Getting upstream: shifting from reactive to proactive

MikeD Injury Prevention, Performance, Physical Therapy, Strength & Conditioning 1 Comment

I must confess, sometimes I experience a sense of social media-induced frustration. This frustration is often easily remedied by not looking at social media, but sometimes it comes up regardless. What confounds this sense of frustration is that I know what I’m frustrated about and often struggle to find the words to explain what I’m frustrated about. Today, I found words for it.

In the random way that random things tend to happen, I stumbled upon news of a book release: Bridging the Gap from Rehab to Performance, by Sue Falsone, just hit the shelves, so to speak. A couple of years ago, I was at Perform Better’s 3-day Functional Training Summit with Theresa and we decided to go to a lecture by Sue Falsone. On the surface of it, she was talking about understanding pain. That being a topic that is near and dear to me because of my own experiences with pain, I was intrigued. The lecture itself fit the concept of pain and pain management nicely into the larger continuum of professionals who contribute to the care and development of an athlete. It was pretty awesome to say the least and there have been elements of that talk that have continued to circulate in my ongoing thoughts on circus and performance and health ever since. So, of course, when I saw the book and the title, I jumped on it.

In the introduction by Mark Verstegen, he mentions the idea of “getting upstream” of the various factors that contribute to injuries by developing “a seamless continuum of proactive care” and steering away from the more dominant approach: “reactive rehab”.

And then it hit me: this is what has been frustrating me lately! I’ve said this before and I will no doubt say this again: This is the approach to athlete development that the circus world needs to adopt! Sure, Cirque du Soleil appears to have adopted this sort of model already, but outside of their enviable Performance Science department and in the world of recreational circus arts (and at various versions of professional beyond that), we still have a ways to go. (And, to be fair, we also have different obstacles to overcome). In the meantime, (many) parts of the world of recreational circus arts, there persists an approach to training and self-care that is a bit like a constant triage:

  • a muscle feels tight, so we smash it with a lacrosse ball;
  • we struggle with a skill, so we seek out specific exercises that we can do to try to make that one thing better;
  • something gets hurt, so we go to physical therapy where they can make that thing better…we get a series of exercises and they become a permanent part of our pre-circus routine.

To be fair, this kind of thinking exists in the larger fitness industry as well. But we can do better.

And please don’t misunderstand me: none of these things are wrong, per se. (Well, lately I’ve been thinking the ‘smash it with a lacrosse ball’ idea deserves some re-thinking…). It’s just that they’re all very reactive.

This idea of ‘getting upstream’ suggests adopting a proactive approach

I would like to begin by noting that a proactive approach for already-established, elite-level professionals is going to look different than it will for recreational circus arts students and coaches and the professionals who work in all of the places that are not Cirque du Soleil. The core elements, however, are very much the same.

Getting upstream basically means adopting a proactive approach to improving capacity (read: getting stronger) by strength training outside of your circus training.

As a strength and conditioning coach, I am, of course, going to talk about strength and conditioning. But that’s mainly because it’s a part of circus training that we don’t talk about nearly enough.

But before I do, I also want to stress that I am not in any way suggesting we shouldn’t be listening to our fantastic physical therapists when they talk about injury reduction strategies such as soft-tissue care or doing a proper warm-up. After all, they represent an integral part of the continuum! What I do want is for us all to begin thinking in terms that continuum—the performance continuum (I’m sorry I don’t remember where I got that term from, I really think it’s apt here).

The Performance Continuum

It’s easy to conceive of it when an injury happens:

We start by seeing an MD (medical doctor) to get a diagnosis. I know, it doesn’t always start here, sometimes we skip straight to step two:

Then we go to see a rehabilitation professional—namely, a physical therapist—because this is where they shine: decreasing pain, managing tissue healing and introducing basic strength training are all vital to getting back to where you want to be.

Speaking of where you want to be, I’m sure by now we all know that the first port of call in your rehab journey involves making sure you can manage Activities of Daily Living. I’m pretty sure that this is the step that most circus artist-athletes are least concerned about. This brings us to an intermediate stage that Sue Falsone calls rehab integration. This is the stage where you begin restoring some of the more general attributes you need for circus.

This is also where rehab ends for many folks. It is vital to this larger conversation that we appreciate that this does not constitute ready to return to circus training. There remains room for a lot of additional physical preparation in the form of strength and conditioning training. (I would be remiss if I didn’t note here that this also constitutes a form of mental preparation for returning to your apparatus or discipline of choice).

And then, finally, we have circus training. At last, you’re back to doing what you love!

Back to circus training! At last, you’re back to doing what you love!

But wait! It doesn’t end there!

In fact, this continuum involves moving back and forth between each part:

Assuming you want to improve your capabilities in your circus discipline(s), strength and conditioning will always be a part of the plan. The stronger and better conditioned you are, the more cool stuff you’ll be able to do. (And the better able you will be to stay in character during performances without slipping into the tired aerialist character!)

The nature of training hard as a circus artist-athlete means that periodic visits to your physio will be necessary. Be it for those times when you ‘tweak’ something and there’s pain or for those times when you want to do a proactive movement check-up.

Aside:
I’m mindful that I mention strength training quite often and it’s possible that people might confuse the “conditioning” work they do with the more functional strength and conditioning to which I am referring.

[Aside within the aside: for a variety of reasons, the fact that the circus community uses the inaccurate umbrella term “conditioning” to cover everything that might count as ‘physical preparation’ drives me a bit bonkers. I’m going to spend some time elaborating on what I mean by strength training in the hope of clarifying why strength training and conditioning are not the same thing and why I think it will serve us all better to use more accurate terms to describe the goals we are working to achieve.]

This is where the idea of strength and conditioning training for circus becomes a much more nuanced idea. When designing a training plan for circus artist-athletes, it’s important to take the following into consideration:

  • Maximal or absolute strength
    • This is simply the amount of force that your muscles can produce. Being able to produce more force is desirable.
  • Strength endurance
    • This is about repeated, higher force-production efforts. That’s a wordy way of saying that if each of the skills you do in your routine takes some effort, it’s better to have enough endurance to make it through your whole routine without getting (and looking) exhausted.
  • Do your joints behave like joints?
    • This has room to be both simple and complex. The simple version is that if any given joint isn’t functioning the way it’s supposed to, then other nearby joints will pick up the slack, so to speak. This often ends up meaning more stress on the whole system and that’s how stuff breaks down.
  • Mobility and end-range strength and control
    • Closely tied to joint function, not only do your joints need to work well for circus, but they generally need to be able to function in a greater-than-normal range of motion. And you need strength and control in those end ranges.
  • Recovery ability
    • Generally speaking, this can refer to how well you recover from one training session to the next but it also refers to how well (read: quickly) you recover from that particularly challenging sequence of moves before you can do it again.

As you can see, strength and conditioning is so much more than just circus abs and pull-ups.

Now, it’s all well and good for me to say to check-in with your physio on a regular (bi-annual, at least) basis, but the reality for many is that physical therapy is not necessarily easily and/or readily accessible. I know that the ridiculous health insurance situation here in the United States only serves to reinforce the idea that physical therapy is only for when you’re injured. And if your insurance makes going to a physio a costly affair, it might even be something you consider only when you’re really injured.

As an observation, I’ve noticed that some folks are far more likely to see a massage therapist on a regular basis to take care of those nagging pains. I suspect it is because they like how it feels (which is completely valid), because they may not have had the best experiences with physical therapy in the past or because they don’t know that a movement check-up with a good physio could end up teaching them how to minimize or eliminate the things that cause those nagging pains in the first place. It could be all of those things or a mix of factors. I point this out because there are times when pain needs to be assessed by a medical professional.

Either way, the point to the performance continuum is that there are professionals you can see at various points along the continuum whose unique skills contribute to the larger goal of helping you, the circus artist-athlete, to perform at your very best. The key lies in recognizing where your current needs fit on the continuum.

The point to this rant is to say that as we all strive to develop a more multidisciplinary approach to improving everyone’s physical performance, strength and conditioning plays an important role in not only performance enhancement, but injury reduction and mitigation. Without a balanced and functional strength and conditioning program, there is a gaping hole—a gap, if you will—in your overall training.

Solutions: Ideas for the coaches and studio owners

First, I’ll address the coaches and studio owners. The best I can offer right now is to describe how we’re developing our program here (“here” being Esh Circus Arts just outside of Boston) as an example. Your mileage may vary, of course.

Here, we provide people with the opportunity to have a personalized strength and conditioning plan developed for them, based on a thorough individual assessment and movement screen and, of course, their circus goals. Essentially, we meet people where they’re at and develop a plan for how to get them where they want to be.

Folks can train one-on-one or in small groups with us or they can take the plan we develop and train independently. It all depends on their individual needs.

This works for us here for two reasons:

One is that Theresa and I happen to be strength coaches with a background in circus arts. So that may mean existing circus coaches learn about strength and conditioning or existing strength coaches learn about circus.

The other reason is that Boss Lady Ellen is very forward thinking and places a high value on the services we can offer. That means that there are now kettlebells on hand along with a couple of other pieces of equipment that we use. And it means that people can come in and do their workouts during open studio times.

Solutions: Ideas for the individual circus artist/athletes

For the individual circus artist/athletes looking to round out their personal strength and conditioning plans, there are a few ways you can go.

It is my firm belief that everyone can benefit from having a (strength and conditioning) coach—even if just for a short span of time. Especially one who understands both the needs of your body—and understanding they will gain through an initial (and ongoing) assessment—and the demands of your activity.

For those looking to find a strength coach or personal trainer, I am inclined to suggest looking for someone familiar with Functional Range Conditioning (find someone near you) and/or a Certified Functional Strength Coach (find a CFSC here).

If you are comfortable training on your own (or simply prefer it), you can always reach out to me to see if my online training program is a good fit for you.

If you happen to be working your way through rehab for an injury and you’re open to working with a coach, ask your physio and your coach to talk to each other. I connect with people’s physios all the time  and the difference it makes in terms of getting people strong and healthy faster is amazing.

Going forward…

Because I know there may be some confusion, or at the very least a lack of clarity, over what goes into a balanced, functional strength and conditioning plan, I’ll write about that next time to give you a place to start if you’re developing a plan of your own.

In the meantime, thanks for reading. As you can tell, I’ve completely given up trying to make my posts short.  Given the important and complex nature of this particular topic, I can’t imagine how I would keep it short. Anyway, please feel free to reach out–I’d love to expand the dialogue.

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  1. Pingback: Rethinking Thoracic Spine Mobility | Get Circus Strong

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