Assessing Risk Of Injury - The Mindful Strength Podcast

About Travis Pollen

Travis Pollen is a Philadelphia-based personal trainer and Ph.D. in Rehabilitation Sciences. He also holds a master’s degree in Biomechanics and Movement Science. His research interests focus on movement screening, training load, and assessing risk of injury for athletes. 

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Show Notes

To follow Travis on IG click here @fitness_pollenator

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Assessing risk of injury.

Is it possible? If so, what even consists of an injury?

Travis Pollen Instagram Page

About This Episode

Travis and Kathryn talk about injury risk factors, whether or not assessments are effective, how to define an injury and active vs. passive range of motion. Travis critiques one of the more popular assessments and shares insights from his rehab science studies. Kathryn brings up the idea of alignment, and Travis talks about how alignment isn’t what we think it is. They also discuss the current theories about closing the gap between active and passive range and how important this actually is.

This interview will encourage you to critically evaluate what you hear about mobility, injuries, and risk factors. This is a really important discussion to be having right now.

 

Travis speaking assessing risk factor for injury in swimming

Podcast Transcription

 

Kathryn: [00:03:56]

All right Travis welcome to the podcast.

Travis Pollen: Thank you for having me, Kathryn.

Kathryn: Yeah, my pleasure. I’ve been following you online for a little while and if folks are not following you especially on Instagram they should because you make all these wonderful posts. I have picked out a few today that I want to ask you more about. But in case people don’t follow you online or they don’t know who you are. Do you want to take a few minutes and just tell people a little bit about your background and the type of work that you do?

Travis Pollen: [00:04:22]

Yes. So I had just completed my Ph.D. and rehabilitation sciences at Drexel University in Philadelphia. So I am a researcher and I’m also a personal trainer. I have been certified since 2013 and I’ve worked in commercial gyms I’ve worked in homes, I worked in some trading studios, I’ve worked online. So that’s what I’m doing now. A combination of research and personal training but rewind sort of to how I got into all this.

[00:04:57]

Going way back, I was born missing my left my so I am effectively and above the knee amputee. I guess my rehabilitation journey but also my athletic and training journey started in high school when I joined the high school swim team. Long story short I had a seven-year swimming career where I continued swimming in college.

I tried out for the Paralympics in 2012 and all of that sort of led me to personal training because when I finished my undergrad degree, my undergrad degree was in physics. I realized that I didn’t want to pursue higher education or employment really in the realm of physics but I loved to exercise.

I loved all of the stuff that I was doing outside the pool from a strength training standpoint to get me better in the water. So I decided I would become a personal trainer and I did that for a little while before then going back and getting a master’s degree in biomechanics and movement science. Which is pretty much like the perfect hybrid of exercise and physics. Because it’s the mechanics of human movement.

So that was a really good fit for me and it sort of positioned me then to go and pursue the Ph.D. in rehabilitation sciences which is sort of the research side of physical therapy for my dissertation. I looked at risk factors for injury and swimmers. I’m really interested in the way that movement affects injury risk and the way that training load affects injury risk as well as the psychosocial components of an injury risk.

[00:06:45]

So I did all that for my dissertation and now I am looking for faculty jobs but there’s not a whole lot of openings right now. As you mentioned I’ve been getting more consistent with my Instagram posting. I’m just trying to really focus on bridging the gap between research and practice. Because I feel like there was a lot of stuff that is really important in the research that isn’t known about in practice whether that’s personal trading or rehabilitation.

There’s just a big gap. Then also bridging the gap between rehabilitation and performance. One of the things that I observed through the last few years where I was very involved with physical therapists, collaborating with them, and also athletic trainers and sports medicine and strength conditioning coaches was that there was a bit of a communication barrier between each of those professions. So just trying to figure out how to harmonize those worlds a little bit better is sort of where I see myself in the big picture of things.

[00:07:49]

And maybe for your listeners sort of how I found you and some of the more general movement practices outside of just a training setting is that I’ve actually been a yoga student since I was 15. So half of my life. I’ve done it sporadically at some times and work consistently at other times but lately or prior to the pandemic I was taking a weekly yoga class at my rock climbing gym. Rock climbing and sort of the main sport that I’m interested in right now.

But I’ve used yoga as a way to facilitate mindfulness and relaxation and kind of balance out the intense training that I was doing in swimming while I was doing that. Now I just continue to enjoy it because I see a lot of parallels between what we do from a training standpoint and then what yoga teachers and yoga students talk about and think about in the way that they look at movement.

[00:08:47]

And so I have been collaborating a lot lately with Jenny Rawlings who your listeners might be familiar with. That’s been really an incredible experience to learn from her and learn more about the movement and Science of Yoga and kind of contribute my research expertise to some of the work that she does.

Kathryn: [00:09:04]

That’s awesome. Actually didn’t know that you were a yoga practitioner. When I follow you online I see so much like strength training and stuff like that and that’s so interesting to hear that you’ve been practicing yoga for all these years as well. I feel like this will be even more helpful for the people who are listening.

Travis Pollen: I hope so. Also, I am definitely not an expert by any stretch of the imagination but I think that having done it for so long. You know on a recreational basis I can at least speak the language of yogis a little bit.

Kathryn: [00:09:39]

Yeah totally. So what is the difference between a Ph.D. in rehab science and a Doctor of physical therapy?

Travis Pollen: That is a great question and something that as I’ve been applying for jobs, I understand it but, trying to convey what a Ph.D. in rehabilitation is on my resume and my cover letter is tough. It’s not like you’re an exercise scientist or a kinesiologist or a physiologist. So it’s kind of a vague term. But I can start by saying a doctorate in physical therapy is a clinical degree that you get over about three years.

[00:10:17]

It involves a lot of classes and then a lot of clinical rotations and that degree prepares you to be a practicing clinician. So practicing physical therapists or physiotherapists as other countries call it. I am not a clinician or a physical therapist. You could say my in the trench experiences as a personal trainer and the research that I’ve done and the degree that I’ve done has been a doctor of philosophy and rehabilitation sciences.

And so that is more of the research side of physical therapy. And so I’ve been involved in research on risk factors for injury in competitive swimmers. I’ve looked at some testing for anterior cruciate ligament return to play. So that’s kind of the two avenues that I’ve been pursuing during in the last four years of my doctorate.

[00:11:09]

And so basically my degree prepares me to be a teacher a professor at the University and to engage in teaching undergraduate or graduate students as well as conducting research. It doesn’t allow me to be a practicing physical therapist. And so the confusing thing I guess when you look at my resume is that my degree is in rehabilitation science yet I’m not a clinician.

So my niche I guess in teaching would be that I could teach statistics, research methods, exercise biomechanics, like exercise prescription, kinesiology, I could teach evidence based practice. Like helping future physical therapists better understand how to critically appraise research.

[00:11:56]

The challenge though is that most universities with physical therapy programs are looking for clinicians to teach their clinical classes and maybe they have one person who does those other classes that would sort of fall into my area of expertise.
That’s my challenge right now. I have this PhD but where would be the best fit for me? Because the other thing that I could do would be to teach exercise science, at an undergraduate level.

But my background isn’t actually in exercise science. So I’ve only taken one anatomy and physiology classes and it was at the undergrad level.I’m really not equipped to teach those sorts of classes. I kind of have this broad area of expertise but it doesn’t fit exactly the shape or the norm of what a lot of universities are looking for. It’s been an interesting challenge for me so far and I think we’ll be moving forward as I continue job hunting.

Kathryn: [00:12:49]

Yeah, it’s so interesting to hear what people end up doing with these specialized educations.

Travis Pollen: I think the normal trajectory is you do your PhD then maybe you do a postdoc which is one to three years maybe of further research training and grant writing. Then you go and get a faculty position. But I don’t want to deal with all the grant writing. I’m interested in research but I want to do that on the side and kind of focus on teaching if I do go the academic route.

But then there’s this other side of me where I really like working with people in person and I’d like to continue personal training. But I’m a little bit overqualified as a personal trainer with a Ph.D. But at the same time, I really do see there is a need for trainers with advanced research skills to help other trainers learn and just be a really great asset to clients. So I’m happy doing that for now even if I can’t find my dream academic position for how long.

Kathryn: [00:13:48]

I want to ask you about injury risk and I know you said you were studying injury risk in swimmers. So if we’re not going to talk specifically about swimmers, what are some of the big factors you’re looking at from a more general injury risk perspective?

Travis Pollen: Yeah. So I did my research on swimmers. I was a swimmer obviously but my interest in athletic injury, mechanisms, and ideology focused on swimmers but it applies more generally to athletes. Also to anybody who is engaging in physical activity. So the biggest risk factor, as I’m sure you’re familiar with and many of the listeners might be, is having a previous injury.

[00:14:31]

That has been shown in a variety of sports. I found the same thing in my research with swimmers and it isn’t just necessarily if you’ve had a previous shoulder injury then you’re more at risk for another shoulder injury. You could have a previous shoulder injury and be more risk for an injury to the other shoulder or to the hip.

So it can that you’re more at risk for another shoulder injury but it can also just apply more generally. Once you’ve had one injury you’re more likely to have another. That’s sort of the biggest and best thing that we know right now. Or the thing that we know most consistently is that if we’re trying to identify people who are at increased risk of injury, all we have to do is ask them if they’ve had a previous one.

[00:15:13]

It’s kind of really simple on the one hand but it’s also complicated because now that you’ve had a previous injury we call that a non-modifiable risk factor because you can’t change the fact that you’ve had a previous injury.

You can make sure that that injury has been fully rehabilitated and that you’ve fully recovered compared to your opposite side. Which is often a common competitor from a strength or range of motion standpoint. Or you can look at if you have good normative data for a given test. Let’s say if you’ve had a low back injury and you’re focusing on building back up your endurance in a side plank.

[00:15:51]

There’s research showing what a normal hold time for a side plank would be that you could then compare to. From an athletic standpoint though the best thing to do actually would be to have pre-injury data on all athletes. So we know exactly how long you can hold that side-plank before you got injured. Then we could test you as you’re going through rehabilitation to see if you are back to where you were at before. Maybe even we want you to get even better than that in the side plank or whatever the test is.

Kathryn: [00:16:22]

Could I ask you how you define an injury?

Travis Pollen: Yeah, that’s a super fantastic question because that is like one of the biggest challenges from a research standpoint. It’s hard to compare between studies because a lot of studies define injury differently. So there’s a push lately to just try to get more consistency in the way that injury is defined. I can just give a few examples of how an injury is often defined.

[00:16:53]

So sometimes it is that the injury in an athletic setting it had to result in time loss. The athlete wasn’t able to train for at least a day or they had to miss a competition. That’s one injury definition. You could then grade that based on how much time the person missed. So if it was one day that’s like a relatively minor injury, if it was 10 days or three weeks we would call that more severe injury. Then you could also define injury based on whether the athlete sought medical attention.

If that athlete went to the athletic trainer’s office or they had a visit with a sports medicine doctor then the injury was severe enough in their eyes to seek medical attention. So those are the two most common definitions and they’re both valid. But the problem with that is if you look at two studies and two studies find different things then you try to compare them. It’s not exactly apples to apples because they were defining injury in a different way.

[00:17:56]

So it just depends on what your research question is and what the injury patterns look like in the population that you’re looking at and what the norms are for that population. The other side of the coin is who’s reporting those injuries? Are you querying the medical records that the doctor or the athletic trainer took? Or are you directly asking the athletes themselves?

What we find is that the athletes themselves, especially in the case of overuse injuries, tend to report more injuries. If you send them a weekly email and ask them whether they’ve had an injury in the last week. Rather then if you consult the athletic trainer. Sometimes the athletes just aren’t going to the athletic trainer for whatever reason. So that’s another side of the story.

Kathryn: [00:18:45]

OK. I think that’s important. Yeah. That’s interesting. I guess I was expecting you to say something like If you have something that hurts then that’s an injury or something like that.

Travis Pollen: So that’s the tricky part, especially with swimming. There have been studies that have shown 9 out of 10 swimmers experience shoulder pain at some point in their career or in their season. If you just base it on the fact they had shoulder pain well then when you’re doing a study you need to separate the people who had pain in the people who didn’t. If almost everybody has pain, that makes it really difficult to tease anything out statistically.

[00:19:24]

So for that reason, I used a different definition that has never been used before. Which was just if they had pain that interfered with their ability to train for 50% of one practice. Which is well-defined. But how do you define what 50% is? That’s kind of like a judgment call. There were instances where the athlete said that it didn’t affect them that much and the coach thought it did. And so then I had to get to the bottom of that a little bit more. But that’s tricky at first.

When I was writing about it in my dissertation I was calling it an interfering injury. One of my advisers who is overseeing the work said you’re really asking them about pain. You should change that word to pain and not injury. So there’s a there is a subtle difference between those two things.

Kathryn: [00:20:08]

Yeah and I guess what that does is also just normalize pain a little bit especially in athletes.

Travis Pollen: Yeah. Which can be good and bad. That’s another thing in the swimming literature. It shows that the pain because it’s so prevalent, a lot of swimmers just consider it a normal part of the training process due to the high volume.

What that does is make them tend to swim through the pain and not sit out because of it. In some situations that can be OK. If somebody is dealing with chronic pain and the exercise aggravates their pain but we know exercise is good for them. If they can stay below a certain threshold of pain, that could have positive implications for their recovery and for their pain levels overall.

[00:20:55]

But when you’re talking about a swimmer who’s having severe pain and they’re continuing to exacerbate it because they don’t want to miss out on training. They don’t want the coach to know that they’re injured. They don’t want to disappoint their teammates or they don’t want to look weak in the eyes of their teammates.

So many different reasons why they could be continuing to do that. But that can contribute to more long term problems where maybe if you caught it in the first instance and you let it in the bud then it might not be a problem.

Kathryn: [00:21:22]

OK. So back to the risk factors. The major risk factor was previous injury. Was there anything else you want to mention?

Travis Pollen: Yes. So the training load was the other really big focus of my work. It is a really hot topic right now in the global sports injury literature. I in particular looked at this ratio called the acute to chronic workload ratio.

Which is a ratio of the amount of training that the athlete had been doing in the most recent week compared to the most recent months of training. So let’s say for the last month you’ve been doing three sessions a week on average and this week you got really gung ho and you decided to do six classes.

[00:22:11]

If you take the 6 compared to the 3x/week for the last month before that. Six versus 3, it would be double. So your future chronic workload ratio would be 6 divided by 3 equals 2. And there is some research that shows that anything over a ratio of 1.5 increases an athlete’s risk of injury.

It came out in 2016 where they sort of talked about that 1.5 being the danger zone. That’s what they described that as. And over the last maybe two years there’s been a lot of argument back and forth about whether the way that that ratio was derived is mathematically rigorous and what it actually means. We need different types of study designs to sort of validate that further.

[00:23:06]

There’s a lot of arguing going on about that particular value. But the idea of that I think is pretty well agreed on. Just the premise not to do too much too soon and maybe we don’t even need a mathematical value to associate with that. Maybe we can just understand it conceptually.

Also when you do get down to research and you want to quantify these things then you do need a way to do it. And so that is the way that it’s often being done right now even though it is problematic.

I can say that from my research I did find that athletes were more likely to sustain an injury during weeks in which they’re future chronic workload ratio was high. Like over that 1.5 value. But I also just looked at the raw workload. The number of yards that they were swimming during that week, without comparing it or dividing it by the previous month.

[00:24:05]

I’ve also found that if you just look at the number of yards that they swam that week, there was a similar relationship. Where if they did a lot of training that week they were more likely to be injured, than weeks in which they did less training. So that is kind of contradictory to that model on which the acute to chronic workload ratio is based. Because the thinking is that as long as you’re accustomed to doing a lot of training over the last month then if you encounter a high workload in the current week, you are probably going to be OK because you’re used to it.

Versus if you have a low chronic workload for the last month and now suddenly you do a higher workload in that week then you’re more at risk. That’s not what I found. I didn’t find that athletes who were better prepared from the previous month were more at risk than just looking at the current week of training.

Kathryn: [00:24:59]

Do you think that’s because they got like really well recovered?

Travis Pollen: So that’s definitely part of it and that’s the confusing thing if you just look at the external workload. Which is just the general amount of training that they’re doing. Which says nothing about how the athlete is responding to that training or what their state of recovery is.

[00:25:20]

I haven’t seen a lot of research that has combined these two things. But I was just talking to a friend who is a strength coach for a college football team. The way that he does it is he not only looks at the training volume but in particular, they also look at the number of yards that an athlete has run above a certain mile per hour.
So that’s really high-intensity training and there’s a certain volume of training that they want to stay below in a given practice or over the course of the week.

But then they’ll also marry that with how the athlete is responding based on fairly frequent vertical jump testing. If you know what an athlete’s average or normal vertical jump height is and the variability of that, then you can see if an athlete comes in today and they’re way below that average, that means that they’re likely under recovered.

[00:26:17]

We can then look at what they just did well they had a practice or a series of practices where they ran a ton of that high-velocity, high miles per hour. Let’s say it was wide receivers and there were running routes. So if you have both of those things then now we want to seriously consider with this athlete whether they need to take a step back from the training for a few days and try to get them a little bit more recovered.

That’s how it would apply in a high-performance football setting. But it could apply equally to a yoga context where you’re looking at how much of the movement practice you’ve been doing. You can even just ask yourself well how am I feeling today? There are so many things that can go into that. How has your sleep been? How has your nutrition been? How’s your hydration? How is your stress?

[00:27:10]

If you wanted to, you could quantify those things by taking a daily wellness questionnaire and rate each of those things on a one through five scale. Then look at that over time. Or you could just simply ask yourself or your students “how are you feeling today? If we’re talking about a certain pose like handstands maybe, where we know that going upside down, if you fell over from that you could hurt yourself.

Whether a student decides to do their handstand on that day or just stick to some sort of modified handstand progression, the teacher in a one on one setting could ask the student any of those questions are just simply how are you feeling that day.

And I think that already happens to a large extent. Do you want to do a handstand today? Yes or no. Why would you or would you not feel comfortable doing it today based on all those many factors.

Kathryn: [00:28:02]

What you said about the idea of having like the vertical jump test to check in on how people are doing and then kind of gauge from there. I think that is really interesting. Like a cool way of checking in with someone.

Travis Pollen: So that’s one that’s commonly used. Another one that’s commonly used is handgrip strength. I have a handgrip dynamometer that I bought on Amazon for $30 dollars. I’ll use that sometimes. Just a quick squeeze or two on each hand. See how that compares to what I’m usually able to grip and I’ll do that at the beginning of a workout just to see what’s my neurological state today. Am I under ready, I guess you could say, or is my grip really strong today and I’m going to push my training.

[00:28:46]

You could readily do that in a yoga context. What’s my grip today? Okay, I’m going to do a more rigorous practice or I’m going to do something more restorative because I’m not feeling ready to go today. Or you could take it and realize today you just need a little bit more of a warm-up in the strength training session or in the yoga session before I get to the heavier lifts or the more intense bout. Maybe you just need to ramp yourself up a little bit.

The last one that comes to mind immediately is resting heart rate I’ve actually found that if my resting heart rate is higher than usual I may be a few days away from getting a cold. And this is purely anecdotal I don’t think there’s research on this. Maybe there is?

I know that I’m recovered when my resting heart rate comes back to normal. This is just a very rudimentary way of looking at it because there’s a more advanced metric called heart rate variability that looks at between-beat variability and that can also be a way to gauge how recovered the athlete is

Kathryn: [00:29:57]

So one thing that I think is interesting, we’ve been talking about injury risk and so we’ve looked at what an injury is, previous injuries the potential of too much too soon, recovery, nutrition, all of those different things. But in the postural yoga setting, there’s a lot of talk right now about injuries. I think the first thing that comes to people’s mind when you ask them about injury risk is alignment and I don’t hear any of that from you right now?

Travis Pollen: It’s funny that this is coming after all those things because at the beginning of my doctoral journey, that was the primary thing that I was also interested in. It was actually the reason why I chose to study at Drexel with my mentor. Her most recent research with her previous Ph.D. student developed this really comprehensive movement assessment.

[00:30:54]

Maybe you’re familiar with a really popular movement screen called the functional movement screen? It’s a series of seven tests that are designed to grade and rank fundamental movement patterns. I sound like the manual. There’s a lot of research over the last 14 years on that particular assessment of movement and its relationship with injury.

So what my adviser and her previous Ph.D. student did was they took bits and pieces from that functional movement screen but they developed a more comprehensive screen. Where FMS is seven tests, the movement battery that we used was 14 tests.

The tests that we derived, were based on previous research and had shown associations between the tests that we were looking at an injury and various athletic populations. Whereas the FMS was designed just based on the two creators’ clinical intuition.

[00:31:50]

We thought that the research on the functional movement screen is very mixed or contradictory. There are some studies that show that athletes who perform poorly below a certain threshold on that assessment are at increased risk of injury. There are other studies that don’t show that association.

It might be dependent on the injury definition. It might depend on the athletic population, the level. But long story short, it’s not a really strong association from the standpoint of moving poorly can guarantee that you’re going to get injured.

I can tell you that there’s nothing right now, not even previous injury is a guarantee that you’re going to get a future injury. It’s just that you’re at increased risk and there are some mathematical complexities involved with that. There’s no super strong association between anything. Injury is multifactorial so you have to consider many things, not just one.

[00:32:46]

But I digress. From the movement standpoint, we thought we can do something really comprehensive. Look at the upper body and lower body, the core, strength, range of motion, endurance, and motor control. Then maybe this gives us this best chance at finding athletes who are more at increased risk of injury.

So I use that 14 test battery in my dissertation and I found nothing in the swimmers. No association between the total score on that battery. I didn’t even find an association between any of the individual tests and injuries. Which was pretty surprising because we looked at shoulder rotational range of motion.

[00:33:31]

We looked at closed kinetic chain stability of the shoulder. We looked at a lot of different upper body tests that we thought if there were any population where this would matter it would be swimmers because of the high incidence of overuse injuries in this population.

That’s not what we found. So on the one hand you might be able to explain that as swimmers do all of their training in the water, dry-land measurements just aren’t that relevant to them.

[00:34:00]

So I also looked at swimming technique because I was anticipating that that might be a possibility. And I also didn’t find a lot from the actual in-water standpoint. There was one measure that sort of involves going into an extreme range of motion overhead. When the hand is entering the water during the freestyle stroke and that increased an athlete’s risk of an injury in the study.

But all of the other six things that I looked at from a swimming technique standpoint didn’t. The bottom line that I’m concluding from this is that, at least in swimmers, their alignment and movement competency or quality on land really isn’t that important when it comes to their injury risk when they’re swimming.

[00:34:44]

I only had 37 participants which is still a relatively small study. We wouldn’t want to make really firm conclusions off of one team of people. But that is kind of consistent with what we’re seeing from the functional movement screen which there’s a lot more research on and a lot larger groups.

You can kind of extrapolate that out. Maybe to other movement practices like yoga where we have long thought that if you aren’t able to resemble that perfect shape you’re putting yourself at more risk. And it just doesn’t seem to be that cut and dry.

[00:35:22]

It’s not to say that that can’t be a factor especially for somebody who is already in pain. Changing the way that somebody is performing a movement or a pose can modify their symptoms.

But it’s not to say that if your knees knocked together suddenly if you go into valgus just when you’re doing chair pose, you’re not destined for knee pain. It probably has more to do with what we talked about with training load. If you didn’t do a chair pose for a month and now you’re doing a chair pose eight times a week and your knee hurts.

Well, it might have something to do with the way that you’re doing it but probably has more to do with just the fact that you’ve done so much more of it lately compared to what you’re accustomed to.

Kathryn: [00:36:04]

Oh boy. So this is kind of interesting because I haven’t done the FMS training but I know a lot of people who have. I can’t remember even when all those seven movements were off the top of my head. But I remember a friend of mine went to go do the course then came back and was like “oh my goodness this is what we should all be doing” and started putting like all of his clients through it. Saying this is how we can predict injury.

Then I remember going through the test myself and being like “I can’t do some of these things” like there’s no way I can do that. But I was also like “but I don’t think I’m at an increased risk of injury”. I guess it also depends on what I want to do and who I am.

Travis Pollen: That’s the biggest and what you just said is everything. Those seven movements are those seven movements but what are you actually trying to do? Like one of the tests is an overhead squat with a dowl rod. So yeah it’s an interesting test. It sort of looks at your global ability to get small and get big like global flexion at the ankle-knee-hip.

Then flexion through the shoulders and extension through the thoracic spine. So a perfectly good test but if you can’t do it does it matter as long as you’re not doing Olympic weightlifting? Where you have to go into that position for a snatch.

[00:37:32]

For a long time, I guess I was enamored by those seven tests. I thought that they were really thorough looking at a lot of different requirements for a mobility standpoint and a stability standpoint. Which they are, but maybe over the last year, I’ve sort of had more of that “Ah-Ha ” moment which is what you just said earlier. Why would seven generic movements matter for every single person?

Wouldn’t we want to better understand what their goals are? What their target activities are, what they want to be able to do, and then base our assessment on those things. Not some arbitrary set of seven other things. The other thing is that a lot of people think “well I have to be perfect”. Each of those seven tests is graded on a 0-3 scale and 3 would be a textbook performance in the test, and they think “oh well I have to get a three”.

While the FMS people think you actually only need to get a two. Two is good enough. So that would be doing the movement but with some minor compensation. Maybe the twos are more realistic for your everyday person but even then if you can’t get a two on the overhead squat does it matter?

Kathryn: [00:38:47]

There’s this idea, especially in the mobility-exercise community right now. Where you need to be able to do these certain things before you start putting load on top. So one really basic example is wrist extension. Meaning if you can’t put your wrist at 90 degrees of active extension then should you really be training planks or handstands?

In my personal opinion, I am a human who’s always trained handstands my whole life, and I cannot get my wrist to 90 degrees of active extension. Which I’ve tried. Like I just don’t think it’s in the cards for me for whatever reason.

Plus, I know a lot of people who if they had to wait until their wrist was going to go into that perfect range of motion before they could start doing planks or push-ups, they’re going to be waiting probably a really long time.

What do you think about that whole idea?

Travis Pollen: I can’t believe you’re asking this question because I’ve literally been thinking about this exact thing for the last three weeks. Jenny Rawlings and I have something in the works where we’re going to be delving into this. I don’t want to say too much more about it but yes first of all I totally agree with you that that’s crazy.

[00:39:58]

That you would need 90 degrees of active wrist extension before you do a handstand. I think that’s silly. I’ve been looking at some of the research on what constitutes normal wrist extension range of motion and normal even for passive I think was less than 90.

So that’s sort of a side note but basically what my current thinking is that the prerequisite that you need the active range of motion in whatever joint action or all of the joint actions of the pose before you engage in that pose. I think that’s the wrong prerequisite.

I think we should be talking about passive ranges of motion as the prerequisites for the movement. Because you can imagine that if you go to do the handstand or a plank pose or push-up and you can’t get into the passive range of motion then you’re just not going to be able to actually get into a handstand with like a relatively straight line.

You could maybe compensate through like lumbar hyperextension like the banana looking handstand. Then maybe you could take the mental leap to say well that’s going to increase your risk of injury at your low back because of that. But not even talking about that, just talking about whether or not your wrist is going to get injured because you don’t have the 90 degrees of even passive range of motion?

[00:41:19]

I would just say probably not. You’re just not going to be able to do a really good looking handstand. Now if you’re way far away from 90 degrees of passive range of motion that might be something that we want to work on but the idea that you would need 90 degrees of active range of motion for that movement is I think ridiculous.

Gravity puts you into passive wrist extension in all of these movements. So the thinking that you need to actively be able to get there is just silly to me and I understand that some of the arguments are based on having control.

[00:41:53]

That’s the big buzzword right, over that position. But I don’t really see that being that specific to the movement itself. I think just practicing the handstand is going to give you the control that you need rather than being able to actively extend your wrist.

I’m with you. I actually measured this on myself the other day and I just took a picture and then drew some lines in PowerPoint and did some trigonometry and I think I have like 60 degrees or maybe less of active wrist extension and I do handstands just fine. So hopefully that was a long-winded answer to your question.

Kathryn: [00:42:32]

Yeah, I think it’s really helpful because I think there’s a lot of these ideas right now.  I’m teaching a course right now that has a lot of teachers in it and there are so many questions about mobility. How much mobility does the person need? I think that there are these ideas about mobility always being the prerequisite and if you can’t do this you can’t do that.

Travis Pollen: Yeah, there’s the psychological component of telling people that you can’t do something and I think that can just be really damaging. Let’s just, within reason, let people try things in an integrated fashion and see if they can do it rather than putting movements off-limits .

Kathryn: [00:43:09]

So okay my last comment on this is then what do you say to the people who then say “oh well your risk might not get injured but somewhere down the chain you’re going to compensate and then that’s going to be where you get injured”.

Travis Pollen: Yeah, it’s harder to see at the wrists. So let’s look at the shoulder. If you have full shoulder flexion, whatever full means, but roughly 180 so that you can get your arm overhead. That’s the other thing is that what’s normal for these things and what’s abnormal for these things isn’t super well-defined. But anyway if you’re missing 10 degrees of overhead motion that’s going to mean that you’re not going to be able to get into that straight line and your lumbar spine is going to hyper-extend a little bit and does that put you at increased risk?

[00:43:53].130

Well maybe? As long as you’re wrong and as long as you’ve built up to that over time, your body can probably withstand that. I mean it is a fair amount of load through that structure. You need this amount of shoulder or wrist extension because I just don’t think we know that yet. It’s more if you’re really far off. Like I’m talking excessive.

You can’t raise your arm more than halfway between parallel to the floor and perpendicular to the floor. That’s where we’re going to pump the brakes on handstand. But if you’re close and as long as you’re progressing in a gradual fashion I think it’s OK.

The one thing that I have been thinking about in terms of this whole active versus passive and what do you need. When it comes to the shoulder and handstand, I would say that the active range of motion is more important than the passive range of motion.

[00:44:50]

I think we know that intuitively. If you were going to test somebody’s active shoulder flexion, you would say raise your arms up overhead and see how you go. You wouldn’t say lie on your back and let me push your arms into flexion and see where you’re at.

The reason why I think that’s important is that when you’re in handstand gravity is working against your shoulder extension so you have to actively be going into shoulder extension. That’s different from the wrist where if you’re in handstand gravity is assisting you into wrist extension.

I think mostly we need the passive ranges of motion but there might be some instances where we need the active but I couldn’t really think of that many more examples where the active was the important range of motion besides that one.

Kathryn: [00:45:38]

Maybe like if you wanted to do a really nice like back tuck, like a backflip and you didn’t have that active flexion of your spine and your hips something like that.

Travis Pollen: Oh for sure. Yeah in a context like that.

Kathryn: Yeah very interesting. I feel like a lot of people are listening right now and they’re just like oh boy. There’s more critical thinking to be done.

Travis Pollen: We’re trying to get to the bottom of it a little bit more and so we’ve put some feelers out to people. Hopefully, in the coming weeks, we can shed some more light on it.

Kathryn: [00:46:10].

Yeah. Cool. Well, I’m looking forward to seeing what you two come up with. So if people want to reach out to you or follow you on Instagram or work with you in some way where do they go online to check out your stuff.

Travis Pollen: Yeah, my website is fitesspollenator.com, pollenator like the Terminator but Pollenator. If you just Google my name Travis Pollen, it should be the first result. And I’m also on Instagram at @fitness_pollenator as well as Facebook. Just look up my name. Those are the best places to reach me. If you want to reach out to me there’s a contact page on my website.

Kathryn: [00:46:49]

Awesome. Well Travis this has been wonderful and I would love to have you back on the podcast because I got through like a third of the questions I was actually going to ask you but I knew this would happen.

Travis Pollen: Going into this I was like I’m going to try not to be too long-winded but I get carried away.

Kathryn: I knew this would happen. It’s awesome it’s great to have so much detail on these topics and yeah thank you so much for being here. We really appreciate it.

Travis Pollen: Thank you, Kathryn, it was fun.