SPOTLIGHT SERIES 02 – Tony Huang: Movement, Mobility, and Rehab

This week, we got to sit down with Tony Huang and talk about movement, mobility, and rehab! Tony (@tonyrehab) is a Doctor of Physical Therapy student who has transitioned from the world of academia to a world of sharing his life and passion for the things he enjoys. Following the completion of his BSc. in Kinesiology (Hons), he looked to share his knowledge to a greater extent. This inspired him to use social media as a platform to educate others on the principles of movement and training by blending his years of training and his passion for exercise science.

Tony has goals to help others recover from their injuries and to improve athletes’ performance through his university education and field experience. He continues to learn and is enthusiastic about learning new ways to not only improve an athlete’s physical well-being, but also mental well-being. More recently, he has drawn interest in neuroscience and the importance of psychosocial risk factors in pain and injury management during musculoskeletal disorders. 

Tell our followers a little bit about what got you to this point in your career along with why you wanted to go into physical therapy.

Tony: “As a child growing up, I lived a very active lifestyle and became fascinated with the human body through sports. From there, I discovered my passion for fitness at a very early age. I idolized the best athletes on the TV screen; Steve Nash, Ashton Eaton, Reggie Bush, Usain Bolt and Sidney Crosby to name a few. When I was 13, I would analyze by watching videos and reading up on how Steve Nash or Usain Bolt approached their training and then mimic them in the training room or mold my skill set after theirs. I watched them perfect their craft. I was relentless and was addicted to the idea of getting, bigger, faster, and stronger so I could out do my competition. I didn’t want to be good at just one sport; I wanted to be the best in every sport.

On the other side of the spectrum, my late grandfather was bed and wheelchair bound since I was 2 years old. Growing up, I never understood the underlying cause because I was uneducated and simply did not understand. It pained me not knowing how or why he was the way he was. Even more so, it was difficult growing up watching the obstacles my family had faced due to the situation. He had no movement in the lower limbs and very little motor control the upper extremities. I wanted to help so much. It wasn’t until later on in my studies that I was able to understand neuronal degeneration and spinal cord injuries that I was able to piece things together.

Upon entering high school, I was introduced to weight-lifting during competitive sports. I then realized that training in the gym was the key which would also help me improve at my other hobbies. From there, I would watch YouTube videos and educate myself on training and movement. Some of the OG’s would be Jeff Cavaliere (Athlean-X), Scooby1961 and Scott Herman. This ultimately lead me down the road towards more of a bodybuilding style early on in my training career. While training with track and field Olympian Justyn Warner one day, he introduced me to physical therapy as an occupation as he was getting treated. It was something that could transition me as an athlete into a role that would help athletes allow me to share my experiences. From that day on, it opened up my eyes to a passion for bridging training and rehabilitation together. It was the day I knew what I wanted to do.”

What do you feel are the most overlooked aspects of performance, movement, mobility, etc?

Tony: “I think the two overlooked aspects of training overall is deloading in your program and nutrition. Nutrition is an aspect I am learning more on which I won’t address in this. As athletes, we often go into training with the mindset of training as hard as we can, as much as we can, and for as long as we can. In doing so, we ignore the recovery aspect. By increasing your volume or load in your training, I agree that you will see some improvements of gains early on. However, eventually you will plateau and stagnate or worst, regress due to overtraining. You can lift and train heavy or hard but without adequate recovery, there is no time for the body to adapt to the changes. I do not mean just your muscles to recover but also the mental stress, central nervous system, and the joints or ligaments placed on the body. This is where a more rounded approach needs to be addressed with recovery, specifically in regards to what is known as “deloading”. There has been research which compared athletes who train continuously for 6 months vs. those whom take a 3 week break every 6 weeks and saw minimal differences.

(check this out: http://suppversity.blogspot.com/2012/10/detraining-and-training-periodization-6.html)

Interestingly enough, those who take a break sometimes even see a spike in performance and results upon returning from rest. There isn’t an ideal deload that fits everyone, but some parameters you can tweak are to reduce the load/intensity to 60% while maintaining the sets/reps or volume by decreasing the reps but maintain the sets and load. To summarize, it would just be counterproductive to increase the volume or intensity of training during a time period and neglect giving more attention to aspects of recovery. I see this all the time in athletes all across the board… and then they wonder why their performance gains are minimal or they become stagnant. It is one of the hardest things about coaching an athlete: convincing them that it is okay to take a break. It just makes sense to me. Simply put, if I were to add to my training, I should also take the additional steps to add more recovery regiments into my routine.”

As a coach, do you feel that it is sometimes difficult to take an already experienced athlete/weightlifter and convince them that they must drop the amount of weight being used and focus on a safer/more efficient movement?

Tony: “Absolutely. Regardless whether they are an athlete or not. Regress in order to progress or unload to reload. It is a philosophy and model that I have adopted more recently in a rehabilitation setting but it can also be applied in a training setting with athletes as well. From a rehabilitation point of view, if a patient comes in with knee tendinitis or pain while performing lunges or squatting, I would never say stop the movement, just modify.

I believe the dosage of stressors and our ability to withstand them are the main factor we need to be concerned with. For example, if they are squatting 135lbs with pain, but they are capable of squatting 110lbs pain free, why stop squatting then? We have uncovered their pain threshold, so all we have to do is just scale it back and build up the tolerance. It is a pain science desensitization method inspired through Greg Lehman that I use in order to avoid training and movement all together. It’s almost insulting for me to tell them to stop performing the movement because this can also cause detraining. This concept again overlaps with deloading and can be applied in training as well, convincing an athlete to scale down the volume or drop down the weight in order for them to progress. Otherwise they may do more harm than good.”

What are some common misconceptions among athletes/general population when it comes to mobility and movement?

Tony: “This is more of a personal experience, but I think it is also very common. I find that a lot of people, males in particular, find themselves confused about what occurs in yoga. Though classes are predominantly females, they are under the impression that yoga is specifically for females (not true) and as a result, lack the confidence to take a class. The other misconception is that they say “I have to be flexible” or “I don’t have the mobility to do yoga” which is also not true.

I took my first yoga class just about a year ago when a friend of mine convinced me to take a class with her but partly because I was interested in new ways of movement. She explained to me that she noticed increased performance inside the gym but in the sport of rowing. However, this class wasn’t just ordinary yoga. This was power hot yoga which is a more difficult form for beginners.

I was one of two males in a class of about ten, but I have never been one to be embarrassed about little stuff like this and it never bothered me because of the confidence I’ve always had. By the end of the class, I could feel how rejuvenated and connected to my body I was, I was hooked. Overt ime, I began taking classes regularly about at least once a week to keep my body in tune. Yoga not only taught me how to become more aware of my body, but more importantly it showed me restrictions in my body. By knowing these restrictions, it provided me with a stepping stone of areas of weakness (e.g. tight hamstrings, decreased pelvic control) I should work on for the benefit of other movement patterns. Mobility or being capable to use our body to move through its full ranges is often an overlooked element. When I started putting more emphasis on yoga, I realized that many of the recurring aches especially in my lower back and pelvis were attributed to the inability to effectively move it. It’s like self-diagnosing yourself.

My point is that men should definitely move past the stigma that they attribute to yoga. Moreover, everyone should give yoga a shot regardless if “you are not flexible” or “you don’t have the mobility”. It is a great way to move the body for mobility and it’s more than merely stretching and relaxing.”

If someone is struggling to hit adequate depth on their barbell back squat, where are the first few places you recommend to look/correct before progressing in weight?

Tony: “The first 2 places I look at are the ankles and hips. We see individuals squat down and the first thing you may notice is that their heels pop off the ground. This could be due to calf tightness or ankle mobility issues. Calf tightness can be easily addressed with stretching, manual soft tissue work, or foam rolling. In regards to ankle mobility, if there is a lack of dorsiflexion, your squat depth will also be decreased. During a squat, the ankle is performing dorsiflexion where the talus moves posterior while the tibia moves forward. Limited dorsiflexion can therefore be attributed to the talus bone being jammed into the tibia and fibula as it tries to glide posterior. Banded joint mobilizations can help with this restriction.

Limited hip flexion is usually another culprit if an individual is unable to achieve depth in their squat. A quick way to check your hip mobility is to lie on your back and bring one knee towards your chest. Ideally, you should be able to bring the quad or thigh close to or touching your chest without the opposite leg popping off the surface. If the other leg lying flat pops up, then it may indicate tightness and restriction on that side of the body. If you bring the knee towards your chest and feel a pinching sensation in the hip on the same side, this may indicate a joint restriction. This is known as a modified Thomas Test. Joint mobilizations can usually help with joint restriction issues by passively moving the joint into further ranges that an individual is unable to activate. Check out the ankle and hip banded mobilizations I have on my Instagram page!”

How much mobility work do you feel is necessary per week? And how long should a mobility or primer warm-up take prior to a training session? And why? 

Tony: “That is a difficult question to answer. I don’t think there is a general value I can provide per week with how much mobility an individual should do or how long a warm up should be. In my opinion, it depends on the athlete and their goals. Therefore, they should be prescribed based on the individual. Many athletes know that warming up is important, but I’m not sure they understand why it is important. There are a variety of reasons as to why an individual should warm up but here are my top two. First, it is for injury prevention. Increasing the body’s temperature is simply the strongest argument for decreasing the risk of injury although reaching an optimal ready temperature point is subjective and varies from individual to individual. Mainly, it will depend on the individual’s duration to reach this threshold based on their cardiovascular endurance and conditioning. For me, it is exercise to mild sweating or treadmill for 10min is usually my point of readiness. A rule of thumb could be working to aim for 60% of your max heart rate.

The second reason is that it improves performance. I think this blanket statement can extend to everyone; not just athletes. Increasing the body’s temperature has a relationship with increasing muscle metabolism due to improved creatine phosphate efficiency. Additionally, the increased temperature augments the function of the nervous system, specifically the sensitivity of nerve receptors and transmission speed of nervous impulses which are affected by temperature. All of these factors subsequently result in greater power production from the body. From my personal experience, it also improves psychological readiness and alertness. It simply primes your body and puts you “in the zone” so that you feel prepared to lift and compete.”

Follow Tony Huang on Instagram: @TonyRehab

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