Staying Sharp

Highlighted Section of Book

 

Over the past few weeks, I’ve had some time to try and sharpen my mind.   While I’ve looked at numerous topics, much of my effort has focused on the assessment of movement and correction of errors.  It has really made me evaluate a lot of things that I have learned previously.  While I’m certainly not ready to throw out all of the “old” things that I have done, I am going to try to find ways to integrate some new things with my clients.  This is largely because I have gained a better understanding of how everything in the human body works together.  Even as an ATC, we tend to focus on the location of the pain and don’t always look far enough past that.  I’m really glad that I’ve had a chance to spend some time on this topic.  In the next few weeks, I’ll be getting back to posting more often.  I’ll also be discussing more about what I learned and the resources that I read and watched.

Mark

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Lower The Injury Rate By Strength Training

Weights Pic

Strength training helps to prevent injuries.

 

What is the most important function of a strength training program?  To get stronger to perform better?  To get faster?  To be able to jump higher?  Guess what?  It’s none of these.  The most important function is to help prevent injuries. I’ve mentioned this many times before in my other posts. Here’s a doctor who is delivering the same message.  It’s a short read but worth your time.  You can share it with others to help teach the importance of strength training for young athletes.  I hope that you enjoy it.

Mark

 

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An Ounce of Prevention for Ankle Injuries

Ankles Pic

If you’re an athlete, you need to keep your ankles healthy.

Often I hear athletes mention that they have “weak ankles”.  My guess is that the problem isn’t so much “weak ankles” but an initial ankle sprain injury that was never given a chance to fully heal and be fully rehabbed.  I don’t doubt that some people are born with weaker ankles than others, much like some people are born faster than others or stronger than others.  The thing is, many athletes don’t seem to take the time to strengthen their ankles.  One way to help with this is to work some exercises into your training program.  I like to find ways to incorporate them into the warm up when possible.  This allows you to use them to help get the body ready for the training session while also doing some prehab or rehab work for the athlete. Most of the activities are fairly easy to do.  Here are some ideas:

  • Walks – These include variations of normal walking.  By putting the feet in unusual positions, you are forcing the ankles to adapt and become stronger.  So what types of “walks” are there?
    • Toe walks
    • Heel walks
    • Toes pointed in
    • Toes pointed out
    • Inside edges
    • Outside edges

I usually have the athlete begin with 10 yards of the first four types of walks. Over time I progress them to 20 yards.  I generally substitute the inside/outside edge walks for the toes in/out every other workout.

  •  Line Hops – These basic plyometric hops can help the ankles get used to landing in various positions.  It is another great and easy activity to help strengthen them.  These can be worked in as part of a warm up or as part of the actual training program.  To do them, simply pick a line on the ground and hop over it. The jumps don’t have to be high but should focus on getting back and forth over the line as fast as possible.  The athlete should begin using two feet to hop and then progress to one foot hops.  They can be done for reps or for time.  The hops should be done in multiple directions:
    • Laterally
    • Forward-back
    • Diagonally
  • Moving Hops –  Moving hops are all done over a distance and on one leg.  This makes them more difficult than line hops.  I usually have athletes start at 5 yards per foot and progress to 10 yards.  Here are the variations.  They should be done each direction on each foot.
    • Forward
    • Backwards
    • Right
    • Left
  • Single Leg Balance Drills –  These drills are conducted while standing on one leg while on an Airex balance pad.  Here they are in order of difficulty.  (Note – the drills should be done on flat ground first before progressing to the Airex pad).
    • Standing –  The simplest drill is to stand on one foot and balance.  This should be done for 10 reps of 10 seconds each.
    • Arm drills – One variation is to combine balancing on the pad with arm drills. This creates more body movement which increases the stress on the ankle joint.  I usually have the athletes do 20 reps with their arms but they can also do them for time.
    • Squats – While I’m not sure that I would have an athlete attempt to do a full one-legged squat on a pad, I think that partial squats are fine.  I usually have athletes complete 1-2 sets of 10 reps.

These are just a few ways that I have found to include ankle work in a training program.  In encourage you to try them and to create your own variations. There are certainly many other great ankle exercises including using exercise bands and training in the sand. While I’m also a big advocate of both of these, I prefer to use many of the examples I gave above instead.  Many of them have other benefits besides just helping to strengthen the athletes ankles (ex. – plyometric benefits).  Give them a try.

 

Mark

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Injuries Happen

marcus lattimore pic

Marcus Lattimore, Running Back for The University of South Carolina

If you keep up with sports, there’s no doubt that you heard about the injury to Marcus Lattimore this past weekend.  While I’m not a South Carolina fan, I loved watching him run the ball.  Even though he was coming off of ACL surgery last season, he was still a  great back with an incredible future in front of him.  While I’ve never met him, a lot of people have great things to say about him as a person.  I’m one of many people who is hoping a praying for a full recovery for him.

Now comes the really unfortunate part of things.  I’m sure that Lattimore lifted, ran, conditioned, rehabbed, and did everything else that he should have done to be 100% healthy and to prevent any type of injury.  I’m sure that his ATC’s, PT’s, and S&C Coaches did everything they could to prepare him for the physical demands of playing football in the SEC.  The unfortunate thing is that no matter how good of a job we all do to prepare the athlete, not every injury is avoidable in sports.  One of the major purposes of a quality strength and conditioning program is to help prevent injuries.  Unfortunately, we can’t prevent all of them.  Lattimore is a prime example of this.  He has suffered two knee injuries in the last two seasons. Both were contact injuries and I’m not sure that either could have been termed as “preventable”.

I had a discussion with one strength coach recently about this very topic.  He was frustrated because several of his athletes had recently had season ending injuries.  He knew that the kids worked hard in the off-season and he hated to see them have significant injuries.  I pointed out to him that no matter how good the program, sometimes injuries just happen.  Unfortunately, they are a part of sports.  I know that this didn’t really cheer him up, but I felt that it was accurate.

Of course, his feelings on the issue are a great example of how Coaches, Athletic Trainers, etc feel about their athletes.  We all want the very best for every athlete that we work with.  We want them to excel on the field, in the classroom, and in life.  We also want them to stay healthy.  When they don’t, we all take a look at the situation and wonder if there was more that we could have done or if there is more that we can do to get them well quicker.  That’s the nature of a good coach and a good person.  It’s also what fuels the fire for some strength coaches to never stop searching for a better way.  Because yes, injuries do happen in sports.  However, that doesn’t mean that we should just accept that fact and stop trying to eliminate all of the injuries that we can.

Mark

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Concussion Prevention For Football: Strengthening The Neck

Football Tackle Pic

Is this a concussion happening?

Concussions In Football

One of the hot topics in sports medicine the last few years has been concussions.  It seems that every where you turn, concussions are being discussed.  Many articles and news stories have been run covering all aspects of concussions – testing, treatment, prevention, even the possible limited lifespan of American football as we know it.  One idea that has received some mention is the concept of neck strengthening to help prevent concussions.  Since football season is underway, I thought that I’d address this topic.

Why is neck strength important?

Almost any type of impact in sports can cause a concussion.  These impacts can come from other players, the ground, or even a ball.  We usually think that you have to get struck in the head to get a concussion.  That’s not entirely true.

Youth Football Tackle Pic

Even a blow to the body can cause a concussion if the forces are great enough

Anything that causes a sudden movement of the head can cause the brain to accelerate inside the skull.  Of course, after it has accelerated, it strikes the inside of the skull which causes a concussion. Having strong neck muscles can help to limit the dramatic forces that can take place when struck in the head or elsewhere.  While not all concussions can be prevented, anything that we can do to keep the head more stable should help to decrease the chance of getting one.  Years ago, I was taught that it was important for football players to strengthen the neck to prevent neck injuries.  It’s also an important to part of concussion prevention.  Some college football programs have placed a renewed emphasis on neck strengthening.  Has it helped reduce concussions?  Several of these colleges have reported about a 50% decrease in concussions.  While these weren’t scientific studies, I think that  we should all take note and realize that include neck training in the programs for our teams.

What To Do

So, what should you do to train the neck?  You should focus on exercises that work the neck in six directions:

  • Flexion
  • Extension
  • Lateral Flexion (right & left)
  • Rotation (right & left)

These exercises should be done twice per week for 2-3 sets of 10.  If you have access to one, you can use a 4-way neck machine for everything except the rotation movements.  Other possible methods to complete the exercises include:

  • Manual resistance (individual or partner)
  • Resistance with a towel (individual or partner)
  • Resistance with an exercise band (individual or partner)
  • Neck Bridges

While it is important to train all of these specific neck motions, you must also train the trapezius muscle.  The trapezius helps to extend the neck and can help to add stability if it is strong.  The best exercises to use are shrugs and upright rows.  These exercises should be included twice per week also.  Shrugs can be done for 3-5 sets of 5-10 reps.  I usually keep upright rows to 3-4 sets of 8-12 reps.

One more thing that can be done is to add in some perturbation movements.  Many times in football, an athlete doesn’t see a block or hit in time to prepare his body for the impact.  These movements can help  improve neck stability during these unseen impacts.  To do perturbations, have an athlete in a seated position with their eyes closed.  Their neck should be held in a neutral position.  Have their partner suddenly but gently push their head in random directions.  The athlete should respond to the push by attempting to stop the head motion using their neck muscles.  I would suggest doing one set of 20 repetitions.

I have always believed in training the neck to prevent neck injuries.  With the  rash of concussions that seem to be happening in football, it has become even more important to train these muscles.  Make sure to find time in your program to include these exercises.  I know, none of us ever have enough time to fit everything in our strength programs.  Now there’s one more thing to include?  Just remember, while it may be important to do the bench, squat, clean, etc,  there is nothing more important than preventing potential injuries.  Make neck strengthening a priority in your program.

 

Mark

P.S.  While the info in this post was related to football, it applies to many other sports also.  The same program can be used for athletes that play soccer, lacrosse, and many other sports.  It can be especially vital for females to strengthen their necks.  Experts in concussions have begun recommending neck strengthening for females after realizing that they tend to have less neck strength than males.

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Help For The ACL: Correction Of Poor Landings In Volleyball

Beach Volleyball Pic

More on the ACL

While writing my last blog post on landing mechanics and ACL injuries, I came across a study by Parsons & Alexander that was recently published.  The study attempts to discover if the use of one video coaching session can help to make positive changes in the landing mechanics of volleyball players.  I encourage you to read more about this study on modifying landing mechanics.

Here is a quick summary of the volleyball study:

The researchers took video clips of volleyball players completing a spike jump/landing.  They used Dartfish software to give the girls immediate feedback and also to analyze the results in further detail.  They measured numerous angles related to landing position at ankle, knee, hip, and torso.  The researchers found numerous improvements resulted short term from their video & verbal feedback.  While there were some decreases in the results during the 4 weeks prior to retesting, several of the variables maintained a significantly positive improvement.  Basically, the one feedback session did help the volleyball players to make and maintain positive improvements.

So, what are the take home points?

  1. Video can play a huge role in helping your athletes to make improvements.  Remember that some people are visual learners.  Using video can help them to truly understand what you are saying to them in your verbal coaching.
  2. The athletes were able to maintain some of their improvements over 4 weeks.  What if there was to be more of an emphasis on the changes in landing mechanics?  What if they took 15 minutes a week to focus on them?  What if they received visual feedback multiple times with constant verbal coaching everyday?  I’m sure that the results would be more significant.  As they say, “practice makes perfect”.  What would this do the the number of torn ACL’s in volleyball?  I’m sure it would decrease it dramatically.

Here are two other things worth reading:

More of my thoughts on ACL tears in volleyball

Predicting A Torn ACL?

More info on the importance of video analysis:

Wired UK Article on Dartfish 

Mark

Contact us for info on how we can provide a landing assessment for your athletes.

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How Important Is Landing In Preventing ACL Injuries?

Drag Racing Pic

No question that it will go fast. But how does it stop without crashing?

I have previously written about the role of a proper landing in the prevention of ACL injuries.  I thought that I would expand on that somewhat.  We often think about landing playing a role in basketball and volleyball injuries.  I’ve also had it happen to athletes playing football, soccer, and lacrosse.  If we take time to carefully evaluate our athletes, many of them in all sports display poor landing mechanics.  This can put the knee into an awkward position and can cause extra stresses to be placed on the ACL.  Since an ACL reconstruction generally keeps an athlete out of action 6 months, anything that we can do to help prevent these injuries can be huge for our athletes.

So, what can be done to help?  We often get into a hurry to get kids running and jumping too fast.  In my mind, when car gurus design a newer, faster car, they make sure to spend plenty of time designing and testing the braking system before they take the car on any test runs.  It should be the same with athletes.  We need to test and train the braking systems before we go crazy with the jumping and running.  The simplest way to help your athletes is to teach them how to land properly.  Now this isn’t just a 5 minute drill that you do once and never repeat.  You have to emphasize landing every time that you do a jumping drill.  We all want to see how high or how far the kid jumps.  However, it’s probably more important to watch how they land.  Yes, you should try to watch and coach everything.  Just make sure that you are putting emphasis on the landings.

Want to see the effect that proper landings can have?  Myers and Hawkins published a study in 2010 that looked at changes in tibial shear forces when they worked on landing mechanics.  They found a 56% decrease in forces when the emphasized proper mechanics.  The athletes that they worked with also increased their vertical jump about 2.5 cm.  The only negative was the fact that the athletes tended to revert to their old habits once they got tired (see this article on knee landings which discusses the study further).

I think that a 56% decrease in forces could make a huge difference in ACL rupture prevention for athletes.  Because of this, make sure to emphasize it during your training.

So how should the athletes land?

  1. Should land on their toes
  2. Keep their knees flexed
  3. Keep their head/shoulders up
A good way to check on their landings is to listen.  The athlete should “land softly”.  If you hear a loud landing, it’s a good sign they they landed on their heels and probably had their knees straight.  This type of landing puts too much force through their ankles, knees, and hips.

As for how to limit the return of bad habits once your athletes get tired, I have two suggestions:

  1. Repetition, repetition, repetition
  2. Make sure to do some of the landing training when the athletes are tired.  We all get sloppy when we are tired.  Putting them into this stage for some of the training will give you a chance to show them what happens and then correct it.

Happy Landings,

Mark

 

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Why Junction Boys Syndrome Still Exists

The May issue of the Journal of Strength & Conditioning Research has an excellent article called “The Junction Boys Syndrome”.  The syndrome title is based on the book and movie called “The Junction Boys”.  These both tell the story of the year that “Bear” Bryant took over as head coach at Texas A&M.  He took his players off-campus for a brutal pre-season camp.  Numerous players were injured and/or quit the team during the camp.

The article by Scott Anderson discusses the fact that modern football “training regimens are too often built on tradition versus based on science and place players at-risk”.  He then gives us information and facts about the 21 nontraumatic deaths in NCAA FBS football since 2000.  Sixteen of these deaths occurred during strength and conditioning activities.

Is Anderson right?  Yes,  Are many of these deaths caused by the “tradition” of intense work making tougher and better football players?  Unfortunately, yes.  Why is this?  There are numerous resources available to help people design safe and effective training programs.  There are also qualified Strength & Conditioning coaches to design and implement the programs.  We even have Certified Athletic Trainers who can help monitor athletes for signs of medical problems during workouts and then care for them if necessary.  So why do we still have deaths?  I think that there are three main reasons:

  1. Influence of the Football Coaches – The S & C world is full of stories of sport coaches dictating how they want the strength and conditioning program run.  While some of this has to do with trust and respect, if the S & C Coach is qualified and competent, let them do their job.  If they aren’t qualified and competent, then hire someone who is.
  2. The “I’ll Make You Puke Mentality” – While I understand the get tough mentality, I think that if a S & C Coach uses puking as the goal for the workouts that he designs, it’s sad.  With all of the research and knowledge at our disposal, there should be a better goal that they can come up with.  Vern Gambetta has discussed his thoughts on work and makes a good point “…puking at the end of a workout is not the measure of a good training.”
  3. Tradition – It is true that in some instances, football training is still in the dark ages.  Top this with the fact that there are still numerous veteran coaches who believe in doing things traditionally, and it leads to problems.  New research is published all of the time to help show what works and what doesn’t.  S & C Coaches should constantly be trying to learn and use this knowledge to make their programs better.  As for the football coaches, see #1 above.

Should we still have nontraumatic deaths during football training?  No.  The last thing that any of us want is for one of our athletes to die due to the training program that we have designed and overseen.  Scott Anderson ends his article by saying that it is time for these deaths to stop.  I don’t see how anyone could disagree.

Mark

P.S. If you want to know how we believe that training should be, click here to find out Sports Upgrade

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Predicting A Torn ACL?

I spent this past weekend at a volleyball tournament.  Most of the players were 12 – 14 years old.  With so much volleyball to watch, I tried to use it as a chance to gain a better perspective of the sport.  I was trying to look at it from both an ATC viewpoint and a strength and conditioning one.  I made several observations, some of which I’ll post later this week.

Today I thought that I would discuss the one that stood out the most.  One team had a player that I feel is a recipe for a future ACL injury.  First off, I hope that I’m 100% wrong.  Now for the facts.  The girl was already wearing a knee sleeve on one knee, and probably not by coincidence, she had a bad habit of landing only on that same leg after a jump.  She was also somewhat overweight.  Now, please don’t read too much into the fact that I said that she’s overweight.  I don’t believe that fact itself guarantees a torn ACL.  I do however believe that it could contribute if other factors are present.  My major concerns revolved around her landing mechanics.  While I don’t know the girl or her medical history, I would guess that poor mechanics have led to previous knee problems.  My question is this:  has anyone else realized this?  Have her coaches noticed during the endless hours of practice and games?  What about her doctor, assuming she saw one about her knee?  The next question is when will they work on her landing mechanics?  We all know that poor landing mechanics lead to bad things, especially for female athletes.  Unfortunately, the first time this gets addressed may be in rehab after an ACL repair.  The sad thing is that a good jumping / landing program might be able to lessen the chance of a serious knee injury ever occurring to this girl.

Mark

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