An Interview with Dr. Drew Morcos on the Importance of Multiplanar Resistance Training

In sports performance and physical therapy circles, Dr. Drew Morcos is a man who needs no introduction.

If you don't yet know him, here is his quick bio:

Drew is the founder of southern California-based Motus Specialists Physical Therapy where he applies a functional movement approach to clinical rehabilitation for athletes of all abilities, including those in the NFL, NBA, NCAA, USA Indoor Volleyball, USA/AVP Beach Volleyball, and the World's Strongest Man competitions.

Prior to opening Motus, Drew was the director of rehabilitation at the University of Southern California Athletic Medicine Department, and he continues to serve as an adjunct instructor of clinical physical therapy for the division of BioKinesiology and physical therapy at the Herman Ostrow School of Dentistry at USC.

Drew earned his Bachelor of science in kinesiology, with an emphasis in athletic training from the University of Nevada, Las Vegas, received his doctorate degree in physical therapy from USC, followed by completion of a residency in Orthopedics and a fellowship in Sports Physical Therapy through Kaiser Permanente, Los Angeles.

I recently had a chance to sit down with Drew to discuss some of the specific needs of rotational athletes and how the VECTOR is helping him offer next-level, multiplanar resistance training to his clients.

(Some of the following questions and answers have been edited for brevity.)

Seth Forman: Many of your clients are NFL players; from a training standpoint, what do they need to excel on the field, and to stay on the field by avoiding injuries?

Drew Morcos: It's not just NFL players -- I would say it's all athletes, and especially the rotational athletes -- the ones who need the most care because there are so many different moving parts happening for them to compete. For them to be able to excel in their sport, they need the mobility in multiple joints at multiple angles all the time. It's not just an isolated movement of the rotator cuff, for example, and then that's it. They definitely need a combination of movements all the time, synergistically, so the whole kinetic chain is working together

Seth Forman: Is this what first attracted you to the VECTOR?

Drew  Morcos: Yes, from the early stages, I was highly impressed with the VECTOR, and it wasn't just an ability to quickly change resistance, it was the ability to be very functional and creative in what you're trying to do. So, with a rotational athlete, for example, we want to be able to contract over the hips, in the ankle and the knee, in the core. And with multiple uses of a VECTOR, and even using more than one at a time, you can really reproduce a lot of these movement patterns they go through in their sport or activity to mimic what muscles they need to be contracting and to isolate what you're trying to target for that session. So, the VECTOR really helps differentiate the game in terms of what we're trying to do for these athletes when they're trying to get back to sports from an injury, or even in a preventative matter. And I think that's super important to understand, not just for NFL players, but all types of athletes

Seth Forman: Are you saying you find benefit in being able to apply additional layers of resistance to specific areas or movement patterns, such as the posterior cuff, and have rotational resistance applied through the kinetic chain? 

Drew Morcos: Yes, because when an athlete is throwing a ball, it's never just a posterior chain; that's where the arm is being used. But if your core is not on, and if your lower leg stability is not on, you're going to throw it straight into the ground. So, they need to be able to contract all of those together at one time.

Seth Forman: Who else would you consider to be "rotational athletes?"

Drew Morcos: Rotational athletes would be anyone whose sport requires some type of rotation, primarily in the hip joint or in the shoulder joint. So, a quarterback who has to rotate over the front, lower leg, the hip, as they release the ball. Or a tennis player who's hitting a forehand or backhand has to rotate the pelvis over a fixed femur. A golfer –- it's very common to see a lot of lower back pain in golfers because they may not have enough rotation in that lead hip. So, that internal rotation in a closed chain fashion causes more excessive motion at the lumbar spine. A lot of sports we play require rotation. In soccer, kicking the ball, the pelvis has to rotate over the plant leg. So, really, when we're talking about rotational athletes, we're talking about almost everyone.
 
Seth Forman: To that point, do you use the VECTOR for multiplanar resistance training with your non-NFL clients?

Drew Morcos: Yes, and it allows you to be as creative as possible in your treatment approach. For example, you can have multiple VECTORS connected in multiple areas, at different angles, and it's good for anybody. Not just rotational athletes, but even as someone's aging, they might not want to lift weights as much. Getting all the muscle fibers involved, rather than just training in a single direction, is important to being able to function in a multiplanar direction or engage in a multiplanar activity. I think that's super important.

Seth Forman: What are the comments your pro athlete clients say about VECTOR? What is their first reaction to it?

Drew Morcos: For a lot of them, their first impression is, "Wow, this is really getting every muscle I want to fire to actually fire." In the past, you could use a band and do some simple arm or leg exercises, but now, with the VECTOR, you can get more specific to where, for example, they can be in a lunge position; they can be in their actual throwing position, and you can have VECTORS on their resistance hand and their throwing hand, as well as the trunk, the ankle, and the knee. So now when you're trying to tell them, "Okay, bring that ball, or bring your right arm forward, or do external rotation," now they're like, "Wow, I really feel all of these muscles working."
 
Seth Forman: How does the VECTOR help your business?

Drew Morcos: I really like the versatility and efficiency of it. I can quickly change the resistance level in one VECTOR but leave the other ones at a different level, and I don't need as many people to do the job. Now, you only need yourself and the client; that makes your treatment time much more efficient. Number two, the session itself can be much shorter. You don't have to separately work on the glutes, and then the shoulder and then the rotator cuff, and then the ankle, and then the core. Now, you're getting them all done at the same time, which allows you to be much more efficient with your treatment strategy and approach. 
 
Seth Forman: Speaking of efficient training sessions, do you also notice a cardiovascular effect?

Drew Morcos: One of the cool things about the VECTOR is, if you get clients in a really good position where they're fighting and they're utilizing the right muscle groups, they get pretty tired by the second set, third set, depending on how many reps you're doing. So, for a soccer player, what we're really trying to do is focus on that stance leg when they're kicking a ball. And after a while, when they're swinging their swinging leg forward and back that stance leg is really, really, really going because it's not just the quad, it's not just the glutes, it's everything kind of working all together, even the little muscles in the foot and the ankle are really activated. So yeah, they get pretty winded at the same time, which is an added benefit.
 
Seth Forman: And the constant Time Under Tension is happening in every plane. 

Drew Morcos: That's a really cool aspect, too. The Time Under Tension is really valuable in using the VECTOR because you can give the muscles and the muscle fibers "real world" activation rather than just straight repetitions. Because now you're doing isometric holds on one of them. You're doing more isotonic on the others, but then some are just always having to be on while you're moving. What's really cool is you have this contraction with movement allowing the muscle fibers to stay isometric and connected, but then also allowing them to move within the plane you want them to move in and it always stays under that same tension depending on how you're setting up the configuration.
 
Seth Forman: Yes, an amazing feat with all of that happening at the same time.

Drew Morcos: Yes. Not too many rehabilitation tools can do that.
 
Seth Forman: Do you ever use the VECTOR in combination with other equipment?

Drew Morcos: I use it with blood flow restriction. So, if it's a lower extremity, we'll add BFR to the hip and then kind of go through those same motions that we're trying to combine it with. But, realistically, the VECTORs kind of do the job on their own because there's so many different pieces you can connect to it. So, whether you want to hold a golf club or a baseball or a football, those actually can connect to the VECTOR system. So, it allows you to be much more sports specific. You don't really need too many other things. But I would say one of the best things to use it with is the BFR.
 
Seth Forman: What kind of responses have you noticed when doing BFR with the VECTOR?

Drew Morcos: We use the Johnny Owens recovery science BFR. So, it allows us to maintain the pressure that we need throughout the whole treatment cycle. By doing that, BFR by itself gives clients such a great workout and burn. VECTOR by itself gives them a great workout and burn. But now with the BFR, combined with the VECTOR, the session becomes even more specific. With the protocol of 30, 15, 15, 15 BFR, by the time they get to that second or third set with the VECTOR combined at a very light resistance, it's still a very difficult and very sport-specific task that pretty much shuts them down from moving forward, very far.

Seth Forman: When you first start using the VECTOR with someone, what is the most effective way to explain it to get understanding and "buy in?"

Drew Morcos: Clients first notice how we can change the resistance really quickly and how it can be used in multiple ways because there's so many different connection pieces to it. People realize now we don't necessarily need a full pulley system. Now we don't need resistance bands hanging around everywhere. They see, "If I connect it here, I can now do this exercise, but then I can also do this other exercise. And then hey, you know, if I'm already doing this exercise, why don't I add one more, and now add it for my arm while it's on my knee pulling into valgus, so I have to really use my external rotators on the hip. And then why don't I use it on my arm while the same one is on my knee?" So, people are very smart when they start playing around with the VECTOR and they realize that if I can place it on one joint, why can't I place it on another?
 
Seth Forman: Earlier you mentioned being able to use the VECTOR in creative ways. Can you tell us about some of those?

Drew Morcos: Obviously, the primary VECTOR usage is for strengthening, but we also started using it for mobility training. So, if someone is lacking ankle dorsiflexion, we can put the smaller sleeve on and have them pull in the AP direction and really get a lot of anterior glide for the talus, so we can really work on dorsiflexion. Likewise, we've been playing around with the hip to get lateral traction while they're doing some movements. So, we have started blending mobilization with movements, stuff physical therapists have been doing for so long. Now it's a little bit more in an upright position, a standing position, and you're still getting the same effects because you're mobilizing it while it's moving. So, it's been really cool to kind of play around with the VECTOR and be as creative as possible because it allows us to take our rehab to a different level than we've normally been accustomed to with just straight bands.
 
Seth Forman: Would you say there's an evolution of the mobilizations because you don't have to manually do it - you can add functional movements around it, and you can focus on the larger picture of the athlete because you're not only focused on the single joint mobilization?

Drew Morcos: Yes, because classic mobilization with movement is maybe with their ankle on a table, and they're moving while you're standing there. Now, the VECTOR is doing all of that work. And now you can be focusing on other aspects of the body to make sure the client is getting it. So, maybe they're doing dorsiflexion, but now you're adding a little bit more tibial internal rotation, or extra rotation or moving the pelvis a little bit more with them to add to that ankle dorsiflexion that you're trying to gain. So, your hands can now be free to do it any other way you want to.

Seth Forman: I know you what you mean; that stuff is pretty tiring.

Drew Morcos: Yes, especially with the bigger guys!

 
Seth Forman (M.Ed., CSCS, IIN-HC, JKD-AI) is the head of education and training for the Kayezen VECTOR and the founder of Advanced Athletic Development, a New York-based training consultancy for elite professional and amateur athletes. In addition to being a former NFL Combine preparation consultant, Seth holds a Master of Education degree in Applied Exercise Science; he is a Certified Strength & Conditioning Specialist; he is on the board of advisors for Springfield College Graduate Strength & Conditioning Program; and he has earned certificates as an apprentice Jeet Kune Do Instructor and as a Health Coach from the Institute for Integrative Nutrition.