If you’re having anterolateral ankle pressure or pain with dorsiflexion, give this mobilization a try.  We’ve used this a lot in the last week at IFAST and have seen some outstanding results.

It was a good day at the gym today.  Everyone that came in was feeling good and putting out a great effort.  I even got a session in at IFAST.

I’ve been working on some foundational things like developing my cardiac system and my ability to produce energy locally in the muscles as well as addressing some mobility issues in my hips.  This is the kind of work that really isn’t much fun, but it will set me up for the more intensive training to come later.  It screws with your head a bit because, as you’ll see some of this programming is easy from an effort standpoint, but it can challenge your mental toughness.

Sled drags warm-up
followed with lower body mobility

Subjective readiness:  7/10
forgot my heart rate monitor

Safety squat bar (SSB) step-ups to just >=90 degrees
95 x 6, 135 x 3 x 6
SSB Squat to box just below parallel
225 x 6, 275 x 6, 305 x 6
SSB Tempo squats
135 x 30 sec x 3 on 60 sec rest
SSB deep quad dominant split squat
135 x 2 x 5

Sub jective level of effort 7/10

3 hours later 30 min of LISS aerobic work at 120 bpm.  This is to ultimately improve recovery and I’ll be doing it more frequently.  Intensity is so low that it won’t impact any other aspect of programming, but I’m expecting to see some improvement in sleep as I adapt.  It is horribly boring, so I watched a bit of Ironman to occupy my brain.

All in all, not a bad session.  Still felt challenged from an energy standpoint which brought my level of effort down to a 7/10.  Nothing was to failure and I did’t really have any hip pain during training.  It did stiffen up a bit after cooling off a bit.

Subjective readiness

Subjective readiness is a measure of how ready I feel for training after warming-up.  It will vary depending on sleep patterns, stress (mental and physical), nutrition, state of recovery, etc.  It’s a good measure to allow you to make programming changes on the fly.  For instance, if you normally get 7 hours of sleep and wake at 6am, but last night you got 5 hours and woke at 5am, you may not feel as good and not as ready as you should be for an intensive training session.  If you still rate your readiness at a lower than normal level (it varies depending on the person), you can effectively adjust your training for that day to prevent excessive loading that may slow or even halt progress.

I do recommend that you warm-up first as a little activity may actually improve your rating and level of readiness.  I’d also track this measure before every training session to allow you to establish your own typical trends as to how your react to certain intensities and loads.  I tend to use <5/10 as a cut-off for continuing with a regular session or just doing some light recovery work.

Ankle mobilization

A lot of coaches will use an active mobilization to improve ankle dorsiflexion as part of their preparation for training.  I’ve had a bit of issue myself in my left ankle, but using Mulligan’s mobilization with movement techniques help quite a bit.  Problem is that it’s damn awkward to try to mobilize your own ankle when a skilled practitioner is not around. 

I was messing with a technique that I’ve recently started using on myself with a couple clients this morning.   They had some rather significant improvements and were pretty pleased with the result.  It was also quite easy for them to pick up the technique.  I have no idea if anyone else has used this method before, so I’m going to create a video and pass it around to some people and have them test drive it themselves.  If it goes well, I’ll try to post it for all to use themselves.

Have a great Independence Day!

Bill

If you’ve read through some of the blog posts here, you’re probably aware that I believe the impact of fatigue to be a large component of sports-related injuries.

Fatigue has been shown to alter proprioception, muscle activation patterns, stability, etc.  This only reinforces the importance of effective training programs for athletes based on their specific needs.

I came across this article at mmajunkie.com today that discusses the same subject and thought you’d like to take a peek at it.

Rant warning…

Back in the days before big screen TV’s and internet when I played football in high school, we were allowed to have supervised summer conditioning programs but no organized practice until two weeks before the season started. 

Now the programs have absorbed the entire summer of our fall sport athletes by having organized practices and conditioning sessions.  Sure, the programs may be offered as voluntary, but you and I both know that “voluntary” means “manditory if you want to play this year.”  Now you have to make the 7-on-7 team just to get noticed by the coach.

Two things are really bugging me…

One, from this day forward football players, your summers will never be as fun and relaxing as they should be.  Now don’t get me wrong.  I loved playing football.  I love preparing to play football.  But I also loved having down time from school and formal schedules. (note to parents who think your kids need to be in school year round…you’re all idiots.  It won’t make your kid any more intelligent.  The guys that sent other guys to the Moon and back got their summers off when they were in high school.)

Two, having seen some of the conditioning programs from the local high schools, it’s clear that most sports team coaches know very little about preparing their athletes to perform when they need to perform.  Nothing like getting beaten up and exhausted before the season even starts.

I predict a record injury rate this season.

I hope I’m wrong.

Bill

Mike Robertson and I were discussing this study that showed how training the trunk muscles for improved stability resulted in a reduction in hamstring stiffness.  In other words, flexibility improved without stretching the muscles.

To bring you up to speed, here’s the study in a nutshell:

The hypothesis is that increased hamstring stiffness compensates for the insufficient performance of the deep stabilizing muscular subsystem (does anyone smell the TVA bias in the room?).

To test their hypothesis they measure the hamstring stiffness of 30 people using a PKES test (Supine, hip flexed 90 degrees, extend the knee and measure the knee angle).  The subjects spend 2 days learning to perform “isolated, conscious activation of the deep stabilizing muscle subsystem”.  They then perform a variation of a plank with feet elevated in slings (body is horizontal) and a variation of supine hip extension twice a week for 4 weeks.  At the end of four weeks, the hamstring stiffness had decreased (flexibility improved).

Their conclusion:  The results of this study support our hypothesis.

Huh?  How do you figure?

Now certainly the training performed resulted in a reduction in hamstring stiffness which is very interesting (we’ll get to that in a minute), but how did they determine it was the result of an improved deep stabilizing whatever, whatever?

There was no pre-test of the deep stabilizing whatever, whatever.  Sure they spent 2 days learning to consciously activate it, but that doesn’t mean that its function was improved nor dysfunctional in the first place.  They used an integrated exercise that involved all of the abdominal muscles, hip muscles, and other trunk and shoulder muscles.  And there was no post-test of deep stabilizing…well, you get the point.

I’m not saying that they are wrong or right, only that you can’t conclude much more than that the training performed for improved stability reduced hamstring stiffness.  To their credit, they do mention in the second to last sentence that “it is still possible that stability training influenced stiffness of the hamstrings in some other way than by improving action of the deep musculature.”  Well done.  It could have also been improved hip stability or even shoulder stability (yes, there’s a connection)

The interesting stuff…

The point to take away from this is that mobility restrictions aren’t always mechanical tissue related issues.  In other words, stretching isn’t always the answer.

In situations where an individual is faced with a task that exceeds his ability to adequately control posture, balance, or range of motion, it’s not uncommon to see what appears to be a lack of mobility or some form of movement compensation.

This compensation is often a “locking up” of joints, frequently by two joint muscles like the hamstrings, to create stability with a comprise to mobility.  The movement will frequently appear to be uncoordinated or the athlete may seem slow or weak in reacting.  This is not a dysfunction that you can fix with the correct stretching protocol.

The fix requires restoration of stability utilizing a lower level activity that the athlete can control effectively and progressing toward more complex tasks that lead to higher force, higher speed, and higher skill movements.

This also reinforces the importance of observing your athletes in action where they experience and participate in the specific conditions and demands of their chosen sport.

Everything is an assessment.

Bill

I’m an assessment guy.  I do a pretty extensive assessment on everyone we train at IFAST.  I do a very broad spectrum of testing because I know that there are few if any definitive tests. I also realize that when it comes to predicting potential injury, anything I do during my controlled assessment will have limited validity in certain situations.

Why?  Because fatigue changes everything.

Fatigue will alter trunk muscle function and therefore balance. (1)

Fatigue alters technique. (2,3)

Fatigue changes landing mechanics and motor control that can result in ACL injuries. (4,5,6)

Fatigue measured as low aerobic power increased risk of injury for rugby players. (7)

Fatigue altered the coordination (acuity) of the entire arm of overhead throwers. (8)

It’s obvious that injuries are the result of multiple factors.  We can never rely on one test or even a battery of tests if they don’t take into consider fatigue and forces similar to those that are experienced in a play situation.

So should we just ignore the whole concept of injury prevention.

No, I don’t think so.  Not by a long shot.

I think the first key concept to address is to train your athletes effectively in the first place by addressing their specific needs and those of their sport. 

Do they have a foundation of general physical preparation to allow them to train at an intensity that will support their performance in game situations?

Do they demonstrate sufficient mobility to perform the required activities without compensation? (Can you identify compensation?)

Do they demonstrate appropriate energy system development for their desired sport?

The next key concept to understand is that everything is an assessment.  It just doesn’t stop when game starts or when the training session begins.

Watch for obvious signs of fatigue (open mouth, heavy breathing, distressed appearance, etc.) and the not so obvious (changes in technique, ability to change direction, signs of instability, etc.).

Give rest when needed (even if it’s not programmed or it’s a crucial point in a game).

Change the training program to adapt to the athletes current reserves.  Nothing is written in stone and your “perfect” program may not be so for every athlete on every day.

We all want our athletes to be successful, and yes, there are times that you must push them harder than they want to be pushed to assure that they are prepared.  However, you must focus on the quality of your athletes’ performance in training or in a game if you’re serious about preventing injuries.
1.  J Sport Rehabil. 2008 Nov;17(4):380-6. 
2.  IEEE Trans Biomed Eng. 2008 Nov;55(11):2666-74.
3.  J Orthop Sports Phys Ther. 2009 Mar;39(3):210-20.
4.  Am J Sports Med. 2008 Mar;36(3):554-65
5.  Med Sci Sports Exerc. 2006 Oct;38(10):1836-42
6.  Am J Sports Med. 2005 Jul;33(7):1022-9
7.  Am J Sports Med. 2005 Mar;33(3):428-34 
8.  J Athl Train. 2007 Jan-Mar;42(1):90-8

If you want to learn more check out www.indyperformanceseminars.com

Bill