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The Benefits of Performance Therapy


For those of you that are familiar with Gallagher Performance, you understand the importance we place on the integration of our sports training, chiropractic, massage, and manual therapy services. We feel this model allows for optimizing sport-based outcomes while keeping our athletes healthy and ready-to-train. The model is not completely unique, as chiropractors, therapists, physical medicine providers, and strength/physical preparation coaches are collaborating in similar models to better serve their clients and athletes.

With that in mind, one frequently asked question we receive is,
"How are these services different from sports medicine care I can receive from a physical therapist or other specialist?"
The concept of what is commonly referred to as ‘Performance Therapy’ can be seen as a unique and completely separate approach from traditional sports medicine or physical therapy. To illustrate this, here's a quick look at a comparison of the mindset behind sports medicine and performance therapy.

Traditional Sports Medicine
  • Reactive approach to sports injuries
  • Therapy and rehabilitation focused
  • Emphasis placed on passive modalities, manual therapies, manipulation, therapeutic exercise
  • Tissue-specific
  • Patient-centered
  • Occasional focus placed on "injury prevention" strategies
  • Primary goal is the return to training or sport abilities prior to injury
Performance Therapy
  • Proactive approach between coach, athlete, and doctor/therapist
  • Focus is on mechanical efficiency for skill acquisition and motor learning
  • Continual "tweaking" to optimize performance
  • Manipulation and manual therapies used for facilitation, to enhance the process of building mechanical efficiency
  • Skill-specific
  • Athlete-centered
  • “Injury prevention” is a by-product of the process
  • Primary goal is to enhance sport performance
We are very fortunate to have a skilled and knowledgable team of therapists and coaches working at GP. The dynamic created between therapist and coach allows us to not only screen each client and athlete prior to all training programs, but to also carefully watch their movement during each training session. The goal is identify specific movement qualities that could potentially have a negative impact on sport-specific movements, the acquisition of new skills, or injury prevention methods. This approach continues throughout the duration of the training program and allows movement dysfunctions to be addressed before they lead to greater issues.

Performance therapy becomes not just about normalizing function or "returning to sport", but optimizing the function of the athlete and "enhancing performance". Therapeutic intervention (or "treatment") occurs as needed during training sessions. This can include the use of a variety of exercises to improve stability/mobility or techniques that activate the nervous system to improve movement coordination. Regardless of the intervention, the goal is for athlete to adapt and improve more quickly than if training and treatment were approached separately.

The transition between training and treatment must be seamless. When it comes to performance therapy, we have noticed the following goals are achieved:
  1. Greater Body Awareness. By integrating the appropriate intervention into the training plan, there is an effect on motor control that generates greater permanence on a neurological level. Basically meaning the athlete masters new movement skills faster. The instant feedback from treatment allows the athlete to provide the coach or therapist with an understanding as to how they feel/move during training. Coaching the athlete thus becomes more specific, allowing them to learn and improve quickly.
  2. Optimization of the Training Session.  Performance therapy integrated with training typically involves a lot of “tweaking” in order to meet the demands of the athlete. It provides the framework to keep athletes performing at their best more consistently. Several athletes receive some type of treatment or practice regeneration/recovery methods prior to competition. So why would they not receive similar interventions during an important training phase?  Both serve the same purpose to optimize performance.
  3. Improved Monitoring of the Athlete. Performance therapy provides additional information on the readiness of the athlete to train. Both the therapist and the coach use this information to make educated decisions regarding the details of each training session, allowing for true customization of your training plan. It’s important that athletes are monitored for how well they have recovered between training sessions so you know how hard to push them. Also, athletes tend to have the ability to 'hide' things very well. Being able to identify slight differences in muscle tightness or movement abnormalities not only will allow us to make better decisions about the training session, but also help prevent more serious matters such as injury or overtraining.
Keep in mind that performance therapy is not intended to create athletes who are dependent on this model, but rather athletes who are held more accountable in the pursuit of their own goals. The coach or therapist is provided with the information needed to recommend the most appropriate "homework" for the athlete, such as foam rolling specific muscles, mobility or stability drills, and the use of recovery methods. Furthermore, performance therapy is not intended to serve as a replacement for other forms of therapy. It is not simply moving the treatment room to the training room. Even though the goal of performance therapy is to reduce the amount of time spent on treatment and return to sport measures, there is a time and place for other medical and/or alternative interventions that should be understood and respected.

Closing Words
Both sports medicine and performance therapy are necessary components in the health and performance of athletes. Failure to integrate therapy in a complementary manner can be a mistake. Without performance therapy there tends to be an increase in reliance on other forms of therapy that stress rehabilitation and recovery.

In sports, the term "game changer" is often used to describe an athlete or action that results in a successful outcome that changes the course of a game. The same can be said about performance therapy because of its ability to play an invaluable role in an athlete's development. If you've been experiencing lack of results or just can't seem to stay healthy, performance therapy may just be the "game changer" you have been looking for to improve your abilities as an athlete and GP is where you can find it.

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athlete athletics chiropractor coach exercise injury movement performance performance therapy program quickness recovery speed sports sports medicine strength therapy treatment

3 Simple Steps to Reduce Your Risk of Sports Injuries

The Problem
Youth, high school, college, and professional sports continue to rack up thousands of injuries each year. Despite advances in areas of sport such as equipment, coaching, and player safety guidelines, injury rates are not decreasing. In fact, many sport-related injuries have increased dramatically over the last decade, with a sharp rise in youth sport injuries as evident by some alarming statistics:

  • High school athletes account for an estimated 2 million injuries and 500,000 doctor visits and 30,000 hospitalizations each year.
  • Overuse injuries are responsible for nearly half of all sports injuries to middle and high school students.
  • Since 2000, there has been a fivefold increase in the number of serious shoulder and elbow injuries among youth baseball and softball players.
  • According to the CDC (Centers for Disease Control and Prevention), more than half of all sports injuries in children are preventable.
With those numbers in mind, let's look at football injuries since they alone account for over 500,000 injuries per year, twice as much as any other sport. More than half of all football injuries are to the lower extremity and roughly 67% of all football injuries are sprains/strains. Several injuries occur at the joints, especially the shoulders and knees. Many of these often require surgery and potentially have career-ending and/or lifelong implications.

The Solution
While injury is an inherited risk of participation in sport, there are steps that can be taken to reduce the risk of serious injury and to give athletes the best chance of a rapid and complete recovery when injuries do occur. Again, consider that more than half of sport-related injuries are deemed preventable. As with any health issue, prevention should be of primary importance. With that in mind, let's look at a few simple steps to reduced your risk of injury.

#1 - Movement Screening/Assessment
Many injuries are preventable with movement pre-screening that is designed to identify musculoskeletal asymmetries and weaknesses that are known to increase the risk of injury. Ideally, movement screening is performed before the season begins. These movement assessments are utilized by several professional and collegiate sports teams and are proving to be an asset in their ability to keep athletes healthy.

How?

They provide a starting point for implementing specific exercises and routines to bring structural balance back to the body. Don't make the assumption you or your young athlete is 'ready' for the season without any objective evidence that there is work they need to do. This is exactly why you will hear the advocates of movement screening say, "Assess, don't assume."

#2 - Intelligent Strength and Conditioning Program
Once your weaknesses and imbalances have been identified, it’s important that you find someone in your area who is capable of addressing them through intelligent programming.  If you’re injured, it’s more than likely that you have developed compensation in your movement that contributed to your injury. These compensation patterns are typically best handled with an appropriate combination of strength training and corrective exercise. The combination is key. Corrective exercise is not the only means of approaching imbalances in the body. Many people fail to appreciate that appropriately applied strength training has the ability to be corrective on its own.

Furthermore, if you are injured, finding someone who has a firm understanding of functional anatomy, how it relates to your injury, and how to train around your injury while still addressing your weaknesses can prove to be the difference in making a speedy recovery. After all, you don't just want to return to your sport, you should want to return better than you were before.

#3 - Appropriate In-Season Program
This point can't be stressed enough, as too many athletes tend to slack off during the season and don't place a priority on maintaining adequate strength, mobility, and neuromuscular control of their body. Basically, they don't pay as close attention to the little things as they did during the off-season. There can be any number of reasons for this, but if staying healthy is important, you must find the time. This becomes evident when you consider that 85% of non-contact ACL injuries occur mid-late season. Other sport-related injuries also have greater frequency of injury as the season progresses.

Appropriate in-season training is intended to provide lower volume and frequency of strength training while continuing to address injury prevention and recovery methods. To complement in-season training, services such as chiropractic and massage therapy can be implemented to restore structural balance and function to the body. This provides a solid template for keeping sport performance as high as possible throughout the season. Plus, athletes are able to enter the next off-season close to peak performance, rather than spending weeks or months returning to their previous form.

That's All Folks
Injuries are part of the nature of sport and, unfortunately, completely preventing injury is an unrealistic expectation. Despite that, the risk of injury should not be taken lightly by parents or athletes when the risk of serious injury can be greatly reduced by taking appropriate steps as outlined above.

For those of you in the Greater Pittsburgh area, this approach to keeping athletes healthy and performing at their best is available at Gallagher Performance. These services are not exclusive to athletes, but are available to all individuals who enjoy being active and wish to take a proactive approach to staying healthy.

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assessment athlete chiropractor injury massage therapy performance recovery sports injury therapy treatment

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.

 

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assessment athlete athletics chiropractor DNS exercise functional hamstring injury movement performance program recovery sprint strength treatment

Not All Trainers Are Created Equal

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

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

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

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

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

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

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assessment coach injury nutrition performance trainer training

Suffering From a Recent Back Injury?



Back injuries are not rare. Unfortunately, back pain will affect most people and interfere with their daily routine at some point in their life. To combat this issue, many people feel it is necessary to maintain a 'flexible' back.

According to research performed by Dr. Stuart McGill, professor of spine bio-mechanics at the University of Waterloo, statistics show that individuals with more 'flexible' backs are more likely to get injured. The joints and muscles of the hips and shoulders are designed for movement. The muscles of the torso and back are designed to prevent or stop movement, maintaining a stable back and preventing excessive range of motion. A stable back provides the platform to generate movement and transfer force/power.

This information demonstrates the importance of teaching athletes and clients how to maintain the control of a stable torso/back during movement. Any area of the body that lacks proper stability/control will compromise movement and increase the risk of injury.

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adjustment chiropractor injury program recovery therapy treatment