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Archive for “Youth Sports Injuries” Category

4 Reasons Why a Muscle Feels Tight – Dr. Greg Schaible

Stretching can often be a polarizing topic among rehab and performance specialists.

On one end of the spectrum, you have people who seemingly hand out stretches for every injury and think it’s the solution to everyone’s problem. On the other hand, you have people who believe that you should never stretch and that there are no benefits to stretching whatsoever.

Before we start talking about what is right and wrong, we first need to appreciate what “tightness” really is, so we can discuss the potential reasons why one may choose a particular intervention over another. Hint: It’s not as simple as long or short, stretch, and strengthen! Watch the video to learn the 4 reasons why a muscle ACTUALLY could be perceived as tight!

Ultimately people feel the need for stretching because of “tightness”.

The problem here is that “tightness” is just a sensation, and a muscle can be perceived as “tight” for a variety of reasons. Before we discuss these reasons, it is important to note that bones and joints act and muscles react!

Said differently, your body is always manipulating position. We are never stagnant creatures; we have a constant postural sway! When asked to stand perfectly still we cannot. This is because our body is constantly interacting with gravity and manipulating it around our center of mass. As such we are always moving and always using a variety of strategies to either create (overcoming contraction) or control movement (yielding movement).

There are really three reasons someone would feel “tight”:

Reason 1) A muscle is concentrically oriented or in a state where the tissue sustains contraction at low levels for a prolonged time period.

Reason 2) A muscle is eccentrically oriented or where the tissue sustains a yielding contraction trying to prevent/stop/or reverse movement

Take a look at the picture below. You will see someone on the left displaying both concentric and eccentric orientations due to the anterior orientation of rib cage and pelvis. The individual on the left is utilizing an eccentric (yielding) contraction at the anterior hip to prevent further forward translation of the pelvis. This creates a subsequent thoracic extension followed by rounding of the shoulders to create a counterbalance.

In either instance, the body is trying to organize itself in the best manner it can to manipulate their center of mass around the line of gravity.

**Simple practical takeaway – The individual on the left potentially could benefit from stretching or eccentrically training their quads such as a half-kneeling stretch or eccentric leg lowering exercise that concentrically orients abdominals and takes quads through an eccentric contraction. The individual on the left however likely would not benefit from stretching of the quads because the muscles are in a position of eccentric orientation already.

Reason 3) As a protective mechanism to create rigidity or control depending on the environment, task, and situation. Example: think driving in a snowstorm how the external environment can create uncertainty or lack of control. As a means of creating more internal perception of control the body starts to grip the steering wheel tightly. Essentially creating co-contraction and rigidity around the joint to restrict movement.

Bonus Reason #4) You just performed an intense workout, and as a result there was some eccentric micro trauma to the musculature which occurred. Your intent is that stimulus hopefully results in recovery and net gain of strength/hypertrophy in the long run when programed correctly. However, acutely there will be restricted movement as the body repairs.

Notice in all the above scenarios, stretching may not be the most advantageous thing to be doing.

Perhaps the biggest issue is that many people’s current understanding is that muscles either get “long” or they get “short”. While this is a simplistic way of viewing things, it does not do the body justice and it leads to confusion when we talk about proper application.

This makes sense!

If muscles truly got longer, then we would develop a lot of “slack” in muscle tissue as the distance between origin and insertion of the muscle do not change unless the individual is growing and the bones are elongating.

You certainly would not want the guidewires in a bridge to develop “slack”, as the integrity of the structural support system would be lost.

So the ability to stretch further does NOT make muscles longer. It simply just builds increased tolerance to an eccentrically oriented position. Which may not be beneficial for tissue that is already oriented in an eccentric fashion! Remember, bones/joints act and muscles respond based upon ones center of mass, gravity, and the task.

While I do not have an issue with stretching concentrically oriented tissue. I do believe that controlled eccentric training to that musculature is probably more useful simply because it requires more coordination and control over ones center of mass and gravity.

Now with all that being said, if the individual still wants to lightly stretch because they find it helpful to provide “looseness” or “ease of movement” in the short term. That is 100% fine by me.

However I will still educate them on the following and let them make their own decisions based off this guidance:

1) Changes in sensation are momentary – If you are stretching to provide relief to the sensation of “tightness” without addressing the cause of the tightness you are operating at the effect level and not the cause. Which is why the sensation of tightness does not always go away when gradually exposed to a stretch. Maybe it does in the very immediate short term, but you have to keep applying that stimulus in order to maintain or improve.

2) If the sensation of tightness came from a workout and eccentric damage. It does not make much sense to aggressively eccentrically elongate the muscle as means of recovery as eccentric activity is what caused the soreness in the first place. Simple active movement would suffice!

3) Stretching does not take into account orientation of axial skeletal system (origin and insertion). For example, an anterior rotation of an innominate and anterior rib flare would indicate the paraspinals and quads to be in a concentric orientation of muscle via position of axial skeletal system. The hamstrings and abdominals would be eccentrically oriented. Note: This also happens in frontal and transverse plane not just sagittal.

Length tension relationships of musculature is important to consider. The reason for differences in length tension relationship is the axial skeletal position. Stretching does not change position of origin and insertion.

If you are a clinician who is looking to expand their clinical skill set with athletes and the orthopedic general population, I invite you to check out our Sports Rehab Expert “Fast Track” course which is the first step in making you a sharpshooter when it comes to getting results for your clients predictably, reliably, and with ease!

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance and a regular contributor the the IYCA. 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.

 

Dr. Schaible was instrumental in putting together the completely updated version of the Youth Athletic Assessment Specialist 2.0 course that covers a wide range of screens, performance assessments, and advanced assessment techniques.  Learn more about the YAAS 2.0 by clicking the image below.

Pelvic Tilt Control for Athletes – Jim Kielbaso

Pelvic tilt control is something that frustrates both coaches and athletes, but it is often not addressed very thoroughly.pelvic tilt   Coaches may recognize an exaggerated arch in the lower back, but that’s just one part of the equation.  The ability to control anterior and posterior pelvic tilt is critical to sprinting, squatting, hinging, and a variety of athletic movements.  Many athletes struggle with these movements because they simply don’t know how to create or control pelvic tilt.

For example, when you see an athlete struggle to maintain a flat back during squatting or hinging, they may not be able to control anterior pelvic tilt.  When you see an athlete sprinting with excessive lordosis, it may look like they can’t get their knees up or they have excessive backside mechanics, but this often stems from an inability to control the pelvis and maintain a neutral position.

Coaches often want to assume that these issues stem from strength or mobility issues, so we begin with stretches in an attempt to create better muscular balance.  This is not wrong at all – tight muscles can create all sorts of issues – but flexibility may not be the root problem.  More often than not, I’ve found that athletes simply cannot control or create anterior and posterior pelvic tilt.  They don’t have the proprioception or muscular control necessary to control these motions.  If he/she doesn’t know how to fire their abs, lower back, and glutes properly, they will appear to be “stuck” when asked to perform certain motions.

When this happens, I often use something I call the “Rubber Pants Full of Water” technique to teach athletes what it feels like to control anterior and posterior pelvic tilt.  The following video goes into much greater detail on this technique and others I use to help teach athletes how to control this important motion:

Try the Rubber Pants Full of Water technique or the homework exercise described in the video to get athletes to begin controlling their pelvic tilt.  You will find it much easier to teach common movements, and it will help them develop the ability to control their posture during any kind of movement.

 

Jim Kielbaso is the President of the IYCA and owner of Impact Sports Performance in Novi, Michigan.  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.

If you’d like to learn more about developing athletes, the IYCA Certified Athletic Development Specialist is the industry gold-standard for youth fitness and athlete development.  Click on the image below to learn more about the CADS certification program.

 

Complete Achilles Tendon Treatment for the Sports Performance Coach – Greg Schaible

When working in an outpatient orthopedic rehab or sports performance facility you will commonly be treating Achilles Tendon injuries.

That could be an Achilles Tendon Rupture, Achilles Tendinitis, or Achilles Tendinopathy. All are slightly different in their mechanism of injuries but all have the same milestones and goals to progress through in order to experience a full recovery. Obviously a rupture will take a longer time frame to recover than a tendinitis or tendinopathy scenario (but that’s probably a topic for a completely separate post).

***Be sure to pay special attention to step #3 as this is often missed by many rehab clinicians and strength coaches

The first step into the process is understanding the influence of pain on the problem as well as anatomy and biomechanics influence on the problem. These are two separate issues, as often pain does not correlate directly with the amount of tissue damage present. This makes it important to understand the guidelines of pain (what is okay to work through and what is not okay to exercise through).

We discuss this in the below video:

The other important consideration we pointed out in the video above is the anatomy of the calcaneus. The shape of the heel creates a compression force on the Achilles tendon when stretched which is important to consider if the pain or location of the injury is at the base of the tendon or if the tendon is highly sensitive. For these reasons, it is often NOT a good idea to stretch your Achilles tendon (especially when you are experiencing pain).

Once you understand the pain and irritating factors it is important to understand how to re-establish capacity back into the tendon without aggravating the tissue.

We do this through strengthening in a NON stretched position FIRST. Then start gradually working our way back into STRENGTHENING THROUGH a stretched position. Not hanging out for 30 seconds in a sustained stretched position.

In Part 2: the video below we discuss our two favorite exercises to start accomplishing this:

Step #1 and #2 are the easy parts of the rehab gameplan. However, this will probably only solve about 70% of cases. In the other 30% of cases, you need to consider other factors that may be influencing pain, as well as return to play scenarios for those involved with higher levels of activity!

To understand this further we need to consider the two main archetypes of feet you will see…

A pronated (flat) foot, and a supinated (high arch) foot.

Depending on what media and other healthcare providers have led you to believe, you probably feel that both flat feet and arched feet are undesirable. However, that couldn’t be further from the truth!

Both types of feet are necessary for everyday tasks. It’s no different than the ability to rotate your head right and left. Flat feet and arched feet are two extremes that the body should be capable of experiencing both. If the foot is not adaptable at creating both, and experiencing both at the correct moment, then you limit the foot’s capabilities.

During gait or walking our foot SHOULD experience supination, to pronation, to re-supination. That is normal and necessary mechanics of walking, gait, running, etc.

Pronation is needed to absorb force (store potential energy) or absorb/attenuate forces. Supination is necessary to produce force by creating a rigid foot.

The body’s ability to re-supinate the foot is accomplished through the windlass mechanism. Which is only created by getting great toe extension. The only way to get great toe extension during gait is by allowing the foot to pronate and weight bear over the great toe as your center of mass moves forward (horizontally) during gait, walking, running, etc.

If you cannot pronate effectively, you will not create an effective windlass mechanism and thus not experience re-supination. So all those towel scrunches or tripod foot exercises you are doing with the knee straight have little carry-over to life as during walking, running, etc we are moving forward! The tibia is moving forward, the knee is moving forward, the hips and body are moving forward…

So we must pronate effectively to allow our body, knee, and tibia to move forward. Load the foot and the kinetic chain. Experience pronation effectively and let the body get over the great toe to effectively utilize the windlass mechanism to re-supinate the foot and prepare for propulsion. The video below will hopefully give you a better understanding:

This above step #3 is often the most overlooked problem to Achilles injuries as well as many foot/ankle/knee problems. Understand it, and you can make a world of difference for people who seem to be constantly stuck in a state of injury or rehab purgatory.

Finally, the last step in the process is exposing the tendon back to a situation similar to sport.

Sure eccentric loading is great for the tendon histology development, and the athlete will certainly experience eccentric loading of the tendon in sport. However, a concept often overlooked is the ability to create co-contraction of the kinetic chain to distribute or absorb force more effectively. When running or jumping, the body needs relative stiffness in the ankle (as well as all the other joints) to not crumble when applying a force into the ground. Then store the potential energy to propel themselves forward. Look at any sprinter at top-end speed or dunker taking off from a one-foot jump approach.

Those who do it effectively create a lot of stiffness around their joints at ground contact. Meaning you will not see a large counter movement occur during a one-foot jump approach (or really even someone who is more of an elastic two-foot jumper). A sprinter you will notice a very stiff an rigid foot and even knee at ground contact. This is because the body is co-contracting the calf, hamstring, quad, and glute to quickly apply force and absorb force through the kinetic chain.

In video 4 we discuss some of my favorite dynamic exercises that take into account teaching co-contraction at ground contact.

If you found this article helpful, you will probably love the newly revamped Youth Athletic Assessment Specialist 2.0 course that I helped create for the IYCA.  I hope this gives you a better understanding of the Achilles tendon and how to address it in your training programs.

 

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance and a regular contributor the the IYCA. 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.

 

Dr. Schaible was instrumental in putting together the completely updated version of the Youth Athletic Assessment Specialist 2.0 course that covers a wide range of screens, performance assessments, and advanced assessment techniques.  Learn more about the YAAS 2.0 by clicking the image below.

Overuse Injuries in Athletes – Jason Goumas, PT

Overuse Injuries in Athletes – A Real Pain!

Youth sport injuries are responsible for not only pain felt by an athlete, but also lost time on the field enjoying the sport, and in certain cases career-ending injuries. It is estimated that annually 12 million individuals between the ages of 5-22 will suffer a sport-related injury and result in 20 million lost days of school(1) and $33 billion in medical expenditure(2). This article will discuss overuse injuries in athletes that primarily affect the knees and ankles of young athletes – specifically the patellar tendon and extensor mechanism of the knee, and the Achilles tendon and plantar fascia of the foot.Overuse Injuries in Athletes

As a physical therapist, coach, and referee in both soccer and basketball I’ve worked with many athletes over the years with various knee and ankle issues. While I will include some information regarding certain medical conditions that can affect young athletes, it is not intended to serve as medical treatment. What I hope to accomplish is help coaches, parents, and athletes understand the relevant mechanisms which drive the development of these problems so they may be avoided.

What Makes the Young Athlete Unique?

The injuries I will be describing happen frequently in adults, but are called by different names which you likely know: patellar tendonitis, jumper’s knee, patellofemoral syndrome (PFS for short), Achilles tendonitis, and plantar fasciitis. Each of these problems (with the exception of PFS) is an overload of the attachment of tendons and fascia to their bony attachments. Because children are in the process of growing some of these attachments also include growth (epiphysial) plates which are the active parts of their bones which may be disrupted when subjected to either sudden or repeated excess tension. In extreme cases, surgery may be necessary to reattach the bone fragment.

The good news is that the treatment of these problems in both adults and youth is actually very similar. Rest, ice, and anti-inflammatory agents (NSAIDs, etc) all work, but these actions are only a small part of not only helping athletes overcome these problems, but also to help avoid them altogether! One component which I see overlooked or not addressed FAR too often are the biomechanical factors that contribute significantly to the overload of the painful tissues. Offending movements and activities are usually blamed such as running and jumping, but if the athlete’s movement pattern(s) is also causing increased stress is it really the activity that is to blame or how it is being performed? More on this later as we will first go over some of the more common youth overuse injuries in athletes.

Issues involving the knee

Osgood-Schlatter Disease (OSD), Sinding-Larsen-Johansson syndrome (SLJS), and Patellar Tendonitis

Both these problems involve the attachments of the patellar tendon, but which end is the defining characteristic? With OSD it is the involvement of the distal attachment of the patellar tendon into the tibial tuberosity. If there is sufficient tension to cause some disruption of the growth plate in the region it can begin to detach. The resultant attempts of the body to heal this by bone growth (similar to the bone callus which forms at other fractures of long bones) causes the classic lump that is often seen below the patella. SLJS on the other hand involves the proximal attachment of the patellar tendon at the patellar base, and the mechanics are similar in nature. Patellar Tendonitis is simply irritation of the patellar tendon itself, or either of its attachments, but without the involvement of the growth plate. As you can see, these conditions are very similar and are sometimes misdiagnosed. The good news is that the process of correcting them is actually the same!

Athletes will typically complain of pain with squatting, stairs, jumping, and running. With OSD there will also tend to be significant pain when attempting to kneel on the affected side.

Chondromalacia Patella/Patellofemoral Syndrome (PFS)

Rather than involving the patella tendon, this condition is actually an irritation of the cartilage lining the posterior surface of the patella as it contacts the femoral condyle. As with the above problems the athlete will report pain with squatting, jumping, etc. There may be audible crackling and popping (crepitus) with loaded knee flexion and extension, and one unique complaint is usually pain and a burning sensation with prolonged sitting. PFS is also a result of excess tension moving through the patella except that instead of the patellar tendon becoming irritated, it is the cartilage that breaks down.

Sever’s Disease and Achilles Tendonitis

Like the knee problems above, Sever’s disease is a result of excessive and/or repeated tension generated by the calf muscles into the heel (calcaneus) via the Achilles tendon. In growing children, there is a growth plate which like with OSD can become disrupted and painful. If only the Achilles tendon is involved then it is technically Achilles Tendonitis.

Plantar Fasciitis

Plantar fasciitis is caused when there is irritation of the tough plantar fascia where it attaches to the calcaneus (heel bone). Most often this a result of tight calf muscles, but weak intrinsic foot muscles as
well as biomechanical issues will also contribute to the overall loading of the tissue.

Tracking Down the Root Problem

While proper stretching is important (and you’d be surprised how many people are not stretching effectively), as mentioned earlier one of the most often overlooked factors is how the athlete moves. Almost without exception, the youngsters I’ve seen with these issues (especially the ones who have had one or more conditions for years, have been to PT, ortho, etc.) have significant movement deficits where they are not effectively using the hips. The net result is that greater force development and absorption demands are now required of the knees and ankles and causing the issue. Until certain movements are corrected it is much more unlikely that the problem will resolve; especially if the athlete is actively competing. This is where youth coaches can really play a huge role in helping athletes avoid these issues altogether.

What Movements are the Keys

From the Barbell Physio

There are two movements that are essential in getting the hips in the game: the hinge and the squat. I want to see athletes hinge to 90 degrees of hip flexion with the knees slightly flexed. If an athlete cannot perform a hinge properly, then it is quite unlikely the squat will be correct. There are various methods to train these movements, however, I will share my favorite techniques.

For the hinge, my go-to technique is using a dowel along the back to cue the athlete into proper position. The dowel helps the athlete get the lumbar spine under control because if they allow the back to round, the dowel will lift up from either the upper back or from the sacrum. The goal is to keep a bit of wiggle room for the fingers at the low back. I’ll have athletes practice sitting down and standing up holding the dowel. Every now and again an athlete really struggles with this, and I will have them practice moving the trunk as a unit in sitting which eliminates the need to worry about the knees and ankles. Then they can progress to the squatting movement.

When it comes to the squat, the deficits are typically the knees moving forward excessively as well as moving inward. When they are allowed to move forward excessively this is what functionally creates the extra tension in both the knees and ankles as they are in a more flexed position. If a simple squat has deficits, then you can be sure that jumping, landing, and direction changes will have similar motion. My favorite exercise to correct the squat is the Chinese Wall Squat. It’s actually quite amusing to watch athletes attempt this! Have them stand 2-3 inches from a wall with feet forward and about shoulder-width apart. The goal is for the athlete to squat to maximum depth without touching the wall. The knees should not be allowed to flare out (a common “cheat”). The beauty of this exercise is that it absolutely forces proper form, and I’ve told many athletes that I don’t want to see them with weight on their backs until they can perform at least 20 reps of this exercise. It is acceptable for the athlete to stand further away to begin. One alternative I will use is to have them squat while facing a chair so that the seat is just over the toes which will prevent the knees from moving forward. This is easier because they are able to lean forward a bit more to focus on the knees.

Conclusion

I hope that this information helps you understand some of the most common overuse injuries in athletes and gives you some ideas on how, through training movement deficiencies, they can be resolved and prevented! I am currently filming and hope to soon offer an online program for parents, players, coaches, and trainers. The pilot, which has been live video calls with several families around the world whose children suffer from OSD, has been very well received with several athletes reporting significant improvement in their pain in under 2 weeks. 

References:

  1. Janda D, The Awakening of a Surgeon: A Family Guide to Preventing Sports Injuries and Death,The Institute for Preventative Sports Medicine, 2004, p. 208.
  2. “Summer sports top injury list,” Orthopedics Today, 2002; 22(6):13

Jason Goumas

 

Jason Goumas is the owner and Director of Physical Therapy at New Direction Wellness and PT in Kentucky.  In addition to being an excellent PT, he is also a youth sports coach, referee, and a Certified Speed & Agility Specialist through the IYCA.  Jason prefers to treat injuries using exercises that can be done at home, and believes that education is the key to both rehabilitating and preventing injuries.  It is Jason’s mission to prevent overuse injuries in athletes.

 

To learn more about how to address overuse injuries in athletes and to be better at coaching young athletes, the IYCA Youth Fitness Specialist certification is the industry gold-standard for youth fitness and sports performance.  Click on the image below to learn more about the YFS1 certification program.

IT Band & Knee Pain – Greg Schaible

One of the most common injuries I see in runners is IT band syndrome or lateral knee pain.

Many people try endlessly stretching and foam rolling this area in hopes to get relief. Instead what they get is sometimes temporary relief, but they always feel the need to stretch or foam roll the area because the problem keeps returning.IT Band Pain

Instead, find the source of the problem to fix it for good!

In the first video below we talk about why building medial (inside) strength of the hamstrings, but also the quads in order to limit the over-activity of the lateral musculature of vastus lateralis, bicep femoris, and the IT band.

Often the tone/stiffness experienced in the lateral knee is due to a poorly balanced workload across these muscles from an underlying bone/joint orientation tendency. Distributing this workload differently and using more medial musculature such as the semitendinosus, semimembranosus, gracilis, adductor magnus, and VMO can be game changer to change pain and improve your running pain free.

Now I know what you are thinking….I thought we were behind the “isolation” exercise days and the “VMO” days.

Simple open chain Isolation work is NOT what I am suggesting at all!
In the second video below, I show a sample rehab routine I’ve used time and time again to solve IT Band Pain for runners and athletes of all kinds. Of course there could be some differences in an athlete’s presentation that would impact what exercises are selected and all the exercises are performed as symptoms allow. But generally this is a good place to start with daily exercises to progress towards the return to sport preparation.
What you will notice is in a acute or sensitive knee we use easy/simple isolation work to progressively load the tissue in a very general manor as symptoms allow.
While this is occurring we use compound exercises with VERY specific cues and intentions which will orient the joints in a particular manor to shift them away from their biomechanic loading tendency and gives the muscles and joints a completely different loading experience.

Try these strategies the next time an athlete is complaining of IT Band Pain or Knee Pain on the lateral aspect of the knee.  Of course, there can always be other issues involved, but this approach has worked for many athletes and will hopefully allow you to get your athletes back on track.

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance and a regular contributor the the IYCA. 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.

 

Dr. Schaible was instrumental in putting together the completely updated version of the Youth Athletic Assessment Specialist 2.0 course that covers a wide range of screens, performance assessments, and advanced assessment techniques.  Learn more about the YAAS 2.0 by clicking the image below.

An Open Letter to Student-Athletes: Who Are You Without Sports? – Jill Kochanek

My name is Jill, but everyone calls me Jake. No one ever called me Jake, however, until I joined the Amherst College Women’s Soccer Team.  As a timid freshman, I was eager to prove myself and determined to play the sport that I love. With an upperclassman named Jill already on the team, during preseason my coaches asked me if I went by another name. I hesitated; I had always been Jill. Shortly after though, in the chaos of competition, my teammates’ commanding calls blended my initials, “J-K” into “Jake.”  

In the beginning, I accepted Jake but did not fully embrace the nickname.  I recall a teammate commenting that her brother’s name was Jake and another teammate telling me that her dog was named Jake. Great— I thought—there goes the cool first impression I was trying to make. Over the course of four seasons though, I would answer to Jake more than Jill on the field, in the classroom, and even at home. Eight years later, the name has stuck. My parents, siblings, old friends from Amherst and new friends extending from those Amherst ties all call me Jake.

Jake would stick with me in more ways than one: just as Jake grew on me, so did I as a player, teammate, and person. As Jake, an inexorable force outside of me but inseparably linked to me pushed me. It kept me tirelessly attacking and defending, following and leading, in formation with twenty other women in Amherst purple. As number 26, I felt that force drive me across the darkening grass—six and back, eighteen and back, half field and back, full field and back.  At the end of each practice as the sun set on Hitchcock field, sweat poured down our necks leaving our bodies as we set ourselves on the line to sprint again. Nourishing the field below our tired feet, sweat was the one thing we all agreed to sacrifice. In my senior season, that sacrifice would prove worthwhile and culminate in a league championship, NCAA Elite Eight match, and a record of 20-0-1. These tangible gains were just the beginning.  

On the field with my teammates, I learned how to be selfless; how to trust and be trusted; how to embrace my strengths and fearlessly confront my weaknesses; how to commit, be patient, and own my/our process: the next achievable step. I learned that what you communicate matters but “how” (you say something) given the “who” (you say something to) makes all the difference. And, I learned how important it is to control life’s controllables. My teammates challenged me to be a leader—a servant: someone who does not stop with bringing out the best in themselves but lifts others up. Inspired by their sacrifice, I grew to be a better player, teammate, and person. I grew to be Jake.

My student-athlete story seems to have a happy ending. It does. And—not but—and, it’s not without some unexpected challenge. In the last 10 minutes of our NCAA Elite Eight match against Messiah College, we were down 0-1. I was physically and mentally drained. I awkwardly, stretched out my right leg across my body to go for a loose ball. Off-balance, I tore my ACL and meniscus. I hobbled off the field and knew something was wrong but didn’t want to admit it. I didn’t want to concede. I asked our athletic trainer to try and tape my knee up to give me support and go back in. But I couldn’t walk. I was done.

Tears rushed down my cheeks and fell to the grass like the collective sweat that rushed down our necks. I wanted to be inside the lines again. I yearned to still be a part of our sacrifice. To be living the collective commitment we made to one another. To be on the field playing the game that we loved. In those final moments, I was flooded with a sense of loss. 

I am fortunate to have played injury-free for most of my high school and college career. We were fortunate to have made such a deep run into the NCAA playoffs alongside teammates and coaches who I’d do anything for. In those final moments and months to follow during my recovery process I felt a range of strong emotions. I felt gratitude for my experience, for the protected time I’d have to fully recover rather than rush back to play at the start of the next season. I felt relief that my body had held out. And, I also felt loss. I felt lost. 

I knew our season and my soccer career were soon coming to an end. But, I was not prepared for when it actually did. When the final whistle blew. 

I share my student-athlete story with you because at some point for all of us, sports will stop. There will be a day when the final whistle blows for all of us. A day when we all play our last game, when we are—like I was—left asking: Who am I?

For all student-athletes, not just our graduating seniors, this shutdown presents us with a unique opportunity to pause. To reflect and remember: why do you love sports? 

Maybe it’s the power of movement—the sense of freedom and empowerment you feel moving your body and seeing what you can do. 

Maybe it’s a love of competition—of the process, of challenge, of taking risks and testing your limits, of learning new skills and game strategies. 

Maybe it’s being a part of a team. Working together through adversity—making lasting friendships, building trust and having fun through all the little moments: the team dinners, bus rides, and locker room dance parties.

If it helps, we have 3 basic psychological needs as humans, the need to: 

(A) feel a sense of autonomy (“I have choice, control and agency”). 

(B) feel a sense of belonging (“I am valued and supported”), and 

(C) feel competent (“I am capable”), 

If you look down this list of “maybes”, you’ll notice that these reasons highlight all 3 of our basic needs. What we can call our ABCs—Autonomy, Belonging, and Competence. Meeting these needs supports our inner motivation and overall health and well-being.

So, what are your ABCs? Why do you play your sport/sports? Maybe you’ve got reasons outside the ABCs. Even better. The point is to take this time during the quarantine to reflect and be honest with ourselves. What’s your “why”?

During this shutdown it’s also important for student-athletes (at any age or stage) to ask: who am I without sports? It’s a both-and. Not an either-or.

You can be both an athlete/teammate/competitor and be a:

…painter

…musician

…writer

…singer

Tell me (and— coaches and parents if you’re reading this ask your student-athletes to tell YOU):

What energizes and excites you? What would get you out of bed at 5:30 AM for/to do?

What are you curious to know more about? 

What do you want to spend more time doing? What do you want to try? 

How do you want to connect with people? 

What larger purpose do you want to serve? How do you want to contribute? 

For the high school and college seniors graduating this spring, the COVID-19 shutdown has cut your season short and brought your career to an abrupt end. You are likely feeling a bitter sting: our harsh reality has replaced celebration and closure with COVID-19 restrictions. The senior year you thought you’d have, the special end-of-year events that would seamlessly, properly close this chapter of your life and open a new one may have instead been filled with uncertainty, loss, and sadness. Senior student-athletes I feel with you. And, I am here to tell you that you are not alone. Whatever emotions you are experiencing are valid and understandable. Allow yourself the time and space to acknowledge what you’re thinking and feeling. What you are going through is hard.

When you reflect on why you play and what/who you are grateful for, know that you will always carry with you your reasons for playing, valuable lessons you learned, and memories you made. It took me time after I played my last game to realize that:

My student-athlete experience was a process of discovery. Soccer was a meaningful setting that helped me discover aspects of who I am—a trusted teammate, lifelong learner, and performer who loves to commit to a big-picture vision and goal and to work the small actionable steps needed to get there. Soccer was a context that brought these aspects of “me” into focus. Soccer gave me a supportive, challenging space—and opportunity— to work towards being my best self: to embrace my inner-Jake.

I found so much meaning in, I drew so much of my self-worth from sports. And while I found so much of myself through sports, and—not but—and, I now know that sports are not ALL of me. Sports are not ALL of you. 

Identity is who you are. It’s a word with a paradox at its core (Stryker, 2017). It means that two things that are not exactly the same can be substituted for one another as if they are the same.

When we say “I am a student-athlete” the “am” is like an equals sign. Your individual sense of being something, a category (e.g., student-athlete, musician) that you consider yourself belonging to. You and the category, however, are not the same exactly the same.

You are a student-athlete.

You are also more than a student-athlete. 

Human beings we are weird. Don’t read the term “weird” in the negative sense: we are unique, dynamic, complex, and multi-dimensional.

Know that so many of the reasons you played sports, the lessons that you learned, memories that you made will stick with you. These are forever a part of you. Also know that your life, your identity, and your “why” do not end here. They don’t end with athletics. You might find that an activity, experience, or context fulfills you like sports do or did. You might also find that these different pursuits excite and inspire you in unique ways that sports did/do not offer you. 

You have so many gifts to share with us beyond what you do on the court, field, track, diamond, and pitch. There is a whole world out there with people, place, and opportunities beyond sports to explore. 

This open letter is not a “how-to”—with specific steps on what I think you should do. Only you can determine the steps that are best for you. Only you can chart your course: Be brave. Be curious. Be true to your whole self. Share that whole person with us. Your whole self is your best self, and when we know the true you, we will all be better. 

My name is Jill but everyone calls me Jake; I embrace when they do and I know now that there’s so much more to Jill than Jake. 

Jill Kochanek is a doctoral student at the Institute for the Study of Youth Sport at Michigan State University. She is also a high school soccer coach. As a coach-scholar, Jill is passionate about bridging the research-practice gap to make sport a more inclusive, empowering context. Her research and applied work centers on helping athletes (and coaches) take charge of their own developmental process and social progress. If you enjoyed this article, feel free to visit her youth sport coaching blog, bothandcoaching.blog, for posts that address other topics related to sport psychology and sociology and follow her on Twitter @bothandcoaching.

 

The IYCA Certified Athletic Development Specialist is the gold-standard certification for anyone working with athletes 6-18 years old.  The course materials were created by some of the most experienced and knowledgeable professionals in the industry, and the content is indisputably the most comprehensive of any certification related to athletic development.  Learn more about the CADS certification here:

Foot & Ankle Strengthening for Athletes – Jordan Tingman

You may have heard that many injuries and long-term structural issues can arise from issues in the feet.  The feet and ankles are often neglected in training, but we should really be focusing a lot of our attention on the quality of movement coming from the feet. Structurally, the feet and ankle areas are comprised of many bones and ligaments, and if not able to move properly/efficiently, these structures may not function the way they should under stress, which can easily lead to injuries and compensations.

The foot contains 26 bones, 33 joints, and over 100 tendons, muscles, and ligaments.  There are also 7000 nerve endings in each foot that not only feel different sensations, but more importantly, help us balance, move, stabilize, and sequence movement strategies throughout our bodies.  The structure is intricate because the foot has to perform incredibly small and subtle movements in order to shift weight during complex movements, remain rigid yet supple, and respond to a wide variety of stimulation.

Literally every force we deliver or accept from the ground goes through the feet and ankles.  When we jump or run, we usually think of our quads and glutes creating large amounts of force to propel our bodies.  While this is true, all of those forces ultimately have to go through the foot.  So, neglecting this area would be a major oversight.

Many coaches are intimidated by the complexity of the foot and ankle.  Doctors and therapists spend years to learn the intricacies of this area, so how could we possibly know everything about the foot and ankle?

We don’t have to.

While it would be very beneficial to have a deeper understanding of the foot/ankle, the truth is, incorporating any sort of foot and ankle prep into a program will offer benefits to the athlete. You can incorporate simple exercises into a dynamic warm-up before a practice/training session or you can incorporate them throughout a workout!

I’m not suggesting you are intentionally ignorant of the subject, but it’s not necessary to get overwhelmed and decide to do nothing at all.  Instead, gather as much information as you can, and choose some simple exercises that do no hard and can help keep your athletes healthy and functioning properly.  If these exercises cause pain or reveal more complicated issues, definitely refer them to a specialist.

Here are some simple exercises that you can add to the beginning of your workout:

Foot/Ankle Video

When considering all the different planes that the ankle works in, it is nearly impossible to train every single movement or range of motion, but we should try to provide as much variety as possible in order to strengthen them!

Banded Ankle Work

Always consider how you’ll fit these exercises into a complete program.  You probably won’t have time to perform every exercise shown, but don’t let that stop you from including at least one thing aimed at training this important area.

 

Jordan Tingman – CSCS*, USAW L1, ACE CPT, CFL1 is a graduate of Washington State University with a B.S. in Sports Science with a Minor in Strength and Conditioning. She completed internships with the strength & conditioning programs at both Washington State University and Ohio State University, and is currently a Graduate Assistant S & C Coach at Eastern Washington University.

 

 

The IYCA High School Strength & Conditioning Specialist is the only certification created specifically for coaches training high school athletes.  The course includes several hours of video instruction (including a complete Olympic lifting instructor course) and two textbooks with contributions from some of the top strength and conditioning coaches in America.  Click on the image below to learn more about how to become a certified high school strength & conditioning coach.

Letter to Parents – From Jim Kielbaso: Handling Sports Injuries

Sports Injuries

Dear Parent of a Young Athlete,

 

Your kid got hurt playing sports.  It happens. Now, what should you do about it?

While it’s true that sports injuries are common, there are two things I’d like you to consider:

  1. How did it happen?  
  2. How is it being handled?

Some sports injuries are pretty much unavoidable if your kid is playing sports.  Kids will fall, run into each other, or have a fluke accident occur. You take certain risks in sports, and this is one of them.  If an injury occurs that you feel was simply part of the game, just move on to the second question and handle it in the best way possible.  

Other sports injuries occur from overtraining, improper training/practice, or compensations that your child develops in order to keep up with the demands of the sport.  These injuries need to be investigated differently.

If your child is suffering from repeated injuries that don’t seem like “accidents” or “part-of-the-game” things, there’s probably something else going on that needs to be addressed.  It could seem like something relatively straightforward like an overuse injury, but simply resting until it feels better, then going right back to the same routine is a set up for re-injury.  The volume of training might just be too high, but it could also be that your child’s mechanics (running, throwing, kicking, etc.) aren’t correct, which can cause all sorts of problems.  

In these cases, mechanics should be addressed by a professional, or you run the risk of these injuries plaguing a child for a long time.  

Sometimes, kids simply aren’t ready for the mechanics or demands of a sport.  For example, most kids under 11 simply don’t have the ability to adequately control the pelvis during rapid spinal rotation.  This is just part of the maturation process, and it kind of seems like a built-in governor, that keeps growing bodies from performing crazy athletic feats too early.  Unfortunately, when kids are taught how to throw or kick really hard at a young age, they can develop issues at the shoulder, elbow, knee, and hip stemming from the inability to perform these actions efficiently. Because they can’t control that spinal/hip rotation, they figure out other ways to compensate in order to throw or kick really hard, and other areas of the body take the brunt of these forces.  

That’s why we see things like 12-year-olds getting Tommy John surgery or 13-year-old soccer players with hip dysplasia.  These things are typically a result of athletes being pushed too hard, too early. They “appear” to be able to do things that they simply shouldn’t be doing yet, like throwing 80 MPH at 12 years old.  

There can be all sorts of reasons for overuse sports injuries.  Just be sure to look into what may have caused the injury, and try to address it before it happens again.  

You should also know that “different” injuries are often “related.”  What I mean is that it’s possible for a kid to start out with hip pain.  He rests, it gets better, and he goes back to playing. A few weeks later, he has back pain.  He rests, it gets better, he goes back. A few weeks later, he rolls his ankle. Something is going on here.  It appears as though the injuries are unrelated, but there’s a good chance they are. A good therapist, doctor, or experienced strength coach may be able to figure out what’s happening through a comprehensive evaluation, and it’s important to address it before it becomes worse.

Sometimes, you’ll have to talk to a coach about what’s going on with your child.  A coach who says it’s “my way or the highway” may not be a great partner when it comes to your child’s health.  Now you’re dealing with politics, and you might have to tip-toe around things to ensure you’re prioritizing your child’s well-being.  Most coaches know sports and care about kids, but very few are also medical professionals who know exactly how to handle injuries. It’s very important to work with coaches when possible and defer to their judgment on certain things.  It’s also important to recognize when your child is in a dangerous situation, and you may have to step in to do what’s best for your child. This can get really tricky (and should probably be a separate letter), so let’s just hope your coach cares about your child’s well-being.  

The second part of this injury equation is how the injuries are handled.  Far too often, I see parents take kids to their pediatrician for orthopedic issues that the pediatrician simply isn’t trained to treat.  This is NOT the pediatrician’s fault. They are amazing doctors, but their training probably wasn’t in orthopedic injuries. It’s the same reason you wouldn’t go to a podiatrist for a heart issue.  Or you wouldn’t ask a basketball coach to correct your golf swing.

Find the expert for the specific issue you’re dealing with.

How do you find the right person?  It’s important that you take charge of these situations by doing some research.  Find someone in your area that knows a lot of other health care professionals, and ask for some guidance.  Physical therapists and athletic trainers often know the experts in their area, so they are a great resource.  Some strength coaches and primary care physicians are also great resources.  

Just explain what the issue is, and ask if they know who the experts are.  You can walk into any physical therapy clinic to ask questions like this, and they should be happy to help if they can.  You can also call or stop into a doctor’s office. You might not see the doctor, but they’ll get a message and someone will offer help.  

Don’t be scared to ask questions and find the right person.  Too many people say things to me like “my neighbor is a ______, so I go to him/her for every issue.”  Well, MY neighbor is an outstanding ER doc, but I didn’t go to him for my thumb surgery. Find the right person.  

There are so many different injuries associated with sports, and they are definitely going to happen.  When they do, just make sure you are covering all of your bases by looking into why the injury occurred and finding the right professional to address it. 

I hope this helps keep your kids safe.

Sincerely,

Jim

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.

 

To learn more from Jim, check out the IYCA Certified Speed & Agility Specialist course.  The CSAS is the most comprehensive and scientifically sound speed certification in the athletic development profession.  It truly prepares you to teach and develop speed.  Click on the image below to learn more.

speed & agility certification

How to Perform Face Pulls – Greg Schaible

Face Pulls are on the top of my list for upper back exercises to help develop healthy shoulders, backs and necks.

The problem is that a lot of people do them poorly and actually irritate the shoulder or upper back when performed incorrectly.

This article and video will help you understand some of the key considerations when performing face pulls, and how to avoid the most common errors.

 

Many people choose to use bands, especially in rehab because so many physical therapy places just have bands. However, you must consider that the tension of the band increases as you get further into the movement where the hardest point of the exercise is. This means the most tension is at the highest position of difficulty.

For that reason, going lighter then you’d think is a good idea when starting out using bands. Also, the resistance should never compromise form.

A better alternative as you increase the load is a cable machine with the proper attachment because the resistance will be equal throughout the exercise.

To keep safety on the rotator cuff and not irritate the shoulder we should also be aware of the attachment point. Which when done correctly is at about the level of your forehead. Too many people use a low attachment point which causes an awkward upright rowing moment. This almost removes the rotator cuff from the exercise and makes it more rear delt. But also places the arms in more of a internally rotated position generally. Which more times than not just irritates the shoulder when done for sets and reps.

Be sure to use a thumbs back grip as this drives supination which leads to external rotation which helps us open our chest and use the muscles of our back and rotator cuff.

The biggest error people make is leading with their elbows and leaving their wrist behind.

The elbows and wrists should move together! This again helps you avoid an internally rotated position with the elbow above 90 degrees helping you avoid impingement at the shoulder. If you cannot coordinate the elbow and wrist moving as a unit you are either using too heavy of a band. Or you are trying to force yourself into a range of motion that you don’t currently have.

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance and a regular contributor the the IYCA. 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.

 

Dr. Schaible was instrumental in putting together the completely updated version of the Youth Athletic Assessment Specialist 2.0 course that covers a wide range of screens, performance assessments, and advanced assessment techniques.  Learn more about the YAAS 2.0 by clicking the image below.

T-Spine Mobility – Jordan Tingman

Incorporating a small amount of mobility each day will eventually turn into great gains over time.

Mobility can be easily thrown into a complete warm-up, within the workout or at the end of a workout. It is much more important to do a little of something, than doing nothing at all.

The upper back/thoracic spine is made up of a lot of different musculature. The muscles surrounding the thoracic spine tend to tighten up, and often get neglected when working on mobility. When ignoring working on mobilizing these areas, the upper back can get tight, limiting overhead exercises and movements.

When thoracic spine mobility is compromised, athletes will unconsciously compensate by creating excess movement in other joints.  This typically means that the lower back has to create excess movement or stability because the T-spine is not functioning adequately.  It’s not uncommon for low back pain to be the result of issues in the T-spine/scapula, so taking a pro-active approach by spending a little time on this area can pay dividends you may never even know about because the athlete will be healthy.  While we’ll never get credit for it, that should ultimately be the goal of all performance coaches.

t-spine mobility

There are various reasons why we need to work on t-spine mobility:

-Overhead and throwing movements can be limited due to tightness

-Tightness can affect posture in the various squat patterns

-Mobilizing any especially tight areas can lead to injury reduction

To warm up for t-spine mobilization, foam rolling the entire upper body can be very helpful in warming up and stretching the muscle belly.

:30 seconds of each area

  • UPPER BACK-Starting with an upper back roll, crossing the arms in front of the chest
  • LATS-Roll out the lats, by keeping the hand palm up, arm by the ear, rolling all the way from the armpit to the mid rib cage area
  • PEC/SHOULDER- roll out the pec/shoulder area using either a foam roller or even better a lacrosse ball to really dig into the troubled areas
  • T-SPINE PEANUT- utilizing a mobility peanut, roll out the erectors or focus on t-spine extension using the peanut.

There are a variety of exercises that can be used to mobilize the t-spine in extension and rotation. You can use everything from foam rollers and kettlebells to bars and bodyweight exercises.

Here are a variety of exercises that can be used for t-spine extension:

Here are some exercises that can be used for t-spine rotation:

These exercises can also be used as an assessment. When you find an athlete who struggles with these exercises, you can spend additional time with them to address the issue.  If you never perform these exercises, you may never know it’s an issue.

Hopefully, this gives you several options to include in your programming.  It’s not necessary to perform all of these exercises in every session, but inserting them into an overall plan will help you address these issues in a pro-active way.

Jordan Tingman – CSCS*, USAW L1, ACE CPT, CFL1 is a graduate of Washington State University with a B.S. in Sports Science with a Minor in Strength and Conditioning. She completed internships with the strength & conditioning programs at both Washington State University and Ohio State University, and is currently a Graduate Assistant S & C Coach at Eastern Washington University.

 

 

The IYCA High School Strength & Conditioning Specialist is the only certification created specifically for coaches training high school athletes.  The course includes several hours of video instruction (including a complete Olympic lifting instructor course) and two textbooks with contributions from some of the top strength and conditioning coaches in America.  Click on the image below to learn more about how to become a certified high school strength & conditioning coach.

PNF Stretching – Joe Powell

PNF Stretching is one of the most effective, yet often overlooked, training techniques that coaches can employ to enhance flexibility.

For being recognized as an essential pillar of strength and conditioning, flexibility seems to lack the same attention and interest generated by other physical qualities that are developed through training. For example, look no further than the world PNF Stretchingof strength and conditioning on social media. You’ll be much more inclined to find strength coaches showcasing impressive feats of strength, power, speed or even balance.  How often do you see coaches talking about amazing flexibility routines?

It isn’t the fact that coaches don’t see value in increasing an athlete’s flexibility, it’s more to the effect that there are so many other athletic qualities that garner the spotlight, and thus have a higher emphasis within a training program. Luckily for us there are ways to improve flexibility that happen almost organically. Static stretching is universally known by athletes of all ages, and is typically found in some regard in any warm-up or cool down. A well-rounded strength training program featuring exercises performed throughout a full range of motion will even increase joint flexibility. However with flexibility, as well as other training effects like strength, power, speed, etc, in order to improve and display lasting effects, there needs to be a direct training stimulus occurring regularly.

So how can a coach utilize their allotted time with an athlete effectively and work to improve flexibility beyond simply static stretching at the end of a workout? Three letters: PNF.

What is PNF and how does it work?
Proprioceptive Neuromuscular Facilitation, or PNF, is a stretching technique that is used to improve muscle elasticity, and thus increase flexibility. For years PNF primarily existed in clinical settings, utilized by therapists to restore or increase joint range of motion in patients who were going through rehabilitation. Currently it has gained a lot of traction and is practiced within athletic and even therapeutic settings. The reason why it has gained popularity and should be included in a coach’s repertoire? It works. Research supports its effectiveness in increasing joint ROM.

While research has been conducted on PNF and its possible effectiveness for decades, it is still ongoing to determine what the exact mechanisms behind this form of stretching are. Four theoretical physiological mechanisms for increasing range of motion exist. They are: autogenic inhibition, reciprocal inhibition, stress relaxation, and the gate control theory. These four mechanisms are reflexes that occur when the golgi tendon organs in the tendons of the agonist or antagonist muscle detect harmful stimuli. Between them, these four theoretical mechanisms likely define why increases in joint range of motion are seen when using PNF.

There are two methods of PNF that are typically the focal points of any research on the topic. These two methods are also most commonly practiced in the athletic, clinical and therapeutic realms. They are known as the “contract-relax method” (CR) and the “contract-relax-agonist-contract method” (CRAC).

Contract-Relax Method (CR):
1. The target muscle is stretched and held passively
2. An isometric contraction of the target muscle is subsequently held for an allotted time
3. The target muscle relaxes and is re-stretched passively.

Contract-Relax-Antagonist-Contract Method (CRAC):
1. The target muscle is stretched and held passively
2. An isometric contraction of the target muscle is subsequently held for an allotted time
3. The antagonist of the target muscle is subsequently contracted while the target muscle is passively stretched

When performed regularly, PNF has been shown to have a positive effect on active and passive range of motions. This occurs by increasing the length of the muscle while also increasing neuromuscular efficiency. These results can be seen in healthy individuals, but also in those going through a rehab program to regain strength and ROM after sustaining soft tissue damage.

PNF Guidelines
The manner in which PNF is performed greatly dictates the results yielded. Just like any training program or exercise prescription, there are guidelines to follow that will enhance results and prevent any decrements in performance.

When to Perform PNF
Studies have shown that in order to increase muscular performance, PNF needs to be performed after exercise, or without exercise. However, when completed prior to exercise, doing a bout of PNF stretching will actually decrease performance in maximal effort exercises. Therefore, PNF is best utilized when placed directly after a lifting/conditioning session, post practice, during an athlete’s downtime (ie. Before bed) or on a true rest day. The research states that it is in the athlete and coach’s best interest to avoid using PNF in any capacity before a game, practice, lift, or conditioning session. When performed before any of these events, there is evidence of decreased performance in anything where maximal muscular effort is required, such as during sprinting, plyometrics, weight lifting, etc.

How to Perform PNF
Just like resistance training, results from PNF stretching can differ depending upon how it’s administered. While the passive stretch will differ depending upon the flexibility levels of each individual, it is important to give guidance on how much of an isometric contraction is given, as well as the duration of each stretch and contraction. The isometric contraction given by the individual being stretched can be 100% maximal, however if this is the case the athlete must be aware that muscles soreness and a potential contraction induced injury is possible. Giving a high, yet sub-maximal effort is recommended. In a healthy individual around 80-90% effort will suffice, and with an injured individual the contraction needs to be more individualized based upon nature of the injury as well as pain tolerance.

The typical time spent passively stretching an athlete when using PNF will range from about 6-10 seconds, where as the muscle contraction can produce effects when held anywhere from 3-10 seconds. The literature states that 6 seconds is preferred and will yield the appropriate response. Consistency and simplicity with athletes is crucial, so whatever time frame parameters are chosen need to be kept and utilized. As far as how many repetitions or bouts of PNF per muscle group are recommended will depend upon the individual, yet three seems to be an effective and appropriate number. After three repetitions, the ROM that is “unlocked” decreases significantly and the athlete has reached their so called finish. This ROM can improve but each rep seems to access around 15-20% increases in ROM and those increases just simply cannot keep occurring after each rep.

There will be varied affects when performing PNF, and while many stem from controllable variables such as the intensity and timing of the contractions and stretches, some changes in ROM will also depend on biological age, training age, and gender. The best results will come from a properly administered protocol that occurs several times a week.

Where to Perform PNF
PNF can be used on many muscle groups, however some remain easier to administer than others. As mentioned simplicity is key and it’s crucial to remember that majority of strength and conditioning professionals are not therapists. Majority of the following don’t require additional set-up, however if access to a massage/therapy table or anything to elevate the athlete off of the ground may make some muscle groups, like the hip flexors, more accessible.

Common Muscle Groups
• Hamstrings
• Quadriceps
• Hip Flexors
• Hip External Rotators
• Hip Internal Rotators
• Calf muscles
• Shoulder External Rotators
• Shoulder Internal Rotators
• Lat/Upper Back
• Chest Muscles

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.

Letter to Parents – From Jim Kielbaso: What Did They Do When They Were Young?

Dear parents of young athletes,

I know you want your child to be the best, so I can understand why you like to watch training videos of world-class athletes so you can have him/her do what they’re doing.  You’re probably assuming that whatever the best athletes are doing is what your child should be doing, so they will end up like them.

I get it.  And, I know you just want to give your child the best, so they can be their best.     

Unfortunately, it seems like you’re missing one key component here – your child isn’t a world-class athlete yet, so he/she has different needs.  

World class athletes train a certain way because they have built a solid foundation of movement, strength, mobility, work capacity, power, skill, etc.  Their needs are more about refinement than development, so their training is very different than what they did when they were younger and trying to get to where they are today.  

Instead of looking at what the pros are doing NOW, look at what they did when they were your kid’s age.  This will give you insight into what helped them develop the foundation of athleticism they have today.  

Most world-class athletes participated in many sports/activities when they were young.  They typically engaged in more hours of various activities than less successful athletes, but they almost always did it because they loved it.  Athletes who achieve high levels of success have an internal drive at a young age to play sports. They wanted to go to the back yard or playground and practice because that’s what they loved doing. 

You can also look at professional sports clubs in other parts of the world where they start developing athletes at a young age.  In addition to playing plenty of soccer with amazing coaches, European soccer clubs have young kids doing all sorts of different activities like gymnastics, calisthenics, etc. that essentially act as their “second sport.”  Those coaches have seen the process play out through many years of coaching, and they don’t want their young athletes doing the same movements over and over again because it leads to injuries and a lack of overall athletic development. 

They don’t do these same things with their elite players because they understand that athletes at different ages/levels need different things.  The older athletes are lifting weights, doing structured speed work, and in the case of their elite professionals, fine-tuning their bodies to ensure longevity and optimal performance.  Training changes at each level because the needs are different. 

So, while it’s really interesting to watch videos of Stef Curry, Usain Bolt, Mike Trout, and Cristiano Ronaldo training, try to remember that they have very different needs than your child.  What you see them doing now is not what they did when they were your child’s age, so it would be inappropriate for you to copy their training programs.  

Instead, focus on fundamental motor skills, give them physical activities outside of their main sport, keep sports fun, and teach them to value the slow process of constant improvement.  Have them play other sports, and let them explore the full capacity of their bodies.  While you might not see the payoff this weekend, this is the path that most world-class athletes took, so have patience, and enjoy the experience of watching your young athlete slowly develop.   

Sincerely,

Jim

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.

 

Hip Stretches for Lower Back Pain – Jordan Tingman

It is very common for athletes to experience lower back pain, especially when they begin a new training program or train harder than they have in the past.  As muscles get sore and/or stiff from training, they will “hold onto” certain positions as a way to maintain different positions.  Often, tightness in the internal hip/back muscles throws postural alignment off, which can lead to even more pain.  This pain can be felt in various parts of the spine, but in this article, I will mostly focus on stretching muscle groups in the hips and lower back.

When stretching tight areas, it is not necessary to stretch to the point of great pain.  Of course, many people feel a little uncomfortable while stretching, especially when they are tight, but it shouldn’t be extremely painful.  There is absolutely no evidence to show that stretching “harder” will elicit better results.  In many cases, stretching too hard can cause muscles to contract as a protective mechanism and may even lead to acute injuries.

Slowly ease into a stretch, and gradually increase the range of motion.  There is evidence that suggests stretches of up to one minute will increase flexibility faster than very short times.  It is also recommended to stretch often in addition to working through full range of motion movements.  Correcting imbalances and/or alignment issues is also crucial to the process of alleviating tight muscles so be sure to assess and address these issues if tightness persists.

This diagram shows many of the internal muscles around the hip and lower back than often get tight or sore and contribute to lower back pain:

Lower back pain in athletes is often an indication that something in the core isn’t functioning properly.  A variety of reasons that lower back pain may occur include:

  • Imbalance of the hips
  • Tightness of the structure around the hips
  • Weakness of the core muscles- putting pressure on joints to attempt to stabilize external load
  • Soreness of the lower back musculature when exposed to lower body pulling exercises

Of course, there is always the possibility of disk derangement, fracture/spondy, or other serious issues.  If the injury is extremely painful, do not allow the client/athlete to stretch too aggressively or continue normal training, especially if the area is still very inflamed. Make sure to consult with a doctor or physical therapist before getting cleared to train them again.

It is recommended to train “around” lower back injuries with modifications rather than train “through” them without altering your program.  An example would be replacing squatting movements (or any movement where weight is placed on the back) with exercises like lunges, leg press, or resistance-band work.

If the pain is less acute and more of an “achy” feeling, try working on these stretches to aid in releasing the hip structure around the lower back.

These exercises can be paired with movements like squats, deadlifts, or Olympic lifts to use rest time between sets more productively.  This rest time can be very useful in mobilizing various aspects of the lower body in an effort to get more out of the training program.  They can be used as a part of a comprehensive warm-up or cool down, and they can even be given as “homework” for specific athletes who need additional work.

In addition to these stretches, make sure you are strengthening the core alongside them. Until the core structure around the back is strong enough, loading the spine may continue to cause discomfort.

These mobility exercises should help keep athletes functioning properly and feel less stiffness or pain in their hips and lower back.  Once you teach them and place them into a routine, your athletes will thank you for helping them stay healthy.

Jordan Tingman – CSCS*, USAW L1, ACE CPT, CFL1 is a graduate of Washington State University with a B.S. in Sports Science with a Minor in Strength and Conditioning. She completed internships with the strength & conditioning programs at both Washington State University and Ohio State University, and is currently a Graduate Assistant S & C Coach at Eastern Washington University.

 

The IYCA High School Strength & Conditioning Specialist is the only certification created specifically for coaches training high school athletes.  The course includes several hours of video instruction (including the Olympic lifts) and two textbooks with contributions from some of the top strength and conditioning coaches in America.  Click on the image below to learn more about how to become a certified high school strength & conditioning coach.

Training Muscles vs. Movements – Karsten Jensen

Regardless of which process strength coaches use to create training programs, such a process must have a step where exercises are selected.  Exercise selection is always executed based on certain criteria that include:

  • Scientific research
  • Foundational bio-mechanical principles
  • First person experience with athletes.

It is logical to assume that the better the criteria, the greater the likelihood of a positive outcome of the training program.

 

Criteria include principles, strategies, and tactics. This article suggests the 1st Principle of exercise selection, followed by a description of primary exercise selection strategies. Last, current research findings on the effects of single-joint vs multi-joint exercises are discussed and concrete guidelines for exercise selection are suggested.

1 First Principle of Exercise Selection
The first principle of exercise selection could be that:

Any exercise ever performed must – in the short or the long run – improve the athlete’s ability to practice or compete.

If these criteria are not met, how do we explain that the exercise is in the program?

Even exercises that might be included for fun and variation can be said to meet the above criteria.

Why would we include an exercise in the program where the purpose is “just” fun? The answer is that we would include exercises for fun so that the athlete stays in our program. What is the outcome if of the athlete staying in the program? With practice, over time, the ability to practice and compete is improved.

Exercise Selection Strategy (Part I): Bio-mechanical specificity
For athletes, the ability to practice and compete involves the ability to safely, effectively and repeatedly sprint, cut, kick, throw or perform any other sporting movement.

How do we know which strength and conditioning exercises will improve the above abilities?

The primary strategy is to select exercises based on biomechanical specificity which means that there is a certain biomechanical resemblance between the training movement and the sporting movement. (10)

This strategy is often misunderstood. Correctly used the exercises should stimulate, not simulate the sporting movement. (7,8) More accurately, the exercises must always stimulate the ability to practice or compete in the sport. The most foundational exercises do not necessarily look that much like the sporting movement. As the movement patterns are built the resemblance to the end goal become gradually more obvious.

Example: Especially eccentric knee-flexor strength may be important for preventing hamstring injuries during sprinting. The first video below shows a more foundational hamstring exercise that does not really look like sprinting. In contrast, the second video shows a hamstring exercise where the resemblance to sprinting is more obvious

https://www.youtube.com/watch?v=6-JrwG9CpAs
https://www.youtube.com/watch?v=1JQnRD5kUN0

Exercise Selection Strategy (Part 2): Intra- and inter- muscular coordination
Train the movement, not the muscle – one of the original taglines of functional training – is a logical proposition when the end goal is to improve the ability to perform a sporting movement.

However, the body is only a strong as its weakest link. (6) Further, the basic phenomenon is that the body avoids positions of weakness and seeks positions of strength. Thus, practicing complex movements with identifiable weak links may inhibit long term progress as far as that particular movement.

Therefore, a longer training cycle has an early phase where the primary focus is to develop any identified weak links. In this early phase, there is a secondary focus on practicing a version of the final movement that challenges the identified weak link. As the weak links become strength’s the focus is reversed and practicing the complete movement is the first priority. Train the muscle, then the movement is the (over)simplified tagline for this dynamic that is also expressed as “first isolate, then integrate.”

How could we describe the benefits of exercises that focus on weak links? How could we describe the benefits of exercises that focus on practicing the movement?

The concepts of intra- or inter-muscular coordination describe which exercises that focus on weak links aim to do. (9)

Intra-muscular coordination
“Another possibility for improved power results from improved intra-muscular coordination. The term “intramuscular coordination”, describes in the author’s opinion the relation between excitatory and inhibitory mechanisms for one muscle for a specific movement.” (93)

Inter-muscular coordination
“A further way to improve power results from improved inter-muscular coordination. Inter-muscular coordination describes the ability of all muscles involved in a movement, agonists, antagonists, and synergists to corporate wholly with respect to the aim of the movement.”
It is obvious that inter-muscular coordination requires the use of multi-joint exercises. However, intra-muscular coordination can be developed with both single-joint exercises or targeted multi-joint exercises.

3 Tactics – Single-joint or multi-joint exercises.
The following section offers some research-based guidelines regarding the benefits of single joint vs multi-joint exercises.

The most foundational aspect of the choice between single-joint and multi-joint exercises is the ability to develop intra- or inter-muscular coordination:

  • Single joint exercises are more effective to strengthen a weaker muscle group, but the single joint exercise must eventually be replaced with a multi-joint exercise to obtain more impressive strength increases. (3)
  • Multi-joint exercises offer an increased opportunity to develop inter-muscular coordination through the involvement of multiple segments of the body. (6)

Example – Frontal Plane Stability in for sprinting

Early phase 6 weeks:

A1. Forward Walking Lunges with a pause to demonstrate balance as the trail leg passes the stance leg. The exercise can be vertically loaded with a vest, dumbbells or a barbell.

B1. Standing Hip Hike

Later phase (6 weeks)

A1. Forward Walking Lunges Dragging a Sled, explosive execution. Add vest if needed.

B1. Standing Hip Hike is included with low volume as a warm-up or finisher exercise.

Structural strength, including hypertrophy (muscle mass), is a foundation for developing maximal strength:

  • Single joint exercises and multi-joint exercises for the same target muscle group – with similar RM loads – results in similar levels of electromyographic activity. (1)
  • With the use of multi-joint exercises, synergists might fatigue before prime movers and limit the stimulus of the prime movers OR synergists might not be sufficiently stimulated due to the dominance of the prime movers. (1)
  • To the extent that the same fibers of a target muscle experience the same stress (load) the hypertrophic response from single joint and multi-joint muscles is likely going to be similar. (2,5) However, due to different patterns of muscular hypertrophy between single-joint and multi-joint exercises (so-called regional hypertrophy) a combination of a single joint- and one or more multi-joint exercises may be required for complete muscular development. (1,4)
  • Compared to using multi-joint exercises to develop the same target muscles, single joint exercises may result in faster increases in muscle mass due to a shorter duration of neural adaptations (1,2)

With respect to the development of maximal strength and Vo2max:

  • Multi-joint exercises may result in a greater training stimulus due to greater load lifted. (2)
  • Multi-joint exercises may have greater potential as a tool to develop V02max due to a higher muscle mass involved. (5)

Application Summary
To utilize the information presented in this article strength coaches must work from a needs analysis of the sport and assessment of the athlete’s strengths and weaknesses. (10)

The body can be understood as a kinetic chain that is not stronger than its weakest link(s). For this reason, there is an initial emphasis on developing weak links through targeted multi-joint exercises or single joint exercises.

Once the weak links have become strengths the emphasis switch to practice the final, key movement.

References

  1. Gentil P, Fisher J, Steele J. A Review of the Acute Effects and Long-Term Adaptations of Single- and Multi-Joint Exercises during Resistance Training. Sports Medicine 2016
  2. Gentil P, Soares S, Bottaro M. Single vs. Multi-joint Resistance Exercises: Effects on Muscle Strength and Hypertrophy. Asian J Sports Medicine. 6(2): 1-4. 2015.
  3. Giannakopoulos K, Beneka A, Malliou P, Godolias G.Isolated vs Complex Exercise In Strengthening The Rotator Cuff Muscle Group. Journal of Strength and Conditioning Research. 18(1):144-148. 2004
  4. Ribeiro AS, Schoenfeld BJ, Sardinha LB. Comment on: A Review of the Acute Effects and Long Term Adaptations of Single and Multi-joint Exercises During Resistance Training. Sports Medicine. 2016
  5. Paoli A, Gentil P, Moro T, Marcolin G, Bianco A. Resistance Training with Single vs. Multi-joint Exercises at Equal Total Load Volume: Effects on Body Composition, Cardiorespiratory Fitness and Muscle Strength. Frontiers in Physiology. Vol 8. Page 1-8. 2017.
  6. Teixera CVS, Evangelista AL, Novaes JS, Grigoletto MES, Behm DG. You are Only as strong as Your Weakest Link: A Current Opinion about the Concepts and Characteristics of Functional Training. Frontiers In Physiology. Vol 8, page 1-8. 2017
  7. Stone MH, Stone M, Sands WA. Principles and Practice of Resistance Training. USA: Human Kinetics; 2007. 243-253 p.
  8. Siff M. Supertraining. 6th Ed. The Means of Special Strength Training. USA: Supertraining Institute; 2004. 240-246 p.
  9. Schmidtbleicher D. Training for Power Events. In Strength and Power in Sport, Chapter 18, p. 385-395. Blackwell Science; 1992.
  10. Jensen K. Needs Analysis of Sports. The Foundation of Success With The Flexible Periodization Method. https://yestostrength.com/fpm-move-better.html

 

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 Certified Athletic Development Specialist, which is the gold-standard certification for anyone working with athletes 6-18 years old.  The course materials were created by some of the most experienced and knowledgeable professionals in the industry, and the content is indisputably the most comprehensive of any certification related to athletic development.  Learn more about the CADS certification here:

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 to 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.