. That's an important concept. So, yep, you go. Over time, yes, small movements can contribute to larger movements. It's that sort of idea that, you know, small micro-tearing can lead to the bigger problem at the end.

Yeah, yeah. What kind of people or injuries do you work with mainly? You mentioned that initially you started with shoulder rehab, but what would you say you work with mostly now?

Well, because most of the athletes who see me are strength athletes or fitness athletes, pretty much everybody is squatting or deadlifting these days, which is just a fantastic thing to do. So I probably spend most of my work in working with people who have back problems or hip problems, and they can relate it back to a squatting or a deadlifting pattern. And then naturally you'll get the athletes who have some pressing problems that are producing shoulder issues. So they would be the big ones I tend to see. Well, obviously knee pain comes in there as well, because if you've got a problem with your squat technique, you'll probably find that you'll get some knee aggravation as well.

Have you found an injury you couldn't fix, and if so, what did you do?

Well, it's interesting to say, is it an injury I couldn't fix or was it a condition I couldn't fix? Because occasionally when people come in, I would obviously have been educated in what we would say is a Western paradigm. We think on certain patterns of movements, we think of certain patterns of symptoms. When some of those things don't add up and I really can try one or two interventions, but if it isn't changed and it should have changed under the approach that I would take, I would often refer them off to see a Chinese doctor who I know of, because sometimes there's an Eastern paradigm. They diagnose in a different pattern, and I've had good success sometimes moving them away from a Western approach if it's something I know pretty well, and I can get an evaluation from, say, one of the Chinese doctors. So yeah, I've had occasional things where they just don't add up. And I can try everything within my sort of toolkit, but at that point I'd almost move away from Western examinations, and I'd actually sometimes move off to see someone who uses a different paradigm of thought. Now, I reckon I get one or two of those every year.

It's pretty good odds then, because how many people would you say that you see a year?

That is a tough call. I have to figure that one out right now. That involves some higher maths right now, you realize that, don't you? There'll be a few thousand anyway for sure, quite a few thousand.

Yeah, we definitely send a fair few people to you as well, as I'm sure a lot of other personal trainers do the same.

That's right, because, well, I suppose I always say physiotherapists, what our job is, is our job is to keep the people in the fitness industry healthy and busy. You know, people who come to us don't wanna stop training, and I think it's the worst thing you can do is to basically stop training, really. You know, if a person's got an injury to a leg, well, they can still go and train their upper body in most cases. You know, the trainers who send people to me understand this, and they've got a big toolkit of exercises. So, you know, it's important to keep the people in the fitness industry able to train, able to move. And not so, because one of the worst things I always find is people come to me and they say, I took 3 months off, then I just returned to whatever I was doing and the injury happened again. Well, that's going to happen because you've done nothing different for 3 months. You haven't figured out what the problem was. So often people say, I have a pain when I deadlift, so I took a couple of months off from deadlifting, I went back to deadlifting again. And you go, yeah, well, of course it hurts because you still didn't figure out what the problem was. You just stopped doing it.

And plus, your body's probably detrained to a certain level as well.

Yeah, it'll truly start to make more accommodations and more compensations. So that's one of the most important things, is solving a problem means usually we've got to keep moving to establish the new patterns of movement.

So talking about movements, you talk a lot about kettlebells. Kettlebell swings in particular. What about them got your attention?

It goes a fair way back, really, even back to the earliest stages, probably when they first did come out in the late '90s. I was actually given a 16-kilo kettlebell by a very smart entrepreneur who thought I might find it interesting. And I read a lot on them and I worked a lot on them, and I was fortunate enough to review a lot of educational material that came out on kettlebells. As a result, I was probably there at the start of when they really came into Australia. What I like about them is they're wonderful for creating movement patterns. They're great for people who are learning how to hip hinge. They're great for deadlifting because you can put them in a position where you can't put a bar. I think the only thing I ever figured out I couldn't quite do with a kettlebell was a hammer curl.

You can if you have very strong wrists.

Exactly, it takes a fair bit of work. So you pretty much can do, well, once again, everyone enjoys doing get-ups, and yes, you can do them with dumbbells. Kettlebells feel a little bit better for me. But the swing enables me to access a little bit more of lumber endurance work. So one of the major problems that we've identified in ongoing low back injuries is a lack of muscle endurance. So when I get a person to the point where they're capable of swinging, then often swinging will become part of their muscle endurance protocols. So, I fired a particular athlete who was a good surfer, and he had problems really within about 20 minutes of surfing. Well, we did a lot of things anyway getting him to the point, but by the time he got up to where he was swinging 4 sets of 60 reps for 3 sets, he had moved on to the point where he could now surf for 2 hours without pain. There was a direct relationship between those two situations occurring. When his kettlebell swing started to go up and his endurance also improved, everything fell together.

What would you say is a good amount of reps and sets for someone to be able to do? And I guess the weight would depend on the weight of the person. What kind of volume would you recommend?

Well, it all depends. If I'm teaching a movement pattern, I keep the volume— I keep the repetitions very low because we have to learn how to move first. So similar to the work that Charles Staley brought to us, where we look at doing excellent movements, the volume might be 10 reps, but you might end up doing 5 sets of 2 reps. But their movements are excellent, the nervous pattern is firing off excellently, there's no fatigue in the movement pattern. So often I start off people with under 5 reps to get their hip movements right, to get everything moving well. And once they can establish 5 reps very well, we might do multiple sets, then we'll increase and move towards whatever their particular demands are. So I wouldn't say get Benedikt Magnussen to do a set of 20 because he doesn't work that way in his lifting. He would do 1 and 2 reps. Andy Bolton, when he swings, he swings for 10 sets of 10 reps with 92 kilos.

A 92-kilo kettlebell?

Yeah, that's a fairly big one, isn't it?

It is very big.

Andy Bolton's fairly big as well.

Yeah, I know that you've got a pretty decent kettlebell at your facility. Is it 80 kilos?

I've got the 80, yes. So pretty much everything up to 80 kilos, but I'll have to get one of the 92s just in case Andy Bolton ever turns up.

Yeah, well, you know what they say, with a master the students should be able to surpass them. So it shows that you're obviously doing a great job.

I have to put on more weight. But yes, kettlebells are a fantastic versatile tool. I just love them. I think they're one of the best ways to teach movement patterns, and they're incredibly easy for people to work with. Now you can't do better than teaching a face-to-wall deadlift to get somebody to learn a good hip hinge.

They have nowhere to go, do they?

Nowhere to go, and with a kettlebell, you don't have to worry where the bar path is. The kettlebell's between the feet. It's a beautiful movement, and safe as. So I get a fellow who comes to see me, who's sent by the doctor, and they're all saying he can't lift anything more than 5 kilos in his job. Well, I can put his, I had the fellow walk straight up, put his feet up on the other side of the 52. I said, stand up with that. Of course he could do it. He weighed 100 kilos, his back wasn't a problem. But he was being fed an idea that he couldn't lift something. And in the right place, they're incredibly safe.

Yeah, so with that said, on this same topic of kettlebells, you mentioned to me with Charles Poliquin that he's not a fan of kettlebells for back rehab. What's your opinion on this? Are you there? Andrew?

Yes, it was quite strange. It was quite strange when somebody mentioned it to me that Charles Poliquin said kettlebell swings were bad for backs. I listened to a particular podcast and found— it just seems strange that a guy who sells nutritional supplements makes comment upon rehabilitation. I don't know where he gets his information from because according to Professor McGill's studies and some of the studies that have been done also by James Ross, It's very interesting. They've— the kettlebell swing can be one of the most effective things for helping a lower back under the right conditions. It actually has a particular situation where it has a shear force, it's a posterior shear force instead of an anterior shear force. And when Charles said that the reason he didn't like kettlebell swings was due to shear forces, I thought, well, that's the whole point, is the shear forces are actually demonstrated to be quite effectively useful for a lot of backs. So it was a bit of a strange thing when someone can say something such as Mr. Poliquin there that doesn't really seem to be borne out by research, and he doesn't quote any study particularly that backs up his statement.

Yeah, what would you say is the most common mistake people make when doing a kettlebell swing?

Well, there are different forms of swings. The most common one I tend to see is they are a little bit too slow, so the kettlebell, they're having to lift it Getting people used to moving the kettlebell fast is what will then— they'll see how easy it moves. But people tend to get a little bit scared, so they move it a little bit slow like they would any other exercise. But once you can teach them to increase the velocity, then they get the pendulum motion and it will snap beautifully. So usually the problems with the kettlebell swings are things like soft knees, they tend to squat the swing rather than hip injured. And once you get the velocity up, you'll tend not to squat it, but you'll tend to hip hinge as well.

So you're a fan of hip hinging rather than the squatting one?

All depends upon what the person's presentation is. Most of the rehab swings that I'll work with will hip hinge. Certain ones I will take to a softer movement, such as a, as we call it, a scoop arm swing. So it's a little bit less forced to the back because the knees bend and take a bit.

Is that due to the person's flexibility?

Usually whatever their physical endeavor is. If they've got a particular sport or a particular event that I can see that that would be okay to work with. Most of the rehab stuff is I'm working with, say, a person who's deadlifting. I'm going to use a hip hinge because the hip hinge is what we deadlift from. We don't deadlift with knees forward.

Can you give me an example of who you would give the scoop swing to?

It might be somebody who I'm actually starting to introduce the movement to, who has shown that they can tolerate some shear forces, but I'm not 100% confident of their ability to take a hip-hinged one yet.

Yeah, because the, the more they took forward, the more shear forces. Is that correct?

Um, it's more, I think, on the upper part of the swing. So it's just, it's just a bit of the knee softness will take out some of the force on the back.

Yeah. So you're a former powerlifter yourself. Did you find that complement your skills as a physiotherapist?

I probably did most of my heavier lifting, I suppose, more in the early years of physio. But now I'm back into it again, as in, you know, setting good goals again. So it never went away. It just, you know, as we say, when I peaked up to the 230 kilos in the gym, it was a bit of a different time when I was not studying or working as hard. In what I'm doing now, so I gave it a lot more time. But now I'm starting to find more time to train.

With achieving the 230, what did you— what kind of programs did you do to get to that?

I'm a bit of an archaeologist when it comes to the sport, so I actually went back to some of the work that Bob Peoples, the great deadlifter, performed. And Peoples was very good on— he may have been the first who invented the first power rack. Peoples is very good on working on partial ranges. So where I started was to get used to actually having 230 in the hands and setting it up in a power rack to press from. So I was pressing from partial ranges bottom upwards and then slowly bringing the rack down and bring the rack down a little, you know, another inch or so every now and again. And it took a long time, but My elbows certainly paid the price on that one.

Are they okay now?

The best they've ever been. But if I'd known what I know now then, I would certainly probably started wrapping my elbows earlier in my career in training.

Yeah, that actually brings me to my next question. If you could do it again, would you train or do anything differently?

So I'm only going to probably wrapping a little bit more often because an elbow joint's a pretty small joint. And if you look at your knee joints, the knee joints are big joints. So when we squat and we deadlift with large amounts of weight, the knee joints are fairly well set up to be able to take those forces. But when you're looking at a couple hundred kilos in your hands and you're starting to bench press, if you look at the size of the elbow joint itself, they're small bones and they're taking large amounts of weight that they reasonably, in an evolutionary sense, aren't set up to take. So I would tend to wrap elbows in training as a precaution and to simply help the elbow joints survive a bit better.

Yeah, I found that with my dumbbell presses, as they're getting heavier, wrapping my wrist is definitely helping.

Yeah, all these things, I think they're great for our training, and if we're setting up for comps, it doesn't mean we're getting in the way of our comps. We can easily wrap and then unwrap in training, preparing for comps. But in the last, you know, the majority of our volume, we probably should look after our joints a lot better.

Yeah, I, I 100% agree. With the, the bench press, when you went from 200 to 230, did you— what did you change to get you to add that extra 30 kilos?

Funny enough, probably more frequency. I would have bench pressed in some form pretty much 6 days a week, but of course it wasn't 200 kilos 6 days a week, it would be practice. So I would have gone to the gym and put 100 on the bar and just worked on where my foot position was, worked on where my hand position was, worked on the arch. So I would have perhaps trained solidly 2 good sessions a week, but I would practice 4 other sessions a week working on technique.

It's a good answer.

It is. It worked. The great Bev Francis, the first female to bench press 300 pounds, it was interesting when I spoke to her. She said that was her approach to getting the 300. She basically trained 7 days a week on bench pressing. Well, she practiced 7 days a week, but she also trained a couple of days. And that's how she became great at what she did. She took a track and field mentality to powerlifting. Where instead of just saying we train that point a couple times a week and don't touch it, you teach your nervous system by practicing. And you practice your skills, and your nervous system gets better at applying those skills. As we know, strength is a skill. And this is what it's about. It's about using what you have more effectively and efficiently. So you gotta practice it and learn it.

Yeah, it's like learning a language.

Yeah, definitely. I'm still working on English.

Mark asked me to ask you, with mobility versus strength, have you found there to be an optimal range for certain joints? For example, the ankle mobility, and more specifically, do you have any ideal tasks or exercises for testing mobility versus strength?

I always put it, I always put mobility in regard to performance. So I look at what the person needs to be able to perform. So if I've got a powerlifter and they're deadlifting and squatting, I don't need them to have any ankle mobility at all. They could have fused ankles because effectively when you're applying correct force— now this is for most people, it's not going to be 100% of people because I can always find an anatomical reason for somebody to break the rules. And as Bruce Lee always said, "The way is no way." When you think you've not got all the understanding of all the rules, then you'll find out you can also break the rules. But in the vast majority, and that'll be close to 99%, I can find that a vertical tibia position means we don't need to have ankle mobility for a powerlifter. But you're gonna need it if you're an Olympic lifter. So put mobility in regard to task or performance. And that's pretty much what I would look at any joint. So if I have somebody who's getting overhead with lifts, we're gonna make sure not only do they have good neck mobility and thoracic mobility and lumbar spine mobility, They probably need to have good hip extension, they'll need to have shoulder mobility. There's a whole lot of pieces behind it. So it's a look at what is the performance task that I'd look at before I would prescribe anything.

Yeah, yeah.

So I've only got so much time when you have a person to be able to perform their warm-ups or their mobility work, so I have to make it very specific to the exact task.

So say if it was an Olympic squat, how much ankle mobility would you recommend?

I'd have to look at the individual person once again, but for them, for example, some of my height, I'm 6 foot tall in the old language, I look at about, I can look at about quite a few centimeters probably. Happily would like to see somebody who could do about 10 to 14 centimeters into a lunge. So it will depend upon the individual person and the length of their various body parts.

Yeah, yeah, yeah.

So I always think a body should go through a full range of motion of every body part at least once a day. Now that's for health, because if you could imagine that, um, you— as you would often hear, you know, people being told, okay, you don't want to squat below 90 degrees. Well, what's the rest of the range in your knee there for in an evolutionary sense if it's not there to be used? So I would say I would always want a person to go through a full range of each particular joint at least once a day so they never lose what they should have.

Yeah, absolutely.

So there's your health aspect to it.

Charles Poliquin speaks about ratios of, say, your standard bi-chromial grip on bench press converting to 9.8% of that lift for an external rotation for a set amount of reps. What's your thoughts on this, and have you found any ratios between strength exercises and structural muscles?

No, I'd actually be interested to see the exact studies that he quotes there and have a look at how they were measured, and not only how they were measured, but what the error factor within the measurement devices were. So I sort of want to know more about the underpinning of the references before I actually looked at whether what he was saying there is actually true. You know, not only does a person quote their references, but I want to also see what the references themselves said, because it's easy enough to quote a reference and the reference can say something different. I'd like to see the measurement devices that are used. What's the error factor on the measurement devices? Yeah, so those numbers might actually be entirely useless. They might be so full of error that they have no actual application. That's just someone saying something. So I haven't actually read his research on that.

Yeah, well, let's use you as an example. You can— you've bench-pressed 230 kilos, so with external rotation, did you, did you train external rotation at all?

Or I suppose there we come to perhaps an isolationist view when we look at that, because what we've got to look at is the human body as a whole. That person's got to put their feet on the ground. Oh well, that means there's going to be contraction of some of the posterior and anterior musculature. If I'm gonna be making an arch, I'm gonna be using my butt to come up, using my lats to come up towards my shoulders. I'm gonna be using my shoulders to get down to my lats to set up some stability base. And then I'm gonna be firing off my internal and external rotators to help perform that lift. Now, if I'm doing all those things, that's a heck of a lot different to somebody who decides to bench press with their feet up on the bench and relaxed. So the internal external rotators, what their ratio might be, I don't actually think there's any good study that possibly has been demonstrated because there's all these individual factors that are going to have to be evaluated. You know, that's the problem with this is if you look at two people bench pressing and you look at what they're using for cues, they're going to be different things. Well, that means the ratios aren't firing off the same neurological patterns. So I don't actually think that that's something we can validly even put together yet.

Yeah, so for you, you didn't really do much external rotation work specifically?

No, not at all. No, I was— I had no pain, so I had nothing that ever caused me to work on my external rotators at that point.

Did you need to work on any structural muscles in particular, or just keep training the lift?

Just kept training the lift. Yeah, I mean, I did the accessory sort of things that everyone would do, which would be For triceps, I tend to be very strong on parallel bar dips. I used to do a lot of those, and with a lot of weight around the waist. That would be most of my tricep approach. Probably did a lot of incline pressing as well, because all sorts of pressing, close grip pressing once again too, paused presses, all forms of presses having a carryover. And they were probably the big ones there, and front delts always seem to grow. So they must be getting some stimulation. But even to get that 230, I actually was not— I never fired it well and truly off my lats as well as I should have, which is probably what I'll do better now, I think.

Yeah, so you've changed your approach a little bit then?

Improved it, yeah, definitely learned a lot more. Yeah, that was a, that was a big grunt out, one 230 at a body weight of nearly 140 kilos, and, um, that was fine, but now I'm sort of close to 125-ish again, um, it's a lot different. So I'm definitely using a lot more lat stability.

Yeah.

And the joints are heaps happier.

And for you to do that, uh, what are you concentrating on in your mind to keep them more active?

I'm working mostly on pulling the shoulder blades to opposite glutes. And the glutes to the opposite shoulder blade. So it's almost like creating a Roman arch approach. So if you ever look at, and if you go anywhere in the world, and you can always go through Europe, you'll always tell where Greeks have been in the past because all their ruins are lots of straight up columns and straight lines. And it was then that after a while that the Romans understood that you could actually span greater places without needing all those columns by creating an arch. Arches create stability. Arches therefore can be really good for lower backs under the right conditions. So I'm looking to create an arch by pulling from my shoulders towards my butt and from my butt towards my shoulders. So creating an arch.

That's a very good answer.

It is, it's a good one.

When doing structural balance testing, what I find quite often is tight hip flexors. 'in your opinion, what would you say the cause is and how would you address preventing it from happening again?' It probably even comes down to a little bit of something I've noticed in bodybuilding too.

When I judge the masters classes, you tend to see that the old guys tend to be lacking in their butts quite a lot. So they tend to become a little bit butt deficient as time goes on. And I think that's one of the biggest problems therefore of why we tend to get the impinging hips is because we sit in chairs all the time. And by sitting in a chair, you tend to be a little bit tightened in your hip flexors consistently. That doesn't mean they're short, it just means they're tight. And the butt gets a little bit lazy. And so you get the, um, the femur gets pulled forwards and we tend to get some impingement. So it's usually an imbalance between your hip extensors and your hip flexors at that point.

So in that case, it'd just be a case of strengthening glutes?

That's it, get your glutes back. Yep, you wanna get that Kardashian butt going. So that's the aim, yeah. It seems to correlate to nearly everyone who's ever come to me who's been scheduled for hip surgery has not gone to hip surgery if they have worked their glutes hard.

Yeah, specifically what kind of exercises would you recommend for glutes in particular?

Very much activation's the first thing, get a neurological relationship between you and your butt. So usually it's in hip extension in lying face down. So just lying face down, keep the pelvis so it's lying flat on the ground, and you extend your hip. You don't let your pelvis roll off the ground, you gotta keep the pelvis down. Now with people who are very butt deficient, they'll be over hamstring dominant. They may have to bend their knee to take the hamstring out of it, so they are just getting some hip extension using the glute. And they gotta work on doing at least 100 reps a day of trying to get a glute activation. Once they can talk to their glutes and they're getting some feedback with it, then we can integrate it into another pattern, because that's hip extension in extension, but we also wanna look at hip extension starting from flexion as well. So we'll look at all ranges of hip extension from just extension and also from flexion.

Yeah, so what would be the next exercise?

Hmm, let's see, might look at a, um, a bridge with a band if we want to also include a little bit more of the glute medius firing. We might look at, um, single leg bridges, trying keeping the pelvis level so the glute is controlling the pelvic position as well. So we tend to go to that as a next movement. Quite often if you test that after a person's had hip impingement and you can get a good contraction, you can find that they've lost their impingement within about the first 10 seconds while the glute's been active, and that's a really good sign that you'll have success then. So then we can work on to step-ups, you can work on the hip thrusters, because now we're looking into moving into some flexion positions.

Yeah, and training that at a greater range. Once they've got that activation, you can then Lengthen the range.

Yep, and apply it to whatever their endeavor is that they perform.

Absolutely.

So we always think of what is it the person is trying to do. That's why Pilates is useless.

We'll get to Pilates in a minute. I have some questions later, but I want to save it for the end. So I get the impression you've done a lot of reading and courses. What was the top 3 courses of or books you would recommend?

I think every trainer should get a hold of Pavel Tsatsouline's book, Power to the People. You almost shouldn't be allowed to operate without it. It's just a really well-written book that understands the importance of neurological training for anyone who's going into our endeavors. It underpins some of the basic sciences. It makes you think clearly about how you do things. So I think that's a fantastic book, Power to the People. Basically, there should be a statue of Pavel up in every major city just because of that one. I'd also go with Low Back Disorders by Stuart McGill, just because I think anyone who trains in the industry is gonna run into people with lower back problems. Yes, it's a big book and it takes a fair bit of reading, but realistically it's broken up into very good chapters, and it really lets somebody understand the important concepts about lower back treatment. Outside of that, I'll probably have a crack at Jacob Bronowski's The Ascent of Man. It's a really, once again, a book that makes you consider how we've processed or gone from one part of our evolutionary heritage to the next. It's a really good piece of work, but it makes you understand also how we do and why we do what we do today. And probably for For Mark over there at Enterprise, I'd look at Batman: The Dark Knight Saga. Fantastic. Can't beat it.

Have you read that personally, have you?

I've actually got some of the spectacular copies of that. You name it, yeah, the big ones. I've probably even got 3 copies of it.

You have a course coming up that you're presenting at. What topics are you going to be covering at this?

Yeah, I'm doing it with the brilliant Andrew Reid and incredible Greg Day. Both really super experienced fitness people. Greg's worked with the Chinese Olympic teams as a physiotherapist. He's awesomely good lateral thinker and he looks for interesting ways to approach problems. Andrew's so experienced in the industry, he's recently written a book called, I think it's Run Strong. And he talks about the importance of strength and running as well. And let alone, he's probably one of the best kettlebell exponents I've ever seen. He's taught a lot overseas and he's really an in-demand fellow. So I'll be speaking specifically for about 6 hours in the course, about 3 2-hour blocks. I'm gonna be going through, first part will be going through some subjective work, which is when you talk to your clients What are the questions that you need to ask? This is basically specifically for lower back problems, this one. And what do those questions tell you about that person? How can you make a hypothesis from an interview with a person? And that's the important thing that trainers should be keen to the next stage, I suppose, in their evolution is the ability to run a good history and to understand the implications of exactly what the answers to those histories will give a trainer. how to assess static and dynamic influences on that person's postures through days, and what the other histories will tell a person. So that's about 2 hours of work, and then I'll do a 2-hour objective on looking at flexion, extension, squatting patterns, and talking about what you see in those patterns that can make a prediction about things you may need to change on a person who has a back problem. And so we'll be breaking those 4 movements down. And then on the last 2 hours I'll do the resistance applications to the problems that we've seen. So that'll be my part within the course. That's in March, the weekend of the Arnold Classic in Melbourne.

That's poor timing.

It's okay, I should still be judging the Arnold on Friday and Saturday nights as well. So yes, we're fixing the seminar and heading off to see the Arnold Classic as well.

Oh, it'd be a killer weekend for you.

Oh, it's a killer weekend for everyone. Best weekend in Melbourne the whole year.

Who would you say your course would be best suited to?

That one's definitely suited to trainers. That's the— for the personal trainer who's looking to be able to understand their clients better in the future, to be able to look at thinking in ways that they've never thought before, and to perhaps introduce a new level of their competence and skills. Sort of like adding a few more tools to their toolkit that will help them protect their clients and also make them better and stronger.

Be able to see more.

See more, that's it. How to look for those things, subtle movements and not so subtle ones.

It's good to be able to see an injury before it happens.

It sure is, and we can make good predictions from those. Yes, that'll be a fantastic weekend, and then later in the year I'll be looking at doing some full 2-day workshops which will be just based around more of the heavier sciences that will be going around the anatomy of spines and how we can use that to apply a hypothesis to. So a little bit A little bit different, they'll be probably more built up around the trainers who are really at the top of their fields at that point.

Awesome, I'm looking forward to that one.

That'll be good. I think it should be done at Enterprise Fitness.

Well, we've been asking you to come and run a course there, we're just waiting for you to give us the green light.

I promise to finish my book first, which will be hopefully in the next 8 weeks.

Okay, I'll be patient.

Don't be.

I've got a couple of questions here from a couple of people, just because basically what happens is I post up on Facebook that I'm going to be interviewing you, and Fiona asked, she said, what are some general tips in gaining and maintaining— of gaining and maintaining good functional mobility and stability of the thoracic spine?

One of the things I'd put there is the principle I tend to apply to most joints is to find the positions and postures that your thoracic spine is in most of the day and do some things that are the opposite to that. So if you imagine a person who's sitting at a desk in front of their desktop working all day and they've got some thoracic flexion that they're stuck in, first thing after that means I would get someone to do some intermittent thoracic extension. So you've got to offset the flexion that you'll be stuck in all day with some thoracic extension.

Also known as back bends?

That would be a seated style one.

Okay.

Because we're going to focus more into— more specific. Yeah, so looking to maintain the most extension we can get through the thoracic spine. Then because the thoracic spine has a rotational component, we also want to do some thoracic rotation. So Maybe sitting in a chair and reaching to the right as far as you could and looking around that way and then going to the left as far as you could. And the idea is to loosen those movements up so that during the day you're not rusting. So I would look at mobility as something I don't put in just at the end of a day or start of a day. I like to put a little bit of it in between somewhere within the day as well. So we gotta stop the rust from forming in the thoracic spine. It's really important for shoulders. In shoulder rehab, you've gotta do some thoracic mobility to make sure that the stiff thoracic spine isn't impeding your scapula's movement.

How many reps and sets would you recommend for someone to do, or how often should they stop to do something like that?

I tend to do it for every couple of hours, so it might be about 3 times a day. But it's also, once a person starts to do mobility work and do it frequently enough, Then the numbers become less relevant than how the person starts to know what their natural movement feels like. So we might do the arbitrary 10, which is no better than 9 or 11 reps as far as I've seen yet, but it's a number we'll choose. And the person's going to get a feeling for what their mobility gets to after quite a few repetitions. Now there are times that we're actually moving quite well and we do a couple of extensions and rotations and we're feeling good. It's not getting stiff. It doesn't mean we've got to go do the full numbers at that point then. But there are other times where we might have done less over a period of time, we go to test it out, and in fact we're stiffer than we should be by the 10th rep. Well, that means you gotta do a few more. So it's a case-by-case thing that a person will get used to if they do it frequently enough.

So as you do your reps, you should know noticeably start to feel a little bit more freedom of movement.

Yeah, of course, naturally. We're not looking at pain, we're looking at improvement in movement. So for me, because I hurt my back over 20 years ago, I do lumbar extension every day, a couple of times a day, and always before training. For me, that's what I need to do.

And how many reps was it that you recommend? I remember what you said, but—

Well, the overall plan that I remember Pavel speaking about would be A person should put each joint in their body through a full range of movement for 1 repetition per year of age that they are.

Yeah, I remember clearly you saying that.

Yeah, so we say 1 repetition per year of age would be the normal thing to do. So by the time you're 100, all you do is spend all day trying to do mobility exercise.

I've got 3 questions here from Jesse. If you could give one piece of advice to a young Andrew Locke still at university, what would it be?

It would be read the references in the references, which means just don't believe, um, because a research paper gets given to you that that research paper is entirely telling the truth. Find the references that they quote and if you can, read them. And that's about the only thing that I would like to have done earlier.

Yeah, that's a good one.

Everything else is pretty perfect.

In your opinion, what is the most common clinical misconception out there among physios and osteos and other related health professionals?

Probably that Pilates has any value whatsoever for low back injuries for athletes.

Okay, so Jesse's third question brings me to my next question, so I'll get to it. Basically, What's your opinion on Pilates?

Well, Joseph Pilates himself died around about the 1960s. So, basically he invented a thing called a reformer bed. Well, he invented a lot of things. So if you ever wanna see, you know, Den Oz Direct on TV and stuff like that, I think Joe Pilates would've been totally at home on doing that stuff on a late night TV show, selling his various inventions.

The Chuck Norris training as well.

Oh, totally. So this is pretty much, where the reformer comes into it. It's a piece of equipment that he invented, and to call everything that a person does on a reformer Pilates is doing him a disservice. If you look at his original works, he was entirely wrong on his concept of back problems. He was right into getting rid of your lordosis and heavily into flexion. That was Pilates. Now, after he died, everyone else who had reformers and various things, decided that what they were doing was called Pilates. Now if you look what people are doing and calling it Pilates now, it's got basically no relationship to what he originally produced. And back in the year 2000, I remember reading that the US Supreme Court decided the name Pilates itself couldn't be trademarked because there were so many different versions of it. So recently what we're looking at is we're looking at something that you can go brush your teeth and say you're doing Pilates, or walk your dog and say you're doing Pilates. 'cause no one can stop you. There's no Pilates Federation that has any, I suppose, authority whatsoever. So it's basically a word that now can mean anything, and it basically pretty much usually now just means people lying on a reformer. Now, that's what Pilates is. It doesn't have any structure, it doesn't have any, well, clear worldwide international body that seems to agree upon what it is.

[Speaker] Have you found there to be a form of Pilates then? 'Cause you said there's multiple forms. That is actually beneficial? 'Cause say CrossFit, CrossFit, there's some boxes that are actually okay, whereas others are just madness.

Well, I suppose it happens in pretty much all different things, but we can call Skype Pilates now for as far as I know. So they got a big boost from the transverse abdominis concept. But once again, if you go back to read the research that started that tsunami of work, That research was incredibly poor that started that industry. The idea that pulling your belly button in produced some form of stability, which it didn't. It was very clearly demonstrated by Professor McGill that pulling your belly button in to the exclusion of all other muscles does not produce stability, it produces instability.

It's quite the opposite, isn't it?

Yeah, it is. And that's, you know, the research is incredibly poor. It was said to be a force couple, but transverse abdominis doesn't attach to the spine directly. It comes to a piece of fascia. It's not local to the joint, whereas multifidus is. So it fails a whole lot of definitions that it was said not to fail. So I think what happened is basically physios unfortunately did get taught back through the '90s and the 2000s the idea that there was this local muscle control that was produced by pulling in your belly button. And I actually think it's more a political teaching than it ever was a really good scientific teaching. We were very strong in it in Australia, so we teach Australian styles of evidence.

With the powerlifting, the reason they wear the belt, my understanding is it gives them feedback on something to push against when they're inhaling.

Well, there's also those who don't wear belts who lift quite successfully.

Yeah.

So yeah, I've had quite a few people say that they only wear the belt for the feedback. There's not been a definitive study to really demonstrate across the board where its strengths lie, and we tend to say that if you're wearing a belt, you shouldn't really be wearing one under 80% of your maxes. Because it tends to be thought that you're not giving yourself a good proprioceptive feedback at that point. But at heavier weights, it's much more effective.

Yeah.

So yes, I've even seen people wear their weight belt down the beach in St. Kilda, looking quite, um, quite dapper.

And then those muscles become lazy, don't they?

Well, they learn perhaps how to rely on the belt. Yeah. Yeah.

Can you comment on why clinical Pilates and transverse abdominis rehabilitation protocols aren't as effective as lower back erector spinae training for treating lower back pain? That's Jesse's third question.

I wouldn't even put just the erector spinae in there. I'd actually say we'd also include everything else in our— well, I hate the word core because it's been overused, but the true core is basically the abs, the QLs, the extensors, everything that surrounds that cylinder which allows us to stabilize. So the idea is if you are putting up, say, a tent post and you had a whole bunch of ropes, you'd want to be putting as many good ropes tightly down to produce maximum stability. But if you only had one rope, and that's your transverse abdominis, you haven't got a very a stable tent pole. And that's the basic concept which we would look at from a McGill point, in that we have an instability problem if we have a problem where the spine needs to be more stable. And stable means that it's able to resist the forces better which are going to be placed upon it. Not that the spine bones are moving in any particular way, but that you want to produce as much force as you can to produce as much as a concrete-like stability to the spine. So you need to integrate all the muscles possibly.

I really like the tent analogy. It simplifies it very well.

That's pretty much how it works. If you just pull your belly button in, you lie down on your back and wave your arms and legs around on a reformer, you're not really demonstrating any stability. But anyone can produce an exercise that's hard. And I hear that from people with the Pilates reformers. Oh, ballet dancers do this. This is really hard. Well, yeah, well, try standing up in a, in a hammock. That's hard too. Doesn't mean it's good for you.

Yeah, just because something's hard doesn't mean it's beneficial.

Not at all.

Thanks again for coming on the show, Andrew. How can our listeners follow you and keep your advice coming their way?

Always best to catch me on, um, either the breakingmuscle.com website for the articles or on Functional Strength Rehabilitation on Facebook, which is the practice. And we'll look forward to catching up somewhere in the future, no doubt, Dr. East. It should be wonderful to do another part to this interview in the future.

Absolutely.

Lots of brilliant questions, and we shall look forward to setting a new standard for this century of real good back care with resistance training work.

I 100% agree.

No doubt. Well, stay sharp, stay ripped, be big.

Hope you guys enjoyed that podcast. I know I did. Please, please, please leave a review for us on iTunes. Love us or hate us, we don't mind, but leave a review. Give us a 5-star rating or a 1-star rating, preferably a 5-star rating. that would be much appreciated from yours truly. And you know, Reece needs the, you know, the ego boost as well. So be kind and leave a review on iTunes. Announcements for us to make, obviously you guys, you want to get in contact with us, you want to do personal training, get ready for a comp, smash some PBs, or just simply do a photo shoot for yourself and get in the best shape of your life, you can contact us, reach out. Our hotline is 1300 737 737. 1300 887 143, or shoot us an email at info@enterprisefitness.com.au. Obviously go over to the Facebook account, obviously Enterprise Fitness Australia or Enterprise Fitness, you'll find us on Facebook. We're very, very active on Facebook, very, very active on YouTube. So stay tuned for more interesting and awesome content from the world of enterprise fitness. Because we have a lot of things coming. Now if you're new to the show, obviously you can jump on our blog which is at melbournepersonaltrainers.com, hit the blog and get looking at the old shows. Likewise, you can subscribe to us on iTunes and see the old shows that we've done. This is a completely brand new podcast channel. Obviously you guys might remember the Maximus Mark podcast that I ran a couple of years ago. Well, this is a different podcast. This is the Enterprise Podcast. Hosted by Reece Adams. So hope you guys are enjoying the show so far. We've got some pretty big interviews coming up in the next couple of weeks. You want to stay tuned for that. So till next time, guys, you know how it is— train hard, supplement smart, and eat well.