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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Throwing Curveballs?

Little League Pitcher Pic

Is his arm in danger?

The 2012 Little League World Series ended yesterday, with Japan winning impressively.  Of course, with youth baseball always comes some debate about arm injuries.  Should young pitchers throw curveballs?  Should the pitch be banned in Little League?  Do pitchers throw too much?  Are neither of these factors to blame when a pitcher gets hurt?  Are both of them to blame?  It’s always interesting hearing the different sides of this issue.  Let’s look at a few facts:

  • Breaking Pitches – Many people place the blame for arm injuries on kids throwing curveballs.  Is this really a factor?  There is evidence that certain pitches (especially sliders) can place more stress on the elbow joint.  There are some who believe that the curveball argument is valid, and some that don’t.  In my opinion, while the curveball may not be fully to blame, it certainly isn’t helping things.
  • Round and Round –  Is year round baseball to blame?  It certainly seems to be a factor.  In my opinion, a major factor.  Kids need a chance for their arms to rest and recover.  They can’t do that when they play baseball (or softball) 10+ months a year.
  • Keeping Count – Do pitch counts help?  Most youth baseball leagues have some form of limit on how much a player can pitch in game and in a week.  These are steps in the right direction.  They also need to be in place since some youth coaches probably are less concerned about the long-term health of their players than they should be.  However, a short term limit on pitches may not solve all of the problems.  One study of MLB pitchers recently showed that the cumulative effect of high pitch counts affects the pitcher long term more than one outing may affect them in the short term.  This ties in with the whole year round argument.
  • Well Hello Tommy John – The number of “Tommy John” surgeries to repair elbow ligaments has risen dramatically in recent years.  This surgery used to rarely be done for young athletes.  Not surprisingly, it is now done much more often.

What To Do?

To save us all some time, I’m going to list three things that we can do to stop this arm abuse epidemic:

  1. Stop having kids play baseball/softball year round
  2. Get kids on a strength and conditioning program that will develop their overall athleticism
  3. Stop teaching young pitchers the curveball

Will this stop all arm and shoulder problems in young pitchers?  Probably not, but it should definitely help reduce them.

Mark

Here are a few related posts:

Year Round Sports – Agggghhhhhh!!!

Youth Training & Development

The Sports Specialization Solution

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It Keeps Getting Better

image

We’ve all seen some amazing performances during the Olympics the last two weeks.  We’ve seen athletes display amazing abilities.  The question in my mind right now is, just how far can these athletes go?  Remember when a sub 4 minute mile was unthinkable? That is until Roger Bannister ran one?  Remember how it used to be watching the men’s 100 meter dash?  Then Usain Bolt came along and started blowing everybody away.  Today’s athletes routinely perform feats that were unimaginable when I was a child. Just how far can they go? With the ever growing amount of research and knowledge into sports performance, are we nearing the limits of human potential? Or have we just scratched the surface? I personally hope that the latter is the case. If it is, the next 30 years are going to be loads of fun.

Mark

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Thoughts On The Olympics

Ryan Lochte Training

Just like many of you, I’ve spent part of the last week watching the Olympics.  There has been a big deal made about Ryan Lochte’s training and some of the unusual things that he does to prepare.  These include tire flips, keg tosses, and using ropes.  Some other S & C coaches have given their thoughts on his workouts.  Some of these were positive and some not so much.    Some of us might not feel comfortable putting an athlete through strongman type activities.  Ryan’s S & C coach, Matt Delancey, does.  I’ve heard Matt speak on a few occasions at clinics, including one lecture on the use of strongman exercises with athletes.  I also had an opportunity to watch him at work.  Matt is a former strongman competitor so yes, sometimes strongman exercises make it into the routines he uses with his athletes.  One thing that you may not know is how much Matt emphasizes correct form.  He is much less worried with how much weight someone can lift than he is with developing and maintaining proper form.  His number one rule for strongman exercises is that as soon as the athletes form breaks down, you stop the exercise.  I believe that having a full understanding of an exercise how to perform it correctly is crucial to being a good S & C Coach.  While many of us might not feel comfortable including strongman exercises, often that is due to our background and a lack of knowledge about the exercises.  While some might not agree with using these exercises with a swimmer, his coach is very comfortable with it.  He is also very competent to teach the exercises and keep them safe.  Whether we agree with the program that Ryan does or have some issues with it, we need to keep one thing in mind:  every coach is different.  Every coach has different backgrounds and experiences, different styles, and different levels of comfort with certain exercises or methods.  That’s one of the neat things about strength and conditioning.  While there is a lot of science that we rely on, there is also room for each of us to be unique and create our own program.  Just because a program is different than one we might design, that doesn’t mean that it’s bad.

Here’s a sample of Ryan’s Training.

Strongman Exercises For Everyone?

One post I read a few days ago stated that Lochte’s training would have a negative effect on many clients.  The author felt that many of their clients would come in begging to include tire flips, etc in their training.  He’s probably right.  I’m sure that due to the publicity, many athletes and coaches will suddenly want to include these in their training.  Guess what?  In general, that’s probably not a good idea.  Remember, training programs should be individualized based on many factors including what the athlete is capable of.  There also needs to be consideration given to what the coach can safely teach the athlete.  This is where my greatest fear is.  I hope that coaches stick with what is right and with what they can safely teach.  Unfortunately, some won’t and they will end up needlessly injuring some athletes.

Mark

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Smart Work

I spent the past week working at a sports camp for young kids.  The camp used a large local park that was open to the public. During several of these days, I saw a local Strength & Conditioning coach working privately with a young athlete (about 13 years old).  During my breaks I tried to sneak a peak at what drills they used.  While I didn’t see anything new, what I saw did make me think about working smart vs just working hard.  What I saw each day wasn’t smart work, it was just hard. I saw lots of repetition of drills, but very little teaching and correction.   While working hard can be the focus of certain days or certain drills, it seemed to be the focus of every day for this athlete.   While I wasn’t close enough to hear what the coach was saying to the athlete, I didn’t see the coach trying to demonstrate or correct any technique. What I saw was a series of drills run over and over until the kid was exhausted. Most of the young teens that I have trained need a lot of fundamental drills and a lot of technique work so that they can develop their basic athletic skills. That is working smart. That is also smart coaching. S & C coaches get paid to develop athletes. Yes, sometimes that involves working them hard. However, when dealing with young athletes, there should be a lot of smart work. That should be what differentiates a S & C coach from the average person – the ability to teach an athlete, not just run them through some drills. A great coach is a great teacher.

Mark

Here are 2 other related posts that you might enjoy:

Coaching = Teaching

Why does junction boys syndrome still exist?

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Don’t Be A Sucker!!!

Pic of a sucker

Don’t Be A Sucker!!!

The British Medical Journal just published an interesting study about sports performance products. They looked at a variety of products that are marketed in the sports performance world. No matter if the product was a supplement, a shoe, a sports drink, or any other item, the scientists checked to see what claims the product made. They then tried to find research that validated the claims. Guess what?  In many cases there wasn’t any published research that supported the product claims. Even if research did exist, many times it wasn’t enough to scientifically conclude that the advertised benefits were in fact true. Is this surprising? Probably not. While this study was conducted in Britain, I would guess that similar results would be found in the United States. Several notable American companies (Nike & Powerade) were included in the study because they market and sell in both countries.

In the U.S., the FDA thoroughly evaluates any new drug before it is approved for use. I’m sure that Britain has a similar process in place. Unfortunately, the FDA doesn’t try to regulate supplements. They only step in if there are numerous complaints and/or health risks (who remembers ephedra????).

Here are a few surprising facts from the study:

  • Over 50% of all product websites that made product claims did not provide any references for studies that would support these claims
  • When contacted, some companies were not willing to share their research (In reality, this may not be that surprising)
  • Once company believed that simply providing a video of their product being used was “sufficient”

So, what is the reality?  Just like with many other products, companies tend to make impressive claims about the benefits of using their products.  Unfortunately, these claims often aren’t supported by solid research.  Regardless, due to marketing to a gullible public, many people don’t question the claims and just buy the products without further investigation.  This tends to work out great for the companies who keep putting money in the bank.  So what should consumers do?  Remember the old P.T. Barnum quote “there’s a sucker born every minute”.  Don’t be a sucker!!!  Don’t believe everything that some company tells you about it’s newest diet pill, muscle growth powder, sports drink, shoe, shirt, or anything else.  Be smart and do some research.  While it is great to be able to just hop on the internet and Google something to get info about it, realize that not everything you read on the internet is true either.  Make sure to get info from good sources.  If you’re not sure where to start, Pubmed publishes abstracts from numerous scientific journals related to health, fitness, exercise, and medicine. Start there and see what you find.

Just remember, Don’t Be A Sucker!!!

 

Mark

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Good Nutrition is 24/7

Fruit stand pic

What do your athletes eat???

As a coach, you have control over what your athlete does for a few hours a week.  You can control what drills they do, how they do them, etc when you are coaching them.  As for what happens the other 22 hours of their day, that is up to them (and their parents if they are young).  Unfortunately, what they eat during that time away from you can drastically affect their recovery and their future performance.  As we all know, the eating habits of the average person in the US are currently lousy.  This includes both adults and kids.  That means that we have an uphill battle to fight.

(As a side note, sometimes parents allow kids to make horrible choices.  A prime example was an 11 year old that I used to train.  He regularly showed up to training sessions with a huge energy drink.  What???  How does an 11 year old do that???  Oh, that’s right.  His mommy let him do it.  When dealing with kids and teens, it is often vital to change the parents ideas on nutrition.  If they don’t change, the kids won’t ever change either.)

So, what can we do?  Here are 3 things:

  1. Get the athlete professional help – First off, we have to leave the diet planning to the Registered Dietitians (RD).  We wouldn’t want them writing our training programs and we shouldn’t try to do their job.  We can however have one speak to athletes and parents.  This could be done as an occasional seminar for all athletes/parents.  It could also involve one-on-one help if needed.  Regardless, it can be beneficial to develop a good working relationship with a local RD who has a background advising athletes.
  2. Have plenty of handouts ready – Having handouts ready on nutrition is a good way to get info to parents and athletes.  Parents are often willing to look through these while their kids train.  There are all kinds of wacky diet plans and concepts that have been publicized.  While someone may believe some of these, it never hurts to present them with good info from trusted sources.  Who knows, it might change their thinking.  Where can you find this info?  Try your local RD or various nutritional sites on the web.  The Gatorade Sports Science Institute also has a lot of valuable handouts on their website.
  3. Become a thorn in the side – Make sure to constantly remind your athletes (and parents) about good nutrition.  Ask them how they ate since their last workout.  Remind them when they are leaving to eat well.  Just mentioning it to them once probably won’t do the trick.  Let them know that even though you aren’t there with them 24/7, what they do during that time still matters.  For older athletes, if you know that they are going to a big cookout or some other event, you might send a text to remind them to keep things in check and not eat everything in sight.

How an athlete chooses to eat when they are away from you is ultimately up to them (or their parents).  While I’m not one that thinks that a kid should never have a piece of cake or pie, I do believe that it is part of a coaches job to impress upon them the importance of good nutrition.  As we’ve seen in the news, most of the teens and adults in the US are missing out on that message somewhere.  Maybe we can help a few of them.  Plus, if they are serious about their training, good nutrition is vital to recovery and performance.

Mark

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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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Post Season Recovery For Athletes – How?

Basketball Hoop Pic

In my previous post on post-season recovery, I discussed why it is important for athletes to recover after their season concludes.  Now lets discuss some guidelines for how to accomplish sufficient recovery.

First off, remember that these guidelines are based on an ideal situation.  As we all know, those rarely happen in the sports world.  Since the NBA Finals are going on right now, we’ll use them as an example.  In case you’re not paying attention to the finals, the Oklahoma City Thunder are playing the Miami Heat. If that series goes the full 7 games, their season won’t finish until June 26th.  Obviously making the finals is a great achievement and no team would trade that for anything.  At the same time, teams that didn’t make the playoffs finished playing their last games on April 26th.  That’s two months before the Heat and Thunder will be done.  To fully put things in perspective, last year NBA training camps were originally scheduled to open October 3rd.  That was before the lockout ended up shortening the season.  If the dates stay similar in 2012, that means that the teams that didn’t make the playoffs will have as much as two extra months to strength train for next season.  It also means that they will have more time to recover from the rigors of the 2011-12 season.  The odd twist is that the teams that had the best seasons and played the most games will have the least amount of time to recover.  As a strength coach you have to be prepared to work around multiple issues, especially if the length of your off-season can be drastically shortened by your teams success.

So what guidelines should you follow during your recovery?

  • Heal Up – during a season, almost every player ends up with some bumps and bruises.  No matter how my we work to prevent them, it’s going to happen.  Many of these can be healed up with some rest.  For more significant injuries, make sure to continue rehabbing them.  With no time devoted to practice and games, you should be able to make some serious headway towards getting well.
  • Check For Imbalances – Checking for imbalances ties in closely with rehab.  Over the course of a season, players can develop numerous strength and flexibility imbalances.  As an example, baseball pitchers tend to develop greater external rotation in their pitching shoulder during the season.  Some people believe that this can lead to other problems if it is not addressed in the off-season.  Step one to solving these problems is to identify them right after the season.  Then the player can begin to work on them during the recovery phase.
  • Stay Active – This phase is a recovery phase, not a sit on the sofa and be lazy phase.  In many of the publications on periodization, this phase if called “active rest”.  Athletes need to stay active to some extent, even during recovery.  Staying active doesn’t mean going to the gym for a two hour lift-a-thon.  It does however mean doing something physical.  This is a great time for athletes to participate in other fitness or sports activities that they enjoy.  I read once that Arnold Schwarzenegger used to enjoy riding bikes and playing volleyball after he competed in the Mr. Olympia each year.  I believe that it can be beneficial for athletes to follow the same sort of plan.  Find one activity (or several) that you enjoy doing that will help you to exercise.  Then participate in this activity several times a week.  The idea is to keep yourself active, break a sweat, use your muscles, and get your heart and lungs going.  If you do choose to lift weights, keep things light – 3 sets of 10-12 at bout 70% of your one rep max is a good guideline.
  • Rest – Yes, you should rest your body during this recovery time.  Get plenty of sleep and relax some.  This is not the time to stay out until all hours of the night partying it up.  Enjoy time with your family and friends but just remember, the crazier you get with your lifestyle, the harder it will be to get back into peak shape later.
The big question now is, how long should the recovery phase last?  Periodization models tend to recommend 1-2 weeks.  I have always like Arnold’s recommendation.  He said that he would stay out of the gym until he really got the itch to go back.  He figured that was his body’s way of telling him that he was ready to start training again.  I believe that two weeks is a good starting point.  If you communicate with your athletes, you may find out that some of them need more time and some need less.  You can always tweak the length of time if you need to.  If you are dealing with younger athletes, it may be necessary to provide some structure for them during this time.  If you tell them to “go rest but stay active” you will have athletes doing all sorts of things based on their own interpretation.  A structured plan may be better for them.  That way you can have some control over what they are doing for recovery.
Regardless of what the circumstances are, a post season recovery period can be very beneficial to your athletes.  Make sure to include one in your planning.
Mark

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