Clearing up some B.S. in Golf Performance and Fitness
Let’s Clear up some of the B.S. in Golf Performance and Fitness
Today, I am going to breakdown some of things I have taken issue with that exist in golf fitness and the health and fitness world as a whole. The main topics I am going to look at are the ELDOA method, the joint by joint approach, and the idea of having to earn the right to perform a basic lift like a squat or deadlift. My intent today is not to directly attack anyone but when you challenge peoples deeply held beliefs inevitably it happens.
This article is based solely off of my understanding of the current science, my knowledge and experience, the knowledge and experience of other professionals I respect and my opinions. I am more than glad to be proven wrong on any of these ideas and open to have a discussion with anyone regarding my thoughts on them.
The ELDOA Method
Let’s start with ELDOA, as this is the hot new tool in the toolbox out there. One of the main reasons I am picking on ELDOA as I have seen it marketed as the magic pill for low back pain. Low back pain is a very complex and multi-factorial based problem and marketing any one approach as the magic pill is false advertising at the very least. I will say that my experience with ELDOA is solely based off of taking the TPI online course and videos and articles I have read by ELDOA practitioners for whatever that is worth. I will say that in my opinion the ELDOA method is simply a bunch of novel movements and neural mobilizations that can be effective for those in pain but not for the reasons that they claim. They seem to claim that that can isolate and lock down certain spinal segments by positioning alone and open up joint spaces but I have yet to see any real evidence that they are doing this. The following are the claims taken from their website:
“ELDOA (Étirements Longitudinaux avec Decoaptation Ostéo Articulaire), or more easily translated to Longitudinal Osteo-Articular Decoaptation Stretching, is a revolutionary technique created by World renowned Osteopath Dr. Guy VOYER.
ELDOAs are postural self-normalizing techniques designed for widening the space within a chosen articulation. This is accomplished by creating fascial tension to fix the vertebra below and contraction in extreme range to normalize the vertebra above the targeted disc. For example, it is possible in one minute a day to relieve disc compression between T6-T7 or even more specifically at the base of the long arm of the left sacroiliac joint. Dr. VOYER developed an ELDOA exercise for every articulation in the spine starting at the base of the skull and ending with the sacroiliac joint. It is possible to create more room in a particular articulation with an exact position adapted to each person.
ELDOA postures are very specific compared to other techniques. Disc compression existing at any level of the spine can be addressed through a specific ELDOA exercise. If a client experiences pain because of compression between the 5th lumbar and 1st sacral, the de-coaptation position should target this exact level and not the one above or below. ELDOAs are not limited to just the spine. There are ELDOA postures for all joints of the sacrum and pelvis as well as the shoulders and skull.”
We know through the research that we can’t isolate joint segments through manual external pressure so I find it hard to believe we can do this through positioning. See this article by Dr. Bahram Jam PT as he breaks down the research nicely: https://physicaltherapyweb.com/new-paradigm-manual-therapy-abandoning-segmental-motion-palpation/
We also know that when we move, we effect to some degree the skin, nerves, muscles, connective tissue, joint(s). neural pathways and more that are involved in that movement all to some degree therefore we cannot isolate certain tissues. While I do find some of the moves in the ELDOA effective as I have used similar movements in my practice, I don’t see them as anything special and definitely cannot get on board with the claims that are made by them. On top of this claiming that any one approach is a magic pill for any pain is usually a red flag for me.
The Joint by Joint Approach
I have been hearing about the idea of the joint by joint approach since I got out of PT school 12 plus years ago and it has never fully made sense to me the. I will be taking a lot of my information from this great article by Justin Kompf: http://nicktumminello.com/2014/01/the-joint-by-joint-approach-claims-vs-the-evidence/ To my knowledge the joint by joint approach to training was conceived by physical therapist Gray Cook and strength coach Mike Boyle and first introduced around 2007. The approach looks at the body functioning properly as follows:
Low back: Stable
Thoracic spine: Mobile
If a mobile joint like the ankle became too stable it would result in sloppy knee movement and so on. Immobile hips would lead to a mobile lumbar spine which would eventually lead to low back pain.
Loss of mobility –> aberrant movement of a stable joint –> pain
In my opinion we need to be able to provide stability and mobility through all joints depending on the needs of the task at hand. Basing your training or exercise prescription around the above ideas is a huge mistake IMO. We need to look at each individual in front of us, asses and determine what movements or areas may or may not need to be addressed based on their presentation, needs and goals. We know that there is not a high correlation of injury or pain with certain postures or movements, therefore trying to predict injury or pain due to limitations at one joint or based on how a person moves are damn near impossible. We have no proven accurate ways to quantify good vs bad movement therefore how do we start to test it or blame injury or pain on it. Now does this mean we throw the baby out with the bathwater? No absolutely not if someone has pain with a certain way of doing things, I may make some changes at least temporarily but those changes are not made off of a predetermined joint by joint approach by based on how they present to me. Justin summarizes his thoughts well below and I tend to agree:
“The joint by joint approach did bring a nice way of thinking to the table and I’m in agreement that joints should move the way they were proposed to move in this thought process. I also believe the authors have done a lot to bring about progress in the fitness industry. Problems arise with some of the broad and generalized assumptions that were made especially when trying to connect the dots on causes of pain. The implications garnered from this idea have led to the creation of an infinite amount of mobility drills that have been adopted by trainers and therapist alike sometimes to the point where no training effect is elicited because we deem clients too dysfunctional do exercise. We end up giving them an endless supply of corrective exercises rather than working around their limitations to create a training effect.
We need to question the benefits of these mobilization drills we give our clients based off of the joint by joint concept. Does the time spent on corrective exercise make more of a difference than the time we could have spent exercising?”
I personally find the joint by joint approach useless in my practice and prefer to look at my clients as individuals and understand that everyone will present differently and will need different approaches.
Earning the Right to Lift
On the heels of the above topic is the idea that people have to earn the right to perform a certain lift. Now when it comes to complex lifts like Olympic lifts, I think you should learn them before adding load. The issue is I have seen this same thought geared towards things like squats, deadlifts or overhead pressing and those I don’t agree with on this sentiment. The deadlift is one big area I have seen this mentioned where if a client can’t touch their toes, they can’t deadlift. That is complete bullshit IMO. There are plenty of ways to bring the weight up to the client or simply have them perform it form the top down and have them safely perform a loaded deadlift. You can still try to improve the toe touch while doing this but there is no need to have waste their time performing 20 corrective exercises trying to improve it for weeks before they start. The same goes for being able to squat to full depth or have full overhead motion and perform overhead lifting. This is not an either-or scenario you can load clients in a safe way while still trying to improve movement at the same time.
Instead of worrying so much about what our clients can’t do let’s focus on what are clients can do and get them loaded and moving then look at where their deficiencies are and address them as needed. Let’s help our clients improve the quality and control of motion at all joints, let’s help our clients get stronger in the basic human movements and in multiple planes of movement, let’s improve their cardiovascular health, let’s get them active and more athletic and let’s help them build healthy eating habits without overloading them with info b.s. or making them afraid of everything.
As clinicians and fitness professionals I will never understand this constant need to always be searching for a new tool to add to our tool box. Let’s not forget that first and foremost we are dealing with human beings not mechanical machines. We need to do a better job of learning how to deal with those human beings, how to motivate them and help them build consistent positive habits and learn the need to be able to adjust day to day based on their presentation each workout. We need to worry less about the shiny new method put out there or hold onto to unproven beliefs because we are so entrenched in them. We must learn to be skeptics and to adapt to changing science and information.
We offer a variety of in-person and online training options to fit your needs. Don’t forget to check us out at www.guidrygolfandsport.com and find us on social media:
Youtube: Guidry, PT, Golf and Sport
Also, head over to www.barbellsandbirdies.com to check out our new Golf Fitness and Performance apparel store.
John Paul Guidry DPT CSCS TPI Fitness L2