Chapter 98 Exercise, Conditioning, and Performance Training

Exercise is most beneficial when it directly trains function and healthful biomechanics. A surprising number of exercise and conditioning activities do not build function for daily life, the trail, or survival itself in the wilderness; they may even instill unhealthful movement patterns. Sets and repetitions of stretches and exercises do not fix injuries or change poor movement ergonomics. Some reinforce movement habits leading to increased injury, mistaken for overtraining and pain syndromes. This chapter covers healthy, functional training for lifetime health, pain prevention, and healthier wilderness travel.

Fitness as a Lifestyle

To many people, fitness means stopping daily life to do repetitions of motions in a gym with little similarity to movement patterns in daily life or sport, then returning to sedentary behavior, moving with poor ergonomics, bending in unhealthful ways hundreds of time daily, riding elevators, and slouching when driving and sitting. Fitness as a lifestyle does not mean working out or going hiking. Rather, it is the collection of healthful functional movement throughout daily life. Instead of sitting and moving slouched, then stopping to stretch to relieve back pain, sit and stand well to get exercise as a lifestyle and prevent pain in the first place. Instead of lifting packages, babies, groceries, laundry, and other loads incorrectly all day, then stopping to do back exercises to relieve back pain, lift properly for functional exercise. Instead of isolated abdominal exercises, employ a neutral spine during running and movements of daily living for functional abdominal use to prevent unhealthful spine posture. Instead of driving for unhealthful fast food, and standing stressed and slouched at the kitchen counter, anxious to finish to engage in a meditation session, healthful straight standing, washing and cutting, bending and reaching for ingredients, and remembering the good fortune to have them, is in itself a healthier and truer meditation. It is important to be active, but not as a different, inconvenient part of the day. A gym is not needed to develop fitness. Ordinary daily needs to bend, move, lift, reach, and balance should perhaps be changed to functional healthful patterns for built-in exercise as a lifestyle.

Specificity

Strength, power, muscular endurance, balance, and cardiovascular fitness require different body systems. Each develops through different exercise. Stressing one part, such as arms or legs, or one system, such as strength or flexibility, does little to develop other parts or systems.⁹ Running, for example, makes cardiovascular, metabolic, and structural changes specific to running but not necessarily to hanging from rock faces. Trained runners may exhaust themselves during long swims, and paddlers during climbs, even though all may have high aerobic capacity. Another example is a weightlifting practice of lifting at lower than normal speed. This does not train the more rapid joint angle movement needed in common wilderness, daily life, and rescue situations.¹³ Slow lifting may build strength, just as with any other weightlifting, but not the power that depends on speed, or the injury-prevention capability that comes from training rapid stabilization. To get off the ridge before weather hits, and be fast and safe when it is most needed, one needs to train for it.

It is best to train closely to the way needed for function, and to train abilities together. Wilderness skills and activities of daily living are multisystem, multijoint, multispeed, and multifunctional. The wilderness often demands endurance, strength, power, and balance simultaneously—for example, holding healthy joint positioning under the weight of a pack while crossing a rope bridge, descending carrying a stretcher on skis or in foul weather, rock hopping, getting out of a flash flood, or just hiking with small children.

Strength, Muscular Endurance, AND Power

Strength is generally defined as how much you can move or carry in a single or a few efforts. Muscular endurance is how long you can continue being strong. Power in a fitness setting is how quickly you can be strong; power is work per unit of time.

Ability for strength, endurance, and power tasks depends on individual level of fitness, workload, type of work, exercise efficiency, and leverage, and on whether the work is external, such as carrying weights,⁵³ or internal, such as carrying oneself,¹⁷⁵ which varies with bodyweight. On ascents, a heavy person may work harder and closer to his or her maximum than a lighter person of similar fitness or even of lesser fitness, depending on the workload. Internal work like hiking and climbing may favor the smaller, lighter person. For external work like portage, rescue, and hauling gear, a larger person of high muscular fitness may have an advantage.

Different activities require different ratios of strength to muscle contraction speed. A higher strength component compared with speed of contraction (e.g., portage and rock-face scrambling) is strength-dominated power.⁹ Kicking with fins, swimming, running, jumping, and deploying safety equipment primarily employ speed-dominated power.¹²⁵ Many situations, like navigating rapids, require both strength and speed in constantly changing proportions.

Abdominal Muscles and the Core

It is a common assumption that a strong core supports the back and body for activity. However, abdominal strength or endurance does not automatically support the body. Support entails a voluntary and specific change in vertebral and pelvic angles to reduce pain-producing positioning and loading.²⁰ Hyperlordosis is too much inward curve to the lower spine. It is not a condition, but a bad posture. Tightening or strengthening abdominal muscles does not change unfavorable spine angle or pain. Preventing the overly large arch to move to neutral spine stops the cause and the pain. Maintaining neutral spine employs abdominal muscles, but strengthening abdominal muscles does not automatically produce neutral spine. Slightly built people who reduce a hyperlordotic lower spine to neutral spine will reduce painful angulation of the lumbar spine, and thus tolerate a heavy pack without strain, whereas someone with a strongly built core who stands with increased lordotic arch (hyperlordosis) imposes much load on vertebral facets¹⁰⁶ and discs²³ from the weight of the upper body on the unfavorable vertebral angle. The person who uses core muscles to prevent injurious spinal angle will reduce back pain at that time, without exercise or medical treatments.²¹ To feel change from hyperlordosis to neutral spine, try the following:

• Stand with your back against a wall. Touch heels, backside, upper back, and the back of your head to the wall. Notice if you need to increase lower back arch or allow ribs to lift. (Do not do this if you have back pain.)

• Remove exaggerated lordosis by pressing the lower back toward the wall, reducing the large arch. Tuck hips as if starting a crunch, without curling the upper body forward. Lower back pressure should be gone. Do not tighten abdominal muscles.

Use abdominal muscles functionally in this way to reduce a hyperlordotic spine during all activity, particularly when lifting overhead and carrying loads (Figure 98-1). This technique reduces loading and pain from functional poor posture²¹ as well as increased vertebral sheer of spondylolisthesis.²⁴ See Conditioning, later, for functional retraining for core muscles.

FIGURE 98-1 Hyperlordotic lumbar angle shifts load to the low back (left). Prevent hyperlordosis when reaching or lifting. Tuck the pelvis, reducing overly-arched lower spine until reaching neutral spine and vertical pelvis (right). Maintaining neutral spine (not strengthening or tightening) is how abdominal muscles prevent back strain.

Flexibility

Flexibility training may reduce the incidence of activity-based injury.¹³¹ One proposed mechanism is the increase of muscle length before reaching a tearing point,¹³⁷ probably from change in the viscoelastic properties of muscle–tendon units.¹⁷⁷ Another is reduced tendon organ activation.¹¹⁹ However, the number of injuries that occur seems to dispel the hope of stretching as preventive.¹⁵⁰ The disparity seems to lie in how stretching is commonly accomplished, and in movement patterns used during exercise and daily life.

Many common stretches promote the original problem of thoracic rounding and stretch-weakness of the back and hip. After rounding forward all day over the computer, desk, steering wheel, handlebars, or backpack, more forward rounding is not healthful or needed. The widespread phenomenon of forward bending for the majority of stretching and exercise creates a widely occurring lack of extension range of motion needed to simply stand up straight, often resulting in chronic low-grade aches, injury, and wear and tear from habitual unhealthy ergonomics and positioning.

To understand functional flexibility for resting muscle length, try the following: Stand against a wall with the back of your head, shoulders, hips, and heels touching the wall. This is aligned standing position. A small space remains between low back and wall, but not a large space. Are your back and shoulders too rounded to stand straight without strain? Do you have to arch your back to touch your head? Does your chin jut forward or lift up? Are your hips so tight that your back is too uncomfortable to stand straight? When lying supine, can you rest comfortably without a pillow under head or knees? Anterior muscle tightness is often the culprit.

Tight, rounded anterior chest and shoulders contribute to neck pain, upper back pain, and shoulder pain.⁷⁰ Tight anterior hip muscles, common in people who sit for extended periods, change the normal angle of hips and low back, inhibiting normal standing, walking, and running, and adding a large share of low back pain.⁴⁵ Tight hip muscles, calf muscles, and Achilles tendon contribute to walking duck-footed, or toe-out.¹⁵¹ The resulting change in gait and stance may wear on ankles, knees,⁷⁹ hips, and big toe,¹⁵¹ and contribute to bunion formation.¹⁴² Tight feet add to plantar fasciitis.¹⁶¹ Tight hamstrings are prone to pulls and may contribute to low back pain.³⁹ See Conditioning, later, for functional stretches to remedy these problems.

Conditioning

This section covers specific functional exercises for health during wilderness travel.

Functional Conditioning

Training in the manner used for actual activity is called functional exercise. Many common exercises may strengthen or provide exercise but not train fitness or movement in the manner needed for health, daily life activity, or wilderness skills. For example, strength increase through lifting weights by isolating specific muscles with discrete exercises does not train the multifunctional movement needed to prevent injury when opening a window or carrying a heavy pack. Many people accustomed to running on a treadmill or elliptical trainer later turn an ankle on uneven terrain because they have not trained balance, proprioception, or stabilization muscles.

An effective approach to training for wilderness skills is to change the practice of exercise for each body part to natural, integrated, functional motion for real-life health and physical ability. Instead of using a treadmill, walk and move over uneven ground for movement and balance training to reduce risk of sprain on uneven footing and unstable slopes. Use muscles to hold neck, back, and legs in healthy positions all the time for built-in, functional exercise and injury prevention, rather than slumping under heavy packs. Climb stairs and hills, not a stair-climber machine, to train for the hills. Use good bending technique for the innumerable activities of daily living, to strengthen legs and accustom the body to functional movement. Lift, move, lunge, walk, and squat to prepare to portage, haul, climb, and hoist, and to squat where there is no plumbing.

Strength, Endurance, Power for Wilderness Preparedness

To increase strength, lift a weight heavy enough to produce muscle failure after 8 to 10 lifts. Continuously lifting weight light enough to be moved or lifted more than 10 times increases muscular endurance. Lifting the same weight faster trains power.

For external work of dragging sleds, building shelters, carrying gear and packs, and rescuing, train by carrying and moving weights in functional movement patterns, at varying speeds, while maintaining healthy positioning of back, neck, and knees. Have fun devising training to simulate conditions. Drag a tire on a rope. Run while dragging children on the tire. Run with a rickshaw. Give piggyback rides. Haul a trailer on the bike.

To develop muscular ability to move your own body for hiking, climbing, skiing, and hauling up inclines, practice lifting your body at varying speeds for various repetitions with pull-ups, push-ups, lunges, and squats. Lifting external weight strengthens, but the joint and muscle mechanics of lifting weights are different from moving yourself against the ground or overhead support. To progress, lift yourself while wearing a backpack or other weight. Loading bodyweight also trains the important skill of safely moving your body under the weight of external loads.

Climbing with packs and other skills requiring both internal and external strength to lift and haul is best prepared for with intelligent cross training to optimize several fitness components. Vary lifting and training workouts to avoid injury and stagnation.

All strength training programs have the common goal of trying to maximize muscle work done to maximize gain. Practice different components and variations of strength, power, and endurance training in the manner to be used on the trail.

Upper Body

Abdominal and Core Muscle Conditioning

Strengthening core muscles is commonly thought to solve back pain by correcting muscle weakness. On scrutiny, core strengthening has not been found to reduce pain ⁶⁹ or effect any greater relief than aerobic exercise or nonstrength programs.^1,^56,¹⁰⁰ Exercising abdominal and torso muscles does not alter the poor mechanics that are the source of much pain.¹¹⁵ Using abdominal and core muscles to reposition the spine to reduce excess lordosis is how the abdominal muscles unload the facets and support the back.²⁰ Using abdominal muscles, without tightening, to prevent hyperlordosis when standing, running, and lifting overhead gives functional abdominal exercise during all daily activity.

Crunches, and other common flexion-based exercises, may increase strength, but not functional strength for standing and lifting in the upright position of real activity.²⁰ Holding neutral spine against a stationary or moving load is the key to learning how to use abdominal and core muscles for back pain and posture control. For effective abdominal muscle strengthening specific to daily life and trail ergonomics, try the following:

• Lie face up on the floor holding a pair of light dumbbells, legs straight, to simulate standing.

• Extend arms on the floor overhead, biceps next to ears, holding dumbbells about an inch off the floor. Notice if your ribs lift and the lower spine arch increases. Press the lower back closer to the floor. You will feel the load shift to the abdominal muscles.

• The key to using abdominal muscles is to prevent the ribs from lifting up, or the low back from arching from the floor. Press ribs downward.

• Raise and lower the dumbbells to about an inch from the floor, as many times as you can (at least 8 to 10 times), continuously using abdominal muscles to keep the lower back from rising from the floor at any point during the exercise. Keep breathing.

• When you have mastered controlling torso positioning during slow arm movement, increase the speed of raising and lowering the weights. Raise the weights no more than a few inches from the floor. If you can see them, they are too high. As the weight lowers, the momentum and weight will encourage lifting the ribs and arching to shift the work of the exercise off the abdominal muscles to the vertebral joints. Use abdominal muscles to prevent this. This abdominal exercise also works the arms and back. The benefit is to learn to use abs to hold safe, effective, and functional neutral spine posture when using the rest of your body.

• It is commonly repeated that knees must be bent to protect the back. However, normal standing and function during real activity are not done with knees bent. Bent knees do not protect the back, as does using core muscles to maintain neutral vertebral angle.²⁰ Use this straight-leg exercise to retrain use of abdominal muscles to hold the spine and pelvis in position when standing.

Next, using the technique just described to prevent hyperlordotic arching under load, do push-ups, with hips tucked to neutral. Without the tuck to remove low back overarch, core muscles are not in use, and bodyweight shifts to the vertebral joints called facets.

• Holding the tucked push-up position, turn to the side, raising one arm from the floor, not allowing hips to sag to use oblique abs in functional training for posture under side loads.

• Try this side push-up, raising one leg.

• Hold a neutral spine push-up position with one arm raised to or above ear level. Keep the body level, not turned. Raise the opposite back leg, keeping a straight neutral spine.

• Do push-ups on a medicine or exercise ball. Practice holding neutral torso posture, using abdominal and core muscles to train healthy postural habits. Do not take a good exercise adjunct like a ball and lose benefits by doing crunches on it.

• Do push-ups with tucked hips and one leg out to the side 90 degrees and parallel to the floor.

Using abdominal muscles does not mean “sucking them in,” “tightening,” or “pressing navel to spine.” Breathing and healthy movement are restricted or impossible with tightened abs, and tightening does not change the poor posture that loads the low back. To understand this, try the following: Tighten abs as commonly taught. Press navel to spine. Tighten the entire area. Now breathe. Note that such tightening would not be possible or useful for daily activity. Next, stand with arched posture. Tighten the abs and surrounding musculature. Note that posture does not change. Stop tightening the area so that movement is unrestricted. Tuck the spine and hips to remove the lordotic arch, straightening posture. Train the abdominal musculature for wilderness activity by using muscles to hold healthy spine and pelvic positioning under load, during standing, lifting, and movement. This will provide efficient exercise at the same time as retraining posture and back pain prevention habits.

Hands and Wrists

Hands and wrists are often a weak link. They require strengthening and training like the rest of the body for daily use, and for wilderness needs of grabbing, holding, lifting, hanging, pulling, belaying, carrying, and rescues.

• Open jars. Wring wet clothes. Work with clay. Squeeze things. Give massages. Use pliers and screwdrivers. Saw wood.

• Hang from a bar or tree limb to strengthen grip. Increase time held. Hang from fingers, then fewer fingers, and groupings of fingers. Perhaps, eventually, hang from one finger. Who knows when that will be handy?

• Carry groceries with hands, not a cart. Do not lean back when carrying. Stand straight, torso tucked using core muscles (see Abdominal and Core Muscle Conditioning, earlier).

• Carry suitcases and other items with handles, arms by your sides, holding with finger grip (farmer’s carry). Carry heavy dumbbells across the room (lifting and setting down properly, using legs, not bending forward). Use farmer’s carry on unwieldy items like plate weights, and heavy books like encyclopedias, as if they were suitcases.

• Train pinch-grip and holding-grip strength of fingers and palm by carrying partially inflated medicine balls of different weights or rubber balls filled with water.

• Do push-ups to strengthen wrists and arms, and become accustomed to holding and pushing weight with your hands. Keep weight on whole hand and fingers, not just concentrated on the wrists.

• Do push-ups, or hold the push-up position on fingertips, then fewer fingers, and groupings of fingers.

• Use fingers to push and pull things.

• Instead of hanging directly from a pull-up bar, loop a towel over the bar. Grip the towel at each end and hang to train grip for climbing and rescue.

• Hang from door jambs and oddly shaped overhead structures for finger grip training.

• Jump up to hang from fingers, instead of first gripping and then lowering bodyweight, to practice unexpected situations requiring quick, sure grasp.

• Get rest and stretch fingers back (extension) between intense periods of finger and hand grip training to prevent tendon irritation.

• Regularly stretch fingers back softly, and open fingers as wide as possible.

When lifting weights, and using hands for everything from typing to driving, instead of compressing the wrist backward under the entire load, use hand and forearm muscles to contribute to the effort, and keep weight distributed across your entire hand, not just on the heel of the hand. Train hand strength and dexterity to prevent hand and wrist injury, to reduce risk of osteoporosis, and for strong climbing, carrying, rescue, and self-rescue.

Feet and Ankles

Feet and ankles need exercise, often overlooked in fitness routines. Tight, weak feet and ankles are more likely to cramp, hurt, strain, and develop plantar fasciitis ^102,¹⁸² and deformed toes. When the big toe joint does not extend normally when walking (hallux rigidus, or stiffness in the first metatarsophalangeal joint), it alters gait and posture, reduces needed plantar stretch, and promotes hallux valgus (big toe bent away from midline) and bunion. Altered gait may affect hip and low back dynamics. Weak, unused toes easily deform and curl. Toes must be straight and strong for balance and healthy gait. Weak, overly stretched ankles without good proprioceptive sense training are prone to recurrent sprains. Feet are easy to condition, because they routinely bear bodyweight, giving built-in conditioning opportunities.

Exercise feet by retraining muscles and increasing general exercise with attention to using foot, ankle, and leg muscles to hold foot and ankle posture, instead of letting muscles atrophy in tight shoes. Here’s how:

• Keep feet facing straight ahead for gait. Parallel gait builds needed, functional stretch to the fascia and Achilles tendon with each step. Gait with feet and legs turned out contributes to hip and knee pain, and bunion formation, and is often mistaken for flat-feet because it weights the medial edge of the feet, pronating, everting, and flattening arches. Toe-in strains the foot, knee, and hip, and affects normal gait.

• Use lateral ankle and thigh muscles to maintain neutral ankle and prevent pronation. Many cases of “flat feet” are acquired pronation (bad posture and weak, untrained muscles), not a structural problem.

• Learn to preserve arch and ankle stability without supportive shoes or devices.

• Stretch feet daily using the lunge, described earlier. Keep the back foot straight, not turned out even slightly, or stretch on the foot and calf will be lost. Lift the heel to stretch the bottom of the foot. Then turn the top of the back foot (volar surface) toward the floor and stretch the other way. When stretching the sole of the foot with your hands, stretch the entire sole, not only the toes.

• When standing on toes, keep weight over the big toe and second toe, not allowing ankle inversion, tilting toward the small toes. Practicing neutral ankle on toes deliberately preventing inversion, uses the knowledge and stability needed to prevent inversion sprains.

• When you lift weights, stand in a healthful position balancing on one leg.

• Put toes under something like a door, your other foot, or a friend, and lift toes and foot.

• Play hopscotch. Hopscotch was possibly developed for Roman soldiers to exercise their feet and ankles. Do other fun combination balancing and hopping games.

• Have fun with the balance exercises (see Balance Skills for the Trail, later). They strengthen and train ankles and feet in ways needed for normal life and to keep balance on narrow, rocky, uneven, and slippery trails.

• Stand on one foot for increasingly long periods. Move the other leg in inventive directions at varying speeds.

• If toes do not move freely, or shoes make toes touch each other, the shoes are too tight for daily wear. Practice moving toes in all directions often. Stretch toes with your hands and by using your foot muscles. When standing, do not clench toes, or lift toes from the ground. Avoid heeled shoes; they are prone to deform feet and are detrimental to posture and gait, affecting the kinetic chain from feet to back and neck.

• Hold foot and ankle posture against pronation. Do not wear a tight boot to do what your own muscles and kinesthetic sense can do. You would not wear a neck collar for upper body posture. Do not let foot muscles atrophy from the disuse that a tight, supportive shoe allows.

• Walk softly; heel first, rolling to your toes. Keep foot straight, not turning in or out. Bend at the toe knuckles and push off the ball of the foot, not the sides of the toes. When descending stairs, come down toe first, then bring the heel down. Do not crash down on heels. Bend knees for shock absorption with each step down.

Power and Plyometrics

Plyometrics are exercises designed to train muscles for quick powerful moves.¹⁸ The muscle is first quickly stretched under load (contracted eccentrically), then immediately, forcefully contracted concentrically—for example, push-ups with a clap between each pair, and rapidly jumping over a line of boxes with quick deceleration crouches between each pair. Plyometric exercises stress muscles and associated attachments more than do other exercises.⁵⁴ Learning and maintaining healthy joint positioning and good shock absorption are the keys to safety in plyometric training. Here are some fun training examples:

• Throw and catch a heavy medicine ball against a (sturdy) wall or in the air in a quick succession of forceful throws and quick deceleration catches, fully bending arms. Many small children love being thrown in the air and safely caught. Remember safety for all in this exercise. Do not arch the low back when throwing or catching. Keep hips tucked, using torso muscles to handle the load, not the low back. Do not lean back when standing and throwing overhead (see Abdominal and Core Muscle Conditioning, earlier).

• Lie on your back, feet in the air. A partner leans heavily on your feet. Bend your knees to do leg presses. When the partner and you are secure in healthful positioning, press strongly enough to fling the partner off the surface of the feet (a few inches to start), then catch him or her again on the feet, bending knees before straightening knees to press him or her away again into the air.

Stretching for Wilderness Preparedness

Heavy packs and difficult terrain make poor body positioning tempting. Sagging usually occurs in directions already favored by tightness. Strain and injury often result, confused for overtraining. Fitness classes and gyms are filled with people stretching, often in unhealthy ways that emphasize the injurious positioning that caused their tightness, pain, and injuries in the first place. Flexibility training needs reframing to retrain muscle length so that you no longer stand, sit, and move with strained unhealthful positioning, rather than holding arbitrary poses for set lengths of time. The main areas to stretch for functional wilderness health and ergonomics are anterior shoulder and chest, hamstring, hips, and feet. Stretches should be functional, which means how you move in real life. Following are a few main functional retraining stretches.

Anterior Shoulder and Chest

• Stand upright near a wall with arms relaxed at your sides. Notice if your thumbs point toward each other. This internal arm rotation usually indicates pectoral shortening. Note that trying to hold arms with thumbs facing forward instead of inward may feel tight or unnatural, as tightness prevents it. Next, stand back against a wall, touching heels, backside, upper back, and the back of the head. Notice if this aligned standing is uncomfortable or if you increase lower spine lordosis instead of having muscle length to stand upright. To restore healthy resting length to the anterior chest, face the wall and pull one bent elbow out to the side behind you. Turn your body away from the wall and use the wall to gently brace the elbow back. Feel the stretch in the anterior chest muscles. Do not hunch or tighten the shoulder. Hold a few seconds on each side. Drop arms and observe thumb positioning, which this stretch corrects by lengthening the previously tight anterior chest. Restored functional anterior muscle length should now allow comfortable straight standing against the wall, with heels, hips, back, and the back of the head touching (see Fitness as a Lifestyle, earlier). Do this stretch in the morning, before exercise, and throughout the day to restore healthy shoulder and head positioning (Figure 98-2).

• Next, stretch the top of the shoulder (trapezius), by placing one hand behind the opposite hip, as if in an opposite pants pocket. Remain with your back against the wall. Tilt your head and slide your free arm down toward the knee, keeping the back of your head touching the wall. Do both sides for a few seconds each. Keep breathing. Do not lean forward. Try the preceding wall-stand posture check again. It should become even more comfortable and possible.

• A stretch that is both diagnostic and therapeutic for tightness is to lie flat on your back without a pillow under either the head or knees. Do not lift your chin or arch your back. Practice relaxed straight posture. Can you put your arms straight out to the side on the floor without arching your back? Can you bend your elbows keeping hands against the floor? Can you relax upper arms against your ears, still touching the floor without arching your back? Many people are so round shouldered that this is uncomfortable or impossible. Use the two preceding stretches.

• Lie supine with a small roll or pillow between your shoulders. Retract shoulders to the floor over this roll without arching the low back.

• Lie face down, hands at sides and off the floor. Slowly lift your upper body a few inches, then lower. Feel the lift from your upper chest, not by lifting your chin. Notice if you bend from the neck. Instead, keep neck neutral and feel the range of motion from your chest. This upper back extension is an effective postural strengthener that combines range of motion. As you progress, move hands to the side, then overhead.

FIGURE 98-2 Restore muscle length to anterior chest to prevent tightness that promotes neck and upper back pain. Maintain vertical pelvis (center). Avoid hyperlordosis by flexed hip (left), forward head (center), and hyperlordosis by thoracic lean (right).

Hip and Thigh

• The lunge described in the strengthening section is an important functional stretch for the anterior hip and thigh, Achilles tendon, and foot. Tuck pelvis to vertical and spine to neutral to gain the crucial hip flexor stretch. When used for daily bending and reaching, you gain hundreds of built-in stretches daily.

• For deep lateral rotators, lie supine with knees bent, both feet on the floor. Cross one ankle over the opposite knee. Move the foot on the floor away from the midline until deep stretch is felt. Gently press the crossed knee away. Hold briefly, then drop both legs to each side gently. Repeat with other ankle crossed. For this stretch in a chair, sit up, one ankle crossed over the other knee. Press the crossed knee down. Sit upright and lift the head up, chin in.

• An effective low back and hip strengthener that includes a functional stretch is good bending. For all daily bending where you use a half-squat, keep both heels down and upper body upright. You will get hundreds of built-in functional stretches daily.

• To stretch the quadriceps while standing, hold one foot behind you. Tuck the pelvis to vertical and spine to neutral. Arching the back will lose the stretch.

• To stretch the quadriceps lying down, curl on one side, both knees bent in front. Extend the top leg behind you, foot in hand. Keep the bottom knee bent in front.

Hamstrings

Lack of hamstring flexibility reduces capacity to sit on the floor with feet outstretched without rounding the back, which in turn puts pressure on the lumbar intervertebral discs. The result is that many people sit (and stretch) rounded because tightness makes slouching more comfortable than a healthy position. Stretching the hamstrings can restore resting length sufficient for healthy sitting ergonomics.

• Bending forward from a stand overloads low back structures.^146,¹⁶⁹ Such overload does not become healthy by calling it a stretch. To stretch hamstrings without this bending, lie on the floor and lift one leg, pointing the foot to the sky. Keep the other leg straight and flat on the floor. Notice if your anterior hip is so tight that the leg on the floor lifts also. Include anterior hip stretches by lunges, described earlier, until remedied. Keep shoulders and neck relaxed on the floor. Do not round the back and call it a leg stretch.

• For a functional standing stretch, face a wall not more than fingertip length away. Face both feet straight, not turned. Lift one leg to about hip height and press the heel toward the wall. Lift the chest and stand straight. Standing trains functional lengthening for high steps, jumps, kicks, climbing, and other activities.

• Another hamstring stretch is downward dog, described next.

Achilles Tendon and Foot

• A common Achilles tendon stretch is to lunge toward a wall. It is ineffective when done with the hip flexed and protruding posteriorly instead of tucked to vertical. Bring the hip forward, as if trying to touch it to the wall. Keep the back foot straight, not turned out, or the stretch is lost and the medial knee bears the pressure.

• A more effective Achilles tendon stretch than leaning forward to the wall is standing with one heel pressing toward the wall at about shin height. Stand no more than fingertip distance from the wall and stand upright (see Hamstrings, earlier). Keep the hip tucked and back foot straight, not turned outward.

• Downward dog is an effective multijoint stretch with bodyweight supported on hands, protecting the back. Put hands and feet on the floor, hands far forward of the feet as if starting a push-up, weight mostly on hands. Keep feet where they are, lift hips up in the air, pushing hips backward until heels relax to the floor. Arch the back, rather than letting it round or hunch. Relax head downward. Keep feet straight, not turned, weight on rims, not arches. Push fingers forward with straight, not locked, elbows. You have probably seen dogs and cats stretch this way.

• During daily walking and movement, do not let bodyweight fall inward to the arches; keep weight on the sole of the foot. Point toes straight ahead. This prevents uneven and unhealthy stretch forces that gradually deform feet, ankles, and knees. Make sure straight leg posture continues through the knee and hip, to prevent straightening the foot from overstraining another part up the kinetic chain.

Flexibility-Enhancing Techniques

Several methods augment stretching gains. Stretch regularly. Be warmed before stretching.^57,¹⁷⁴ Warming up means raising body temperature, because elasticity increases with temperature. Active warming is accomplished more quickly and effectively with a few push-ups and lunges than with light jogging. Do not be afraid of exercise without air conditioning. Within limits, warmer environments help. Passive warming in a hot-tub or shower, or locally applied heat, can help prepare for movement, although direct activity should also be part of warm-up.

• A quick technique to improve immediate flexibility is called push–pull, contract–relax, or proprioceptive neuromuscular facilitation (PNF).⁴⁹ While holding a given stretch at maximal comfortable stretch, push (contract) against resistance in the direction opposite the stretch for 4 or 5 seconds without moving or reducing the stretch, to fatigue the muscle. Then pull (relax) into the stretch. Use this technique slowly and safely for any desired stretch.

Remember that functional movement is training in the manner useful to real life. Many stretches are static and nonmoving. However, muscle lengths needed on the trail and during exercise are achieved while moving, such as when navigating large boulders, or performing a high brace in kayaking. Incorporate stretches as needed for movement, rather than solely practicing static stretches. A good example is using good bending ergonomics of the lunge and squat for daily reaching and bending (see Lower Body, earlier). With healthful positioning throughout the movement, good bending dynamically stretches the anterior hip, quadriceps, calf and Achilles tendon, and plantar surface of the foot.