Episode #25: Live Hot Seat Q&A Session | Clinical Coaching, Technique, Injury Rehab & More
This episode of the PRS Podcast was a free event offered to individuals who signed up to receive our free PRS Lifting Manual or Clinical Coach Starter Kit.
During this live Hot Seat event we answered pre-submitted questions and questions from the live audience.
Here are just some of the questions we discussed during this live event:
How long should we wait to increase the weight on the bar for a new lifter?
Do we need them to have perfect technique before increasing the bar weight?
What are some good cues for getting someone to keep tension in the bottom of a squat?
How do you go about addressing knee pain in a lifter female who's fairly strong, has good leg muscle mass and MRI shows patellar tilt but other, which she puts in quotes, but otherwise no issues on the MRI.
If I'm looking to buy equipment without limitations from my clinic, but I have financial limitations. What equipment should I buy first? I won't be able to purchase everything at once, but I would like to start with equipment that will be useful on its own until I can get everything.
Since there is so much variety in hip structure. Is it wise to do anything diagnostically to try to understand the lifters anatomy that might include watching them walk or stand? If not, what do we look for in our squat in order to determine if they need to adjust toe angle, stance, etc. based on hip anatomy?
What modalities do you guys use, if any, in this setting or what do you recommend?
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Rori IG: @rorimegan_prs
Alyssa IG: @alyssahope_prs
Dr. Rori Alter, PT, PRSCC, SSC: [00:00:46] Welcome, everyone. We have a couple of people here, and we got some questions in advance. I'm Dr. Rori Alter, head clinical coach here at Progressive Rehab & Strength, with my lovely co-host, Dr. Alyssa Haveson. She's just my right-hand person here at PRS. She is also a clinical educator here at Progressive Rehab & Strength. We have what's called the Clinical Barbell Coaching Institute. It's the new rebrand of what used to be called the Barbell Blackboard. We have a ton of educational opportunities at Progressive Rehab & Strength. We have our courses and free content, including what you downloaded or obtained from us. We have the Clinical Coach Starter Kit, the Lifting Manual, free programs, a ton of free ebooks, a Clinical Coach Mentorship program, and a business course. So at Progressive Rehab & Strength, we've got two sections. We have our online coaching and rehabilitation and in-person coaching and rehabilitation. Then we also have our Clinical Barbell Coaching Institute and what we're doing today. This is one of the free things we like to do with our Clinical Barbell Coaching Institute.
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:10] So, anyone who downloaded the PRS Lifting Manual or the Clinical Coach Starter Kit was invited to join us today for hot seats. So what we do with the hot seats is basically if you have questions that you want to pick our brains about as it pertains to the Lifting Manual or the Clinical Coach Starter Kit, but anything kind of veering off of that if necessary. So if you have questions about that stuff, feel free to ask us questions. So we're going to do this in two ways. So one, you can just post a question in the chat or use the question function, or what we want to do is we're doing hot seats. So what that means is you use little hand function. So if you're on a desktop, there's a little hand at the bottom bar, or on the cell phone, you just have to swipe, I think, swipe the phone to the left, to the right, and then the hand option should pop up or just swipe around. So if you put your hand up, what we'll do is we'll promote you to a panelist, and then that will mean that you can come on here with us.
Dr. Rori Alter, PT, PRSCC, SSC: [00:03:18] Hopefully, you can show us your lovely face. This is a great opportunity to meet and greet with you guys, get to know each other, and you could ask your question. And we spend about 5 minutes in deep dialog with you trying to answer your questions and help you gain more clarity around your questions. So we have three people who are here, so if you have questions, you can use either the Q&A or the chat to submit your question. The Q&A is better to submit your question if you don't want to come. But if you do want to come on. So Diallo, Janice, or Nitosha, if you guys have a question and want to join us for the hot seat, go ahead and raise that hand function so we can bring you on. But we did get questions submitted in advance. I looked through two of them and chose them for Alyssa, and she took two of them and chose them for me. So we're going to start with those Qs that we got in advance so that people have time to roll in and ask questions. So, Alyssa, why don't you ask me a question?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:04:22] This question was about our Lifting Manual. We were asked how long we should wait to increase the weight on the bar for a new lifter. And do we need them to have perfect technique before increasing the bar weight?
Dr. Rori Alter, PT, PRSCC, SSC: [00:04:43] This is a really, really good question, and I think that a lot of people get hung up on the fact that. Well, two things. From a coaching perspective, people think we have to add weight, or the lifter isn't going to be happy. And then also from a fear perspective, "well, I don't want my lifter to get hurt. And if they're not moving perfectly, they're going to be at a higher risk for injury". And this is kind of where programming and technique meet. When we're first working with a new lifter, I'm curious if this question relates to a novice or an intermediate or advanced lifter. We don't know because that person's not here, but I'm going to guess that that question is related to the novice lifter. So someone who hasn't ever barbell trained and they're learning the lifts for the first time. So as it pertains to a novice lifter, when we program for them or choose their starting loads, we're going to choose loads that are very light initially so that they can start practicing their technique enough because it's not going to be perfect. It's going to be kind of all over the place depending on so many factors: their age, athletic abilities, and how well they pick up movements. Do they have any injuries? Do they have any medical considerations? So we typically don't expect perfection in the first training session or even in the first couple of weeks to months of someone becoming a new lifter or being introduced to the barbell lifts on a novice program. A novice program intends to keep the load relatively light and add set increments to stay light for some time.
Dr. Rori Alter, PT, PRSCC, SSC: [00:06:40] While they're mastering the technique. And that's where the coaching comes in in terms of technical coaching. The better you are at communicating with the lifter, the better you are at understanding their learning style and communicating with them with the appropriate cues and the appropriate language and the most effective language for them, and understanding when to back off and when to push with technique. Then they will develop their technique quicker. Does that make sense? So, we don't expect perfection in the first training session, and we generally will not see perfection in the first year. Honestly, you'll still never see perfection, ever. No one is ever going to be perfect. We have technique, form breakdown, and raw technical errors and issues in the beginning in the novice stage. But then, when we transition into the intermediate and advanced stages, we have form creep. So someone might be good at lifting. They might be very methodical, their technique will be developed, they'll be good at lifting, and they'll be strong. But at the same time, their technique can change and waver over time. And that's where we must always keep an eye on our lifters and say, "this is starting to happen. Let's back off on the load so we can readjust our technique and kind of recalibrate our technique." Does that make sense?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:08:24] Yeah. And it sounded like this question was about a novice or somebody who was just starting to train, and we do run into this type of thing a lot. Sometimes we'll have people ask questions in Secret Society of Barbell Mastery like, "I'm just going to keep repeating this weight until I get it."
Dr. Rori Alter, PT, PRSCC, SSC: [00:08:42] oh, yeah!
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:08:43] And we usually say, "no, no, no, don't do that." As you said, we should be starting light enough. Especially with a newer lifter that's not going to have a big weight on the bar. Which isn't a big risk factor, and increasing it will help to develop their technique.
Dr. Rori Alter, PT, PRSCC, SSC: [00:08:59] Yeah. And often, to see technique improve as the weight gets heavier because it gives them a little bit of something more substantial to push against. Also, as the load gets heavier, it almost forces you to move better. So yeah, we don't hold back. Suppose we're choosing a light enough starting load and a load progression appropriate for that person's age, abilities, movement abilities, and medical and injury considerations. If we're choosing an appropriate progression, it's okay to progress, even if their technique is not perfect. It should improve over time, especially if you're coaching them appropriately. But if you're not jumping in and helping them learn, things can go awry. So, Alyssa, I got a question for you. What are some good cues for getting someone to keep tension in the bottom of a squat?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:10:13] That is a good question.
Dr. Rori Alter, PT, PRSCC, SSC: [00:10:13] I have some ideas, but...