Archive for “Youth Sports Injuries” Category

Concussion Awareness & Prevention for the Strength Professional – Joe Powell

Part 1 of 2 on concussion awareness and mitigation for the S&C Professional focuses on defining the injury and its primary root causes, as well as clearing up common misconceptions about the injury. The article focuses in on published research to define prevalence and rate of instance among popular sports. 

The term concussion has long been feared, yet largely misunderstood by both athletes and coaches alike. However, as of late, concussion awareness in athletics has been at an all-time high. Increases in clinical diagnoses of the injury as well as research devoted to the cause, effects, and preventative strategies have helped spearhead awareness and thus increased prevention attempts. High profile athletes have begun to step forward into the public eye to raise awareness on concussions and the subsequent consequences that can accompany the injury and, unfortunately, plague their everyday lives. Controversial debate has even taken place in professional sports among league officials and referees to change the rules of the sports where concussions occur at high rates. Sure, concussions have always occurred in the sports that we love, but only recently have they garnered the mass attention necessary to begin the prevention process at all levels. Like any other injury commonly sustained by athletes, it is our job as strength and conditioning professionals to help lead the movement on mitigation and make it a priority in our training.

The first step in creating a program to help our athletes minimize the occurrence of any injury is to better understand the nature of the injury and everything that accompanies it.

What is a concussion and how can it occur?

A concussion is the result of external force being applied upon the body wherein the result of the impact causes a sudden acceleration or deceleration of the head, resulting in a collision between the brain and the skull. Sustaining a concussion can result in severe cognitive, psychological and structural damage to an individual. Common symptoms of the injury include headache, dizziness, nausea, fatigue, and even loss of consciousness. The injury may last days, weeks and in some cases even longer. The severity of the injury is dependent upon many factors. How it was caused, the force of the trauma that occurred, the amount of previous head injuries the individual has sustained, and even the time it took to report the injury to a licensed health care provider are just a sampling of factors that influence the severity of a concussion.

From Children’s Hospital Oakland

Head injuries such as concussions are most commonly thought to occur due to a direct blow to the head via another athlete. These are your big highlight reel hits in football or the massive check into the boards in hockey. This scenario is certainly one of the most common causes of concussion in sport, however it is far from the only one. The direct contact hits by another individual that result in a concussed athlete are easy to recognize because the signs and symptoms of a concussion are usually immediately on display. It has almost become the norm to expect an injury when a vicious hit is sustained during play. However, these types of concussions may partially explain why the injury is so misunderstood. When an athlete displays concussion symptoms to themselves or others, yet cannot trace the symptoms to an event where a large collision took place, they may not actually think they’ve suffered a concussion. This results in athletes failing to report their injury and thus do not get the treatment needed to be placed on a proper rehabilitation protocol.

Other common scenarios where concussions are sustained in athletics may not be as recognizable as the highlight reel hit or direct head contact. Yet these events are every bit as serious, even if though go unrecognized initially. These situations may include when an athlete suffers repeated low-level blows to the head, when an external object (not another human) hits an athlete in the cranial region, or when a player gets wrapped up and their head becomes susceptible to hitting the environment around them, even if at a low velocity. To put into perspective how common these injuries can occur, look no further than specific examples of routine plays that happen in almost any game or match. Instances may be when a soccer player attempts a header and strikes the ball with great force, when a baseball or softball strikes an athlete on the helmet, when a wrestler is taken down and cannot brace themselves before hitting the mat, or a lineman in football colliding against defenders for the duration of a game. The possibilities are numerous. The root cause of concussion can certainly differ, but the injury remains incredibly serious regardless of how it is sustained. Now that the injury and some of its causes are better understood, more effective strides can be made to minimize its prevalence.

Which athletes are at risk?

For many years the primary concern around concussions was based around contact sports, such as football, hockey, rugby and lacrosse, and the high-velocity collisions that accompany them. These contact sports are primarily male-dominated, which meant if you were female or played a non-contact sport you were likely safe from getting a concussion. Even youth athletes that played contact sports were not seen as a high risk of concussion since they could not typically generate the high-velocity impacts that are usually seen at the high school level and above. Those assumptions are actually quite false according to numerous studies on the topic and given the circumstances previously mentioned, it is now better understood that athletes of all ages, both male and female, across all sports, can be at risk of sustaining a concussion in their sport. The goal of bringing awareness to parents and athletes of the potential injuries in sport is not to scare them off and prevent them from playing the games they love, rather it’s to educate with the hopes of increased prevention methods, as well as understanding the proper steps to report and treat an injury if it does indeed occur.

Concussions and youth sports

Research has emerged within the last several years that paints a better picture on the prevalence of concussions in youth and high school sports. The CDC estimates that 20% of the roughly 1.7 million concussions that are reported each year are sports related, with the majority of those stemming from participants in youth and high school sports. It was reported that youth athletes who sustained a concussion from participation in contact/collision sports account for 3-8% of all sports-related injuries reported to the ER (Kelly, et al. 2001). Given the high number of participants in youth sports, those statistics are staggering. For years, concussion instances in youth sports was long an afterthought, yet studies show that young athletes are in fact likely more susceptible to concussions than adults. Concussions represent 8.9% of all high school athletic injuries compared to just 5.8% at the collegiate level (Karlin, 2011, Boden, et al. 2007). Possible explanations for higher percentages of concussion rates in youth athletics include youth and adolescent athletes possessing a larger head to body size ratio, they possess weaker neck muscles, and have an increased injury vulnerability due to the brain still developing (Sim et, al. 2008). To make matters worse, research suggests that children and adolescents take longer to recover than adults (Grady, 2010).

A systematic review and meta-analysis done by Pfister et. Al. examined the incidence of concussions in youth sports. 23 articles were accepted for systematic review (out of 698 considered for review). The accepted research focused on both male and female athletes under the age of 18 and included the following sports as part of the research: football, rugby, hockey, lacrosse, soccer, basketball, baseball, softball, wrestling, field hockey, track, taekwondo, volleyball, and cheerleading. The data compiled from the studies demonstrates concussion prevalence in terms of what the researchers refer to as an athletic exposure, or AE. The researchers define an athletic exposure as “one player participating in any game or practice, regardless of the amount of time spent playing and therefore at risk of sustaining an injury.” In this analysis, the data shows concussion prevalence out of 1000 athletic exposures across the 12 sports. The average incidence of an athlete sustaining a concussion across all identified sports was 0.23 per 1000 athletic exposures. The numbers range drastically dependent upon the sport. Rugby was the highest at 4.18, whereas volleyball the lowest at 0.03. The average incidence of an athlete receiving a concussion may seem low when thought of at 0.23/1000 AE, however when taken into consideration that as of 2011, 30-45 million children, and an additional 7 million high school students participated in athletics, that ratio (.023/1000) is actually incredibly startling. The following chart taken from the systematic review by Pfister et. Al shows the reviewed sports and their rates of concussions in order from highest to lowest, as well as the studies the data was taken from.  

The popularity of youth and high school sports are at all-time highs in today’s society. Parents, coaches and athletes alike are constantly vying for any edge in performance they can find. While the constant desire for improving sports and fitness related skills is great for the field of strength and conditioning, it’s imperative that athletes, parents, and coaches allocate time on injuries and preventative methods. Understand that injuries do occur, and will keep occurring, however the better understanding of how and why they occur, the better we can aim to mitigate them. This is especially important in regards to the serious injuries such as concussions where the long term effects are still unfortunately largely unknown.

In Part 2, we will examine some of the preventative measures and how strength & conditioning professionals can assist in protecting athletes from brain injuries.

References

Boden BO, Tacchetti RL, Cantu RC, et al. Catastrophic head injuries in high school and college football players. Am J Sports Med 2007

Grady M. Concussion in the adolescent athlete. Curr Probl Pediatric Health Care 2010;40:154–69.

Karlin AM. Concussion in the pediatric and adolescent population: “different population, different concerns”. PM R 2011;3(Suppl 2):S369–79.

Kelly KD, Lissel HL, Rowe BH, et al. Sport and recreation-related head injuries treated in the emergency department. Clin J Sport Med 2001

Pfister T, Pfister K, Hagel B, et al The incidence of concussion in youth sports: a systematic review and meta-analysis Br J Sports Med 2016;50:292-297.

Sim A, Terryberry-Spohr L, Wilson K. Prolonged recovery of memory functioning after mild traumatic brain injury in adolescent athletes. Neurosurgery 2008

 

Joe Powell is an Assistant Strength & Conditioning Coach at Utah State University.  He formerly held a similar position at Central Michigan University where he also taught classes in the Department of Health and Human Performance.  Joe is a regular contributor to the IYCA Insiders program and has been a huge part of bringing the Behind the Science series to the IYCA.  He is also the author of the IYCA Guide to Manual Resistance Strength Training.  Get more of Joe’s contributions in the IYCA Insiders membership.

Understanding How Thorax Position Impacts Scapular Orientation – Dr. Greg Schaible

We understand the body can move in three planes, giving us many options to move with numerous degrees of freedom.

Most can then appreciate how each joint will have different amounts of freedom based on the type of joint.

The scapula is one area in which many people are able to name all the movements, but not necessarily appreciate all its movement capabilities. Performance professionals often work with athletes who either perform overhead movements (i.e. throwing) or suffer from shoulder pain that can often stem from thoracic/scapular issues.

The main purpose of this article is to call your attention to how manipulating body position can impact the outcome of a movement based upon the athlete’s presentation.  Once you read the article and watch the video, you should have a better understanding of how the scapula, rib cage, and thoracic spine interact.

(Note:  Somewhat different than many of my other articles, this article is not as much about fixing a specific problem as it is to enhance your understanding of how the thorax and scapula interact so that you can make more appropriate suggestions and programming decisions with your athletes.)

The scapula moves in any combination of the following:

  • Elevation & Depression
  • Protraction & Retraction
  • Upward & Downward Rotation
  • Anterior & Posterior Tilting
  • Internal & External Rotation

What we like to see with the overhead position is scapula upward rotation (wrapping around the thorax), posterior tilt, and external rotation.

It’s usually not that simple though.

First, we want to ask ourselves what position is the scapula resting in?

The easiest way to generalize that answer is to figure out if the scapulas are in a protracted or retracted position? Protraction and retraction tend to be a recognizable trait which will include some coupled movements into upward rotation (protraction) and downward rotation (retraction).

The reason for asking this question is that we need to know if the scapula is starting “ahead” or “behind” the starting line.

While it’s important to make sure the scapula is moving properly when taking the arm overhead, it’s just as important to recognize their starting position as it will impact the timing and congruency of the ball and socket joint during overhead motion.

The simplest way to address this is by looking at how the resting position changes when the body position changes.

Consider the following examples:

  1. Wall Slide – The wall gives some assistance and proprioception to the movement which often facilitates better mechanics from the start. However, while standing there is going to be a tendency for some individuals (not all) to display a flat t-spine or increased lordosis to perform the activity. This could impact the scapula’s static position or dynamic position.
  2. All-4s on Elbows Reach Roll Lift – This increases the amount of proprioception. Demands more anterior core engagement, and takes gravity out of the equation until you perform the lift-off. For certain individuals, this will look and feel the best for them.
  3. All 4s on Hands Reach Roll Lift – This position you will often find people with flat T-spines struggling to manage gravity and the thorax position. As a result, you may see a noticeable medial border of the scapula.
  4. All 4s on Stability Ball for Ribcage Retraction – The sole purpose of this is to use bodyweight and gravity to apply pressure into the sternum so that the ribcage passively retracts back toward the scapula. Which for a flat t-spine individual can be a useful starting point to work on scapular coordination and strength. Many people will place the ball at waist level which would facilitate more extension to occur. Which if the individual is starting from an extended flat thoracic spine state. You should be monitoring how much the athlete relies on extension to complete the task.

None of these exercises are inherently right or wrong, but each one may be helpful depending on the person’s needs. 

This video gives you more in-depth information on these movements, and should help you understand positioning better than only reading about it:  

This very brief video from Dr. G. Bhanu Prakash of Medical Animations will give you a clear view of the motions discussed above and an understanding of which muscles produce each movement:

 

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. Greg is the owner of On Track Physiotherapy and owner of the popular online education resource Sports Rehab Expert. Greg works with athletes and active individuals of all ages. As a former athlete himself, he attended The University of Findlay and competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and a 6x Division II Academic All-American.

Top 10 Tips for Training Young Athletes – Jim Kielbaso

The IYCA has produced hundreds of articles and dozens of courses/certifications on important topics related to training young athletes.  There is a lot to know and understand about long term athlete development (LTAD) and creating exceptional training experiences for young athletes.  While it’s impossible to have a full understanding of everything involved in this process, this article boils it down into the Top 10 tips for training young athletes.
Whether you’re a trainer, coach, administrator or parent, this list will give you a basic understanding of the most important concepts involved in training young athletes.  training young athletes
1.  Progress over Performance: Focusing on wins and losses is like fools gold.  You may have won the game or race, but that doesn’t mean you made progress or performed your best.  Celebrate progress rather than performance.  Have a plan and goal for training, and don’t let unimportant competitions get in the way of sticking to the plan.  For young athletes, competitions should be viewed as opportunities to use what has been worked on in practice rather than judging who is good or bad.
2.  Think Long-Term:  Rather than taking shortcuts to see some short-term success, build a strong foundation that will allow an athlete to build upon. Young athletes need to develop fundamental motor skills, coordination and all-around athleticism that will enable them to perfect sports skills later in their development.  Athletic development takes time and can’t be rushed.  The goal shouldn’t be winning the game this weekend.  Instead, build athletic qualities that will allow for continued growth.
3.  Balance General & Specific:  Many coaches want to focus exclusively on one sport or event in order to achieve early success.  While this may help children perform well at a young age, you cannot go back and develop foundational skills like coordination and motor control once the window has closed.  While sports skills certainly need to be taught, be sure to include “general athleticism” drills when training young athletes to build a stronger capacity to learn and perfect skills later.  These two concepts should not be mutually exclusive.  It’s absolutely possible to use the warm-up period to enhance athleticism by including fundamental motor skills, plyometrics, coordination activities, strength development, and mobility work.

kids meeting athletes

4.  Ignite a Fire & Develop Confidence: The goals of every youth sports coach should always be to inspire a desire to excel and to keep kids coming back for more.  Give them examples of what they can be by introducing them to older athletes, taking them to events, and painting mental images of what their future may hold.  Get them to see where they could be someday.  Keep dreams alive in every child until they decide to move on.  Many athletes mature late, and just need to stay with a sport long enough for their strength, size, and power to develop.

5.  Teach Young Athletes More Than Sports: Sports are metaphors for life.  Use sports to teach lessons about the value of hard work, listening, cooperation, repetition, and other life skills.  If all you focus on is the sport, you are missing an opportunity to make a much larger impact on a young athlete.
6.  Focus on the Nervous System: While young athletes can improve strength and endurance, their hormones and anaerobic energy systems are not fully developed yet, so they will not see major improvements in muscular size or anaerobic capacity until adolescence.  Before that time, focus on developing the nervous system by training technique, coordination and fundamental abilities like balance and kinesthetic awareness.  Gradually change the focus over time as the athlete matures.
7.  Balance Variety & Repetition: Variety is an excellent way to stimulate the developing nervous system, but repetition will develop technique.  Young athletes need both and should be taught the value of repetition and the enjoyment of variety.
8.  Basic Scientific Principles Apply: The two most important scientific training principles to understand when training young athletes are Systematic Progression and Specific Adaptations to Imposed Demands (S.A.I.D. Principle).  The S.A.I.D. Principle states that the body will adapt very specifically to the stimulus it encounters.  In other words, we get better at what we practice.  For example, if we want to increase strength, we must consistently put the muscle under tension with intensity.  It will respond by adding more protein strands which will eventually manifest as a stronger, larger muscle.  On the other hand, performing low intensity, high volume exercises will increase muscular endurance rather than muscular strength.  Both are good, but you need to understand the goal before you choose the training method.
progressive overload for training young athletes
Systematic Progression is the concept of systematically increasing the demands placed upon the athlete in order to stimulate constant adaptation.  As a very simple example, if an athlete wants to increase her pull-up strength, and can currently do 5 pull-ups, she should eventually strive to get 6 reps.  When six reps are achieved, she should try to do 7 reps.  This is a very basic example, but the point is that athletes should constantly be challenged to do that which they are not currently able to do.  This concept holds true for all physical attributes.
9.  Slight Overreach:  This concept works hand-in-hand with Systematic Progression, but can include practices and competitions as well.  The idea is to push athletes barely out of their comfort zone – both in training and competition.  Have them compete against opponents that are slightly better than them so they are always striving to improve.  Be very careful not to put them in too many situations that are completely out of their reach as this often leads to frustration and decreased self-esteem.  It’s also important for young athletes to feel successful, so give them opportunities to succeed as well.  There should be a healthy balance between a young athlete feeling confident and knowing he/she can improve.  Great coaches are able to keep confidence high while helping the athlete work toward larger goals.
10. Use Volume, Don’t Abuse It:  The volume (or amount) of work is one of the most misunderstood concepts in athlete development, and it can be highly individualized.  A volume of work that is too low will not elicit progress.  On the other hand, a very high volume of work is often unnecessary and leads to injuries, boredom, and burnout.  An athletes biological age, training age, genetics, nutrition, sleep patterns, and outside activities are all factors in how much volume is appropriate.  Coaches and parents need to constantly monitor a young athlete’s physical, mental and emotional well-being, and be prepared to make adjustments at any time.
These 10 tips provide an overview of the most important concepts to understand when training young athletes.  For more in-depth information on the concepts and specifics on how to implement them, the IYCA encourages you to go through the Youth Fitness Specialist Level 1 certification and look into the Long Term Athlete Development Roadmap.
Jim Kielbaso is the President of the IYCA and Director of the Total Performance Training Center in Wixom, MI.  He has authored multiple books, articles and training products and has spoken at events around the world.  He holds a BS in Exercise Science, an MS in Kinesiology and has gone through multiple certifications through the IYCA, NSCA, NASM and more.  Jim is a former college strength & conditioning coach and has trained thousands of athletes at every level of competition.  He runs a successful NFL Combine training program in Michigan and has been hired as a consultant for major sports programs like the University of Michigan Football Program and the University of Kentucky Basketball Program.

Strength Coach’s Guide to Achilles Tendinopathy – Greg Schaible

When working with athletes who are pushing their bodies to the limit, inevitability you will end up having a client who starts developing a tendinopathy. One of the most common tendinopathies that can develop is in the Achilles tendon.

This type of tendinopathy can be a frustrating area for a lot of people because it tends to linger on longer than most other tendinopathies. Before diving into what actions you can take, it’s important to have a general understanding of what a tendinopathy is.

Simply put, a tendinopathy occurs when either an acute or chronic overload to a tendon happens which exceeds its current capacity to withstand. While it’s important to remove the provocative factors to allow for healing to occur, its generally not a good idea to completely deload and just rest the tendon either. Complete rest does nothing to improve tissue resiliency and capacity. In fact, it generally worsens it!

It’s important to understand that you can load a tendon in a variety of different ways based on how sensitive the location of injury. For the Achilles tendon, symptoms tend to be present at the insertion to calcaneus or mid tendon portion of Achilles tendon. How you will work with the athlete will differ depending on this location.

Distal Achilles symptoms at the calcaneus can be more difficult to manage. It’s important avoid high amounts of dorsiflexion in times the tendon is highly sensitive. This is due to the biomechanics and structure of the foot and tibia and how it influences compression to a tendon.

This position of closed chain ankle dorsiflexion may irritate an area which is already symptomatic. For this reason, it is generally not a good idea to be performing any stretches in this case. With strengthening exercises such as eccentrics, you also need to limit range of motion that they are performed in. More on this later….

For a mid-tendon Achilles tendinopathy, compression against the calcaneus is less of a concern.

Some light stretches may be warranted, and often you can strengthen the Achilles through a larger range of motion.

Below are 3 of my favorite ways to start loading the Achilles tendon again:

Isometric barbell

Eccentrics Gastroc Heel Raise

Eccentric Soleus Heel Raise

All 3 of these exercises can be performed in the weight room. For the isometrics I will usually perform longer duration holds 20-30 seconds depending on tolerance. Then if able perform a couple with ramping up intensity to 90-100% effort for 5-6 seconds.

The eccentrics can be performed on a step or on flat ground depending on location of symptoms. With the gastric heel raises generally being more tolerable than the soleus heel raise.

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. Greg is the owner of On Track Physiotherapy and owner of the popular online education resource Sports Rehab Expert. Greg works with athletes and active individuals of all ages. As a former athlete himself, he attended The University of Findlay and competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and a 6x Division II Academic All-American.

What’s Really Limiting Thoracic Spine Rotation? – Dr. Greg Schaible

It’s no secret that rotational power in sport is imperative to a successful athlete. Much emphasis has been placed on making sure an athlete has adequate thoracic rotation to complete the task.

Many coaches have probably noticed that a decent number of athletes have poor thoracic rotation. Or they achieve thoracic rotation in a compensatory way. The purpose of this article is to show you how many athletes compensate and what to consider biomechanically when someone does rotate through the T-spine.

The most common way people will look at T-spine rotation (aside from directly watching a sport or lifting movement), is through a quadruped rock back position shown below to try and limit lumbar and pelvis contribution. In general you are shooting for around 60 degrees give or take.

I like the hips rock back to butt position because they are less likely to compensate. However, you will see a lot of athletes cheat the test by simply side bending or shifting their body weight to the side. As you watch the athlete perform this, the two most common compensations I see are:

1) The shoulders shift laterally outside base of support. In the case of the picture above, you would see the left shoulder shift laterally toward the left and move outside the knee and hip.
2) The hips/butt shift laterally outside base of support.
3) In general, you want to see a uniform motion as opposed to a large hinge point that is noticeable through the spine.

When considering rotation, we need to appreciate what is happening at the ribcage as well. When someone rotates to the right the contralateral ribs will IR and the ipsilateral ribs will ER.

Another way to look at it is that the ribs that ER should be moving in the direction an individual is rotating.
Realize as well that during normal respiration, expansion and recoil of the ribcage should happen. On inhalation the ribs will ER and on exhalation the ribs with IR. Respiration will have an impact on one’s ability to rotate or lack rotation.

A simple way of addressing this is through a rotation-based activity and utilize isometric holds at end range with respiration. See video below:

The purpose of this would be giving the athlete some assist to achieve their capable ROM. Then demanding control at the end range by including respiration. On inhale you breathe into the top side ribcage (ribs that are ER’ing). On exhale you should feel more down side ribcage activity happening (ribs that are IR’ing). This would help facilitate the IR/ER relationship of the ribcage we are striving for.

To see examples of other positional based isometric exercises that demand control, coordination, and variability check out my previous articles the stretching conundrum part 1 and 2.

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. Greg is the owner of On Track Physiotherapy and owner of the popular online education resource Sports Rehab Expert. Greg works with athletes and active individuals of all ages. As a former athlete himself, he attended The University of Findlay and competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and a 6x Division II Academic All-American.

The Stretching Conundrum, Part 2 – Dr. Greg Schaible

In part 2 of the “Stretching Conundrum” we are going to cover how to start best implementing these alternatives to stretching.

Inevitably, Part 1 of this series opened Pandora’s Box for a plethora of questions…

If you are not stretching, then what are you doing?

We do dynamic warm-ups, so why would I need to do these active positional breathing exercises?

How would you place these into a client’s programs?

Don’t worry….We have you covered!

The purpose of a warm-up is to simply prepare the body for whatever task or event is at hand. The cooldown is a time to kick-start the recovery process. At both of these times, it can be beneficial to work on other injury reduction strategies.

Your goals as a trainer or clinician are usually to help improve an athlete’s performance and reduce the likelihood of injury.  With this in mind, it’s important to do everything you can for the athlete in the time allotted.  Because time is limited, you must prioritize and determine the best use of that time.  That is often the biggest challenge for coaches, so we need to consider what is even possible.  

The trainable qualities that accomplish the goals outlined above are as follows:

  1. Strength/Power
  2. Work Capacity
  3. Motor learning/coordination

The first two are accomplished through solid training programs. The third is often forgotten, or it gets prioritized so heavily that there’s not enough time to adequately address #1 & #2.

It’s no secret that dynamic warm-ups are an excellent way to prime the nervous system while also getting the tissue “warm and ready” for high-level activity. Continue performing these dynamic routines as you typically would, and think of this as an excellent time to introduce motor learning/coordination.

The most frequently missed component of a dynamic warm-up, in my opinion, is positional integrity. I tend to see a lot of athletes in rehab who are excellent at utilizing momentum to their advantage. They rely on external forces such as momentum and excessive or accessory joint compression to create stability as opposed to utilizing their active muscular support system to its fullest capacity.

Teaching joint control in space via utilization of muscles to create positional integrity, while taking momentum out of the equation, is very challenging for a lot of athletes.

That’s what these “stretching replacement” activities are intended for, and they often reduce the sensational need for continuous stretching.

Another downside of stretching is that it takes a long time to incorporate and hit all the muscle groups. Done properly, including a couple of these exercises can address many things all at once. This saves you time to get to bigger and better things like actual practice and training!

To keep it simple, I usually pick 1 or 2 of the following activities to include in someone’s program before the dynamic warmup. There certainly are others depending on the situation, but this is a good place to start! Exercises are listed from easiest to hardest:

The Lazy Bear

Hamstring Crossovers

The Bear

Wall Press Abs Bilateral Lowering

Hamstring Hooklying Bridge

Modified Side Bridge with Glute

I usually give my athletes the option of light “stretching” or foam rolling for 2 minutes hitting their “needy” areas.  Again, I’m not against stretching, but I don’t think it’s a long-term solution worth spending a lot of time doing.  Next, we move onto 1 or 2 of the above exercises, performing each 2 x 5 long breath cycles (this should take a maximum of 4 minutes). You then move right into your dynamic warmup and into your training session.

The end of each session would include the same 2 exercises from the above list as part of a cool down. The emphasis is still on positional control, but the long cycle breathing also works to help shift into a parasympathetic state after high-level activity.  So, not only will this help improve positional control, but it aids in the recovery process.  

Tip: This is why these activities are included prior to the dynamic warmup. Because of the breathing component that can shift the body toward a parasympathetic state, we need some neural activation before high-level activity.  These exercises improve positional stability, while the dynamic warm-up activates the nervous system.  

Because these exercises can be done anywhere, the athlete now has activities that are easy to do and can help them continue to recover between training sessions.

All in all, the addition of these activities should not take any longer than 8 minutes to include your programs. If you are really hard-pressed for time, I would consider adding them only at the end of the session and perform your typical dynamic routine as a warm-up.  These exercises are an excellent way to promote controlled mobility and positional integrity, and they truly challenge body sensory/motor awareness without letting the client utilize external stabilization methods.  Give this approach a try for a few weeks and see how your athletes feel. 

 

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. Greg is the owner of On Track Physiotherapy and owner of the popular online education resource Sports Rehab Expert. Greg works with athletes and active individuals of all ages. As a former athlete himself, he attended The University of Findlay and competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and a 6x Division II Academic All-American.

Early Sport Specialization: Getting Them To Listen – Brett Klika

Early sport specialization has been a hot topic for years, and it doesn’t seem to be going anywhere.  As strength and conditioning coaches, it’s baffling when we see parents and coaches embracing the notion of early sport specialization despite the mountains of data, expert opinion, and well- reviewed evidence highlighting the downfalls.

Our heart breaks when youngsters in these situations get injured or depart from sports and physical activity altogether. The last thing we want to have to say is “We told you so.”

But, well…. “We told you so.”

Despite us “telling” parents, coaches, and our local communities about the importance of long term skill development and a well- rounded approach to athleticism, it feels like many don’t listen until it’s too late. Overcoming this communication breakdown is essential for youth strength and conditioning coaches if we are going to truly create a positive impact on the kids in our community.

How do we get the world of youth athletics to not only hear our message, but embrace it?

I discovered this communication disconnect early in my career directing the youth athletic program at Todd Durkin’s Fitness Quest 10 in San Diego. I would send kids home with printed manifestos on the importance of long term athletic development. I would share the latest research and training paradigms with coaches and parents during team meetings and “parent night” promotions.

Despite some success, I quickly realized that the volume of information provided was not the limiting factor in creating change. It wasn’t until I changed the delivery method that I was able to actually impact more parents, coaches, and teams.

The overwhelm of daily life leaves adults with a limited capacity for absorbing new information. With the opinions, recommendations, and even outright facts we hear every day, we have to apply a filter for what we trust, understand, and believe to be relevant. It’s essential we keep these three components in mind when talking with parents, coaches, and other influencers in the community.

Get Them to Trust Your Message
Obviously, parents wouldn’t let their children work with us if they didn’t trust us. However, trust is hierarchical. When it comes to information, a parent may trust what we say more than someone on the street, but the family doctor, a former or current pro athlete, or someone they hold in “celebrity” regard is going to invoke their greatest level of attention.

If this isn’t you yet, it’s important to find out where the parents and coaches you work with get the information they trust. Can you develop a relationship with these people? Letting local pediatricians and orthopedic surgeons know about your program can create both a network of trust and referral.

You may need to go broader and find/share interviews or articles with celebrity athletes or professionals associated with them that back up your approach. I’m not saying it’s fair, but a parent will pay more attention to a short interview from the Rock saying, “The People’s Elbow thinks kids should be kids” than a 5-page research-cited thesis from you on the same topic.

Developing relationships with and sharing information from people high on a public information trust hierarchy increases the likelihood this information will be absorbed. It also slowly increases your social validation as an expert and one day you won’t need the middle man!

It’s also important to continually seek opportunities to write, speak, and educate. The more your name and face is in public, the more people recognize you as an expert and take heed in what you say.

Get Them to Understand Your Message
Founder of Precision Nutrition, John Berardi once wrote “With everything you send to a parent or coach, envision them reading or watching it while waiting at a red light with a minivan full of screaming kids, radio blaring, and coffee in hand. In other words, keep it short and simple.”

Long term athletic development, or LTAD, may be the hottest water cooler talk of our industry niche. However, this term means nothing to parents. They acknowledge and react largely to what is in front of them.

For information to be absorbed and understood, it needs to be delivered concisely and in the simplest terms. If you use video, shoot for 60 seconds or less with clear visual-based information. Boil down a complex concept into terms a grade-schooler could understand. Remember, the goal is not to impress colleagues. It’s to create a ground level understanding for people with no background in our field. Just imagine if you were learning how the stock market works in 60 seconds or less. How would you want that information presented?

For written information, use a single-sided page with large-font bullet points. Infographics are more shareable across all platforms and are by far the most effective. As far as the info, consider hard statistics, clear research findings, and bold data.

Make Your Message Relevant
In order for coaches, parents, and even ourselves to value information, relevance is key. Our information should inherently answer the question “Why do I need to know this?” While general concepts provide valuable insight, adults are surrounded by general concepts. In order to make it through the filter, information must be presented in a near “first-name” basis.

For example, if sharing general statistics on injury and early sport specialization, parents may or may not raise an eyebrow. They know the information is pooled through various ages and sports across the country. However, sharing sport-specific or age/sex related statistics particularly after someone on the team has become injured has a much greater impact.

I have actually contacted local leagues and gotten injury numbers for the reported concussions, ACL injuries, and shoulder/elbow pathology and compared them to national standards. These were some of the most impactful pieces of information I ever shared.

If there is a simple movement, mobility, or other evaluation found in the literature linked to injury prevention or performance, share it with parents. I’ve done these during live “parent nights” for teams knowing 90% of the room will fail. It puts the notion of “Why is this important to me” right in front of everyone’s face.

Most importantly, listen to parent’s questions and answer them. Write down the 10 most common and answer them through the “trust” and “understand” filters. When parents solicit questions, then trust and understand the answers, it’s a win.

As you can see, educating the public takes much more than posting rants about early sport specialization on social media and bashing the local coaches who buy into it. As youth strength and conditioning coaches on the right side of the cause, we have to be lighthouses of trustworthy, understandable, and relevant information. This station is arrived at through constant learning, educating, and most importantly, listening.

Strive to improve how you share your message and soon your entire community will join your mission to inspire the kids of today to become the happy, healthy, active adults of tomorrow!

Brett Klika is a youth performance expert and regular contributor to the IYCA.  He is the creator of the SPIDERfit Kids youth training program and has run successful youth fitness programs all over the country.  Brett is an international speaker whose passion for youth fitness has helped thousands of people learn how to create exceptional training experiences for young athletes.

 

The old “windows of opportunity” Long Term Athlete Development model is a thing of the past.  Learn the truth about LTAD and how to approach athletes at every level in the IYCA’s LTAD Roadmap.  This is the most comprehensive approach to athlete development available.  Click on the image below to learn more.

ACL Injury Prevention in Women’s Basketball Players: Accelerated Deceleration Drills

ACL Injury Prevention is always an important topic with female athletes.  There are several reasons why a female basketball accelerated decelerationplayer has a 50% more likelihood of suffering a non-contact Anterior Cruciate Ligament (ACL) injury than their male counterpart. Many experts have looked into why and have rationalized several different theories that focus on possible biomechanical difference, hormonal changes, poor neuromuscular integrated strength or a possible decrease in ligament tensile strength.

Along with these theories there are also a few research facts that reflect:
1. A higher degree of thigh dominant versus hip dominant strength which can predispose female athletes to a higher neuromuscular risk of injury
2. A greater valgus knee angle with lateral movements which in turn places a greater strain on the medial compartment of the knee and the ACL.
3. Less active knee and hip flexion during ground contact events like jumping and cutting which in turn lessens the amount of deceleration control through the lower extremities and hips.

The fact is that 95% of all non-contact ACL injuries are a result of poor deceleration control of momentum and ground reaction sheer forces that occur as a result of change direction. This is why an ACL injury prevention program is so important.  Sheer is a simultaneous application of a vertical, rotational and horizontal force vector that has been show to be the exact force combination (mechanism) that results in the ACL being compromised.  Interestingly when evaluating strength and conditioning programs in women’s basketball specifically, the combination of a rotational and horizontal force vector training application is rarely seen. In most cases only body weight resistance is applied during these types of exercises.

This is where flat, continuously-looped, resistance bands can play a significant role in training and can assist in ACL injury prevention. Resistance bands are essentially independent of gravity and therefore can create a true horizontal-rotational force vector when attached around the hips. Using this attached set-up to perform multi-directional 2 step locomotion drills like shuffling, backpedals, crossovers and hopping, it provides the perfect training environment for female athletes to reactively strengthen the body, specifically the hips and core abdominal region, to increase control of deceleration sheer forces.

Over the past several years as strength coach of our local high school girls basketball team, I have implemented a resistance band training program for women’s basketball players that we refer to as “2 Step Accelerated Deceleration” Drills. These drills apply a pair of linked up Quantum Bands to create an “accelerated deceleration” training momentum that reflexively trains the body to handle increased momentum forces that requires a faster deceleration force response. Using short amplitude, multi-directional, 2-step movements allows athletes to gradually increase their band resistance force which increases the deceleration momentum force velocity. Like with any strength training program, as movement skill and strength improve, athletes developed a greater level of confidence in their deceleration foot work and strength.

The following videos demonstrate how to perform 2 Step Accelerated Deceleration Drills as it relates to a lateral, sagital and rotational change of direction. All of these drills require a pair of similar size 41 inch long continuously looped Quantum bands linked together using a link strap. This simple set-up provides athletes with 4 yards of total training distance which is more than enough to train two to three steps of movement.

Shuffle 2 Step Deceleration

Backpedal 2 Step Deceleration

Crossover 2 Step Deceleration

 

Typical Programming for Introduction
Initial programming involves using rep based sets that allow athletes to train at their own pace. I recommend performing 5 reps per set with a 30 second rest between sets. They will start with 2 sets performed with backpedals and in both direction when performing shuffles and crossovers. As conditioning and skill set improves, I recommend increasing to 3 sets. Once 3 sets are well established from a conditioning level I will switch to time based sets of 20 second work and 20 seconds rest to begin bringing in more of conditioning component.

Not only will these drills assist in ACL injury prevention, they will help improve the quickness and performance of the athletes.

To get Quantum Bands (and many other bands) for these drills go to ResistanceBandTraining.com.

 

ACL Injury Prevention Dave SchmitzAbout the Author:  Dave “The Band Man™” Schmitz, has been writing, teaching and training how to implement resistance band training for rehabilitation, fitness and performance since 1996. In 2008 Dave founded Resistance Band Training Systems, LLC and with that launched Resistancebandtraining.com, the only online website exclusively devoted to training with RBT Quantum Bands. As a teacher and coach, Dave has authored and produced 100’s of articles, digital training resources and DVDs as well as creating the only online Resistance Band Training Certification and virtual band training membership site “The Band Gym.” All of these unique resources have allowed Dave the platform to teach 1000’s of coaches, athletes, therapists, doctors, trainers, teachers and fitness enthusiasts how to get their body looking, feeling and moving better training with continuously looped resistance bands. Since December of 2008, Dave has hosted the RBT newsletter and blog that today includes special weekly events like, A Minute with The Band Man, RBT Weekly and the Friday RBT Workout. Along being a national and international speaker, Dave also consults regularly with over 100 high schools, universities and private performance training business. As a result of his efforts in 2011 and 2012 Dave was recognized as one of Top 100 most influential Fitness Professionals in America.
Dave also gives back on a local level as the owner of G’Town Boot Camps and G’Town Fast-n-Fit while also volunteering his time since 2010 as the Head Strength and Conditioning Coordinator for Germantown High School Athletics (Germantown, Wisconsin). Dave is a 1986 Graduate of the University of Wisconsin-La Crosse where he earned his Bachelor’s of Science Degree in Physical Therapy with an emphasis in Orthopedics and Sports Medicine and Athletic Training.

5 Tips to a Healthy Football Season – And Any Sports Season

Football Season is Here

The season is upon us. Yes, ladies and gentlemen, it’s football season. The time of year where you can lose more friends than in an election year. So with that said, 2016 may be an interesting year. Let’s call 2017 the year of reconciliations.

If you are an athlete, football season can be grueling and can wear you down. If you are a coach, it can do the same thing. If you are a parent…well, parents have it easy. All you have to do is print out this article, tape it to the fridge, and your young athlete will follow all 5 tips, right?

The goal of this quick article is to give the athletes 5 tips to a healthy football season and give coaches some things to harp on with your athletes. In a loving way, of course.

5 Tips to Having a Healthy Football Season

Tip #1: Nutrition

Eating “properly” for performance is a year long struggle for the young athlete and can get even more difficult during football season. One of the hardest goals to meet is getting the calories an athlete needs to perform. With lunch around noon and practice after school, kids can go 6-7 hours without eating in the afternoon.

Pro Tip: Bringing snacks to school is important to fill those huge gaps in the day. But don’t forget, breakfast is the most important meal of the day. Don’t skip it.

Tip #2: Strength Train

If we work hard in the off-season, why lose all those “GAINS” during the season? Yea, I know, “I don’t have any time” or “we gotta spend that time watching film” is a common reason for skipping strength training. Time can be of the essence, but 2 days a week minimum is a must! Get into the weight room.

Pro Tip: The main goal in-season is to combat muscular imbalances that are caused by the season which CAN help prevent injuries. Oh yea, athletes CAN get stronger in-season! Don’t skip out on strength training during the season. Your off-season will thank you!

Tip #3: Sleep

You know what? I love video games too! I think it’s important to have fun with friends but don’t let it affect the season. Athletes need 8-9+ hours of sleep each night so the body can repair itself. Period.

Tip #4: Injuries

This is a big one for highly motivated athletes. Nobody likes to be hurt and miss games. But that slightly rolled ankle can quickly turn into a season ending injury if not treated correctly. There is a big difference between some bumps and bruises and an injury that can lead to something more serious.

Pro Tip: Maintain a good working relationship with ATC’s and make sure injuries are discussed.

Tip #5: Academics

Poor academics can lead to ZERO play time. Make school work a priority. Time management is one of the skills athletes will need to learn as a student athlete.

Pro Tip: Take advantage of free time. Use study hall for studying and homework (obviously), and use bus rides for the same thing. Being an athlete is work!

Have a Productive Football Season

Parents, I hope this is “fridge worthy”. Coaches, keep these tips in the front of your mind when it comes to your athletes. I hope that your football athletes will use these 5 tips to have a healthy and productive football season.

Josh Ortegon


About the Author: Josh Ortegon

Josh Ortegon - 5 Tips to a Healthy Football SeasonJoshua Ortegon is co-founder and the Director of Sports Performance Enhancement at Athlete’s Arena in Irmo, SC. Joshua earned his Bachelor of Science degree in Exercise Science from Western Michigan University in 2000.

As an IYCA-certified High School Strength and Conditioning Specialist, speaker, and writer, Joshua has helped establish Athlete’s Arena as the premier high-performance center in South Carolina since 2005.

Joshua has worked with a wide range of athletes from youth to professionals specializing in the areas of injury prevention, return to play and performance enhancement.


Are Your Athletes Prepared to Perform this Season?

IYCA-LTAD-LM-Blog AD-V1 - 5 Tips to a Healthy Football Season
 

Thank Yourself

The Purpose of Youth Sports

I am a medical professional so there is a duty to talk about “problems” and “pain.” After enough years I would like to approach it with two different “P” words: purpose and progress.

thanks-1183283_640I have written a hundred plus articles on the topics of injury prevention, rehab, and sports performance but have not fully addressed something more profound…that youth sports are great.

Problems exist, and we talk about them a lot. Massive increases in over training injuries and dropping out of sports by 8th grade are at an all-time high. Also, the number of crazy parents and coaches doing embarrassing things seems to be growing daily.

But what is the purpose of youth sports? Some could say, to develop top notch athletes but more economist types would say to support a growing multi-billion-dollar industry.

I say it is about fun.

Youth Sports is Not a Job

Fun, determination, hard-work, success, failure, big highs, disastrous lows, and all the rest that goes into building strong character. Sports is only a good paying job for an infinitely small part of the population and at those levels, it still is a job.

Youth sports is not a job—it is an opportunity to participate in something a child loves.

The whole purpose is to give our children a chance to experience greatness for themselves, in whatever tiny amount, which in turn can carry on to so many other things. Opportunity for success and risk of failure is what sports is all about.

As we live in a crazy interconnected world, let’s take a moment and appreciate what you do. You show up day and night to provide children with the opportunity to live out their dreams, their fun and their chances at glory.

In these moments, we can watch fun unfold.

Thank Yourself

If you are reading this article, perhaps you have been visiting the IYCA for some period of time in the hopes of learning. Learning how to make youth sports better, safer and smarter. Learning how to maximize the fun and minimize all the other stuff.

So just take a moment and appreciate yourself, that you care about the well-being of children, and that you are a coach.

That sounds like a purpose. That feels like progress. So thank you.

Dr. Keith Cronin, DPT


About the Author: Keith J. Cronin

Keith CroninKeith J. Cronin is a physical therapist and owner of Sports and Healthcare Solutions, LLC. Keith currently supports US Operations for Dynamic Tape®, the “Original” Biomechanical Tape®, providing guidance for education, research, and distribution. He graduated with his Doctorate in Physical Therapy (DPT) from Belmont University in 2008 and later earned his Orthopedic Certification Specialist (OCS).

Prior to graduate school, Keith was a collegiate baseball player and top-level high school cross country runner. He also had the opportunity to work as a personal trainer (CSCS) prior to his career in physical therapy, providing a very balanced approached to educating fitness and rehabilitation. Keith has focused his career on the evaluation, treatment, injury prevention, and sports conditioning strategies for athletes, with particular attention to youth sports. He currently lives in the St. Louis, MO area with his wife and two daughters, Ella and Shelby.

 

NFL Pro’s Journey Through Injuries – A Message for Your Athletes

NFL Pro’s Journey Through Injuries

Along the path to the NFL, I confronted many different forms of adversity. My journey was like many others who dare to achieve something rare. One form of adversity that I frequently faced was dealing with serious injuries. When I say serious injuries, I mean injuries that take at least six months of recovery.

Although serious injuries are physically and emotionally painful, it is important to remind your athletes that they can be excellent teachers.

My First Injury

My laundry list of serious injuries started in high school when I severely tore my left hamstring. It happened while doing jump squats. The hamstring gave way during the last set as I landed with 205 lbs on my back. My left hamstring immediately grabbed.

Instead of seeking medical attention, I fought through the sharp pain for months. The injury only worsened. Not until my explosiveness had diminished drastically did I finally see a doctor. It took me two years to fully recover from that hamstring injury. Imagine if I would have addressed it right when it happened. The recovery time would have been exponentially less.

My Second Injury

patch-510168_640My second severe injury took place months before fulfilling my childhood dream of playing college football. After finishing a rep of power cleans, I lowered the barbell loaded with 265 lbs to the ground instead of just dropping it. Poor choice and form. I felt a pop in my lower back.

For the next few days, my only symptom was back soreness. All of a sudden, about a week after the incident, my left leg went numb. I was diagnosed with a herniated disc. Improper Olympic lifting form took me on a 6-month detour from prepping for my first year of college football.

My Third and Fourth Injuries

My third and fourth severe injuries were ACL reconstructions. The first one occurred in the fourth quarter, in week thirteen during my first start as a rookie in the NFL. The fatigue of over-training had caught up to me. As I was running down on a kickoff, I attempted to stop and redirect. Unfortunately, my overworked and fatigued leg muscles gave way when my left knee twisted awkwardly rupturing my ACL.

My second ACL reconstruction was somewhat of a mystery. While doing a minor operation on my left knee, the ortho observed that my ACL was a ticking time bomb barely attached by a small strand. We opted to do a full reconstruction to ensure the stability of the knee. Pushing it too hard led to 2 ACL reconstructions and 18 months of rehab.

Thanks to modern medicine and training, I fully recovered from all of my injuries—turning potentially devastating injuries into positive learning experiences.

Lessons I Learned

Lesson #1: Listen to the body.

The body has ways of communicating. If your athletes feel an ache here or pain there, the body is indicating that “something isn’t right”. I’m not saying that any small ache or pain justifies sitting out. But learning “the why” leads to learning “the how” in recovery and preventing future problems.

For example, after having recovered from my first ACL, I began to have achilles tendonitis in that same leg from over using my calf muscle when I ran. I was taught that I needed to activate and strengthen my “glutes” in that leg to alleviate the stress off of that calf muscle. After making glute activation and strengthening a daily routine, my achilles tendonitis subsided. Properly troubleshooting aches and pains with the athlete goes a long way in fully recovering from and preventing injuries.

Lesson #2: If injured, physical abilities count for nothing.

Availability is the most important ability. That means when performance training, health is priority number one. Your athletes will need to feel good in order to play good. It’s not about how much weight your athletes lift, but how they lift that weight that counts.

For instance, performance training has become synonymous with Olympic lifting. The sport of Olympic lifting is extremely technical. Most athletes who are not Olympic lifters will naturally prioritize learning the skills of their sport over Olympic lifting—increasing the likelihood of poor technique and risking unnecessary injury. Why train for a sport with another sport?

Train your athletes like they compete while minimizing potential injury and stress on the body. There are a number of different alternatives to Olympic lifting that are more effective in developing sport specific skills and that are easier to learn, while minimizing wear and tear on the athlete.

Lesson #3: Rest is as equally important as work.

Resting for those who are strong workers can be challenging. But it is essential for optimal performance. A good night’s sleep is necessary in regenerating and re-energizing the body, mind and spirit. Tapering during the season, as I learned, is crucial. Counting a game as a high intensity workout can help in balancing the scale of rest versus work.

Wrapping it Up

Injuries are a part of athletics. Not all injuries are preventable. They are a form of adversity that, if managed correctly, can work as springboards. It all comes down to empowering your athletes to learn from the injuries. That is key.

Brady Poppinga


About the Author: Brady Poppinga

Brady PoppingaBrady Poppinga played in the NFL for eight seasons (2005 to 2010 Green Bay Packers, 2011 St. Louis Rams and 2012 Dallas Cowboys). Brady is a member of the 2010 Green Bay Packers Super Bowl championship team. After retiring from the NFL over three years ago Brady has reinvented himself as an inventor of the worlds first Omni directional smith machine.

Brady is also an entrepreneur starting up a company called Ultraflex Fitness LLC (www.myultraflex.com). He’s also a nationally recognized broadcaster (Fox Sports, Fox Deportes and Westwood 1 radio) and author of the book True Spirit of Competition.

Being bilingual, Brady made history by calling Super Bowl 48 in a purely Spanish production for the first time ever. Drawing from the training principles that he learned while playing football at the highest level, Brady has designed his own 20 to 30 minute high-intensity training program.

 

5 Injury Myths You Need to Know

Injury Myths: What You Need to Know

football-619243_640Does it just seem that some people are more injury prone than others? I know this from personal experience, I was one of them.

Perhaps that’s what drove me to become a physical therapist—a yearning to understand what was wrong with me.

Along the way I learned a few things and with that, I now share with you my favorite 5 Injury Myths.

5 Injury Myths

Injury Myth #1: “A Torn Rotator Cuff is a Torn Rotator Cuff. Doesn’t Matter How It Happened.”

 
The cause of injury is just as important as the injury itself.

I remember once having a 45-year-old male construction worker and an 18-year-old baseball pitcher both in rehab at the same time for reconstructed rotator cuffs.

What stood out in that moment was the athlete saying, “Oh, he has the same thing as me.” Not even close.

The construction worker was carrying a ladder over his shoulder and turned a corner, hit a wall, and it jerked his arm backward causing a forceful twisting of the shoulder, shredding the rotator cuff.

The baseball pitcher was the result of throwing 150+ pitches a game, back-to-back days for several years. These two injuries are not the same.

The construction worker’s injury was the result of instantaneous load that exceeded his ability to control motion. The baseball player’s injury was from years of microtrauma. The former was an accident, and the later was more deliberate.

These two are not rehabilitated the same way or for the same purpose due to age, cause, and desired return to a specific activity.

Injury Myth #2: “Kids heal faster than adults. You don’t need to worry about them as much.”

 
Oh contraire! Adults have fully formed, constructed body parts that when damaged, a blueprint exists to reform the broken parts.

It sure won’t occur as fast as children but the body’s healing mechanisms have an idea of where everything is supposed to go.

Children, particularly athletes, are in the process of writing the blueprints.

There is a pre-determined set of instructions that is being edited daily by the forces of physics. With enough beating and breaking, even the most resilient athlete may result in having these blueprints messed up.

I am not talking about legs and arms that are 3 inches shorter or longer. I am referring to subtler things such as lower legs that are prone to shin splints or bony formations in the shoulder from inappropriate friction. This stuff shows up later.

It is imperative that the body tissues get to the finish line, fully completed, and ready for the decades of life to come.

Injury Myth #3: “The more it hurts the worse the injury is.”

 
Pain is not input, it is output. Past experiences, desire, experience with handling injury, mood, environment, and education are just a few of the things that cause pain.

In our multi-billion dollar youth sports world that is high competition and high volume (both of which need a bit of balancing but that is for another blog post) this idea of pain is tricky.

Pro Tip: If there are concerns, it is best to leave it to the professionals. When your car starts making funny noise, unless you are a mechanic, you don’t open up the hood and start moving things around. Same with your young athlete—take them to the shop for a diagnostic and tune up.

Injury Myth #4: “Swelling is not a big deal as long as the body part is wrapped.”

 
Swelling does something funny to body parts, particularly joints: it makes them work pretty crappy.

Swelling is the body’s natural response to damage—starting an inflammation process to get rid of damaged tissue and restore parts to normal working order. It also shuts down muscle activity to help facilitate this regeneration.

Pro Example: Clinically, if I have an athlete recovering from an ACL surgery and during the course of sports conditioning the knee gets really swollen, I will shut everything down. Why? Because I know that thigh muscle is going to fire as fast or as strong due to the joint swelling. That could impact the stability of the joint, putting the ACL at risk. This could also be true that the same swelling makes the knee less responsive, sluggish if you will.

Fluid is not compressible, which is why we have hydraulic systems in our cars. It helps transfer energy from one area to the other because fluid cannot compress.

Everything else in your body, including nerves, ligaments, muscles, even bones are compressible and that fluid pressure wreaks havoc on all the parts affected.

Injury Myth #5: “If it hurts, just take some anti-inflammatories and it will be fine.”

 
I would like a few doctors to give their two-cents on this one but I am happy to stick with this simple statement: Stop it.

Children are not adults. If you have an athlete that is taking fifteen 200mg tablets of ibuprofen every day to get him through hockey season, just sit down and ask yourself, why?

bandage-1235337_640If your doctor made this suggestion then follow orders.

There is a reason for this, but if it’s because this OTC, cheap treatment gets your athlete through the day and without it they are miserable, limping blobs of pain, then there is no understanding of “the why”.

Almost every serious overuse injury that resulted in missing whole seasons or having surgery before the age of 20 has a similar backstory.

Many times parents and athletes do not report this to the doctor. They weren’t hiding anything, they just thought this was the norm and wasn’t worth mentioning. THIS IS NOT NORMAL!

A drug that has interactions on the body should not be taken lightly just because the athletic world has been eating them like Skittles for decades.

Dr. Keith Cronin, DPT


Get Your Prepared to Perform Free Gift Today

Learn how to leverage the Long Term Athletic Development Model to ensure your athletes are prepared to perform. In expert Wil Fleming’s free 7-minute video and PDF checklist, he covers how to create a training system that prepares young athletes to move better, get stronger and enhance their performance.

Learn More


About the Author: Keith J. Cronin

Keith CroninKeith J. Cronin is a physical therapist and owner of Sports and Healthcare Solutions, LLC. Keith currently supports US Operations for Dynamic Tape®, the “Original” Biomechanical Tape®, providing guidance for education, research, and distribution. He graduated with his Doctorate in Physical Therapy (DPT) from Belmont University in 2008 and later earned his Orthopedic Certification Specialist (OCS).

Prior to graduate school, Keith was a collegiate baseball player and top-level high school cross country runner. He also had the opportunity to work as a personal trainer (CSCS) prior to his career in physical therapy, providing a very balanced approached to educating fitness and rehabilitation. Keith has focused his career on the evaluation, treatment, injury prevention, and sports conditioning strategies for athletes, with particular attention to youth sports. He currently lives in the St. Louis, MO area with his wife and two daughters, Ella and Shelby.

 

Why Do ACL Tears Occur?

ACL Tears: Why Do They Occur?

The anterior cruciate ligament (ACL) is one of four main ligaments in the knee and provides a significant amount of stability during agility and sports specific movements.

Unfortunately, over 200,000 athletes are affected by ACL tears each year, and even more importantly the ratio of females to males is 9:1.

The most common age for ACL tears to occur ranges from 15-45 y/o with the primary focus being the youth sports population due to the higher demand and intensity of youth sports. (Griffin, 2000 & Chapman, 2001)

70% of all ACL tears are found to be non-contact in nature. This means that 70% of all ACL tears result from a biomechanical abnormality or insufficiency.

They can also result from an athlete performing a sports specific movement incorrectly causing too much stress on the ACL than it can withstand, resulting in a tear.

The other 30% of all ACL tears occur due to a contact force during a practice or game. For example, a contact ACL injury is when a football player tears their ACL by having a linemen tackle them on the side of the knee.

Both non-contact and contact ACL injuries most commonly occur in basketball, soccer, skiing, and football. (Griffin, 2000 & Chapman, 2001)

One of the Biggest Questions Is…Why do ACL Tears Cccur??

Early Specialization Among Youth Sports

 
Overall, youth sports in America today are completely flawed, secondary to youth athletes specializing in one or two sports too soon.

When early specialization occurs there is a lack of skill development with basic human movements leading to kids in America becoming undeveloped, under-prepared and over-exposed.

Athletes who focus too soon on one sport during the developmental process can cause their bodies to be exposed to inappropriate developmental stressors, therefore leading to injury and poor performance.

Pro Tip: It is highly recommended to encourage all youth athletes to participate in a variety of sports and activities to allow for proper development and well-rounded athletes. “You need to crawl before you walk.”

Knee Valgus Angles

 
A knee valgus angle is defined by the angle formed at the knee joint when it goes inward utilizing the tibia and femur as the axes “knocked knees”. During all functional and sports specific movements it is ideal to see 5 degrees or less of knee valgus.

When athletes are not trained correctly and/or do not have the proper body awareness during functional and sports specific movements, increased knee valgus angles at the knee are common causing significant amounts of stress on the ACL. (Hewett et al, 2006)

Poor Form and Muscular Activation/Strength with Functional Movements

 
It is important for all athletes to understand proper form with all functional and sports specific movements and to develop a solid baseline level of strength in all musculature groups important for their given sport.

It is common to see several athletes on a field performing sports specific movements with poor form, naturally increasing stress on the knee.

The lack of cross training for a given sport to develop the proper amount of muscle activation and strength in muscles is very common.

Pro tip: Due to the higher demands and intensity of sports, it is crucial for all athletes to participate in a well-rounded cross training program including balance, strength, coordination, education with verbal and visual feedback etc. This is to make sure each individual athlete understands proper form with all sports specific movements.

Balance and Proprioception Deficits

 
Balance is defined by the ability for an athlete to maintain stability and control during sports specific and functional movements. Proprioception is the ability for an athlete to understand where the body is in space during a given time both on and off the field.

Both variables are important for every athlete to develop early on to allow for participation in an open environment and demonstrate control and stability with sports specific movements.

If an athlete does not participate in a training program with balance and proprioception as components of the program, they are at greater risk for ACL injuries during maturation. (AAOS, 2007)

Poor Neuromuscular Education and Control

 
The development of accurate and efficient neurological pathways to muscles during the maturation of a youth athlete is crucial.

The ability of the brain and important muscle groups to communicate allows an athlete to develop proper muscle activation, timing, control, and stability with functional and sports specific movements.

If the proper neuromuscular pathways are not developed and an athlete does not participate in the proper amount of neuromuscular education within their training, they are more at risk for ACL injuries. (AAOS, 20007)

Gender Specific Anatomy

 
The primary reason for the 9:1 ratio of females to males being more at risk for ACL injuries is due to gender specific anatomy.

The first area to focus on is the q angle.

It is defined by the angle developed when you draw a line from the ASIS of the pelvis (bony landmarks on front of hips) to the mid-line of the patella “kneecap” and a second line from the tibial tuberosity (bony landmark below your kneecap) through the midline of the patella.

Women by nature have an average Q angle of 11-15 degrees which is 4-5 degrees greater than males. A larger average q angle for women compared to men is related to having a wider pelvis meant for childbirth.

A wider pelvis will naturally cause larger knee valgus angles leading to increased risk of ACL tears. (Griffin, 2000 & Chapman, 2001)

Secondly, common trends among women compared to men tend to lead to significant quad dominance, weakness of hip extensors “glutes” and over pronation of feet “flat feet” during functional movement causing increased stress on the knee.

Lastly, female hormones during their monthly menstrual cycle have been shown to lead to ligamental laxity putting women more at risk for ACL injuries. (Griffin, 2000, Chapman, 2001, & Hewett, 2006)

Summary

Encourage all youth athletes to participate in well-rounded training programs and ACL injury prevention programs to ideally allow an athlete to develop and mature properly, prevent injury, and maximize sports performance.

Brittany Lillie PT, DPT, CSCS
Brittany Lillie


References

  1. Chapman MW. Chapmans Orthopaedic Surgery. 3rd Edition, Volume 3, 2001; 2348-2388
  2. Grifffin LY. Noncontact Anterior Cruciate Ligament Injuries: Risk Factors and Prevention Strategies. Journal of the American Academy of Orthopaedic Surgeons. 2000; 8: 141-150.
  1. Hewett TE, Myer GD, Ford KR. Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors. American Journal of Sports Medicine. 2006 Feb; 34(2):299-311. Hardaker W
  1. American Academy of Orthopaedic Surgeons, July 2007, Anterior Cruciate Ligament Injury: Surgical Considerations, http://orthoinfo.aaos.org/topic.cfm?topic=A00297#A00297_R4_anchor (July 11, 2008).

Develop Well-Rounded Athletes by Preparing Them To Perform

Dr. Lillie references the importance of developing well-rounded athletes, which is why it is so important that your athletes are Prepared to Perform!
 
IYCA-LTAD-LM-Blog AD-V1
 

5 Tips You Need to Know About Knee Injuries

Tips About Knee Injuries

football-619243_640Knee injuries are rampant, and in the physical therapy world they tend to keep us employed.

There are so many types of knee injuries that, for coaches, it can be hard to know what is what.

Patellofemoral Syndrome? Patellofemoral Dysfunction? Lateral Tracking Patella? Did you know those are the same thing?

So to break down the barriers to understanding knee injuries, here are…

5 Knee Related Tips that Every Coach Should Know

Tip #1: Basic Anatomy Factoid

The knee is the largest, most unstable, joint in the body. Somehow our evolution created a very large, somewhat disarticulated joint with a bony hockey puck on top, and 4 ligaments stringing it all together.

The ankle can move in two planes of motion very well. The hip moves in three planes of motion, and then the part between the two moves in one and if it moves in three, you have now lost your ACL!

This body part is set up for failure so that’s why tip #1 will hopefully shed light on tips #2-5.

Tip #2: The Joint is Sensitive But for Good Reason

There are millions of receptors coursing through the knee that transmit a lot of information.

When cutting on a basketball court and a little rotation at the knee is registered, what happens? Simple, the hips and lower back rotate—and the athlete goes up onto the ball of the foot to allow fluid motion to prevent twisting. This creates strong and efficient movement patterns.

The orientation of the kneecap (patella) allows the quad to generate increased force by making a bigger lever arm with every jump, land or sprint. It’s a great shock absorber when used correctly.

So when aches and pains start showing up in the knee, the message to the head is “I can’t handle the pressure, please stop.” Just think of it as a barometer for the lower body.

Ankles and hips have this type of capacity but they are also so intricately involved in balance strategy that they are focused on other tasks.

Tip #3: Address the Problem Early

Rolled ankles occur frequently. Hip joint injuries are less common, such as a labral tear, and when they happen it will really slow down or stop an athlete.

As a clinician that teaches online courses for Patellofemoral Syndrome and ACL Rehabilitation, please heed my recommendation to not ignore knee pain because there are a lot of causes.

For young athletes the most common response is “it’s just growing pains”, right? Sure, that could be the answer but let ME, (the Physical Therapist), figure that out.

Before, I mentioned the idea of the knee as a shock absorber. If a knee cannot handle the load, pressure, force, etc. going through it and the athlete continues to push through, changes will start to occur.

Pro Tip: Correctly using the forces of physics can build great athletes but when mismanaged becomes a wrecking ball.

Problems are much easier to address in the first couple of weeks. Timing and positioning mechanics of the knee—when pushed too far—eventually fall apart. Excessive loading through the patellar tendon can cause painful bone formation that we know as Osgood Schlatter’s.

Constant pain behind or on the side of the knee cap can cause maltracking. This is due to a bad combo of tightness and weakness in the quad muscles, known as Patellofemoral Syndrome.

Repeated abuse of the knee joint will begin to shut down quad strength because of this awful pain/inflammation cycle. If there is any uncertainty to the cause of knee pain, get the athlete to the doctor and hopefully to a sports-minded clinician that is going to figure out the underlying cause.

Pro Tip: The longer knee pain persists, the longer it will take to correct the problem.

Tip #4: Pain Does Not Equal Damage

This applies to any injury, but I find it very relevant to the knee. The knee is a very painful structure, as I mentioned—lots of tiny cells that relay information with every step. It is pretty well known in the physical therapy world that the fat pad behind the kneecap, which provides cushioning, when pinched is “drop to the floor” painful.

An IT band that slaps awkwardly across the outside of the knee joint may also take an athlete’s breath away. While both incredibly painful, when addressed appropriately can be quickly resolved.

Bringing this back to the “get it checked out” message I have already conveyed—as a coach it is important to realize this because fear and doubt will settle into the athlete’s brain.

Pro Tip: Pain is a way for the body to say “Hey, I don’t like what is going on here, do something about it.” Lots of things affect pain so getting a clear understanding of the cause is critical, before some real damage starts.

Tip #5: It’s Too Important to Cover Up

If you do not know what the issue is affecting the knee, don’t cover up the problem. I am talking about all the braces, bands, clips, gels, and bottles of anti-inflammatories that young athletes get rigged up with.

If your doctor or therapist recommended something like this, absolutely listen and follow the sound advice.

If an athlete is limping around and you slap on a compression sleeve and wrap, and then it miraculously feels better, it doesn’t mean the issue doesn’t still exist. The typical response is “back to business as usual”. STOP, and direct that child towards the doctor.

As adults, we mask things to make it through the workday, manage pains at home so we can bend over and bathe the kids, or perhaps to participate in recreational softball tournaments.

Children are not adults.

Take Home Message

A lot of the article may be interpreted as “any knee problem, take an athlete to the doctor.”

If an athlete’s knee is sore after doing box jumps for the first time, is slow moving following a run into a wall, or is a bit irritated after increasing running mileage from 5 to 7 miles, there are cases where you know a potential cause or instigator.

For the athletes that have been limping around for weeks and getting worse, a professional medical evaluation is warranted. I am always going to error on the side of caution with this type of thing because at the least, an athlete will get their part checked out and learn ways to head off problems before they start.

Dr. Keith Cronin, DPT


Help Prevent Injuries by Preparing Athletes To Perform

Learn how to leverage the Long Term Athletic Development Model to ensure your athletes are prepared to perform. In expert Wil Fleming’s free 7-minute video and PDF checklist, he covers how to create a training system that prepares young athletes to move better, get stronger, and enhance their performance.

Learn More


About the Author: Keith J. Cronin

Keith CroninKeith J. Cronin is a physical therapist and owner of Sports and Healthcare Solutions, LLC. Keith currently supports US Operations for Dynamic Tape®, the “Original” Biomechanical Tape®, providing guidance for education, research, and distribution. He graduated with his Doctorate in Physical Therapy (DPT) from Belmont University in 2008 and later earned his Orthopedic Certification Specialist (OCS).

Prior to graduate school, Keith was a collegiate baseball player and top-level high school cross country runner. He also had the opportunity to work as a personal trainer (CSCS) prior to his career in physical therapy, providing a very balanced approached to educating fitness and rehabilitation. Keith has focused his career on the evaluation, treatment, injury prevention, and sports conditioning strategies for athletes, with particular attention to youth sports. He currently lives in the St. Louis, MO area with his wife and two daughters, Ella and Shelby.

Additional noteworthy items about Keith:

  • Keith is currently a reviewer for the International Journal of Sports Physical Therapy (IJSPT) on a variety of topics including throwing athletes, concussions, and ACL rehabilitation.
  • Keith has produced several online CEU courses for PTWebcuation.com on the topics of running injuries, ACL rehabilitation, Patellofemoral Syndrome, and injuries to the Foot and Ankle.
  • In 2012, Keith participated in a concussion education program in Newcastle, OK that resulted in the documentary “The Smartest Team: Making High School Football Safer” which had several runs on PBS worldwide.
  • Keith has also been published in a variety of media, publishing almost 100 articles through venues including MomsTEAM.com, Advanced Magazine, the 9s Magazine, the American Coaching Academy, and Suite101.
  • Keith was also featured on Fox2News several times on topics of concussions and ACL injuries.
  • In 2008, Keith was a winner of the Olin Business Cup at Washington University for his product innovation “Medibite” a jaw rehabilitation system designed to improve the outcomes for individuals suffering TMJ dysfunction.

 

When The Body Says “Yes, But The Mind Says “No”

By Tom Hurley

It is estimated that between 15 and 20 million sports injuries occur in the United States alone. These injuries can range from nagging constant pain due to overuse, to season ending injuries such as ligament damage in the ankle, knee or shoulder; and the age of the athlete’s affected can range from very young, (7 years) to not so young, (70 years and beyond). The statistics are staggering, but not necessarily unpredictable. The bottom line is, in terms of classifying athletes, it has been said that there are two types: those who have been injured, and those who have not been injured yet.

As opportunity for youth participation in sport grows, the number of injuries related to participation naturally rises. Not only does this create a larger need for the biological, (physical) problems associated with the injury to be addressed through possible surgery, rehabilitation and conditioning, it also creates a necessity for young athletes, parents and coaches to understand the mental and emotional, (psychological) factors that need to be addressed for a full recovery.

“Get back on the horse”
So you want to get your son/daughter/team member/athlete back in the game. The Doctor has given them “medical clearance” and all physical indications are that he/she should be able to participate at their pre-injury level. You’ve tried everything to get them there, but nothing seems to be working. You wonder “what will it take to get them back on the horse”? This is a huge subject matter, one that can not be fully addressed in a simple article. There are however, some specific strategies that can be noted for further exploration.

sports injuries

Scenario 1:
The young athlete begins practicing with the team and aside from a let down in physical “game-time” conditioning, seems to be performing at or near pre-injury level. This is the scenario that we would all like to experience. In this case the child simply needs to know that there is an open, non-judgmental line of communication available to them should they begin to experience pain or inhibition.

Scenario 2:
The young athlete refuses to return, or when they do begin practicing, doesn’t seem to have the same intensity or focus that they once had. They are noticeably more “timid” in their approach to the sport. This is an extremely common scenario whereby we see the physical return to the sport but factors are in play that are creating inhibition. It can not be understated that open non-judgmental communication between the athletes, parents, and coaches is vital in all of these situations, and should be the standard for all youth athletics. There are usually three different factors involved in the “timid play” scenario.

“It still hurts”
The first factor could quite simply be that the child still experiences pain as they are trying to play. Though it may sound simplistic, we often forget to ask the proper question. If the young athlete feels empowered as a member of their own re-habilitation team, they will be more likely to let you know that “it still hurts”. The fix here is simple; go back to the doctor or get a second opinion.

“I’m all done”
This factor is a little more difficult to rule out. In our efforts to promote our children through sport we sometimes forget that they are not little adults. Their likes and dislikes are fickle at best as they move through development and maturation. Today’s favorite activity may be tomorrow’s memory. Your child/athlete may be trying to let you know that they have simply lost interest in this sport and don’t know how to tell you for fear that they will let you down.

The temperament, coping skills, daily stresses, trait anxiety and emotional maturity of each young athlete is unique and under construction. The injury and pain associated with it may have been enough to disengage that child’s desire to continue with this particular sport.

Of course we all want athletes to “get back up on the horse” because it “builds character”. The suggestion here is to begin having conversations with the athlete about their continued participation. It has been my experience that once a child knows that they are able to have good honest “talks” about how they feel; they are more likely to make decisions based on how they actually feel as opposed to how they think they should feel. Often times the child will understand where the apprehension to perform is coming from, and will be willing to try to work through it and continue with the activity. Of course, the fact remains that they simply may be “all done”.

“I’m Scared”
Fear is a primary emotion. That said, when a young athlete focuses on the fear of re-injury it is nearly impossible for them to focus on the prospects of returning to pre-injury play. The fear of re-injury not only inhibits intensity of play, but places the athlete at a higher risk of more injury due to compensatory movement patterns as they avoid using the injured or affected body part. This is the factor most commonly associated with an athlete’s return to full participation, and can be the most frustrating for the athlete to try to overcome.

There are four vital elements that should be considered when dealing with the psychological aspects of all of these injury scenarios. For this scenario, since it is often times the most difficult to deal with, it’s important to be familiar with all four, though within the confines of this article, and because we are focusing primarily on the child athlete, concentration will be on the first two of these.
1) First and foremost it is vital to validate the child’s fear as a rational, normal and completely expected outcome of having been injured.
2) Set specific, progressive, reasonable goals for the athlete’s full return to play.
3) Utilize imagery and relaxation techniques.
4) Incorporate positive self-talk.

Encouraging a young athlete to discuss feelings of apprehension or of being “afraid” to play again is extremely important for their emotional development, not only as an athlete but as a person in general. The realization that they are experiencing a normal consequence of having felt pain, and that all athletes at some point experience the same thing, allows them the freedom to move toward dealing with this emotion. Remember, we are talking about children who are still in the process of developing psycho-socially. This is an important first step toward eventually returning to activity; especially when it is a young athlete’s first injury.

Setting goals may sound easy, but requires that you know whether your child is ego oriented or task oriented. In its simplest terms, an ego oriented athlete bases their self-worth on how well they perform compared to others, while a task oriented athlete is driven by an internal desire of skill mastery, effort and self-improvement.

An example of a simple ego-oriented goal may sound like this: “Jane (a teammate) made four lay-ups in a row from the right side, now it’s you turn to see how that knee holds up.” Though the focus of the goal ends with a statement regarding this athlete’s knee (the site of the prior injury), this ego oriented athlete will focus on trying to do as well as Jane; allowing her to perform on the rehabbed knee while focusing on performance.

An example of a task-oriented goal may sound like this: “Today you will perform 3 sets of lay-ups from the right side. Each set will be made up of 10 reps. Try to make as many in a row as possible.” Here the focus is on the lay-up, which will require her to decelerate then drive through her previously injured knee. No concrete number is given as a goal for completed lay-ups per set, as this athlete will use the first set as a benchmark and attempt to improve on each subsequent set. Remember, a task oriented individual is driven by self effort and improvement.

Notice, in each of these examples we kept it as simple as possible by not creating a time limit or actual person to person competition. The point here is whether ego or task-oriented, the goals remain attainable, reasonable and progressive. We also need to remember to debrief or discuss with the athlete how they felt during these performances. Allow them the opportunity to share what it felt like. When a goal is achieved, celebrate with them by recognizing the achievement, and then increase the difficulty of the goal. The young athlete’s self-confidence should continue to improve. As adults we need to be aware that all healing takes time and sometimes the emotional and mental healing requires more time than the physical healing. These are, above all, developing human beings.

Earlier I mentioned imagery, relaxation, and positive self talk as vital elements to incorporate in the injury recovery process. Though I use them on a regular basis with athletes that I work with, it is not something that was learned overnight or in a brief article such as this. Concentrating on good open communication and development of proper goal setting skills can go a long way in helping young athletes through emotional challenges.

Reference:
Murphy, S. (2005). The Sport Psychology Handbook. Champaign, IL: Human Kinetics.

Tom Hurley, M.Ed., YFS3, YNS, SAS, HSSCS applies over 30 years of combined knowledge as a Behavioral Therapist, Health and Physical Education Teacher, and Mental Skills Coach in his current business as a Performance Specialist. He currently programs with over 200 athletes and is dedicated to providing each one with the opportunity to develop spirit, mind and body.

Resistance Bands and Olympic Lifting

By Dave Schmitz

 

Wil Fleming recently wrote a very powerful article on “Why Olympic Lifts” that I found very thought provoking.

I agree with Wil that when you begin to discuss Olympic lifting with coaches, red flags immediately goes up about concerns for proper teaching, concerns for safety, and the stigma that Olympic lifting is only for the highly skilled or older athletes. For those coaches I understand their opinion and will not argue those points. Instead I will pose the question, is there a way to achieve some of the benefits of Olympic lifting without struggling with the teaching challenges or putting athletes at risk for injury.

As I read Wil’s article I continued to see a strong correlation between the benefits of resistance band training and Olympic lift training. Therefore as a follow up to Wil’s outstanding article, I wanted to touch on all 5 of Wil’s key points and relate them back to how resistance bands could assist young athletes and coaches with “improving” Olympic Lifting skill sets.

Please note that I am not suggesting you replicate Olympic lifting with bands but rather that you can get some of the neuromuscular benefits of Olympic Lifting by training with resistance bands. I also feel that performing certain movement with resistance bands will carry over to helping young athletes become better Olympic Lifting candidates.

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Changing Views on Long-Held Beliefs for Training Young Athletes

Training Young Athletes: 3 Changing Views

Training young athletes

Foam Rolling, aerobic training, and ice: In terms of training young athletes, conventional wisdom says one thing, but does the evidence really support it?

We all know that the profession of training and coaching is a constantly evolving process of learning and adapting. Heck, that is what training itself is all about: staying ahead of adaptation to make continued progress.

(more…)

Stop the Insanity!

 

Young Athletes Sports-Specific Training Insanity

 

By Mike Mejia
 

You see the ads all the time. Typically rife with promises of “radical increases” in strength, speed and power, they grab the attention of athletes, parents and coaches alike. Capitalizing on the desire of young athletes to gain any possible advantage over their peers, sports-specific training programs have been popping up all over the place in recent years. Whether it’s a soccer player seeking a more powerful kick, or a basketball player that wants to increase his, or her vertical leap, parents are shelling out big money for training that’s aimed at increasing their child’s physical prowess in a given sport. The question is, though, how specific does a training program really need to be for bodies that are still developing and as such, often have a variety of needs that far outweigh the enhancement of particular sports skills?
 

The unfortunate reality is that often times these programs do little more than contribute to the rapidly increasing rate of overuse injuries currently seen in youth sports! By replicating the same movement patterns and taxing the same muscle groups that are already being overused during practice and competition, this emphasis on “sports-specific” training is the exact opposite of what young athletes actually need. Rather than seek to enhance overall athleticism and reduce injury risk, many of these programs load kids up with bands, sleds and various other types of resistance, long before their bodies are physically prepared to do so. The thought process being that by overloading specified movement patterns, the athlete will be better able to meet the specific demands of his, or her sport.
 

Is this really necessary…
 

Young athletes sport specific training

 

Seemingly sound thinking; particularly when applied to young athletes age 16-17 and older, who’ve likely been training longer and as a result, possess a more sound physical foundation to work off of. Even then, however, such athletes should be thoroughly assessed to identify any weak links (i.e. strength and flexibility imbalances) that may serve as potential precursors to injury. For younger kids though, this trend towards sport specificity is an unmitigated mistake- especially when the intent is future sports stardom! As experts in the field of athletic development and sports conditioning continually point out, the vast majority of world class athletes didn’t specialize too early and instead, were exposed to a wide variety of sports that helped them develop more in the way of global athleticism.
 

In direct contrast to this, nowadays we commonly see kids who despite dominating in a particular sport, lack the ability to run properly, skip, throw a ball, change direction, land from a jump, or execute a host of other basic physical skills that require efficient, coordinated movement.
 

That’s why I’m imploring parents and coaches alike to stop buying into the hype and subjecting young athletes to this type of approach.

 

Get your kids working on improving things like mobility, flexibility and systemic strength and resist the temptation to have them mimic specific sports skills through training. If they play tennis, instead of having them try to replicate their swing against rubber resistance tubing, have them work on general core strengthening. If basketball’s their game, forget all of the intensive plyometric drills until they’ve first demonstrated the ankle mobility and knee stability necessary to safely engage in this type of training.
 

Granted, this may not be the popular approach and is in fact, often the last thing that scholarship obsessed athletes (and their parents) want to hear. I guess it just doesn’t pack the same marketing punch as potential division one success, or lucrative pro contracts. However, with up to half of the 2 million sports injuries suffered each year by middle and high school aged young athletes being attributed to overuse, it’s a message that desperately needs to be heard. It also happens to be where this industry is eventually headed and exactly the tact we need to take if we’re ever really going to get this young athletes injury epidemic under control.
 

 

Speed and Agility Training Program for Youth Football

Making a Speed and Agility Training Program Work for Everyone

There is often a disconnect between what we know is the ideal training for young athletes and what parents/coaches want for them—especially when it comes to a speed and agility training program.

We know through our education and in-the-trenches experience how to devise an athletic development program and implement it with athletes of various abilities and sports interests.

On the other hand, parents and coaches all too often adopt a “results now” mentality, and they’ve been fed loads of misinformation to boot. What are we to do when the opportunity presents itself to work with an entire youth league of athletes with a board president and coaches who have a philosophy that doesn’t match our ideals?

Make sure you keep your focus on their needs by asking questions—and a lot of them. You will gain the trust of the coaching staff when they know you are there to help them versus taking control over any aspect of their practice sessions.

If you do this with care and patience, the outcome can be very beneficial to your business and most importantly to the young athletes involved.

Youth Football Training Program Case Study

Speed and agility training programAfter several conversations with the president of the youth football league and some of his coaches, I was able to ascertain the areas they were most concerned with. They were, in their words:

1. “Revamping the warm up” to get the kids ready to play

2. Agility in small spaces

3. Injury prevention

Once we narrowed it down to these specifics, I could devise a game plan. They did not want the new programming to be intrusive to their practice time or ability to coach football.

Keep in mind the relationship with the president of this youth football league began nearly 2 years ago. Be patient when engaging coaches.

The outcome was to implement a pre-written youth football training program for every age group in the youth football league that the coaches would learn and implement for every practice.

What we gained from this exchange was exposure to every football player from 1st grade through 8th grade and the buy in of every coach. You just can’t buy that type of exposure for your business.

Upon completion of the last practice session, we set a time for the coaches and I to meet in order to troubleshoot any issues they were having.

The Nuts and Bolts of the Speed and Agility Training Program

Our situation was far from ideal. The coaches had limited time to learn their new programs. I only had one practice session with each team, and there was not enough time to include everything I wanted. Therefore, I knew the programs had to be prioritized.

The speed and agility training program had to deliver what the president and coaches asked for, and it had to be simple enough for both coaches and players to learn.

Templates Put into Action for Each Program

Not included are the descriptions and key points for each age group that were provided for each coach.

Pembroke Titans Football Mighty Mites (1st & 2nd Grade)

–Warm Up–
1. Reactive Game or Fun Activity
    a. Simon Says
    b. Tag Variations
    c. Movement Mirroring (coach or each other)
    d. Rhythm Machine (clapping)
    e. Coach’s Choice
2. Monster Walks
3. Bear Crawls
4. Dragon Walks
5. Log Rolls

–Speed/Agility/Strength = Coordination Training–
1. Scramble to Balance 2x Each leg
2. Rats/Rabbits
3. Red Light – Green Light (add football themed lights)
4. Push Up Hold/High Fives (partners)

–Speed and Agility–
1. Dynamic Repeats (run to stop)
2. Dynamic Repeats with Return (run, stop and return)
3. 4 x 4 x 4 Drill (survive for 7 seconds)
4. Bear Crawl to Hand Taps 6:4
5. Forward Crab Walk to Table Top 6:1

–Cool Down–
It is so important to give parents and coaches what they want while staying true to your beliefs as a coach. Below is a perfect example.

A formal cool down is not necessary from a developmental standpoint and static stretching is not advised for this age group. To acclimate the kids to a structure and expectation for future youth football practices, you can put them through the following passive active stretching activities.

1. Cobra 2 Second Hold x 5
2. Alternating Knee Hugs x 5 Each
3. Around the Worlds 2x Each Leg


Pembroke Titans Football Mites (3rd & 4th Grade)

–Warm up–
1. Activity – Game, Laps, etc…Coaches Choice
2. Spiderman 2 x 10
3. Alternating Supine Extension 20 Second Hold
4. Squat to Stand 2 x 5 (squat, knees out, arms up and stand)
5. Prone Extensions 2 x 8
6. Lunge with Toe Touch 1 x 10 Each
Speed and agility training program 67. Dynamic Warm Up
    a. Skipping Patterns
         i. Straight
         ii. High
         iii. Back
         iv. Side
    b. Knee Hugs 1 x 10
    c. Butt Kicks
    d. Straight Leg March 1 x 10
    e. Heel Walks/Toe Walks 1 x 10 Each
    f. Side Shuffle/Carioca (tight) 10 yds Each x 2

–Speed and Agility–
1. Dynamic Repeats (run to stop)
2. Dynamic Repeats with Return (run, stop and return)
3. 4 x 4 x 4 Drill (survive for 7 seconds)
4. Bear Crawl to Hand Taps 6:4
5. Forward Crab Walk to Table Top 6:1

Speed and agility training program 7–Cool Down–
1. Static Stretching
    a. Hamstrings
    b. Inner Thigh
    c. ITB/Hips
    d. Cobra Stretch
    e. Calf Stretch

Choice as needed


Pembroke Titans Football Pee Wees (5th & 6th Grade)

–Warm up–
1. Activity – Game, Laps, etc…Coaches Choice
2. Spiderman/Inside Elbow to Ground 2 x 10
3. Alternating Supine Extension 2 x 8 Each Side
4. Squat to Stand 2 x 5 (squat, knees out, arms up and stand)
5. Prone Extensions 2 x 10
6. Lateral Lunge with Toe Touch 1 x 10 Each
7. Dynamic Warm Up
    a. Skipping Patterns
         i. Straight
         ii. High
         iii. Back
         iv. Side
    b. Knee Hugs 1 x 10
    c. Butt Kicks
    d. Straight Leg March 1 x 10
    e. Heel Walks/Toe Walks 1 x 10 Each
    f. Side Shuffle/Carioca (tight) 10 yds Each x 2

–Speed and Agility–
1. Pro Agility
    a. 5-Hold-10
    b. 5-10-Hold
    c. 5-10-5
2. 4 x 4 x 4 Drill (survive for 7 seconds)
3. Bear Crawl to Push Up 6:1
4. Forward Crab Walk to Table Top 6:1

–Cool Down–
1. Static Stretching
    a. Hamstrings
    b. Inner Thigh
    c. ITB/Hips
    d. Cobra Stretch
    e. Calf Stretch

Choice as needed


Pembroke Titans Football Midgets (7th & 8th Grade)

–Warm up–
1. Activity – Game, Laps, etc…Coaches Choice
2. Spiderman with Hip Lift 2 x 10
3. Supine Extension with Rotation 2 x 8 Each Side
4. Squat to Stand 2 x 5 (squat, knees out, arms up and stand)
5. Atlas Stretch 2 x 6 Each
6. Prone Extensions 2 x 10
7. Alternating Lateral Lunge Walk 1 x 10
8. Dynamic Warm Up
    a. Skipping Patterns
         i. Straight
         ii. High
         iii. Back
         iv. Side
    b. Knee Lift/Heel Lift 1 x 10
    c. Straight Leg March 1 x 10
    d. Cradles
    e. Heel Walks/Toe Walks 1 x 10 Each

–Speed and Agility–
1. Pro Agility
    a. 5-Hold-10
    b. 5-10-Hold
    c. 5-10-5
2. 4 x 4 x 4 Drill (survive for 7 seconds)
3. Turn and Burn (Hip turn and go)
4. Bear Crawl to Push Up 6:1
5. Forward Crab Walk to Table Top 6:1

–Cool Down–
1. Static Stretching
    a. Hamstrings
    b. Inner Thigh
    c. ITB/Hips
    d. Cobra Stretch
    e. Calf Stretch

Choice as needed

Summary

So there you have some great examples of a youth football speed and agility training program that can be applied to nearly any sport. You also have some tips on how to deal with coaches to best suit their needs and ideals.

Dave Gleason


About the Author: Dave Gleason

Speed and agility training programDave Gleason is the owner and head coach of Athletic Revolution in Pembroke, MA. Dave’s career passions are training young athletes 6-18 years old as well as playing an integral role in the development of Athletic Revolution International. Dave was the 2010 IYCA Member of the Year, columnist and presenter. A proud member of the IYCA, Dave is honored to be named to the IYCA Board of Experts.


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Understanding Low Back Pain in Adolescents

 

Low Back Pain in Adolescents

 

By Jake Moore

 

Every one of us has worked with a young athlete with low back pain. In fact, we have all likely have worked with and missed the signs of serious low back pain in our athletes. Looking back at my career so far, I’m sure I have. Of those young athletes with lower back pain, up to 47% have spondylolysis or spondylolisthesis (1). Spondylolysis and spondylolisthesis are injuries to the posterior vertebrae and result from excessive spinal extension loading. Unfortunately too many young athletes are over-trained and exposed to poor training, leaving them at risk for these injuries. On the positive side, these injuries are preventable with good movement training and knowledgeable coaches. As IYCA professionals we expect to be held to a higher standard than youth fitness professionals when working with young athletes. If we can recognize the signs of serious back pain, and how to train to prevent such injuries, it will go a long ways in diminishing low back pain amongst your youth fitness athletes, help those with low back pain get timely treatment and decrease the impact of low back pain into adulthood.

 

Young athletes are at a vulnerable time to develop low back pain from excessive trunk extension. In late middle school and early high school they may be participating in multiple sports throughout the year. It is not uncommon to be in-season for one sport and still participate in off-season training for their club teams. (It would be worth another article to discuss how these athletes would benefit more from developing fundamental movement skills instead of being in-season all year.) In addition these athletes will be asked to begin a youth fitness or strength and conditioning program in their school as part of their athletic participation. Meanwhile this athlete is at a time in their development where:
1. The rate of bone growth is often outpacing the lengthening of muscle and fascia, leading to tight hips and poor posture.
2. Growth plates are still open and bone density is not yet fully developed.
3. Core strength is not developed as the body adapts to having longer limbs.
4. Motor control and posture are continuing to be shaped.
If these athletes are asked to perform fully loaded strength movements with poor form with an immature and ill-prepared body, the body has but one choice to accomplish this task. That is to hang onto ligaments and bony restraints instead of utilizing muscular control.

 

youth fitness

 

Pelvic influence on spinal curves

 

The spine has three curves. A lordosis, or slight backward bend at the cervical and lumbar spine, and a slight kyphosis or forward bend at the thoracic spine. This helps the spine absorb shock and increases stability versus a completely vertically stacked spine. The lumbar spine position is controlled largely by the pelvis. The pelvis is able to anteriorly and posteriorly rotate based on the muscle pull on the front and back side of the body. The images below demonstrate the muscles involved in creating rotation of the pelvis. The line of action of the hip flexors and spinal erectors pull on the pelvis to create anterior rotation. This anterior rotation results in increased lumbar lordosis. On the other hand, the glutes, hamstrings and abdominals create posterior rotation and a decrease in lumbar lordosis. It’s common to see individuals with inhibited glute and abdominal musculature and tight hip flexors and spinal erectors. The result is a tendency to position the pelvis in anterior tilt and increase compression of the lumbar vertebrae. When this occurs repeatedly over time, the posterior structures of the lumbar vertebrae are at risk for injury.

 

youth fitness

 

Spondylolysis and Spondylolisthesis

 

Some of the most significant injuries affecting adolescents are spondylolysis and spondylolisthesis. We all have likely trained athletes with this injury, whether we knew it or not. Spondylolysis refers to a stress reaction of overload to part of the vertebrae. In the lumbar spine this is often the pedicle or pars interarticularis. Spondylolisthesis is an advancement of spondylolysis with an identifiable fracture to the vertebrae and possible forward slippage.

 

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The pedicles and pars interarticularis are located on the back side of the vertebrae and are placed under compressive and shear load when the spine moves into extension. Injuries to these structures often occur gradually over time. As an athlete is asked to do exercises that are beyond their ability for the core musculature to control, the lower back will drift towards extension to find stability. Think about trying to bend a copper wire. As you initially bend the wire a hinge point develops. As you do this over and over again the wire will bend more easily and eventually break. This is exactly what is happening to young athletes with spondylolysis. It’s critical that these individuals get treatment before it is too late (spondylolisthesis).

 

youth fitness

 

Recognizing serious low back injury

 

To recognize the signs of spondylolysis or athletes at risk, look at posture, core strength, hip mobility and activities. Posture is often excessively lordotic when doing squats, overhead presses, deadlifts, back extensions, push-ups and planks. These athletes may be some of your more capable squatters and deadlifters because they understand how to keep the spine from rounding forward. The problem is they can’t control spine extension. Athletes with poor core strength are more apt to use this type of strategy to make-up for inadequate active lumbar stabilization.

 

youth fitness

 

An athlete with limited hip mobility is also at risk. Without flexibility in the hamstrings, glutes and hip flexors, the athlete will have to bend more through the spine on order to perform sport specific or weight room movements. Tight hip flexors will pull the spine into excess extension and poor glute and hamstring mobility will force the athlete to contract more through spinal erectors. The end result either way is increased posterior spinal loading. Any athlete who has made recent large increases in loading in the weight room should be monitored closely for low back pain. Football players and gymnasts seem to be most at risk as well as athletes participating in multiple sports at the same time.

 

Initial symptoms of spondylolysis may be a dull ache in the back with no initial onset. These athletes often have the most pain with running and jumping due to large ground contact forces. Squats, cleans, deadlifts, overhead presses, planks and leg lifts are also exercises that can increase symptoms. These athletes may be able to do every exercise in your program but have pain doing it. These symptoms may go on for months before they bring it to your attention. It may even recur every year, increasing during track season for example, going away during the summer only to return during football season. Once diagnosed, these athletes may be held out of sports and put in a brace for up to 6 weeks with another 4-6 weeks of rehab before full sport participation. An athlete who develops spondylolisthesis may battle low back pain on and off for the rest of their lives.

 


Keys to prevention of Low Back Pain in Adolescents Through Youth Fitness Programs

 

Low Back Pain Youth Fitness Solution #1
Teach pelvic tilt. Understanding how to pelvic tilt is fundamental to developing awareness of the position of the spine and pelvis. An athlete who does not know how to posteriorly pelvic tilt will have difficulty controlling trunk extension and rest on boney structures during exercise. The athlete who cannot anterioly tilt the pelvis will have a hard time learning how to hip hinge and keep neutral spine with squats and deadlifts. Teaching pelvic tilt is easily done if doing and floor based core exercise. Have your athletes start with knees bent, feet flat. Have athletes practice arching the lower back up off the floor, keeping the glutes and shoulders down, then have them smash the lower back down into the floor. This can be progressed to quadruped, tall kneeling and athletic stance positions. Once your athletes understand pelvic tilt, many of your strength exercises will be easier to teach.

 
Low Back Pain Youth Fitness Solution #2
Train in neutral spine. Have your athlete’s pelvic tilt both ways and then find a happy medium. That’s roughly what we would call neutral lumbar spine. To find neutral spine a stick placed along the lower back works well. The athlete should be able to contact the stick at the sacrum, thoracic spine and back of the head.

 

youth fitness

 

Floor based core exercise should use neutral spine as well. Dead bug progressions work very well here. Have your athletes lift one leg or extend one leg and opposite arm, keeping neutral spine. Check under their back to be sure there isn’t an increase in the gap between the spine and the floor. Exercises such as double leg straight leg lifts will be too challenging for most athletes without a progression. This is why kids put their hands under their butt if asked to do excessive leg lifts with a weak core.

 

Look at how your athletes perform planks. Ideally the glutes should be tight and spine neutral. The pelvis position should not change when doing planks or push-ups. If it does, then the abdominals are fatigued or the athlete has poor core control and the lower back passive restraints will bear the load. Discontinue the set. This means push-ups may be limited more by core strength than by upper body strength.

 

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Neutral spine applies for other strength exercises as well. Athletes should be able to use the force couples around the pelvis, engaging the glutes and abdominals to help control pelvic position. Exercises should maintain lumbar lordosis without forcing end range lumbar extension. Back extensions for example should be taken to full hip extension without hyper-extending the low back. For strength exercises, the cues to squeeze the glutes and tighten the abs will often help create balanced forces around the pelvis to control excessive pelvic tilt.

 

youth fitness

 

Low Back Pain Youth Fitness Solution #3
Improve hip mobility. As mentioned earlier, the hip flexors can create a force pulling the pelvis into anterior rotation, increasing lumbar lordosis. Keeping the hip flexors mobility is essential to allowing for neutral spine positioning when strength training and running. For younger athletes a specific static hip flexor stretch is not necessary. You can adequately train the hip flexors with lunges and split squats to develop mobility and neuromuscular control. Again use a dowel held along the spine and cue abs tight to improve pelvic control during the movement. On the other end of the spectrum, the athlete with tight hamstrings may not be able to utilize their glutes well when doing deadlifts, squats or getting into athletic stance. Getting the hamstrings more mobile will help young athletes access their glute strength and decrease demands on the lumbar extensors. Again, an isolated static hamstring stretch is not needed. Get your athletes to hip hinge with a stick and RDL with a neutral spine and you will develop functional hamstring mobility and trunk stability. These types of exercises along with many of the hip mobility exercises from your IYCA certification will help your athletes develop great hip mobility and allow for decreased demands on the lumbar spine during training and sport participation.

 

If you encounter Low Back Pain in Adolescents or an athlete who complains of LBP, take it seriously. Suggest that they see a therapist or physician for further evaluation. If their back pain is still there, suggest they see an orthopedic specialist. To help diminish the risk of spondylolysis, teach pelvic control through fundamental movement patterns and core exercise. Correct excessive spine extension just as much as you would the athlete who tends to round over. Teaching athletes how to move well and stay injury free is the essence of an IYCA professional and avoiding Low Back Pain in Adolescents. Being aware of the risk of spondylolysis in adolescent athletes will help direct those who need it to medical attention while improving the quality of training for all our athletes.

 

 

1. Motley G, Nyland J, Jacobs J, Caborn D. The pars interarticularis stress reaction, spondylolysis, and spondylolisthesis progression. Journal of Athletic Training 1998; 33 (4): 351-358

 

If you are interested in learning more about proper programming for youth fitness programs check out the IYCA Program Design System.

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