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.

Working with Injured Athletes

For the duration of the season, we of course have our handful of injuries. Currently I have set aside Tuesday and Thursday mornings strictly for them. Putting this time aside has made it easy to be very individual with these guys. Some are out for a couple weeks and a few for the year but no matter they always show either a serious asymmetry or poor/weak strength in very specific area which can be strengthened as much as possible before return to play. So far those that have returned haven't had to come back which is great and they continue there workouts but, it is those that are done for the year that need more than strengthening and ROM work.

One of the hardest things when your hurt is the fact that can't do what they love doing. There is always a denial, followed by some sort of depressed feelings, and hopefully acceptance occurs quickly. But, the emotional state of the injured athlete can hold you back if you ignore it.
Set them up for success
When someone is hurt they obviously lost something they did very well. It may be kicking, throwing, jumping whatever. So in setting them up for success, you might want to add in a lift or movement you know that will improve quickly. Make them aware of any increase in strength or ROM. This will make them feel like they re making progress. Attack something that is there weakest point whether its a flexibility or strength issue just hammer it so they notice great improvement.

Be real With Them
It seems like every time we have a workout they always spend at least the beginning of the workout or some of the rest periods talking about what they used to be able to do. "before I was hurt..." "I wish I could do _____ again" and so forth. Many of these guys weren't cleared to workout for a month, some were hurt coming in and hadn't lifted in longer periods of time. You have to explain the facts that they loose certain qualities that were previously well developed. If they are really interested in why explain the physiology and what qualities will be first to go, the residuals they lost and need back, and they effects of they asymmetry built due to compensating during there injuries. They just need to know that it's normal not to be where they were at.

Set Goals
This is something that is huge and almost automatic. Every player has said to me usually day one that I hope to be back at this date or I want to be able to do this by that date. This is a great time to talk with them about some legitimate goals and explain how if they are serious about them that they have to be consistent. That is where the previous stuff comes into play where you can track progress toward goals and make sure they are realistic. Of course you need short term goals and long term goals so making sue they are achieving something on a regular basis but while still striving for the ultimate achievement.

Tape an Asprin to it!!

With any sport you will see your fair share of injuries. So far in football we have had a handful on some unfortunate contact injuries ranging from a back problem, ACL, and a couple hyper extensions. Currently the Athletic Trainers have turned over most all of these athletes to me for assessment/workouts. In doing do I have noticed one very pronounced commonality. Thinking in terms of the mobility/stability continuum, they are somewhat in reverse order. I have only had a few weeks to work on this in terms of reinforcing mobility and stability in the right areas with the team but after looking at these athletes whom are sidelined, it is telling me that there will be a strong emphasis on developing these qualities this off season and now. A couple things I have also gotten done is getting the AT's to stop doing repeated flexion for rehab to strengthen "core" and we have been really working the stability component. Also working on movement patterns especially the squat. Just yesterday, after getting an injured athlete with a knee injury to squat properly, he was bewildered at the fact that all the activation was burning in his hips and he didn't feel that strain one his knees and quads to bring himself up anymore. Improving these qualities and movements hopefully will get a reduction in the amount of athletes standing on the sidelines and keeping them on the field.