Wednesday, June 30, 2010

Back from GAIN

What a great way to end my school year and re-charge my batteries.

As usual we were formally on the go from 6:55 am until 9 pm. Our new members, or "delegates" as Coach Kelvin Giles calls them, were the real stars. It's so inspiring to see professionals, some even older than myself, showing such dedication and enthusiasm for athletic development; from the coach all the way up to the MD. My day began at 5 with workouts with Kevin Moody. No weight lifting workouts with Tracy Fober, she blew me off once again.

Joining us this year was Frans Bosch, co-author of "Running: Kinesiology and biomechanics applied in practice." It was the first time I was exposed to the neuromuscular approach to sports training and condtioning. Frans' point of view is to fix the mechanical abnormality and the body will heal itself from injury. There is so much to tell you all about; it will be the topic of many future posts. He gave us 4 hours of intermittent lecture broken up by explaination, demo, and practice of drills he uses to teach good running form. I found it amazing that he had never met, or heard of, Dr. Lederman from London, yet the language the two use is so consistent.

James Radcliffe, athletic development coach at U. Oregon got us up to snuff on planning and implementation; with plenty of learning by doing. If ever I could be as good as him at program design...

Greg Thompson gave us a glimpse of how he begins athletic development where it SHOULD begin- in elementary school; and how it's all integrated with learning.

Tracy Fober, a very cool approach- physiotherapy by way of weightlifting and it's hybrids. I'm convinced stress fractures would be a thing of the past if she had her way.

Coach Kelvin Giles proved to us, in black & white, that it all begins with physical competency. There are no substitutes or short cuts, and there were no doubters by the time it was all over.

John Perry got everyone up to date on lower extremity FUNCTIONAL muscle function in a cool learning by doing seminar.

Athletic Trainer to the Stars Bill Knowles gave us some great ideas on how he uses aquatic therapy in rehab.

Ed Ryan & Dr. Dave Joyner gave us a great overview on concussion research. In addition, Ed ran the program this year as a well oiled machine.

Finally, Vern demonstrated to me as he always does that there is no one better at planned performance training.

I ended the week with my head just spinning. So much to digest and figure how I will implement these new ideas in my neck of the woods. Good to be back blogging again.

Monday, June 14, 2010

GAIN '10

Heading down to Fla for GAIN '10 Thursday morning. I probably won't be posting for about 2 weeks, but I'll be sure to give a synopsis when I get back. Think about joining us next year!

Wednesday, June 9, 2010

Two great studies on muscle cramps

"Three Percent Hypohydration Does Not Affect the Threshold Frequency of Electrically-Induced Cramps"- Miller et al, Medicine & Science in Sport & Exercise, 3-10.....

"Reflex inhibition of electrically induced muscle cramps in hypohydrated humans"-
Miller et al, Medicine & Science in Sport & Exercise, 5-10....

The conclusions? "cramps may be more associated with neuromuscular fatigue than dehydration/electrolyte losses. Health care professionals may have more success preventing EAMC by focusing on strategies which minimize neuromuscular fatigue rather than dehydration".........."Pickle juice, and not deionized water, inhibits electrically induced muscle cramps in hypohydrated humans. This effect could not be explained by rapid restoration of body fluids or electrolytes. We suspect that the rapid inhibition of the electrically induced cramps reflects a neurally mediated reflex that originates in the oropharyngeal region and acts to inhibit the firing of alpha motor neurons of the cramping muscle".

The authors speculate the cramping mechanism is exhaustion, either caused directly or through the biochemical processes associated with fatigue.

Scapular Stability

This exercise is a great quick screen for scapulothoracic Stability. It's a pushup plus from the quadriped position. There should be a straight line from the pelvis to the top of the head as the athlete presses his hands "through the floor"; ABD/ADDing the scapulae.

This is an athlete with a history of several L anterior shoulder subluxations. Although the exercise is the test and the test is the exercise, even this one is obviously outside their zone of function and you need to come up with alternatives.

Monday, June 7, 2010

Makes you Think

"Computed Tomography Assessment of Hip Joints in Asymptomatic Individuals in Relation to Femoroacetabular Impingement"-Kang et al AJSM

The author CT scanned 50 people's hips from 15-40yrs. 39% of the joints had at least 1 predisposing factor for impingement syndrome; and the majority of the findings were bilateral. However, all were asymptomatic and will most likely stay that way.


- If the asymmetry is symmetrical to both hips does it cancel out?
- Might proximal or distal joint anomalies cause an individual to become symptomatic?
-Were their activity levels too low to create symptoms?

Sunday, June 6, 2010

June 6, 1944

Dad has been gone 12 years now, and I still not one day goes by I don't think about him.

For years after he had passed, the surviving guys from his unit (only 8 of 60 had survived WW2) found out and sent letters with their memories to my mom. Dad had what you would call a "trick thumb" and I never knew why. Here's the story-

It was D+1 and the vehicles that had come ashore were badly damaged by salt water. My dad and another soldier had gotten an order to clean up the vehicles and get them moving. As the guy tells it, all of a sudden he hears a sound like a train coming down the tracks, which was strange for the French countryside. With that my dad grabs him and yanks him off the tank onto the ground which was a good 10 feet below.

The sound was the machine gun of a M109 German fighter plane that was strafing them. The sound was deafening, like a series of sledge hammers slamming into metal. The guy said he was crying; terrified he would never make it home alive. He wrote how my dad comforted him and calmed him down. Then he says, "What happended to your thumb"? Dad's left thumb was dislocated onto his wrist when the guy fell on top of him diving off the tank. He snapped it back and that was that.

That was just one of many stories. I'll post the next one on Vet's day.

Friday, June 4, 2010

Good post from Vern Gambetta today; making the statement about (at least some) athletic trainers wanting to be physical therapists.

I hope one of the things I am doing in this blog is helping to define the ATC. Of course we overtly & greatfully borrow from the physical therapy profession. However, in MY early days there may have just as well been a brick wall between the two professions. My MD happened to be an osteopath, and they had a heavy influence on me. Remember- a P.T. or osteopath may see an athlete for a few months, while we have them for 4 years or longer. Big difference. That's where athletic development comes in; and it's often a missing link in many programs.

In my ankle book, sure there are many direct and indirect techniques aimed directly at the joints. But I think a lot of stuff in there is going to leave many scratching their heads wondering what it has to do with the ankle. Oh yeah- except for the physios over at U.Dublin.

Wednesday, June 2, 2010

pivot lunges with ankle mobes

I just got finished doing a little IASTM on this athlete with a HIGH ankle sprain. Both the anterior and posterior tibiofibular ligaments are much easier to treat with instruments.

The pivot lunge with the opposite leg is creating the motion I desire in the ankle. My hands are assisting the "locking up" process as the foot goes from pronation to supination.

I'll be including these in my new book-

"Integrated Functional Rehabilitation of the Sprained Ankle" due out this fall.