The Louie Simmons Expand Capsular Space Case

The details of the clinical strategy that generated buy-in within the clinic at Westside Barbell.

Leveraging the Internal Strength Model for Informed Decision-Making

The inputs of the Internal Strength Model enables us as strength practitioners to open up feedback loops which provide real-time insights to the physical state of each element of Point B. These feedback loops supply "bottom-up" information from the athlete’s responses, which then helps inform "top-down" programming decisions. With more accurate and detailed feedback, uncertainty in programming decreases, enabling practitioners to make better-informed, and more specific decisions.

One key feedback loop is based on the athlete's neurological network for absolute strength. When an athlete has a highly developed, interconnected neurological network, it appears to be physiological fact that they can extract greater benefits from internal training due to their nervous system’s increased capacity to compress, generate, and efficiently direct force within their biology.

The Big Bang of the Neurological Training Paradigm

Instead of just taking our word for it, let’s examine a unique case we managed: an athlete who was also the most influential strength coach in powerlifting—Louie Simmons. This American powerlifter was responsible in bringing Soviet strength training methods to the West during a time when the Cold War was ongoing. With the unique, conjugate perspective of an athlete-coach, he organized and sequenced these methods in a way that stimulated the human nervous system to generate force as never before, sparking the genesis of what we at Absolute now call the neurological training paradigm. Once this system was established, his barbell club became the Big Bang for this approach, propelling the sport of powerlifting to heights only Lou could have envisioned. Since then, the neurological training paradigm has only continued to expand.¹

Source

The Standard—The Culture

Max effort training wasn’t just a standard at Westside Barbell—it was the culture.² If Westside were a religion, max effort would be one of its gods: adhere to it, and it will take you to the promised land with rewards along the way that you never dreamed possible. Through this relentless lifelong commitment to this method, Louie developed one of the most interconnected neurological networks of absolute strength.

For a true example of skin in the game in strength coaching, look no further than Louie and the crew he trained with in his heyday (see image above)—there was never a question of buy-in among them. It’s safe to say Louie took more training maxes than all the lifters pictured—and more than any human that has walked on this planet.

Positioned For Success: A Developed Neurological Network of Absolute Strength in the Clinic

As any FR practitioner can image, working with an athlete who has a training history like Lou positions us for success in the clinic. In utilizing training as feedback loop, there are enough bits of information to understand that decades of maximal effort training work had constructed a scaled up neurological network of absolute strength—enabling him to compress and generate force at levels that intensely stimulate the biology we are targeting³ in the clinic. It is in cases like this when you get to see the Biological Law of Specificity reward you, that you understand just how potent an mechanics of positive change that treatment work is—transforming the skeptics into true believers.

Innovating in the Clinic: Extending Maximal Effort to Therapeutic Settings

Over years of working with Lou, we came to recognize the value of maximal effort in the clinical setting, when appropriate.⁴ Louie’s openness to logical experimentation—and frankly there were zero constraints—allowed us to push boundaries, introducing maximal effort work into the clinic to create the same level of stimulating intensity in treatment that he used in training. This approach aligned seamlessly with the culture of his barbell club, where maximal effort was the standard. By replicating this intensity in the clinic, we established a seamless bridge between treatment and training for the athletes. Buy-in was never an issue; the standard was clear—to treat so that the work in the clinic would reach a level of intensity that would stimulate the biology we were targeting.

As Dr. Zatsiorsky says, "The human nervous system adapts to the load placed upon it."⁵ It doesn’t matter whether that load is in the clinic or the weight room—the nervous system doesn’t discriminate.

Pushing the Boundaries of Clinical Practice

Practitioners often ask how to secure buy-in within the clinical setting. Achieving this requires a willingness to push the boundaries of what has been traditionally done in the clinic. This approach not only actualizes both the neurological and biological potential of the individual being treated but also stimulates the growth of practitioners themselves—actualizing their skill set into reality. In this scenario, everyone benefits—except for the strength bureaucrats who make a living by prescribing rest only or use theraguns. These bureaucrats not only drive stagnation in sport but also reflects poorly on our profession, as they fails to actualize the true potential of our work as practitioners.

Only those who will risk going too far can possibly find out how far one can go.—T.S. Eliot

Maximal Effort: The Pathway to Buy-In

Strength practitioners working in high-performance clinics need to understand that elite athletes, specifically those used to training to the point where maximal effort is elicited, simply won’t respect a clinical approach that lacks to reach the same levels of intensity—it’s just the reality. To secure buy-in, practitioners must provide treatment inputs that stimulates new biological adaptations.⁶ Athletes with high kinesthetic intelligence—you know, the best athletes—will immediately recognize the value of this clinical work, securing their buy-in. Now, let’s get into the Louie case.

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The Louie Simmons Hip Joint Case

For years, I treated Lou every Friday. As a powerlifter, Louie was always focused on his next competition, and as a coach, he was constantly looking for any edge to benefit his barbell club.⁷