At Endeavor, we really pride ourselves on constantly looking for better ways to develop our athletes. All of our coaches continuously look for cutting edge information on program design, more effective exercises, nutrition, recovery strategies, and injury prevention (amongst others). Working alongside such passionate people is what makes my job so much fun to do.

Over the weekend I spent some time watching DVDs of a 3-hour presentation from Dr. Vladimir Issurin on Block Periodization. Dr. Issurin is a scientific advisor to the Soviet and Israeli Olympic teams. His presentation delved into how to alter the emphasis of various training aspects to best peak for competition. Eastern European training methods have always intrigued me, so I was psyched I got an opportunity to hear from one of their secret weapons.

Is this development?
One of the things he said that really caught my attention was (to paraphrase) that in today’s athletic development systems, competitive workloads have replaced training workloads. Think about it. Add up the total time athletes spend practicing and training in a given month. Add up the total time athletes spend playing games. In previous athletic development models, a ratio of preparation: competition would likely be AT LEAST 5:1, meaning athletes would spend 5 hours of preparation (practice and training) for every 1 hour of competition. Now this ratio is significantly closer to 1:1, if not 1:2.

Concomitant with this shift in competition emphasis, we’ve seen a drastic increase in the amount of burnout amongst high school athletes and an UNACCEPTABLE increase in the number of non-contact and overuse injuries. To address the former, this means that when athletes should be entering their best years, they’re so burnt out from the non-stop competitive nature of their sport that they give it up. This is tragic.

The Cause of Overuse Injuries

The increase in overuse injuries is related to what I think of as “tissue stress accumulation”. Simply, this means that the stresses placed across tissues within your body (muscle, tendon, ligament, etc.) accumulate over time, ESPECIALLY if special attention isn’t paid to recovery. When I was in San Jose, John Pallof (a brilliant physical therapist) said he thought one of the reasons groin strains, hip flexor strains and sports hernias were so much more prevalent now is because people are training more than ever before.

John noted that the training is absolutely necessary for the prevention of a host of other injuries, but he alluded to a great point: With the increase in competitions both within a season and across multiple seasons (Issurin) and the necessary increase in training (Pallof), our body’s just aren’t given the time to recover that they need. This reality is exemplified by the fact that almost ZERO attention is paid to recovery and improving soft-tissue quality.

Take Home Message
There are three things you should take from this (and pass along to everyone you know and love):

1) As a community, everyone in sports needs to ease up on the competition and put a greater emphasis on practices with components of skill development. It’s okay to slow down practice and focus on individual skills. In fact, it’s paramount for development.

It's okay if every practice doesn't end with athletes looking like this!

2) From a training standpoint, the goal is to get the maximum benefit from the minimum amount of training. This comes back to minimizing tissue stress accumulation and highlights the fatal flaw in the “more is better” idea. This focus underlies the design of all our athletic development programs at Endeavor. It’s why we sometimes use 2 sets instead of 3, why we tell athletes to lift lighter weights on certain sets, and why we dial back our strength work significantly when it’s time to really hammer home conditioning. Maximum results, minimum stress. That’s the goal.

3) Lastly, EVERY athlete should be actively pursuing improved soft-tissue quality. I recently heard someone say that athletes ignoring performance-limiting factors (such as poor soft-tissue quality) are essentially driving with the brakes on. At Endeavor, we address soft-tissue quality by having our athletes go through a self-myofascial release circuit before they do their dynamic warm-up, which uses foam rollers, tennis balls, and medicine balls to break up knots and adhesions within the muscle (taking the breaks off). These implements can help restore normal muscle extensibility and fluid motion in young athletes and help maintain tissue quality in older athletes.

As athletes get older, it is ABSOLUTELY IMPERATIVE that they go see a manual therapist on a regular basis to do some soft-tissue work done on their hip musculature. In this case, manual therapists include professionals that can do massage, A.R.T. (Active Release Technique), and Graston. This is truly the secret behind long-term injury-free athletic excellence. I’ve found that most massage therapists avoid the hip musculature for liability reasons, and therefore aren’t of much use for our purposes (although the relaxation is still awesome and I’d never tell anyone not to get a massage). If a therapist shies away from this area for liability reasons, find a new therapist. Because not all manual therapists are created equally, I made it a mission to seek out the top professionals in our area to refer our athletes to. I generally tell our older athletes to go see one of these therapists once per month to get work done, sometimes more or less depending on the therapists recommendation.

Endeavor's Manual Therapist Network
If you’re reading this and you’re unfamiliar with the work I’m referring to, I highly recommend you contact one of the 4 professionals below and schedule an appointment. Don’t wait until you (or your players) are hurt before you take an active role in improving your soft-tissue quality and start to focus on recovery!

Craig Bohn                                Dr. Anthony Lafferty
Hockessin Athletic Club                Lafferty Family Chiropractic   
100 Fitness Way                          402 Commerce Lane
Hockessin, DE 19707                   Suite 114 Parke Place Blvd #D
(302) 239-6688                          (856) 768-7737
cbohn@hachealthclub.com

Dr. Michael Tancredi                 Dr. Mark Kemenosh
Tancredi Chiropractic                   Glen Oaks Health and Spine
600 Reed Road, Suite 101            3 Jefferson Drive
Broomall, PA 198008                   Laurel Springs, NJ 08021
(610) 353-9400                          (856) 228-3100
 

To your continued success,

Kevin Neeld, MS, CSCS
Director of Athletic Development
kneeld@endeavorfit.com
(856) 269-4148

P.S. Call or stop in today for more information or to sign-up for one of our Athletic Development Training Programs, GUARANTEED to get you the results you deserve.

My friend Mike Potenza was kind enough to invite me out to San Jose last week to help out with the San Jose Sharks prospect camp. Throughout the week, I had the opportunity to interact with the entire coaching/scouting staff, the athletic training staff, a few of the Sharks players (that were around for the Summer), ~45 domestic and international elite level prospects, Mike and his supporting interns/volunteers, and John Pallof (one of the smartest people in human performance that I’ve ever met). Needless to say, it was an eye opening experience.

More than anything else, there was ONE common theme for this camp:

In a previous post, I outlined the joint-by-joint approach to performance training. This approach, based on the fact that adjacent joints tend to lie on opposing sides of the mobility-stability continuum governs every aspect of athletic movement and performance. In case you missed it, you can check it out at our blog here:

The joint-by-joint approach provides a phenomenal framework for people in the athletic world to understand how JOINTS work to create movement, but is limited in its ability to explain how muscles function to create movement.

One of the key areas of the body that dictates performance levels in most athletes is the hips. Learning how to move properly through the hips and activate/strengthen the right muscles in the surrounding areas will do more for performance and injury prevention than focus on any other area of the body (as I mentioned in last week’s newsletter: failure to maintain proper hip rotation will call excessive rotation at the lower back and eventually injury).

Is glute dysfunction limiting your performance?
One illustration of this lies in one of the most common performance limitations in athletes today: glute dysfunction. From a performance standpoint, it’s important to understand that your Gluteus Maximus (your butt muscle) is a strong hip extensor (think of the motion your hip goes through once your foot touches the ground during sprinting). It should be one of the strongest muscles in your body.

Unfortunately, because we sit so much during the day most people have what is sometimes referred to as glute amnesia. Muscles that are held in a stretched position tend to become weak and aren’t activated to the extent they should be during most movements. In this case, sitting all day causes the gluteus maximus to become weak and affects its ability to produce force. Not only is this a HUGE barrier to peak athletic performance, but it’s also a major cause of one of the most common athletic injuries.

Synergistic Dominance
I mentioned earlier that your Gluteus Maximus is a strong hip extensor. Your hamstrings are also pretty strong hip extensors and assist the Gluteus Maximus in this movement. Muscles that assist others are known as “synergists”. As is the case all over your body, when one muscle is too weak or not activated correctly (in this case the Gluteus Maximus), a synergistic muscle (in this case the hamstrings) needs to pick up the slack. Over time, the synergist (hamstrings) takes on the extra workload (a phenomenon coined as “synergistic dominance” by world-renowned physical therapist Shirley Sahrmann), becomes overtaxed and eventually fails (strain/tear).

For some people, it’s helpful to think of a coworker/family member/teammate/friend that they rely heavily on in one way or another. Now imagine if this person went on a 1-month vacation and you had to pick up the slack. You could probably handle the extra stress for the 1st week, maybe even the first two, but eventually you’d snap. After all, you can only handle so much in your life and most of us are already overworked!

Performance Implications
This example highlights how a poorly functioning glute can lead to a hamstring injury. There are other examples of this throughout the body (e.g. poorly functioning psoas major, a hip flexor, leading to high rectus femoris, one of the quadriceps muscles, strains). This also explains why so many athletes have the same injuries over and over. When an athlete strains a muscle, the 1st goal of many trainers/therapists is to stretch and strengthen the muscle. The symptoms are being addressed, but the cause is not. In the example above, it’s easy to see that the hamstrings are more than likely overly strong from having to do the extra work. Strengthening the hamstrings in this case may be counter-productive, and if glute activation isn’t addressed, the athlete is likely to re-injure his or herself in the future.

Take Home Message
The big picture here is that the body is highly adaptive, but can only sustain so much stress. Sometimes unlocking higher levels of athletic performance is a matter of “waking up” dormant muscles and THEN strengthening specific movement patterns. There are a few fundamental activation exercises that we have almost every Endeavor athlete perform on a regular basis. We’ve found that these exercises, while sometimes easy for athletes to perform, can go a long way in maximizing performance and minimizing injury risk. Athletic performance is as much about quality as it is quantity. Athletic development programs need to include an emphasis on improving joint mobility/stability according to the joint-by-joint approach and muscle firing patterns BEFORE adding load (e.g. external weight) or volume (e.g. more sets or repetitions).

To your success,

Kevin Neeld, MS, CSCS
Director of Athletic Development
 

Over the last several years, Michael Boyle and Gray Cook’s “Joint-by-Joint Approach to Training” have changed the way the sports performance world looks at athletic development. Starting from the ground up, the joint-by-joint system outlines that the body has joints alternating in emphasis on whether they need mobility or stability to maximize function. Look at the chart below for more specific details on which joints need mobility and which need stability (note that if you read from left to right, you’ll see the progression from the ground up within the body: ankle -> knee -> hip -> lumbar (low back) -> thoracic (upper back) -> scapulothoracic (shoulder blades) -> glenohumeral (shoulder joint) -> elbow). 

The Mobility-Stability Continuum

This breakdown helps us understand a lot of common injuries. To be overly simplistic, if a joint in the mobility column has sub-optimal mobility (or range of motion), an adjacent joint will need to “fill in the gap” by providing the additional range of motion. Usually this “compensatory movement” occurs at the next joint up. Following this idea, you can refer back to the table and see that mobility restrictions in the left column lead to compensatory movements (and consequent injuries) to the joints in the right column.

Performance Implications
If your ankle lacks mobility, you’ll get it from your knee. Result = knee pain (common in basketball players. If your hip lacks mobility, you’ll get it from your lumbar spine. Result = back pain (common in just about everyone, but especially hockey players and golfers). A lack of glenoumeral mobility results in increased range of motion and stresses across the elbow (common in tennis and baseball players). The list goes on. You can see how this joint-by-joint approach creates a paradigm that explains so many athletic injuries.

While I’m sure this wasn’t the original intention of either Coach Boyle or Gray Cook, this idea has been interpreted in a black and white fashion: Joints either need mobility or they need stability.

The truth is that EVERY joint falls somewhere on a mobility-stability continuum:

←---------------------------------------------------------------------------------------------→
Mobility                                                                                                      Stability

Core Rotation Example
Let’s take a look at the lumbar spine. Each segment of the lumbar spine has about 2-4 degrees of rotation range of motion, for a total of about 13 degrees total rotational capacity. In contrast, the thoracic spine has in excess of 70 degrees (and so do the hips: about 30-50 degrees in both internal and external rotation). From this viewpoint, it’s obvious that we should be emphasizing rotation through the hips and thoracic spine and NOT through the lumbar spine. This fits well in the mobility/stability table above. Failure to do so results in excess rotation through the lumbar spine, which can cause a host of disc and spinal bone issues.

With that said, it’s important to note that we still NEED that 13 degrees of rotation range of motion in the lumbar spine and should use it. We don’t want to force motion past the end range of the joint, but using the allowable motion is absolutely essential to efficient movement.

Coming back to the continuum, understand that even joints that necessitate a high level of mobility (e.g. the glenohumeral or “shoulder” joint) absolutely need some requisite stability. The same is true for the ankle. In both cases, ligament damage due to injury creates an increase in joint laxity, which by definition improves mobility. However, this mobility comes at the expense of NECESSARY structural stability and increases the risk of subsequent injury to that joint (one example of why previous injury is the best predictor of future injury). In reality, these joints probably don’t belong in columns as much as a continuum as displayed below.

←---------------------------------------------------------------------------------------------→
Mobility                                                                                                      Stability 
              Glenohumeral       Hip/Ankle                            Lumbar


Take Home Message
When we think of maximizing human performance, we can never think in black and white terms. Each joint needs a specific balance of mobility and stability. If you take only one thing from this discussion, it should be that the body functions as a cohesive unit, meaning limitations in one area will absolutely affect (usually negatively) both adjacent areas and areas further up/down an anatomical pathway. This is just one more reason why isolation training is moronic.

To your continued success,

Kevin Neeld, MS, CSCS
Director of Athletic Development
kneeld@endeavorfit.com

Last week, Eric Cressey put up a few great posts on an issue that I think everyone working in the human performance arena should be aware of. You can check them out here:

Preventing Lower Back Pain: Assuming is Okay

Healthy Shoulders with Terrible MRIs?

Who Kneeds Normal Knees?

Despite the last title, these three posts contain a lot of great information. The big take home message from all these posts is that many people (athletes and non-athletes alike) have positive MRI findings (positive MRIs means something is wrong), despite not having ANY symptoms. This is most profound in the lower back area, where one study found that 82% of the 98 MRIs taken of asymptomatic individuals came back showing a spinal disc abnormality (Jensen et al, 1994). Eric points on in these posts that similar (although not QUITE as profound) findings have been found in the knees and shoulders of various athletic and non-athletic populations.

Recall from my post Off-Season Hockey Leads You to Surgery? that similar findings have been found in the hips of elite level hockey players. To refresh your memory, the article found that MRIs of 39 NHL and NCAA Division 1 players, twenty-one (54%) had labral tears, twelve (31%) had muscle strains, and 2 (5%) had tendinosis (degeneration of the tendon). Overall, 70% of these hockey players, who otherwise present as "healthy", had irregular findings on their MRIs.

To your success,

Kevin Neeld