Thursday, May 15, 2014

Pullover Complications (1990) - Joseph Horrigan

Tony Massimo

Vince Gironda

Click Pics to ENLARGE

Some Articles by Joseph Horrigan:

On Negative Training:

The 7-Minute Rotator Cuff Solution

Knee Bands, Squats and Extensions:

A New Look at Hip Pain:

Trap Training and Neck Injuries

The Need for Soft Tissue Treatment in Athletic Injuries:

Low Back Pain from Squats:

Some IronMan (Australian Edition) Horrigan Articles

Reverse Grip Bench Press:

Joseph Horrigan Archive at the Disc, Sports and Spine Center

Credited film work as an athletic performance consultant
(The Matrix, The Hunger Games, etc.): 

The dumbbell pullover has been popular with bodybuilders for decades, and as with so many weight training movements, those decades have brought numerous myths surrounding the exercise and how to perform it. In the case of the pullover, however, there are even questions about which areas the exercise develops. Not surprisingly, the pullover also demonstrates unique injury patterns.

The most unusual (but not uncommon) injury caused by pullovers is a tearing of the linea alba, or medium rectus. This is the line of connective tissue that holds the two vertical rows of the rectus abdominus muscle (your abs) together. Visually, the median rectus is the 'line' down the middle of your abdominals, between the muscles.

The injury is caused by overstretching that connective tissue. Consider how the movement is performed: You lie transversely across a bench, your arms extended above your head supporting a single dumbbell, and then you lower and raise the dumbbell behind your head.

The operable gym myth is that when you lower the dumbbell, you should drop your hips so that you can achieve a 'good stretch' of the rib cage and chest. And while you're doing this, you're supposed to take the deepest breath you possibly can in order to 'expand the rib cage.' This puts you in a position of spinal extension (lumbar and thoracic), with the shoulder in full flexion.

Let's look at what's actually happening to your abs. The abdominals are flexors of the spine, and they are also involved in the forced expiration when you breathe out; therefore, in this position of the pullover they, too, are being stretched. The complication arises when you go to take the next deep breath (forced inhalation).

The forced breath inhibits (relaxes) your abdominal muscles while they are stretched to near maximum length,which puts the stress and stretching force onto the centrally placed connective tissue (median rectus). Each repetition causes more stretching, and as the training pattern continues for years, the median rectus weakens and finally tears.

The tear is relatively small and falls into the category of hernia (there are many types of hernias). Most trainees who experience this notice a small bulge located 'right between the abs' and, consequently, they panic, fearing that they've developed some sort of tumor.

A hernia of the median rectus is soft, and if you press on it, it may subside momentarily. If you press on it repeatedly, however, it may become irritated and sore.
This injury is of little clinical significance; that is, it doesn't really hurt or cause physical impairment. There are not very many options available to resolve it. The most common advise is to do nothing at all. The only other solution is to undergo a surgical procedure to repair the tear. Either choice involves what may seem like a flaw to a bodybuilder seeking the highest level of physical perfection - a lump or a scar.
If you discover this kind of lump, do not attempt to diagnose yourself. See your physician and let him put your mind at rest with a correct diagnosis.

This problem is simple to prevent. You avoid overstretching and tearing of the median rectus by not placing your spine into hyperextension during the motion and during forced inhalation. The accompanying photographs show professional bodybuilder Charles Glass demonstrating the right and wrong ways to perform the pullover and prevent this injury.

Figure 1: The wrong way.
In this position the abdominal wall is vulnerable.
Figure 2: Note the stretching of the abs.

 Figure 1 shows the starting position, and Figure 2 demonstrates the 'full stretch' (spinal hyperextension) across the bench. These photos illustrate the wrong approach to the pullover. The safer, 'right' approach is shown in figures 3 (starting position) and 4 (bottom position).

Figure 3: Charles Glass demonstrates correct pullover form while lying lengthwise on the bench for better stability.

Figure 4: Note how hyperextension of the lower back is kept to a minimum.

  Note that Charles is lying lengthwise on the bench to prevent the hyperextension and overstretch. If you closely compare these two photos, you can see a mild degree of lumbar hyperextension from the forced inspiration in addition to the long lever provided by the dumbbell being held at arms' length. When you compare Figure 2 to Figure 4, however, the decreased stretch with the proper technique is blatantly obvious.

Figure 6: Incorrect starting position because of the stress on the median rectus when the dumbbell is lowered.

Figure 7: In the pullover the triceps muscle takes much of the workload.
Figure 8: The finish position. Note the lengthening of the triceps.

Patients often ask why this method of training is so common if it can cause injuries such as these. I addressed this very subject in the November 1989 issue of IronMan ("The Anatomy of an Injury"). Trainees approach the gym as novices to weight training. They hire a trainer, find a more 'experienced' training partner, read all the available books and magazines and/or simply observe others as they train. This is how they learn, and as they have a great desire to make progress in their new physical and social environment, trainees quickly adapt to the common methods of performing various exercises.

Usually, their trainer or mentor passes on the same techniques that were taught by his mentor, and so on and so forth for generations of iron enthusiasts. Many of today's training flaws and myths can be traced back for many decades.

It is generally thought that bodybuilders perform pullovers in order to achieve back development, chest development, serratus anterior development and also rib cage expansion. An analysis of the movement and the anatomy involved shows that not all of those assumptions are correct.

The motion of the shoulder joint during the pullover is flexion and extension. The muscles that are involved perform concentric shoulder extension (positives) and eccentric shoulder flexion (negatives). The primary shoulder extensors are the teres major (upper lat), posterior deltoid (rear delt), and the long head of the triceps (inner tricep).

Since the position of full shoulder flexion is so close to full abduction, the pectoralis major (pec) is somewhat active in initiating the motion, but that's all it does. The serratus anterior is the foundation of the shoulder, and it is involved in upward rotation and support of the scapula (shoulder blade), as when you do an overhead press. (Note the serratus development on any Olympic weightlifter.) Since the shoulder blades are not bearing the weight in this movement, the serratus is not really involved either.

The major emphasis, therefore, is placed on the upper lats and the long head of the triceps, which is active because it passes over the shoulder joint as well as the elbow joint.

Injuries and problems in a number of areas can impair your performance of the pullover. You may find that you've lost range of motion in your shoulder joint. This could be due to a lack of lengthening ability in your lats or the long head of your triceps if you've developed fibrous adhesions from a previous injury (not necessarily caused by pullovers), or if adaptive shortening has taken place because you haven't been doing any overhead actions.

Overhead movements such as shoulder flexion or abduction cause the adductors and extensors to become inhibited and to lengthen. If you avoid overhead motion for long periods of time - for example, if you sit at a desk all day and haven't worked out, or if you've been avoiding overhead movements in the gym because they're painful - it will lead to the adaptive shortening. When that happens and then you try to achieve a full range of motion while doing pullovers, you may well suffer an injury because you'll be forcing structures that are incapable of lengthening to do just that. Under these circumstances, before you attempt to perform pullovers you must first reestablish range of motion through stretching.

Rotator cuff problems caused by poor training techniques (my article in the May 1989 Ironman) can also restrict movement in the pullover. If your rotator cuff muscles have been compromised, you may not have enough shoulder stability to take you through the movement, and it will be painful. Again, stretching first is important to reduce the stress on the cuff. Forced flexion or hyperflexion (forcing the shoulder further in the bottom position of the pullover) will guarantee injury to a multitude of structures, including the joint capsule, various bursae and the expected muscles and tendons.

Pullover Problems Article:
Straight Arm Pulldowns Article:
Pullover: Dumbbell vs Machine Article:

My final point is about the old idea of using the pullover in conjunction with the 'breathing squat' to singularly increase the circumference and diameter of the thorax (rib cage). Another myth. The only way you can increase your overall chest measurement is by increasing your bodyweight - just like every other body measurement. The only conceivable change in chest measurements without an increase in bodyweight is the stretching of the abdominal muscles, causing less depression on the ribs and sternum. This would be short-lived, if it even occurs, however. It does not constitute an actual change in chest size.

If you do breathing squats before pullovers in order to increase the deep breathing effect, the full ventilation of your lungs during the pullovers may induce a feeling of fullness in your lungs and chest, but no bony change in the ribs takes place and the cartilage does not hypertrophy and, specifically, lengthen to increase your chest measurement. The sternum does not broaden to cause these changes either. And the articulations (joints) of the ribs with the vertebrae and the sternum have only a very finite ability to move.

No claims of increased chest measurements or changes in bodyweight due to pullovers have ever been properly documented or proven. As I said before, if someone trained hard and gained weight, there would be an increase in size, and when that same person lost the weight, there would be a decrease in the measurement. The chest measurement will not stay the same after the weight loss.

Your vital capacity, that is, your ability to intake an amount of air, can change to a degree with training. At the very least, if you train for forced inspiration, you should also train for forced expiration, perhaps during your abdominal training.

In conclusion, to keep or regain your shoulder flexibility, perform the pullover lengthwise on the bench, and train your abdominal muscles as well.

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