It’s been a long time since I’ve written and I appreciate all who have taken the time to reach out to me in one form or another over the past year. In a future post, I plan to elaborate on what exactly I’ve done with myself since April 2011 and maybe even start kicking around ideas again, but that’s far less important than what follows, which is the story of a cool young man with cat eye syndrome in honor of Cat Eye Syndrome Awareness Day. Don’t know what that is? Visit here to learn more.
Begin Joey’s story:
Joey is four-years-old and is a preschooler at Blix Elementary School in Tacoma, WA (USA). He loves to do puzzles, play games, read, sing and hopes to be a teacher, heart surgeon or baseball player some day.
When Joey was born he was quickly transported to Tacoma General Hospital’s Neonatal Intensive Care Unit (NICU) and underwent surgery the next day to repair his imperforate anus. While he was recovering it seemed like he was checked out by almost every specialty in the hospital and was diagnosed with bilateral colaboma, ear tags and ear pits, moderate hearing loss on one side, Total Anomalous Pulmonary Venous Return (TAPVR), a tethered spinal cord, vesicoureteral reflux and one kidney that was multicystic dysplastic and had no function. All of these features and symptoms lead the doctors to believe he had Cat Eye Syndrome, a diagnosis that was confirmed by genetic testing a few weeks later. Joey had his second surgery on this three-week birthday to place a g-tube in his stomach because he was not allowed to eat by mouth. When he was four weeks old he was able to go home with a strict regimen of medication for his heart and round-the-clock feeds.
Joey still needed open heart surgery to save his life, and had frequent visits to his cardiologist to monitor his congestive heart failure. There is risk of organ failure with open heart surgery, and with his existing kidney problems the likelihood of him needing dialysis after his surgery was high. Together, his cardiologist and nephrologist determined it best that he go to Seattle Children’s Hospital for the surgery. The date was set and when he was 2-1/2 months old he was once again on the operating table, this time for approximately six hours. During the operation a tube was placed to prep him for dialysis if it would become necessary. As with his previous surgeries, Joey did extremely well and within a few days was moved from the Cardiac ICU. His kidneys did not fail and he did not need dialysis. His first smiles came a few days later, and after a week he was sent home with his incredibly relieved and thankful parents.
Since Joey’s heart surgery he has had five more minor operations for things like placing ear tubes, taking off his ear tags, closing his g-tube site after her learned to take a bottle and most recently to repair his kidney reflux. He never ended up needing the spinal surgery that had been expected; an MRI done when he was five months old showed that the problem had fixed itself. He was also diagnosed with bilateral vocal cord paralysis and laryngomalacia, as well as other malformations of his airway. He participated in birth-three services and physical therapy, and still attends weekly sessions with his speech therapist at Mary Bridge Children’s Hospital focusing on aural rehabilitation.
Joey continues to see most of the specialists he was introduced to as a baby regularly, though less frequently. He wears a hearing aid in one ear, and while his vision is very limited on one side, the other eye is in the normal range and he manages with that just fine. He loves to tell stories, and thanks to the help of his hearing aid and speech therapy most of the time he doesn’t stop talking. Sometimes when Joey gets a cold or flu he needs extra help with his breathing and has been hospitalized three times with various bugs. He is always well taken care of at Mary Bridge Children’s Hospital, and bounces back each time.
Joey has a whole team of amazing doctors, nurses, teachers, therapists and family members who have fought with him and celebrated his accomplishments. In turn, Joey is a bright, loving boy who brings joy to many.
If nothing else was gained from Joey’s story, I hope that you were able to take away some level of awareness and at least a smile.
Travel is an unavoidable part of the elite athlete’s lifestyle, and with the beginning of the summer track season season on the horizon the departure of a number of athletes from our high altitude training base here in Flagstaff is soon to begin with travel not ceasing until as late as September, it’s a good time to look into optimizing travel for optimum performance. It’s not uncommon for an athlete to bounce from one country (and time zone) to another by plane, train, or automobile across Europe chasing meets and fast times in quick succession. Substantial risks exist when pushing the limit of the body’s recovery reserves and the stress of travel can push athletes over the edge to fatigue and poor performance.
Elite team sport athletes are also at risk from the detriments of the stress of travel. Teams may compete in Arizona one night then play an afternoon game in Georgia less than 20 hours after the conclusion of their last competition. Others may spend two to three weeks at a time on the road traveling from city to city and competition to competition.
Because high stress–emotional and physiological (which I think is an artificial distinction)–can result in accelerated erosion of trained biomotor abilities and facilitate negative adaptations, anything that can be done to prevent Performance Brinksmanship is worth exploring in the interest of high performance.
As with most aspects of this industry, having an understanding of the physiological consequences of long distance and frequent travel stress will lay the foundation for making the appropriate choices in interventions.
The Physiology of Travel Stress
Travel can lead to a myriad of stressful experiences for the athletes, but even if all accommodations have been made well in advance, distinct changes in the physiological milieu still occur. The physiology of travel stress occurs acutely and chronicly, which puts the body in less than favorable conditions for performance.
Li and colleagues demonstrated that three hours of road travel resulted in depressed heart rate variability (2005). Long durations in hypobaric hypoxia as in air travel result in decreased melatonin secretion and increased sympathetic drive (Coste, 2004). Ambient aircraft noise results in repeated spontaneous arousal and is associated linearly with increases in urinary epinephrine and inversely with sleep quality (Basner, 2008; Maschke, 1993).
Reduced sleep quality and length occur both as a result of travel’s physical restraints–uncomfortable seats, turbulent air, snoring teammates, screaming babies, et cetera–and the physiological responses in sympathetic mobilization and decreases in biochemical components regulating sleep. Repeated sleep inadequacy decreases mobilization of testosterone, IGF-1, and growth hormone while it elevates cortisol and myostatin creating an unfavorable endocrine environment with net catabolism. This means muscle atrophy, reduced sattelite cell proliferation and differentiation, and ultimately, worse recovery (Dattilo, 2011; Imai, 2009).
Fit athletes are also at risk hypercoaguloapathies, experience travel-related changes in macronutrient partitioning, and then get to experience the subacute impacts of jet lag upon arrival. Add to this pile the stress of actually having to find places to train, to train, to get ready to compete, and to ultimately compete, and it’s no wonder why the post-season break is so welcomed.
In the next few posts we’ll explore ideas on improving responses to travel and frequent competition through several lenses focused on the physiology of travel stress.
Recently there has been a little bit of discussion on the necessity of assessment. Some argue that if you simply coach movements to look pretty, the need for assessment is nil. As I chimed in last year regarding a definition of corrective exercise, I, in principle agree that great coaching can be highly “corrective” in nature. I thus maintain that failing to coach movement quality is both unacceptable and entirely unprofessional.
This reasoning, however, does not support the idea that assessments are unnecessary if you know how to coach.
Assessments and screens are just as much (if not more) about knowing what not to have a client do that day as they are for telling us what to do. In all of health care, the first priority is to identify contraindications to a proposed solution prior to intervention, and exercise should be no different.
Waiting until your client has a 315 barbell on her back at the bottom of a squat to learn that she has limited hip and ankle mobility or an inability to weight shift that prevents her from squatting with ideal load distribution is simply unacceptable. Waiting to learn your client experiences pain with multisegmental flexion until the end of his first set of deadlifting is equally ridiculous. If you are not clearing basic movement competencies, you’re just ignoring the fact that there may be some underlying issue that prevents safe execution of an exercise irrespective of how great of a job you do coaching and is absolutely negligent behavior.
Failing to assess or screen is akin to a physician handling all of his patients with latex gloves without inquiring into their allergies. Playing the numbers, he (and you) and his patients will be undisturbed most of the time, but it only takes one sensitive patient before somebody is severely harmed even if the execution of the treatment is flawless.
While there is much more than movement quality alone that leads to pain and dysfunction, this does not allow us to dismiss the fact that there are components of movement quality in the overall neurosigniture that must be respected. You can’t coach what’s not there, and the safest way to find out what’s not there is to identify it in the low load, low risk environment of the assessment period.
Protect yourselves, protect your clients. It’s your job.
In the last several years redress of ankle mobility restriction has been done with strictly talocrural mobilizations in ankle rocks with the knee flexing and advancing toward the pinky toe with the subtalar joint in neutral or slight inversion to, in effect, lock out the midtarsal joint. While the mobilization certainly has its perks and definitely improves dorsiflexion range of motion with the knee flexing as I have tested it, I’ve more and more begun to realize that it may be an incomplete picture for a number of reasons.
As anyone who uses the SFMA is surely aware, an apparent mobility issue in full weight bearing is not necessarily a mobility dysfunction as there could be extenuating stability deficits that block full excursion. A simple lack of a posterior shift of the center of mass, for example, may result in a dysfunctional toe touch. Additionally, the biomechanics professional would recognize that in true functional movement the talocrural joint is required to explore full ranges of motion with different relative positions of the subtalar joint and arrangement of the center of mass relative to the feet. These changes are especially apparent and easily illustrated with a simple model of gait.
In gait at ground contact; the center of mass advances rapidly from posterior relative to the foot just slightly to anterior of the foot at toe off. The subtalar joint strikes in an inverted or neutral position, everts through midstance or so, then reverses to inversion at toe off. The knee flexes through midstance and begins to extend toward toe off with requisite rotations relative to the hip and ankle. The talocrural joint first sees action in any gait cycle with slight plantar flexion prior to contact then experiences increasing dorsiflexion with a flexed knee prior to holding it on a gradually straightening knee through stance phase terminating with powerful plantar flexion.
If it stands to reason that movement specifics are different on a flexed and straight knee with a flexed and extended hip and that the center of mass’ position may influence relative mobility, we may not be getting it done with the usual knee drive. Hip extension plus knee extension plus dorsiflexion differs substantially from the traditional hip flexion plus knee flexion plus dorsiflexion configuration. Additionally, subtalar and midtarsal play and positions differ substantially from position to position in function. The ankle mobility is function dependent.
Where I see this playing a larger role is in running athletes who see early heel lift due to inadequate dorsiflexion with the knee and hip in extension. If the mobility is lacking in this point, you get a very “bouncy” gait at the expense of running economy. You also (or maybe because you) get some compensation that will ultimately erode proximal elasticity requiring more active and less reactive work of the hip flexors and abdominals. This mechanism may also be a proximal dysfunction that alters available dorsiflexion.
The solution, I believe, is very simple. As ankle mobility is function dependent (and position dependent) I am beginning to incorporate more mobilizations where the hip and knee get to extend on a dorsiflexed ankle and vice versa to see if we can make a difference. Backwards walking, skipping, various lunging reaches, wall exercises, and step up and down exercises have become a mainstay in dynamic warm ups provided we determine a need for the specific intervention. Inspired by some work of Gary Gray, I, too, have been toying with joint specific biases using wedges and manual overspeed actions to increase the effect.
What do you think? Plausible? Fact or Fiction?
The headlines say it all; “Ryan Hall: 2:04:57,” “One for the Ages in Boston,” and “Ryan Hall: His way is the right way at Boston Marathon.”
Despite much negativity and bets on career cataclysm amongst the keyboard running analyst after choosing to leave his coach and move to Flagstaff, Ryan Hall broke the American Record in the marathon yesterday, adding a second to his collection. Though surprising to the keyboard jockey only having witnessed his race results over the last 4 months, those inside his camp are not. His way is, as the headline suggests, the right way and a way that should be emulated by those aspiring to elite levels of performance.
When Ryan first walked into the door of the gym, it was clear that he was a man bound for (more) success. He was focused, patient, confident in his decisions, and trusting of the process–a set of skills and attitudes necessary to make the appropriate steps not just in training but throughout the day to support his training. Ryan also had the foresight to surround himself with a multidisciplinary team of professionals to help him both train hard and recover hard to push the envelope of adaptation.
A huge part of success in elite distance running is simply remaining healthy and consistent in training, and it’s not something that is easily done with controlling running volumes alone. Instead of hoping running is enough, the truly elite rely on regular assessment of biochemical markers, frequent treatments with qualified manual and massage therapies, carefully planned nutrition, unbelievable social support, and work with an athletic development coach devoted to clean movement and progression to help maximize training benefit while reducing risk of going over the edge.
No athlete with whom I’ve worked has established this team as well as Ryan has and his performance speaks volumes for the value of such a commitment. Congratulations, Ryan!
Watch more video of 2011 Boston Marathon on flotrack.org]]>
Today is a contribution from Sam Leahey, who is a strength and conditioning coach at American International University and a long-time connoisseur of strength and conditioning. This piece lays the groundwork for a few posts to follow and for much athletic movement, rending the information valuable to the athlete, coach, and therapist alike.
Many refer to elasticity as “reactivity,” “plyometrics,” or the “stretch-shorten cycle” but at the end of the day I believe the term “elasticity” is the most literal and best descriptor of the quality we’re after. Athletes in most sports will benefit from increased amounts of elasticity in various body segments. Be it the lower or upper extremity or the core, an elastic response by our bodies can yield a much greater output of force, impulse, power, and/or stability. That said we can only attempt to develop our elastic response within the confines of our current levels of mobility, or length-tension relationships. This can be good or bad depending on reference. The elastic response has, for the most part, three phases. The first is defined by a rapid excursion of a joint which actives the “stretch” part of the “stretch-shorten cycle.” Then various bodily mechanisms respond to counteract the rapid lengthening causing a switch from eccentric to concentric contractions. This portion between the lengthening and shortening is term the amortization phase. Said mechanisms of elasticity are illustrated in my diagram below which depicts how elastic energy is stored and released during the stretch-shortening cycle phenomenon:
For the sake of brevity I won’t elaborate fully on each constituent but suffice it to say the entire diagram above can be filtered down into a simple dichotomy – contractile and non-contractile elements:
The neurophysiologic mechanism (muscle spindle) does not need to be discussed here because we don’t have as much control over it. In time the nervous system adapts and adjusts for the muscle spindle and golgi-tendon organ (GTO) interplay by reducing the effects of the GTO. What is worth elaborating on is the interplay between contractile and non-contractile elements during the stretch-shorten cycle. Said elements both have the potential to store elastic energy and release it causing greater force output. However the non-contractile component (tendon) has much more potential for elastic energy output compared to the contractile component (extrafusal muscle fibers). In the ideal world the percent contribution of force would come mostly from the non-contractile part of the equation. We’re looking to shift the source of our elastic energy production to the structures that can give us the most return.
In order for this to happen, stiffness of the muscle fibers must occur so the “stretch” part of the “stretch-shortening cycle” is shifted to the tendon. Ideally we would have an isometric contraction of the extrafusal muscle fibers so nearly all the elastic rebound comes from the tendon. In lay terms – the red part of the picture of above stays still while the white part stretches out and snaps back into place.
It’s healthy to understand the mechanism of our training initiatives. In latter posts, I’ll return with the application of this science.]]>
Adam Rotchstein and I first met moons ago during my time at Athletes’ Performance. What struck me most about Adam was that he was a guy who took great pleasure in helping the younger generation advance. Though still fairly young himself, Adam has had a multitude of experiences that have influenced his development from his time at East Carolina University to the Carolina Panthers to Arizona State University to Chivas USA, to currently a man who has a hand in Athletes Performance’s combine preparation and NFL Veteran programs.
Adam’s top athletic development resources:
While I could give you a list of books that I like and have read, I am going to list the 5 books that I feel
have not only influenced my coaching the most as of today, but are also the most valuable, page per
page, and would give an up and coming coach or a seasoned coach a well rounded perspective on
improving their knowledge base in our field. Here they are…
#1 – Principles and Practice of Resistance Training – by Michael H. Stone / Meg Stone – This goes #1
on my list because I believe this is the book that should be used by the NSCA for their CSCS credential
education. If you are unfamiliar with Michael Stone, get familiar with him and his research. Even better,
go to one of his annual conferences that is held at ETSU each year.
#2 – The Charlie Francis Training System – by Charlie Francis – If you were to only read one Charlie
Francis book, in my opinion, this would be it. He outlines nearly everything he does, and why. This
book has helped me greatly in preparing and peaking athletes for specific events, especially helping me
with our NFL Combine / Pro Day guys. The athletes I train have recorded multiple PRs at their pro day/
combine by using his methods.
#3 – Vermeil’s Sports and Fitness Training System for Enhancing Athletic Performance – by Al Vermeil
– While some may not classify this as a “book”, because it is not in print, and it could even be considered
a cult-status type read, it is without a doubt in my top 5. Al Vermeil was able to win Championships in
two of the biggest sports in the USA. Not an easy task, no matter how much talent is on a team. Thus,
he had to have done a thing or two correctly. After reading the book though, you will realize he did
WAY more than 1 or 2 things correctly. An overall great read and it will definitely help you with your
coaching, if you can find it!
#4 – Running : Biomechanics and Exercise Physiology in Practice – by Frans Bosch & Ronald Klomp –
The best and most in depth look at running in a bound form that I know of in my opinion.
#5 – How to Make the Big Time Where You Are – Frosty Westerling – A book about leadership and how
to be big-time without acting like a “big-timer”.
Honorable Mention: New Psycho-Cybernetics by Maxwell Maltz; Movement by Gray Cook; Supertraining
by Mel Siff; Athletic Development by Vern Gambetta; So You Want to Become a Strength & Conditioning
Coach by Ian King; A Chance To Win by Mike Gentry; and Poliquin Principles by Charles Poliquin.
Vern Gambetta is, as far as I am concerned, one of the forefathers of this entire industry and is riding a career approaching 4 decades. I recall at a Perform Better Summit a few years back, Vern mentioned that he had to that date (August 1) read 106 books on the year. His recommendation at the time turned out to be one of my favorites–The Talent Code–that I’ve since read and listened to three times so I was very excited to hear his top recommendations of all time. Coach Gambetta did not disappoint. Enjoy.
Bosch, Frans., and Klomp, Ronald. Running – Biomechanics and exercise Physiology Applied in Practice. London. Elsevier Churchill Livingstone. 2005
Davids, Keith. Button, Chris. Bennett, Simon. Dynamics of Skill Acquisition – A Constraints-Led Approach. Champaign, IL: Human Kinetics Publishing Company. 2008
Olbrecht, Jan. The Science of Winning – Planning, Periodizing and Optimizing Swim Training. Swim Shop, Luton, England. 2000
Drabik, Jo’zef Ph.D., Children & Sports Training, Island Pond, Vermont: Stadion Publishing Company, Inc. 1996
Logan, Gene A. and McKinney, Wayne C. Kinesiology. Wm. C. Brown Company Publishers. 1970
Scholich, Manfred. (1986) Circuit Training. Berlin: Sportverlag
Kreighbaum, Ellen and Barthels, Katharine M. Biomechanics – A Qualitative Approach for Studying Human Movement. Fourth edition. Boston, Allyn and Bacon. 1996.
Lieber, Richard L. (2002) Skeletal Muscle Structure, Function & Plasticity – The Physiological Basis of Rehabilitation. Second Edition. Philadelphia: Lippincot Williams & Wilkins.
McArdle, William D. Katch, Frank I. And Katch, Victor L. (2001) Fifth Edition. Exercise Physiology – Energy, Nutrition and Human Performance. Baltimore, MD: Lippincott Williams & Wilkins
Todd, Mabel E. The Thinking Body. Princeton Book Company Publishers. Highston, NJ. 1937
Wilt, Fred. (1964) Run Run Run
Harre, Dietrich. Principles of Sports Training – Introduction to the Theory and Methods of Training. Sportverlag. Berlin 1982
Thank you, Vern Gambetta.]]>
Our next list of the top athletic development books comes by way of Kirkland, Washington and Joel Jamieson. Joel is a man who is dedicated to enhancing the field of athletic development into a true science, working to leverage high-intensity training methods and precision monitoring of training stress. Though he works predominantly with mixed martial artists, his resources below are applicable far beyond MMA. Enjoy Joel’s top athletic development books:
1: Why Zebras Don’t Get Ulcers by Robert Sapolski
Hands down a must read for anyone involved in the health/fitness profession. I’d go so far as to say it should be the first book anyone in our field reads. The book discusses stress and the complex ways in which our bodies adapt to it, which is the foundation for understanding the entire training process. This should also be read along with the original book on stress, “The Stress of Life” by Hans Selye
2: Adaptation in Sports Training by Viru
The best exercise physiology book I have ever read. Very in depth and comprehensive guide to the specific adaptations that result from various types of training. There’s a huge amount of research and interesting material on how each of the body’s systems respond to the stress of training.
3: Children and Sports Training by Drabek
Phenomenal book on training young athletes, which pretty much every strength coach does in his career at one point or another. It’s by far the most comprehensive text I’ve seen in this area and is an absolute must read for anyone working with athletes under the age of 18.
4: Special Strength Training: A Practical Manual for Coaches by Verkhoshansky
Many coaches get bogged down in the more theoretical based manuals by Verkhoshansky and don’t know how to apply the information, but this one outlines many of his methods in a very easy to understand manner. It also provides many different sample training programs to be used with various sports and I can personally attest to their effectiveness as I’ve used the framework provided with many athletes with great success.
5: Fundamentals of Sports Training by Matveyev
Although this book is very difficult to find these days, it is the first book ever written on periodization and the concepts discussed still apply today and many professionals should have a better understanding of them. Matveyev is the godfather of periodization and the book presents a very thorough overview on what periodization really is and even 30 years later, few books have as much good information on the principles of programming as this book.
If you haven’t checked it out already, be sure to go to Joel’s site, where he is beginning to compile some excellent articles on physical preparation.]]>