Strength solves a lot of problems.

A high level of maximal strength is arguably the most important physical quality in performance and athletics. Regardless of whether you are an elite athlete, average Joe, weekend warrior, or someone who just wants to look and feel great, training to increase your strength levels with make you better. Period.

Here are three simple reasons why strength is important:

#1 - Move Better, Reduce Injury Risk
Adding strength to a balanced body will aid in preventing injury and help you move with greater ease. Greater ease means greater efficiency. Training for strength improves neuromuscular coordination, thus improving efficiency of movement. As strength increases, it simply takes you less effort to perform the same amount of work. Researchers have identified strength training and its association with stronger connective tissue, enhanced function of the muscle-tendon unit, and reduced injury rate due to improved neuromuscular function and greater muscle mass.

#2 - Be Faster, More Powerful
As you gain strength, the faster and more powerful you become. The body gains strength by motor unit recruitment and neural drive. This means that when you lift something heavy, the body will recruit more motor units and more muscle to accomplish the task. By continually challenging yourself with increasingly heavier weight, the body becomes more efficient and coordinated in its ability to recruit more motor units, activate more muscle and move weight more explosively.

Maximal strength training builds fast-twitch muscle fibers. The muscle that matters. Everyone can benefit from building the fast-twitch, powerful muscles from heavy strength training. All athletes perform at higher levels with improved strength, including distance runners, cyclists, rowers, martial artists, track and field athletes, gymnasts, swimmers, soccer, rugby, baseball, and hockey players. But it's not just for athletes either. Everyday tasks such as getting out of a chair, opening a jar, or lifting groceries all are depended on fast-twitch muscle. Strength is an important element of life because it simply makes daily tasks easier to perform.

#3 - Lose Fat, Gain Muscle by Training for Strength
A missing component of many fat-loss or muscle-building programs is lifting heavy weight. Over the long term, building fast-twitch muscle fibers with strength training increases metabolism. Increased metabolism means you burn greater amounts of calories, even at rest.

Boston University researchers explain,

“Type II muscle fibers have a previously unappreciated role in regulating whole-body metabolism through their ability to accelerate the energy burning processes in remote tissues.”

And if your goal is to gain more muscle, maximal strength is an essential component of your training. As mentioned previously, you gain all the benefits of Type II fibers in addition to the fact that Type II fibers can grow up to two times the size of Type I fibers. To achieve maximal hypertrophy, you have to tap into your Type II fibers with heavy weights. Research has demonstrated that near maximal strength training (93% or higher of 1RM or rep max) activates satellite cells. Satellite cells are dormant muscle cells within Type II fibers and they regulate hypertrophy. Maximal-load training causes greater activation of satellite cells and gene signaling involved in the process of building muscle.

Curious about what a strength training program can do for you? Contact us for more information at This email address is being protected from spambots. You need JavaScript enabled to view it..

References:
Aagaard, P., Andersen, J., Effects of Resistance Training on Endurance Capacity and Muscle Fiber Composition in Young Top Level Cyclists. Scandinavian Journal of Medicine and Science in Sports. 2011. Published Ahead of Print.
Andersen, J., Aagaard, P., Effects of Strength Training on Muscle Fiber Types and Size: Consequences for Athletes Training for High-Intensity Sport. Scandinavian Journal of Medicine and Science in Sports. 2010. 20(Suppl 2), 32-38.
Comfort, P., Haigh, A., et al. Are Changes in Maximal Squat Strength During Preseason Training Reflected in Changes in Sprint Performance in Rugby League Players. Journal of Strength and Conditioning Research. 2012. Published Ahead of Print.

Please watch: https://www.youtube.com/watch?v=RRZL6Y6gtZI

In this video, we discuss exercises aimed at training proper hip dissociation - an often overlooked and undertrained function of the hips. Poor hip dissociation is commonly a reason for pain and poor performance.

Some key points discussed in this video:

• What hip dissociation means. Hip dissociation is the ability to independently move the hips without compensations from the rest of the body.
• Why poor hip dissociation and compensations are often a reason for low back pain, hip pain, and even pain within the knees and feet/ankles.
• How poor hip dissociation is related to increased risk of injury.
• Why the inability to move properly though the hips limits athletic potential and will negatively impact your performance.
• And most importantly - what to do to improve your ability to move your hips independently with simple exercises that you can perform at home, at the gym, or basically anywhere with just a few simple tools.

Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://www.gallagherperformance.com/blog/advanced-training-for-elite-athletes

https://www.gallagherperformance.com/blog/2-exercises-for-groin-and-knee-pain

https://www.gallagherperformance.com/blog/the-solution-to-long-term-improvement-of-back-pain

https://www.gallagherperformance.com/blog/pistol-squat-or-skater-squat-which-is-better

https://www.gallagherperformance.com/blog/how-dns-solves-pain-and-improves-performance

https://www.gallagherperformance.com/blog/a-powerful-innovative-approach-to-improving-how-the-body-functions

 

This training client sought out our services for three primary reasons:

1) Rehabilitate a chronic recurrent low back condition that has prevented him from training with any type of intensity or frequency for over two years AND get back to training while staying healthy in the process

2) Get stronger while packing on some quality size, and

3) Regain the feeling of athleticism from when he played college football.

We recently concluded 12 weeks and during that time he had three BOD POD evaluations. Debate on the accuracy of the BOD POD aside, impressive changes were made in only 8 weeks. These evaluations occurred on 11/21/17, 12/19/17, and 01/16/18.

Some of the BOD POD highlights include:

• Fat Weight lose of 3.786lbs
• Body Fat % decrease from 12.6 to 10.3
• Fate Free Weight gain of 6.745lbs
• Body Weight increase from 182.9 to 185.9

Images 1-3. BOD POD results from 1/16/18. This was the third, and most recent, analysis during an 8-week period.

Included below are photos of a few of his training weeks to give you a glimpse of how his training was structured. Along with the changes seen in his body composition, his strength continues to progress and he is training with weights and a frequency that he has not seen in over two years while maintaining a healthy feeling body.

There is no question that knee injuries are a common occurrence among athletes. The incident of devasting knee injury, such as ACL tears, has been on the rise for years. Once considered an adult injury, ACL tears are occurring more often in children as reported by orthopedic specialists, estimating that thousands of children and teens suffer an ACL injury each year. According to statistics presented at the American Academy of Pediatrics 2011 annual meeting, over the past decade youth ACL injuries have increased 400% and girls are at eight times the risk of an ACL tear as compared to boys. Clearly, there is a problem with knee injuries among youth athletes. But where is the solution?

Mechanism of Injury and Risk Factors
To identify a solution, we must first identify the problem. In this case, the problem is the mechanism(s) of injury most commonly associated with ACL injury. Keep in mind that about 2/3 of all ACL injuries are non-contacted related. Meaning, the athlete didn’t have someone tackle them or have a player roll-up on their leg, resulting in injury. Non-contact injury opens the door to the possibility that a large percentage of ACL injuries can be reduced or prevented. Here are the most common mechanisms of injury associated with ACL injury:

• Jumping/landing improperly
• Planting followed by cutting or pivoting
• Straight-knee landing
• Stopping or landing with the knee hyperextended (too straight)
• Sudden deceleration of movement

• Weak hamstring and gluteal (hip) muscles
• Poor neuromuscular control and balance
• Poor dynamic biomechanics (Jumping, landing, cutting, etc.)
• Fatigue
• Female Gender

1. Improve hamstring strength. The hamstring muscles have a critical role in maintaining healthy knees. Proper hamstring training and strengthening must take into consideration how the hamstrings function during the primary sporting movement(s). For example, land-based sports with an emphasis on jumping and sprinting ability will place a high demand on the hip extension action of the hamstring. The hamstrings must be trained accordingly to be able to meet and accommodate the forces generated during sport.
2. Improve hip and core strength. The musculature of the core and hips have a tremendous amount of control on the pelvis and femur, and thus the knee. Poor hip control puts the knee in compromising positions, increasing the risk of injury. When the core and hips are weak, they needs to be a focus of treatment/exercises. This will serve to improve the stability of the knee.
3. Improve Proprioception (Balance) and Neuromuscular Control. Sufficient proprioception and neuromuscular control is the difference between being able to ride a bike and falling on your butt every time you get on a bike. Understand that altered proprioception and neuromuscular control contribute to abnormal motion during dynamic sporting activities, such as cutting and jumping/landing. One study revealed, “Improved joint mechanics during landing were achieved regardless of the individual’s muscle strength, suggesting that strength may not always be a prerequisite for movement re-education.”  This should demonstrate the importance that mental focus and repetitive use of proper movement has on correcting mechanics.
4. Decrease fatigue. There are 2 types of fatigue, peripheral (muscles) and central (brain).  Peripheral refers to exercise induced processes leading to decreased force production (typical muscle fatigue).  Central fatigue relates to a gradual exercise-induced reduction in voluntary muscle activation. Essentially meaning the brain gets fatigued. It is plausible to say injury comes from both, however from an injury prevention stand point; peripheral fatigue is difficult to manage because your muscles will get fatigued.  But targeted training of central fatigue might be the way to go in preventing injury. How does one train central control. As one study put it, “Exposure to more complex or cognitively demanding movement tasks may facilitate improved perception and decision making within the random sports environment.” This is were mental focus and developing an athlete's awareness of their body during drills becomes important. Mental imagery may prove beneficial in developing central control by utilizing “mental reps” to help engrain proper movement and ideal mechanics.

1. Powers  CM, Souza RB. Differences in Hip Kinematics, Muscle Strength, and Muscle Activation Between Subjects With and Without Patellofemoral Pain. J Ortho Sports Physical Thearpy. 2009;39(1):12-19.
2. Powers CM. The Influence of Abnormal Hip Mechanics on Knee Injury: A Biomechanical Perspective. J Orthop Sports Phys Ther. 2010;40(2):42-51. http://www.jospt.org/issues/articleID.2396,type.2/article_detail.asp.
3. Heiderscheit B. Lower Extremity Injuries: Is It Just About Hip Strength? J Ortho Sports Phys Ther. 2010;40(2):39-41. http://www.jospt.org/issues/articleID.2404,type.2/article_detail.asp.
4. Mizner R, Kawaguchi J, Chmielewski T. Muscle Strength in the Lower Extremity Does Not Predict Postinstruction Improvements in the Landing Patterns of Female Athletes. J Orthop Sports Phys Ther. 2008;38(6):353-361. http://www.jospt.org/issues/articleID.1408,type.2/article_detail.asp.
5. McLean SG, et al. Impact of Fatigue on Gender-Based High-Risk Landing Strategies. Medicine & Science in Sports & Exercise. October 2006.
6. McLean SG. Fatigue-Induced ACL Injury Risk Stems from a Degradation in Central Control. Medicine & Science in Sports & Exercise. January 2009.
7. Hilgefort M, Winchester B. Preventing ACL Injuries in Female Athletes.

For those of you familiar with GP, you know we take the balance between training and recovery very seriously. It's a subject we feel we cannot educate our clients on enough. Recovery is too often a poorly understood or ignore aspect of training and the organization of sport (i.e. practice, competition). Many coaches and trainers push their athletes to the brink, attempting to build physical stamina and mental resilience. This is a part of sport and a necessary component to improving physical attributes such as strength, speed, and power. However, if you miss the boat on recovery, you could be sabotaging your efforts.

Why is recovery so important?
How much time do you spend training on a weekly basis, working towards physical or athletic goals? Probably not much, at least when compared to the amount of time spent between those sessions.

Training, regardless if you run, lift, swim, or skate, is a stimulus to the body. It's a stimulus for change and that stimulus will only generate results if you recover adequately between training sessions.

When recovery is poor, health and performance begin to suffer. This is the point at which many people describe themselves as "feeling flat" or “hitting a wall.” What they are communicating is low energy levels and an overall sensation of not feeling right. Fatigue has built-up because recovery has not been adequate. This state of fatigue can be referred to as “over-reaching" and in more serious cases it is known as "over-training."

Over-training can involve signs/symptoms such as:

• significant decreases in power or capacity of physical attributes such as strength, speed, or power
• significant and chronic joint and muscle pain
• significant changes in mood, such as depression
• significant sleep disruption
• major immune problems — frequent illness (i.e. bacterial/viral infections)
• hormonal suppression (i.e. low thyroid, low sex hormones, amenorrhea or irregular periods in women)

• low energy
• lack of motivation to train
• feeling "run-down"
• persistent sore and achey joints or muscles
• mild mood changes such as feeling more irritable, moody, or anxious

1. Central (CNS) - The central nervous system (CNS) serves the purpose of monitoring the body, similar to the function of a car engine regulator. If you "redline" the engine of your car too long, the engine shuts down. Your brain attempts to protect your body in the same fashion by reducing the ability of your body to "fire muscles" through nerve impulses.
2. Peripheral (muscular) - The other form of fatigue, peripheral, is related to energy system depletion and/or metabolic byproduct accumulation. Sticking with the car analogy, this is similar to running out of gas.

• Sympathetic activities – often referred to as “fight or flight”
• Parasympathetic activities – often referred to as “rest and digest”

• Low-intensity, aerobic-based exercise (cycling, walking, hiking)
• Massage
• Yoga
• Meditation
• Hot tub or sauna
• Relaxing hobbies such as reading or listening to music
• Meaningful relationships
• Drinking tea

• Sedentary individuals are at moderate risk for infection. Their immune system isn’t running as well as it could be.
• Individuals who are regularly active, using moderate intensity and variety in their training, demonstrate the most resistant immune systems.
• Individuals who are active, but consistently pushing the limits in workout frequency, duration, intensity, or loading without proper recovery put themselves at increased risk for becoming sick.

• Make a point of including 20-30 minutes of parasympathetic activity each day (i.e. meditation, massage, warm bath, good conversation, laughing, etc.)
• Consume nutrient dense foods at regular intervals, use herbs and spices, and drink adequate amounts of water and tea
• Consider using a carbohydrate, protein, BCAA, and/or creatine supplement as part of your peri-workout nutrition
• Incorporate variety into your training program
• Utilize low-intensity exercise on days between high-intensity training sessions to promote recovery (i.e. walking, cycling, swimming, flexibility work)
• Avoid the regular use of anti-inflammatory medications
• Make rest a priority and aim for 7-9 hours of sleep per night

An interesting dynamic has been developing in youth sports. The dynamic has been generated by the current nature of greater focus placed upon competition rather than athlete development. This is evident by the increasing number of games played at the youth level, commonly seen within travel or club organizations. Now, while this trend is not a favorable one and can actually be detrimental to youth athletic development, it has seemed to be the driving force for another trend.

The trend being the greater awareness and proactive nature some parents and young athletes are taking to become more educated on proper nutrition and training. The reality is, at the youth, club, and high school levels of sport, there is a competitive advantage to athletes who not only improve their athletic qualities (strength, speed, power, stamina, etc.), but also become healthier by making better food choices or finding ways to improve recovery.

When it comes to athletic development and preparation, there is no such thing as a “one size fits all” approach. There are far too many individual differences to account for. However, there are some basic principles or guidelines that most any aspiring athlete can implement and see results.

That said, here are five tips that can put you on track to experience better health and more consistent sport performance:

1. STRATEGIC FOOD SHOPPING
 When shopping for food, stay on the perimeter of the store. This is where you’ll find the best in whole food selection such as beef, chicken, fresh produce, and other food that should be the foundation of quality nutrition. The middle aisles mostly consist of processed foods. Sure they may taste awesome, but they do little to support the nutritional demands of young athletes.

2. READ FOOD LABELS
 The importance of reading food or ingredient lists cannot be stated enough. It's important that you know what you are consuming. Food labels can be misleading. For example, items can read “Low Fat” or “Non Fat” in an attempt to appear as a ‘healthier’ choice. However, if you read the label closely, you will find that these foods often have added sugar and/or artificial flavors. As we discussed in this article, fats, such as saturated fat are not the bad guy. Sure, you should avoid foods with trans fat, but the over-consumption of sugar and other processed foods will do more harm to your body than quality, healthy fat ever will.

Focus on selecting foods with a short ingredient list. Food manufactures appear to be taking notice, as they are producing a greater selection of foods with few and familiar ingredients to appeal to the consumer demand for healthier, natural foods.

3. EAT RIGHT, ALL DAY LONG
 When it comes to meals, you can find plenty of people who will advocate breakfast as the most important meal of the day. Others will say dinner. Some may even say lunch. Regardless of opinion, it’s more important to be consistent with your nutritional intake during the ENTIRE day. As a growing and developing athlete, simply focusing on nailing one meal won’t cut it.

It’s important to consume food at adequate levels throughout the day to replenish energy stores and promote an environment within your body that is essential for growth and repair.

4. IN-SEASON MAINTENANCE
 Strength and weight gains occur during the offseason. During the season, athletes need to focus on maintaining what they have built during their offseason.

Why?

With the abundance of practices and games during the season, athletes do not have the energy reserves and time to make strength or weight gains and recover in time for competition. Plus, many athletes can be banged up during the year, thus limiting what you can do with their training. This makes having a trainer or coach who understands how to work around minor injuries of tremendous value.

Establishing an in-season maintenance program can keep athletes healthier and performing at more consistent levels during the season. It also allows them to step into offseason training with greater ease and ahead of the game.

5. TRAIN SMARTER, NOT HARDER
 This is contrary to what almost every athlete hears at some point in their career. Athletes are told to train hard, work hard, etc. While hard work is necessary and valuable, there comes a point when being smart about your training is even more valuable.

Training should produce results. You should be getting something out of it rather than just being exhausted. It’s not difficult to make someone tired. Anyone can make you tired. Those trainers and coaches are a dime-a-dozen. What athletes need is someone that will produce results. There should be measurable gains in strength, speed, and power. If you are not seeing gains and simply becoming more and more tired, you need to start training smarter.

For additional reading on the difference between training smart vs. training hard, check out this article.

Let’s start off with illustrating a scenario that may sound familiar to many of you:

As an athlete or someone who simply enjoys being active, you put in plenty of hours working out, training, practicing and competing.  Whether it’s running, jumping, throwing, swimming, skating, shooting, or swinging, you slowly begin to notice some minor irritation in a joint or muscle. It could be a knee, a shoulder, back, quad muscle, groin, foot, wrist, or your rotator cuff. You sense things don’t feel right, but you convince yourself it’s nothing serious. After all, it may be a little painful during activity and goes away quickly when you are done. Plus, you got an important game, match, or race coming up and you can’t afford to take any down time.

You decide to put conventional wisdom into practice and take it easy, resting as much as possible. You ice the area. After all, it’s what we have been told to do for years. You may even take it a step further and do some stretches to bring some relief to the area. If the pain is bad enough, you may reach for medication to help take the edge off.

However, over the course of weeks or months, you begin to notice this pattern occurring more frequency as your pain persists. It’s got you puzzled. Now your pain is not just present during training or sport, but you notice it with everyday tasks such as walking or opening doors. You could shrug off the pain before, but now pain during simple tasks has your attention. You may now be getting concerned since it’s not only taking less to cause pain, but your pain may be getting more intense. You may even start to avoid certain activities.

What you are learning and beginning to realize is that despite the efforts to ease your pain, your symptoms persist and are getting worse. Despite rest, ice, and medication, your symptoms are not improving.

Change the Approach
Contrary to what has been preached for years, it is now known that interventions such as rest, ice, anti-inflammatory medications and electrical stimulation will not solve your problem. The application of these interventions was based upon the assumption that inflammation within connective tissue or joints was created by repetitive motions and sustained postures associated with labor, sport, or other forms of activity. However, this assumption has been proven to be wrong. New understanding of overuse injury is providing the foundation for treatment that truly addresses the root cause of your symptoms, not merely alleviating them.

New Understanding
We all know someone who has been told they have tendinitis, or inflammation of a tendon. Tendinitis is commonly referred to as an “overuse” injury.

Tendons are the structures that connect muscle to bone. They are critical in transmitting the force produced by muscles during movement. It was believed that tendons, when injured or over-stressed, became inflamed and painful. Inflammation is the body's natural response to injury. Inflammation begins the healing process. Applications such as rest, ice, and anti-inflammatory medication are prescribed to minimize the effects of inflammation.

Interesting thing is, research has demonstrated that inflammation is rarely present within tendons, thus providing a new understanding of how overuse injuries develop.

Back in 1979, a couple surgeons by the name of Robert P. Nirschl and Frank A. Pettrone examined sections of injured elbow tendons under a microscope. What they found was no presence of inflammation. None. What they did notice was how the tendons had degenerated. Their color and texture had changed. The tendons were grayish and swollen rather than white and soft.

No inflammation? No tendinitis. Tendinosis is the correct name for this condition. Tendinosis is the result of repeated or sustained muscular contraction associated with poor movement or posture, which decreases blood supply. The body begins to react in similar ways as if you had injured muscular tissue and scar tissue development is triggered. This would be a normal response if there were actual damage, but the body has been tricked. There is no injury, but scar tissue accumulates in healthy tissue due to compromised circulation. Accumulated scar tissue increases mechanical stress on tendons, limiting normal function of muscle contraction. Limited function means reduced strength, range of motion, and can lead to pain during activity.

Now that we understand the mechanism behind scar tissue production, the deeper question is, "What is the underlying reason for poor movement or poor posture that is responsible for the overload?" Because if the reason was simply just sustained postures or repetitive movements, wouldn’t we see more of the population coming down with overuse injuries?

Mobility vs Stability: Stabilizing the Confusion
Mobility seems to be the buzzword of the fitness industry and it’s certainly popular among certain camps within the physical medicine profession. There are plenty of products, assessments, and even entire workouts that are devoted to mobility. Some define mobility as the ability to achieve a certain posture or position, while others define it as the ability to achieve a certain range of motion specific to a movement (i.e. squat, push-up).

Advocates of mobility claim that mobility should be achieved first. We need mobility and lack of mobility is implicated as a predisposing factor for overuse injury. But is mobility the secret to preventing overuse injuries and unlocking athletic performance?

While mobility is important, if we consider the developmental model, stability should be the primary focus.

Enter the Developmental Model
Developmental kinesiology, or essentially understanding how we develop motor function through early childhood, emphasizes the existence of central movement patterns that are “hard-wired” from birth. For example, an infant does not need to be taught when and how to lift its head, roll over, reach, crawl, or walk. Each and every one of these movement patterns occurs automatically as the CNS matures. During this process of CNS maturation, the brain influences the development of stability before purposeful movement can occur.

The process begins with the coordination of spinal stabilization and breathing through what is known as the integrated spinal stabilizing system (ISSS). This constitutes the “deep core” and it is activated subconsciously before any purposeful movement. The musculature of the ISSS  contracts automatically under the control of the nervous system. The role of the ISSS is critical because it provides a fixed, stable base from which muscles can generate movement. The ISSS is essential to maintaining joints in a neutral position, thus maximizing muscular forces with minimal stress to structures such as ligaments, capsules, and cartilage.

Bottom line: Inadequate activation and stabilizing function of muscles may place greater stress within the body, compromising posture and movement. Mobility is DEPENDENT upon stability. You need stability first before you can achieve purposeful, efficient motion. A deficient stabilizing system is likely to lead to strain or overuse injury due to compensatory movements.

Managing Overuse Injury
Now that we have a better understanding of why scar tissue develops in the body and factors that contribute to poor movement and posture, its time to discuss what can be done in the treatment and prevention of overuse injuries.

#1 - Myofascial Release Techniques. Understanding that overuse injuries are most often degenerative scar tissue problems rather than inflammatory conditions, treatment strategies should change accordingly. Rest, ice, anti-inflammatory medication, and electrical stimulation are no longer ideal treatments. Treatment that involves myofascial release or soft-tissue manipulation becomes the focus in order to breakdown scar tissue and allow for normalized muscle/tendon function. Clinicians or therapists are able to locate scar tissue by touch. The hand is a powerful tool.  Characteristics they evaluate for may include abnormal texture, movement restriction, or increased tension. Treatment is often delivered by the hand or with the use of an instrument and is non-invasive in nature.

#2 - Improve the stabilization function of muscle. To ensure quality movement during functional activities or sport skill execution, it is critical that all stabilizers of the body are adequately activated. Insufficiency within certain muscles in the kinetic chain will result in muscular imbalances that can contribute to chronic pain or poor performance. Corrective stabilization strategies thus should always be the foundational concept of any training or rehabilitation program. Clinicians are beginning to recognize the importance of “training the brain” since the majority of motor dysfunctions may be more related to altered CNS function than local joint or muscle issues. The CNS is the “driver” and attention must be given to how it coordinates muscular patterns during movement in order to provide stability.

For example, if someone has difficulty performing a squat, rather than focusing on local “tight” or “weak” muscles or restricted movement in a specific joint, one may need to realize that the insufficiency is due to a dysfunctional ISSS pattern at the brain level.

Rather than focusing on mobilizing a tight glenohumeral capsule/joint and strengthening the rotator cuff musculature in the treatment of shoulder impingement in a baseball pitcher, should you focus on an inadequate ISSS and the "weak" link in the kinetic chain, such as poor dynamic scapular stability, proprioceptive deficits, or impaired lower extremity mobility.

The body functions as a single unit during complex movement, not in segments. The key is to maintain control, joint stability, and quality of movement. Every joint position depends on the coordination of stabilizing muscle function throughout the entire body. Through repetition, ideal stabilization patterns are achieved and then integrated in with sport-specific movements.

Conclusion

New information has provided a deeper understanding of how overuse injuries develop and led to improved treatment. These concepts are foundational to the patient-care and sports performance training clients receive at Gallagher Performance. Myofascial release techniques can help offset the build-up of scar tissue within tendons or muscles, promoting normal function of those tissues. Ultimately, the ability to coordinate and control precise movement will minimize stress on the body and the trigger for scar tissue development. Developmental kinesiology provides a method for both assessment and the training or rehabilitation of muscular stabilization as it relates to efficient movement. The combination of these approaches not only reduces the risk of injury and pain syndromes resulting from overuse, but impacts sport performance.

Sources:
Cholewicki J, Juluru K, McGill SM. Intra-abdominal pressure mechanism for stabilizing the lumbar spine. J. Biomech. 1999a;32(1):13-17.
Hagins M, Lamberg EM. Individuals with low back pain breathe differently than healthy individuals during a lifting task. J Orthop Sports Phys Ther. 2011;41:141-146.
Janda V. Muscles; central nervous regulation and back problems. In Korr IM (ed). Neurobiological mechanisms in manipulative therapy. Plunum Press, New York, 1978, pp 27-41.
Janda V. Muscles and motor control in cervicogenic disorders. In: Grant R (ed). Physical therapy of the cervical and thoracic spine. 1^st edition. Churchill Livingstone, Edinburgh. 1994, pp 195-215.
Kibler WB. The role of the scapula in athletic shoulder function. AM J Sports Med. 1998;26(2):325-336.
Kolar P, Sulc J, Kyncl M, Sanda J, et al. Postural function of the diaphragm in persons with and without chronic low back pain. J Orthop Sports Phys Ther. 2012;42(4):352-62.
Kolar P. Facilitation of Agonist-Antagonist Co-activation by Reflex Stimulation Methods. In: Craig Liebenson: Rehabiliation of the Spine – A Practioner’s Manual. Lippincott Williams & Wilkins, 2^nd edition 2006, 531-565.
McGill SM, Grenier S, Kavcic N, et al. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol. 2003;13(4):353-359.
Page P, Frank C, Lardner R: Assessment & Treatment of Muscle Imbalances. The Janda Approach. Human Kinetics. 2010.
Panjabi MM. The stabilizing function of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5(4):383-9.
Panjabi MM. The stabilizing function of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord. 1992;5(4):390-6.
Schlottz-Christensen B, Mooney V, Azad S, et al. The Role of Active Release Manual Therapy for Upper Extremity Overuse Syndromes: A Preliminary Report. J of Occup Rehab. 1999;9(3).
 
 

When my brother and I envisioned Gallagher Performance, one of our primary objectives was to provide a system that truly identified the structural and functional limitations of athletes, thus addressing these issues properly before they became implicated in serious injury or potential surgery. We knew the perspectives and coordinated efforts of a strength coach, massage therapist, nutritionist, and chiropractor with advanced training in manual and rehabilitative techniques could provide athletes with the avenues needed for improving sport performance and health. After all, achieving high-end sport performance is a multi-faceted and complex process.

Among the approaches and individualized considerations that are made for each of our athletes and clients, a fundamental concept within our programming is the emphasis on proper breathing patterns through focused exercises to optimize breathing and its impact on sport-specific movements.

Breathing Correctly
When we breathe, proper function of the diaphragm is the key and it should drive respiration. The question is, are you using it correctly when you breathe? To find out, simply place the web space in between your thumb and index finger firmly on each side of your abdomen in the area between your lowest ribs and your hip bones (or iliac crests). Now take a few normal breaths.  What is happening? If you're using your diaphragm correctly, you should feel a "bulge" outward into your hands. Why? As you breathe in, the diaphragm pulls the lungs down and creates compression within your abdominal cavity. It is this compression that creates the bulge outward into your hands. You can also think out it as breathing into your waistband or belt. You should feel your abdomen expand in all directions with proper breathing and this should occur normally, not only with deep breathing.

Another area of focus is how much your shoulders elevate during inhalation. Commonly, when someone wants to take a deep breathe, they have the tendency to lift their shoulders up to get more air in. But this is the exact opposite of what we want. Lifting the shoulders during breathing pulls the lungs up, which prevents the diaphragm from pulling the lungs down and will reduce the amount of air we can breathe in. It's important to note that shoulder elevation is normal with intense physical exercise; however, during normal breathing and even moderate exercise, there should be no shoulder elevation.

Don't sweat it if you didn't pass the test? Breathing has more to do with poor habits than anything else, which opens to door to retraining. The retraining of proper breathing patterns is something we spend a lot of time focusing on at GP with our clients and athletes.

Breathing and Its Influence on Athletic Performance
Previously, the role breathing has in the promotion of a healthy spine, prevention of neck and back pain, and enhancement of muscular coordination was underappreciated by many in the world of sport performance and physical medicine. Nowadays, breathing patterns have gradually gained more and more attention for the critical role they play in spinal stabilization, movement efficiency and athletic performance. Now it’s time for us to get in on sharing the knowledge. Below are three simple ways that breathing can affect your performance as an athlete.

1. Improve Joint Mechanics There is no question that movement and range of motion needed from specific joints throughout the body is always activity dependent. For example, hip internal rotation (IR) deficits have gained a lot of attention in regards to faulty lower extremity mechanics during movement, such as the squat. To address the deficit, the idea of performing internal rotation stretches has been popular to help improve the restriction. But it is interesting to observe that simply teaching an athlete proper breathing, abdominal and hip extension/external rotation activation through exercise can improve hip IR tremendously without the application of any static stretching. This raises the question of stretching and we addressed that in the article, Why Stretching Won't Solve Your Tight Muscles. Essentially, if range of motion was improved through breathing and stabilization techniques, the limitation was due to position of the spine, pelvis, and surrounding musculature, NOT because of a limitation in the hip. The same can be said of any joint in the body. Using specific breathing exercises can restore balance to the key joints of the body (i.e. spine, shoulders, and hips) by promoting normal expression of movement and range of motion.
2. Optimize Movement Patterns If an athlete attempts to execute a sport or skill-specific movement from a non-neutral position, they are already set-up to be inefficient and will limit their performance to some degree. The result is compensatory movement patterns and athletes may or may not be aware of how they are compensating for poor movement quality. If you consider rotational sports such as baseball, hockey, golf, and throwing sports (i.e. shot put, hammer throw), it’s easy to see that spinal rotation is a key component to the execution of movements specific to each sport. If an athlete cannot rotate adequately through their spine, the first compensation becomes lateral bend. This will limit power and efficiency and predispose the athlete to overuse syndromes. Using breathing exercises to help restore a neutral spine will potentially help restore rotation to the spine. As spinal rotation improves, this new range of motion is then re-integrated into sport-specific movements with emphasis on quality and control. The outcome of focused breathing exercises becomes improved joint mechanics, more efficient technique, more power, and less risk of overuse injury. This is just one of the reasons we want coaches to understand that our job is to make their life easier.
3. Decrease Injury Risk, Improve Recovery Injury prevention is a challenging task. There are several factors that play into specific athletic injuries, each carrying their own unique considerations and strategies to decreased risk. There are many factors that predispose athletes to injury and with targeted approaches, appropriate steps can be taken to reduce the risk of injury by focusing on improving joint/muscle function, reducing the impact of fatigue, and ensuring adequate recovery. We already discussed how breathing can improve joint and muscle function. Utilizing optimal breathing patterns can delay fatigue by assisting in maximum air/oxygen exchange, therefore delaying the point at which aerobic metabolism ceases and anaerobic processes kick in. This is especially important during high-intensity activity, when the demand for oxygen is critical to prevent accumulation of metabolic byproducts responsible for lowering pH levels and inducing fatigue. Ideal breathing will also accelerate the recovery process between intense bouts of exercise, therefore promoting recovery of the body’s energy systems. Following training and competition, the use of proper breathing patterns will help the body shift into more of a parasympathetic state. Returning to parasympathetic dominance is the essence of recovery and breathing is one tool that can be used to enhance recovery. More detail on the importance of recovery can be read in our article, Understanding The Role of Recovery in Health and Performance.

The concept of sport-specific training has continually gained popularity over the years. It’s a growing market and business-minded individuals are taking notice. Similar to trends in functional exercise, you have a growing number of trainers stating they offer the “latest in sports training”. Frankly, anybody online can say their method or approach is the best. In a competitive market, people enjoy using words to attract your business. There are plenty of gimmicks that exist, namely in the world of speed training. Often times, athletes acknowledge such methods did little or nothing to improve on-field performance. If these gimmicks worked, it's simply because the athlete was a novice or of low qualification. Novices have the unique ability to respond to almost any form of training. But does this mean what was done is most appropriate? Does it mean training was efficient or effective? Not necessarily. When it comes to the training of higher level athletes, previously used methods and/or exercises will eventually fail to produce continual improvements in sport performance. There is a point of diminishing returns and training must adapt accordingly.

For any athlete, sport-specific training must ensure maximal transfer of the training program to on-field results. If exercise selection or organization has little carry over to making athletes better, you are wasting valuable time and money. Transfer of training can be summed up with the SAID Principle (Specific-Adaptations to Imposed-Demands). The SAID Principle has been proven time and time again in both research and training. This principle implies that training is most effective when resistance exercises prescribed are similar to the target activity or primary sport form/movement. Furthermore, every training method will elicit a specific (and different) adaptation response in the body. There must be compatibility between training and sport. This becomes of increasing importance as an athlete reaches higher and higher levels of athletic competition.

As mentioned before, research has demonstrated how exercises that once worked to improve sport performance for an athlete at a lower qualification level, will eventually lose training effect as the athlete gains mastery. For instance, indicators of maximal strength (squat 1RM) often have a direct correlation in low-level athletes, but lose significant correlation with enhancing sport performance in higher-level athletes. Similarly, movement abilities such as sprinting and change-of-direction (agility) are each separate motor tasks, characterized by specific motor abilities. Improvements in linear sprint speed and change-of-direction ability have limited transfer to each other and the degree of transfer decreases as an athlete progresses.

Thus, in order to enhance the sporting ability of high-level athletes, there comes a time when we must get more detailed than simply chasing increased strength and 'quick feet'. It’s inevitable. There is no way to avoid it. The world’s greatest Sport Scientists understood this and proved the need to go beyond traditional training approaches to see continual improvements in performance as athletes reached higher levels of competition. This is where the concept of Special Strength Training (SST) becomes of importance in the training plan.

Introduction to Special Strength Training
Pioneered by Dr. Anatoli Bondarchuk, SST has been incorporated for decades by coaches in other countries, mostly in the Olympic sports. Dr. Bondarchuk is most noted for his involvement in the throwing sports, particularly the hammer, and his results speak for themselves. It was Bondarchuk’s identification and implementation of special exercises with the highest degree of dynamic correspondence to the sporting movement that became the focus of his athletes' training plan. His organization of training allowed athletes to set world records and win numerous international and Olympic medals despite the fact that they did not possess the greatest strength in movements such as the clean, squat, or bench press.

Exercise Classification System
Bondarchuk classifies exercises into 4 categories:

1. GENERAL PREPARATORY EXERCISES are exercises that do not imitate the competitive event and do not train the specific systems.
2. SPECIAL PREPARATORY EXERCISES are exercises that do not imitate the competitive event, but train the major muscle groups and same physiological energy systems as your sport. However, movement patterns are different.
3. SPECIAL DEVELOPMENTAL EXERCISES are exercise that replicate the competitive event in training but in its separate parts. These exercises are similar to the competitive event, not identical.
4. COMPETITIVE EXERCISES are exercises that are identical or almost identical to the competition event.

“General exercises have little relevance to the sporting action. Specialized preparatory exercises use the same muscles that are involved in a particular sporting action. Specialized developmental exercises include single joint actions that duplicate one portion of the sporting action. They also mirror the velocity and range of motion seen in the competitive movement. Competitive exercises are those that fully mimic the competitive movement in more difficult conditions and easier ones.”

When it comes to athleticism, there is a sad misconception among far too many individuals that athletes are "born not made". People that believe this will often say, “You can’t teach speed” or “That’s just a gifted athlete”. While genetics can play a role in athleticism, arguably the greatest impact on an athlete’s development (or lack thereof) is the training system that is implemented. This would include all elements from its organization to exercise selection and other variables.

While all sports have their own unique considerations, ice hockey demands high levels of athleticism. The transfer of training from off-ice preparation to on-ice performance presents a host of challenges. With the nature of today’s game, proper off-ice training can provide youth and elite level hockey players with the advantage they need to elevate their game.

Here are some tips: 
1. WARM-UP PROPERLY 
In preparation for exercise, the body should be moved through large ranges in all three planes of motion (sagittal, frontal and transverse). Movement prepares the brain and body for exercise by activating the nervous system, warming tissues such as muscles and tendons, and lubricates joints. Movements performed in all planes of motion on a consistent basis will improve stabilization patterns, mobility, coordination, balance, and movement efficiency. Making the time to properly warm-up with allow you to get more out of your training. Simply put, it makes training more productive and will reduce the risk of injury.

2. TRAIN MOVEMENTS, NOT MUSCLES 
The human body operates as an integrated system. Joints and muscles are all coordinated by the central nervous system to produce movement. Muscles never work in isolation, meaning that there is always a pattern of muscle recruitment that occurs with every movement we make. Depending on how we recruit muscles, movement will occur in efficient or inefficient ways. Athletes require mastery of movement. Unlike those who train to for basic fitness or simply to ‘look better’, athletic development and performance-based training programs aim to improve how an athlete moves. Goals focus on strength, stability, mobility, speed, and skill execution with a high degree of movement efficiency.  Sure many athletes look good, but this is often a by-product of their training, not the primary goal.

There can be a mistake in young athletes simply go to the gym and “working out”, either by themselves or with their friends. Especially when they have no plan. If most young athletes are honest, they don’t know what to do during the off-season. Even some trainers have no idea what they are doing with athletes and just “make-up” a training session as they go or select a random workout off the Internet. As the saying goes, “One program on a dry erase board for your group of clients/athletes isn’t training, it’s babysitting.” Higher quality strength and athletic development programs are becoming more available to young athletes; those athletes not involved in those programs will be left behind.

This concept was detailed in our article on Training for Elite Athletes.

3. GET IN TOUCH WITH THE GROUND
This point builds off the previous one. The majority of sport movements and skill execution are initiated by applying force to the ground with the feet/legs. As with land-based sports, the more force a hockey player applies to the ice, the greater acceleration and speed they generate. Strength and power development exercises should be selected based on their ability to enhance ground-force reaction. The same can be said for both speed and conditioning drills.

Utilizing squat and deadlift variations, Olympic lifts, medicine ball throws, jumps, plyometrics, sprints, and hockey-specific agility/change of direction drills would be the most beneficial in developing ground-force reaction. Unilateral movements such as single-leg squats and jumps, lateral bounds, split squats, and lunge variations will also help to develop the movement proficiency need for a powerful skating stride.

4. TRAIN THE CORE FOR FUNCTION, NOT LOOKS
The core is the body’s center of force transfer and movement control. The core is not simply your abs. It includes almost 30 muscles that attach to the spine, shoulders and hips, which function to stabilize the areas during movement. When the function of the core is compromised, inefficient movement results and risk of injury is increased. Hockey and its movement skills require high levels of core stabilization, endurance, strength and power transfer. The demands of athletics on the core will never be met by performing thousands of crunches. Your core training needs a more specific, specialized focus.

Stabilization exercises should focus on things such as maintaining proper lumbo-pelvic posture and the ability to resist or control movement in all planes of motion. Once proper stabilization is achieved, greater attention can be given to rotational power and force generation exercises for increased transfer of training into sport.

5. BE SMART ABOUT YOUR CONDITIONING
The sport of ice hockey places demands on both the anaerobic (alactic and lactic) and aerobic energy systems of the body. For the most part, hockey is an anaerobic game, characterized by intense bursts followed by periods of rest. The anaerobic system is challenged during these intense bursts while the aerobic system is utilized during the recovery period between shifts. This illustrates the need for both systems to be well developed for optimal performance.

Thus conditioning for hockey should focus on an interval-based approach to meet the energy system demand of the sport. Place a priority on developing the capacity and power of the anaerobic-alactic system along with the use of tempo runs/bike sessions to develop the aerobic system. Anaerobic-lactic training is extremely taxing on the body and difficult to recover from. This form of exhaustive conditioning should be used less frequently in the training program.

Remember, conditioning does not mean the same thing as speed training. For more information of developing hockey speed, read this article.

6. RECOVER, RECOVER, RECOVER
Recovery from exercise can be accelerated with proper attention to flexibility, mobility, massage, chiropractic treatment, nutrition and sleep. These approaches facilitate the body’s ability to recover from exercise. Nutritionally, ingesting the proper amounts of whole foods and supplements at the appropriate times during the day can prove to be a huge part of the recovery process. Replenishing energy stores (i.e. muscle glycogen) and providing the building blocks (i.e. protein, fats, vitamins, minerals) for tissue repair and regeneration are just some of the primary goals of proper nutrition. Self-management strategies such as foam rolling and stretching/flexibility work are valuable components in the recovery process. Maintaining proper muscle function and joint range of motion is critically important to minimize injury risk and ensure that you get the most out of your training.

Conclusion
Keep in mind the above tips serve as guidelines. Individual considerations cannot be met in an article of this nature. However, if applied correctly, these guidelines can serve to provide aspiring hockey players with a better understanding of how to go about their off-ice training. For those interested, GP specializes in the training and preparation of hockey players. Contact us for more information.

Athletic performance is a developmental process, one that ideally involves the integrated efforts of coaches/trainers and therapists in order to maximize results. This is often a complete paradigm shift for many of our athletes and their parents. Unfortunately being focused on short-term results over long-term development is hurting athletes more than it will ever benefit them.

After some recent conversations with our athletes and their parents about the importance of understanding the integrated approach taken to athletic development at GP, we thought we'd provide our readers with a few recommendations. Our hope is that these recommendations help guide the decision making process for young aspiring athletes when it comes to selecting who oversees their training and why an integrated approach may just be what they need.

1. The ‘watchful’ eye of a coach/trainer and therapist is an invaluable asset to athletic development. This is a skill set that many athletes are unfortunately never exposed to. The ability to identify mechanical faults and implement collaborative strategies between coach and therapist to correct these faults sets the stage for reaching athletic mastery while minimizing injury risk. The ‘eye’ for mechanical faults is one thing, knowing how to manage and correct them is an entirely different story. Athletes require an individual(s) competent in both.
2. Physical limitations due to anatomical/structural changes and motor control/technical deficiencies require different management strategies in an athlete’s programming. It is the job of the coach/trainer and therapist to recognize this difference. This should be a prerequisite when considering the services you are about to invest in. If they don't understand these concepts, that should be a red flag. Developing movement efficiency is arguably the best way to simultaneously enhance sport performance and reduce injury risk. Understanding how to manage physical limitations will directly impact movement efficiency and athleticism.
3. When injury occurs, integrated models for “rehab” are better than medically driven models. This of course is dependent on the level and experience of both the coach/trainer and therapist involved. Ideally the athlete’s recovery process utilizes exercises and drills within a modified training program. This serves to minimize time away from the field or weight room and maximize technical improvement of sport-related skills. Dysfunctions of the musculoskeletal system can also be addressed through performance therapy. For more reading on performance therapy, check out this article.

Similar to a growing number of athletic facilities across the US, Gallagher Performance places a significant amount of emphasis on assessing our athletes in order to address structural adaptations and movement dysfunctions appropriately during the course of the athlete’s training program. This trend is seen throughout collegiate and professional athletics as organizations are recognizing the importance of keeping their athletes healthy by promoting optimal training environments.

However, this service is rarely available to young athletes prior to sport participation or a training program. This is truly unfortunate since proper screening of athletes is not available when it arguably matters most, during the early stages of athletic development. Dr. Mike O’Donnell DC, CCSP, CSCS touched on this concept in a recent interview. He states,

“In North America, athletes start playing a sport as unprepared youth with no background in general conditioning. This isn’t always true, but we have no system to condition young athletes besides just playing the sport. In an Eastern model, camps are held without a sport focus to condition young athletes, and the specialization comes later. In general, early specialization is a mistake. This has been proven to limit progress, lead to early burnout, and increase injury rate.”

• 79% of asymptomatic professional baseball pitchers have evidence of shoulder labrum abnormalities on MRI.
• 40% of dominant shoulders in asymptomatic tennis and baseball players had evidence of partial or full-thickness rotator cuff tears on MRI.
• 34% of asymptomatic individuals in the general population had evidence of rotator cuff tears. 54% of those 60 years of age and older had evidence of rotator cuff tears - so if you’re dealing with older adults, you could safely assume they are present in almost half of this population.
• Recent research has demonstrated that high school baseball pitchers from southern, warm weather climates have decreased shoulder internal rotation range of motion and external rotation strength compared to northern, cold weather climate players. This is likely attributed to adaptation from the number of months spent participating in pitching activities during the calendar year.
• 64% of asymptomatic people that underwent an MRI of their lumbar region had abnormal findings. Keep in mind these are individuals with evidence of lumbar disc pathology (i.e. bulge or herniation) who have NO symptoms and NO pain.
• 93% of youth hockey players age 16-19 have evidence of femoroacetabular impingement (FAI) and hip labral tears. FAI is the result of bony overgrowth found at the femoral head and/or acetabulum of the pelvis. FAI has been linked to increased risk of injury for osteitis pubis and sports hernias.
• 77% NCAA D1 and professional hockey players evaluated in one study had abnormal hip/groin MRI despite being asymptomatic. Hockey players are also more likely to have a structural change known in the hip known as hip retroversion, which allows for greater hip external rotation and reduces the degree of hip internal rotation.
• 87% of 125 NFL prospects had findings consistent with FAI on MRI. The only independent predictor of groin pain was the degree of bony overgrowth.
• Evidence suggests that roughly 25% of men in the general population have some degree of FAI despite being asymptomatic.

1. Miniaci et al. Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers. Am J Sports Med. 2002 Jan-Feb;30(1):66-73.
2. Connor et al. Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study. Am J Sports Med. 2003 Sep-Oct;31(5):724-7. 
3. Sher et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995 Jan;77(1):10-15.
4. Jensen et al. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994 Jul 14;331(2):69-73.
5. Kaplan et al. Comparison of shoulder range of motion, strength, and playing time in uninjured high school baseball pitchers who reside in warm- and cold-weather climates. Am J Sports Med. 2011 Feb;39(2):320-328. 
6. Birmingham et al. The effect of dynamic femoroacetabular impingement on pubic symphysis motion: a cadaveric study. Am J Sports Med. 2012, 40(5), 1113-1118.
7. Philippon et al. Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players. Am J Sports Med. 2013, 41(6), 1357-1362.
8. Silvis et al. High Prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players. Am J Sports Med. 2011, 39(4), 715-721.
9. Larson et al. Increasing alpha angle is predictive of athletic-related “hip” and “groin” pain in collegiate national football league prospects. Arthroscopy. 2013, 29(3), 405-410. 
10. Hack et al. Prevalence of cam-type femoracetabular impingement morphology in asymptomatic volunteers. J Bone Joint Surg Am. 2010, 92(14), 2436-2444.

In our previous article, Structural Adaptations – Not Just An Athlete’s Problem, we discussed structural adaptations and why they must be accounted for in both training and treatment plans. Clearly, structural adaptations have impacts from a sports performance and clinical perspective.  With that in mind, prior to treatment, our goal is to not simply assess from a structural standpoint, but to also assess functional capacity to determine if there is a functional capacity deficit (i.e. endurance, strength, balance, reactivity, dynamic posture control). It is my job as a clinician to choose the most appropriate evaluations to identify functional deficits. I choose not to limit my evaluations to x-rays or imaging and finding structural abnormalities. It should be evident that treatment based on the findings of imaging alone is flawed when you consider the enormous amount of false positive rates in asymptomatic people. This is why I couple structural evaluation with a functional evaluation that looks at motor patterns or movement, not just isolated joint range of motion or strength.

As a chiropractor, I tend to go against traditional approaches in how much attention I give to static body alignment compared to most of my peers. Reason being is that often times a patient can look a certain way (i.e. “dysfunctional”) in a static stance, but when asked to perform a skill, they nail it. This can be especially true of athletes. What I was able to learn over and over again during the course of my residency is that if someone can’t perform a certain movement (i.e. squat), it may be more practical to coach or educate them on better movement (i.e. motor learning) prior to isolating and treating joint or mobility “dysfunctions”. The reality is, if a patient or athlete is performing a new or unfamiliar movement, sometimes they simply lack the skill to execute it in an ideal fashion. This is the prime reason why I find functional evaluations invaluable in determining the best course of treatment.

When it comes to functional capacity, the assessment is intended to identify the relevant functional deficit of that patient. What is relevant to that patient will depend on their history. What areas are bothering them? What does their injury history tell you? What activities have they been involved in that have provided accumulated stress or strain to their body? This can provide insight into the adaptations or compensations patients may exhibit. As for athletes, it is important to remember: the higher level the athlete, the better they are at compensating. Despite being asymptomatic, those compensations will eventually catch up to them and become symptomatic. This will not only impact performance, but injury risk and longevity as well.

Once a functional capacity deficit is identified, the process of treatment can begin. For example, poor stabilization patterns during movement are a common functional deficit. Whether it is lack of stability during everyday tasks such as walking, carrying, lifting, etc., or sport-related skills such as kicking, throwing, sprinting or jumping, it’s important to understand that the functional capacity of each of these activities has different demands as it relates to stability. Our approach must be tailored to match the stabilization demands in order to normalize movement patterns and improve the load-bearing capacity of tissues involved. This is the goal of treatment. Perfection of movement is not the goal. Arguably, perfect movement does not exist. Consider elite athletes who practice their skills all day, consistently, year after year. Are they perfect with their movement 100% of the time? No. Movement has far too many variables to achieve perfection. The goal is better movement coupled with increased tissue capacity to better withstand overloads when movement goes awry.

As a chiropractor, I possess a license to manipulate and improve the function of the neuromusculoskeletal (NMS) system. I prescribe what I feel is necessary for treatment, whether it is joint manipulation, soft tissue/massage therapy, or exercise prescription. When it comes to the management of the clients and athletes here at GP, we perform functional evaluations prior to all training programs and chiropractic treatment. But the evaluation process does not end on day one. Evaluation is a continual process, from session to session. This is vital to monitor for improvement and knowing when to adapt the current training or treatment plan. Continual functional evaluation enables us to handle physical ailments appropriately when they occur. This is just part of the process of our Integrated Approach. It’s important to understand the rationale for a prescribed course of action. Thus giving both chiropractic and training services a better understanding of what to do for each individual to maximize results. So from a treatment perspective, it really isn’t just about knowing how to manipulate or perform ‘active release’ on muscles. Far too often people may know what they do; they may know why they do what they do; but do they actually understand the effects of what they just did? As a clinician, it’s important to understand the effects of the treatment you just provided and the reasons why they were provided.

Summing it All Up
Functional assessments provided at GP help to identify the most necessary intervention or treatment. It helps to identify the root cause of your symptoms and enables you to function better. Structural evaluations can be valuable, but functional evaluations should not be overlooked. There is important information to be gained from both. If you are experiencing unresolved issues such as joint pain, muscle tightness, or limitation in performing specific sport-related or daily activities, consider seeking out a clinician in your area who is credible and offers functional evaluations as part of their services.

 

[embed]https://www.youtube.com/watch?v=bQj4CnMyU1M[/embed]

Going back once again to the podcast with Clinically Pressed, I mentioned the jump rope as a great tool for developing low grade plyometric qualities in the foot and ankle.

Let's take this a step further and demonstrate how these same qualities apply to sprinting. Front side mechanics or tripe flexion is extremely important to running and sprinting ability. Most people focus on the posterior chain and triple extension with little focus on triple flexion.  There is a reason why sprinters spend so much time practicing and rehearsing front side mechanics with marching and skipping drills.

A critical part of triple flexion is dorsiflexion at the ankle. Often you'll see athletes sprint with a lazy foot that isn't brought into dorsiflexion during the gait cycle. This must be addressed and trained accordingly. We want to train an 'active' foot, not a lazy foot. Training an active foot will require cues but the use of external cues such as the jump rope will force an athlete to become more reactive, thus possibly leading to quicker learning of new skills.

The jump rope can be included in skipping drills to develop ideal foot/ankle mechanics as they are necessary for optimal speed and power development. If these qualities aren't trained and mastered then athletic potential will be hard to realize.

 
For more related reading:

https://gallagherperformance.com/health-and-sport-performance-improved-in-5-simple-steps/

https://gallagherperformance.com/a-few-words-on-athletic-development/

https://gallagherperformance.com/what-is-natural-talent/

One of the biggest challenges plaguing sports performance is the prevalence of general fitness programs masked as "sports performance" programs.

Sadly the concept of sports performance has become so polluted that most parents and young athletes buy into programs that ultimately are just heavily fitness-focused with very little or poor instruction in regards to true development as it relates to sport.

True sports performance addresses much more than how fit you are or how hard you are willing to work. It's much more than cleans, sled drags, sprints, and conditioning circuits. You can use all these methods and more to sell someone on the "look" of sports performance. But if you truly analyzed most "sports performance" programs they boil down to general fitness and that's it.

Some will say, "Well fitness is important in sports. You got to work hard. You got to be in shape. You got to learn how to push through." Fact is anyone can workout tired. Anyone can workout sore. If they want it bad enough. The problem is none of that matter when it comes to performance. The reality is once an athlete has to go up against another human being, only one thing matters - is their ability greater than their opponent?

It doesn't matter how fit you are and how hard you train if you show up on competition day and fail to be at your best. Sport performance is multi-faceted and should never be treated in the context of fitness-focused training. There are general fitness attributes that are important in sport, but true sport performance must move beyond fitness in order to allow athletes to truly realize athletic potential by focusing on specific adaptions relevant to their sport.

It's important to do your homework and look beyond what may seem like sports performance. Despite what you may see on Instagram or hear from a friend, what you sign up for may not be exactly what you were looking for.

A testimonial worth sharing:

When I first visited Gallagher Performance 6 months ago, I went for a nagging discomfort around my shoulder on the right side of my back that had stuck with me for the past 7 years. Not only was this uncomfortable, but it was also a major limiting factor in my physical performance. For years on my own, I tried various types of stretches, mobility exercises, and strengthening exercises, all to no avail. Due to its chronic nature, I continued to research the potential issue, and was convinced it was fascial adhesions in that area causing the discomfort and limited mobility. From there, I went to a number of deep tissue massages from various professionals, but those only resulted in short-term relief, not the long-term fix I was looking for. I continued my journey by going to various physical therapists in the area. I would tell them I thought facial adhesions were causing this issue. They would listen, target that area with facial release methods, give me various stretches and mobility exercises, but still no results.

Finally, I found Gallagher Performance one day as I searched for a fix for my shoulder and decided to give them a shot. Since I was still convinced that fascial adhesions were my issue, I went for a deep tissue massage for my first session with Ryan. Ryan listened attentively as I told him about my symptoms and the fascial adhesions that I believed were causing my discomfort and limited mobility in that area. Once the session started, he went to work on those fascial adhesions that I so strongly believed were the culprit. But this is where Gallagher Performance separated themselves from all of the other practitioners that I visited. Even though Ryan started on the facial adhesions, through his extensive knowledge and expertise, he quickly identified that fascial adhesions were not the issue. In fact, I unknowingly had issues in other areas in my body that were the root causes of my discomfort in that area. From there, through Ryan’s genuine desire to help his clients, he introduced me to Sean in order to work through the multitude of issues that caused this chronic discomfort and limited mobility for the past 7 years. Since that first visit, I’ve continuously worked with Sean and have practically eliminated the issue that had limited me for so many years.

Ryan and Sean were the first professionals to take an honest and objective approach to my issue. Instead of allowing my unprofessional diagnosis of my issue dictate their actions and approach, they independently applied their experience and knowledge to diagnose my issue and set me on the correct path for a long-term fix. Sean’s expertise in his field, specifically his knowledge of DNS (Dynamic Neuromuscular Stabilization), gave me the tools I needed to fix the root causes of my issue. His unique knowledge of DNS was imperative to my early success, but as we continued to work together on my path to maximizing functionality and physical performance, his experience and expertise in every area physical therapy allowed him to effectively diagnosis and treat any issue that would arise. Even though my discomfort has subsided greatly, I continue to work with Sean on correcting other problem areas that are limiting the full functionality of my body that I require to perform at a high level as an ice hockey goaltender. Only when I began my work with Sean was I not only able correct a lingering issue, but was also able to (and continue to) maximize my physical performance and functionality in ways I’ve never experienced before.

In addition to my periodic visits with Sean, I have been working with Ryan on the nutrition and training side for three months now, and as with my work with Sean, experiencing results that I have never experienced in those areas. For years, I have tried various exercise and nutrition programs, but the results that I experienced (if any) were short-term. I was never able to stick to a nutrition plan for very long or have a training program that was designed specifically to my needs. Ryan met those needs by developing a nutrition and training program built on a very simple yet powerful concept – sustainability. No longer was I burning out of my nutrition program because it was to strict and unsustainable, nor was I giving up on my training program because I wasn’t seeing any progress. Through the scope of sustainability, Ryan develops programs that not only brings incredible results, but also have the ability to be adhered to for the long-term. In addition, since Ryan and Sean work closely together, Ryan is able to take the feedback from my work with Sean and adjust my nutrition and training plans accordingly. I never had success in the past using various cookie-cutter nutrition and training programs. But once I started working with Ryan, I began to see great results on a consistent basic through the plans that he developed specifically for me.

My experience with Ryan and Sean has been, and continues to be, exceptional. Not only is their knowledge and expertise high-level, but they are truly tremendous people. They genuinely want their clients to succeed and will do whatever it takes to make that happen. The level of support and professional expertise that I have received from both Sean and Ryan is unparalleled, and I can’t thank them enough for success they helped bring into my life.

I would not hesitate to recommend anyone to see Sean and Ryan. Whether you are an athlete or non-athlete, young or old, I have no doubt in my mind that Ryan and Sean will be able to provide the level of support you are looking for. Gallagher Performance is much more than just a chiropractor, a personal trainer, or a massage therapist – they offer a multitude of services that restore health, functionality, and maximize physical performance. If you are looking for a high level of expertise and support in any of these areas, I urge you to give Gallagher Performance a try. They are hand-down some of the best in the business.

-Zaid Alzaid

 
For more related reading:

https://gallagherperformance.com/dns-solves-pain-improves-performance/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/before-you-go-to-a-chiropractor-read-this-first/

 
There's no single blueprint coaches follow when building an athlete. There are no shortcuts. Those cool looking, cookie-cutter programs found online, they often result in failure. In the training world, athletes aren’t built by copying the same program and applying it across the board. At GP, we are in the business of individualized architecture – intelligently designing personalized programs for each athlete. Whether in the weight room or on the field, it should be individual-specific.

We dial in to specificity instead of just saying let’s just go train hard and get bigger, stronger, or faster in the generic sense. Coaches and athletes can be obsessed with bigger, stronger, faster. Yes these are important elements of training but not at the expense of movement skill.

Sometimes athletes need more specific work when it comes to the quality of their movement in regards to stabilization, sequencing, rhythm, relaxation, timing, etc. Developing movement skill is often ignored or disregarded. The problem is there can be a huge disconnect between what an athlete thinks they are doing during a specific movement and what they are actually doing. We must improve their perception and awareness of movement. When combined with proper strength and conditioning, Improving an athlete's body awareness and movement skill will yield far greater results than just focusing solely on strength and speed numbers.

Movement skill acquisition should increase with as strength and speed development increases. This will only enable the athlete to move more efficiently and with less risk of injury.

There are different methodologies, philosophies, systems and styles used in the strength and conditioning industry. Reality is there is no gold standard by which everyone should follow. It’s about finding the right fit for both athlete and coach. Every athlete is slightly different and there won’t be one method that will work for every athlete. That's exactly why individualized decisions should be made for the athlete.

 
For more related reading:

https://gallagherperformance.com/thinking-of-taking-your-child-to-a-trainer-read-this-first/

 
https://gallagherperformance.com/understanding-the-benefits-and-concerns-of-youth-strength-training-programs/

https://gallagherperformance.com/the-essentials-of-speed-training/

https://gallagherperformance.com/how-do-you-build-an-athlete/

https://gallagherperformance.com/guidelines-for-selecting-a-strength-coach-or-personal-trainer/

 
 

[embed]https://www.youtube.com/watch?v=WwIba7PpgXA[/embed]

Keeping with the concept of core stability and hip mobility, the shin box has become a popular drill for improving hip rotation, eccentric loading of the hips, as well as reinforcing ideal intra-abdominal pressure (IAP) and core stability.

Ideally the shin box is performed in a progression of static to dynamic variations. Progressions are dependent upon the ability to achieve ideal external rotation in the lead leg and internal rotation in the trail leg while maintain an upright, braced torso with sufficient IAP.

When it comes to health, fitness, or athletic goals, there is no secret. There is no special exercise class, no special equipment or supplement. There is no magic. Yet people keep looking for one.

The truth is there are no shortcuts and anyone promoting shortcuts is lying to you. And if you bought it, you were buying 'hope' only to discover you actually got a bunch of nonsense that left you disappointed and frustrated.

Chasing shortcuts is a mentality that is robbing people of not only achieving their goals, but the ability to maintain them. If you some how think that serious health and fitness goals are able to be achieved with anything less than 100% commitment, dedication, discipline, and will power to sacrifice for your goals - there is nothing anything or anyone can magically do for you.