Training & Conditioning 13.8

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TRAINING

November 2003 Vol. XIII, No. 8 $5.00

CONDITIONING

◆ Menstrual Pain ◆ Communication Skills ◆ Volleyball Conditioning

Strong Knees A look at rehabbing in the NBA


-Josh Cox Marathoner

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C ONTENTS

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Training & Conditioning • November 2003 • Vol. XIII, No. 8

F E AT U R E S ◆ Special Focus ◆

Painful Periods..........13 Few subjects have been the butt of more jokes, but for some young women, menstrual pain is no laughing matter. The good news is that there are several ways you can help these athletes through their cycles. By Laura Smith ◆ Tr e a t i n g t h e A t h l e t e ◆

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An NBA Knee.......... 21 Rehabbing a knee injury often requires looking at much more than the knee. This case study examines the rehab protocol for an NBA veteran who suffered pain and limited range of motion six years after his initial surgery. By Micheal A. Clark, Aaron Nelson, Tyler Wallace & Casey Smith ◆ Optimum Performance ◆

The Multi-Sport Challenge.........30 Contrary to popular belief, it’s possible to design a safe and effective strength program for multi-sport athletes. The key is to find commonality between the movements and pay attention to timing. By Vern Gambetta ◆ Management ◆

Tips for Talking..........37 One of the most important skills a professional can have is the ability to communicate. But it’s also one of the most neglected. Here are ways to get better at getting your point across. By Shelly Wilson

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D E PA R T M E N T S ◆ Sideline ◆

Protein Supplementation..........3 ◆ Nutrition Roundup ◆

Amino Acids … Recovery Drinks … Alcohol ..........4 ◆ ATC Award ◆

This Issue’s Winner..........8 Nomination Form.........11 ◆ Competitive Edge ◆

Poised & Ready ..........45 Getting volleyball athletes ready for competition involves focusing on their core, knees, and shoulders. By Jim Kramer Advertising Directory.........58 Scouting Report: Strength Training & Cardiovascular Products.........52 Scouting Report: Arm & Shoulder Products.........64 More Products.........63 Catalog Showcase.........54 Web Connections.........67 Cover photo: NBAEvia Getty Images©, Nathaniel S. Butler

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TRAINING & CONDITIONING • November 2003 • Vol. XIII, No. 8

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Marjorie Albohm, MS, ATC/L Director of Sports Medicine and Orthopaedic Research, Orthopaedics Indianapolis Jon Almquist, ATC Specialist, Fairfax County (Va.) Pub. Schools Athletic Training Program Brian Awbrey, MD Dept. of Orthopaedic Surgery, Massachusetts General Hospital, and Instructor in Orthopaedics, Harvard Medical School Jim Berry, MEd, ATC, SCAT/EMT-B Director of Sports Medicine and Head Athletic Trainer, Myrtle Beach (S.C.) High School Leslie Bonci, MPH, RD Director, Sports Medicine Nutrition Program, University of Pittsburgh Medical Ctr. Health System Christine Bonci, MS, ATC Asst. A.D. for Sports Medicine, Women’s Athletics, University of Texas Cynthia “Sam” Booth, ATC, PhD Manager, Outpatient Therapy and Sportsmedicine, MeritCare Health System Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center Cindy Chang, MD Head Team Physician, University of California-Berkeley Dan Cipriani, MEd, PT Assistant Professor, Dept. of Physical Therapy, Medical College of Ohio Gray Cook, MSPT, OCS, CSCS Clinic Director, Orthopedic & Sports Phys. Ther., Dunn, Cook, and Assoc. Bernie DePalma, MEd, PT, ATC Head Athl. Trainer/Phys. Therapist, Cornell University Lori Dewald, EdD, ATC, CHES Athletic Training Program Director and Associate Professor of Health Education, University of Minnesota-Duluth Jeff Dilts Director, Business Development & Marketing, National Academy of Sports Medicine David Ellis, RD, LMNT, CSCS Sports Alliance, Inc. Boyd Epley, MEd, CSCS Asst. A.D. & Dir. of Athletic Perf., University of Nebraska Peter Friesen, ATC, NSCA-CPT, CSCS, CAT, Head Ath. Trainer/ Cond. Coach, Carolina Hurricanes Lance Fujiwara, MEd, ATC, EMT Director of Sports Medicine, Virginia Military Institute Vern Gambetta, MA President, Gambetta Sports Training Systems Joe Gieck, EdD, ATC, PT Director of Sports Medicine and Prof., Clinical Orthopaedic Surgery, University of Virginia Brian Goodstein, MS, ATC, CSCS, Head Athletic Trainer, DC United

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Gary Gray, PT President, CEO, Functional Design Systems Maria Hutsick, MS, ATC/L, CSCS Head Athletic Trainer, Boston University Christopher Ingersoll, PhD, ATC, FACSM Director, Graduate Programs in Sports Medicine/Athletic Training University of Virginia Jeff Konin, MEd, ATC, MPT Assistant Professor of Athletic Training, James Madison University Tim McClellan, MS, CSCS Director of Perf. Enhancement, Makeplays.com Center for Human Performance Michael Merk, MEd, CSCS Director of Health & Fitness, YMCA of Greater Cleveland Jenny Moshak, MS, ATC, CSCS Asst. A.D. for Sports Medicine, University of Tennessee Steve Myrland, CSCS Owner, Manager, Perf. Coach, Myrland Sports Training, LLC Instructor and Consultant, University of Wisconsin Sports Medicine

Publisher Mark Goldberg Editor-in-Chief Eleanor Frankel Circulation Director Mark Shea Associate & Assistant Editors Dennis Read Kenny Berkowitz David Hill Laura Smith Guillermo Metz RJ Anderson Editorial Assistant Greg Scholand Art Director Leslie Carrère Production Manager Kristin Ayers Assistant Production Manager Kristi Kempf Production Assistants Jonni Campbell Hildi Gerhart Prepress Manager Adam Berenstain IT Manager Mark Nye Business Manager Pennie Small

Mike Nitka, MS, CSCS Director of Human Performance, Muskego (Wisc.) High School

Special Projects Dave Wohlhueter

Bruno Pauletto, MS, CSCS President, Power Systems, Inc.

Administrative Assistants Sharon Barbell Amy Walton Daniela Reis

Stephen Perle, DC, CCSP Associate Prof. of Clin. Sciences, University of Bridgeport College of Chiropractic Brian Roberts, MS, ATC Director, Sport Performance & Rehab. Ctr. Ellyn Robinson, DPE, CSCS, CPT Assistant Professor, Exercise Science Program, Bridgewater State College Kent Scriber, EdD, ATC, PT Professor/Supervisor of Athletic Training, Ithaca College

Advertising Materials Coordinator Mike Townsend Advertising Sales Associates Diedra Harkenrider (607) 257-6970, ext. 24 Sheryl Shaffer (607) 257-6970, ext. 21 T&C editorial/business offices: 2488 N. Triphammer Road Ithaca, NY 14850 (607) 257-6970 Fax: (607) 257-7328 info@MomentumMedia.com

Chip Sigmon, CSCS Strength and Conditioning Coach, Carolina Medical Center Bonnie J. Siple, MS, ATC Coordinator, Athletic Training Education Program & Services, Slippery Rock University Chad Starkey, PhD, ATC Associate Professor, Athletic Training Educ. Program, Northeastern University Ralph Stephens, LMT, NCTMB Sports Massage Therapist, Ralph Stephens Seminars Fred Tedeschi, ATC Head Athletic Trainer, Chicago Bulls Terrence Todd, PhD Co-Director, Todd-McLean Physical Culture Collection, Dept. of Kinesiology & Health Ed., University of Texas-Austin

Training & Conditioning (ISSN 10583548) is published monthly except in January and February, May and June, and July and August, which are bimonthly issues, for a total of nine times a year, by MAG, Inc., 2488 N. Triphammer Rd., Ithaca, NY 14850. T&C is distributed without charge to qualified professionals involved with competitive athletes. The subscription rate is $24 for one year and $48 for two years in the United States, and $30 for one year and $60 for two years in Canada. The single copy price is $5. Copyright© 2003 by MAG, Inc. All rights reserved. Text may not be reproduced in any manner, in whole or in part, without the permission of the publisher. Unsolicited materials will not be returned unless accompanied by a selfaddressed, stamped envelope. POSTMASTER: Send address changes to Training & Conditioning, P.O. Box 4806, Ithaca, NY 14852-4806. Printed in the U.S.A.


Do Extra Amino Acids and Protein Build Bigger Muscles? By Martin J.Gibala, Ph.D. Do athletes really need massive amounts of protein or amino acid supplements to maximize muscle growth? Many believe the answer is yes, but experts from leading organizations such as the American College of Sports Medicine and the American Dietetic Association say athletes have only slightly higher protein requirements than sedentary individuals. Athletes who follow sound nutritional practices and take in enough energy to maintain their body weight need only about 15 percent of their total energy intake from protein (e.g., 450 kcals or —113 g of protein for a 3,000-kcal diet). They do not need to fortify their diets with expensive protein or amino acid supplements.

The vast majority of athletes consume sufficient amounts of dietary protein; however, the timing of protein ingestion during and following exercise can profoundly alter the muscle adaptive response.

That said, there is compelling scientific evidence to indicate that the timing of protein ingestion can profoundly alter the muscle protein response to intense exercise. For example, an acute bout of weightlifting exercise increases the rates of both protein synthesis and protein breakdown in muscle for many hours following a workout. In the absence of food intake, however, the rate of breakdown exceeds synthesis, and thus these athletes actually lose muscle protein if they do not eat during recovery.

A surprisingly small dose of essential amino acids can stimulate gains in lean muscle following resistance exercise. Studies show that ingesting a solution containing 6 g of essential amino acids promotes a small, transient net increase in muscle protein balance that persists for one to two hours following ingestion. Stimulation of muscl protein synthesis by essential amino acids is a saturable process, and thus ingesting a single massive dose of amino acids in hopes of further promoting muscle growth is futile. This does not mean that athletes need to consume amino-acid solutions. Highquality proteins in “real” foods (e.g., skim milk, yogurt, fish, chicken) are likely as effective for promoting muscle growth following resistance exercise.

Athletes should consume about 0.1 g of essential amino acids per kilogram of body weight, either immediately prior to heavy resistance exercise or during the first few hours of recovery. Given that the “anabolic boost” following amino acid ingestion is transient and returns to basal levels within 1 to 2 hours, ingesting repeated small doses of essential amino acids during exercise and recovery may be an effective strategy to optimize muscle growth.

Martin J. Gibala, Ph.D., is an Associate Professor in the Department of Kinesiology at McMaster University in Hamilton, Ontario.

For more information on amino acids, please visit the Sports Science Center at www.gssiweb.com.


Nutrition Roundup

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By Christopher Mohr With all the research being done in nutrition, it can be difficult to provide athletes with the most up-to-date advice. Therefore, to help facilitate understanding of this constantly evolving subject, Nutrition Roundup will be presented three times a year, devoted to research studies of nutrition, dietary supplements, and athletic performance. References are provided for those who want to obtain more information on specific studies.

Amino Acids & Performance The first study we’ll look at examined the effects of amino acid supplementation on muscular strength, power, and high-intensity endurance. Seventeen previously trained subjects were randomly assigned to either a placebo or amino acid supplement group. Subjects underwent four weeks of a periodized resistance training program specifically designed to allow the researchers to effectively measure the outcomes of the study. Subjects in the test group received an amino acid supplement that provided 0.4 grams of amino acids per kilogram of body weight divided into three daily doses. To reduce the confounding factor of energy differences between groups, all subjects were instructed to follow a calculated isocaloric diet throughout the study. However, the researchers noted that subjects in the amino acid supplement group consumed an additional 25 to 55 grams of protein per day through the supplement. There were no significant changes in any of the physiological variables measured, such as weight. But there were some significant performance changes among the experimental group. For example, one-repetition maximum squat and bench press increased significantly during the final three time points of the study. There were also trends towards significance in improvement of other variables. The authors noted that these gains may be attributed to the fact that amino acid supplementation increases protein synthesis, enhances glycogen resynthesis, and reduces muscle damage. Take home message: While the results of this study demonstrate that supplementing with amino acids may benefit individuals in very specific aspects of training, getting adequate amounts of protein should suffice. Remember, those in the amino acid group consumed an extra 25 to 55 grams of protein per day. If individuals were to consume this additional protein without adding amino acids, more than likely they would receive the same benefit as with a supplement. A study comparing the effects of an amino acid supplement versus those consuming the same amount of extra protein through foods would be interesting. Study Specs: “The effects of amino acid supplementation on muscular performance during resistance training overreaching” in The Journal of Strength and Conditioning Research, 17(2), 250-258, 2003. By Nicholas A. Ratamess, William J. Kraemer, Jeff S. Volek, Martyn R. Rubin,

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Ana L. Gomez, Duncan N. French, Matthew J. Sharman, Michael M. McGuigan, Timothy Scheett, Keijo Haakkinen, Robert U. Newton, and Francesco Dioguardi.

Recovery Drinks Go Head to Head Carbohydrate drinks are often recommended as a way for athletes to replenish glycogen stores. The hope is that athletes will recover quicker and thus perform better at their next practice or competition. However, research is emerging that indicates carbohydrate isn’t the only nutrient necessary during recovery and that protein may be just as important for optimal results. Researchers compared a carbohydrate-electrolyte beverage to a carbohydrate-protein beverage. It was hypothesized that the addition of protein would enhance the insulin response that occurs with the consumption of carbohydrates, subsequently enhancing the restoration of muscle glycogen, since insulin helps facilitate the storage of glycogen. The study was broken up into two segments. The first part, which determined the actual outcome of supplementing with the two drinks, will be covered here. The second part examined why this outcome happened. Eight male cyclists were recruited for this study and after initial testing, were asked to cycle for two hours at 65 to 75 percent VO2max on a cycle ergometer. This protocol was designed with the intention of depleting muscle glycogen. Subjects consumed either 355 mL of the carbohydrate-only beverage or 355 mL of the carbohydrate-protein beverage immediately post-exercise and again two hours later. After the two-hour rest, each subject then completed another exercise bout and their time to fatigue was determined. Time to fatigue was significantly greater when subjects consumed the carbohydrate-protein supplement versus the carbohydrate-only supplement (31.1 minutes and 20.0 minutes, respectively). While I agree that protein should be added to post-workout recovery food or beverage, the results of this particular study are difficult to interpret because the carbohydrate-protein drink also provided an additional 205 calories and 32 grams of carbohydrate in each 355 mL portion. Considering the subjects ingested this twice before their performance test, those in the carbohydrate-protein group each consumed an additional 64 grams of carbohydrate and 410 calories. Take home message: Although the design of this study does not fully explain the mechanism, the results support the notion that protein should be added to recovery drinks. Future studies should use isocaloric beverages to examine the mechanisms of the increased glycogen resynthesis. Study Specs: “Effects of recovery beverages on glycogen restoration and endurance exercise performance” in The Journal of Strength and Conditioning Research, 17(1), 12-19, 2003. By Michael B. Williams, Peter B. Raven, Donovan L. Fogt, and John L. Ivy.


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Nutrition Roundup Alcohol & Recovery The question at hand was to see if acute alcohol consumption, as may occur among athletes, particularly after a game or event, would affect glycogen storage. This is important because glycogen is the primary source of energy during exercise. The 15 subjects in the 24-hour study (the researchers also conducted a similar, 8-hour study, but only results from the 24-hour study will be presented here) were all trained cyclists. The participants first performed cycling bouts intended to deplete glycogen stores. They were then fed various diets during the 24-hour recovery phase. The different diets were a control diet (which provided 60 percent of energy from carbohydrate), a second diet with 37 percent of energy from carbohydrate and 22 percent from alcohol, and a third diet with 49 percent of energy from carbohydrate and 18 percent from alcohol. Each subject performed the cycling procedure three times, so the researchers could determine the effects of each of the experimental diets. Each diet and exercise bout was separated by one week to reduce potential carryover from the previous experimental bout. The researchers found that when alcohol was consumed, there was a

(Continued)

trend for lower glycogen storage despite equal dietary carbohydrate. While the exact mechanism is unclear, the researchers concluded that alcohol can have an indirect effect on post-exercise glycogen resynthesis, if it displaces carbohydrate consumption. Take home message: Emphasize the importance of consuming adequate post-exercise nutrients (carbohydrates and some protein) prior to consuming any alcohol, if at all. Alcohol should not be recommended to athletes in general, but on the practical side, athletes don’t always know what’s best for them and sometimes partake in unhealthy activities. Providing scientific evidence that consuming alcohol may negatively affect their performance may sway them from these behaviors. Study Specs: “Effect of alcohol intake on muscle glycogen storage after prolonged exercise” in Journal of Applied Physiology 95, 983-990, 2003. By Louise M. Burke, Greg R. Collier, Elizabeth M. Broad, Peter G. Davis, David T. Martin, Andrew J. Sanigorski, and Mark Hargreaves. ◆ Christopher Mohr, MS, RD, LDN, is a Graduate Research Assistant in the Physical Activity & Weight Management Research Center at the University of Pittsburgh. He previously was the Sports Nutritionist for the University of Massachusetts athletic department.

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T&C’s Above The Call Award November 2003

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Passion for the Profession By Kenny Berkowitz

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hen budget problems came to Oregon in the early 1990s, Portland’s public school system was hit particularly hard. Since then, some schools have shortened their academic calendars, trimmed extracurricular activities, and in some cases, threatened to cut athletics out of their budgets entirely. At inner-city Franklin High School, administrators saved money by eliminating their part-time athletic trainer position. Yet Dave Sherden, ATC, ATR, remained active in the profession even as his athletic training duties at the school were eliminated. He kept a hand in the field as coordinator of medical coverage for the state wrestling tournament. And while remaining a teacher and coach, Sherden served as president of the Oregon Athletic Trainers’ Society (OATS) from 1996 to 1999, helping write, lobby, and fund-raise for the passage of the

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Photo: Harold Dixon

A loss of district funding didn’t keep Dave Sherden from contributing to the field. Even after budget cutbacks eliminated his athletic training position, Dave Sherden has kept his hand in the profession. Here, he works with a football athlete at Franklin High School, in Portland, Ore.

Oregon Athletic Trainers Act, which governs the licensure of all the state’s athletic trainers. In addition, he’s the Chair of the Oregon Board of Athletic Trainers, which oversees compliance with the new statutes and licensing of all new athletic trainers. And Sherden helped found a local chapter of OATS, called the Westside Athletic Trainers Society, where he hopes to provide new opportunities for athletic trainers who are just joining the profession, and where he serves as interim Secretary-Treasurer. “The profession has grown so much in Oregon since I became president of OATS,” says Sherden, “and I saw a need to create a local group where new athletic trainers could take positions of leadership on committees. My hope is that the organization can encourage people to become more involved in the profession, and help us develop more leaders at the local level.”

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Sherden has since returned to athletic training at Franklin, with a part-time position paid for by fund raising, in which he works solely for the football program. Monday through Friday, he spends an hour each afternoon in the athletic training room, examining and rehabbing injured student-athletes. On Thursdays, he covers home games for the freshman and j.v. teams, which alternate from one week to the next, and on Fridays, he covers home and away games for the varsity team, where he is assisted by his squad of athletic training student aides. “It feels good to be back,” says Sherden. “I’m able to be involved with the student-athletes again, which is very satisfying, and I can devote my attention to being an athletic trainer, even if it’s only for a few hours a week.” Kenny Berkowitz is an Assistant Editor at Training & Conditioning.


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Above The Call Award “He makes sure that the kids have somebody to turn to,” says Tom McCarthy, Head Football Coach. “With Dave there, we know our student-athletes are getting the best care possible, from someone who really cares a lot about them. He’s willing to go the extra mile to make sure our players get what they deserve.” “He’s very, very good at what he does,” agrees Scott Santangelo, Athletic Director at Franklin. “At our level, it’s really hard to find a certified athletic trainer. Dave does it because he absolutely loves teaching, he loves working with kids, and he loves football.” Sherden started out at Franklin High School in 1987 as a studentteacher from Lewis and Clark College. A couple of years earlier, as an undergraduate biology major, he’d been planning a career as a teacher and coach—until a course in the prevention and care of athletic injuries, taught by athletic trainer Jerry Krummell, ATC, ATR, changed his life. “I had never met an athletic trainer before, because we didn’t have one at my high school [in Redwood City, Calif.], and I didn’t even know what one was,” says Sherden. “Then I met Jerry Krummell and realized athletic training was completely up my alley, because it involved sports, science, biology, and medicine—all the things I was interested in. I started hanging out in the athletic training room, and after a year or two, Jerry encouraged me to pursue the profession seriously. So I did, and I ended up landing a teaching job in what was at the time a very tough market.” Over the next decade, as Sherden worked at Franklin as a parttime science teacher and part-time athletic trainer, the market got even tougher. By the mid ’90s, his athletic trainer position had been trimmed 10 ◆ T & C N O V E M B E R 2 0 0 3 ◆

Award Winner

Dave Sherden Franklin High School, Portland, Ore.

to two seasons per year, and by the late ’90s, it had been cut entirely. Without room in the budget for an athletic trainer, Sherden went to work as an assistant track coach in the spring and assistant football coach in the fall, which allowed him to remain involved with the teams and support his student-athletes. Then in the 2002-03 school year, Sherden got out of coaching entirely because of the time it took away from his newly expanded family life—he and his wife Paula had their first child, daughter Mary Catherine—and resumed athletic training in the new football-only role. “He’s wonderful with the kids, and they love him,” says Santangelo. “If they’ve got an injury, they know he’s going to tell them the truth, and they’re very appreciative. It’s great to watch him work, because he doesn’t get stressed out. He’s an expert, and that’s how they treat him.” At his busiest, Sherden covered more than 40 teams a year at Franklin, and remembers a pair of injuries as his biggest rehab chal-

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lenges. In the first, an athlete with severe scarring from a dislocated elbow was given a regimen of strengthening, stretches, joint mobilization exercises, and counseling to recover. In the second, an athlete with stenosis in his cervical spine was experiencing stingers every time he took to the football field; after a treatment of rotation, flexion, side-bending, and strengthening, he was able to compete pain-free, finishing the season as the team’s long snapper and not suffering any lasting damage. Over the course of the football season, Sherden usually treats four or five injured athletes at any given time. In this year’s first two games, he’s already treated a forearm fracture, thigh contusions, a subluxating rib, and a set of hip pointers. Meanwhile, he’s continued his full load of classes, teaching courses in Life Science, Human Anatomy and Physiology, and Athletic Training, which has more than 30 students this year—the largest enrollment the class has had in all his years at Franklin. The course provides a broad-based curriculum for his students, who can earn community service credit for work as Sherden’s student training aides. “A lot of the students in the class are athletes, so I want to teach them about the nature of injuries, treatment, and recovery,” says Sherden. “I want them to learn about terminology, tissues, the physiology of injury and healing. They all come out with some basic treatment skills, and even if they’re basic skills, like strapping an ice pack to a sprained ankle, it gives them a sense of their value to the program. “The best part of this job is taking students who are emerging from childhood, and putting them in a position where they realize what they’re capable of doing,” he contin-


Above The Call Award ues. “They learn to set high standards for themselves, and to get a positive experience out of setting goals. They get some knowledge that the general public doesn’t have, and if they can use that to explain something to someone else, that’s going to help their selfesteem. And from talking to their parents, I know the students are showing off at home, watching ‘ER’ on television and explaining the terminology.” When school is out, Sherden spends as much time as he can taking care of his 18-month-old daughter, fixing her meals, and playing together in the backyard. Finding a healthy balance between work and family has been very important to him, even though it’s forced him to cut back on the time he spends as an athletic trainer. “The set-up at Franklin allows me to keep a hand in athletic training and still have a good family life,” says Sherden. “It allows me to get home at a decent hour three days a week, see my daughter, see my wife, and still stay involved in athletics and sports medicine. “Even if it’s only for an hour, I get to keep in touch with the team and the profession,” he continues. “I love studying medicine, I love keeping up with the profession as it changes and evolves, and I love working with kids—especially student-athletes.” According to Santangelo, Franklin’s athletic department appreciates Sherden just as much as he enjoys being involved. “We’re really lucky to have Dave here at Franklin,” he says. “He comes and talks with the athletic teams about safety, just because he feels it’s important. He talks to the coaches, and makes sure that all the teams are being taken care of. If he weren’t here, it would put a lot more stress on all of us.” ◆

Nomination Criteria and Procedures

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he “Above The Call” Awards Program serves to honor outstanding athletic trainers for work not otherwise recognized. This may include someone who has shown exemplary dedication and devotion to his or her job or outstanding work outside of the everyday ATC duties. The goal is to honor those athletic trainers who go above and beyond the already extraordinary demands placed on anyone in the profession.

Examples include: Someone who is doing something different and exciting in the profession. ◆ Someone who serves as a role model and mentor to others. ◆ Someone who has taken on ◆

additional significant duties in the field. Someone who gives 110 percent in all that he or she does. Someone who has a special way with athletes.

TO NOMINATE AN ATHLETIC TRAINER: Please fill in the form below, and attach a 500- to 1,000-word description of the athletic trainer’s achievements, including: ◆ Why you think this athletic trainer stands out from the crowd. ◆ Where he or she is currently working and any pertinent academic or work history. ◆ Testimony and/or quotes from those he or she works with.

✁ Above The Call Award NOMINATION FORM Name of Athletic Trainer:___________________________ His or Her Phone No.:______________________________ Your Name:______________________________________ Your Affiliation:___________________________________ _________________________________________________________________

Your Phone No.:___________________________________ Your Address:_____________________________________ ________________________________________________ Send nominations to: Above The Call Award Training & Conditioning 2488 N. Triphammer Road Ithaca, NY 14850 If you have any questions, feel free to call us at (607) 257-6970, x. 18, or e-mail us at info@momentummedia.com.

A T H L E T I C B I D . C O M ◆ T&C N O V E M B E R 2 0 0 3 ◆

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Painful Periods

BY LAURA SMITH Illustration: Naomi Shea

I

n April 1996, Uta Pippig toed the line looking for her third Boston Marathon victory. With a 2:21:45 personal best— almost six minutes faster than her closest rival—Pippig wasn’t expected to have much difficulty achieving her goal. From the very start, however, it was clear that she was struggling. By mile four, she was considering dropping out of the race. The reason?

Few subjects have been the butt of more jokes, but for some young women, menstrual pain is no laughing matter. The good news is that there are several ways you can help these athletes through their cycles.

Excruciating menstrual cramps. When Pippig came back late in the race to win, every media outlet covering the marathon marveled that she had run through the agonizing menstrual pain for a victory. Winning the Boston Marathon was a highly visible feat, but many female student-athletes who will never Laura Smith is an Assistant Editor at Training & Conditioning.

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HOW THE CYCLE WORKS he normal menstrual cycle is divided into three phases: the follicular phase, ovulation, and the luteal phase. Two areas of the brain, the hypothalamus and the pituitary gland, control the hormonal changes that drive the cycle. The cycle begins when the hypothalamus sends gonadotropin-releasing hormone (GnRH) to the pituitary gland. GnRH tells the pituitary to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH target the ovaries, where they stimulate the development of follicles. Each follicle contains an ovum, or egg. As they grow, developing follicles release estrogen, which rises gradually and peaks just before ovulation. Mid-cycle, around day 14, ovulation occurs when one of the growing follicles bursts, sending an egg through the fallopian tubes on its way to the uterus. After ovulation, the luteal phase begins. The outer walls of the burst follicle form a structure called a corpus luteum within the ovary. The corpus luteum produces progesterone that causes the lining of the uterus to proliferate. “The progesterone acts like mortar in a brick wall, to maintain the uterine lining,” explains Michael Randell, MD, FACOG, an Atlanta-based physician specializing in women’s health. “If pregnancy occurs, the progesterone level remains high to maintain the pregnancy. But if pregnancy does not occur, the corpus luteum begins to break down after about 14 days and progesterone falls. That has the effect of pulling the mortar out of the uterine wall—the lining is shed through menstruation, and the cycle begins all over again.”

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reach Pippig’s elite status also fight a monthly battle when they get their period. Whether they’re facing a major competition or simply trying to train effectively, menstrual problems can interfere with athletes’ aspirations at any level. Individual experiences vary greatly. For some female athletes, the physical and emotional changes during their menstrual cycles are a minor inconvenience, while for others, they cause major disruption. The good news is, athletes don’t have to simply live with it. There are a variety of ways to manage the symptoms, starting with solutions as simple as anti-inflammatories, all the way to a hormonal option called tri-cycling. TABOO TOPIC

As many as 25 percent of high school and college female student-athletes experience menstrual cycle-related problems severe enough to disrupt their training or competition and warrant a doctor’s help, according to Terrill Bravender, MD, MPH, Director of Adolescent Medicine at Duke 14 ◆ T & C N O V E M B E R 2 0 0 3 ◆

University. But the vast majority of them don’t seek help, either because they don’t know it’s available or because menstruation is a taboo topic that can be difficult to bring up. “The biggest mistake female student-athletes make is thinking they have to suffer in silence,” Bravender says. “Athletes who are proactive and forthcoming about menstrual cycle problems are few and far between,” agrees Kris Ring, LAT, ATC, Head Athletic Trainer at Texas Woman’s University. “Unfortunately, a lot of them still see it as an off-limits topic with a stigma attached.” “Since athletes are reluctant to bring the issue up, it’s important for athletic trainers to address it,” says Bravender. “If an athlete is suffering in silence, it’s going to affect her performance and her well being.” Ann Grooms, MD, Team Physician at the University of Florida, finds that team talks can provide a forum for breaking the silence about menstrual difficulties. “It’s an issue that we’re very proactive about,”

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Grooms says. “I do a series of meetings with every women’s team, and we talk about a variety of women’s health issues. I take that opportunity to bring up menstrual concerns. I tell them, ‘Almost 100 percent of the time, we can find something that will help you. There are lots of options—but first, you have to let us know you’re having trouble.’” Preparticipation physical evaluations are another good time to broach the subject, according to Randa Ryan, PhD, Associate Athletic Director for Student Affairs at the University of Texas. Most PPE history forms include questions about amenorrhea, but few query athletes about issues such as cramps, fatigue, and emotional ups and downs. “We find it’s helpful to ask those questions and get them into the mix right away,” Ryan says. “That way, we can make sure we catch athletes who are having problems but who are unlikely to bring up the issue on their own.” If male athletic trainers feel awkward addressing the topic, Bravender suggests they acknowledge the malefemale gulf up front. “One approach I recommend is using some self-referential humor to ease the situation,” he says. “If you say, ‘I can’t exactly say I’ve experienced this firsthand, but I’ve heard it can be a real problem,’ you can often get a smile and the athlete will let down her guard.” Regardless of their gender, athletic trainers need to remember just how much menstruation can affect some athletes. “Be sensitive and listen carefully,” advises Rebecca Morgan, MD, Team Physician at the University of Tennessee. “A lot of people, even other women who don’t experience severe symptoms with their periods, lack empathy in dealing with this issue. If an athlete comes to you, the best thing you can do is take her seriously.” PHYSICAL SYMPTOMS

For most student-athletes, symptoms that disrupt training and competition appear during the latter half of their cycle and are most intense during the perimenstrual period—the days just


before and the first few days of menstruation. Perhaps the most common physical complaint is of cramps. “When student-athletes come to me with problems related to their menstrual cycles, it’s usually because they have dysmennorhea, or painful periods,” says Morgan. “And the pain is not just abdominal—they often complain of pain radiating into their legs and lower back. They’ll tell me, ‘I’m in so much pain that I can’t train effectively for the first few days of my period.’” Menstrual cramps are caused by contractions of the uterine muscles in response to molecular compounds called prostaglandins, designed to constrict the blood supply to the uterine lining so that the tissue dies and can be shed. Studies have shown that women who experience menstrual cramps have prostaglandin blood levels several times higher than women who don’t. Other commonly reported symptoms that affect athletic performance include

“Be sensitive and listen carefully. A lot of people … lack empathy in dealing with this issue. If an athlete comes to you, the best thing you can do is take her seriously.” fatigue, headache, and breast tenderness. Iron deficiency, which occurs more in athletes with lengthy or heavy menstrual periods, is another concern. “About one out of five teenaged girls will become iron deficient at some point during their teenaged years,” Bravender says. “The normal amount of blood loss per menstrual period is

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less than 80 milliliters. That’s considered a normal period, because that’s the amount of blood the average person can replace each month. But if a woman loses more than that, and doesn’t eat an adequate amount of iron, she’ll become iron deficient. An athlete who is anemic will not be able to perform as well, because of the decreased oxygen-carrying capacity of her blood.” When a student-athlete experiences problems related to her menstrual cycle, the first step should be to encourage her to see a physician. Not only can the doctor discuss options for managing the symptoms, but an exam may be needed to rule out an underlying pathology. “There are several serious conditions that can lead to dysmennorhea,” Morgan says. “While they’re rare in women in this age group, no pain management strategy is going to be effective if the student-athlete is suffering from one of them.”

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PMS OR PMDD? or some student-athletes, adverse physical symptoms during their menstrual cycles take a backseat to psychological side effects. “I have some student-athletes who are very concerned about changes in their mood and how that is going to affect their competition,” says Kris Ring, LAT, ATC, Head Athletic Trainer at Texas Woman’s University. “They can battle through the cramps, but if they’re feeling depressed, anxious, easily frustrated, or extra sensitive to criticism, they’re going to have a harder time performing at their best.” “The transitional stress of being away from home, the academic stress, new teammates and coaches bring a huge amount of pressure, and that can cause a worsening of premenstrual emotional symptoms for a student-athlete,” agrees Randa Ryan, PhD, Associate Athletic Director at the University of Texas. Taking birth control pills can help some studentathletes, but it’s not a surefire solution. “Some women with premenstrual depression respond the opposite of the way we’d expect when they start to take birth control pills,” says Rebecca Morgan, MD, Team Physician at the University of Tennessee. “They become even more depressed.” Studies suggest that calcium and magnesium supplements, and a carefully managed carbohydrate intake offer help for premenstrual emotional difficulties. Teaching student-athletes coping strategies for dealing with premenstrual emotional symptoms can help, Ryan believes. “A female student-athlete who’s suffering from premenstrual depression is likely to engage in a lot of negative self-talk,” she says. “One of the biggest things we work on with female studentathletes is their confidence and self-esteem, so they can silence that negative self-talk.” “When a student-athlete is suffering from PMS and facing a big competition,” says Ring, “I get her to focus on all of the work she’s done to prepare. Getting

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Once serious health conditions have been ruled out, there are two general strategies physicians typically recommend for dealing with menstrual symptoms. One involves the use of anti-inflammatory drugs to control pain combined with nutritional and other lifestyle modifications that may alleviate symptoms. The other involves the use of oral contraceptives or another form of hormonal birth control. NSAIDS & NUTRITION

Prescription or over-the-counter pain 16 ◆ T & C N O V E M B E R 2 0 0 3 ◆

her to focus on something she can control—the skills she’s developed and how well she uses them—goes a long way toward restoring her confidence.” However, an athlete whose emotional symptoms are very severe may be suffering from Premenstrual Dysphoric Disorder (PMDD). Its symptoms are similar to PMS, but much more pervasive. The Diagnostic and Statistical Manual of Mental Disorders outlines the following criteria for a diagnosis of PMDD: • Depressed mood or dysphoria • Anxiety or tension • Unstable, rapidly changing emotions • Irritability • Decreased interest in usual activities • Concentration difficulties • Marked lack of energy • Marked change in appetite (overeating or food cravings) • Hypersomnia or insomnia • Feeling overwhelmed “The biggest difference between garden variety PMS and PMDD is how much it affects the studentathlete’s day to day life,” says Morgan. “Ask her how she is getting along with her roommate, her boyfriend, her teammates. Is it affecting her school performance? If her symptoms are causing trouble in all aspects of her life, she could be suffering from PMDD.” A major part of the PMDD diagnosis is determining whether symptoms have occurred during most cycles of the past year and are clearly documented for at least two consecutive menstrual cycles. The use of a class of antidepressant drugs called serotonin reuptake inhibitors (SRIs) is becoming increasingly common for the treatment of depression related to the menstrual cycle. According to Morgan, a student-athlete who may be suffering from PMDD needs to see a doctor who can provide a diagnosis.

relievers are a simple solution when cramps get in the way of training. However, it’s important to choose the right type of medication. “One very common mistake student-athletes make is using acetaminophen for menstrual pain,” Bravender says. “Remind them to use non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen instead. Acetaminophen works to block pain in the brain, but NSAIDs work directly at the site of the pain, and can also help to decrease the actual amount of cramp-

ATHLETICBID.COM

ing. And if you treat the cramping and the pain that goes with it, you’ll often treat the fatigue, breast tenderness, and other symptoms as well.” Using the medication correctly is equally important. “The key is for the student-athlete to begin taking the medication the day before she expects her period to begin, and to take it on a scheduled basis, whether or not she’s experiencing pain,” Bravender says. “It’s much easier to prevent the pain from starting than to stop it once it’s started, so if she waits until she’s hav-


ing severe cramps, she’s already lost the opportunity for good pain control.” Ibuprofen should be taken every eight hours, and naproxen every 12 hours, through the third or fourth day of the menstrual cycle. A student-athlete’s diet is another relatively simple place to look for solutions. “For an athlete who experiences fatigue and mood swings around her period, it’s very important to make sure she’s getting adequate carbohydrate in her diet to support serotonin and blood glucose levels,” says Leslie Beck, RD, a Toronto-based dietician and author of Leslie Beck’s Nutrition Guide for Women. “Advise her to eat five or six times a day, and make sure each meal or snack contains some carbs. Focus on choosing carbs that get digested and converted to blood sugar slowly, like fruits and whole grains, because they last longer and keep blood sugar more stable.” Calcium is also vital. “Studies have shown that women who are given 1,200 mg of calcium a day have as

much as a 50-percent reduction in menstrual cramps, back pain, mood swings, fatigue, and food cravings,” Beck says. “Women need 1,000 mg of calcium every day, and most studentathletes don’t come close to that. Each serving of milk or soy milk has about 300 mg, so for every serving a studentathlete isn’t getting, I recommend a supplement.” Studies have also shown that magnesium helps reduce menstrual-related depression, anxiety, fluid retention, and breast tenderness. A daily dose of 200-360 mg is recommended. “Get a calcium supplement with magnesium in it,” Beck says. Vitamin B6, at 50-100 mg per day, has also been shown to significantly reduce menstrual symptoms. However, it’s important not to exceed 100 mg per day, to avoid vitamin toxicity. “Student-athletes who are taking a multivitamin or a B complex vitamin should check before they add more,” Beck cautions. Beck also recommends that men-

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struating athletes take a daily iron supplement. “They need 18 mg every day, and that’s virtually impossible to achieve through diet,” she says. “Most multi-vitamins with minerals will provide 18 mg of iron, and I advise every woman to take one.” Herbal supplements can also offer help. “One remedy that has been shown to be very effective, especially for athletes who find that breast tenderness gets in the way of their training, is evening primrose oil,” Beck says. A typical dose is 2-3 grams per day. As with all herbal supplements, it is important to look for a product that is standardized. Beck advises using a product that is standardized to nine percent of the active ingredient, gamma-linolenic acid (GLA). Beck recommends avoiding caffeine, alcohol, and foods high in sodium during the perimenstrual period, as they can worsen symptoms. Staying well-hydrated can also help ease symptoms. When a student-athlete opts for a

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nutritional approach to managing menstrual symptoms, it’s important not to look for instant results. “Tell her not to try something for a month and decide it’s not working,” Beck says. “Modifying the diet is effective, but it takes at least three cycles before she’ll see the full effect.” HORMONAL OPTIONS

When NSAIDs and nutritional strategies fail to help, birth control pills can often lessen menstrual symptoms,

according to Grooms. “If an athlete is really struggling, I recommend she try birth control pills,” she says. “They often lessen cramps and lessen flow, making periods lighter, shorter, and more predictable.” “Birth control pills contain both estrogen and progesterone in higher amounts than would normally be present in the body,” explains Michael Randell, MD, FACOG, an Atlantabased physician specializing in women’s health. “The pills feed infor-

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mation back to the brain and the brain shuts down the normal cycling and release of hormones. That prevents the ovary from ovulating. A typical prescription for birth control contains 21 days of combined estrogen/progesterone pills, followed by seven days of placebo pills that contain no hormones. During the week of placebo pills, withdrawal from progesterone causes menstrual bleeding, and then a new pill packet is started.” The amount of estrogen and progesterone, as well as the form of progesterone, vary depending on the type of pill, so it’s important to find the one that works best for each individual athlete. “Some people have significant menstrual symptoms on one pill that resolve completely on another pill,” Grooms says. “I tell my student-athletes that they need to tell me how it’s going. I always see them within a few months of starting the pill, and I tell them to keep track of the symptoms they have that they don’t like. That will help us choose the pill that’s going to work.” For student-athletes who want to have fewer periods, physicians recommend using a hormonal contraceptive method continuously for three months, without taking the traditional weeklong break each month. This method is known as continuous use or tri-cycling and results in the athlete having only four menstrual periods each year. Although it’s a relatively new idea, most physicians believe that tricycling is a healthy practice. “Studies have shown that it’s quite safe,” Randell says. “There is nothing physiologically beneficial about having a period every month. In fact, having a period every month is really something that’s unique to modern women. Going back in the history of our species, women spent much of their reproductive years either pregnant or breast feeding, and they weren’t having periods during that time. Nowadays, women are having more periods in their lifetimes than we’ve ever had as a species.” Morgan agrees. “As long as a woman cycles every three months, there really are no negative side effects,” she says. “Going longer than


three months can lead to irregular bleeding for some women, because of the build up of endometrium. Otherwise, it appears to be a very safe thing to do. Gynecologists have been doing this for years to treat women with conditions like endometriosis, and we haven’t seen any adverse effects. “I’ve used this method very successfully with my swimmers for a long time,” she continues. “They can look at their meet schedule and manipulate their pills so they don’t have a period in the middle of NCAAs, for example. It’s very helpful from that respect.” Eliminating periods may even bring some health benefits. “It’s particularly helpful for student-athletes who have heavy periods and bad cramps,” Grooms says. “If you do the tri-cycles, she has to deal with those bad times a whole lot less frequently. And fewer periods means less risk of anemia.” Morgan advises her student-athletes interested in tri-cycling to begin by using birth control pills the tradi-

Although it’s a relatively new idea, most physicians believe that tri-cycling is a healthy practice … “As long as a woman cycles every three months, there really are no negative side effects.” tional way first. “Particularly with those who have never been on birth control before, I find it’s important to see how they do for a couple of months,” she says. “Once we know they’re going to tolerate it and they’re not going to have any mid-cycle bleeding, I will teach them how to use it so they can cycle every three months.” With the FDA’s September ap-

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proval of Seasonale, an oral contraceptive manufactured by Barr Laboratories of Pomona, N.Y., doctors will soon be able to prescribe a birth control pill designed specifically for tricycling. Seasonale contains three months worth of tablets, with 84 active pills followed by seven placebo pills. Bravender adds one cautionary note for student-athletes who use hormonal contraception and the athletic trainers who advise them. “The use of birth control pills, traditionally or for tri-cycling, can mask amenorrhea, because you eliminate the warning sign of a missed period,” he says. “When a woman is suffering from the female athlete triad, birth control pills may help slow the bone loss, but they don’t stop it. When a student-athlete is on birth control, it’s critically important to pay close attention to her weight and monitor her body composition to ensure that she isn’t suffering from an eating disorder or inadequate energy intake.” ◆

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Rehabbing a knee injury often requires looking at much more than the knee. This case study examines the rehab protocol for an NBA veteran who suffered pain and limited range of motion six years after his initial surgery.

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BY MICHEAL A. CLARK, AARON NELSON, TYLER WALLACE & CASEY SMITH

KNEE ometimes it seems that basketball and knee injuries go together like high-flying dunks and the NBA. From recreational players to worldclass all-stars, the jumping and twisting in the sport often wreaks havoc on the vulnerable knee. The good news for basketball players is that, with proper treatment, most ought to be able to return to their preinjury levels. Some injuries, however, are so

TREATING THE ATHLETE

compartment of his left knee in 1997. The injury resulted in damage to the lateral meniscus, and he underwent a subsequent lateral menisectomy. He then underwent a micro-fracture procedure on the same knee in 2000 and a lateral compartment debridement in 2001. The athlete was able to return to the court and perform at a high level, but continued to complain of posterior knee pain, and decreased range of motion (ROM) (primarily flexion), strength, and power. These led to decreased performance and playing time. He said he had posterior-lateral knee pain for approximately five years. LK had undergone a traditional sports medicine rehabilitation following damage to his lateral meniscus, but did not return to his previous level of functional ability. Therefore, when he came to us, we knew we wanted to look at more than just his left knee. We took the approach that LK may have had a complex dysfunction resulting from an imbalance in a kineticchain component. A tight muscle stuck in a shortened state may have altered joint position, setting off a proprioceptive chain reaction that worsened the imbalance and left him functionally weak. Therefore, we began by looking at the entire kinetic chain. A WHOLE-BODY APPROACH

deeply rooted in larger neuro-physioanatomical problems that traditional rehab protocols only touch the surface. Athletes with these injuries return to their sport but don’t recover fully. They require a more in-depth assessment and whole-body rehabilitation. Early this summer, an 11-year NBA veteran came to our performance academy with just that problem. (We will refer to him as LK, left knee, to protect his privacy.) LK had suffered a contact injury to the posterior-lateral

The kinetic chain is made up of the muscular, skeletal, and nervous systems, which work together to allow optimum function. If any component Micheal A. Clark, MS, PT, NASM-PES, CSCS, is President and Physical Therapist and Tyler Wallace, NASM-PES, is Performance Enhancement Specialist at the National Academy of Sports Medicine. Aaron Nelson, ATC, NASM-PES, CSCS, is Head Athletic Trainer and Casey Smith, MS, ATC, NASM-PES, is Assistant Athletic Trainer and Head Performance Enhancement Specialist for the Phoenix Suns.

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Assessing Movements ovement deficiencies can have a wide range of causes depending on where they are located. This chart explains some common causes of typical deficiencies.

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FOOT/ANKLE Eversion Muscles: tightness in the peroneals and lateral gastrocnemius; weakness in the posterior tibialis, anterior tibialis, and medial gastrocnemius Joints: decreased mobility of the talus External Rotation Muscles: tightness in the soleus and lateral gastrocnemius; weakness in the medial gastrocnemius, medial hamstring complex, gracilis, and sartorius Joints: decreased mobility of the talus and proximal tibio-femoral joint KNEE Abduction/External Rotation Muscles: tightness in piriformis, gluteus medius, and biceps femoris; weakness in the adductor complex and medial hamstring complex Joints: decreased mobility in the hip joint (iliofemoral joint) Adduction/Internal Rotation Muscles: tightness in the adductor complex, medial hamstring complex, gluteus minimus, and the tensor fascia latae; weakness in the gluteus medius and maximus Joints: decreased mobility in the hip joint (iliofemoral joint) LUMBO-PELVIC-HIP COMPLEX Extension Muscles: tightness in the erector spinae, latissimus dorsi, and psoas; weakness in the rectus abdominus, external oblique, and intrinsic spinal stabilizers Joints: decreased mobility in the lumbar facet joints Flexion Muscles: tightness in the rectus abdominus, external obliques, hamstrings, and gluteus maximus; weakness in the erector spinae, psoas, latissimus dorsi, and intrinsic spinal stabilizers Joints: decreased mobility in the SI joint and illiofemoral joint of the system is out of balance, it leads to a complex dysfunction. Muscles work most efficiently in specific positions. They have an ideal length-tension point or position from which they can produce the most force. If a muscle is “stuck” in a lengthened or shortened position, then force production decreases. Likewise, joints also function in an ideal position. During movement, two joint surfaces roll, glide, or spin on one another. The path of instantaneous 22 ◆ T & C N O V E M B E R 2 0 0 3 ◆

center of rotation is the path that one joint takes on another during motion— think of the head of the humerus moving on the glenoid fossa of the scapula as you lift your arm over your head. Muscles and joints have sensory receptors that are constantly sending proprioceptive feedback to the central nervous system. When the muscles are the right length and the joints are moving correctly, the central nervous system receives the correct information to allow optimum performance.

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However, if muscles are too short or too long, they change the position of the joints to which they attach. Both muscle length and altered joint position change proprioception to the central nervous system. This altered kinesthetic awareness leads to synergistic dominance, reciprocal inhibition, athrokinetic inhibition, and decreased flexibility. Muscles work in synergy to produce force, reduce force, and dynamically stabilize the kinetic chain during function. If one muscle is too long (underactive) or too short (overactive), then other muscles in the chain become over-dominant. This is called synergistic dominance. An example might be the hamstrings becoming synergistically dominant during hip extension if the gluteus maximus is underactive or weak. ASSESSMENT

In assessing LK, we used a team that included a physical therapist, athletic trainer, and performance enhancement specialist. We conducted several static, transitional, and dynamic tests to gauge underlying muscle imbalances, joint dysfunctions, and neuromuscular inefficiencies that could be leading to the lack of progress and persistent pain. The first test we conducted was a Squat Print™ (developed by the National Academy of Sports Medicine and Biotonix), which allows assessment of integrated kinetic chain movements. For the test, LK performed overhead squats and we examined his movements by following a kinetic chain checkpoint list. This involves systematically looking at each functional segment of the movement to determine efficiency. If the athlete has proper flexibility, balance, core strength, functional segment strength, and neuromuscular efficiency, then he or she should be able to squat to parallel or below without compensating at the foot/ankle, knee, lumbar spine, or upper extremity. However, if he or she has altered length-tension relationships (muscle tightness), altered force-couple relationships (weakness of a primary mus-


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TREATING THE ATHLETE

cle with compensation from a secondary synergist), or joint hypomobility, then you will see abnormal movements. These are easily picked up during the movement pattern. From there, we did more testing. To test range of motion, we used goniometric assessment using AAOS criteria. We conducted manual muscle testing and positional kinematics. We also asked the athlete to do two performance tests: a vertical jump test and shark skill test, which assesses singleleg balance, eccentric deceleration, and stabilization. OVERVIEW OF IMBALANCES

The results of this athlete’s assessment revealed several movement dysfunctions. During the overhead squat test we noted bilateral external rotation of the feet and eversion of the left foot. This demonstrates tightness in the lateral gastrocnemius, soleus, peroneals, and short of the biceps femoris, which was confirmed with the goniometric assessment. We also found weakness

in the anterior tibialis, posterior tibialis, medial gastrocnemius, popliteus, and gracilis, which was confirmed with muscle testing. Another problem we uncovered during the overhead squat was that the athlete’s left knee adducted and internally rotated. This suggested a tightness in the adductor complex, which was confirmed in the goniometric testing. It also points to a weakness in the gluteus medius, and we confirmed this with muscle testing. Weakness in the gluteus medius leads to dominance of the adductor complex, tensor fascia latae (TFL), and piriformis. Overactivity in the piriformis causes the sacrum to rotate into extension. This was confirmed in LK with positional kinematic testing. Functionally, these combined deficits cause several problems. Lack of dorsiflexion (tight lateral gastrocnemius, soleus, and peroneals, with decreased posterior glide of the talus) during running, cutting, jumping, and landing causes the foot to externally

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rotate and evert. This causes the femur to adduct and internally rotate over a fixed tibia, creating tremendous compressive forces on the lateral tibiofemoral joint. When the femur adducts and internally rotates, the gluteus medius and maximus are not as efficient in controlling deceleration of femoral adduction and internal rotation. This also leads to increased compressive forces at the knee. Weakness and underactivity of the gluteus medius also causes synergistic dominance of the TFL. The TFL attaches to the IT band, which attaches to the distal tibia and the lateral patella (fascial slips). Tightness in the IT band forces the tibia to externally rotate. During closed-chain movements, if the tibia is restricted from internally rotating during knee flexion, then the femur is forced to internally rotate and adduct over the fixed tibia. This again causes excessive compressive forces at the tibio-femoral joint. Clearly, the above biomechanical and neuromuscular deficits were caus-


TREATING THE ATHLETE

The Results he following tables show some of the athlete’s test results before and after the integrated rehab program. Initial scores are listed first. Post rehab scores are listed second. Percent improvement is in parentheses.

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RANGE OF MOTION: Normal Dorsiflexion 20 Knee Flexion 135 Knee Extension 0 Hamstring 90/90 10 Hip Internal Rotation 45 Hip External Rotation 45 Hip Adduction 45 Hip Extension -5 Shoulder Internal Rotation 70 *=injured knee

9 90 10 50 25 30 31 0 30

Left * Right 15 (40%) 10 14 (29%) 125 (28%) 140 140 (0%) 3 (70%) -5 -5 (0%) 30 (40%) 45 35 (23%) 35 (29%) 30 35 (15%) 35 (15%) 30 35 (15%) 35 (12%) 33 35 (6%) 0 (0%) 10 2 (80%) 60 (100%) 30 60 (100%)

PERFORMANCE PROFILE: Vertical Jump Bilateral = 27, 30.5 (12% or 3.5" increase) Left = 17, 19.5 (13% or 2.5" increase) Right = 18, 20 (10% or 2" increase) Shark Skill Test (single-leg neuromuscular control test) Left = 6.42, 4.85 (25% improvement) Right = 5.94, 5.01 (19% improvement)

ing repetitive stress to the entire kinetic chain, with the greatest damage to the lateral tibio-femoral joint. Therefore, it is very probable that LK’s chronic knee pain had been caused from decreased ROM and strength in the ankle and the hip. Focusing solely on the knee would lead to only partial recovery. Fully alleviating this athlete’s complex kinetic chain imbalances required an integrated approach. Our integrated approach included manual therapy to correct joint and muscle imbalances, exercises to correct flexibility and strength deficits, and an integrated strength and conditioning program. REHAB SPECS

The manual therapy we used with LK included positional release therapy, soft tissue release therapy, active release therapy, and joint mobilization. The goal of the positional release therapy was to decrease hypertonicity in

overactive muscles. Positional release techniques were used on all muscles held in a lengthened position. Muscles treated included: bilateral medial gastrocnemius, bilateral anterior tibialis, bilateral posterior tibialis, left distal gracilis, and left gluteus medius. To increase soft tissue extensibility, we initiated soft tissue release therapy on muscles that were in a shortened position. The muscles we treated were the bilateral soleus, lateral gastrocnemius, peroneals, short head of biceps femoris, vastus lateralis, adductor magnus, left adductor complex, tensor fascia latae, piriformis, and biceps femoris. Active release therapy was used to increase soft tissue extensibility and antagonist activation. We treated the same muscles as we did during soft tissue release. The one addition to our active release therapy was using the athlete’s voluntary contraction of the antagonist

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TREATING THE ATHLETE

to stretch tight muscles. For example, we had the athlete contract the anterior tibialis while performing active release on the lateral gastrocnemius and soleus. This allowed us to develop improved neuromuscular control in the antagonist muscles. To improve joint mobility in segments with limited mobility, we used joint mobilization techniques. These included: bilateral talus posterior mobilization, left tibio-femoral joint internal rotation, left iliofemoral joint

inferior glide, right iliosacral joint posterior rotation, left iliosacral joint anterior rotation, and left sacroiliac joint flexion/rotation. LK was also given a comprehensive corrective flexibility exercise program. He started by using self-myofascial release (with foam roll) on the following areas: bilateral soleus, lateral gastrocnemius, peroneals, left adductor complex, left IT band/tensor fascia latae, left piriformis, and bilateral shoulder posterior rotator cuff and capsule.

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Static stretching was then done on the following: bilateral soleus, lateral gastrocnemius, left peroneals, left adductor complex, right psoas, left rectus femoris, left biceps femoris, left piriformis, and bilateral pectorals, latissimus dorsi, and posterior rotator cuff. Neuromuscular stretching was accomplished on the same areas with the assistance of the physical therapist or athletic trainer. Immediately after the manual therapy and flexibility exercises, we had LK do isolated corrective strengthening, consisting of multi-planar isometrics and controlled isotonics. This sequence helps improve neuromuscular efficiency by focusing on intra-muscular coordination. Specific contraction of each muscle in the synergy helps prevent synergistic dominance from a stronger muscle in the synergy. This also serves as a form of active isolated flexibility and preparation for the integrated strength exercises that will follow. Isolated strengthening exercises were each performed in two sets of 20 repetitions. For the bilateral anterior tibialis, posterior tibialis, and medial gastrocnemius we used an ankle isolator to make sure that we were able to focus the force specifically to each muscle. We also worked on the left popliteus, left gracilis and pectineus, and left gluteus medius. Next up was integrated corrective strengthening. We started with two sets of an iso-abdominal series made up of the following 30-second holds: prone with isometric, prone with hip extension, and prone with hip abduction. Second were two sets of 15 reps of a stability-ball core series consisting of bridges, crunches, and prone cobra. Neuromuscular stabilization exercises were third. We did these as positional isometrics in a closed-chain position to facilitate total kinetic stability prior to transitional and dynamic movements. We started with single-leg stability (3x30), then did single-leg stability with multi-planar reaching (3x10 each plane of motion). This was followed by single-leg stability with upper-extremity activity. We accomplished this through a cable/tubing series—chest press, row, rotation,


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chops, lifts—at 2x10 and a medicine ball series of throw and catch (2x10). The above exercises were performed on progressively less stable surfaces (foam roll, Airex pad, Reebok core board, and pivot plate) to facilitate increased proprioceptive activity. These exercises themselves are not functional but they do prepare the athlete for transitional and dynamic movements. The fourth part of our integrated corrective strengthening consisted of a tube walking series. To conduct these exercises, we placed tubing around the ankles, and had the athlete twice walk 10 steps. We did side-to-side walking in an athletic stance using perfect form and front-to-back walking both straight and diagonally. LK eventually progressed to an integrated strength and conditioning program. We use what we call Optimum Performance Training™ (OPT), which incorporates flexibility, core training, balance training, reactive training, speed/agility/quickness training, integrated strength training, meta-

bolic conditioning, and skill training. The program has seven phases, each with specific acute variables that are modified in an innovative periodization strategy to develop optimum performance. The phases of training work through stability, strength, and power and include the following: 1. Corrective exercise training to correct muscle and joint imbalances 2. Integrated stabilization training for neuromuscular efficiency 3. Stabilization equivalent training for stability and strength 4. Muscular development training 5. Maximum strength training 6. Elastic equivalent training 7. Maximum power training A BETTER ATHLETE

LK progressed very well using the individualized OPT program (see “The Results” on page 25 for his specific numbers). He reports 90 percent functional capacity compared to 60 percent functional capacity prior to training. He played six weeks in a summer

TREATING THE ATHLETE

league without any complaints of knee pain or decreased function, and his performance levels have improved to preinjury levels. This athlete will continue to follow the OPT program during the competitive season. During the next offseason, LK will be able to train at a significantly higher level because we took the time to identify and correct the imbalances that were causing him pain and hindering his performance for almost five years. This case study illustrates a problem that is all too common. Many athletes “recover” from surgery, showing the classic signs of decreased pain, swelling, and restored ROM, but are left with poor neuromuscular control, muscle and joint imbalances, and poor movement patterns that may have predisposed them to an injury in the first place. By performing a comprehensive kinetic chain assessment, we can pinpoint exactly what to do with each athlete to ensure he or she returns to optimum performance. ◆

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y ersit Univ n o cet Prin ski, n a zym BJ S

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The Multi-Sport Contrary to popular belief, it’s possible to design a safe and effective strength program for multi-sport athletes. The key is to find commonality between the movements and pay attention to timing. any people believe that those who try to serve two masters usually end up pleasing neither. But strength and conditioning coaches are often required to serve two masters when they work with athletes who compete in more than one sport. And both these masters must somehow be satisfied. Training multi-sport athletes certainly presents some challenges, since preparation for a future season must fit

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around the demands of an active season. But it’s far from impossible. Contrary to popular belief, the demands of most sports are usually not that different, so it’s actually not that hard to design a program to benefit an athlete involved in more than one sport. Often, the biggest issue is time, since in-season athletes have limited time available for strength training work. Another concern is overloading the body. But by taking advantage of the common demands of different

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sports, you can design an efficient program that does not result in overtraining, no matter how many sports the athlete plays. CONSTANT BUILDING

A common misconception is that once the playing season begins, strength training should go into a maintenance mode. Let’s dispel that myth early on because this is an outdated concept that needs to be reconsidered. (For a look at other myths, see “Debunking Myths” on page 32.) It is imperative for athletes to continue to build strength within a playing season, especially high school athletes, who are still very much in a developmental stage. These athletes benefit so much from strength training that even a limited strength program is benefi-


OPTIMUM PERFORMANCE

Sente rrio L andru m, Du ke Un iversit y

CHALLENGE cial. And the length of playing seasons at the high school level means athletes will actually regress if their in-season training goes into a maintenance mode. It is also important to keep building strength throughout the playing season so that the athlete can begin the second season at a higher level than he or she began the first. This does not require huge amounts of time, just consistency of effort. Even 20 minutes of strength training a couple of times a week can do the trick. Think build, not maintain. Planning a program that will keep building strength requires careful program design based on each athlete’s stage of physical maturation and the amount of playing time he or she will receive within a season. For example, a

backup sweeper on the soccer team can do more strength training during the season than a starting midfielder. In order to properly design a program for a multi-sport athlete, you must first talk with all of his or her coaches to understand his or her role on each team. You should check in regularly with the offseason coaches to see if anything has changed in their plans that would affect a player’s expected role. COMMON GROUND

When training multi-sport athletes, many people focus on the differences between the sports. But most sports are more alike biomechanically than they are different. For example, in terms of

BY VERN GAMBETTA

body movements, basketball is very similar to soccer with the use of hands, while soccer is a form of basketball played with the feet. Yes, there are certainly specific skills unique to any sport, but these skills usually make up a small part of the sport’s physical activity. Too many people focus on the 20 percent of activity that is unique to a sport and forget that 80 percent is not unique. Thus, the best place to start when faced with training an athlete who Vern Gambetta, MA, is the President of Gambetta Sports Training Systems in Sarasota, Fla., and the former Director of Conditioning for the Chicago White Sox. He is a frequent contributor to Training & Conditioning and can be reached at www.gambetta.com.

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Debunking Myths thletes and sport coaches often carry a lot of misinformation when it comes to strength training. This misinformation can be multiplied when athletes play more than one sport. Here are some common myths that coaches and athletes sometimes believe about strength training during the season, and the truth hiding behind those myths. Myth: I will get tired. Truth: Fatigue will not be a problem if the program is appropriate for the sport and the athlete’s development level. A properly designed strength training session should be energizing, not fatiguing. Remember, an in-season program is not a body building program where multiple sets are devoted to developing an individual muscle, which would be fatiguing and counter productive. Myth: If I put that much time in, I will burn out. Truth: Burn out comes from monotony, not from directed work with built-in variability. It is important to have as much variation as is reasonable in the strength training program. As a matter of fact, many of the athletes I work with look forward to the variation their strength work provides from the demands of their playing season. Myth: The sports are too different. Truth: They may look different to the sport coach, but you can point out similarities between the sports. Use video to show common movements and areas that must be strengthened to succeed in both sports. Myth: Strength training will hurt skill level. Truth: When placed in proper relation to skill work, strength training will not hurt skill work. Stronger, better conditioned athletes are usually better able to develop their skills. But the strength work must be coordinated with skill work. Do not target the upper body if the team practice that day focuses on skills involving the upper body. Also, strength work must be related very closely to strength training done in the off season and the preseason. A playing season is not the time to begin a strength training program.

A

plays two or more sports is to look at compatibility of the sports. Carefully assess each sport’s strength and power demands and look for commonalities in strength and power that you can capitalize on. Use those commonalities to build as unified a program as possible. For example, a basketball player and a football player will both need explosive power from their lower body, so exercises that work the core and legs should be emphasized. Even at a casual glance, you will see that strength programs designed for specific sports are already similar in structure. Every strength training program should have a remedial injury prevention component. There must also be core strength, leg strength, and explosive power components to every program regardless of the sport. Upper 32 ◆ T & C N O V E M B E R 2 0 0 3 ◆

body strength requirements vary by sport, but there will almost always be an element of upper body training required. By tweaking programs to take advantage of commonalities between sports, you can create effective programs for the multi-sport athlete without straying far from the single-sport programs. PROGRAM STRUCTURE

As in any good training program, the strength and power needs of each multi-sport athlete must be reconciled with the in-season sport demands. In addition, careful consideration must be given to the developmental level and training ages of the athletes involved. Older players who have already done strength training will be able to do more than those just beginning.

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How much time is needed to strength train? Start with 30 to 40 minute sessions in the early season. After two or three weeks, this should drop to 25 to 30 minutes. The assumption is that the athletes know all the exercises from participating in an offseason program. If not, then you must start with a very remedial program for any athletes new to strength training. The goal is to gradually get them up to the level of the athletes who participated in the offseason program. The time demands will drop to 20 to 25 minutes in midseason. At the very end of the season, when the game demands on the athletes are the highest, it’s safe to go into a maintenance mode of 15 to 20 minutes per session once a week. Each strength training session should have a specific emphasis. For simplicity, I divide the training into a total-body emphasis, a lower-body emphasis, circuit emphasis, and an upper-body emphasis. Core training is included in every strength training session and also should be part of the daily warm-up. Endurance training is usually not an issue, since that is typically covered through work in the inseason sport. Excluding core exercises, the maximum number of exercises in a session is six, unless it is a circuit training session. In selecting the emphasis for a particular session, make sure that it is coordinated with what the coach is doing in the team’s practice session on that day and fits into the game schedule. This, of course, requires constant communication with the sport coach, in addition to the usual preseason meeting where you discuss goals, directions, and schedules. When choosing specific exercises, a good rule of thumb is to always build from the ground up. Start with the legs! Emphasize total body movements and compound movements that allow for efficiency as well as variability. Narrow the menu of exercises and build the program around variations of those exercises. Remember that the adaptive stimulus in-season is intensity. An optimum goal to shoot for is three to five sets with three to five reps per set.


Once you’ve got the basics in place, you can think about how to address the parts of the sports that differ from each other. The most common example of divergent demands is the need to improve power (such as jumping ability) while still working on endurance, as with a basketball player who runs cross country. The best way to address this is to set priorities based on which quality is most important during that particular playing season. In this case, you could emphasize endurance early, with more strength and power work phased in later in the season. In some cases, one sport will clearly be more important to the athlete than another. At early training ages and developmental levels, general strength work should predominate, so there is little need to prioritize sports since this work will not vary by sport. With advancing training age and development levels, strength training can be more closely tailored to the individual and increased emphasis can be placed on the needs of one sport over another.

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Following the late-season taper, the first phase in the second sport takes on more of a general strength emphasis and should look like the off-season program. SAMPLE PLANS

There are two distinct scenarios you’ll encounter when implementing comprehensive strength training programs that span two sports. The first is the consecutive-season scenario where the athlete goes immediately from one sport to the next without a break. This requires an unloading period to ease the transition between the sports and to take full advantage of the strength training program. This unloading will take the form of a taper at the end of the first sport season, which is often

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needed for performance reasons anyway. Following the late-season taper, the first phase in the second sport takes on more of a general strength emphasis and should look like the off-season program for up to six workouts. This structure will also work well for threesport athletes who have no break between their seasons. In general, the training weeks should be something like this: Off-season 3 or 4 strength training sessions a week rotating between total body, upper body, lower body, and circuit training. In-season I Early season: 3 sessions per week rotating between total body, upper body, and lower body. Midseason: 2 total body sessions per week with a slight alternating emphasis on upper body and lower body. Late season: 1 total body session per week, with lower number of reps, emphasizing intensity over volume and

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tapering to the end of the season. In-season II Early season: 3 or 4 sessions per week rotating between total body, upper body, lower body, and circuit training, similar to a preseason program. Mid season: 2 sessions per week with a slight alternating emphasis on upper body and lower body. Late season: 1 or 2 sessions per week emphasizing inten-

The second scenario is a split-season schedule where there is a distinct break between the seasons ... The key here is the break … This period of time offers a chance to tap back into the work done in the previous offseason and make substantial gains.

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sity over volume, with a taper toward the end of the season, if needed for performance reasons. The second scenario is a split-season schedule where there is a distinct break between the seasons, such as a fall sport and a spring sport. The key here is the break between seasons. This period of time offers a chance to tap back into the work done in the previous offseason and make substantial gains. The distribution of workouts per training week in a split-season scenario will look something like this: Off-season I 3 or 4 strength training sessions a week rotating between total body, upper body, and lower body. In-season I Early season: 3 sessions per week rotating between total body, upper body, and lower body. Midseason: 2 total body sessions per week with a slight alternating emphasis on upper body and lower body. Late season: 1 or 2 sessions per week emphasizing intensity over volume, with a taper toward the end of the season, if needed for performance reasons. Off-season II 3 or 4 strength training sessions a week rotating between total body, upper body, and lower body. In-season II Early season: 3 or 4 sessions per week rotating between total body, upper body, lower body, and circuit training, similar to a preseason program. Midseason: 2 sessions per week in mid season with a slight alternating emphasis on upper body and lower body. Late season: 1 or 2 sessions per week emphasizing intensity over volume, with a taper toward the end of the season, if needed for performance reasons. Remember that training is cumulative. Plan ahead and divide the competitive season into distinct blocks with a specific emphasis for each block. Look for opportunities to make remedial strength movements part of the warm-up or the cooldown. ◆


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Tips for Talking A

Illustration: Chris Murphy

BY SHELLY WILSON

One of the most important skills a professional can have is communication. But it’s also one of the most neglected. Here are ways to get better at getting your point across. nyone who has spent time around infants and toddlers knows that one of the most amazing things about them is their ability to effectively communicate their wants, needs, and expectations without saying a word. If they need a nap, the head goes down and thumb goes in. When they want a story, they give you the book and force their way onto your lap. They are direct, concise, and somehow manage to leave little room for misinterpretation without ever uttering a syllable. Unfortunately, most of us adults

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bear a striking contrast to this. We have decades of learned vocabulary at our command, yet few of us are able to be as concise as our diapered counterparts. We have mastered the mechanical ability to form words and construct sentences, but are we as effective at communicating as we could be? And if not, what can we do to improve? WHY IT’S IMPORTANT

Poor verbal communication can be a problem in any profession, but for athletic trainers, particularly so. Athletic training is extremely detail-oriented as well as responsibility-intensive. You

can’t afford vague communication when the care for hundreds of studentathletes, the performance of dozens of teams and staff, and the education of impressionable student athletic trainers are in your hands. One reason is that good verbal communication is vital to the department’s effectiveness. “Any time you work with people, good communication is the key to success,” says Chuck Kimmel, MA, ATC, Assistant Athletic Director and Head Athletic Trainer at Austin Peay State University. “Without it, you won’t achieve the goals you seek.” Donna Wisely, MA, LATC, ATC, Athletic Trainer at Hoffman Estates (Ill.) High School and Vice President Shelly Wilson is a former Assistant Editor at Training & Conditioning.

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Zip It! robably one of the most overlooked characteristics of good verbal communication isn’t verbal at all. It’s silence. Silence in conversation is generally regarded as wholly undesirable and excruciatingly uncomfortable. And even though many of us do our best to fill those gaps with something, anything, the most confident and effective verbal communicators regard silence as purposeful, and with a host of benefits. Below are just a few of them: Power and Insight. “When people are not afraid of silence, that gives them a lot of power,” says Meryl Runion, a corporate speaker and trainer on verbal communication. “And many times, when you are silent, the other person will show their hand. That gives you tools and information to work with.” Creation of Emphasis. “Critical pauses are important,” says Vince O’Brien, ATC/L, Athletic Trainer for Men’s Basketball at Ohio State University. “If there is an important point I need to make, I like to pause just before or just after, so the other party is waiting to hear what else I have to say.” Digestion. “In my work, I use silence to help the athlete ‘catch up’ and make cognitive connections about the message,” says Patrick Cohn, PhD, a mental game coach and Owner of Peak Performance Sports. “This might be at a time when I have hit upon an important association the athlete is discovering and needs time to process.” Silence can also benefit the speaker by providing a few moments to refocus on the message’s topic or goal. Formulation Time. “If a coach or the director of athletics hits me with a question, I want to make sure I give an accurate answer. So I’m going to think about it and measure my words before I respond,” says Chuck Kimmel, MA, ATC, Assistant Athletic Director and Head Athletic Trainer at Austin Peay State University. Inclusion. “Some people need to be encouraged into a conversation,” says Donna Wisely, MA, ATC/L, Athletic Trainer at Hoffman Estates (Ill.) High School. “Sometimes, allowing a silence gives them what they need to speak up.”

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of the Illinois Athletic Trainers Association, is also discovering the importance of verbal communication in her department. “For the past 15 years, there have been just two of us on staff,” she says. “In that time, we reached the point where we were very non-verbal in our communication. We could finish each other’s sentences and thoughts, and if he left an injury report blank, I could usually figure out what needed to be filled in. But we just added a third person to the staff, and she’s looking at the two of us saying, ‘I have no clue what you’re talking about. How did you know that? Why did you know that? I don’t understand what you want me to do.’ And it has become very apparent that we need to 38 ◆ T & C N O V E M B E R 2 0 0 3 ◆

change our communication style in order to help her help us.” Poor verbal communication can also lead people to conclude that you’re less competent than you are. In fact, research shows that patients judge the quality of a healthcare provider’s work more according to that provider’s interpersonal skills than by his or her technical competence. “If I hear you speak slang all the time, talk down to student-athletes, and not use the proper terminology, I’m going to think you’re unprofessional,” says Vince O’Brien, LATC, ATC, Athletic Trainer for Men’s Basketball at Ohio State University and the Ohio Athletic Trainers Association’s 2003 Athletic Trainer of the Year. “You

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could know everything in the world about athletic training, but I’m not going to trust you or really believe you.” And maybe the most persuasive fact: “Poor communication creates problems and more work daily,” says Robb Williams, MEd, ATC, CSCS, Head Athletic Trainer at the University of Wyoming. “And the person who won’t admit it is not evaluating his or her communication. I recently used the phrase ‘Get in the whirlpool’ to an athlete. I didn’t, however, specify the cold whirlpool, and the athlete ended up in the hot whirlpool because the hot whirlpool is the one that feels good. And to him, a whirlpool is a whirlpool.” So what exactly characterizes great verbal communication? According to the experts, it’s precision, confidence, and top-notch listening skills. PRECISELY PUT

Your boss tells you the injury reports are due Friday. He means he wants them Friday morning so he can review them before the weekend. You think as long as they’re in before the end of the day on Friday, you’ve met his deadline. He hasn’t been precise in his request. And what results from the minor misunderstanding is frustration, resentment, maybe a little temporary hostility between the two of you, and one person’s work schedule being thrown off. Now, how many times today have you been as imprecise with others? It’s easy to see how quickly imprecision in verbal communication can disrupt rehab timelines, camaraderie, and administration in the training room. “We make vague statements all the time and then wonder why the other person didn’t understand us,” says Meryl Runion, a corporate speaker and trainer on verbal communication based in Cascade, Colo., and author of Power Phrases! The Perfect Words to Say It Right and Get the Results You Want. “The more specific you can be, the better the result.” Kimmel agrees. “If staff, coaches, or student-athletes are given the oppor-


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tunity to interpret my words or meaning loosely, then that’s what they’re going to do,” he says. One way to improve your verbal precision is through accurate and specific word choice. “One day I asked my friend Barbara how she was,” says Runion. “She said, ‘Grumpy!’ She could have said, ‘I’m angry. I’m irritated. I’m annoyed.’ But each of these carries its own meaning that is slightly different from the nuances of grumpy. Grumpy suggests no blame and takes full responsibility for the mood. When Barbara said she was grumpy, I did not immediately assume I had done something wrong. Had she said angry, irritated, or annoyed, I might have wondered if I had caused her mood in some way.” Remember, however, that when it comes to medical terminology and jargon, it’s important to be precise without being overly technical. With student-athletes, Wisely does this by partnering concise verbal communication with visual aids. “I try to break information down into terms that they can relate to,” she says. “And because it is sometimes hard to put all of the message into terms they understand, we use a lot of pictures in books to illustrate what we’re saying as we say it.” “If you are too technical and talk down to people, then you’ve lost them,” adds O’Brien. “Then they think, ‘I can’t communicate with this person, so why would I bother going to them for treatment?’” While using medical jargon can impede communication with coaches and athletes, knowing the lingo of the particular sport or culture can substantially enhance the verbal communication process. “Our men’s ice hockey team works out in our athletic training room,” O’Brien says, “and if I say, ‘Put an Ace bandage on that,’ they look at me like I’m crazy, because these athletes are mainly from Canada and they know it as a tensor bandage. “So I’ve made a point of saying tensor bandage with them, and they now smile and laugh when I do,” O’Brien continues. “It helps my com-

munication with them, because they think, ‘This guy knows where I’m from.’ That increases trust, and if they can trust me, they’re going to hear me a little bit better when I ask things of them.” Another way to improve verbal precision is to eliminate waffling and muttering. “It happens more than you’d think,” says O’Brien. “I hear it a lot from our physicians. They’ll be conversing with an athlete and say, ‘I didn’t see anything on the x-ray, so I doubt it’s bone. We’re going to treat it like a soft tissue injury. Though sometimes it shows up as bone later. But I think we’re okay.’ And the athlete leaves thinking, ‘So, is it the bone or not?’” Thinking out loud can also lead to problems. “For instance, we had a staff meeting today,” says O’Brien, “and someone said, ‘Why don’t we pick a day and time to meet every week?’ One of the supervisors said, ‘That’s a really good idea. Tuesdays might work.’ Now I heard ‘He’s considering doing this on Tuesdays. He’s going to let us know.’ Another staff member heard, ‘Next Tuesday, we’re meeting.’ So you have to really avoid thinking out loud or muttering under your breath, because a lot of people will take what you say in those moments literally.” CONFIDENCE COUNTS

Effective verbal communication also requires self-assurance, because a listener is not going to follow your direction or take your message seriously if you don’t appear to trust your own judgement. The most important technique for developing confidence is preparation, and the best way to start is by defining your communication goal. “Most of us start conversations without considering the results we seek,” says Runion. “But if your conscious mind doesn’t choose goals for the conversation, then your unconscious mind will, and most times those unconscious goals are misdirected. The most common unconscious goals are proving ourselves right and others wrong, getting even, and showing the

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other person how smart we are. These goals are counter-productive.” O’Brien has found goal-setting useful in athletic training both for the confidence it creates and the clarity it provides the listener. For example, when an athlete gets hurt in a game, O’Brien sets his communication goals according to what information is going to be most immediately important to the coach. “If an athlete suffers a knee injury

Just go ahead and ask the question. “Avoid fillers like, ‘Ugh, Um, I think I’m going to try to,’” she continues. “They take away from the point you’re making. When we speak more strongly, people take our recommendations more seriously.” TUNING IN

The final talent upon which the most exceptional verbal communicators rely is listening, and there is a definite dif-

“I feel very comfortable taping an ankle and holding two conversations at once … But I think sometimes if you aren’t talking only to the athlete or only to the coach, then they don’t hear you.” in the game’s first half, and you evaluate him in the training room, there are key facts you need to discern,” he says. “You need to diagnose the injury, figure out what the game plan is for the next hour or two, and then what your game plan is for the next day. So those are the three things I want to tell the coach in about 30 seconds. And I need to sound sure and definitive. “If I can say, ‘Brandon has a medial meniscus tear in his left knee, he’s out for the rest of the day, we’ll reevaluate him tomorrow, and I’ll let you know his status by noon,’ the coach has sound knowledge to act upon. The coach can easily translate that to his needs: ‘So Brandon’s not a factor in my substitutions for the rest of this game. They have a plan for treatment tonight, and they’ll let me know tomorrow if he’s going on the road trip.’” For Wisely, preparation also includes note taking. “I gather all my thoughts in writing,” she says. “Then I take those notes with me to the discussion, so I don’t eliminate key pieces of information.” Planning your communication can help avoid poor word choice and using too many non-essential words that make you seem unsure of your message. “For example, sometimes people will say, ‘I just have one little question,’” says Runion. “But ‘one little question’ makes it sound insignificant. 40 ◆ T & C N O V E M B E R 2 0 0 3 ◆

ference between hearing and listening. For verbal communication to be most effective, listening has to be about understanding both the words, and the non-verbal cues that go with them. But being a good listener is a challenge for almost everyone. “It’s much easier to talk than to listen,” says Kimmel. “But listening is a skill that everyone should work at, because if you don’t hear what the coach, patient, or supervisor is saying, then you get sidetracked and you won’t achieve the goals both parties want to work towards.” Athletic trainers face special challenges when it comes to effective listening. “ATCs are constantly multitasking,” Wisely explains. “Whether it’s supervising 12 kids while talking to another athlete or listening to kids walk by while trying to get the scoop on someone else, there’s constantly something else going on in our brains, and that makes it hard to listen well.” In addition, your multi-tasking can affect how well others perceive you are listening to them. “I feel very comfortable taping an ankle and holding two conversations at once,” says O’Brien. “But I think sometimes if you aren’t talking only to the athlete or only to the coach, then they don’t hear you.” To combat this, Kimmel tries to look people in the eye. “I find even when I’m in a room of people, if I lock

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eyes with the person, I’m not as easily distracted,” he says. “Also, if I stand close to them, it sends signals that I’m listening.” O’Brien asks himself whether he’s in the right environment before starting a conversation. “When needed, I bring the person into a different area within the training room, into the doctor’s office, or out in the hallway, just to make sure they can hear what I’m saying,” he explains. Experts also recommend a communication technique called “active listening.” It comprises four parts and facilitates deeper understanding of both spoken and unspoken messages. “The first active listening skill is paraphrasing,” says Patrick Cohn, PhD, mental game coach and Owner of Peak Performance Sports, in Orlando, Fla. “This is an excellent technique to make sure you are both talking about the same thing. You paraphrase by telling the person what he or she said in your own words. The second [skill] is reflection. Here, you simply restate what the person has said [using] their words. Use this skill when you are not sure what the person meant, almost with a questioning tone to your voice. “The third skill is summarizing,” continues Cohn. “You summarize by giving the key points the person has said to you in the conversation. This is used for long conversations to help tie many ideas together. The fourth skill is empathy. This is an advanced listening skill because it requires that you pick up on what the person is feeling at that moment and reflect it back to him or her. This is a good technique for developing trust and bonding with your [speaker].” “Active listening can seem like overkill, and like you’re really overextending the conversation,” says Williams. “But if the communication really needs to be crisp, clear, and shared, then you have to use those techniques.” Runion points out, though, that when it comes to the empathy aspect of active listening, the information isn’t going to be verbal, but non-verbal. People rarely say outright, “I’m angry.


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I’m frustrated. I’m upset.” Another component of listening entails understanding that different people respond to different styles. “To be most successful, you have to role play to some degree and meet the other person’s communication standards, preferences, and experience,” says Williams. “You can pay attention to the words they use as clues to what communication type they are,” says Runion. “For example, if they say, ‘I don’t get the picture,’ then they are probably a visual type. Draw a diagram and use imagery for this type of person.” If they use a lot of pauses in their own speech, then slow down your end of the conversation, too. If they easily get distracted, consider jotting down an agenda you both can see to stay on course. If they are smiling but describing something negative, ask questions to find out how they are truly feeling. BRUSHING UP

So how do you determine how strong or weak your verbal communication skills are? One way is to simply measure your results. “Either people do what I ask them, or they don’t,” says Kimmel. “If a day later, someone doesn’t remember an instruction or request I gave them, then I put the onus on me,” adds O’Brien. “Even if I’m sure I said it, if they didn’t hear it, maybe I didn’t communicate it correctly or in a way that was understandable to them.” More difficult is determining what specific areas of your communication need improvement. Athletic trainers can actually help each other with this. “Ask colleagues to help you critique your communication skills, especially after you’ve made a presentation,” says Wisely. “Or say, ‘I’m about to call a parent. Listen to my end of the conversation.’ Or, ‘Can you come listen to me while I have this conversation with the doctor?’” Cohn suggests the observer look for listening skills, clarity of the message, eye contact, posture, tone, inflection, agenda, manner, pace, attitude

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and confidence, and concentration. If you’re a one-person athletic training department, remembering these components can help you evaluate your own communication throughout the day. “Reflecting back on a conversation that just occurred is one way I improve my communication skills,” says Wisely. “Part of that comes from noting what questions I was asked after I presented my information. Was I not clear? Did I cover that area, but not clearly enough? Did I omit the information completely? And since most of the time we’re not in a position to pull out a Palm Pilot or piece of paper to write it down, I make a mental note and store it so I can process it later.” “I call them THPs, Take Home Points,” explains Williams. “You sit back at night and say, ‘I was clearly misunderstood at this meeting, and this is what I didn’t understand from them.’ And I’ll write them down in my diary or daily planner, because you have to seek to understand those instances.

“You want to speak more about what you want than what you don’t want … Instead of saying, ‘Stop coming late,’ say, ‘I need you to be on time.’ Then state what you will do if they don’t meet your expectation.” Then I’ll go back, revisit those issues, and say, ‘Per our conversation yesterday, this is what I was led to believe. Am I off base here?’ And you take the time to go back and be both the speaker and receiver, assess the task, and get back to specifics.” Also consider taking advantage of technology to help you analyze and improve your verbal communication. By videotaping and reviewing presen-

tations, meetings, or rehab sessions, you have the opportunity to both hear what you say and how you say it as well as observe the messages you are sending non-verbally. If you don’t have access to video equipment, consider using a simple cassette recorder to study how you come across. TOUGH TALKS

The true test of any speaker’s verbal communication skills is listening and making themselves heard in difficult situations. It’s one thing to deliver a short, precise, targeted, and empathetic message over lunch with a friend in an empty cafeteria. It’s another to stick to the rules of good verbal communication when the situation is contentious, emotional, or heated. Here, athletic trainers and experts provide tips on how to communicate well in tough situations. Dealing with a hostile party. The first rule is to remain calm. “You need to avoid matching their intensity,” says O’Brien. “Just because he or she is

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being loud doesn’t mean you need to be.” Second, work to diffuse the intensity. “When someone is hostile or angry, there’s usually a lot of frustration about not being heard,” says Runion. “So your best approach is to first listen and let them vent. If they don’t meet with resistance while they vent, the hostility usually winds down.” O’Brien also emphasizes the importance of moving these situations to somewhere private. “I’ll deal with it in a relatively private area, because what you don’t want is for others to see that person yelling at you, and you not yelling back,” he says. “You might be perceived as weak, or a doormat.” Delivering bad news. When an athletic trainer faces the painful task of telling an athlete that he or she has suffered a serious injury, it’s important to remain calm and confident, says Wisely. “Whether I am actually confident or not is not the issue,” she says, “but I have to appear that way.” To this end, Kimmel finds silence useful on two fronts. “I don’t talk more than I need to,” he says, “and when I do, my message is clear and concise, so I don’t overwhelm them. Also, when an athlete is told they need surgery, or that it’s serious, it’s important to give them a few minutes to process that so they can then ask questions and get answers.” When relaying a painful message, your non-verbal signals are just as important. “The tone of your voice has to soften,” says O’Brien. “And if someone is lying down on the table, I will bend down to get to their eye level, because it’s much more comforting for them. In fact, I’ve seen physicians sit patients up before they begin talking to them, and the doctor will sit down on a stool so the athlete is actually sitting higher than the doctor. That gives the athlete a feeling of much more control of the situation. Also, something as simple as placing your hand on their shoulder or hand provides comfort.” Communicating Displeasure. “Take a step back,” suggests Wisely.

“First, evaluate what your message is, the exact words you’re going to use, the tone it’s going to need, and how to phrase the message so it’s not accusatory or aggressive. Then take that person aside—don’t put on a big show in front of others—and state your case. “But I also feel I have to take responsibility as well,” she continues. “I’ll say, ‘These are my feelings. How are we going to work together to resolve this now and prevent it from becoming an issue next time?’”

MANAGEMENT

“You also want to speak more about what you want than what you don’t want,” adds Runion. “Instead of saying, ‘Stop coming late,’ say, ‘I need you to be on time.’ Then state what you will do if they don’t meet your expectation.” Saying No. For most people, hearing “no” is like a slap on the face, says Runion. But it doesn’t have to be that way. “Instead of saying ‘No,’ begin by acknowledging the request, and then

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Circle No. 25 A T H L E T I C B I D . C O M ◆ T & C N O V E M B E R 2 0 0 3 ◆ 43


MANAGEMENT

briefly explain your situation,” says Runion. “Saying something like, ‘That’s an interesting project. I have other priorities, so I won’t be able to help you out with it,’ is short, but it’s a little more sensitive than a straight ‘No.’” Runion also has advice for those who find telling others ‘No’ particularly difficult. “For chronic yes sayers, I recommend you use the phrase, ‘Let me get back to you on that,’” she says. “Because for people who chronically say ‘Yes,’ it’s a big jump to say ‘No, no, no.’ This buys them time to think about what they really want to do and then get back to the person.” ARE WE FINISHED?

If you’ve ever been talking and had the other party suddenly walk off on you— or wondered why an assistant remains at your office door when you considered the conversation finished—you know that concluding a discussion can sometimes be awkward. So, it’s fitting

that the final hallmark of good verbal communication is knowing how to end a conversation. A good indicator that both parties are finished discussing an issue is when they have asked their last question and had it answered, or you have asked your final question and had it answered. But if you are unsure you just heard the listener’s last question, Wisely recommends employing the same principle that 911 uses. “I let them ‘hang up the phone’ first,” she says. “I let them be the one to walk away first, say thank you, or give a closing statement. I find it works well. It shows I’m still available and open to continuing the conversation, if that’s what they want.” When you and another party are in disagreement over an issue, have reached an impasse, or you’ve made your decision and they want to keep challenging it, ending the conversation can be harder. But relying on good verbal techniques will get the job done.

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“I like hearing from people who disagree with me,” says Kimmel, “because it makes me really re-examine my opinion. But when I need to wrap up with someone I don’t agree with, I try to be empathetic and say, ‘I understand where you are coming from, and I’m sorry you feel that way,’” Kimmel says. “But I can’t agree with you. I’m glad we talked about it, but I have to go now.’ And oftentimes phrasing the closing like that will end it without demeaning or embarrassing the other party.” In a busy working environment like the athletic training room, adopting sound communication principles and putting new techniques to practice may seem too time consuming. But if you remember to formulate all communication with precision, set goals, speak with confidence, and listen to others carefully, it will begin to come naturally. And the misunderstandings, frustration, and work it alleviates will be worth the effort. ◆


C O M P E T I T I V E

E D G E

Poised

& Ready Getting volleyball athletes ready for competition involves focusing on their core, knees, and shoulders.

BY JIM KRAMER

T

hroughout my career as a strength and conditioning coach, I have been fortunate enough to work with some of the top volleyball players in the country, including those on the U.S. National Team. These highly talented athletes have reached the pinnacle of their sport through endless hours of practice, meticulous development of specific skills, and incredible physical ability. These players, and their skilled coaches, have

shown me what qualities are needed to succeed in the competitive volleyball world. Yet, accomplished as they are, even these athletes need strength training. The most gifted athletes can be rendered helpless by injury, and wellschooled players can always benefit from added strength and endurance. Fortunately, volleyball players have shown some of the highest levels of dedication to strength and conditioning among all the athletes I have

worked with. When combined with the right attitude from participants, a properly designed strength and conditioning program can work wonders. In this article, I explain the approach I have used with the national team and also in my previous work at the collegiate level, including injury prevention, performance enhancement, and conditioning. The overriding rule is to keep it simple. There are no magic exercises, no mystical schemes of sets and reps. The keys to a successful strength training program are having a dedicated and consistent effort from the athletes and a sound physiological basis for what you have them do. Jim Kramer, MS, CSCS, is Coordinator of Strength and Conditioning at the United States Olympic Training Center in Colorado Springs, Colo., where he works with several teams, including women’s volleyball. He was previously a strength and conditioning coach at the University of Northern Iowa and Georgia Tech.

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▼ Always keep in mind the two basic purposes of strength and conditioning programs: to aid in the prevention of injuries and to help improve athletic performance. Often, the two purposes overlap. For example, we regularly use the squat to develop hip and leg strength for improved jumping and defensive play, but it is also an effective way to help reduce injuries in the lower extremities. INJURY PREVENTION

Unfortunately, strength training cannot prevent all injuries from occurring. But it can decrease their frequency, lessen their severity, and shorten recovery time. For a non-contact sport, volleyball puts a tremendous amount of stress on certain areas of a player’s body. Areas especially prone to injury are the shoulders, knees, and abdominals. Over-use shoulder injuries are common in volleyball, and much can be done through strength training to prevent them. Rotator cuff and smaller shoulder muscle exercises are mainstays of most volleyball strength training programs, including ours. To strengthen the smaller shoulder muscles, we use a series of exercises called the Super 8 that Jay Omer introduced to me when he was the Strength and Conditioning Coach at Georgia Tech. The series consists of standard flexion, standing supraspinatus, scaption with external rotation, external rotation/ prone abduction, prone saws, deceleration, seated dumbbell military pressup, and internal and external rotation with tubing. The athlete performs one set of each exercise in a slow, controlled manner, then immediately moves to the next with no rest. The key to these exercises is proper technique and controlled movement during each exercise, not the amount of weight lifted. Athletes typically start with 2.5 to five pounds, which should be taxing enough if the exercises are performed correctly. Some athletes eventually work up to eight to 10 pounds, but if they go any heavier, technique and 46 ◆ T & C N O V E M B E R 2 0 0 3 ◆

Figure One: Physio-ball La Ducs help build strength needed for powerful hits.

control may begin to suffer. Don’t forget, however, that every movement used to strengthen the front of the shoulder must be balanced with work for the opposite side of the joint. Thus, we also focus on strengthening the upper back musculature and the rear deltoid, the muscles responsible for arm deceleration. We accomplish this through rows of any nature, lat pulldowns, and rear-deltoid work like rear flys or raises. Working with female athletes in volleyball, we must also address the knee, including prevention of ACL injuries. This means strengthening the musculature around the knee and hip joint. We have found that nothing works this area better than the simple squat (which is a cornerstone of other segments of the program as well). Supplementary to squats, we use single-leg movements, especially side lunges. The hamstrings are critical for stability of the knee joint and are worked constantly in our program. We do this with a combination of Romanian deadlifts, glute ham raises, single-leg curls on a machine, and physio-ball exercises. Another frequent region for injury is the abdominal muscles. To help prevent injuries here, we focus on strengthening movements rather than muscles. If we look at the mechanism for abdominal strains in volleyball, we find the injury, whether acute or chronic, usually stems from the hitting action. The attack phase of the volleyball spike consists of two distinct movement patterns often referred to as

ATHLETICBID.COM

“cocking-the-hammer” (see lead photo on page 45 for an example) and the actual hit. These movements place distinct and considerable demands on the abdominal musculature. To address this area, we first develop a base of strength with core training and general abdominal exercises, such as crunches, extended physio-ball crunches, and physio-ball twist crunches. Once this base core strength is established, we focus specifically on building strength for the hitting action by using more speed and sport-specific movements like physio-ball La Ducs (see Figure One, above) and overhead medicine-ball throws, with special attention paid to working the abdominal muscles and not relying on only the arms for force. IMPROVING PERFORMANCE

Athletes often feel they’re invincible, so they’re typically less concerned about injury prevention than they are about performance improvement. If there’s a chance an exercise will help them win a point, they’ll give it everything they have. One obvious area for physical improvement in volleyball has long been jumping ability. We address this area by having our athletes start with the back squat and front squat, and once they have developed a base level of strength, we begin work on improving explosiveness. Much research and empirical evidence exists to support the relationship between proficiency in the Olympicstyle lifts and jumping ability, making them excellent tools to help improve vertical jump. As always, remember we are training athletic movements, not necessarily muscles. Therefore, it is the pulling movement of the Olympic-style lifts (see Figure Two, on page 47) that correlate well to volleyball movements. I will often start our off-season program by having the athletes perform only the pull portion of the Olympic lifts then progress to performing the full lifts. During the season, if


C O M P E T I T I V E

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▼ athletes have difficulty finishing full lifts due to injury, I will also limit them to the pulling motions. When coaching volleyball players on the Olympic-style lifts, I will look more for speed of movement than how much weight is on the bar. I emphasize the power snatch more than other Olympic lifts and use it as a speed and

lent tool for developing additional explosiveness and power in the lateral movement since it emphasizes lateral reactive strength. When using the slideboard for power development, we perform only 10- to 15-second bouts, attempting to get as many contacts with the ends of the board in that amount of time. After athletes become

Figure Two: For volleyball players, the pulling movements are the most important part of Olympic lifts, such as the clean.

Figures Three & Four: To best develop lateral quickness, make sure athletes bring both legs over the angle board … before exploding back to the start position.

explosive-power exercise, not as an exercise where we will attempt to use maximal weights. Along with jumping ability, volleyball players need to be able to bend and lunge to a ball efficiently and with split-second quickness. To make great plays in volleyball, the athlete needs to have the ability to drop her hips, bend her knees, and get low to the ground. This requires flexibility as well as agility and quickness. Many people overlook the role of strength in flexibility. Strength training can increase both explosive power and flexibility. The key is to make sure exercises are performed through a full, safe range of motion. Lunges and side lunges are excellent complementary strength exercises that help improve flexibility when performed through the full range of motion. Once a good lateral strength base is attained, the slideboard is an excel-

proficient at it, they should be able to exceed one contact per second. Angle boards (See Figures Three and Four, above) are another excellent tool for the development of lateral quickness. This plyometric exercise is performed with the athlete standing three to four feet away from an angle board. The athlete begins by pushing off the outside leg (the leg away from the board) and hops over to the angle board. Both feet must be brought to the board with only the inside foot (which started nearer to the board) touching (Figure Three). Upon landing on the angle board, the athlete immediately explodes off the board (Figure Four) back out to the start. The athlete then takes her time and repositions for the next rep. I use several variations of this drill. One is to have athletes see how far they can propel themselves away from the board. However, they should

be cautious not to sacrifice quickness for distance. Another favorite variation is to have players, after five repetitions, explode off the board, turn, and run into a sprint. Whenever you are attempting to increase speed, agility, and quickness, remember to allow your athletes full recovery between repetitions. When

trying to build speed and agility, you are training not only the muscular system, but the entire neuromuscular system. For increases in speed and agility to occur, most experts believe that the athlete must train at or near 100 percent. A fatigued athlete cannot move at or near these levels. So, start your athletes slowly with low weights and fewer repetitions and allow them to fully recover between reps. CONDITIONING

Most volleyball coaches understand that aerobic training can have a negative effect on vertical jump and is not the type of conditioning that wins matches in the fifth game. The most beneficial way we have found to increase conditioning for volleyball is through metabolic training, in which we integrate agility and jumping movements with short sprints. Unlike speed and agility training, we want to

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Basketball: Better Nutrition = Better Hoops By JULIE BURNS, M.S., R.D. Founder of SportFuel, Inc. and sports nutrition consultant for the Chicago Bears, Chicago Blackhawks, Chicago Bulls and Northwestern University athletes

Basketball is a highly intense sport that requires its players to have speed, agility and power throughout the game. The peak energy level needed for basketball can be maximized with good hydration and nutrition pre- and post-court. Promote Hydration -- “The 3 Pointer” A common cause of early fatigue during exercise is dehydration. Each athlete should have his or her own individual sports bottle. Cool, flavored fluids, like sports drinks, encourage drinking and help athletes replenish fluid losses. Dehydration can be prevented by using these guidelines from the National Athletic Trainers’ Association:

Hydration Guidelines Point 1: Pre-Court

✓ ✓ Drink another 7 to 10 oz fluid 10 to 20 minutes before Drink 17 to 20 oz of fluid 2 to 3 hours prior to playing playing

✓ Record baseline weight to assess fluid losses Point 2: On the Court

✓ Drink at least 7 to 10 oz of fluid every 10 to 15 minutes Point 3: Post-Court

✓ ✓ Within 2 hours of finishing training or competition, Record post-exercise weight to assess fluid losses

✓ Eat familiar foods. Never try a new food on a game day. Experiment with foods only on practice days.

✓ Athletes should try to eat 2 to 4 hours before the game to give their body enough time to digest the food. The closer the athlete eats to a game or practice, the smaller the meal should be.

✓ Consume high-carbohydrate foods. Good choices include whole-grain bagels, breads, fruits and energy bars, like the Gatorade Energy Bar. These foods tend to be easily digested by most athletes.

✓ If an athlete tends to experience stomach problems, eating smaller, more frequent meals will help. Some athletes tolerate liquid meals, such as nutrition shakes, better than solid foods.

✓ For staying power, include some protein-containing foods with the high-carbohydrate foods at the pre-event meal. Examples include slices of turkey, chicken, lean beef, fish, yogurt, beef or turkey jerky or nuts. Once the athlete has finished their pre-game meal, they should sip fluids during the period leading up to the game to help ensure they begin play well hydrated.

drink at least 20 oz for every 1lb. of weight loss

Recovering From The Court Pre-Court Fuel Basketball players need guidance on what to eat before they train or compete. The pre-event meal is important because it keeps the athletes from feeling hungry, helps the athlete prepare mentally for competition and provides fuel and fluids to the muscles. Each athlete needs to experiment to identify what foods feel best, both physiologically and psychologically. Here are a few tips to consider when planning a pre-event meal:

High-carbohydrate foods are essential for replenishing muscle energy stores after practice or a game. Carbohydrate-rich foods along with some protein must be consumed within 30 minutes after a practice or a game. Along with fuel, fluids must also be replaced post-exercise. Ideally, athletes will weigh in and out pre- and post-exercise. Research suggests that 20 oz of fluids per 1 pound of weight lost due to sweat needs to be consumed to get the player back to baseline. Adopting these two simple postexercise recovery strategies will help maximize the ability for the athlete to train and compete at his or her best.


C O M P E T I T I V E

E D G E

▼ decrease our rest periods between repetitions and not allow full recovery. However, we must remember to be mindful of over-use injuries, especially with the jumping movements. Below is one example of a metabolic conditioning workout we do once our athletes have a good base. Athletes are divided into three groups of four, and we use a three-station circuit with athletes going directly from one station to the next. The times and distances are designed to mimic the demands of volleyball. The stations include: Hurdle Hops to Lateral Sprint: We place three sets of three six-inch hurdles five yards apart. Athletes sprint out to the first set of hurdles and begin hopping back and forth, mostly sideways, but occasionally front to back, across the hurdle for four to six seconds. On command, the athletes then turn and sprint to the next hurdle and the next three athletes sprint to the first

set of hurdles. We do three reps total. Wave Drill: Three athletes sprint about 15 feet to a line on the court in front of the coach. The coach then gives these three athletes directional commands by pointing. During the first two reps, the athletes shuffle to the right or left as the coach directs. During the third and fourth reps, the athletes turn and run a varied distance to the right or left, but no more than a few steps. The coach can also give directional commands for a forward sprint, a backpedal, and a vertical jump. Each repetition should last no longer than six to eight seconds. 60-Yard Shuffle: The athletes form three lines. On command, the first three athletes sprint five yards to the first line and back, then 10 yards to the next line and back, and finally 15 yards to the next line and back to the finish. The command is then given to start the next group.

This example provides a 3:1 restto-work ratio, but the exact number of repetitions per drill, rest periods (or group size), and number of sets can vary based on how the athletes are handling the session and how they adapt over several training sessions. The ratio can also be tweaked to provide more work for athletes who are able to handle it or less for those who need more recovery time. One final word regarding strength training for volleyball. A basic program for developing general strength should not be neglected for the sake of sport-specific exercises. During the season, it is important to emphasize general strength over power or SAQ training, since players typically train these aspects during their sport practice. If you maintain strength, you will increase performance, since strength is a function of power, endurance, speed, and agility. ◆

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PERFORMANCE POINTS HAMMER STRENGTH Strength Training For The Multi-Sport Athlete By Mike Shinbski, M.S. CSCS, Assistant Football Coach/Head Strength Coach, Princeton High School, Cincinnati, Ohio Deion Sanders, Bo Jackson, Charlie Ward, Quinn Buckner, Jim Thorpe, Michael Jordan: all great athletes. All multi-sport athletes. They are the exception rather than the rule for college and professional sports. But for the high school coach having the multi-sport athlete on your team is the rule rather than the exception. On most athletic teams 65-80% of high school athletes play two or more sports during the high school calendar year. Then on top of that throw in summer leagues, recreational leagues, and it becomes very common for the high school athlete to be going from a fall sport, to a winter sport, to a spring sport. Hopefully at your school, your entire athletic program works together and encourages every athlete to participate on as many athletic teams and extra curricular events as possible. Hopefully, you do not have to work with coaches who try to keep “their” athletes involved only in their sport. The high school athlete should not have to choose their “best” sport to compete on. That will be handled at the next level by college coaches where they will naturally weed themselves out due to size, strength, speed and ability restraints. Problems do arise for most multi-sport athletes when it comes to being involved in a strength training program. Most coaches still do not do their teams justice when it comes to their strength training programs. How do they juggle the teams practice time, which is so precious and limited to begin with, with film review, new plays, old plays, play review, special team situations, study table and drills? Usually one of the first areas to be thrown out is strength training. Or, the multi-sport athlete plays football and basketball hears from his football coach “...you need to lift weights and gain 10-15 lbs. of muscle so you can play varsity next year”. Then he hears the basketball coach tell him “...you should not lift anything heavier than a basketball this summer, anything heavier will throw your shoot off.” What is the athlete to do? Naturally he wants to please and believe each coach that he plays for. The following are some suggestions that might help your athletes and athletic program reach it’s true potential: 1. Persuade your school to hire a strength coach. Someone who likes and wants to work with athletes in your school’s weight room, not just the football players. Someone who believes in what he is doing for your athletic program and athletes. 2. Convince your athletic department that your school should be using just one strength training program for the entire athletic department. Your athletes will only have to learn one system or method of training, not two or three. 3. Your strength training program should promote injury prevention— slow, steady increases in strength, improvement in deficient strength areas, and safety! Too many of your athletes will get hurt or injured during competition—you do not want or need to get anyone hurt in the weight room. 4. Increase the training time availability of the weight room. Not only should you establish set training times for teams to use the weight room during the season and off-season as well. The weight room can and should be accessible during physical education classes, before school with early bird workouts, and after practice. 5. In-season strength training should be a priority with your coaches. The majority of your injuries are going to occur during the season—not the off-season. This is where you also lose games, so your athletes need to be strong during the season. You also have complete control over your athletes at this time.

6. If you are training a multi-sport athlete who cannot get to the weight room on a regular basis, teach them how to strength train with manual resistance strength training exercises. These can be done anywhere and anytime. 7. Most athletes will have some type of barbell set at home. With proper instruction, this could be another training site for your athletes when they cannot get to the school weight room. Cincinnati legendary high school football coach Gerry Faust started Moeller High School’s first weight room in the basement of one of his assistant coaches. Make good use of what you have available and build your program from there. 8. It is best to train three days per week rather than zero. It is best to train two days per week rather than zero. It is still better to train one day per week rather than zero. “Seven days without strength training makes one weak.” 9. A leg press done for a football player will have the same training effect as one done for a basketball player. Remember that strength training exercises are a general application to sport. Strength training exercises are just that—strength training exercises. It is up to the athlete and the coach to take that strength developed from doing that exercise and develop it into a skill through the daily use of drills and practice.

STRENGTH TRAINING FOR A PURPOSE Basic Strength Primary Muscles Training Exercise Developed A) Hip and Back Buttocks, lower back, hamstrings Buttocks, quadriceps B) Leg Press C) Leg Extension Quadriceps D) Leg Curl Hamstrings E) Side Lateral Raise Deltoids F) Seated Press Deltoids, triceps G) Pullover Latissimus dorsi H) Lat Pulldown Latissimus dorsi I) Bench Press Pectorals, triceps

Specific Skills Involved

Running, hitting, throwing, jumping Throwing, hitting

Football, baseball, basketball, track, volleyball

Throwing, hitting, pulling Tackling, blocking, throwing Running, hitting, throwing, jumping

J) Bent Arm Fly

Pectorals

K) Biceps Curl

Biceps

Pulling

L) Triceps Extension

Triceps

Throwing, blocking

M) Wrist and Forearm Curls

Forearm flexors

Grip, wrist control, passing, dribbling, throwing, shooting

N) 4-Way Neck

Neck flexors and extensors Trapezius

Tackling, blocking

O) Shoulder Shrug

Sport

Swimming, tackling, blocking

Football, baseball, wrestling, boxing Football, baseball, swimming, wrestling, boxing Swimming, wrestling, football Football, baseball, basketball, swimming, wrestling, track, volleyball Football, baseball, basketball, wrestling, volleyball, swimming Protect against injuries in a variety of sports


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ScoutingReport Strength Training & Cardiovascular Products BALL DYNAMICS INTERNATIONAL (800) 752-2255, www.balldynamics.com Ball Dynamics' colorful weighted medicine balls allow for more ergonomically correct strength training and toning than old-fashioned dumbbells. The balls are water-filled, but have the stability of a gel-filled ball. Each HeavyMed ball is color-coded for weight (1.1 lbs up to 11 lbs) and has an easy-grip texture. HeavyMeds are excellent for strengthening, toning and sport-specific training, especially when used with the FitBALL® exercise ball. Circle No. 50 on Reader Inquiry Card

CASTLE STRENGTH & FITNESS (816) 517-2872, www.thepowerstep.com Castle Strength & Fitness offers the PowerStep. Use the same platform that 28 professional sports teams and 32 major colleges are now using. The PowerStep is revolutionizing lower leg training, while providing a base/platform for several other exercises. Several coaches are now realizing the advantages of concentric motion lifts (step-ups) as opposed to eccentric motion lifts (squats). The step-up is an in-season exercise that works the hips, thighs, and glutes without undue stress to joints and ligaments. Go to the company’s Web site for more information or call for a free instructional video. Circle No. 51 on Reader Inquiry Card

CORMAX (701) 845-3986, www.cormaxstrengthpowersystems.com Increase your athlete’s power and minimize the risk of injury with the Cormax Strength Power Systems. Cormax systems control the eccentric load to a safe level eliminating the need for spotters. This system’s ability to train the Stretch-Shortening Cycle {SSC} allows your athletes to focus on rate of Force Development— the key to converting strength to power. To see the system in action please visit the company's Web site. Circle No. 52 on Reader Inquiry Card 52 ◆ T & C N O V E M B E R 2 0 0 3 ◆

Has the risk of injury stopped you from performing squat jumps, cleans, explosive pressing movements or overhead press? Cormax Strength Power Systems offers 4 machines that can train your athletes with more intensity and more safety than you thought possible. The Cormax Systems control the eccentric load to a safe level of your choosing eliminating the need for spotters. Please visit the company's Web site to see this system in action. Circle No. 53 on Reader Inquiry Card

EFI SPORTS MEDICINE (800) 541-4900, www.efisportsmedicine.com Total Gym 24000, from efi Sports Medicine, allows your clients to train, condition and rehabilitate in a functional environment working against gravity, lifting and moving a percentage of their body weight. Total Gym exercises use multiplane motions and recruit stabilizers, simulating the body’s natural synergistic use of muscles during movements. Its low-impact, non-compressive nature allows patients to experience success quickly and safely while stretching and flexing to regain strength and enhance performance. Circle No. 54 on Reader Inquiry Card

The MFT® Multi-Function Disc (medium) is exclusively distributed in the United States by efi Sports Medicine. This premier seven-in-one package consists of a disc (19.67”) with pivot bearing, ball, standing/roller board (15.75”x 23.62”), two seesaw boards and exercise posters. Because of its modular structure, the Multi-Function Disc can be configured for: spinning and heel-to-toe movements, a seesaw board, a balance board (fixed or rotating), a tilting seesaw board (with variable widths for foot placement), stable rotation without seesaw, and multi-function spinning. MFT’s Multi-Function Disc is ideal for sport-specific and proprioceptive training and increasing overall stability and coordination. Circle No. 55 on Reader Inquiry Card

EXERTOOLS (800) 235-1559, www.exertools.com Exertools has introduced the COMBO FOLLER™ as the latest addition to the

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foam roller family of products. The COMBO FOLLER is a unique delivery of a 4" by 36" foam roller inside a 6" by 36" outer wrap, allowing a clinician or trainer to offer twice the physiologic versatility and capabilities. Instead of buying the two separate follers, a clinic can now get both in one package for less than the cost of the two. Simply slide the 4" FOLLER out of the sleeve when you need it and slide it back in when a 6" FOLLER will do the trick. The COMBO FOLLER also fits inside the multi colored Foller Covers available from Exertools. Spend less, save space and increase training options with one simple device. Circle No. 56 on Reader Inquiry Card Exertools, the originator of medicine ball rebounding systems, is now shipping the new and improved Plyoback™ Rebounder. Time tested and clinically proven, the new unit comes with an improved double clamping unit with hardened bolts, and tightened angles, heavy duty multiple zigzag stitching on doubled tramp material, and a hefty vinyl spring cover that protects the ball and user from errant throws. Recognized by many as the most durable rebounder, the PLYOBACK has a single weld 14 gauge steel base that holds the largest square tramp surface available on the market today. The tramp can be adjusted from parallel as a jogging tramp all the way up to a sixty-degree angle. The full-length stabilization bar allows for a quick height adjustment and comes with steel pins for added clamp support. The Plyoback is now available for under $500.00. Circle No. 57 on Reader Inquiry Card

FITTER (800) fitter-1, www.fitter1.com For nearly two decades, Pro Fitter has helped patients rebuild their confidence to overcome physical and emotional barriers associated with injury. It is a dynamic modality that offers the benefits of a complete “Integrated and FUNctional” rehab program for ankle, knee, hip, back & shoulder injuries. From a weight-bearing position, the SRF Board develops rotational stability in the ankles, knees, hips,


Strength Training & Cardiovascular Products shoulder joints, spine and elbows. Call for your free 24-page color catalog. Circle No. 58 on Reader Inquiry Card

FUNCTIONAL DESIGN (866) 230-8300, www.functionaldesign.com Functional Design offers 3D Walk/Jog by Gary Gray. This functional training video is an ideal program to facilitate rehabilitation, prevent injury, and condition the athlete’s biomechanical technique for performance enhancement. The comprehensive program provides a great proprioceptive warm-up regimen, balance training, and benefits overall cardio-vascular health.

explain why nothing rehydrates, replenishes and refuels better—not even water. It's scientifically formulated to have the right taste, the right amount of carbs, and no carbonation. Only Gatorade has a complete laboratory and staff devoted to testing and evaluating its products' effectiveness on athletes. Circle No. 61 on Reader Inquiry Card

HAMMER STRENGTH (800) 634-8637, www.hammerstrength.com Based on customer demand, Hammer Strength recently introduced a new plateloaded Linear Hack unit. The machine is a modern design of a traditional Hack Squat and eliminates spinal compression by loading the resistance through the hips. The footboard, which is posi-

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THE GATORADE COMPANY (800) 88-GATOR, www.gatorade.com Training for athletic competition requires giving it all you’ve got. Achieving your peak performance is easier if you’re properly hydrated. Gatorade® Thirst Quencher, from The Gatorade Company, has an optimal formula that contains electrolytes and carbohydrates. It is based on more than 30 years of scientific research and testing. Nothing rehydrates, replenishes and refuels better than Gatorade® Thirst Quencher—not even water. The Gatorade Performance Series is a proven line of sports nutrition products that gives athletes what they need to maximize their athletic performance. The line includes the Gatorade Energy Drink (grape, orange, and wild berry) and the Gatorade Nutrition Shake (chocolate, vanilla, and strawberry). Gatorade Energy Drink delivers effective levels of carbohydrate fuel for pre-competition or post-exercise. The Gatorade Nutrition Shake is designed to provide balanced sports nutrition for recovery, pre-competition meals, and training. The Gatorade Nutrition Shake was recently reformulated to improve its taste and give athletes what sports nutritionists and strength coaches tell us they’re seeking: the right kinds of calories when it counts most. Circle No. 60 on Reader Inquiry Card

The Gatorade Company has introduced Gatorade Ice, with a clear and light clean taste that leaves your mouth quickly. It's available in strawberry, lime and orange flavors. Gatorade is the most researched sports drink on the planet, which might

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ScoutingReport Strength Training & Cardiovascular Products tioned to remove unwanted forces in the knees, also is ideal for performing calf extensions. Circle No. 62 on Reader Inquiry Card

THE HYGENIC CORPORATION/ THERA-BAND (800) 321-2135, www.Thera-Band.com Each of the two new Thera-Band® Soft Weights Racks holds a complete set of 6 Soft Weights balls. The two-tier rack (6”W x 18”L x 12”H) holds 3 balls on each tier, while the one-tier rack (6”W x 31”L x 5.25”H) stores 6 balls side by side. The Racks, made of heavy-duty PVC pipe, are designed to keep Soft Weights clean and conveniently stored for ready use at fitness clubs, clinics and at home. Circle No. 63 on Reader Inquiry Card

The Thera-Band® Sports Handle is a new and versatile attachment system for TheraBand resistive bands and tubing. The 12inch handle has three attachment points, allowing for a variety of force applications. It is ideal for patients who are rehabilitat-

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ing hands and wrists, and for athletes in training to strengthen and enhance their performance. The handle also comes with an exercise instruction manual with 16 exercises covering hand and wrist rehabilitation, fitness training, sports enhancement, and work simulation. Circle No. 64 on Reader Inquiry Card

JUMP STRETCH, INC. (800) 344-3539, www.jumpstretch.com Jump Stretch, Inc., offers six sizes of heavy-duty continuous-loop rubberbands (Flex Bands®) for strength training, flexibility work, rehab, and even powerlifting. By combining the bands with the company’s customized pipe arrangements (for resisted walking/running and weighted abdominal exercises) and patented tubular steel bases (for squats and squat thrusts), Jump Stretch

can help you make the most of any available space in your workout area. Circle No. 65 on Reader Inquiry Card

KYTEC ATHLETIC SPEED EQUIPMENT (800) 732-4883, www.kytec.us Kytec is the manufacturer and distributor of the ultimate multi-sport Power Fitness Chute that was invented by Ky Michaelson. It has an innovative way of adjusting the resistance by sliding the patented cord lock up the shroud lines to change the shape of the chute. The Power Fitness Chute uses only four lines, compared to other chutes on the market that use eight lines that can easily become tangled. Another innovative addition to the Power Fitness Chute is the “parabolic cup” canopy. Most sports chutes rely on the wind to develop the shape of the chute. The “parabolic cup” design is sewn into the chute and gives the chute instant life and stability. Because of its quick opening and stability characteristics, it is the ideal

Catalog Showcase

DISCOUNT PRICES ON FITNESS TESTING PRODUCTS AND EXERCISE EQUIPMENT from

CREATIVE HEALTH PRODUCTS We stock popular brand name instruments for Fitness Measuring and Testing at the lowest prices. Examples of products include:

• HEART RATE • STRENGTH MONITORS TESTERS • BODYFAT • FLEXIBILITY CALIPERS TESTERS • BLOOD PRESSURE • LUNG CAPACITY TESTERS TESTERS • FITNESS • ANTHROPOMETRIC APPRAISAL KITS CALIPERS • SPIROMETERS • SCALES • STETHOSCOPES • GONIOMETERS • ERGOMETERS • METRONOMES • EXERCISE BANDS • STOPWATCHES AND MUCH MORE QUALITY PRODUCTS GUARANTEED LOWEST PRICES PROMPT FRIENDLY SERVICE WRITE OR CALL FOR FREE CATALOG

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POWER SYSTEMS, INC. (800) 321-6975, www.power-systems.com Since 1986 Power Systems has been a leading supplier of sport training, health and fitness products. The company prides itself in being the one resource for all of your training needs. Its new 2004 catalog has a new look with better graphics and photos. Included areas are core strength, medicine balls, speed, plyometrics, agility, strength equipment, strength accessories and flooring. You will find the catalog full of hundreds of new products and dozens of products available exclusively from Power Systems. The company has also lowered some prices to enable the customer to get premium products at great prices. Go online or call Power Systems to request a free 2004 catalog today. Circle No. 102 on Reader Inquiry Card

Perform Better (800) 556-7464, www.performbetter.com Now increased to 60 pages, the 2003 edition of the Perform Better catalog includes a wide array of high-quality products for training, coordination, and rehab. The items selected focus on speed and agility, plyometric, strength, and weight training, as well as balance and stabilization application to both training and rehab of the individual. The focus of the entire presentation is on functional training and rehab.

800-742-4478 AUTHORIZED POLAR SERVICE CENTER 800-287-5901

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Strength Training & Cardiovascular Products chute for sprinters’ speed development. The Power Fitness Chute comes with a quick-release belt and instructions. Circle No. 66 on Reader Inquiry Card Innovative rust proof stainless steel or painted Super Power Sled, from Kytec, pulls smooth and straight for high-speed resistance sprinting. At the same time you are developing sprinting strength, you can also develop correct and powerful arm swing, a critical component of increased speed. Use the optional quick-release harness so you can release the sled while sprinting, you will feel like you were shot out of a cannon. Circle No. 67 on Reader Inquiry Card

LIFE FITNESS (800) 634-8637, www.lifefitness.com Life Fitness’ 9500XXL Lifecycle exercise bike is ideal for amateur athletes and athletic fitness facilities. The bike, which is the first Lifecycle exercise bike designed for taller athletes, accommodates athletes

ranging in height from 5 feet 6 inches to 7 feet tall, which is 7 inches more than the current Lifecycle upright exercise bikes. It is equipped with 25 levels of resistance and a wide variety of programming options to challenge even the fittest athletes. Circle No. 68 on Reader Inquiry Card

LIPPINCOTT WILLIAMS & WILKINS (800) 638-3030, www.lww.com Sports Supplements, by Jose Antonio, PhD, FACSM, CSCS and Jeffrey R. Stout, PhD, FSCMS, CSCS*D, from Lippincott Williams & Wilkins, provides an in-depth treatment on the dynamic field of nutritional ergogenic aids. The book covers the entire spectrum of supplements and their effectiveness (or lack thereof), including proper dosages and applications to specific goals. The 14 chapters include discussions of cellular hydration,

anti-catabolic agents, anti-oxidants, amino acids, protein, and nutrients that affect the immune system. September 2001/350 pages/100 illustrations/ISBN: 0-7817-22411/$34.95. Circle No. 69 on Reader Inquiry Card ACSM’s Health-Related Physical Fitness Assessment Manual, the newest book from the American College of Sports Medicine (ACSM), is a practical guide for assessing individuals’ physical fitness levels effectively and efficiently and serves as an authoritative reference for theory and practice. Straightforward, howto writing style and organization guide readers in the practice of performing assessments across five major health-related physical fitness components: cardiorespiratory fitness, body composition, muscular strength, muscular endurance, and flexibility. Circle No. 70 on Reader Inquiry Card

Stabilize Chronic Shoulder Dislocators, Separators, and Subluxators With over a decade of experience in shoulder brace design the MAXTM Shoulder Brace by Brace International, Inc. is an evolution in shoulder girdle support. The snug-fitting, lightweight material (under 2 pounds) allows for comfort with movement while its strap design system allows for many options to help protect the glenohumeral joint. Maximum Protection, Maximum Range of Motion

We highly recommend its use for all sports.

800-545-1161 Toll Free - www.braceint.com Circle No. 32

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ScoutingReport Strength Training & Cardiovascular Products MED-FIT SYSTEMS, INC (800) 831-7665, www.Medfitsystems.com The Nautilus STEEL line is now available from Med-Fit Systems, Inc. The STEEL line features Kevlar belt drive, fully enclosed weight stacks, light starting weights, magnetized and tethered selector pins, Nautilus cams and four-bar linkage variable resistance, with most machines priced under $2,000. The new Nautilus STEEL line offers a viable alternative to other less featured, budget driven brands. With the STEEL line, Nautilus now offers three distinct lines of commercial weight equipment, one sure to meet the price and performance criteria for any facility. A CD rom catalog, featuring all of Med-Fit’s product offerings, is available with no obligation, or you may visit its Web site. Circle No. 71 on Reader Inquiry Card

Med-Fit’s HUR line of air resistance machines is ideal for rehabilitation and sports specific fitness application. The HUR line features 30 machines—all designed in conjunction with leading experts in the rehabilitation and fitness arena. HUR has been a leading fitness manufacturer in Europe since 1987. The HUR mechanism is completely enclosed, offering a level of safety and appearance not seen in prior machines. Two-tone upholstery with built in lumbar supports cradles clients in the exercise position. Strategically placed easy access hand grips allow easy ingress and egress into the exercise position. A CD ROM catalogue, featuring video presentation on the HUR and other Med-Fit rehabilitation and senior training stations is available free of charge. Circle No. 72 on Reader Inquiry Card

NASM (800) 460-NASM, www.nasm.org Fire up your clients with new training techniques that will keep them coming back for more. “Power Training” (0.3 CEU’s) gives you all the tools you need to bring excitement to your programs. It enhances your clients’ workouts with increased strength, tone, 56 ◆ T & C N O V E M B E R 2 0 0 3 ◆

and the ability to function more efficiently and also increases your program design possibilities. The program provides optimum performance and transforms the human body into the “ultimate hi-tech machine”. Circle No. 73 on Reader Inquiry Card

strength training and conditioning information available. It also includes 300 fullcolor photographs, which provide a clear illustration of proper flexibility, plyometric, and resistance training exercise techniques. Circle No. 76 on Reader Inquiry Card

Stay on the forefront of training with “Core Stabilization” (0.3 CEUs) by NASM. Discover how to design and implement hundreds of core-stabilization exercises for improved health and performance. You will learn progressions using stability balls, tubing, cables, foam rolls, medicine balls, and more. Health and fitness professionals will achieve a total understanding of the science behind integrated core stabilization and come away with the skills necessary to design, implement and progress programs for clients of all levels. Circle No. 74 on Reader Inquiry Card

OPTP (800) 367-7393, www.optp.com The BOSU™ Balance Trainer has two functional surfaces. The burst resistant dome can be used for balance, core stability, cardio, and proprioception training. It can be used platform side up for pushups or seated exercises. OPTP offers the BOSU Balance Trainer and a variety of BOSU training videos. These videos are geared toward the health care provider and offer an excellent source of training ideas for total sports conditioning, strength and athletic conditioning, equilibrium, cardio fusion, reactive strength and power, and core synergy.

NSCA CERTIFICATION COMMISSION (888) 746-2378, www.nsca-cc.org The NSCA Certification Commission’s Free Weight and Machine Exercise Techniques video cassette is now available as a DVD. Just like the VHS version, this 82minute DVD shows the proper technique for 38 common weight training exercises. The narration describes the 10 machine and 28 free weight exercises. It also identifies the primary muscle groups involved, including the correct grip width, stance, body position, range of motion, and provides tips for correcting errors and avoiding injury. ($40.95 for NSCA members). The DVD may also be purchased as a set with the 68-page Free Weight and Machine Exercise Techniques Manual. (The set is $59.95 for NSCA members.) Circle No. 75 on Reader Inquiry Card

NSCA Certification Commission offers Essentials of Strength Training and Conditioning, 2nd Edition. Written and edited by leading exercise science professionals, the book offers 664 pages and 26 chapters of the most comprehensive

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The Thera-Band® Soft Weights, also from OPTP, were developed as a soft, grip-free weight system. The Soft Weights have a uniform 4.5” diameter and range from .5 kg to 3.0 kg in weight. Six levels of progressive weights are colorcoded and support a broad range of patient skill levels. The soft, pliable surface provides an easy hold and promotes functional grip strength development. The small diameter works well for one hand or two hand activities. Use the Soft Weights singly or in pairs instead of dumbbells for strengthening, balance training, mobilization, and functional grip strength development. Use in conjunction with a rebounder for plyometrics. Each weight includes a professional instruction manual. Circle No. 78 on Reader Inquiry Card

PERFORM BETTER (800) 556-7464, www.performbetter.com New in the Perform Better 2003 catalog, the Omni Resistance Ball combines stability ball training with band training. The ball and the tubing can be


Strength Training & Cardiovascular Products used separately or together. The adjustable tubing easily connects to the ball to create 20-120 lbs. progressive resistance allowing you to do shoulder and bench presses, resisted crunches, lunges, and more. Great for a functional multiplane workout. Circle No. 79 on Reader Inquiry Card Perform Better offers its new Uni-Vest with a stretchable neoprene strapping system that provides a tight, secure fit. Choose from two models-short, with 18 adjustable 1/2 lb. weights, or long, with 38 adjustable 1/2 lb. weights. Please note that the short model holds up to 20 lbs., long model holds up to 40 lbs. the flexible rubber weights contour to the body's shape to provide comfort and safety. Circle No. 80 on Reader Inquiry Card

POWERBAR (800) 58-POWER, www.powerbar.com PowerBarÂŽ PowerGel is a high-energy, fast fuel concentrated carbohydrate gel

(80% complex, 20% simple) that delivers immediate energy during intense athletic activity. So whenever you need that extra edge to blow through the last mile, the last lap, the last push, you can be sure that PowerBarŽ PowerGel will deliver the healthy edge you need. Circle No. 81 on Reader Inquiry Card PowerBarŽ Performance, the number one energy bar, is a low-fat, highly nutritious energy bar specially formulated to deliver long-lasting energy. Since 1986, PowerBarŽ Performance has been dedicated to helping athletes and active people achieve peak performance and has become the “fuel of choice� for top athletes around the world. Circle No. 82 on Reader Inquiry Card

POWER LIFT (800) 872-1543, www.power-lift.com Power Lift has successfully introduced a

new and unique method of doing the Glute/Ham exercise with its Rotating GluteHam Bench. This machine more effectively works the hamstrings, gluteus maximus, gastrocnemius, and erector stabilizers for pelvic stability, than the traditional method. The large rotating pads greatly reduce any discomfort on the thighs and allow for a complete stretch and contraction of the hamstrings. An Easy Glide sliding mechanism very effortlessly adjusts the footplate assembly horizontally, eliminating the difficulty of tubein-tube adjustment. Lower kneepads support the body to allow for proper positioning of the footplate assembly with the body in position for the exercise. Circle No. 83 on Reader Inquiry Card Power Lift has successfully engineered the Combo Power Rack, a dual purpose lifting station that

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3-Point Products (Oval-8) . . . . . . . . . .40 . . . . . . . .61

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Gebauer . . . . . . . . . . . . . . . . . . . . 9 . . . . . . . .17

PowerStep . . . . . . . . . . . . . . . . . . .41 . . . . . . . .63

Biofreeze . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . 5

Hammer Strength . . . . . . . . . . . . . .28 . . . . . . . .51

PrePak Products . . . . . . . . . . . . . . .16 . . . . . . . .26

Brace International (Fluk) . . . . . . . . .37 . . . . . . . .59

Jump Stretch . . . . . . . . . . . . . . . . .45 . . . . . . . .67

PRO Orthopedic . . . . . . . . . . . . . . .39 . . . . . . . .61

Brace International (MAX) . . . . . . . . .33 . . . . . . . .55

Kelly Kinetics (Pivot Plate/Ankle Isolator) .14 . . . . . . . .24

PROTEAM by Hausmann . . . . . . . . .35 . . . . . . . .57

Cadlow Shoulder Stabilizer . . . . . . . .11 . . . . . . . .19

Kytec Athletic . . . . . . . . . . . . . . . . .23 . . . . . . . .41

Samson Weight Equipment . . . . . . . .29 . . . . . . . .53

Cho-Pat . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . . . 2

Lippincott Williams & Wilkins . . . . . .17 . . . . . . . .27

Scandinavian Consulting . . . . . . . . .32 . . . . . . . .55

CorMax . . . . . . . . . . . . . . . . . . . . .12 . . . . . . . .20

Med-Fit Systems (Nautilus) . . . . . . . . . 7 . . . . . . . .12

Thera-Band/Hygenic Corporation . . .10 . . . . . . . .18

Creative Health Products . . . . . . . . .30 . . . . . . . .54

Mueller Sports Medicine . . . . . . . . . . 8 . . . . . . . .15

Total Gym/efi Sports Medicine . . . . . 6 . . . . . . . . 9

Exertools . . . . . . . . . . . . . . . . . . . .31 . . . . . . . .28

NASM . . . . . . . . . . . . . . . . . . . . . .25 . . . . . . . .43

TurfCordz/NZ Manufacturing . . . . . .38 . . . . . . . .59

Exertools (Year-End Sale) . . . . . . . . . . .13 . . . . . . . .23

NSCA Certification Commission . . . . .46 . . . . .IBC

VersaClimber . . . . . . . . . . . . . . . . . 5 . . . . . . . . 7

Ferno . . . . . . . . . . . . . . . . . . . . . .26 . . . . . . . .44

Oakworks . . . . . . . . . . . . . . . . . . .47 . . . . . . . .BC

Vertec (Sports Imports) . . . . . . . . . . . . .22 . . . . . . . .39

FitBALL USA (Ball Dynamics) . . . . . . . . .42 . . . . . . . .63

OPTP . . . . . . . . . . . . . . . . . . . . . . .18 . . . . . . . .29

VertiMax . . . . . . . . . . . . . . . . . . . .36 . . . . . . . .58

FLA Orthopedics/Night Splint . . . . . . 4 . . . . . . . . 6

Perform Better . . . . . . . . . . . . . . .19 . . . . . . . .33

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Functional Design Systems . . . . . . . .24 . . . . . . . .42

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Xvest . . . . . . . . . . . . . . . . . . . . . . .27 . . . . . . . .49

IF YOU WANT TO SEE SOME REAL EXCITEMENT AND PRODUCE NEW PERSONAL BESTS FOR YOUR ATHLETES

IS THE ANSWER! • NO trainer–anywhere, at any price, will increase an athlete’s vertical jump and first-step-quickness like VertiMax. Rapid, large gains are guaranteed! Your athletes will feel and see their improvements immediately!

Adding VertiMax to your arsenal will give you a whole new training dimension, expand your client base, and increase your revenue. • Patented Hip Trackers move laterally with the

athlete to sustain a proper gravity vector and preserve balance and form during lunges and other sports specific exercises. • Engineering under the platform applies a non varying level of resistance through the complete concentric and eccentric movements, optimizing the proprioceptive response.

• VertiMax has been featured in Sports Illustrated and seen on ESPN, HBO, and Fox Sports Networks.

• Individually tailored resistances

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1-800-699-5867

www.vertimax.com DON’T WAIT FOR YOUR CLIENTS TO ASK FOR IT. HAVE IT! Circle No. 36 58 ◆

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3-Point Products . . . . . . . . . . . . . . . 111 . . . . . . .64

Gebauer (Instant Ice) . . . . . . . . . . . . .115 . . . . . . . .64

Power Lift (Glute-Ham Bench) . . . . . . . . 83 . . . . . . . .57

Athletics Plus (Springco) . . . . . . . . . . . 93 . . . . . . . .60

Hammer Strength . . . . . . . . . . . . . 62 . . . . . . . .53

Power Systems (Squat/Lunge Bar) . . . . . 86 . . . . . . . .60

Ball Dynamics International . . . . . . . 50 . . . . . . . .52

Jump Stretch . . . . . . . . . . . . . . . . . 65 . . . . . . . .54

Power Systems (Super Deadlift Bar) . . . . 87 . . . . . . . .60

BioMedical Life . . . . . . . . . . . . . . .105 . . . . . . . .63

Kelly Kinetics (CryoThermal Massage Tool) .117 . . . . . . . .65

PowerBar (Performance) . . . . . . . . . . . 82 . . . . . . . .57

Brace International . . . . . . . . . . . . .109 . . . . . . . .64

Kelly Kinetics (GlidePoint Ultra) . . . . . . .118 . . . . . . . .65

PowerBar (PowerGel) . . . . . . . . . . . . . 81 . . . . . . . .57

Cadlow Shoulder Stabilizer (DM Systems)113 . . . . . . . .64

Kytec Athletic (Power Fitness Chute) . . . . 66 . . . . . . . .54

PowerLung . . . . . . . . . . . . . . . . . . . 85 . . . . . . . .60

Castle Strength & Fitness/PowerStep . 51 . . . . . . . .52

Kytec (Super Power Sled) . . . . . . . . . . . . 67 . . . . . . . .55

PrePak Products . . . . . . . . . . . . . . . 88 . . . . . . . .60

Cho-Pat . . . . . . . . . . . . . . . . . . . . .112 . . . . . . . .64

Life Fitness . . . . . . . . . . . . . . . . . . . 68 . . . . . . . .55

Samson (Power Stand) . . . . . . . . . . . . . 89 . . . . . . . .60

CorMax . . . . . . . . . . . . . . . . . . . . . 52 . . . . . . . .52

LW&W (ACSM Manual) . . . . . . . . . . . . . 70 . . . . . . . .55

Samson (Twist Lock Step-Up) . . . . . . . . . 90 . . . . . . . .60

CorMax (4 machines) . . . . . . . . . . . . . 53 . . . . . . . .52

LW&W (Sports Supplements) . . . . . . . . . . 69 . . . . . . . .55

Scandinavian Consulting . . . . . . . . . 91 . . . . . . . .60

Creative Health Products . . . . . . . . .110 . . . . . . . .64

Med-Fit Systems (HUR line) . . . . . . . . . 72 . . . . . . . .56

Sports Imports . . . . . . . . . . . . . . . . 92 . . . . . . . .60

Exertools (COMBO FOLLER) . . . . . . . . . . 56 . . . . . . . .52

Med-Fit Systems (Nautilus STEEL line) . . . 71 . . . . . . . .56

Thera-Band/Hygenic (Soft Weights Racks) . 63 . . . . . . . .54

Exertools (Plyoback Rebounder) . . . . . . . 57 . . . . . . . .52

NASM (Core Stabilization) . . . . . . . . . . . 74 . . . . . . . .56

Thera-Band/Hygenic (Sports Handle) . . . 64 . . . . . . . .54

Ferno . . . . . . . . . . . . . . . . . . . . . . .106 . . . . . . . .63

NASM (Power Training) . . . . . . . . . . . . . 73 . . . . . . . .56

Total Gym/efi Sports Medicine (24000) 54 . . . . . . . .52

Fitter . . . . . . . . . . . . . . . . . . . . . . 58 . . . . . . . .52

NSCA Certification Commission (book) . 76 . . . . . . . .56

Total Gym/efi Sports Medicine (MFT) . 55 . . . . . . . .52

FLA Orthopedics (Cub) . . . . . . . . . . . .107 . . . . . . . .63

NSCA Certification Commission (video) . 75 . . . . . . . .56

VersaClimber . . . . . . . . . . . . . . . . . 94 . . . . . . . .61

FLA Orthopedics (Safe-T-Sport) . . . . . . .108 . . . . . . . .63

Oakworks . . . . . . . . . . . . . . . . . . .119 . . . . . . . .65

VersaPulley . . . . . . . . . . . . . . . . . . 95 . . . . . . . .61

Functional Design (3D Walk/Jog) . . . . . 59 . . . . . . . .53

OPTP (BOSU Balance Trainer) . . . . . . . . . 77 . . . . . . . .56

VertiMax . . . . . . . . . . . . . . . . . . . . 96 . . . . . . . .61

Functional Design (Basketball) . . . . . . .116 . . . . . . . .65

OPTP (Soft Weights) . . . . . . . . . . . . . . . 78 . . . . . . . .56

Woodway (Pro Lift 360) . . . . . . . . . . . . 98 . . . . . . . .62

79 . . . . . . . .56

Woodway (The Force) . . . . . . . . . . . . . 97 . . . . . . . .61

Gatorade (Thirst Quencher) . . . . . . . . . . 60 . . . . . . . .53

Perform Better (Uni-Vest) . . . . . . . . . . 80 . . . . . . . .57

Xvest (Don Chu) . . . . . . . . . . . . . . . . . 99 . . . . . . . .62

Gebauer (Ethyl Chloride) . . . . . . . . . . .114 . . . . . . . .64

Power Lift (Combo Power Rack) . . . . . . . 84 . . . . . . . .57

Xvest (Fire Fighter model) . . . . . . . . . . .100 . . . . . . . .62

(Gatorade Ice)

. . . . . . . . . . . 61 . . . . . . . .53

Perform Better (Omni Resistance Ball)

Perform Better With TurfCordz!

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Circle No. 37

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Faster! Quicker! Stronger! TurfCordz Safety Cord Gives You... • Explosive Starts! • Increased Power! • Quicker Footwork! • The Safety and Reliability Professionals Demand! • Call 800-556-7464 or visit us online at www.performbetter.com TurfCordz are distributed by M-F Athletic Company

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Circle No. 38 ATHLETICBID.COM ◆

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ScoutingReport Strength Training & Cardiovascular Products combines two lifting stations into one space saving rack. Each Combo Power Rack, available in 8’ or 9’ heights, comes with 2 pair safety spot bars, 2 pair patented “Rhino Hook” bar catches, bar storage, weight storage, 2 dual grip chin up bars, and bumper plate storage. The inside portion of the rack will accommodate two people for spotting two bench press stations at once. Also the Combo Power Rack can be customized with Power Lift’s patented “Lever Action” Benchs and Olympic lifting platforms. Circle No. 84 on Reader Inquiry Card

POWERLUNG (800) 903-3087, www.powerlung.com At 80 percent VO2 max, and up, breathing requires 15 percent of the total O2 used by the body. To reach maximum performance, every athlete must be able to rely on their breathing to be as conditioned as the rest of the muscles in their body. PowerLung trains and strengthens all the muscles involved in breathing to help insure a peak performance. If you're not breathing with PowerLung, you're only competing with half your power. Circle No. 85 on Reader Inquiry Card

POWER SYSTEMS, INC. (800) 321-6975, www.power-systems.com Power Systems’ new, versatile Squat and Lunge Bar is ideal for squats, step-ups and lunges. Its unique cambered design insures proper form. It has a heavily padded shoulder harness with built in hand grips for comfort. Constructed of 7 gauge tubular steel with Olympic size chrome plated barrels. 700 pound weight capacity. Overall bar length 81”; inside bar length 54”. The Squat and Lunge Bar will fit most standard Olympic squat racks. Circle No. 86 on Reader Inquiry Card

The Super Deadlift Bar from Power Systems puts your athlete in the optimal power position to lift more weight while reducing stress on the lower back. Great for dead lifts and shrugs. The new wider inside dimension mea60 ◆ T & C N O V E M B E R 2 0 0 3 ◆

sures 25” to accommodate larger athletes. A two-handle option accommodates athletes of all sizes, high grip for taller athletes and low grip for shorter athletes. Overall Bar dimensions: 66”L. Circle No. 87 on Reader Inquiry Card

PREPAK PRODUCTS, INC. (800) 544-7257, dept. TC01, www.prepakproducts.com Make training and conditioning sessions more productive with the Web-Slide Exercise Rail System from PrePak Products. Regular users of low-cost, high use exercise devices such as tubing, bands, and pulleys benefit from the greater organization, increased versatility, and streamlined efficiency of this space saving exercise station. The Web-Slide Exercise Rail provides 15 anchor points over a range of seven feet for quick and easy attachment of web-strap exercise devices. Or install the 28-inch rail sections separately for individual workstations. A free product offer is included with the full-color catalog. Circle No. 88 on Reader Inquiry Card

SAMSON WEIGHT TRAINING EQUIPMENT (800) 472-6766, www.SamsonEquipment.com The Samson Power Stand combines the features of conventional half racks at a fraction of the price. This compact design is complete with plate storage, bar holders, adjustable cups and safety catches. The Samson Power Stand is ideal for most straight bar exercises while taking up a minimal amount of space. Circle No. 89 on Reader Inquiry Card

Samson’s new Twist Lock Step-Up. This new product has all the benefits of common step up boxes with the convenience of attaching to your existing equipment without the cost of buying a separate piece of equipment. Designed to attach to all Samson Power Racks. The Twist Lock Step-Up can also be custom built to fit any rack on the market. Circle No. 90 on Reader Inquiry Card

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SCANDINAVIAN CONSULTING, INC. (602) 442-2088, www.scipulleys.com The Lojer Plyo Jumper provides all the benefits of plyometric training without taking up a lot of space. Due to its height, it is easy to transfer on and off. R.O.M, circulation and soft tissue endurance are obtained with the sled at 10 degrees. As soft tissues are oxygenated the Plyo Jumper challenges them by allowing for increased speed of movement. Subsequently the Plyo Jumper continues to challenge the soft tissues by increasing the force angle created by gravity or by attaching the sled to low inertia pulleys that dose in onepound increments. Circle No. 91 on Reader Inquiry Card

SPORTS IMPORTS (800) 556-3198, www.sportsimports.com Virtually all professional and college sports teams, including the NFL Scouting Combine, use the VERTEC jump training system, distributed by Sports Imports. It is the best way to evaluate and improve jump reach and lower body explosive power. The Vertec jump training system challenges athletes to improve their vertical leap through instantaneous feedback and recognition. The process is simple, offering a true vertical target, visual motivation and an immediate, accurate measure of success and growth. Wall mount version is now available. Circle No. 92 on Reader Inquiry Card

SPRINGCO ATHLETICS (800) 383-0305, www.springcoathletics.com The Winged Water Walker, offered exclusively by Springco Athletics, is a necessary component of any serious track and field training program. It benefits throwers, sprinters, jumpers, and distance warriors. Coaches from across the country have begun using this device with great success. Once you try a pair, you will realize how much time you have been “wasting” in the pool training without the Winged Water Walker. You will also realize that you can do many of the same drills and exercises you normally


Strength Training & Cardiovascular Products perform on the field, but with greater range of motion and loading if desired. Circle No. 93 on Reader Inquiry Card

VERSACLIMBER (800) 237-2271, www.versaclimber.com VersaClimber SportsMed is a tri-level rehab system that provides non, partial and full weight bearing rehabilitation exercise in one machine. Excellent for post op, amputees, obese patients, spinal cord injuries, stroke patients, and the neurologically impaired, plus it’s easy for geriatric patients to use. Features include: adjustable seat, ROM limiters, lower limb isolators, cross crawl pattern, heart rate control, and more. Circle No. 94 on Reader Inquiry Card

VERSAPULLEY (800) 237-2271, versapulley.com Ideal for diagonal/rotational training, the VersaPulley can perform up to 100 sport specific routines at full speed, with full

range of motion of up to 10’ without the fear of flying weights or plates. More effective than bands, the VP uses patented 100% compliant resistance, providing critical explosive acceleration & deceleration training, while keeping the muscles maximally loaded during the eccentric and concentric phases. Circle No. 95 on Reader Inquiry Card

VERTIMAX (800) 699-5867, www.vertimax.com The VertiMax low-load,velocity-specific platform trainer, from Genetic Potential, is the unchallenged best device ever designed to increase lower body reactive power. It provides unique kinetics and eliminates the shortcomings of all previous platform trainers. (1) An unlimited number of resistances can be set in seconds. (2) The

athlete is fully loaded in the low squat position. (3) The resistance level set does not vary through the complete concentric and eccentric movement. (4) During lateral movement the applied overload maintains a true “center of the earth” gravity vector. Stand by for huge gains in vertical jump and first-step-quickness. Circle No. 96 on Reader Inquiry Card

WOODWAY (800) 966-3929, www.woodway.com Woodway has introduced a way to train for sports-specific speed and power. “The Force” couples the low friction design of the Woodway treadmill with a variable resistance braking system (0150 lbs), for programmable “sport loading”. Any athlete who emphasizes speed and power for optimal play will benefit from the training. The Force is destined to become a staple in the training centers of both professional and amateur athletes and teams. Circle No. 97 on Reader Inquiry Card

Finger Splints one finger splint treats Mallet Fingers, Volar Plate, Collateral Ligament injuries, and more. To order or request a free catalog, call

888-378-7763

Oval-8 finger splints are a proven winner for treating IP joint injuries.

Stevensville, Maryland

Visit our on-line catalog at:

www.3pointproducts.com Circle No. 39

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Strength Training & Cardiovascular Woodway has also introduced the Pro Lift 360 to its line of quality Performance Training products. Utilizing incremental body weight support (BWS) and the versatile and reliable Woodway Desmo model treadmill, this integrated system provides unweighting up to 360 lbs, with a full 360 degrees of rotation available to the user. BWS, or unweighting, is a proven modality for early rehabilitation by providing pain-free exercise. Additionally, high intensity training can be accomplished with less stress and impact on the athlete. Circle No. 98 on Reader Inquiry Card

X VEST (800) 697-5658, www.THExVest.com “I have found the X Vest to be an excellent tool for providing overloads in both plyometric and strength training, conditioning and rehabilitation programs. The fit and adaptability are excellent. The X Vest allows for freedom of movement and doesn’t interfere with any of the agility, bounding or running programs that I write for a wide variety of athletes, both collegiate and professional. The X Vest has proven itself in my programs! Thank you for all your efforts and help in improving my capability as a strength & conditioning specialist.”—Donald A. Chu Ph.D., PT, ATC, CSCS and author of Jumping into Plyometrics. Circle No. 99 on Reader Inquiry Card

X Vest has a new weight configuration and it’s heavy—84 pounds of heavy. The new X Vest, known as the Fire Fighter model, was developed strictly for firefighters and their rigorous training. It has the basic design as the original X Vest, but internally it has a new weight configuration allowing for 84 pounds. Because of its ability to adjust weight like the original X Vest numerous individuals from bodybuilders to the military are buying them. Circle No. 100 on Reader Inquiry Card

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C USTOMER T ESTIMONIAL

C USTOMER T ESTIMONIAL

Shin Splints Compression Wrap

The Functional Video Digest Series encompasses the most up-to-date and proven information for functional analysis, injury prevention, physical rehabilitation, training and conditioning, and performance enhancement. “Thank you for enhancing our professional abilities with the Functional Video Digest Series. We not only have viewed them in the clubhouse, but the convenience of taking them on the road with us has been a valuable educational tool. They have enhanced our ability to evaluate and treat injury patterns in many of our athletes in a much more functional approach. The investment we made in furthering our learning has paid off with our ability to gain valuable CEU's as well as giving us a portable resource library. We recommend the Functional Video Digest Series for anyone serious about increasing their understanding of function in order to effectively treat and prevent injuries as well as design programs to properly train and condition. Your clients/athletes will benefit greatly from Gary's teachings.” Barry Weinberg, Head Athletic Trainer and Mark O’Neal, Assistant Trainer/Medical Coordinator, St. Louis Cardinals, LP

Functional Design Systems, LLC 1042 Sutton Road, Suite 1 Adrian, MI 49221

Toll free 866.230.8300 www.functionaldesign.com

ATHLETICBID.COM

“Shin Splints have caused me pain for many years. The Shin Splints Compression Wrap, from Pro-Tec Athletics, is the only brace I have ever worn that really works. Thank you, ProTec.” Lisa Duke 26-year old Ballerina and Runner “I strongly recommend the Elbow Power Strap and Knee Pro-Tec, by Pro-Tec Athletics, above any other similar products on the market.” Gary Sato Gold Medal U.S. Volleyball Team Trainer “I have tried many knee supports in the past, but never have I experienced the positive results that The Lift knee support provides. I have recommended it to my workout buddies.” Mark Rennison 40-year old Basketball Weekend Warrior “As an avid walker and tennis player, I was having problems with Plantar Fasciitis. I am thrilled with the relief I have felt with the Arch Pro-Tec and I want to thank you so much.” Roz Berk Walker and Tennis Player “I have tried many different styles of patellar tendon straps available and not one comes close to the comfort and effectiveness of the Knee Pro-Tec.” Rachael Sporn, WNBA Australian National Team Silver Medalist “I have found the Achilles Tendon Strap to be the most effective Achilles tendon strap I have ever worn.” Clint Rogers Collegiate Volleyball Player

Pro-Tec Athletics 2743 152nd Ave., NE Redmond, WA 89052

800.779.3372 www.injurybegone.com


ScoutingReport More Products BIOMEDICAL LIFE SYSTEMS, INC. (800) 726-8367, www.bmls.com BioMedical Life Systems has introduced its new generation in electrotherapy devices, the QuadStar® four channel NMS Muscle Stimulator Device. Its compact size and user friendly programming features make the QuadStar’s® design unique among electrotherapy devices. The unit measures 6.75” by 2.75” by 1.25” and has an easy to read LCD screen and a digital keypad. Simple to understand instructions guide the user through nine pre-programmed protocols; two types of waveforms; symmetrical or asymmetrical biphasic square, continuous, cycled or reciprocating stimulation, adjustable pulse rate and pulse width. The device has a patient lock system that, when activated prevents the patient from changing any of the set parameters. The device features a graphic representation of the timing parameters directly on the screen. When the Patient Lock Systems is turned off, a patient compliance meter is displayed showing how long the device was

The PowerStep $29900

A six level platform: 6”, 9”, 12”, 15”, 18”, 21” Used for stepups, box squats, plyometrics, stiff-leg dead lifts, and military presses

used. A timer allows the patient to use the device for a specified period of time. Circle No. 105 on Reader Inquiry Card

FERNO (888) 206-7802, www.fernoperformancepools.com Transform a traditional swimming or lap pool into an aquatic exercise environment with the Ferno AquaGaiter® Underwater Treadmill. Combining traditional treadmill training with the natural properties of water such as buoyancy, resistance and heat, the AquaGaiter is perfect for a low impact workout. The Ferno AquaGaiter features variable speed adjustments that range from .5 to 8 mph for any level of conditioning. Circle No. 106 on Reader Inquiry Card

FLA ORTHOPEDICS, INC. (800) 327-4110, www.HealWellinfo.com The patented Cub™, from FLA Orthopedics, comfortably positions the foot in a controlled amount of dorsiflexion to gently stretch the plantar fascia,

Achilles Tendon, and calf muscles. Clinically proven to reduce symptoms of plantar fasciitis. The Cub™ can also be used to treat other lower extremity conditions. Soft, lightweight materials for half the bulk and twice the comfort of conventional night splint devices. Circle No. 107 on Reader Inquiry Card The Safe-T-Sport® Lateral Knee Stabilizer provides excellent side-to-side support of the knee and is ideal for treatment of Chondromalacia, pain from lateral pressure syndrome, patella instabilities, lateral patellofemoral malalignment and lateral patella dislocations. Features include: sports neoprene, tubular “J” buttress for lateral support, adjustable support straps, flexible stays, tapered sleeve design, and a low profile, slip-on style. Circle No. 108 on Reader Inquiry Card

Quality Matters When the future of your business is balancing on a ball — make sure it’s a FitBALL®! The only burst-resistant exercise ball with dynamic elasticity — firm yet always flexible. Perfect for all ages and ability levels. Available in a full range of sizes and colors and backed by unconditional 30-day guarantee.

Light enough to be moved easily, yet strong enough to support 2,000 pounds and plyometric jumping. Upgrade your PowerStep with side rails for knee and hip rehabilitation exercises

www.thepowerstep.com (816) 517-2872

Available packaged with pump and poster! 03-TC11

14215 Mead Street • Longmont, Colorado 80504

1-800-752-2255 or www.fitball.com

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ScoutingReport Arm & Shoulder BRACE INTERNATIONAL, INC. (800) 545-1161, www.braceint.com Brace International offers the MAX™, a major advancement in the design of shoulder girdle support. The snug-fitting, lightweight material allows for comfort with movement, yet at the same time helps protect the glenohumeral joint from subluxations and dislocations. Its strap design system allows many options for maximal stability where needed while giving the required range of motion. Circle No. 109 on Reader Inquiry Card

CREATIVE HEALTH PRODUCTS (800) 742-4478, www.chponline.com Creative Health Products, a leading discount supplier of rehabilitation, fitness, exercise and athletic testing and measuring products, offers the Hudson UBE, a portable, lightweight tabletop upper body and arm ergometer with pulse monitor. The belt-driven electromagnetic resistance system has 8 different loading levels and uses precision sealed bearings, making the unit both quiet and smooth. Displays heart rate, speed, distance, time, odometer and estimated number of calories burned. Circle No. 110 on Reader Inquiry Card

3-POINT PRODUCTS (888) 378-7763, www.3pointproducts.com Reflex® Putty with Memoryflex® increases resistance the more it’s pulled. Reflex® Putty can be pulled and stretched like exercise bands but, unlike bands, it provides consistent resistance throughout the range of stretch. Muscles receive resistance throughout their contraction for a more effective strengthening regime. Available in three resistance levels and in the new Pro Series for athletes and others requiring a higher resistance level for rehabilitation. Circle No. 111 on Reader Inquiry Card

CHO-PAT, INC. (800) 221-1601, www.cho-pat.com Cho-Pat’s Forearm Support secures and supports forearm muscles that are overexercised or strained during athletic activities such as baseball or tennis, activities where one repeatedly extends the arm and applies force. The strap applies compression at the forearm to absorb 64 ◆ T & C N O V E M B E R 2 0 0 3 ◆

and dispense pain-causing forces, easing stress on the forearm muscles and their attachments and reducing inflammation. Circle No. 112 on Reader Inquiry Card

DM SYSTEMS (800) 254-5438, www.dmsystems.com Cadlow™ Shoulder Stabilizer, the multisport, dynamic shoulder stabilizing brace, is now available from DM Systems, producers of wound care and orthopedic rehab products. Specifically for chronic subluxations and sporadic dislocations of the shoulder, Cadlow Shoulder Stabilizer allows the athlete to fully function in his or her sport without fear of shoulder pain or reinjury. It provides glenohumeral stability while maintaining the athlete’s full range of motion (ROM). This stabilizer’s unique patented pull system strengthens the shoulder by providing graduated resistance through the full ROM. The variable resistance can be increased as the athlete’s strength increases. Cadlow protects the athlete by helping to prevent recurrent shoulder subluxations and dislocations without restricting motion/movement. It can also be used for post-operative protection and strengthening. Circle No. 113 on Reader Inquiry Card

THE GEBAUER COMPANY (800) 321-9348, www.gebauerco.com Gebauer’s Ethyl Chloride® is now available in two easy-to-carry spray can delivery systems: Pain-Ease® Stream Spray and Pain-Ease® Mist Spray. Athletic trainers can choose the spray can that works best for them to relieve minor sports injuries such as bruising, contusions, swelling and minor sprains. It works as fast as ice without the mess— in seconds—so athletes can get back in the game faster. Circle No. 114 on Reader Inquiry Card

Gebauer’s Instant Ice™ is a non-prescription, nonflammable topical skin refrigerant. Gebauer’s Instant Ice comes in either mist or stream spray cans. Both are ideal for the temporary relief of minor pain and swelling from sprains, strains, bruising, contusions, and minor sports injuries. Stream spray is also used for the temporary relief of muscle spasms. Circle No. 115 on Reader Inquiry Card

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C USTOMER T ESTIMONIAL

“I have always been drawn to quality, and quality products which bring the best out in people. Woodway has set a standard for innovation and durability in striving to create solutions which help practitioners and athletes attain their goals in a safe and effective way. “The Force Project was no different. We wanted to create a solution which evaluated, and developed an athlete’s ability to improve on field acceleration through absolute speed. This would only be accomplished by creating a device which put the athlete in a situation to achieve success through kinesthetic learning by rewarding for the qualitative aspects of improved recruitment patterns and force application through proper biomechanics in Acceleration, Transition, and Absolute Speeds. The Force allows this interactive feedback which is incredibly effective, and motivating, drawing their best effort with each repetition. “The Force is a very valuable tool, and I see it as the next evolution to the treadmill.” Mark Verstegen Athletes Performance

Woodway USA W229 N591 Foster Court Waukesha, WI 53186

800.966.3929 www.woodway.com


ScoutingReport More Products FUNCTIONAL DESIGN (866) 230-8300, www.functionaldesign.com Functional Design offers Basketball– Lower Extremity Performance and Prevention with Gary Gray & Vern Gambetta. This functional Basketball Quest video builds upon the Lower Extremity Performance and Prevention video by demonstrating how three dimensional, functional biomechanical principles of performance and prevention can be integrated into a BASKETBALL setting. Beginning with an active warm-up, this video takes you through a progression of various two-player, three-player, and five-player weaves that are tweaked in the three planes (3D) of motion, many with the use of medicine ball. Circle No. 116 on Reader Inquiry Card

tissue site. The Ultra is quick, more effective, and eliminates the mess of melting ice or wet hot packs. Circle No. 118 Reader Inquiry Card

KELLY KINETICS (888) 645-3559, www.kellykinetics.com Kelly Kinetics offers the CryoThermal Massage Tool. Weighing 2-1/2 pounds, this soft grip, solid stainless steel tool allows the user to easily apply the appropriate

amount of pressure, while delivering soothing heat and/or the cool sensation of cryo-therapy. Designed with two removable massage heads, the tool allows for multiple massage techniques while reducing stress on the clinician's hands. Circle No. 117 on Reader Inquiry Card The GlidePoint Ultra, from Kelly Kinetics, features a removable 2 1/8 inch solid stainless steel ball, which rolls effortlessly across the skin, delivering a smooth, deep penetrating hot or cold massage to the soft

OAKWORKS (800) 558-8850, www.oakworks.com The Portable Taping Table Carry Case, from Oakworks, is the perfect teammate with the portable taping table. This heavy duty ballistic nylon carrying case, specially designed to fit Oakworks’ portable taping table, features dual side zippers, a non-slip shoulder strap and includes a convenient outside pocket for field feet. Completely padded this case will protect your table through many seasons both at home and on the road. Circle No. 119 on Reader Inquiry Card

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AtleticBid.com gives you the tools to research products Online Buyer’s Guide Using AthleticBid.com’s online Buyer’s Guide, you are able to: • View the complete product line of companies. t • View catalog pages or spec sheets from many of the top compaF nies. Click on the “View Company As Brochures” button for these compasport thleticBid.com is a free nies, and you will find PDF files titled service to help buyers at schools by product or category. Print them SPORT and athletic organizations TAPES out for easy reference. research and contact companies • Read a profile or description of select in the most efficient fashion. companies by clicking on the “About AthleticBid.com offers the followthe Company” button. ing services. • Request to be contacted by a company representative. • Request catalog and sales literature from companies. Simply click on a button and fill in your address and an e-mail with your request is sent directly to the supplier.

A

Jersey Field Products

Park City, NJ 08832 Phone: (800) 275-8000;

(973) 222-3300 | Fax: (973) 222-3333 Contact Name: John James Email address: Jersey@ aol.net

Company Description: Your “One-Stop Source” for America’s Leading Sport Supplies! Special mixes Surfaces and for infields, pitcher’s mounds , home plate areas and warning by over 100 pro teams and 5000 colleges, with 200 tracks. Used products from more than and bulk plants across the 20 distribution centers country. Call 1-800-275-8000 for more information. View Product Line

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Q&A

C O M PA N Y

Training for Peak Performance: An Interview with Rob Garcia, Part 1

As the training and conditioning coach who in recent years has brought some of the world’s best-known athletes to peak performance in competition, Rob Garcia has a unique perspective. He has trained champions in varied sports, and the one constant he mentions for all, including boxing legend Oscar de la Hoya, is Total Gym. Training & Conditioning recently asked Garcia to share his views on his choice of equipment. Part 1 of the interview with Rob Garcia emphasizes the training of professional boxers. In an upcoming issue of Training & Conditioning, Garcia answers questions related to other sports in addition to boxing, and the world champion athletes he trains.

Q. What role does explosive power play in boxing? How do you train fighters to be explosive? A. Some say punching is something a fighter is born with. That may be true to a certain degree. You can super charge your explosive power with Active Medicine Ball tosses, Tornado Ball speed drills and wood chopping.

(Note: We recognize that athletes of great accomplishment can be female or male. For the sake of brevity only, in the following interview we are referring to the athlete as “he.”)

Q. How do you choose quality equipment? There are so many choices in equipment and training strategies.

Q. What about quick reflexes, speed, and agility training?

Floyd Mayweather Sr., Francisco Bojado, Rob Garcia, Frank Acosta. Pechanga Casino, San Diego, California, 2003.

A. You need training gear that covers and improves coordination, balance, timing, rhythm and speed. Total Gym meets these requirements. It is true that professional athletes have all day to train. However, to be considered a world-class athlete – that takes you to an even higher level of expectation. You must train smarter than the competition and use your time more wisely.

Q. You prepared Oscar de la Hoya for his WBC Jr. Middleweight World title fight with archrival Fernando Vargas. What were some of the key ingredients in the training approach for that great victory? A. In events of this magnitude, there is only so much preparation time. We use sports specific training such as the boxing drills that have become mainstream at many gyms around the country. And there is no one better than Floyd Mayweather Sr. when it comes to boxing. In the conditioning department, we use Total Gym for many of his upper body strength, stamina and flexibility training schemes. For those of you who don’t have all day to train and want versatile, multipurpose training gear, Total Gym is the way to go.

A. Track workouts designed by Rahn Sheffield at SDSU are what I use to potentialize foot speed. Reflexes and agility are sharpened with sparring in the ring.

Q. Tell us about intensity and focus. A. Training with intensity means keeping your attention 100 percent on the task at hand. Do not let yourself be distracted when you are in the gym. Your focus should be drills that require your full concentration of speed, timing and balance.

Q. What about the future? Is there anyone new you are working with? A. Yes. About every ten years, a great one comes along. I’m training a young fighter named Francisco “Panchito” Bojado and I’m very pleased with his potential. You can watch him this November 22, 2003, televised on Showtime. You can bet he will be well-prepared and exciting to watch, so don’t miss it.

Q. Can you give an example? A. de la Hoya is a natural who works extremely hard at being a world-class athlete. Flexibility is an area where he scores at the low end of the intake. With Total Gym, we can train him through a full range of motion, addressing flexibility and strength.

For information about Total Gym and the full line of efi Sports Medicine products, visit efisportsmedicine.com or call efi Sports Medicine: 800-541-4900. More about Rob Garcia and his use of efi Sports Medicine products will soon be available at his Web site: innovativesportsgear.com.

Rob Garcia, Oscar de la Hoya

efi Sports Medicine

(800) 541-4900

7755 Arjons Drive San Diego, CA 92126

www.efisportsmedicine.com


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WWW.JUMPSTRETCH.COM Jump Stretch, Inc. features the complete line of flex band exercise equipment, including six sizes of heavy-duty, continuous-loop bands that provide 25-200 lbs. of resistance per band. WWW.KYTEC.US Kytec Athletic Speed Equipment offers over 300 training and conditioning products that will increase speed, strength, agility, quickness, and rehabilitation at factory-direct prices for all athletes. WWW.MEDFITSYSTEMS.COM Med-Fit Systems, Inc., has been supplying the capital equipment needs of the rehabilitation community for the past 15 years. Med-Fit features a nearly 600-page Web site, and offers a free CD ROM catalog, including video demonstrations of many products. NATIONAL MEDICAL ALLIANCE WWW.NMADIRECT.COM The National Medical Alliance is a professional coalition of the best PT equipment and supply dealers in America. It consistently meets the highest industry standards for the best quality, service, and pricing. NMA’s Web site features its catalog and highlights items such as the Wall Crawler.

WWW.NSCA-CC.ORG Learn more about the Certified Strength and Conditioning Specialist® (CSCS®) and NSCACertified Personal Trainer® (NSCA-CPT®) credentials. As the ONLY nationally-accredited fitness related credentials, they are truly the “Credentials of Distinction” in the fitness industry. WWW.POWER-SYSTEMS.COM Power Systems, Inc., is an international distributor of sport performance, health and fitness products. With over 800 products and instructional programs, it is the one resource for all your training needs. Its Web site features over 75 new innovative products for 2004 and dozens of exclusive Power Systems products. WWW.RICHMARWEB.COM This site is full of detailed information on all Rich-Mar’s ultrasound, stimulation, and combination products complete with photos, descriptions, spec sheets, and contact information, including a dealer locator. You can also download manuals, service information, and MSDS sheets. WWW.WOODWAY.COM Woodway is happy to announce the launch of its new Web site. Please visit the site and see what the company has added. You will be able to custom build your own treadmill at “Woodway Café”, or get online and exchange training ideas and ask questions on the “Coaches Corner.”

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Association Corner The following associations offer services of interest to our T&C readers.

ECA/MIAMI NOV. 14-16, 2003 Sports Sports Training Training && Fitness Fitness Conference Conference

The Voice of the Doctors who care for the Pros The PTP provides resources and services for all sports medicine professionals.

Visit www.proteamphysicians.com to find a PTP doctor, ask a question of a PTP doctor, or explore the educational materials from PTP regarding prevention, treatment and performance.

Don’t miss our Sports Training Mini-Camp!

Call: 800-322-3976 or 516-432-6877 for a FREE brochure

www.ecaworldfitness.com

SPECIALIST IN SPORTS CONDITIONING ISSA Certification Program • • • •

Be the conditioning coach for your team. Expand strength & conditioning programs. Maximize earning potential as a coach. Learn to enhance athletic performance. CALL FOR FREE INFO:

1.800.892.4772

www.FitnessEducation.com

International Sports Sciences Association

Take Your Career to New Heights PERFORMANCE ENHANCEMENT CONTINUING EDUCATION ● CERTIFICATION

• Earn CEUs for NASM, NATA, NSCA • Live workshops, home-study and online courses • Flexibility, core, balance, power, speed and strength training

• Clinical applications • Proven methods

68 ◆ T & C N O V E M B E R 2 0 0 3 ◆

ATHLETICBID.COM

Athletic Therapy. Rapid return to work and play.

Athletic Therapists are dedicated to the promotion and delivery of quality care through injury prevention and rehabilitation and emergency services. In collaboration with other health care professionals, athletic therapists work to create a healthier environment that encompasses the needs of the active community, including the high-performance athlete.

For more information please visit us online at www.athletictherapy.org

All NATA certified athletic trainers are eligible to receive a free subscription to T&C.


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