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The Essentials of Keeping Athletes Healthy

The number one priority of any coach or trainer should be the health of your athletes. At GP, we look at any and all entities that should be addressed to increase the wellness of each of our athletes. This takes into account biomechanical/movement quality considerations, exposure to inappropriate training, the compatibility of current training loads and parameters, nutritional considerations, and the coordination of therapy and restoration techniques.

The process of developing athletes and ensuring they remain healthy in the process can present a major problem and one that could be remedied with both higher coaching education standards and the utilization of performance-based therapy.

1. Raising Coaching Education and Qualification Standards
To ensure the health of our athletes while realizing their athletic potential, we spend countless hours on improving movement efficiency as well as balancing workload compatibility during each training session and block. Statistics consistently demonstrate the more mechanically efficient you are, the less injuries you have. Movement efficiency also translates into athletes having higher levels of performance while expending less energy in the process. Expending less energy means less fatigue. This is important since athletes are more likely to get injured in a fatigued state.

Workload compatibility refers to the importance of understanding compatible training methods when addressing a dominant physical ability during a phase of training. For example, this demands that the coach/trainer understand if they are trying to develop alactic sprint abilities why glycolytic or anaerobic-lactic training must be restricted or avoided.

In the attempt to improve any number of physical abilities, most coaches/trainers often fall into the trap of pushing their athletes too hard in training. They understand that in order for athletes to perform any number of biomotor abilities (speed, strength, work capacity) at higher levels, they must push them during training to create a specific adaptation. In the process of achieving adaptation, often times they manipulate variables (intensity, frequency, duration, workload, etc.) without any understanding as to why they are making the change. As a result they compromise the athlete’s ability to adapt appropriately and set the stage for injury.

Simply put, more educated coaches understand workload compatibility and the development of specific biomotor abilities as they relate to an athlete’s sport. They have a system of checks and balances that dictate training variables and they are constantly monitoring their athletes to avoid declines in performance standards and injury.

Movement efficiency and the proper management of training loads/parameters is a relatively poorly understood concept by the majority of trainers/coaches when most of them have simply taken weekend certification courses and are under qualified, with no background in sport and exercise science. This is far too common in the US, as trainers with minimal experience and knowledge of these concepts as they relate to sport often find themselves responsible for the coaching and development of athletes.

This approach is in stark contrast to the coaching qualification process in the former Soviet Union, where the development of coaches/trainers was a scientific and well-planned undertaking. Those who wished to become coaches had to be high-level competitive athletes themselves and were required to take entrance exams in subjects such as biochemistry, physics, biology, and physiology. The applicants who made the cut were entered into one of the country’s Physical Culture Institutes to undergo four to five years of a rigorous, scientifically oriented coaching curriculum. Coaching in the former Soviet Union was not something one decided to do a “whim”. Coaching and the development of athletes was viewed as a career that required specialized education, mentorship, and training.

It doesn’t take long to realize why the Soviet Union dominated international athletic competition for as long as they did once you understand the qualification criteria for their coaches was a serious and intellectual process.

Athletes should seek out coaches and therapists who have the competitive sporting background and accomplishments, educational background and accomplishments, as well as clinical competence, methods, and track record to keep athletes healthy and performing at their best. Period. Anything less, and you should be skeptical about what you are getting.

2. Integration of Performance-Based Therapy
In addition to raising coaching education and qualification standards, excellence in therapy is another component that is often missing when it comes to keeping athletes healthy. Unless you have integrated sports medicine and therapy (sports chiropractic, massage, manual therapies, recovery methods), eventually an athlete will need to reduce the overall volume/intensity/frequency of training. What you are able to learn about an athlete in a therapy session is invaluable and can serve to help guide what you do in training.

As Dan Pfaff said best,

“A top athlete is like a formula one car and have you seen how much fine tuning they do with those things? The ability to run your hands over an athlete and know what is restricted gives you immense inside information into their functioning. You cannot expect the athlete to tell you either because they are terrible barometers when it comes to knowing what they are ready for. Just asking “are you ok for today’s workout?” is not enough because their motivation is so high athletes do not necessarily listen to what their own body is telling them.”
Therapy serves to normalize joint and soft tissue (muscle, tendon, ligament) function and promote movement efficiency by removing dysfunctional movement patterns. Similar to training, therapy cannot be randomly applied. Random application always equals random results. Therapy must be strategically implemented during the training plan. It should not be ignored that therapy provides a stimulus/stress to both tissues and the nervous system and, depending upon the athlete’s needs, must be utilized appropriately.

For instance, some forms of therapy can serve to promote recovery and restoration by pushing an athlete into a parasympathetic dominant state. Conversely, other forms of therapy can up-regulate the sympathetic nervous system and will either heighten performance levels or prolong the recovery/regeneration period depending upon when therapy is applied. Another factor that must be consider is how each individual athlete responds to therapy. Some athletes may respond to intensive therapy sessions just as they do to intensive training and therefore proper rest/recovery must be accounted for accordingly during the training week.

Closing Words
Both higher coaching education/qualification standards and performance-based therapy are necessary components in the health and performance of athletes. The more coaches know, the better they are able to serve their athletes and address their needs appropriately. Failure to integrate performance therapy in a complementary manner can be a mistake, as there tends to be an increase in reliance on other forms of therapy that stress rehabilitation and recovery rather than optimizing performance.

Related Articles:

What is Performance Therapy?
Have You Mastered Your Movement?

What's the Deal with the Tape?

Similar to the current trend of marketing driving training (discussed in this article), marketing appears to have a similar and undeniable impact on services provided in the world of physical medicine. From the latest and greatest in modalities such as laser therapy and electrical muscle stimulation to musculoskeletal injury interventions such as kinesio tape (KT), the colorful tape that gained popularity from the Olympics.

Earlier this week, a GP client was speaking of someone they know who recently got “taped” because they were having knee pain while running. This client went on to explain that a few days after getting taped, the very same person went out for a run and felt a “tearing and pop” in the same knee that had been taped and is now in worse pain than before.

Our client wanted to know, “What's the deal with the tape? Is it effective or is it a cheap trick?”

Kinesio Tape: Legit or Hype?
What seems to be at the center of any benefit from the application of KT is something known as novel sensory input. Basically, this means when you tape someone, they feel it. Sensory input changes “output” – in this case – motor control and perception of pain.

In the case of the painful knee (or any joint/muscle), stick some tape on it and odds are in your favor that the patient will feel slightly better for a brief period of time.
But is this really “therapy”, getting at the root of the problem, or simply masking pain symptoms?

First, we must start with an understanding of pain. Pain is your body’s way a telling you something is wrong. Pain with movement indicates a movement problem and no amount of tape will ever solve a movement/biomechanical problem. However, taping is very effective at altering proprioceptive/sensory feedback. Sensory input will dampen pain perception, thus making it easier for your brain to ignore pain signals and you are now feeling “less pain”. This is known as “sensory gating”.

You feel less pain and you are happy, so what’s the problem?

You have disrupted the injured tissue’s ability to tell the truth, now you are more likely to continually overload a compromised structure and worsen the condition. To illustrate this phenomenon, one only needs to recall Manteo Mitchell, the sprinter who sustained a fracture of his fibula – wearing KT – while running the 400m in 2012 Olympics. The applied KT allowed the athlete to distribute more load on a painful and compromised ankle. The tape did its job. It blocked pain and allowed the athlete to feel capable of competing, but unfortunately the result was a worse condition than before the tape was applied. Keep in mind, this isn’t always the outcome of taping but it certainly is a risk one must understand.

Not only are companies claiming the pain relieving benefits of KT, now some are stating how their tape prevents injury or enhances performance. Just go to their websites and read for yourself. Spider Tech’s website has the tag line: “Recovery, Performance, Prevention” and Rock Tape (on their About Us page) has this to say:

“I discovered that the tape can be used to ENHANCE PERFORMANCE. I found that taping in advance of exercise promotes increased blood flow to the muscles, thereby reducing fatigue.”
Marketing with fancy words and convenient KT placement on some elite athletes does wonders for a product’s popularity. But are the claims substantiated?

There are few high-quality studies on taping, but a recent systematic review of the research literature revealed that KT had insufficient evidence to support its use for musculoskeletal injury. Studies have shown that benefits from KT are generally minor, brief and inconsistent in nature. The value of taping is unclear, with several experts dismissing the effectiveness of taping as placebo only. The systematic review conclude that KT did provide short-term pain relief and even range of motion (ROM) improvement, but failed to offer any long-term results to patients.

In Closing
For the most part, taping is a lot of marketing hype. At best, taping is mostly a minor and imprecise method of pain control. The amount of tape being used by athletes lately is silly and, in my opinion, its popularity has more to do with marketing than results. Sure taping may make someone feel better and in a “results now” society this can go a long way to keep patients satisfied. However, there is no long-term solution to be found with any amount of tape.

Where does one turn for a long-term solution?

At GP, we consider ourselves part of a growing body of providers who strive to identify the repetitive movements and postural abnormalities that cause pain and discomfort by performing thorough and detailed examinations. Assessments and individualized treatment plans aim to identify the underlying cause of your condition rather than merely alleviating symptoms.

The more accurate the assessment, the more accurately treatment will target a patient's pain generators. At GP, we stress a collective and active approach on the part of each of our patients through education. By clearly educating each patient on their condition and why they are performing prescribed exercises, 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 the average patient realizing fully recovery in 4-8 treatments. Many patients quickly improve in as little as 2-3 treatments.

Reference:
Mostafavifar M, Wertz J, Borchers J. A systematic review of the effectiveness of kinesio taping for musculoskeletal injury. Phys Sportsmed. 2012 Nov;40(4):33-40. 

 
More related reading:

https://gallagherperformance.com/resetting-bodys-function-post-injury/

https://gallagherperformance.com/technique_and_performance/

https://gallagherperformance.com/why-therapists-should-understand-strength/

Does Unstable Surface Training Build a Better Athlete?

At GP, we get plenty of questions from our young athletes about training simply because they are exposed to more training information and conflicting ideas than ever before. Recently, we had one of our athletes ask us, “A lot of my teammates are training at _______ and the trainers there have them stand on BOSU balls and do different movements, telling them it’s what they need as athletes. I’ve watched them and it seems ridiculous to me. They can’t even do simple movements correctly. Why are they doing that?”

We love educating our clients and athletes, especially when it comes to any number of gimmicks that exist in the sports performance industry.

Whether you wish to refer to it as balance training or unstable surface training, plenty of images can come to mind of people standing on wobble boards, BOSU balls, and even stability balls. These items are often marketed as “functional training”, being capable of not only improving your balance, but also increasing core muscle activation and strength. Athletes are often told that balance training is essential to improving as an athlete and reducing their risk of injury.

This school of thought grew out of the physical therapy and rehabilitation setting. In the rehabilitation setting, there is some efficacy regarding the use of balance training in chronic low back pain and reducing the risk of recurrent injury, particularly when it comes to ankle sprains. Unfortunately, there seems to be a sect of the personal training and sports performance industry that has concluded that information gathered on injured patients is somehow applicable to the non-injured individual and high-performance athlete.

The reality is all exercise is 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 attention. 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.

When it comes to balance/unstable surface training, the above paragraph is incredibly relevant.

Why?

Take a moment and ask yourself this question, “When am I ever on an unstable surface during my daily life? When do I compete on an unstable surface?”

If you answered honestly, chances are very little, if ever. So why are we training people on an unstable surface when they are almost never on unstable surfaces?

The fact of the matter is, the floor works just fine.  Unstable surface training probably does more for decreasing athleticism, strength, balance, and movement quality than it helps.

Here is a quote from an article written by the man known as Kiefer:

“You instantly tense up, you almost literally can’t perform certain movements because the nervous system senses the instability of the environment and fires in resistant ways to keep you balanced. In this process, it also shuts down the ability to produce maximum force….Think about it, if you start to slip in one direction and your reflexes caused your muscles to fire with maximum force against that motion—a motion that may be inevitable at that point, like falling—then you risk tearing muscle or connective tissue. The body is trying to protect you by making you weaker.”
Simply put, as the body’s need for stability increases, force production decreases. You cannot build strength, speed, or explosive power in an unstable environment. What all the marketing behind products such as BOSU balls and the trainers that endorse them fail to tell you is that the stabilization action of musculature actually increases when you are on a stable surface, not on an unstable surface.

Want proof? Here are some findings from a growing body of evidence:
  1. Several researchers have demonstrated that there is significant increases in stabilizer activity during movements that require increased force (either greater resistance or higher speed) compared to activity seen in unstable environments [1-4].
  2. Performing squats on unstable surfaces will increase core activation, but not necessarily core strength [5] and definitely decreases muscle force production [6].
  3. Doing pushups on a physioball does less to activate stabilizing muscles than placing your feet on an elevated, stable bench[7].
  4. Unstable surface training contributes nothing that cannot be achieved when performing stable surface exercises [8,9].
  5. Stable surfaces are superior for some scenarios involving scapular rehabilitation [10].
The reality is unstable surface training is not an effective means of training athletes or healthy individuals. Unstable surface training has its merits in a rehabilitation setting, but the application outside that realm is questionable at best. There are far more productive means of training for athletes than performing exercises on a BOSU ball.

References:
  1. Freeman S, Karpowicz A, Gray J, McGill S. Quantifying muscle patterns and spine load during various forms of the push-up. Med Sci Sports Exerc. 2006 Mar;38(3):570-7.
  2. Hamlyn N, Behm DG, Young WB. Trunk muscle activation during dynamic weight-training exercises and isometric instability activities. J Strength Cond Res. 2007 Nov;21(4):1108-12.
  3. Nuzzo JL, McCaulley GO, Cormie P, Cavill MJ, McBride JM. Trunk muscle activity during stability ball and free weight exercises. J Strength Cond Res. 2008 Jan;22(1):95-102.
  4. Willardson JM, Fontana FE, Bressel E. Effect of surface stability on core muscle activity for dynamic resistance exercises. Int J Sports Physiol Perform. 2009 Mar;4(1):97-109.
  5. Anderson K, Behm DG. Trunk muscle activity increases with unstable squat movements. Can J Appl Physiol. 2005 Feb;30(1):33-45.
  6. Saeterbakken AH, Fimland MS. Muscle force output and electromyographic activity in squats with various unstable surfaces. J Strength Cond Res. 2012 Mar 24. Epub ahead of print.
  7. Lehman GJ, Gilas D, Patel U. An unstable support surface does not increase scapulothoracic stabilizing muscle activity during push up and push up plus exercises. Man Ther. 2008 Dec;13(6):500-6.
  8. Lehman GJ, MacMillan B, MacIntyre I, Chivers M, Fluter M. Shoulder muscle EMG activity during push up variations on and off a Swiss ball. Dyn Med. 2006 Jun 9;5:7.
  9. de Oliveira AS, de Morais Carvalho M, de Brum DP. Activation of the shoulder and arm muscles during axial load exercises on a stable base of support and on a medicine ball. J Electromyogr Kinesiol. 2008 Jun;18(3):472-9.
  10. Martins J, Tucci HT, Andrade R, Araújo RC, Bevilaqua-Grossi D, Oliveira AS. Electromyographic amplitude ratio of serratus anterior and upper trapezius muscles during modified push-ups and bench press exercises. J Strength Cond Res. 2008 Mar;22(2):477-84. 
Related Articles:

Are You in Need of More Intelligent Training?
Training for Elite Athletes
Common Mistakes in Developing Young Athletes
 
 
 

Thinking of Taking Your Child to a Trainer? Read this First

In order to meet the demands of working with athletes of all levels of preparation, the services at GP are constantly evolving and adapting on many levels. When it comes to the physical preparation of our athletes, there is no single program or method we use with every athlete. We are constantly assessing each athlete from day to day, learning what he or she is capable of performing during any given training session. Constantly assessing our athletes during their dynamic movements also allows us to identify weakness and address them accordingly from both an injury prevention and performance enhancement perspective.

Our approach can often times be a source of both intrigue and confusion for parents and their young athletes, since the majority of them are all too familiar with a ‘one-size fits all’ approach. Many of these athletes even come with ‘cookie-cutter’ strength and conditioning programs given to them by their coach or previous trainer. It becomes our job to explain our approach to training and athletic development and why these ‘cookie-cutter’ programs fail to address individual needs of each athlete. After explaining why each individual athlete requires their own individualized approach and why no two athletes will respond similarly to the same program, it makes sense to them. They often find this very refreshing. What doesn’t make sense to them is how so many coaches and trainers are ignorant of this fact.

In an interview with Buddy Morris, Joel Jamison addressed the heart of the matter by saying,

“Coaches and trainers maybe don’t do the best job of understanding the needs of the sport and they tend to let their athletes over train because of the….push of this country is more intensity, the quick buck, the fast results. The other thing I think that’s influenced our industry probably negatively more than anything else is the marketing aspect. That there’s products, and there’s training methods, and there’s everything being pushed to athletes and coaches from a marketing perspective. We’ve all seen the cross fits, the P90 Xs, all the functional training stuff. It’s the marketing driving the training rather than the training driving the results or the results being based on something scientific.”
Buddy Morris, now the Head Physical Preparation coach for the Arizona Cardinals, had this to say in response,
”We're trying to create circus acts in this country so, like you said, people can generate revenue. So if you actually read and you understand training methodics and you understand the athlete and training the athlete, you won’t buy into all this stuff out there.”
In my opinion, Joel and Buddy nailed the central issue when it comes properly preparing athletes not just when it comes to training, but ultimately for competition. Within the US, there’s a tremendous lack of scientific influence when it comes to the training and preparation of athletes. This is not always true of each coach or trainer, but it certainly is more common than not. The exact opposite was true of the former Soviet Union and the preparation of their athletes. The USSR’s dominance of international athletics can be attributed to a superior coaching education system and the development of highly sophisticated, multi-year training regimens that focused on long-term development over short-term results.

What the Soviets understood very well is that athletes are never immediately better after the training they just performed. Buddy Morris likens the training process to a ‘slow cooker’, emphasizing that results are best achieved with periods of gradual loading and de-loading to allow the athlete to accommodate to the stress of training. The stress of training is a poorly misunderstood concept as seen by the lack of planned restoration/recovery within many programs. Programs must account for high stressors and low stressors because athletes cannot be loaded with CNS (Central Nervous System) intensive exercises or drills everyday. This is a huge mistake and one that is characteristic of far too many programs.

Young athletes may be able to get away with this for one reason and one reason only, they have youth on their side. Young athletes are capable of handling enormous amounts of volume in training. However, this does not serve as a justification for this type of programming. It only serves as an explanation as to why older athletes who practice the same training methods they utilized when they were younger tend not to see the same results or are more likely to over-train or burnout. You’re not going to be able to train an older athlete like a younger athlete. Older athletes have attained higher levels of mastery, thus they require different training approaches with more focus given to recovery and restoration. This is why consistently analyzing programs when it comes to exercise effectiveness is invaluable. If there’s not a good reason for doing an exercise, get rid of it. The human body has a finite amount of resources, why waste them on unnecessary training?

To illustrate this, Buddy Morris speaks of Bruce Lee and how people could not understand how he continually improved as a fighter, even as he got older. Bruce Lee simply got more specialized in his training, he tossed aside all the unnecessary work in order to be more directed. Bruce Lee was famous for saying, “Don’t fear the man with 1,000 moves. Fear the man with one move that he’s practiced 1,000 times.”

These thoughts and philosophies when it comes to the preparation of young athletes are not at all unique to GP. There is a growing number of coaches and trainers that share these same beliefs. We are simply doing our best to educate the public at large. The more we can help open people’s eyes and get them to understand the broader picture of athletic development, it will only provide more quality training services and allow people to see through the nonsense and marketing tactics.

 
More related reading:

https://gallagherperformance.com/why-specificity-in-your-training-plan-matters/

https://gallagherperformance.com/why-athletes-should-avoid-hiit-programs/

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

 

Athletes Do Not Need Balance to Be Successful

In the attempt to improve athletic performance or prevent sports-related injuries, it is common to read that muscles in the body should be balanced. At times, what “balanced” means is never fully explained and is often assumed to mean that muscles on both sides of a joint should be equal in qualities such as endurance or strength. As a result, trainers and coaches may advise athletes to perform equal training for musculature on all sides of a joint to ensure balance.

The intent is to achieve symmetry. Not just at one particular joint, but often throughout the body. The goal is to see symmetrical movement on both sides of the body. Consider how therapists and coaches will use movement-screening systems to evaluate movement and then apply correctives with the goal to ‘balance’ the body or to reduce the risk of injury.

However, one must question if this the most intelligent thing to do in relation to high-level athletic performance. 
From the few studies done on this topic and from observation, symmetry may not be an effective means of improving performance. Rather, It appears that the majority of high-level athletes are asymmetrical.

This should not be surprising if you have been looking closely at high-level athletes. I recently attended the ACA Rehabilitation Symposium in Las Vegas over this past weekend. Professor Stuart McGill was one of the featured speakers and he has extensively researched the factors which make great athletes great. Professor McGill provided numerous examples from cases he has seen over of the years of athletes being ruined by someone attempting to 'balance' their body. The intent was on improving their performance or ‘correcting’ movement, yet the end result was making that athlete a patient. Essentially, he cautioned us all as chiropractors, therapists, and trainers to be very wise in what we do with our athletes.

One example he provided was Olympic sprinters and how many of them have very stiff, tight ankles. He stated how this is necessary for their performance and ultimately their success as elite level sprinters. Their ankles must be stiff to serve as ‘springs’ for explosive running. Yet, as he stated, many therapists would want to ‘mobilize’ their ankles and ‘release’ or ‘stretch’ the musculature surrounding the ankle to improve range of motion. However, now you have robbed them of the very thing that makes them a great athlete in their sport.

His example brought to mind a high school football player who trains at GP. He is our fastest athlete and his ankles are incredibly stiff. This stood out immediately upon his initial assessment. Did we do anything to mobilize his ankles? No. We didn’t touch his ankles, understanding that his ankle stiffness is what made him fast. Made him incredibly agile and quick.

If you try to balance muscular development or joint function, it can potentially interfere greatly with an athlete’s performance. It’s important to remember that what makes athletes asymmetrical also makes them great. It is not only a consequence of their training, but often what their sport demands. To take time out of their training to balance their body arguably interferes with more productive training.

This does not mean that they do not do exercises to keep their body healthy and prevent injury. We have our athletes perform many exercises for this purpose, but they are typically done during the general preparatory period, not in the competitive or precompetitive periods.

Former Soviet Union sport scientists studied this concept. The Soviets understood that asymmetry appears to be a key to athletic success. Asymmetry that is produced appears to allow athletes to go above and beyond what other ”well-balanced” athletes are capable of doing. It seems that the asymmetry allows the athlete to perform on a higher level.

There appears to be enough evidence to indicate that perhaps we should not be anxious to 'balance' every athlete’s physical development. Keep in mind that this does not mean that you ignore development of antagonistic muscles. But you do not emphasize them to the same extent as you do with the main muscles and joints involved in the execution of the athlete's competitive sports skill.

More related reading:

https://gallagherperformance.com/athletic-development-will-your-child-be-a-success-or-burn-out/

https://gallagherperformance.com/does-practice-make-permanent-how-practice-rewires-your-nervous-system/

https://gallagherperformance.com/commonmistakesindevelopingyoungathletes/

Do You Really Need More Mobility?

Mobility is sexy and it sells.

Get your foam rollers. Get your PVC pipe. Get your stretch bands. Let’s get mobile!

Between mobility screens, mobility workouts, mobility tools, and mobility DVDs, there are plenty of opinions and products available for purchase.  The experts are convincing you of how crucial mobility is for health and performance, while doing their best to convince you to purchase their product.

Enough with it.

While some elements of mobility have merit, many of the approaches to mobility (warm-ups, DVDs, seminars, evaluation systems) are very general and cookie-cutter. A lot of it is unoriginal thought simply repackage and over-priced. Many of these products are not impressive. They are systematic programs that are easy to apply. It’s the classic, “If you see X, then perform Y” approach, providing correctives for movement errors and superficially removing a degree of critical thinking. No wonder the products are so appealing. Someone else has done the thinking for you, so just follow the instructions in the manual and you too can be an expert.

Mobility and movement so easy that seemingly anyone can be an expert?
What troubles me is the trend towards ‘simplifying’ movement, when movement is quite the opposite. Movement is complex. It should be recognized that once you add variables such as load or speed or vector/direction, movement changes. Most screens do not account for these variables and I wish more ‘experts’ understood this clearly.

One individual who has a unique, and truly expert, understanding of the complexity of movement is Stuart McGill. McGill is a spine biomechanics professor from the University of Waterloo. He has authored over 300 scientific publications that address the issues of lumbar spine function, low back injury mechanisms, investigation of the mechanisms involved in rehabilitation programs, injury avoidance strategies, and high-performance training of the back. He serves as a consultant to many medical management groups, elite sports teams and athletes, governments, corporations and legal firms. On top of all those responsibilities, he is often referred the most challenging back pain cases from around the world.

Professor McGill sees two patients per week, spending 3 hours with each patient. His evaluation is of paramount importance in relation to the success he has in treating his clients and athletes. The time he spends on evaluation is often significantly more than many providers spend with a patient on their first visit. As a chiropractor, I know doctors that see 15-40 patients a day and don’t have the time to spend on lengthy assessments. Quick and easy ‘systems’ or ‘assessments’ are exactly what many professionals in the fields of rehabilitation and fitness need.

But does ‘quick and easy’ ensure a thorough exam? Does it ensure all variables have been accounted for? Unfortunately, this is what many have to deal with, so 'quick and easy' is certainly better than no assessment at all. But keep it mind there is a huge limitation to operating in that fashion. This is exactly why my brother and I tailored the operation of GP to allow for the necessary amount of time for our assessments.

At GP, we do not perform general assessments. Every single assessment is personalized to the individual, modified to meet their objectives. What we perform during an assessment “depends” on the presentation in front of us. We understand that movement and the action of musculature is not always obvious. Muscle action will change depending on the movement task, having an effect throughout the entire body. Regarding the ability to recognize the muscular demands of movement, Professor McGill has said, “This is the transition point between a trainer and master trainer.” I’m sure he would say that this also separates a therapist and master therapist.

You will not find our approach in convenient DVD and PDF format, leading you step-by-step through our evaluation and corrective process. Why? The approach we take at GP is very difficult to teach and has taken years to develop through mentorship, experience and self-learning. Whereas, most movement screening systems have the advantage of being easy to teach.

Being ‘easy to teach’ is good for business. But is it the best service for our clients and athletes? Certification courses are designed to churn out new coaches or new trainers at a mind-numbing pace. You would be foolish to assume everyone walking away with a certification functions with ‘expert’ understanding. But that’s what they want you to believe since most attempt to position themselves as experts.

Moving beyond the initial assessment, continual re-assessment is a staple of the process at GP. Our approach focuses on continually assessing and fine-tuning the program as necessary. This is why mobility, like any ‘movement fix’, must be applied appropriately with a solid understanding as to why it's being applied.

Just because someone has a tight hip, doesn’t mean you should blindly advocate foam rolling and performing goblet squats.

Can’t maintain your arms overhead during an overhead squat?

Oh, that is totally caused by tight lats. You need some foam rolling on the lats and then band stretch the daylight out of those bad boys.

Heels come off the ground during the squat? Tight calves and limited dorsiflexion, right?

Let’s foam roll those calves and mobilize those ankles.

This thinking is widespread and too simplistic. In my opinion, it’s no different in application than simply telling someone to stretch because they are tight. Do you think it's superior or different because you applied a foam roller? Sure it may get results a percentage of the time, but often there are deeper underlying issues being missed. Let’s consider the following quotes:

“Soft tissue injuries result from excessive tension, so excessive tension in the rehabilitation setting is counterproductive…stretching of…chronically tight tissue is counterproductive. It may give an initial sensation of relief because the muscle spindles have been deadened, but this practice…weakens the tissue further because of the weakened proprioceptive response.” – Boo Schexnayder
“Stop trying to stretch and mobilize, let tissues settle and regain their proprioceptive abilities so they tell the truth.” – Stuart McGill
Movement Presupposes Stability
Rather than jumping to mobility, we frequently start the therapeutic or rehabilitative process with the emphasis on grooving motor patterns while building whole body and joint stability. Specifically, addressing proximal (core) stability. The musculature of the core is not simply your abs, but all the musculature that interconnects your spine, shoulders, and hips. There is tremendous linkage and interdependence between these key joints of the body. The inability to properly stabilize these regions of the body during movement will ultimately impact distal mobility. Distal refers to the extremities, aka the arms and legs and their respective joints (elbow, wrist, knee ankle, etc.).

As the saying goes, “Proximal stability for distal mobility.”
Through their studies, the Prague school of Rehabilitation has discovered/demonstrated that stabilization and movement are global (systemic) events involving the entire body.

One cannot move without first stabilizing, thus making the support function of the feet, hips, and core of primary importance before movement or mobility is considered.

To improve one's ability to stabilize during movement (AKA ‘dynamic stability’) one must not only train the muscles of the trunk, but also the support function of these muscles.

Dynamic Stability
Training dynamic stability is less about maximizing the loads that the athlete can tolerate and more about training (restoring) the ideal stabilization/movement patterns. Ideal movement patterns are more efficient, leading to increased performance and decreased risk of injury. This is the benefit of quality and efficient movement due to ideal support function.

So what are the consequences of inefficiency?

If you cannot stabilize with proper patterns, compensatory movement patterns dominate leading to hyperactivity of larger muscles groups. Hyperactivity of muscles will make them feel tight. You are going to feel tight. You are going to have restricted joints that are taking an unnecessary beating from the increased forces they are trying to handle. You are going to want to reach for that foam roller and mobilize all day long, but odds are you are going to do so without much success.

In other words, the majority of tightness and mobility issues are a secondary reaction to faulty stabilization patterns and poor support function of the musculature in the feet, hips, trunk, and/or shoulders.

Concluding Thoughts
While others say, "Smash those tissues" or "Mobilize that joint", we say learn to support and stabilize first. Truth is, if you are in constant need of using foam-rollers, tennis balls, and mobility drills, chances are your training is 99% to blame. You need to bring more balance (aka stability) to your body and get strong. It's amazing what can be accomplished when neuromuscular strength qualities, stabilization patterns, and synchronization of movement takes precedent over mobility drills.

This article was intended to challenge the current trend of thinking "mobility first" when it comes to movement-related problems. As mentioned previously, movement is very complex and to approach movement from a simplistic mindset arguably is not an ideal starting point. A thorough assessment, tailored to the individual, will ultimately provide the information needed to implement the most appropriate course of treatment and exercise.

For more reading on this subject, check out these related articles:

Why Stretching Won't Solve Your Tight Muscles
Dynamic Neuromuscular Stabilization: Advancing Therapy & Performance
Rethinking Tendinitis
3 Reasons You Should Train for Maximal Strength

The Importance of Functional Evaluation

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.

 

3 Ways Breathing Impacts Health and Movement

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.
Conclusion 
The importance of proper breathing patterns cannot be underestimated. Karel Lewit, MD, considered by many as the father of manual therapy and rehabilitation, stated, “If breathing is not normalized - no other movement pattern can be.” This statement demonstrates the concept of regional interdependence within the body, meaning all musculoskeletal function is interrelated. Regional interdependence helps to explain how simple breathing exercises can be used to improve joint mechanics, optimize muscle function, reduce injury risk, and enhance recovery.

Sources:
1. Lewit, K. Manipulative Therapy: Musculoskeletal Medicine. 2010.
2. Lum, L. Hyperventilation Syndromes. In: Behavioral and Psychological Approaches to Breathing Disorders. 1994

Finding a Solution to Your Shoulder Pain


 
"He who treats the site of pain is often lost."
- Karel Lewit

The purpose of this article is to provide some basic information about the importance of understanding the role posture and function have in pain and movement dysfunction. The hope is that you will gain an understanding of why your chiropractor or therapist must evaluate and bring into consideration issues that may not seem related to your pain.
When it comes to dealing with chronic musculoskeletal pain, the site of the pain is rarely the actual source of the pain. This concept is often missing or ignored in traditional North American treatment. Let's look at shoulder pain as an example. All too frequently the shoulder pain patient is provided an evaluation and treatment that is solely focused on the shoulder. Depending on the professional you see, the shoulder is typically treated with any combination of adjustments, passive modalities (ultrasound, electrical stimulation, laser), manual therapy, or shoulder exercises. If those fail, you may be referred for shoulder injections or you may become a potential candidate for shoulder surgery.

Notice the pattern? Everything is focused around the shoulder. That's where the pain is, so that's where my problem has to be, right? The same pattern can be seen with low back pain, neck pain, knee pain, etc. This seems like rational thought, but what if you, as the patient, do not respond? Does this mean that conservative treatment failed? Does it mean you need surgery? What if only focusing on the site of pain caused something very critical to a positive outcome to be missed?

Looking Beyond the Shoulder
Czech physician Vladimir Janda likened musculoskeletal pain and dysfunction as a chain reaction, thus stressing the importance of looking beyond the site of pain for the source of pain. Janda observed that due to the interactions of the skeletal system, muscular system, and Central Nervous System (CNS), dysfunction at any one joint or muscle is reflected in the quality and function of joints/muscles throughout the entire body. This opens the door to the possibility that the source of pain may be distant from the site of pain.

Janda also recognized that muscle and connective tissue are common to several joint segments; therefore, movement and pain are never isolated to a single joint. He often spoke of "muscular slings" or groups of functionally interrelated muscles. Muscles must disperse load among joints and provide stabilization for movement, making no movement truly isolated. Meaning shoulder movement does not occur only at the shoulder, but is dependent upon the function of the spine, rib cage, pelvis, and even the ankles. For example, trunk muscle stabilizers are activated before movement of the upper extremities begin; therefore, shoulder pain can be caused by poor core stabilization.

Hopefully you are coming to realize that while you may have pain in a specific area, it's not always the cause of the pain. Going back to the shoulder, a 2006 study that reported 49% of athletes with arthroscopically diagnosed posterior superior labral tears (SLAP lesions) also have a hip range of motion deficit or abduction weakness. This illustrates a key point. How often do you see shoulder pain/dysfunction treated by correcting hip mobility and stabilization patterns?

Outside of glenohumeral joint range of motion and rotator cuff endurance/strength, has your shoulder evaluation included any of the following items:

#1 - Breathing Pattern
The average person will take close to 20,000 breaths per day but until recently the impact breathing has on movement and dysfunction has been largely ignored. Proper breathing certainly provides great benefit to athletes and individuals who display a variety of movement dysfunction.  Neurologist Karel Lewit said, “If breathing is not normalized, no other movement pattern can be.” Understanding the impact proper breathing has on the body and how to restore ideal breathing patterns is critical in both athletic development and rehabilitation.

#2 - Thoracic and Cervical Spine Function
Spinal posture lays the foundation for shoulder function. Improper function of the thoracic (mid-back) and cervical (neck) areas of the spine will compromise the function of your shoulders. Imagine the spine as a series of cog wheels, movement in one area will impact all areas. This is visualized in the picture below:



Regardless of whether they are sitting or standing, the majority of people tend to fall into a posture very similar to what is seen on the left. Increased kyphosis of the thoracic spine (rounded mid-back) is a major reason for forward head posture and rounded shoulders. There are seventeen muscles that attach to the shoulder, many of them influencing the position and movement of not just the shoulders, but spine as well. Shoulder function is dependent on proper spinal posture and without correction of spinal posture, the shoulders don't have a fighting chance to stay healthy.

#3 - Mobility of the Opposite Hip and Ankle
The importance of looking at hip mobility was emphasized previously, but let's also consider the ankle. This ankle becomes of particular importance when dealing with overhead throwing athletes. Dysfunction at the ankle will alter mechanics up the kinetic chain and place undue stress on the shoulder and elbow. Correcting any muscular tightness or poor joint movement of the ankle sets the stage for ideal throwing mechanics and the prevention of shoulder injuries.

Closing Thoughts
Despite focusing on shoulder pain, many of these concepts hold true for any type of chronic musculoskeletal pain. Before abandoning all hope or 'learning to live with the pain', consider that being evaluated by a professional who will look beyond your site of pain could be the solution you have been looking for. That's why these concepts form the foundation of the examination and treatment process at Gallagher Performance.

3 Reasons To Train for Maximal Strength

 

 

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.

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.

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.

Drop the Confusion, Athletes Need Consistency for Efficiency



What you need to know:

  • Neural efficiency is the key to becoming a better athlete, this is known as athletic mastery.
  • Mastery requires time, intelligent programming, hard work, and dedication to consistency. 
Consistency Matters
The primary goal of any athletic and strength development program should be neural efficiency. Fact of the matter is the nervous system controls and coordinates every movement and every function in your body. The nervous system thus is the regulator of strength and movement coordination. This is why ALL successful athletes have periodization implemented into their programming. Periodization is a fancy word for structured, intelligent programming to address individual needs.

Any athlete that has reached elite status in their sport has used periodization to address their needs and to ultimately promote positive, long-term adaptations from the learning of repeated actions by the nervous system. One observation that can be made of such programs is how little they seem to change or when a change is implemented, it follows a progression based on what the athlete is displaying or what they are capable of from day-to-day, week-to-week, or month-to-month.

Don't Let Fitness Trends Confuse You
Programs and/or trainers that endorse 'muscle confusion', randomized daily workouts, or continual change to exercise without following proper programming will always fail to develop an efficient nervous system. Sure for the ADD crowd and those that get bored easily, this appeals to you. Or maybe you are that person obsessed with 'fitness' and have become convinced workouts of this manner are the Holy Grail. If you are one of these people, be my guest. That's your choice. This article is specific to athletes and those that want to see consistent, sustainable results from their hard work. Not to simply have a workout entertain them.

Randomized workouts may sound interesting, even cool. The marketing placed around these workouts will spin words and science to make them appealing to the masses. Ultimately the end result is not allowing the athlete or individual to properly adapt to their training and achieve mastery.

How can adaptation and mastery be a bad thing when you want to improve? Want to be great?

Mastery is the Goal
For many, the frustration with mastery is it requires time. A lot of time. Mastery is a long-term process. This is exactly why great coaches and great athletes stress fundamentals at any level, from 7 year olds all the way up to the professional ranks. Think about it. Coaches don't just go through random drills at practice and if they do, they likely don't last long or frankly shouldn't be coaching in the first place. Fundamentals are reinforced because the better an athlete is at the fundamentals, the greater chance of success they will have when performing more complex sport skills.

Mastery is a grind. Its prerequisites are consistency and discipline. Mastery takes years to develop and this becomes a problem when the fitness industry wants to sell a 'quick fix'. And most Americans want that 'quick fix'. They want results now, not later. They don't want to put in years of work when they see programs that advertise how they can 'get ripped in 60 days' or 'get faster in 4 weeks'.

That's a Wrap
Athletes should recognize that their goals will not be solved with today's latest fitness trend. The only way to achieve mastery is through consistent, focused effort to become efficient in all fundamentals and sport specific skills. The message should be clear. At GP, this is something we feel strongly about and want to provide you with the information needed to make the best decisions for your goals. Mastery and efficiency are critical to the athlete and we addressed the importance of that in this article.

Is your training program allowing you to develop the mastery needed to achieve your goals?