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Hamstring Questions? We Got Answers

It does not take a professional eye to take notice of the frequency of hamstring injuries in sport. Evaluating the injury list for collegiate and professional teams, you will find that hamstring injuries are at the top of non-contact related sport injuries. Even more staggering is that roughly 1/3 of all hamstring injuries will recur, with the majority recurring within the first 2 weeks. Now these statistics mainly reflect sports which involve sprinting, however hamstring issues can create problems for athletes regardless of sport. It is important to understand that hamstring health becomes more critical as increasing loads and demands are placed on them. Given these statistics, one can logically bring into questions if traditional return to play guidelines and rehabilitation programs are truly ideal.

BRIEF ANATOMY
A quick look at the picture above and it becomes clear the hamstring is actually the collection of four muscles. The semimembranosus (SM), semitendinosus (ST), bicep femoris long head (BFLH), and bicep femoris short head (BFSH). Understand that three of the hamstrings are biarticular (SM, ST, and BFLH). This means they are 'two-jointed' and cross the knee and hip, thus influencing both knee and hip movements.  The two primary actions the hamstring produces are hip extension (except for BFSH) and knee flexion (all 4). This brief overview of the hamstrings has implications as to the how and the why behind hamstring treatment, rehab, and training.



INJURY MECHANICS
The act of 'pulling' a hamstring usually occurs at high speed running during the terminal swing phase of the gait cycle. In the picture above, this phase is seen in the athlete's right leg. As the hip is decelerating the forceful momentum as the leg swings forward, the hamstrings are loaded and lengthening as you are finishing the swing phase before foot strike. There are predisposing factors that ultimately cause the hamstring to be compromised such as: poor neuromuscular control or the lumbopelvic region, asymmetries in muscle length and/or hip range of motion, and sacroiliac joint dysfunction. All of these factors need to be and should be considered when devising a treatment and rehab protocol to ultimately reduce the risk of re-injury.

The GP Approach
Effective treatment for a hamstring strain, and for any injury, must address not only the site of pain but ALL possible predisposing factors. As stated above, there are essentially three 'reasons' as to why hamstring injuries occur. Sprinting is not the problem. Focusing on each predisposing factor through progressive treatment and training will best prepare the athlete for return to sport activities.

The utilization of manipulation, massage, soft tissue techniques, and nutritional considerations to support tissue healing become the foundation of early care and recovery from hamstring injury. Everything used to facilitate healing is based on examination and identification of the presence of any predisposing factor(s).

The transition from rehabilitation to return to sport then becomes dependent upon a process that addresses proper tissue healing and exercise progressions to improve structural balance, lumbopelvic control, strength, and coordination of movement required by sport specific demands in output and movement patterns.

 

The Truth About Functional Exercise

Functional exercise/Functional fitness is one of the more popular trends in the fitness industry today. It seems commerical gyms are offering classes and personal trainers are claiming to be functional exercise 'gurus' in greater numbers by the day. One does not have to spend much time on the worldwide internet to find thousands of articles devoted to functional fitness.

Regardless of the exercise, the majority of these functional exercise 'experts' attempt to combine a variety of movements into one exercise or challenge your balance/coordination. They make the claim these exercises improve your ability to perform activities of daily living (ADL) and/or improve athletic performance.

Fact: There is a dramatic difference between what is being advertised by 'experts' as functional exercise and the true principle behind functional exercise.

All exercise can be 'functional', if applied correctly to address the needs of the individual. This takes into account their goals, primary sport form, strengthens/weakness, and imbalances that need correction. If your exercise has no direct transfer into any of these areas, the exercise is not 'functional'. Functional exercise should never be determined by how it looks, but rather what it produces.

GP Athlete Spotlight: Christian Wilson

Christian Wilson (Monroeville, PA) currently is a forward for the Pittsburgh Selects AAA hockey team. Christian is a highly skilled forward with lots of potential to take his game to the next level. His work ethic is tremendous, making Christian a delight to train.

Christian's programming has focused on putting quality size to his frame while improving his lower body power, speed, and quickness. With improvements made thus far, he is already catching the eye of his coaches. Hard work and smart programming pay off.

Welcome to GP, Christian!

GP Athlete Spotlight: Matt Fisch

Matt Fisch (6'5", 190lbs) is a starting power forward for Franklin Regional HS and plays his AAU basketball for the FCA Tar Heels. He will have specialized attention given to adding quality size to his frame while improving overall strength/power in preparation for the upcoming season.

Matt has terrific abilities and difficult to contain when he is on his game. He has already demonstrated the motivation and determination it takes to succeed. We are excited to have him part of GP. Time to go to work!

Welcome to GP, Matt!

GP Athlete Spotlight: Paul Emanuele

Paul Emanuele (RB/DB, Franklin Regional HS) is currently in training with specific attention provided to strength/explosive power and speed in preparation for a number of combines this summer, with the most recent being this weekend at the University of Pittsburgh.

Like all athletes who see consistent improvements, Paul has been a hard worker since day one. Tremendous athletic ability and hard work are always a dangerous combo. Paul has the speed, quickness, and power to break open a game at any moment.

Welcome to GP, Paul!

GP Athlete Spotlight: Todd Summers

Todd Summers (Murrsyville, PA) will be a sophomore at Franklin Regional this fall. At 6'3" and 181 lbs, Todd is a power forward for the FRHS varsity basketball team and also plays AAU ball for the Pittsburgh Pressure and BSA.

GP is aiding Todd in his preparation for the upcoming basketball season. His program has focused on improving lower body strength/power development while adding size to his frame. Todd has a tremendous work ethic and with his vastly improved physical abilities, he is on the path for long-term success.

Welcome to GP, Todd!

3 Reasons Why You Should Skip Breakfast

Breakfast has been coined 'the most important meal of the day'. But is this really true? Sure there are plenty of experts that stand behind breakfast's ability to boost metabolism, improve weight control, etc. But there are some reasons to consider passing on breakfast:

#1 - Breakfast is not required to boost metabolism. Level of energy expenditure (i.e. exercise), amount and composition (fats, proteins, carbs) of calories consumed daily, and genetics are the factors that impact metabolism. Not breakfast. This also means eating small, frequent meals throughout the day is also not necessary to raise metabolism.

#2 - Passing on breakfast can help lower total carb consumption. Most Americans consume far too many carbs and far too little protein and fat. The more we learn, the more we realize that overconsumption of carbs/sugars are a major contributor to many chronic diseases and excessive body fat. Many traditional breakfast foods (cereal, pancakes, muffins) are high in carbs. Your body releases insulin in response to eating carbs which stops your body's ability to burn fat.

#3 - You can get the benefit even if you occasionally skip on breakfast. Intermittent fasting will improve insulin sensitivity and blood sugar regulation. Plus, growth hormone will be released in higher levels. This all means you preserve lean muscle tissue and burn more fat.

The idea here is that breakfast should be optional. Being mindful of what works best for someone is an essential part of any nutritional program. If you love how your breakfast gets your day started, then stick with it. But for those that wish to pass, there is no harm in forgoing breakfast.

Interested in losing weight and improving their body composition? GP takes a unique approach to your goals. We help you get in tune with your body and work to find what you respond to best.

Who's managing your nutrition program?

Magnesium for Better Health, Athletic Performance


Magnesium is the fourth most abundant mineral in the human body and is an essential part of over 300 biochemical reactions in the human body. It plays an essential role in energy production, proper muscle and nerve function, blood sugar control, and blood pressure regulation to name a few. However, literature suggests that 54-75% of the population is deficient in magnesium. And for those that exercise regularly, especially resistance training, your requirements may be higher than what is recommended. Also, daily requirements may be higher for those that are heavy sweaters or experience symptoms of low magnesium such as arrhythmias, muscle spasms, or unexplained fatigue and weakness during exercise.

Research has also demonstrated magnesium's ability to increase red blood cell production, thus increasing the availability of both zinc and magnesium to support energy production, muscle contractions, and waste removal during intense exercise. Zinc is also a part of red blood cell production and the release of anabolic and fat-burning hormones during exercise.

How does one ensure they are getting plenty of magnesium in their diet? First, incorporate whole foods rich in magnesium such as halibut, almonds, cashews, spinach, and potatoes to name a few. Second, supplementation with highly bioavailable forms of magnesium such as magnesium glycinate may be needed.

To get an idea of where your magnesium levels are at, it is recommended to have your red blood cell magnesium levels tested as this provides the most accurate reflection of the body's magnesium stores.

Source:
Molina-Lopez, J. Molina, J., et al. Association Between Erythrocyte Concentrations of Magnesium and Zinc in High-Performance Handball Players After Dietary Supplementation. Magnesium Research 2012.

Have You Mastered Your Movement?

This article was originally published for MPG New England. It has been republished here with permission.

 "The word ‘athlete/athleticism’ is used too loosely amidst the sporting community. It is one thing to participate in a sport and it is another thing entirely to be an athlete."

-James Smith
Athletic development is a long-term pursuit. The organization and implementation of sport training programs can pose many challenges.  Programs should never be a simple concept of various exercises for a given number of sets and reps combined with exhaustive conditioning sessions if individualization in the process of long-term athletic development is of any importance to the coach and athlete.  Athletic development is a process in the mastery of several components. One component of athletic development that is often overlooked (or ignored) by many coaches is proper mechanics as they relate to the acquisition of sport skill. Or in its simplest sense, the concept of movement efficiency. This is especially evident in youth sports, arguably when the instruction and learning of proper mechanics matters most to an athlete.

The training of fundamental athletic qualities should start early in life. These athletic qualities have been described as coordination, mobility, balance, rhythm, relaxation, timing, and kinesthetic sense (awareness of one’s body in space).  It is these qualities or biomotor abilities that separate a true athlete from someone who simply participates in a sport. James Smith wrote, “The word ‘athlete/athleticism’ is used too loosely amidst the sporting community. It is one thing to participate in a sport and it is another thing entirely to be an athlete.”

We all can appreciate this concept. Be it a youth soccer game or an international track and field event, we have seen the ‘superior athletes’. The highest-level athletes standout by their ability to make complex sport movements look effortless due to their high degree of mastery. They simply make things look easy because they have learned to move efficiently.

Whether it is the ability to sprint, jump or throw, several athletes participating within a high level of sport do not demonstrate efficient mechanics. Let’s consider sprinting. Yes, the ability to generate high levels of power and ground reaction forces will allow an athlete to move fast, but speed potential cannot be realized until efficiency of movement is mastered. This often requires the eye of a coach/specialist who understands biomechanics as it relates to sprinting and the ability to instruct what is necessary to the athlete.

The concept of teaching ideal or efficient movement should take priority before increased training loads or demands are implemented. This holds true for sprinting as well as any sport skill or weight room movement. The more a movement or sport skill is practiced at increasing velocities or against greater loads, the more concrete that exact movement pattern becomes programmed at the neuromuscular level.  Meaning that that athletes who perform a specified movement without regard for proper mechanical efficiency only get better at moving inefficiently. This becomes detrimental to their long-term potential as an athlete and elevates their risk of injury. It is the proper mechanical instruction of the sport skill(s) combined with proper management of training load variables that becomes vital in setting the stage for athletic development.

Don't Fall for the Speed Training Trap

 

Driven by Business
Speed, Agility, Quickness (SAQ) training has a unique ability to draw larger amounts of young athletes with promises of becoming a faster, more agile version of themselves. These facilities or individual coaches commonly use methods such as high speed treadmills and ladder drills. The SAQ system is terrific for business because they appear to provide athletes with what they need. However, these systems often fail to produce sustainable, long-term adaptations to improve speed.

When you consider what true speed development is all about, you begin to see why these methods do not work. And even why they may carry a high injury risk with them. Sure these methods will work for some athletes, but they are typically athletes that are already slow. Does this justify using less efficient means? Let's take a look.

# 1 -  High Speed Treadmills
The mechanics needed for ground based speed are entirely different from the mechanics utilized on a treadmill. On a treadmill, the surface moves underneath you whereas on land, you must move over the surface. Training on a treadmill does nothing to develop an athlete's acceleration or drive phase, arguably the most important element of speed in sports. High speed treadmill training becomes about who can pick up their feet and put them down the fastest instead of how much force is being applied to the ground. Furthermore, at high speeds it becomes easy for form to breakdown and ingrain poor mechanics.

#2 - Ladder Drills for Foot Quickness
Ladder drills simply make you good at ladder drills. There is no correlation to actual speed development and developing one's ability to have 'quick feet'. Any benefit to speed can be negated by teaching athletes to chop or shorten their strides. These drills are best suited for a dynamic warmup, but if you think you are going to develop Robert Griffin III agility you are only fooling yourself. Agility is developed from improving relative strength and the practice of sport skills.

How True Speed is Developed
The science behind the world's fastest man, Usian Bolt, gives insight into what true speed development is all about. More important than how fast an athlete moves their legs is the power in their stride. An average runner's stride applies about 250kg (550 lbs) of force to the ground in roughly 0.12 seconds of contact. Bolt's stride applies over 1000 lbs of force to the ground in roughly 0.08 seconds of contact. That's a significant difference. High speed treadmills and ladder drills will not develop high level speed because they ultimately fail to train the physical abilities that enable an athlete to realize their true speed potential.

Speed and acceleration should be train through proper technique instruction and developing power-speed qualities such as limit/maximal strength, explosive strength, ground reactive forces, and rate of force production. These abilities train athletes to develop high amounts of force in a brief amount of time, developing the power that enables them to accelerate quickly and achieve top end speed faster.

The process of speed development must also take into consideration the concepts of Long-Term Athlete Development (LTAD).  Young athletes, both male and female, have unique time periods during which their speed development is very sensitive. These "windows of optimal trainability" must be capitalized on or else the athlete's true speed potential will never be realized. For the vast majority of youth athletes, they miss these windows of opportunity because of over-competition and under-training that is often seen during the ages of 8-13.

Final Thoughts
As with any physical quality, the critical periods for speed development will vary between each child due to his or her genetic makeup. Each critical period respects the stages of human growth and maturation as scientific evidence demonstrates that children vary considerably in their rate of response to different training stimuli. Some children may show potential for speed at age 10, while others may not display the same potential until years later. Consequently, a long-term approach to speed development is needed to ensure that athletes who respond slowly to training stimuli are not ‘shortchanged’ in their development.

This is why a knowledgable coach who understands LTAD models and is skilled in recognizing "windows of optimal trainability" for speed, strength, stamina, suppleness (flexibility), and skill development should be sought out. If the the trainer or coach who is responsible for training your child does not understand LTAD models, I would think critically about the services you are paying for.

Not All Trainers Are Created Equal

The best performance coaches and trainers will always perform thorough and complete assessments before working with a new client. Assessments establish the foundation for success.

On the training side, this means your trainer takes you through movement screening, baseline performance tests, and takes time to understand your injury history. On the nutrition side, this means taking time to evaluate and understand a client’s current dietary habits and other variables such as their work/school schedule, primary objectives, food sensitivities, level of social support, willingness to change, and many more.

With that in mind, is this how the majority of trainers and even nutritionists go about their job? No.

Most coaches/trainers seriously lack detail in their assessments. We hear this all the time at GP during our initial assessments, even from clients who have used a number of trainers in the past. The level of detail and depth of evaluation raises curiosity and they ask, "Why has no one spent the time to do this before?"

This is a huge mistake. Quality assessments are the key to gaining real insight into what a client needs and form the ability to make critical coaching decisions. This is the point at which training ceases to be a science and becomes an art.

If you’re not put through comprehensive training or nutrition assessments before your first session, know that you deserve better than that.

Relief Care vs Regular Chiropractic Care

Many people say that once you start going to a chiropractor you have to go for life. They are afraid they are going to get locked into something for life when the same thing could be said for routine medical physicals, dental check-ups, and even regular exercise if you want to experience the benefits and take a preventative approach to your health.

When it comes to chiropractic care, patients may choose to be seen for a brief treatment period to help relieve a specific problem. They may choose to receive regular care because it helps them feel better. The patient always has the choice.

The reality is, there is a level of personal responsibility one must accept if they want to live an active and healthy lifestyle. Regular exercise and proper nutrition are arguably the two most important life-style changes one can make for themselves. The majority of the clients we see at GP initially are looking for exercise and/or nutritional programming. But once they experience massage or chiropractic care and what it can do for their body, their health, or their recovery, many opt for routine care. This is exactly why several top level athletes make regular massage, soft tissue treatment, and chiropractic a part of their recovery and maintenance program.

At GP, we strive to provide our clients and patients with the tools and knowledge they deserve so they are able to live active and healthy life-styles.

GP Nutrition Tip!



GP Nutrition Tip:

It's summer time and if you are like us, we love watermelon. Recent research has given one more reason to get some watermelon in your diet. Researchers studied watermelon juice and it's ability to help relieve muscle soreness in athletes. Now why would they do this? Watermelon is rich in the amino acid L-citrulline. L-citrulline is known for its excellent ability to reduce muscle soreness. The study used natural watermelon juice, l-citrulline enriched watermelon juice and a placebo. Guess what? The natural watermelon juice performed best since the bioavailability was greatest, meaning the body is able to use it best. Not surprising at all.

It is our opinion that watermelon is best served among friends and family with plenty of good old fashion home cooking.

SourceWatermelon Juice: Potential Functional Drink for Sore Muscle Relief in Athletes. J Agric Food Chem. 2013 Jul 29.

Word to the Wise - Maintaining a Regular Strength Training Schedule



Properly structured and monitored in-season strength programs can be of tremendous benefit to athletes wanting to avoid decline in performance over the course of their season as well as minimize the occurrence of injuries. For example, studies have demonstrated that up to 85% of non-contact ACL injuries occur mid-late season. Maintaining adequate strength, body awareness, and performing exercises that help off-set the repetitive nature of sport can be the difference between a mid-season slump and a break-out year.

Here are some words from a former GP rugby athlete:

"The programming in season was designed to stay close to the gains I had made and still have energy to train for rugby, while utilizing different rep schemes and lifts to avoid undue muscle soreness. I was provided with a lot of information on nutrition, sleep, and mobility. Along with regular adjustments and soft-tissue treatment, I had a great season and felt better than I did while playing football in college."

-Carl N.

Keeping Nutrition and Supplementation Simple

"The amount, composition and timing of food intake can profoundly affect sports performance. Good nutritional practice will help athletes train hard, recover quickly, and adapt more effectively with less risk of illness and injury. The right diet will help athletes achieve an optimum body size and body composition to achieve greater success in their sport."

- IOC Sports Nutrition Consensus (2003)
For athletes and individuals looking to have improved performance and body composition, the number one priority should be eating better. The next step is to then supplement to address any deficiency of essential nutrients and/or target a specific physiological system. Just as important is ensuring that there is research demonstrating real benefit and safety of the supplement.

The FDA does not test the effectiveness, safety, or purity of supplements. There is no guarantee when it comes to accuracy of the ingredient list, accuracy of contents, and safety of contents. A 2001 study tested 634 products, 94 samples were positive for banned substances and 66 were questionable, roughly 25% of all samples. Meaning, chances are 1 in 4 supplements are questionable in nature for banned substances.

It is absolutely critical for athletes, especially collegiate athletes and those subject to drug testing to understand they may be unknowingly consuming a product that could result in them failing a drug test. Equally as important is each individual having a knowledge of what exactly they are putting into their body and potential interactions that may occur.

Below are a list of resources and strategies to help you become an informed consumer:

1. Check with www.wada-ama.org2. Supplement/Food/Drug Interactions and be checked at nccam.nih.gov/health
3. When purchasing supplements, choose a larger company or look for certificates of Third Party Analysis.
4. Check www.consumerlab.com for accuracy of label claims
5. Select products with few ingredients

Training Tip: Improve Your Conditioning



Charlie Francis was famous for the High/Low model developed for his track athletes. But that doesn't mean the concepts only apply to track athletes. This approach when effectively applied to athletes of any sport will produce tremendous results. The key principle of the system is to separate your training into high and low intensity days, with a minimum of 48 hours between High intensity days. This allows for the body to perform at its peak on a more consistent basis by providing the necessary recovery between high intensity training sessions.

How are High/Low days defined or structured?

High intensity days will include any activity that produces high levels of metabolic or nervous system stress. Examples would be explosive sprints/jumps/throws, explosive strength exercises, and high-intensity interval training to name a few. On those days, overall volume of exercise is kept to a moderate level. Low intensity days are designed to keep workout intensity at a moderate level while allowing your body a chance to recover fully. The low days are a great time to include technique work, sport specific drills, and aerobic capacity development drills such as tempo runs.

Interval/Sprint Training vs. Cardio: Which is Better for Fat Loss and Physique Development?

1. Sprint exercise resulted in 3 times more fat loss while expending 1/2 the calories compared to those who performed aerobic exercise. (Tremblay)

2. Low intensity aerobic exercise participants lost lean body mass. Over the long term, reduced lean body mass results in a lower resting metabolic rate and thus reduces the ability to burn fat. (Mouglos)

3. One study found that the addition of 4 hours of aerobic exercise per week had no effect on weight loss, while another found performing 45 mins of aerobic exercise 5 days per week for 12 weeks had no effect over dieting alone. (Van Date, Utter)

4. Twenty minutes of interval/sprint training, 3 times per week for 15 weeks led to greater fat loss compared to steady state aerobic exercise. (Trapp and Boutcher)

So is cardio pointless? Even thought it pales in comparison to other modes of exercise in the ability to burn fat, cardio is still effective. However, cardio should not be done alone as one's only form of exercise. Cardio is effective in promoting CNS recovery from intensive exercise and should be a small part of an exercise program that includes proper eating, muscle-building resistance training, and fat-burning intervals.

GP Differentiator

One question we receive frequently is, "What makes you different from other chiropractors?"

It is our philosophy that patients should not have to come in for care for the rest of their lives. Instead, we strive to identify the repetitive movements and postural abnormalities that cause pain and discomfort by performing thorough and detailed examinations.

This enables us to create a treatment plan which targets each patient's pain generators. We stress a collective and active approach on the part of each of our patients through education. By clearly educating each patient on why they are performing their prescribed exercises or stretches, the focus becomes about patient empowerment and providing them with a sense of what they can do for themselves. This typically results in great patient compliance and shorter treatment plans, with most patients seeing noticeable changes in 4-8 treatments. Some patients may even experience significant changes in 1-2 treatments.

At Gallagher Performance, we work for the individual and not on the individual. Our focus is on your goals and your outcomes.

GP Athlete Spotlight: Charan Singh

Charan Singh recently completed a 12-week strength development block under the direction of Head Performance Coach Ryan Gallagher. The program primarily emphasized max strength development while attention was given to explosive strength conversion and position specific conditioning for football. Recovery/regeneration strategies along with his nutrition were tailored to Charan and his needs from week to week. Below is a video which highlights Charan's results from appropriate programming, and his shear hard work and determination.

Charan Singh Training Video
Tribune Review Article 

Training Hard vs Training Smart


"People are incredibly innovative in their efforts to screw up training."

- Charlie Francis, Canadian Speed Coach

When it comes to sport training and many training systems, there are aspects that are poorly managed or misused in their application. One that is very common is the lack of understanding of physiology as it relates to bioenergetic training parameters and workload compatibility in sport.

Programs and coaches may frequently implement high lactate training loads into their program for a variety of reasons. Exhaustive shuttle runs, suicides, gassers, extended sets, and 'circuit' style workouts are all examples of lactic training. The problem is even though they may be performed with perceived 'maximal effort', in order to accomplish the prescribed work, individuals are training at a medium intensity. This level of intensity is too slow to develop speed. They teach muscles to behave slowly. Furthermore, the recovery requirements are high and thus cut into the ability to perform more intensive work that would directly improve speed and explosive strength.

There is not much justification for the frequent use of lactic training loads when the nature of most field/court based sports is alactic/aerobic with varying degrees of lactate influence. This is illustrated by the influence of bioenergetics on mitochondrial concentration in skeletal muscle. Mitochondria are responsible for energy production and oxidative potential. More mitochondria means greater energy supply and faster recovery. Mitochondrial concentration is elevated in skeletal muscle by anaerobic-alactic and aerobic training, while anaerobic-lactic training results in their destruction. Lactate threshold training must be appropriately prescribed and closely monitored.

This is just one example of why training loads and parameters must have compatibility to ensure the greatest transfer into sport performance improvement. The sports training world has fallen victim to a number of gimmicks in the name of profitability. Gimmicks such as high speed or anti-gravity treadmills, ladder drills, and exhaustive circuit-based training are examples of training that has very little to no carry over into athletic performance. Read more about this here.

For athletes and individuals who take their training and health seriously, your results are too important for someone to 'screw it up'.