Educational Road Trip

Today I had the pleasure of dropping in at the Sanford Running Injury & Performance lab and The National Institute for Athletic Health & Performance in Sioux Falls, South Dakota. Each of these places offer unique equipment and are heading some great research involving individual assessment through gait analysis and fatigue related stability issues.

At the running lab they had a force plate treadmill with Zebris software. What this allowed them to do was match slow motion video analysis with an individuals foot strike. Along with this they would hook up EMG to get a look at specific firing patterns up the chain. Take away message:

* The individual may display similar areas of stiffness and/or firing patterns but treatment is different based on the way in which this stiffness occurs. This is based off roll off patterns in the foot, heel motion, and foot structure.
* Single leg stance is still one of the greatest assessments for stability. But with this tool you can measure the parameter in which your center of gravity is displaced. This with EMG can show the degree in which you compensate and with which specific muscles your relying on.
* Many people strike hard on the outside of the heel and almost immediate go to big toe after a hard pronation.

Overall like you would assume, many of these people were stiff anteriorly and externally rotated.
These guys had a fellowship with Gary Gray and use some very integrated corrective strategies as you would guess with Gray.

At the NIAHP, they have easily the best environmental chamber in the US. Here they have done wonders with hydration study and stability.

* Almost everyone losses sweat at different rates. With that, what is lost (different electrolytes) varies quiet a bit person to person. People perform at a substantially higher rate when they replace what is really needed and not as much of what is not.
* After fatigued, athletes showed highest differences in stability in the frontal plane when landing, and in step-downs.
* 50 % of athletes are in a dehydrated state throughout the day. (DRINK SOME WATER!)

A great experience overall. Once again these are just tools. You can come to the same conclusions with different means. These tools however provide a great deal of information allowing you to obtain results with the ability to compare with computed numbers. I see these sort of tools as a use em' if you have access sort of thing.

Importance of Assessment Part 2

Last time i wrote about our running back whom had a few hip mobility issues come to the surface that have put him at potential risks and exposed a significant instability issue in the lower back. This next athlete has had a few issues in terms of hamstring issues and typical dings and hang ups that would be typical of a usual athlete. The other significance of him is that he is a multi-sport athlete. He is a all conference baseball short stop and was quarterback this season.

He went through an entire assessment and there were some pretty revealing issues. Below are a few test that I feel are important as indicators for potential risks factors when playing these sort of position.

Hip Internal Rotation of Lead Leg









The first thing the sort of raised red flags is the only way to perform this test he had to abduct the leg. When tested in supine position total ROM was approx. 25 degrees. Alarming because when throwing, the lead leg must plant and internally rotate in the follow through phase. It also raises risks in change of direction/planting and turning.


G-H Range of Motion on throwing arm

As you can see he is able to externally rotate pretty well without even any assistance in movement. What you should look for in this case is making sure you achieve full ROM from eternal to internal rotation. Look for 180 degrees of total ROM for sufficient movement.

Prone Hip extension

He complained about frequent hamstring issues and from this test it is evident why. He had a lot of trouble extending the leg with out the hamstring bringing him into flexion. This shows a significant hamstring dominance which also was confirmed by the glute firing pattern

Subscap test

The role of this cuff muscle is significant more for its isometric properties in that it prevents the anterior glide of the humeral head. Looking at the video you can see that he immediately goes into extension and the shoulder protrudes forward. This could indicate weakness in this musculature which was confirmed in other test.

T-spine Rotation/Ext









This is a big one. if you lack sufficient rotation in the t-spine you will inevitably rotate at the lumbar spine. If you lack quality extension you will have trouble upwardly rotating when trying to throw anything. This is an area that regardless of testing you should probably stay on top of due to the upper extremity issues that can arise form lack of mobility in this area.

Even though this athlete hasn't had too many serious issues in terms of injuries preventing his play, it is plain sight that if identified much earlier the many minor injuries may have been prevented. Having athletes go through some sort of quality assessment is definitely the right way to go about keeping them healthy. If your best players are healthy there are on the field and in the end when you have your best players playing you are always in the best position to win!

Re-Building the Efficiant Athlete

The Importance of Assessment

Now that the team is in the off-season there is plenty of time to address any movement issues, pain, and pay respects to injury prevention. It is very typical in American football that athletes who get hurt find a way that will allow them to play through an injury. Understandable, but as they continue to play on an injury, most likely the implement allowing them to play is doing serious harm to the joints above or below.

For example, here is a picture of our running back. He had complaints of bad back pain and played the season with knee pain in his left leg all while earning all-conference honors. Clearly by the photo of some static assessment positions you can see the significant lordosis in overhead reach. He admitted to me that he hurt it lifting something over his head. The is a clear indication that not everyone is qualified for overhead lifting. In his case he lacked the needed thoracic extension and it was way to much stress on his lumbar region.

On his single leg lift he showed a significant tilting of his pelvis (he actually leaned much worse prior to photo.) This being on the same side of his knee injury led me to anticipate some poor glute function in the test to follow. Through the multiple ROM and strength test revealed a significant lack of internal rotation on left side, very delayed glute function with lumbar rotation, and in his Thomas Test his TFL pretty much dominated him on his left side especially.

So, all those underlying issues add up to the described pain sites and were putting him at some serious risks. Luckily he as plenty of time to get this sorted out and will be feeling much better in no time. This goes to show the importance of a assessment in regards to identifying faulty movement patterns and reason for pain. All things that are negative towards athletes and everyday people. After prescribing certain corrective stretches/exercises and avoiding a couple patterns until he is ready, he should be better in no time. I will be sure to post his progress as he continues.