Training & Conditioning 15.6

Page 1

September 2005 Vol. XV, No. 6, $5.00

RUNNING ON EM EMP PT Y A look at athletes’ athletes’ eating deficiencies Career-Ending Injuries Understanding Movement Prep


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Circle No. 100

©2004 MET-Rx USA, Inc.


September 2005, Vol. XV, No. 6

CONTENTS

33 6

Q&A Pat Lamboni, Salisbury University

12

Bulletin Board Steroid testing … New wrestling rules … Caffeine & carbs

54

Sideline Sodium and Heat Cramps

58

Advertisers Directory

50 55 59 61 63

Product Pages Nutritional Products Leg Strengthening Products Pilates Equipment More Products Web News

64

CEU Quiz For NATA and NSCA Members

Cover Photo: © Kevin C. Cox/NCAA Photos

45

39 Nutrition

on Empty 17 Running A new study has found that only one out of four athletes eat enough calories to fuel their workouts and competitions. Here’s an in-depth look at the problem and possible solutions. By Dr. Pamela Hinton Leadership

… and Answers 25 Questions Want to know how veterans in athletic training tackle their jobs, their bosses, and their lives? Your questions, and their answers, are all here. By Dennis Read Optimum Performance

to Lift? 33 Ready In order for athletes to get the most out of their strength training, their muscles need to be prepared beforehand. One way to do that is through a new technique called movement prep. By Gray Cook & Aaron Taylor Treating The Athlete

39 When an athlete suffers a career-ending injury, the rehab process Point of No Return

takes on a different meaning. At Cal State Fullerton, a team approach guides athletes both physically and psychologically. By Laura Smith Sport Specific

45 At Boston University, preseason training for ice hockey includes Before the Puck Drops

a mix of on-ice and off-ice work, with a focus on conditioning. By Michael Boyle ATHLETICBID.COM

T&C SEPTEMBER 2005

1


There are plenty of good things to say about water. It’s easily available, often free, it quenches thirst and it’s definitely better than nothing at all. There are even some occasions when water is good enough – at meals, while studying, or during a light workout. But when your team is working hard and sweating hard, a scientifically formulated sports drink like Gatorade beats water hands down. Hydration from a sweat gland’s point of view: Exercise increases an athlete’s core body temperature, thereby triggering the production of sweat. Beyond this “sweat threshold,” as exercise intensity increases, so does the rate of sweat production. Furthermore, the increased rate of production limits the reabsorption of electrolytes.

Water is a good thirst quencher for those times when you only need to quench your thirst. ®

The case for drinking Gatorade during exercise. So, when your team is working hard and sweating hard, they’re losing more sodium, chloride and potassium. Water doesn’t replace these electrolytes, which is one reason why a scientifically formulated sports drink like Gatorade beats water hands down. Now you know,

water is fine for reading the playbook, not for reading the defense.


Š2005 S-VC, Inc.

Learn more at gatorade.com/ athletictrainers Circle No. 101


Great Ideas For Athletes...

Editorial Board 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

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T&C SEPTEMBER 2005

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, PhD, ATC, PT Assistant Athletic Director for Sports Medicine, James Madison University Tim McClellan, MS, CSCS Director of Perf. Enhancement, Makeplays.com Center for Human Performance

Leslie Bonci, MPH, RD Director, Sports Medicine Nutrition Program, University of Pittsburgh Medical Ctr. Health System

Michael Merk, MEd, CSCS Director of Health & Fitness, YMCA of Greater Cleveland

Christine Bonci, MS, ATC Asst. A.D. for Sports Medicine, Women’s Athletics, University of Texas

Jenny Moshak, MS, ATC, CSCS Asst. A.D. for Sports Medicine, University of Tennessee

Cynthia “Sam” Booth, ATC, PhD Manager, Outpatient Therapy and Sportsmedicine, MeritCare Health System

Steve Myrland, CSCS Owner, Manager, Perf. Coach, Myrland Sports Training, LLC Instructor and Consultant, University of Wisconsin Sports Medicine

Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center Cindy Chang, MD Head Team Physician, University of California-Berkeley Dan Cipriani, PhD, PT Assistant Professor, Dept. of Exercise and Nutritional Sciences, San Diego State Univ. 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

September 2005 Vol. XV, No. 6 Publisher Mark Goldberg Editorial Staff Eleanor Frankel, Director R.J. Anderson, Kenny Berkowitz, Abigail Funk, David Hill, Dennis Read, Greg Scholand, Laura Smith Circulation Staff David Dubin, Director John Callaghan Art Direction tuesdaythursday Brand Advertising Production Staff Kristin Ayers, Director Adam Berenstain, Jonni Campbell, Jim Harper 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 Assistant Sharon Barbell

Stephen Perle, DC, CCSP Associate Prof. of Clin. Sciences, University of Bridgeport College of Chiropractic

Advertising Materials Coordinator Mike Townsend

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 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

Marketing Director Sheryl Shaffer Marketing/Sales Assistant Danielle Catalano Advertising Sales Associates Diedra Harkenrider (607) 257-6970, ext. 24 Rob Schoffel (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 Training & Conditioning (ISSN 1058-3548) 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© 2005 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 self-addressed, stamped envelope. POSTMASTER: Send address changes to Training & Conditioning, P.O. Box 4806, Ithaca, NY 14852-4806. Printed in the U.S.A.

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Q&A

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Pat Lamboni Salisbury University In 2004-05, Salisbury University captured two NCAA Division III national championships, took second in two others, and posted its best finish in the NACDA Directors’ Cup ever. Reaching 11th place, Salisbury scored its fifth top 20 Directors’ Cup finish in the last six years. Some of the credit for that success goes to Head Athletic Trainer Pat Lamboni, MEd, ATC, and his staff. Lamboni arrived at Salisbury as a student in 1976, receiving a bachelor’s degree in 1978 and his master’s degree in 1980. After two years as Head Athletic Trainer at Catholic University, he rejoined Salisbury as Head Athletic Trainer. In the 23 years since, Lamboni has expanded the athletic training room, helped guide the school’s transition to an accredited educational program, and overseen a sports medicine operation that has grown to 12 staff members serving close to 500 student-athletes. In June 2004, the National Athletic Trainers’ Association named Lamboni a Most Distinguished Athletic Trainer, and in May 2005, he was part of the Maryland Athletic Trainers’ Association Hall of Fame’s inaugural class. In this interview, Lamboni talks about building effective relationships with coaches, keeping up with the politics of the profession, and finding a balance between work and family. T&C: Salisbury had a great year in 2004-05. How does your staff play a part in the athletic teams’ success? Lamboni: The first part is the work ethic of our staff. We think that treating athletes three or four times a day is the best way to get them healthy. Yes, it takes some sacrifice, but we believe in working hard. We open the athletic training room at seven in the morning, and we close when the last athlete walks out of here, which is sometimes eight at night. Second, we have tremendous support from our team physicians, who are always available when we need them. That means we’re able to start working on injured athletes as soon as possible. Third, we have a great relationship with the coaching staff. We’re adamant about our treatment schedule, and if athletes aren’t there, the coaches back us up, telling them, “If you miss a treatment, you’re going to suffer the consequences, just as if you’d missed a practice.” 6

T&C SEPTEMBER 2005

Lamboni evaluates an athlete in the school’s expanded athletic training facility. How do you establish relationships like that with your coaches? Every one of our coaches has a strong ego and is very winoriented—that’s why they’re so successful. But they’re well aware that our athletic training staff is the same way. We don’t open the athletic training room when it’s convenient for us, we open when it’s convenient for the athletes. If we didn’t do treatments at seven in the morning, we might not be able to treat those athletes until after practice, and the coaches appreciate that we work so hard. If they have any questions, they know they can come talk with us right away. They are also very good about allowing our athletic training students to travel with their teams. For instance, with football, I usually take four or five students and a graduate assistant, and the coach always asks, “Do you think that’s enough?” That’s very unique, and it gives our athletic training students the feeling of being an important part of the team. How do you keep your staff working together? We have a staff meeting every Monday, when we sit down and plan our calendar for the next two weeks. One thing that’s great about Salisbury is that the academic program diATHLETICBID.COM


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Q&A for treatment by athletic trainers.] Athletic trainers can’t live with their heads in the sand, particularly those who work in colleges and universities and think their jobs are safe. When the new rules first came out, and the NATA put out a call for athletic trainers to respond, between 400 and 500 letters were sent from Salisbury staff, students, and parents. If every university in the country had done that, can you imagine how many letters there would have been? The future of the profession hinges on this decision. If these rules go through, athletic training is going to become unsettled. But if we can defeat this process and continue to duly accredit athletic trainers as legitimate allied health professional caregivers, the future is very bright. We will be able

■ Pat Lamboni Head Athletic Trainer Salisbury University BA, Salisbury, 1978 MS, Salisbury, 1980 First job: Head Athletic Trainer, Catholic University Honors: NATA Most Distinguished Athletic Trainer, Maryland Athletic Trainers Association Hall of Fame rector and the coordinator of clinical education are at those meetings, and if we get into a jam on coverage, one of them will slide over to help us. Then on Friday mornings, we meet as a full staff with all the athletic training students. We go over the schedule again, talk about meetings and club activities, and discuss the issues that students need to be aware of, both in the department and in the profession. What should athletic trainers do to keep up with developments in the profession? We have to be aware of what’s going on at the NATA and the NATA-BOC, and become actively involved in the political process. For example, the lawsuit with the CMS is going to affect athletic trainers for years to come. [The NATA has sought an injunction to prevent the Centers for Medicare & Medicaid Services (CMS) from suspending reimbursement 8

T&C SEPTEMBER 2005

“We have to be aware of what’s going on at the NATA and the NATA-BOC, and become actively involved in the political process ... Athletic trainers can’t live with their heads in the sand, particularly those who work in colleges and universities and think their jobs are safe.” to move into all types of situations where we can work cooperatively with physicians, physical therapists, occupational therapists, and hand therapists, enhancing those professions to take better care of their patients. What did you learn by going through the accreditation process? I used to be one of those old internship guys who said, “Accreditation is going to be the worst thing that ever happened to athletic training.” Well, I hate to admit this, but I’ve come full circle. I’m firmly convinced that accreditation is tremendously important in today’s job market. Credentialing of athletic trainers, state licensing of athletic trainers, and gaining academic and professional recognition are of the utmost importance for the growth of the profession. We had a very good internship program here at Salisbury, and since we’ve become accredited, our program has become even better, simply because we’re now recognized academically. Accreditation has opened a lot of doors for our students—plus, it’s given us a system of checks and balances for running the program, which is important. Accreditation has given us a better road map to produce athletic trainers. But we can’t lose sight of athletic training as a service profession. We are here to treat athletes and work cooperatively with the athletic staff for the betterment of the student-athlete, and I think that focus can sometimes be lost in the shuffle. The athlete should be the center point, the person we’re working for and helping get better. What’s your most memorable rehab? We had a defensive back who injured his long thoracic nerve, ATHLETICBID.COM


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Q&A which controls the mobility of the scapula. We had an orthopedic consult, went through all the necessary testing, saw a neurosurgeon, put a plan together, designed a rehab protocol, came up with a special brace, and got him back for a playoff game—all in about three weeks. But the rehabs that are even more memorable are the ones where I’ve had to tell an athlete that he or she can’t play anymore. The hardest thing to do is to sit there and say, “I’m sorry.

“I want to keep reaching out to our athletic training alumni. We have a newsletter that goes out twice a year to inform them of what’s going on here and encourage them to support our program ... Our goal was to raise $40,000, and we’ve now raised more than $60,000.” We’ve done everything we can for you.” We had a starting quarterback who’d had a series of minor concussions. Then, two weeks before a big game against our state rival, he had another fairly significant one. When we sat down, he looked me in the eye and said, “Pat, what would you do if you were me? I really respect you and I want

10

your opinion.” We went over every possible scenario, and he decided not to play. I don’t remember if we won the game or not—it doesn’t matter. What matters is that after he graduated, he came and said, “I wanted to play in that game in the worst way. But we made the right decision.” I can live on that memory for the rest of my life. What are your goals for the program at Salisbury? I would love to have a full-fledged sports medicine clinic on campus that would enhance the educational process for our athletic training students and expand our services to the entire campus community. One of these days we’ll get it, which will improve our athletic training program, because 65 percent of today’s students are not getting jobs in a traditional athletic training room. I want to keep reaching out to our athletic training alumni. We have a newsletter that goes out twice a year to inform them of what’s going on here and encourage them to support our program. We now have a scholarship endowment, called the Hunter Smith Endowment, named after the founder of athletic training here at Salisbury, which we’ll start giving away next spring. Our goal was to raise $40,000, and by now, we’ve raised more than $60,000. So we’re really excited about that. It’s important to keep our alumni actively involved in the

ATHLETICBID.COM

T&C SEPTEMBER 2005

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Q&A growth of the program. Over the past 23 years, we’ve had between 175 and 200 graduates, and at our latest reunion, we had about 110 people attend. Alumni support is very strong, and the newsletter helps keep it that way. What are the advantages of staying in one place for 23 years? My family is grounded, they’re happy, and they’re able to develop long-term friendships. That’s a real advantage. I’ve been offered other jobs, but when it came down to it, I didn’t think I could do any better than I’m doing right here. I’ve got a cooperative administration. I’ve got tremendous coaches to work with. Who else could say they went to nine playoff games last year? Who else could say they won two national championships? That’s pretty successful, and success keeps us working hard to become even better. In everything I do, I am focused on trying to make our kids the best they can be, and make sure I’m a good father and husband, which is very important. In this profession, the hardest thing to do is get all those pieces to fit together. When I was inducted into the Maryland Hall of Fame, all those thoughts came to me about how lucky I am to be at an institution like Salisbury University and to have a family that’s supportive of what I do. What can athletic trainers do to balance work and family?

Include your family in what you’re doing and give them the opportunity to be as involved as they want. Make them feel like they’re a part of what you’re trying to accomplish. I have three daughters, who are 16, 15, and 11 years old. They all play sports, and I try to help coach their teams. Even though I have a busy schedule, I make time to be there for them. When they have field days, I supply the ice and water— that way, even if it’s not a lot, at least I’m helping. I’ve taken my daughters everywhere: to athletic training rooms, national championship games, locker rooms, down on the field with the football team. It’s tough to find a balance, because I’ve got 500 kids to take care of at school, too. But if you take a team approach with your family, it works out a lot better. In all my years here, I’ve never been questioned about taking time to do something with my family. I may have a graduate assistant cover an afternoon practice so I can watch one of my girls play a game. The GAs are certified athletic trainers, and I have to trust that they know what they’re doing. When I was inducted into the Hall of Fame, I was flabbergasted, particularly by being in the inaugural class. I hope my athletes remember me, and I hope people in the profession remember me, because I try to do the best I can. But I can’t let my daughters forget me. They have to know how much my wife and I love them, because that’s why we decided to have a family. And I don’t want them to think I wasn’t there for them. ■

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Sponsored by

Bulletin

Board States Act On Steroids While much attention has been paid to Congressional hearings on steroid use among professional athletes, state legislatures are also getting into the act. Several states entertained steroid control proposals during the first half of 2005, most of them directed at high school athletes and state athletic associations. Virginia was one of four states to pass legislation intended to discourage steroid use by high school athletes and enacted the toughest penalty of any state law. Students found to have used steroids will lose their athletic eligibility for two years. In addition, administrative or teaching licenses will be revoked from teachers, coaches, or administrators who sell or distribute steroids or who fail to notify their principal or superintendent about known steroid use among students. New laws in Texas and Illinois will require schools to educate students about the dangers of steroid abuse, with the Texas law leaving the door open for future testing. Other states considered bills that would have mandated testing athletes, but none of those became law. In New Mexico, Governor Bill Richardson plans to ask lawmakers to enact random testing next year and has pledged $330,000 toward a testing program. Most states have avoided colleges and universities in their proposed bills largely because of the NCAA drug-testing program. Athletes who fail an NCAA drug test lose one year of eligibility for the first offense and two years for a second offense. ■ The Dallas Morning News Web site features an ongoing look at steroid use among high school athletes, including a series of stories that revealed use at local high schools and prompted the new legislation. Links to the series and other stories can found at: www.dallasnews. com/sports/highschools.

Migraines May Signal Concussion Damage Most athletic trainers recognize acute headache pain, nausea, and hypersensitivity to light or sound as the hallmarks of migraine headaches. Now, researchers at the University of Pittsburgh say that these symptoms can also indicate increased neurocognitive impairment following a concussion. As part of the University of Pittsburgh Sports Medicine Concussion Program, researchers divided 261 high school and college athletes who had suffered a concussion into three groups: those who showed symptoms of post-traumatic migraine (PTM) headache, those who had headaches, and those who had no headaches. Neurocognitive testing (including verbal and visual memory, visual motor speed, and reaction time tests) showed that the migraine group performed significantly 12

T&C SEPTEMBER 2005

worse than both the headache and non-headache groups. “The findings of our study strongly support the need for clinicians to exercise increased vigilance in making decisions about managing a concussed athlete with PTM and extreme caution as to when that athlete should be allowed to return to play,” said the study’s lead author, Jason Mihalik, CAT(C), ATC, a doctoral student now working in the Sports Medicine Research Laboratory at the University of North Carolina. According to the study’s authors, “Given the significantly greater neurocognitive impairments observed in the PTM group in our study, any athlete with a concussion accompanied by characteristics of PTM should be examined in a setting that includes symptom status and neurocognitive testing to address their recovery more fully. Clearly, sports-related concussion is related to increased cognitive impairments, regardless of the presence of headache. It is critical that any athlete sustaining a concussion be followed up to not only assess lingering symptoms, but also to evaluate cognitive impairments. Symptoms may resolve before their neurocognitive deficits do.” The study, titled “Post-Traumatic Migraine Characteristics In Athletes Following Sports-Related Concussion” was published in the April 2005 issue of the Journal of Neurosurgery and is the latest in a series of University of Pittsburgh Medical Center studies on concussions in athletes. A 2003 UPMC study showed that headache is likely associated with incomplete brain recovery following a concussion and indicated the need to keep athletes out of action until headache and other symptoms have cleared. ■ For previous T&C articles on concussions, go to our Web site and type “concussion” in the search window: www.athleticsearch.com.

Weighty Wrestling Rules After years of dialogue, a nationwide minimum weight requirement for all high school wrestlers will soon become a reality. In an effort to make the sport safer, the National Federation of State High School Associations (NFHS) Wrestling Rules Committee is requiring every state to implement a weightmanagement program by the start of the 2006-07 season. Under the new rules, wrestlers will be assigned a safe minimum weight based on a body fat percentage of no less than seven percent for males and 12 percent for females. Safe minimum weights will be valid only when an athlete is measured while fully hydrated (having a specific gravity measurement above 1.025 at the time of their assessment). A wrestler will not be allowed to lose more than 1.5 percent of his or her weight per week and cannot fall below his or her safe minimum weight at any point during the season. In addition, wrestlers will ATHLETICBID.COM


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Bulletin be allowed to gain only two pounds during a multi-day meet, no matter how many days the competition lasts. Athletic trainers in states that have already implemented similar rules have found themselves on the front line of efforts to keep wrestlers safe. Only trained assessors—typically school athletic trainers and area medical professionals—will be allowed to conduct the initial measurements that establish safe minimum weights. The Florida High School Athletic Association initially trained 65 medical professionals as “master assessors,” who then trained over 130 additional people as assessors throughout the state. In New Jersey, seminars were held to train area athletic trainers and medical doctors. ■ More information on the NFHS weight-management program can be found in the “Sport & Rules Information” section of the NFHS Web site: www.nfhs.org.

Caffeine & Carbs Caffeine is a familiar pick-me-up for many athletic trainers, but it may also help their athletes, according to a study conducted at the University of Birmingham in England. Researchers at the school found that putting caffeine into sports drinks raised the absorption rate of carbohydrates in athletes by 26 percent, which can provide extra energy for those competing in endurance sports, such as cycling and distance running.

“You are kind of sparing your small body carbohydrate stores,” Asker Jeukendrup, PhD, told the Associated Press. Jeukendrup is Director of the school’s Human Performance Laboratory and an author of the study. “You can get more energy from your drink, [and that] means you are using less energy from your body stores.” As part of the study, cyclists rode in three two-hour exercise sessions at 55 percent of their maximum output while consuming one of three different drinks—glucose, glucose with caffeine (five milligrams per kilogram of bodyweight), and plain water. Blood and expired air samples taken every 15 minutes showed that the cyclists consuming the caffeine drink absorbed carbohydrates faster than the others. The researchers plan further studies to determine the level of caffeine intake required to increase carbohydrate absorption and measure the actual performance increase that drinks with caffeine may produce. The NCAA bans caffeine only in large doses (greater than 15 micrograms/milliliter in urine). The World Anti-Doping Agency removed caffeine from its banned list in 2004. ■ ■ The study, titled “Caffeine Increases Exogenous Carbohydrate Oxidation During Exercise,” has been accepted for publication in the Journal of Applied Physiology and is available through the journal’s Web site at: jap.physiology.org.

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Comprehensive PES science and precision accurate assessment tools, as well as core, balance, power, integrated speed, reactive and strength training, give you the tools to help professional and Olympic athletes keep playing and keep winning. Call 800-460-6276 or visit www. nasm.org for information on courses, live workhsops, continuing education and more. “I have to be the best I can be every time I walk onto the court. NASM helps me do that.”

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World Champion Pole Vaulter Stacy Dragila

California raisins are a delicious way to add nutrition and flavor to your family’s meals. Convenient and healthy, simply toss a handful into your favorite dishes to add natural sweetness and texture. “Raisins are fat and cholesterol free, high in antioxidants, and an excellent source of energy,” says Stacy. “There’s no telling how high they can take you.”

Find delicious recipes and more about California Raisins at www.calraisins.org Circle No. 111


NUTRITION

Running on Empty A new study has found that only one out of four athletes eat enough calories to fuel their workouts and competitions. Here’s an in-depth look at the problem and possible solutions. BY DR. PAMELA HINTON magine the starting point guard on your men’s basketball team sprinting down the court for a lay-up. Extremely fit, with a chiseled physique and a strong, healthy heart, he looks like the picture of health. How would it change your perception if you knew that he routinely eats fewer calories than he needs, depriving himself of both carbohydrate and protein, and that his daily intake of fat, saturated fat, and cholesterol is off the charts? Now picture a group of female athletes from your school’s soccer team in line at the cafeteria. On their trays: a small portion of lean chicken, a giant tossed salad with low-fat dressing, and fruit for dessert. These athletes are as healthy as they look, right? What if you knew that two out of three of them will leave the cafeteria hungry after consciously restricting their food intake because they want to lose weight, that they’ll then go on to push their energydeprived bodies to the max in practices, workouts, and competitions—and that they do this day after day?

I

©KEVIN C. COX/NCAA PHOTOS

Pamela Hinton, PhD, is an Assistant Professor of Dietetics at the University of Missouri. Her previous studies have focused on iron deficiency and the female athlete triad.

NCAA PHOTOS

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NUTRITION We recently put the eating behaviors of a sample group of NCAA Division I athletes under the microscope, and our study revealed some troubling trends. While the reasons why vary between genders and across sports, we found out that the vast majority of athletes do not eat enough calories to fuel their performance. Only 15 percent of the athletes we studied consumed adequate carbohydrate, and only 26 percent consumed adequate protein. Nearly two-thirds of the female student-athletes reported wanting to lose weight, which is almost always at odds with fueling for athletic performance. Many male athletes, while falling short on overall calories, were consuming more than the recommended amount of fat, saturated fat, and cholesterol. That’s the bad news. The good news is that by simply getting athletes to commit to adequately fueling their bodies, you could see your teams quickly improve. Imagine how such a simple

composition tables, we then determined each athlete’s average daily nutritional intake, and broke this data down by sport and gender. We also asked participants to complete the Questionnaire for Eating Disorder Diagnosis to assess how disordered eating behaviors affect nutritional intake. This questionnaire addressed issues such as the athlete’s fear of gaining weight and their frequency of binge eating or purging behaviors. Based on their answers, athletes were placed into one of three categories: asymptomatic, restrictive disordered eating, or binge eating. Athletes also answered a set of additional questions regarding their sociodemographic characteristics and dietary behaviors. In this section, we asked them to report their current weight, their desired weight, and whether they used supplements or restricted their intake of carbohydrate, fat, or fluid to change their weight.

Eighty-one percent of the female athletes and 90 percent of the male athletes in our study failed to meet the recommendations for carbohydrate intake. As for daily protein needs … only 32 percent of females and 19 percent of males were getting an adequate supply. solution, which our research indicates might benefit as many as three out of four of your athletes, could prevent injuries, improve performance, and enhance well-being. Below, I’ll give a rundown of the results of our study, and follow with some analysis as to why athletes are eating the way they are. I’ll also discuss how athletic trainers and strength coaches can educate athletes, sport coaches, and administrators to help solve the undereating epidemic. OUR FINDINGS We collected data on the nutritional intakes and eating habits of 345 male and female student-athletes at a Division I university. Participation was anonymous and voluntary. To determine how the athletes’ daily food intakes stacked up against the recommendations for their gender and activity level, we asked each participant to complete a Food Frequency Questionnaire. Using computer software based on the USDA’s food 18

T&C SEPTEMBER 2005

When we analyzed our data, we discovered that a large majority of athletes in our sample were eating fewer calories than they needed to fuel their exercise. Using a formula based on energy intake per kilogram of body weight, we found 70 percent of female athletes were falling short of their energy needs. Male athletes’ energy intake per kilogram of body weight was equally inadequate, with 73 percent consuming too few calories. In the process of short-changing themselves on calories, both male and female athletes were also falling short on carbohydrate and protein intakes. The recommended intake of carbohydrate for athletes is six to 10 grams per kilogram of body weight. Eighty-one percent of the female athletes and 90 percent of the male athletes in our study failed to meet the recommendations for carbohydrate intake. As for daily protein needs—1.2 to 1.7 grams per kilogram of body weight—only 32 percent of females and 19 percent of males were get-

ting an adequate supply. For many athletes, the desire to lose weight and/or change their body composition seemed to motivate the undereating. Sixty-two percent of the female athletes in our study reported wanting to decrease their body weight by at least five pounds. For these athletes, insufficient fueling seems to be a direct result of the desire to be thinner—athletes who wanted to lose weight were more likely to report that they purposely restricted their fat or carbohydrate intake. The desire to lose weight was experienced regardless of which sport they played, and the women in our study reported that society—not peers, coaches, or parents—made them feel overweight. The desire to change body composition influences many male student-athletes’ eating behaviors as well, but the picture is somewhat more complicated. While 23 percent of male athletes reported wanting to lose five pounds, the majority of football, basketball, and baseball players said they wanted to gain weight. With football players, even though many desired to gain weight, the majority consumed significantly less carbohydrate, protein, and fat than male athletes in other sports when we took into account the football players’ larger body size. Basketball players consumed the lowest amount of all macronutrients per kilogram of body weight. These lower relative intakes were due to the combination of greater body weight and lower absolute energy intake compared to male athletes in most other sports. While they were under-eating in terms of calories, the diets of many male athletes in our study exceeded the USDA Dietary Guidelines for fat, saturated fat, cholesterol, and sodium. Lack of time to seek out proper nutrition seemed to be driving this trend, as many male athletes reported eating meals and snacks away from home. For these athletes, fat is displacing carbohydrate as an energy source, contributing to their inadequate carbohydrate intake. Nearly one in four males and one in five females reported some type of subclinical disordered eating pattern. Among males, 7.2 percent reported restrictive eating (frequently dieting or fasting to lose weight), and 16.5 percent said they had episodes of binge eating. Among females, 11.1 percent reported restrictive eating and 7.4 percent reported binge eating. ATHLETICBID.COM


“ PASSION IS SACRIFICING IT ALL SO MY ATHLETES DON’T HAVE TO.” —Mark Verstegen, coach of elite athletes

Passion – it's having a vision, quitting your job and sacrificing it all to create a training system and facility unlike any other. It’s new athletes, new challenges and new champions to build. This isn‘t just a way of life. It is my life. Through research, science and technology, EAS allows me to provide an ethical solution for my athletes to fuel their passion. I had a vision to create a multi-disciplinary team dedicated to helping professional and elite athletes maximize their potential to achieve their goals. In 1999 my vision became a reality with the opening of Athletes’ Performance in Tempe, Arizona. As president of Athletes’ Performance, I ensure that we always live up to our mantra: Improve our athletes’ performance, decrease their potential for injury and motivate them through education. As a result, our athletes come away with improved career productivity, increased career longevity, long term strategies and the confidence to succeed. Nutrition is the foundation of everything we do. The greatest training in the world would achieve nothing without the proper fuel. At Athletes‘ Performance, we seek out the finest and safest products to give our athletes the best ethical solutions to achieve their dream. We select our product partners based on three criteria: A relentless pursuit of scientifically backed, break-through products, be the best in the world at offering these products and build deep relationships between our companies. There was no doubt EAS was the best fit for our athletes, that’s why they’re our exclusive sports nutrition supplier. Together we work to provide the finest scientifically backed solutions to give our athletes the competitive edge not only in their sport, but the game of life.

At EAS we understand the no excuses, no pain-no gain philosophy. So for all you athletes and trainers out there who eat, breathe and live your sport, lucky for you, so do we. Welcome to EAS.

TRAIN WITH THE BEST. Call 1.800.297.9776 or go to eas.com for your FREE EAS Product Guide and to order EAS products. (enter dept. 5573) FUEL YOUR PASSION

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NUTRITION

A DAY IN THE LIFE The following are sample eating days of two of the 345 NCAA Division I athletes we studied. Their eating habits illustrate many of the trends our research uncovered.

Female Volleyball Athlete Weight: 140 lbs. (64 kg) Breakfast:

Lunch:

Dinner:

Snack:

1 cup Fiber One cereal 1 cup skim milk 1 cup orange juice 1 large multigrain bagel 2 Tbsp. lowfat cream cheese 6 oz nonfat coffee-flavored yogurt 3 cups mixed greens 2 Tbsp. fat-free dressing 2 small breadsticks 1 cup skim milk 1 cup lowfat Wheat Thins

Nutrient

Intake

Energy (kcal) Carbohydrate (g) Protein (g) Fat (g) Saturated fat (g) Fiber (g)

1,320 243 57 27 8 40

Recommended Intake

2,500 380-640 90 30-80 <33 25

Male Football Athlete, Running Back Weight: 250 lbs. (114 kg) Unlike 73 percent of the male athletes in our sample, this particular football player was getting adequate calories. But since much of his food intake consisted of fast food, he was also consuming nearly twice as much fat and three times as much sodium as recommended, and he was falling short on several micronutrients. Breakfast: 20 oz. bottle Gatorade 6 mini doughnuts, chocolate frosted Lunch: 1 Big Mac 1 large order french fries 32 oz. Coke 1 large chocolate shake Dinner: 1 12-inch supreme pizza, thin crust 6 breadsticks with cheese sauce 32 oz. Coke

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Nutrient

Intake

Energy (kcal) Carbohydrate (g) Protein (g) Fat (g) Saturated fat (g) Fiber (g) Cholesterol (mg) Sodium (mg) Potassium (mg) Magnesium (mg) Vitamin A (mcg) Vitamin C (mg)

6,235 824 161 260 80 24 320 8,000 2,800 300 320 18.5

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Recommended Intake

5,000 684-1140 180 55-165 <33 25 <300 2,500-3,000 4,700 400 900 90

THE CONSEQUENCES With three out of four athletes consuming less fuel than they need, what happens to their health and performance? In short, they’re more frequently ill or injured, they can’t train to their potential or recover between workouts, and they feel psychologically run-down or even depressed. And because an under-fed brain has trouble concentrating, academic performance can suffer as well. Dietary energy fuels the biological processes that allow the body to adapt to the stress of training and to recover between training sessions. Protein synthesis and the production of red blood cells are training adaptations that require energy, and repletion of muscle and liver glycogen also requires energy. Low carbohydrate intake in particular is known to hurt athletic performance. If glycogen stores are low, the ability to perform high intensity activities over time will be limited. The inability to train at high intensity will severely limit an athlete’s capacity to improve their lactate threshold, speed, and maximal strength. Without adequate carbohydrate, athletes are more susceptible to the immunosuppressive effects of exhaustive exercise and more likely to get sick. And because the brain and central nervous system depend on glucose for energy, low carbohydrate availability can cause decreased mental function and even depression. When athletes don’t get enough protein, the lack of amino acids limits the synthesis of new protein. Protein synthesis and muscle hypertrophy will be limited if protein intake is low, even if total energy is sufficient. Also, with chronic low energy intake the hypothalamicpituitary-thyroid axis is suppressed. The resulting hypothyroidism causes the following physical signs and symptoms: bradychardia, postural hypotension, delayed reflexes, and acrocyanosis. Obsessive thoughts about food are another common result when an athlete is not eating enough, leaving the athlete unable to concentrate on school or sport. A GOLDEN OPPORTUNITY Can our findings be generalized to other populations of college athletes? I believe the answer is yes. I think it’s safe to say that our major findings—that many male and female athletes are under-fueling for their activity levels, that the majority of female student-athletes desire to lose weight, and that many male athletes are over-eating on fat and skimping on carbohydrate and protein—probably apply to athletes on most college campuses. However, our results suggest that huge improvements can be made to the health and well-being of many athletes, and quite possibly to an entire athletic department’s performance, with one simple step. Athletes need to be taught that it’s essential to adequately fuel their bodies. The first step can be to address under-eating directly with athletes, and preseason meetings are a great time to bring it up. Make sure to focus on the message: “There is one extremely simple step you can take to improve your performance, and that is to make sure you are eating enough.” Using the analogy of the athlete’s body as a race car and food as fuel is a good place to start. Then follow with a brief education session on the importance of carbohydrate and protein in relation to training and performance. If you can, relate actual cases of one or two athletes whose seasons or careers were negatively impacted by inadequate energy. You want to leave athletes thinking, “I don’t want ATHLETICBID.COM


NUTRITION

SELF-ASSESSMENT

O

ne way to get athletes to improve their energy intake is by asking them to study their own behavior. Have athletes select three days—two weekdays and one weekend day—when they will be following their typical diet. Ask them to keep a written food diary for those three days. They should record what they eat, how much they eat, and how the food is prepared. Beverages can significantly affect energy and nutrient intake, so athletes should remember to record what they drink as well. In addition, athletes should log their training and/or competition information—the duration, intensity, and time of day they perform their workouts. Once the diary is complete, have athletes visit the USDA’s Web site (see address at bottom of this box), which is equipped with assessment tools to determine the quantities of calories, carbohydrate, fat, protein, vitamins, and minerals they consumed. Next, have athletes divide their weight in pounds by 2.2 to obtain their weight in kilograms. Finally, have them calculate their specific needs based on body weight according to the following formulas, and compare their actual intake to the results: • Carbohydrate: 6-10 g/kg of body weight. • Protein: 1.2-1.7 g/kg of body weight, depending on sport. Another way athletes can start to assess the adequacy of their nutrient intake is simply by paying attention to how they feel physically and psychologically. If an athlete experiences fatigue that doesn’t resolve with rest, can’t finish workouts, or has a drop-off in performance, lack of dietary energy may be to blame. If an athlete is hungry all the time or is obsessing about food, he or she is probably not eating enough. Mood changes such as depression, irritability, anxiety, and marked emotional ups and downs can also signal inadequate food intake. If these symptoms are present, advise the athlete to keep a food diary and conduct the self-assessment outlined above to pinpoint areas where he or she is under-eating. Web resource: http://mypyramidtracker.gov

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NUTRITION that to happen to me.” Working with sport coaches is also extremely important, since they have perhaps the strongest influence on athletes’ attitudes about nutrition. If the coach doesn’t send the message that adequate fuel intake is important, or if he or she pushes a weight loss message, athletes are not likely to listen to anyone else who encourages them to fuel up.

lem exists at your school, and suggest putting money into the budget for a nutritionist to work with athletes. Some under-eating athletes will likely require individual intervention tailored to treat the cause of the problem. If an athlete is restricting calories because of a strongly held belief that performance will improve if they lose weight, or if they under-eat because they are afraid

Try telling the athlete, “Let’s increase your energy intake for a couple of weeks and see how your body responds.” Then support him or her by monitoring changes in heart rate, blood pressure, reflexes, mood, and energy to provide evidence that the experiment is working. Solving the problem also means educating administrators on how under-fueling could be sabotaging your department’s success. Discuss specific solutions with them, including making a plan to survey athletes to assess whether (and to what extent) the prob-

of gaining weight, it’s important to take a cautious approach. You’ll probably get further by encouraging him or her to view increasing food intake as an experiment, rather than a permanent change. Try telling the athlete, “Let’s increase your energy intake for a cou-

ple of weeks and see how your body responds. You might be surprised to find that you don’t gain weight. You might even feel better during practices and see your performance improve.” If the athlete agrees to the experiment, support him or her by monitoring changes in heart rate, blood pressure, reflexes, mood, and energy to provide evidence that the experiment is working. Athletes who under-eat because they have trouble fitting healthy meals into their schedules need a different approach. These athletes will benefit most from practical suggestions on how they can increase their energy intake in ways that take very little time and effort. For example, packing a peanut butter and jelly sandwich and a piece of fruit to eat between classes takes minimal time and preparation. Other athletes would benefit from education on making healthful selections from fast food menus and vending machines. A sports nutritionist can be a valuable resource for this type of information. RESTRICTIVE EATERS Another risk associated with chronic

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low energy intake is that it may progress into a clinical eating disorder. Research has shown that individuals who are diagnosed with a clinical eating disorder universally have a history of chronic dieting and food intake restriction. The progression from dieting to eating disorder is influenced by many factors. For some individuals, the precipitating factor is a negative life event like a death in the family or the termination of a long-term relationship. For others, the triggering event is a negative comment about body weight or shape—often from a well-meaning coach, friend, or parent who suggests that the athlete would be more successful if they lost weight. It is not always easy to differentiate between an athlete who is a chronic dieter and one who has an eating disorder, as eating-disordered athletes tend to carefully hide their problematic behaviors. The hallmark warning sign is when an athlete is unable to correct their disordered eating behaviors even when they are clearly hindering athletic performance. In other words, when the eating disorder becomes more important than the athlete’s sport, the problem is serious. Other warning signs are isolation from teammates and friends, ATHLETICBID.COM

gastrointestinal complaints, absence from team meals, and frequent trips to the bathroom following meals. If an athletic trainer or coach suspects an athlete is struggling with an eating disorder, he or she should express concern for the athlete’s current and long-term physical and emotional health. Because athletes may resent feeling they are only valued for their athletic performance, it’s best not to fo-

and that they will not lose their athletic scholarship if they ask for help. Provide contact information for those on campus who can assist them. LOUD & CLEAR Athletes are bombarded with nutrition advice from many sources, some sound and some disastrous. Messages about how they should look and how much better they would perform if they

Another risk associated with chronic low energy intake is that it may progress into a clinical eating disorder. Research has shown that individuals who are diagnosed with a clinical eating disorder universally have a history of chronic dieting and food intake restriction. cus only on how their under-eating may compromise performance. An athlete with an eating disorder needs the evaluation and assistance of a qualified therapist, and the athletic trainer’s efforts should focus on supporting him or her in accessing that help. Reassure the athlete that their problem will be treated confidentially

changed their bodies are clearly finding them as well. At a time when so many voices are battling for athletes’ attention, it’s imperative that the sports medicine professionals they encounter provide a simple message: If you want your body to perform well and feel good, treat it right by not holding back the fuel it needs. ■ T&C SEPTEMBER 2005

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(EAT

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LEADERSHIP

… ? Questions and

Answers

Want to know how veterans in athletic training tackle their jobs, their bosses, and their lives? Your questions, and their answers, are all here. BY DENNIS READ

C

GETTY IMAGES

oaches sometimes say the best thing about freshmen is that they become sophomores. That’s because there are certain lessons that only experience can teach. Fortunately for athletic trainers, that experience doesn’t always have to be their own. During this year’s NATA Annual Convention in Indianapolis, we asked athletic trainers what advice they would like to get from those who have been in the profession longer than they have. We passed these questions on to respected veteran athletic trainers, including NATA board members and Hall of Famers. Their answers are presented below. How do you avoid burning out? Marjorie Albohm: It’s important to pace your work and always make time for yourself and family. Sometimes you actually may need to block out time in your schedule for you. The hours of athletic training are extremely demanding. You have to carefully plan your schedule and talk with your supervisor about release time before it becomes a critical issue. Mike Sahm: You have to budget your time well and learn to say “no.” If someone asks you to work late or do something extra, and you don’t have time to do it, you have to tell them “no,” even though that may be hard to do. Jenny Moshack: One of the most important things is to have balance in your life—you cannot survive on athletic training alone. You need to get out of the work environment and find some different activities—go see a play, visit a museum, go hiking, anything that takes you completely away from athletic training. Sometimes the best time to do this is while you’re traveling with a team. There’s a lot of wasted time on the road that can be used to take care of yourself. Another thing that helps is to learn as much about counseling as you can. Not only will this help your student-athletes and staff, but it will allow you to do some self exploration. Athletic training is a high-burnout profession, and if you’re not taking care of yourself mentally and emotionally, you can’t effectively take care of others. Tara Lepp: Learn to recognize the symptoms of burnout so that you can do something about it before it consumes you. Some typical symptoms are: depersonalization, which is a lack of concern for the people you work with; emotional exhaustion; and lack of personal accomplishment. In other cases, it may be your job becoming your life instead of being part of your life. Dennis Read is an Associate Editor at Training & Conditioning. He can be reached at: dr@MomentumMedia.com. ATHLETICBID.COM

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LEADERSHIP

OUR SAGES The following athletic trainers served as our panel of veterans. Marjorie Albohm, MS, LAT, ATC, is Director of Business Development and Orthopaedic Research at OrthoIndy and The Indiana Orthopaedic Hospital in Indianapolis. A 1999 inductee into the NATA Hall of Fame, Albohm is a past Vice-President of the NATA. Maria Hutsick, MS, LAT, ATC, CSCS, is Head Athletic Trainer at Boston University. Hutsick has been involved in athletic training since 1976 and has served on the NCAA Competitive Safeguards Committee. Joe Iezzi, MS, ATC, NASM-PES, is Head Athletic Trainer at Downington (Pa.) High School West. Iezzi is a past member of the NATA Board of Directors. Tara Lepp, ATC/R, is an Associate Professor, Head Athletic Trainer, and Athletic Training Program Director at Linfield College. She made a presentation titled “Strategies to Avoid Burn Out and Enjoy Work” at the 2005 NATA Meeting in Indianapolis. Justin Miller, LAT, ATC, CSCS, is Athletic Trainer for St. Vincent Sports Medicine and serves as Head Athletic Trainer at Lawrence Central High School in Indianapolis. Jenny Moshack, MS, LAT, ATC, CSCS, is Assistant Athletics Director for Sports Medicine for the University of Tennessee women’s athletic department. Moshack is entering her 15th year at Tennessee where she works directly with the six-time national champion women’s basketball program. Andy Paulin, ATC, is Athletic Trainer at Mt. San Antonio College. He is also an Athletic Trainer for USA Track and Field and the District 8 Representative to the NATA Board of Directors. Bill Prentice, PhD, PT, ATC, is Professor and Coordinator of the Sports Medicine program at the University of North Carolina. A member of the NATA Hall of Fame, Prentice serves as athletic trainer for the 18-time NCAA champion Tar Heels women’s soccer team in addition to his duties as an educator. Mike Sahm, ATC, is Head Athletic Trainer at Roncalli High School in Indianapolis. Sahm works closely with the Roncalli football team, which has won three straight state titles. Scott Sailor, EdD, ATC, is Assistant Professor in the Athletic Training Education Program at California State University, Fresno. Sailor is the NATA District 8 Secretary. James Thornton, MS, ATC, NASM-PES, is Head Athletic Trainer at Clarion University. Thornton has been at Clarion since 1990 and recently became the District 2 Representative on the NATA Board of Directors. Rod Walters, DA, ATC, is Assistant Athletic Director for Sports Medicine at the University of South Carolina. A 2005 inductee into the NATA Hall of Fame, Walters has overseen the athletic training department at South Carolina for 16 years after serving as Head Athletic Trainer at Appalachian State University for 11 years. Dan Wathen, MS, ATC, CSCS, NSCA-CPT, is Head Athletic Trainer at Youngstown State University. Wathen has been at Youngstown since 1976 and was President of the National Strength and Conditioning Association from 1998-2000.

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And then take steps to address the problems. You might have to change some of your behavior or meet with your administration to talk about changing your hours. You should also make sure you have a life outside of athletic training and take time to exercise and relax so you can maintain your health. Joe Iezzi: You have to prioritize family and work—in that order. Otherwise, you will become consumed by the profession. When I was working at the collegiate level, I tried to keep a healthy balance by being with my children at times when other fathers couldn’t. For example, I would spend some time with them before I went to work. You can also look for a job that fits your situation. For example, I went from college to high school and now I have Sundays off and don’t travel as far as I used to. I have no overnight trips orweeks away from my family. James Thornton: One of the most important ways to help prevent burnout is to educate administrators about what athletic trainers do. They need to know that the athletic training room is open at 7 a.m. for rehabs and we’re there until 10 at night. The bottom line is we have to educate our administration so they can have realistic expectations of what can and cannot get done. How can you learn to interact with higher-ups in administration? Rod Walters: You should always be professional, as this carries so much weight. Regardless of how busy you are or what the situation is, be poised and communicate well. In addition, always maintain ethics, as this is what guides us and keeps us doing the right things. Jenny Moshack: One of the challenges in our profession is that no one teaches you how to be a supervisor. Instead, an administrator recognizes that you’re very good at your job, you’re promoted, and suddenly you’re a supervisor and a manager. My advice is to take advantage of human resources courses that are offered within your institution, whether they’re on time management, efficiency, leadership, or supervision skills. A lot of these courses also explain the inner workings of the university and help you speak the language of your administrators. Once you start speaking about budgets, hiring and firing, management of people, and performance reviews in their language, you’ll be operating on the same level as those administrators. ATHLETICBID.COM


LEADERSHIP James Thornton: The main thing is to act like a medical professional, because that’s what you are. When you act professionally, it is much easier to approach and interact with administrators. To do this, you also have to truly think of yourself as an administrator. Once you’re comfortable with being an administrator, approaching other administrators will be much easier. Maria Hutsick: Find someone who is willing to mentor you, which can be your Head Athletic Trainer, an athletic trainer at another school, or even a coach or athletic administrator. Call them when you have a question and discuss it with them. People are very willing to offer advice or share their experiences. I looked up to the older athletic trainers in my conference and always called them when I had questions. I also got involved with the NATA on a national level and then with CATS. The people I met mentored me and taught me how to operate in a political realm. How do I know what products to buy and where to buy them? Jenny Moshack: So much of purchas-

ing depends on university rules, but the biggest thing you can do is establish relationships with vendors. Those folks can often lead you in the right direction and really work with you, whether that means giving you a deal or taking shipping charges off your orders. Once you find vendors who are good to you, you’re golden.

what works and what doesn’t. James Thornton: A lot of it is dictated by budget, as well as bidding processes that athletic trainers have no control over. If athletic trainers want a specific brand of product and have to send it out to bid, then they must spec out that product and make sure that it cannot be replaced or substituted with

“Take advantage of human resources courses that are offered within your institution ... They can explain the inner workings of the university and help you speak the language of your administrators.” – Jenny Moshak Keeping up with all the products out there can be difficult, but if you pay attention and talk to people you might see something different at another institution that works better. It might be something as simple as good ice bags that never leak. Your colleagues can serve as your product testers and let you know

something else. I make a lot of the decisions about who I ask to bid based on whether or not they are involved in the development of my profession. The NATA is there to promote the profession of athletic trainers, so I support companies that support the NATA.

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LEADERSHIP Apart from working at a college athletic department, what other career options should athletic trainers consider? Bill Prentice: Right now there’s so much diversity in job opportunities for athletic trainers. There are many opportunities in high schools, which can be better places for athletic trainers in terms of pay and the number of hours that they’re required to work. Many athletic trainers are also working in sports medicine clinics, in the military, and in private medical offices as physician extenders. There are also a lot of possibilities in education, because the number of accredited programs is growing and there’s a need for faculty members. Most institutions are looking for people who have

portunities or go to grad school and see if one setting fits them as far as interest and commitment and family. Some people say they couldn’t work in a clinic 9to-5 because they have to be out on the field with a team. Others don’t want to be on the field and working nights and want to be in a clinic working one-onone with patients. Explore what options work for you. Justin Miller: Don’t be too picky when you’re looking for a job and think you have to work in one particular setting. Go out and get the job that seems most interesting. Then you can get some experience and have a better idea of exactly what settings you like. And if you have an interest in working at the high school level, get your teach-

“Today’s athletic trainers need to think of themselves as time managers ... The key is to figure out, ‘This is something I really need to take care of, and that is something I can let slide a little bit.’” – Bill Prentice a terminal degree, either an EdD or a PhD, but right now there’s not enough of those individuals. So many institutions are hiring individuals who have a masters degree to function as a program director and encouraging them to seek their terminal degree in the future. Marjorie Albohm: I’ve been in a clinical setting, specifically a physician-owned orthopaedic practice, for 23 years. Although there will always be things that I miss by not being in an academic environment, I have learned so much about the business of health care and have grown so much personally and professionally. As a senior administrator, I am in a key decision-making position that allows me to develop clinical models for athletic trainers that can be shared nationwide. Joe Iezzi: When I came out of school, there was basically the collegiate level and maybe the pros. Now there are so many other options, such as high schools, physician extenders, sports medicine clinics, and different sports such as rodeo and auto racing. Or you could be an entrepreneur and start your own business. If people aren’t sure what they would like to do, they can observe different op28

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ing license. It will make getting a job that much easier. How do you learn to manage your time? Bill Prentice: Today’s athletic trainers need to think of themselves as time managers. It’s critical to establish priorities based on doing the job you’re hired to do. The key is to figure out, “This is something I really need to take care of, and that is something I can let slide a little bit.” Marjorie Albohm: Organizational skills are critical to time management. That means organizing your work place and your schedule. You also must try to manage and minimize interruptions. That’s difficult for athletic trainers, but we really don’t have to be everything to all people, all the time. Jenny Moshack: I think the biggest thing is setting up a system. We’re always going to have things that interfere with our time, like emergencies and practices that get rescheduled. But you still need to plan as much as possible. There are athletic trainers out there who are more than willing to share information about their written policies and procedures, or talk about how they do things. See what

fits within your system and then tailor that plan to work for you. It’s also important to use time as productively as possible. I take my laptop to practice so I can get some work done while the team is watching film or before they start practice. This way I’m being productive, instead of sitting there waiting for them to come out of the locker room. Andy Paulin: I was once told, you can’t “manage time,” it marches on whether you are ready or not. I have found you must start your day with a few quiet minutes to prioritize your day, and rate your tasks A, B, or C. Then you’ll have a much clearer picture of your day and your ability to manage your tasks, not time. Maria Hutsick: I learned to delegate my duties and work on eliminating those tasks that really don’t belong in a healthcare setting. I listened to The Seven Habits of Highly Effective People, which gave me a framework in dealing with people and setting my own goals. I also follow the One Minute Manager, which helps me manage staff, students, and coaches. When it comes to rehab and strength training, are there simple exercises that are just as effective as those requiring elaborate machines? James Thornton: Weight machines often isolate individual muscles and have an athlete work out in the sagittal plane only. We use multi-planar exercises such as single-leg squats or lifting and chopping movements in the front, sagittal, and transverse planes. These are drills that require nothing more than dumbbells, and they are specific to the way athletes move every day. I do not recommend using machines for isolated strength movements because increases in strength don’t always result in increases in performance. An offensive lineman who improves his bench press by 30 percent can still fail when he’s standing on two feet and trying to push back a defender. I’m going to train a lineman standing up using tables or pulleys so he can activate other musculature in his body in different planes of movement and increase his performance and not just his strength. Young athletic trainers who are looking to supplement the wonderful education they get in our curriculum programs should look at the National Academy of Sports Medicine’s PerATHLETICBID.COM


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LEADERSHIP formance Enhancement Specialist certification. I think it’s the single most effective course for showing how to take advantage of exercises that do not require a lot of equipment. Bill Prentice: We are really getting away from using elaborate machines. We have found that when you’re performing athletically you have to be able to adjust and adapt to a variety of different forces and stresses coming at you from all different angles, and you have to be able to balance yourself while doing that. If you’re working on a weight machine, the design constraints limit what kind of forces you have to exert and it doesn’t simulate a real-life situation. For example, one of the things that everyone is doing right now is core stabilization. Instead of putting athletes on a machine for a resistance exercise, we

our profession is going. I see more evidence-based decision making now, which is refreshing and less frustrating to those of us who always think about why we do things the way we do. Maria Hutsick: I would like to see the next generation of athletic trainers continue to build the profession into a strong and well-respected vocation. This means we must continue to play an important role in the health and welfare of the athlete. We also need to keep educating administrators that our profession helps keep them out of the courts and is a vital part of an athletic department. As this happens, they will start to pay us more money and allow us to work more humane work schedules. However, we have to continue to demand respect and maintain a high level of professionalism, which includes

“I see more evidence-based decision making now, which is refreshing and less frustrating to those of us who always think about why we do things the way we do.” – Dan Wathen have them working on a ball in multiple planes using a variety of different types of resistance simultaneously. They have to balance and maintain some postural stability while they’re doing those exercises.

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What direction would you like to see the profession of athletic training go in? Rod Walters: I am so proud to be an athletic trainer. I want to see this profession continue making a positive impact in the healthcare arena. Athletic trainers are key components of the entire healthcare team—and I only want to see this continue to improve. Andy Paulin: I strongly support the path we are taking in creating jobs and placing certified athletic trainers in environments where they have never been before. I also support the more formal educational process that is in place. What I would like to see is a little more of what the quality internship programs used to do—really expose students to the good and bad of all of the clinical rotation sites and show them more about what is not in the textbook. Dan Wathen: I like the direction that

not taking jobs that pay less than an unskilled laborer would make. Scott Sailor: I want athletic trainers to continue to gain recognition for the outstanding contribution we make to the health care of society. I also want to see athletic training salaries fall in line with the high level of training we possess. I believe this is occurring and will continue to get better as the profession continues to grow. How should functional screening be used in return-to-play decisions? Dan Wathen: Functional testing and screening is just one element of the return-to-play decision-making process. But it is a critical element, as no matter how well an athlete is doing clinically, they must be able to perform functional activities that are germane to their sport prior to being cleared. Scott Sailor: I believe the athletic trainer is the individual best suited to evaluate athletes regarding return-toplay decisions. We will constantly consult with the individual’s physician but no other professional is as well-versed in the demands of activity as we are— ATHLETICBID.COM


LEADERSHIP especially athletic activities. Other rehabilitation professionals often lack the biomechanical background and kinesiological preparation of the athletic trainer. Jenny Moshack: First, make sure you establish functional screening criteria with your physicians. Will they leave the decisions up to you or do they need to be involved? Do they want some isokinetic testing to back anything up? The biggest things are getting as sportspecific as possible and not letting athletes go full-bore in practice too early. Get them into controlled practice situations first and go slow. For example, have them do every other drill instead of every drill. Then keep an eye on them, and if it looks like they’re in pain, pull them.

also try to bring a sense of humor to most situations, which allows me have fun and bring joy to others. Maria Hutsick: I learned that if you have a good staff and a good administration, then the job is what you make it. Who you work for can be more important than how much money you make. The number one thing I say to a

How do you continue to make the job exciting? How do you have fun? Dan Wathen: For me, it’s always a challenge to keep abreast of new findings in the field and then to educate those I work with and for about those findings. Our profession, like others, is a journey to seek truth. That’s exciting to me. I

young person is to pick a place to work where the head athletic trainer is interested in developing their assistants and will fight for them. If those things are in place, athletic training is an exciting and very rewarding profession. I enjoy working with the athletes and my staff and watching

younger athletic trainers develop. To keep it fun, I try to stay current, challenge myself, and look for new ways to stay in step with the profession. Scott Sailor: I have fun by trying to learn new things every day. I constantly look for ways to get better at my job. One of the great things about athletic training is that it’s so practical. It’s great

“I learned that if you have a good staff and a good administration, then the job is what you make it. Who you work for can be more important than how much money you make.” – Maria Hutsick to find out something new and then use it to help someone else. Mike Sahm: You always have to be ready to learn in this profession, because there’s always something new. Either you’re moving ahead or falling behind, and it’s more fun to be moving ahead. ■

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OPTIMUM PERFORMANCE

Ready to Lift? In order for athletes to get the most out of their strength training, their muscles need to be prepared beforehand. One way to do that is through a new technique called movement prep.

GETTY IMAGES

BY GRAY COOK & AARON TAYLOR

H

ow do your athletes warm up before hitting the weightroom? For years, coaches asked that they perform static stretches—bending and stretching while sitting and standing. Other coaches have used a general warmup, with the idea of simply getting the muscles moving. But neither approach is truly in your athletes’ best interests. Getting athletes ready for intense activity is not just about stretching, nor is it just about warming up the body. For your athletes to get the most out of their weightroom workout, they need to use a more integrated approach. In response, we have developed a group of movements that we call movement preparation (or movement prep) to ready the body for intense activity. In our work with athletes, movement prep

ATHLETICBID.COM

has replaced the terms “warmup” and “stretching,” not by deleting them but by embracing them and pulling them into an integrated system. EMBRACING INTEGRATION To start, let’s look at the limitations of performing just a general warmup before working out. A general warmup may get the cardiovascular system prepared for exercise, but it does not take joints to their extreme range of motion. It also does not check functional mobility or challenge functional stability. Nor does it indicate whether a joint or muscle is stiff, if a lingering injury is flaring up, or if the athlete seems off-

balance for whatever reason that day. And what’s wrong with static stretching to get ready for weightlifting? Stretching may increase muscle length, but it does not ready the neurological system for intense activity. Isolated stretching works on one simple movement pattern, but lifting a weight involves complicated movement patterns. Pre-activity warmup and stretching are still necessary, but they must be woven into neuromuscular activities that prepare the body on a much higher level for functional activity. The main idea of movement prep is to let go of isolation and embrace integration. As an example, think about how yoga

Gray Cook, MSPT, OCS, CSCS, is Clinic Director and Aaron Taylor, MS, LAT, ATC, is Sports Medicine Coordinator at Orthopedic & Sports Physical Therapy, Dunn, Cook, and Associates in Danville, Va. Cook is also the author of Athletic Body in Balance, published by Human Kinetics. For more on movement prep, go to: www.functionalmovement.com. T&C SEPTEMBER 2005

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Figure One: Hip Flexor Stretch with Chop Motion works. In yoga, the athlete does not simply stretch one muscle group at a time. One muscle group in a particular yoga posture or movement may feel a slightly greater stretch than other muscles, but that is not the focus. The focus is the posture or the pattern of movement. So what goes into a movement prep exercise? Simply put, there are three areas covered in every exercise: stabilized static stretch, dynamic movement with stabilization, and balance drills to address left-right symmetry. The stabilized stretch helps increase muscle length and basic posture and pattern proficiency, the dynamic movement

BEFORE LUNGING Many workout programs incorporate the lunge, which strengthens the muscles of the core, hips, and legs. It is a simple exercise, but a very dynamic one. The abdominal muscles and hip flexors must be warmed up and working together to get the most out of this exercise. Here are two movement preps we use to get ready for the lunge: Hip Flexor Stretch with Chop Motion: This is a stabilized static stretch, which engages the core, stabilizes the pelvis, and lengthens the hip flexors. When doing a lunge, the hip flexors will often try to assist or compensate

Simply put, there are three areas covered in every exercise: stabilized static stretch, dynamic movement with stabilization, and balance drills to address left-right symmetry. functionally prepares the body for complicated movements, and the balance drills ready the athlete for using both sides of the body as well as red flag any posture problems. In all, movement prep will enhance the mobility and stability needed to execute movements with greater control, strength, power, and balance. In the remainder of this article, we provide specific movement prep exercises to be accomplished with specific lifts: the lunge, squat, and deadlift. For all three, the goal is to provide a preparatory exercise that engages the core and readies the athlete for the specific movement pattern of the lift. 34

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where the abdominals should be working. Movement prep for this motion ensures that hip extension and core stabilization work together. It enhances core stabilization while improving the hips’ ability to extend. This movement prep also provides an excellent way to compare left and right function and target the weaker side prior to exercise. (See Figure One, above.) Instructions: The hip flexor move begins with one knee down and the other foot in front in a half-kneeling position. You hold a stick in front of you, in line with the down knee and an arm’s length away. Your base should be narrow, with legs no more than six inches apart. While

Figure Two: Static Stretch with MedBall Chop holding the stick with both hands, push down in a chopping motion at an angle away from the front foot. This will engage the core and stabilize the pelvis. Rock forward while continuing to hold and put pressure on the stick. Hold the stretch for 10 to 15 seconds, then return to an upright position. Verbal cues: • Maintain a tall spine. • Look forward throughout the entire movement. • Maintain a narrow base. • Exert pressure on the stick before and throughout the stretch. Static Stretch with MedBall Chop: This prep exercise is a dynamic movement with stabilization. It will improve static and dynamic balance reactions for lunge-related activities. The quick movement of the medicine ball chop pass stimulates stabilization reactions within the core. Requiring the half-kneeling position to be maintained provides the stretch, and the movement provides an excellent way to compare left and right function and target the weaker side prior to exercise. (See Figure Two, above.) Instructions: Get into the same narrow half-kneeling position as the first movement. Using a medium to light medicine ball, throw a bounce pass to a partner. This movement should follow a chop pattern, starting from a point above one shoulder and finishing by the opposite hip. Make 10 to 12 passes to a partner and have the partner return the passes in the same direction. Catch the medicine ball at the top of the arc and immediately pass the ball back. Try and pick a spot on the floor for the mediATHLETICBID.COM


OPTIMUM PERFORMANCE cine ball to hit so that the bounce is the same each time. Speed up the delivery every two to three passes and try to increase the height of the bounce. Verbal cues: • Maintain a steady and consistent position throughout the movement without any collapse in the pelvis. • Keep the front knee in a straight, up position without letting it collapse. • Maintain an erect spine and move the arms in a diagonal pattern.

©2005 Life Fitness, a division of Brunswick Corporation. All rights reserved. Life Fitness and Hammer Strength are registered trademarks of Brunswick Corporation. USV-044-05 (07.05)

SOLID SQUATS To effectively perform a squat, an athlete’s hips need to be ready for deep range of motion, and the knees, ankles, and feet also require a warmup. In addition, the core must be prepared to balance and support weight. To warm up for this lift, we have our athletes complete two very different prep exercises: Acro Roll Out: This is a dynamic movement with stabilization, which promotes bilateral hip extension in the presence of an actively stabilized core. Having an athlete roll out on Acro wheels stimulates balance and core reactions to stabilize the pelvis while the

hips go through the range of motion required of squatting movements. (See Figure Three, at right.) Instructions: Start in a quadruped position with knees shoulder-w idt h apa r t. Toes should be pointing down and hands a little wider than shoulder width. Hips should start over the heels with hips and knees in a flexed position. Slowly roll forward with the Acro wheels while maintaining hand- and arm-width positions and lower your hips to neutral or 0 degrees. Keep toes pointing straight down. Return to start position. Verbal Cues: • Maintain a tall and erect spine without any lag at the hips or core. • Keep shoulders and scapula movement within position.

Figure Three: Acro Roll Out • As movement improves, let arms increase flexion while taking the hips to neutral position. Squat with Tubing: This is another dynamic movement with stabilization. The tubing assists in two ways with movement prep for the squat. First, the anterior weight shift supports the tech-

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OPTIMUM PERFORMANCE

Figure Four: Squat with Tubing nique by stimulating plantar flexion and hip and knee extension. Second, the adduction creates a need for enhanced glute medius activity. (See Figure Four, above.) Instructions: Place the points of attachment of the tubing (Lifeline FMT) at knee-height and spread the handles about the size of a door-width apart from each other. Then give the band a twist so that the tubing crosses in front of you. Step inside and face the point of attachment. Position the foam handles at the outside of your knees. Point your toes straight ahead with your feet shoulder-width apart. Start your squat.

size of the lift over time, working toward doing a squat with the heels flat. • To increase difficulty, keep moving back to create more resistance. LIVELY DEADLIFTS We often ask our athletes to perform single-leg, single-arm dumbbell deadlifts, which require intense balance and spine stabilization. Our movement prep activities for these deadlifts involve athletes balancing on one leg while lengthening the hip muscles. We also use the movement prep activities to look closely at left vs. right side strength discrepancies. Here are the two exercises we use:

In this exercise, the stick creates feedback for spine stabilization while the single-leg stance requires intense balance reactions by the hip internal and external rotators as well as the adductors and abductors. While pushing your knees down, keep feet flat, and cross your arms over your chest. As you descend, keep your heels down and go as deep as you can comfortably go. Then return to the standing position. Verbal Cues: • Keep the line of your spine parallel to the line of the lower leg (tibia) and keep your knees over the outer half of your feet. • Do not let your heels rise off the ground. • If unable to go completely down, use a heel lift and slowly decrease the 36

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Bend with Stick: A balance drill to address right/left symmetry, in this exercise, the athlete bends over on one foot while holding a stick across his or her spine. The stick creates feedback for spine stabilization while the single-leg stance requires intense balance reactions by the hip internal and external rotators as well as the adductors and abductors. This is also an excellent way to compare left and right function and target the weaker side prior to exercise. (See Figure Five, above.) Instructions: Start in a standing upright position while holding a dowel or

Figure Five: Bend with Stick stick in both hands behind you or slightly off to one side. You will raise the opposite leg. Place one hand (still holding the stick) behind the neck with the palm facing the body. Position the other at the lumbar area with the palm facing away. In one motion, balance on one leg and flex forward (without rotating) while raising the straight leg and keeping the toes pointed up. For the down leg, the knee should be slightly bent. Four points of contact should be maintained: the back of the head, between the scapulae, the hips, and the calf. Then return to the upright position. Verbal Cues: • Maintain a straight line from head to toe on the up leg. Only go as far as you can while maintaining a straight line. • Concentrate on sustaining the points of contact. • Keep the knee of the down leg slightly bent. Tubing Deadlift: This exercise is another balance drill to address right/left symmetry. Here, we are mimicking a single-leg deadlift with little weight, using elastic resistance instead of a dumbbell. By adding the tubing resistance to the deadlift, balance and stability mistakes are quickly detected prior to exercise. The tubing also creates greater rotational force, which enhances stabilization and targets the core for single-leg stance activities. As with the previous exercise, it also provides an excellent way to compare left and right function and target the weaker side prior to exercise. This same move can also be done with a dumbbell. (See Figure Six, above right.) ATHLETICBID.COM


OPTIMUM PERFORMANCE Instructions: Place the tubing (Lifeline FMT) at a low attachment point. Loop the tubing around the shoulder that is above the down leg. Place the same-side hand on the lower back to help maintain a nice arch while doing the single-leg deadlift. Standing upright, grab the handle of the tubing with the opposite hand. This will create a rotational force, so it is important to maintain good posture throughout the movement. Keep shoulders parallel to hips by not letting the shoulders rotate out. Rotate forward in the same fashion as in the single-leg forward bend by keeping the body in a straight line from head to toe with the down knee slightly bent. Verbal Cues: • Keep the body as tall as possible throughout the movement. • Descend only as far as this posture allows. WHEN & HOW While these movements are meant to prepare the body for three fundamental lifts—the lunge, squat, and dead lift—they don’t all have to be done be-

fore strength work begins. They can be performed either as a single set of preparation prior to activity or as a superset between activities. Either way, they will reinforce and improve technique for the lifts. Movement prep exercises also give the coach and athletic trainer an opportunity to observe movement problems, limitations, and restrictions prior to intense exercise or heavy loading. In many cases, movement prep can temporarily become the workout until a movement pattern is corrected or improved, at which time more functional movement or greater load can be added. These movements are effective because they are an extension of corrective rehabilitation exercises that specifically

Figure Six: Tubing Deadlift focus on the neuromuscular system and the correction of movement patterns. They do not just isolate specific muscle groups. Instead, they integrate stretching, movement patterns, balance, and core work into quick and easy exercise patterns that any athlete can benefit from. ■

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Are you prepared for concussions?

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TREATING THE ATHLETE

Point of No Return When an athlete suffers a career-ending injury, the rehab process takes on a different meaning. At Cal State Fullerton, a team approach guides athletes both physically and psychologically.

GETTY IMAGES

BY LAURA SMITH

F

or some athletes, it happens in an instant—one misstep, one quick twist, one bad break. For others, it’s the end of a long, hard road— multiple injuries, a series of surgeries, months spent working and waiting. Either way the final diagnosis is hard to take: “Career-ending injury.” Injuries that take away an athlete’s ability to play his or her sport are statistically rare. But sooner or later, most athletic trainers encounter one, and it turns the rehab process on its head. The usual driving force behind an athlete’s rehab—returning them to the sport they love—doesn’t exist. Returning the athlete to functionality and a good quality of life becomes the goal, and the ATHLETICBID.COM

focus shifts to helping him or her cope, not only with the injury, but also with the grief of a huge loss, a life change, and a reorganization of identity, goals, and dreams. Perhaps more than in any other situation, helping an athlete navigate a career-ending injury means treating the whole individual. At California State University-Fullerton, that challenge is taken on by a seasoned team. Julie Max, MEd, ATC, Head Athletic Trainer, contributes 20 years of experience and a holistic approach to physical and psychological treatment. Ken Ravizza, PhD, Professor of Sports Psychology and a mental skills training consultant, lends his deep knowledge of athletes’ inner experiences. And Amanda Rice, ATC, a

graduate assistant in Sports Psychology, draws on perspectives from both fields. From making the determination that an injury is “career ending,” through the process of physical and psychological rehab, we’ll take a close look at how these three experts collaborate to help athletes who won’t be coming back. MAKING THE CALL Whether an athlete has a sudden, severe injury or a series of injuries that resist treatment, recommending the end of a competitive career is a step that Max takes with extreme caution. It’s also a Laura Smith is an Assistant Editor at Training & Conditioning. She can be reached at: lsmith@MomentumMedia.com. T&C SEPTEMBER 2005

39


TREATING THE ATHLETE decision she never makes alone. “Before we label an injury careerending, we make sure we’re very, very certain,” Max says. “‘Career-ending’ means that even if the athlete leaves this institution, they can no longer compete in their sport. It’s over. This is a very big decision to make, and we believe the only safe way to make it is with a team approach.” In addition to Max, the Cal State Fullerton decision-making team involves the student-athlete, the attending physician, the coach, and often the student-athlete’s parents. As the head athletic trainer, Max is usually the group’s leader. “I spearhead the decision-making process because I’m the one who sees the athlete on a daily basis, and I’m closest to the situation,” she says. “Coordinating collaborative efforts is part of my daily job description, so I know how to do it effectively. And the athletic training office is a natural nucleus where information can be centralized because

pletely understands the athlete’s injury and that he or she is not pushing the athlete in an inappropriate direction.” The challenges behind the decision can vary depending on whether an athlete’s career ends suddenly with a single injury or gradually with multiple events or an unsuccessful rehab. “I have an example of each scenario on my desk right now,” Max says. “We have a female tennis player who sustained damage to three disc levels in her back at once. It was immediately obvious to us that her competitive tennis career was over. “Then we have a wrestler whose career has ended in a very different way,” Max continues. “He underwent three different shoulder surgeries and has been attempting to rehab over a series of months. When he injured himself the last time, it became clear that it was not appropriate for him to continue to wrestle.” For Max, the decision to recommend the wrestler end his career was easier to

“Much of an athlete’s identity comes from their physicality: ‘I am a strong person. I am a fit person.’ We work within the specifics of their injury to find an exercise routine they can do. They need to sweat and put in the effort they are used to, and doing that will connect them back to their body’s competence.” I’m in touch with our team physician and coaches daily.” As the hub of the decision-making team, Max attends doctor’s appointments with the athlete or calls the doctor afterward so information doesn’t get misinterpreted or lost. She also makes sure that multiple medical professionals—team doctor, orthopedic surgeon, neurologist, and general practitioner— are able to share information easily. She facilitates conversations between the athlete and the coach, explains to the athlete in lay terms what is going on with their body, takes calls from parents, and makes sure everybody’s questions get answered. Rice says it’s especially important to involve the coach in the decision to end an athlete’s career. “A coach who isn’t fully aware of what is happening medically can negatively influence the athlete,” she says. “For some athletes, the opinion of the coach can be intimidating. It’s imperative that the coach com40

T&C SEPTEMBER 2005

make. “There was a lot of data adding up over a long period of time, all pointing to the fact that this was the right decision, and that makes it easier for the athlete to accept,” she says. “With a sudden injury, it’s harder for the athlete to believe that one event has ended their career. They want to believe they’ll be the one case that actually comes back. These are harder to deal with in the decision phase, and fortunately, they’re much more rare. The key is to rely even more heavily on the team approach and take extreme caution.” In either case, the attending physician ultimately has the final say on ending an athlete’s career. However, at Cal State Fullerton, more often than not, it’s the athlete who decides it’s time to stop. That’s an important step, according to Rice. “All their lives, athletes have been in control of their athletic success,” she says. “They’ve fixed problems by training harder, eating better, practicing

more, or working hard at rehab. With a career-ending injury, they’re faced with a situation where none of those things is going to help, and they suddenly feel very out of control. We give them as much power as we can in the decisionmaking process to help ease that feeling. “Of course, we don’t hesitate to offer our opinion when we believe returning to play is not the best thing,” she adds. “But we’re patient, and whenever possible, we allow the athlete to reach the decision on their own.” PSYCHOLOGICAL CHALLENGES Once the decision has been made that a Cal State Fullerton athlete’s career is over, Max relies on a collaboration between her staff and Ravizza to help an athlete deal with both the physical and emotional trauma. However Ravizza stresses that, although he is the sports psychologist, Max is really the one who takes the lead in helping the athlete heal psychologically as well as physically. “Julie’s role on the mental side is crucial because athletes know her and trust her, and she is the one who sees them day in and day out,” he says. “When I see her working with these athletes, the empathy she shows is amazing and that is what’s needed the most.” Max is careful to watch for times when an athlete needs more psychological expertise than she can offer. “I understand my boundaries, and when I see that an athlete is struggling, becoming depressed, or in any way needs more help than I can offer, I go straight to our experts, Ken and Amanda.” Every athlete who endures a careerending injury has a unique experience and reaction, but there are several common threads that most face in dealing with the psychological aftermath. These are the issues that Ravizza, Rice, and Max see arising most often, along with some solutions that have worked for them. Grief and loss. “We see the same stages of grief among most athletes: disbelief, denial, anger, bargaining, depression, and acceptance,” says Ravizza. “We used to believe that the stages occurred in that order, but we’ve found that athletes actually bounce around. One day they’re angry, one day they’re in denial, the next day they seem to have accepted it, and the day after that, they’re angry again. But these distinct emotions are all there at some point.” “When I first came to this profession ATHLETICBID.COM


TREATING THE ATHLETE and heard about the stages, I was skeptical, but they really happen,� Max agrees. “As athletic trainers, we put a lot of effort into learning to recognize the stages of grief and being sensitive to what an athlete is feeling on a given day. We also talk with the athlete about these common emotional reactions so they understand that their feelings are normal, and we’re not afraid to address the athlete’s feelings directly. If an athlete comes in and seems very angry, for example, we’ll ask them about their anger.� Educating the athlete about the stages has an added benefit. “Even if they can’t process what you’re saying right away, they’ll recall it later when they run into one of the stages, and that will help them,� Ravizza says. Identity crisis. When an athlete’s career ends, his or her sense of self is almost always thrown into chaos. “During their identity-forming years, they were probably deeply immersed in the athletic world,� Ravizza says. “Their sport is deeply woven into their sense of self. Being very competent in this one area is what has supplied them with a lot of their confidence and self-

esteem. When that gets ripped away, it’s very traumatic.� Again, acknowledging what is happening and why is the first step to helping the athlete deal with his or her feelings. “I sit down with them and explain how identity gets formed and why they suddenly feel so lost,� Ravizza says. His next step is to help the athlete understand that the parts of their personality that made them so successful at their sport are still there, even though they aren’t using them to compete. “They are still the same person with the same drive, dedication, competitiveness, and competence,� Ravizza says. “My job is getting them to see that they don’t have to lose those things— they can apply them to other areas of their lives. I’ve seen many athletes, once they can no longer play, focus their energy on their academics and discover that they can achieve things they never thought possible.� Also, Ravizza and Max pay special attention to keeping the athlete as active and fit as possible. “Much of an athlete’s identity comes from their physicality: ‘I am a strong person. I am a fit person,’�

Max says. “We work within the specifics of their injury to find an exercise routine they can do. They need to sweat and put in the effort they are used to, and doing that will connect them back to their body’s competence and help them feel like themselves.� Loss of social supports. “When an athlete’s career ends, all their major relationships shift,� Rice says. “Their teammates were their closest friends. Now they’re not a member of the team in the same way, and they often feel like they’ve been cast out of the group just when they need support the most.� Disconnection from the coach can be the most painful relationship shift. “We see the gamut of responses from coaches when an athlete’s playing career ends,� Max says. “Some are very supportive and stay involved, and others treat the athlete as if they no longer exist.� When a coach drops contact with an athlete, Max believes it’s her job to intervene. “It’s a delicate balance, but I will speak discretely to the coach and bring his or her attention to the fact that the athlete is having difficulty with how they are being treated,� she says.

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TREATING THE ATHLETE “I’ll point out that the athlete is going through a crisis and let the coach know that his or her behavior is counter-productive to the healing process. Sometimes the coach isn’t aware of what they’re doing and appreciates the heads-up.� Ravizza also addresses the issue with coaches. “I encourage them to make sure they are at least touching base with this athlete,� he says. “I know they have tight schedules, so I’ll ask them to schedule one day a week where they are going to make contact with two athletes on their roster who are not playing, and the athlete whose career has ended is definitely on that list.� Max also works to find a role the athlete can still fill on the team. “They can be a team manager, an academic mentor, or a psychological support person,� she says. “We’ve had athletes who contributed by keeping stats, stuffing envelopes, and doing PR for events. We try really hard to get our coaches to include them. “For many athletes, still being able to contribute helps the healing process, but for others, being around the sport

is too difficult,� Max adds. “Someone who was a point guard may not want to play the role of video manager. We encourage them to do whatever is going to be best for them.� In some instances, Max and Rice become the center of the athlete’s suddenly smaller social network. “Sometimes, we’re the only people who understand what they’re going through,� Rice says. “So we make sure we always listen deeply and never turn them away.� MAINTAINING MOTIVATION After the decision has been made that an athlete will not return to play, the physical rehab continues nearly unchanged. “We don’t alter much,� Max says. “Our goal is still to get the athlete back to full functionality. I take just as much pride in restoring them to a good quality of life as returning them to play.� On the positive side, one thing that usually does change is the pace of rehab. “Once the decision has been made to end their career, the pressure is off for my staff to get them better as quickly as possible,� Max says. “For the athlete,

the pressure is off to drive themselves in rehab. We can allow the body to heal on its own timetable, and that can be a relief and an advantage.� A less positive change in rehab, however, can be a drop in motivation on the athlete’s part. This is particularly true when the athlete has been dealing with injury and rehab for a long time prior to the decision to end his or her career. “Once an athlete no longer has the goal of playing again, a drop in motivation is common and understandable,� says Ravizza. “But it’s important to eventually find a way to motivate them again so they can rehab as best they can for the rest of their activities.� Rice, Max, and Ravizza all believe setting goals is the key to motivation, and when competing is no longer the objective, they help the athlete set new goals that are specific, measurable, and meaningful to the athlete. “Goal setting is another opportunity to put the athlete back in control of what’s happening to him or her,� Rice says. “We have them sit down and write out their goals, focusing on things that are important to them. When motivation drops, we re-

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TREATING THE ATHLETE visit those goals. We’ll say to an athlete, ‘You said you wanted to be running by week eight, and it’s week six. You have two more weeks to reach your goal, and here is what you need to do.’� Motivation comes from seeing results, so Ravizza also focuses on helping the athlete assess progress realistically. “One of the biggest problems is that athletes are often comparing themselves to where they were before the injury,� he says. “If an athlete is spending all their time thinking, ‘I used to be able to slam dunk a basketball and look at me now,’ they’re not going to be able to see that being able to walk to and from class without pain is progress. So I keep reminding them to compare how they are doing today to how they were doing the day after their injury, not the day before.� Because these athletes are vulnerable and dealing with a huge loss, it’s important to know when to push and when to back off. “We keep in close contact with the athlete and watch their mood,� Rice says. “Sometimes they simply need a vacation. Coming into the athletic training room day after day, seeing athletes who are still playing, is wearing. When we

sense they need it, we tell them, ‘Take three days off and go do whatever you want. But don’t forget to come back.’� SILVER LINING When an athlete whose career has ended has had some time to adjust and is ready to hear it, Ravizza presents an-

tle time, I was able to redirect my energy into academics, and I went after a PhD the way I had been going after a football career. Out of that devastating experience came the career I have today. “So I tell our athletes, ‘This crisis gives you a once-in-a-lifetime chance to get a whole new perspective on who you

“Sometimes they simply need a vacation. Coming into the athletic training room day after day, seeing athletes who are still playing, is wearing. When we sense they need it, we tell them, ‘Take three days off and go do whatever you want. But don’t forget to come back.’� other message: Depending on how you handle it, this event can be a wonderful opportunity. Hard to believe? Maybe, but Ravizza has proof to back up his claim. He himself played college football, until a knee injury ended his career during his sophomore year. “My identity was obliterated, and my future was gone,� he says. “But after a lit-

are and what you want,’â€? he continues. “‘You may have thought your sport was the sum total of your identity, but that was never true. Who are you? What do you want to do now with the time and energy you have?’ If we can help the athlete eventually see this event in their lives that way, we’ll have a very successful outcome.â€? â–

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JOHN QUACKENBOS

SPORT SPECIFIC

Before the Puck

Drops

At Boston University, preseason training for ice hockey includes a mix of on-ice and off-ice work, with a focus on conditioning. BY MICHAEL BOYLE

A

t the collegiate level, the sport of ice hockey is thriving, with a large increase in the number of teams playing at the Division I level. Since 2000, the NCAA has expanded the Division I men’s national tournament to 16 teams and added a Women’s Frozen Four. With increased participation comes increased interest in training for the sport. However, there are still many misconceptions about developing ice hockey players for peak performance. Hockey is an interesting sport to train athletes for because it has high energy system needs as well as high muscular system demands. Athletes must possess great speed and acceleration, withstand some of the highest velocity collisions in ATHLETICBID.COM

all of sport, and repeatedly perform at a high exertion level with limited rest. An effective strength and power program must resemble that for a sprinter, utilizing Olympic lifts and multi-joint upper- and lower-body exercises. The conditioning program must prepare the athlete for repeated efforts while also promoting rapid recovery. Meeting these unique demands requires unique programming. While this article will focus on preseason training for ice hockey, let me briefly explain our off-season program

here at Boston University, since it differs from either preseason or in-season training. In the off-season period, from April to Sept. 1, the priority is strength and power work with a goal of building maximum strength and lean mass. Conditioning is maintained through running and extensive use of the slideboard, which develops the proper energy systems while stressing the hip flexors, adductors, and abductors. We do not use the stationary bike in the offseason because it can shorten the hip flexors, and the key to long-term injury

Michael Boyle, MEd, is the Strength and Conditioning Coach for Ice Hockey at Boston University. He served in a similar capacity for the 1998 U.S. Women’s Olympic Team and for the Boston Bruins of the NHL from 1991-1998. He is the author of Designing Strength Training Programs and Facilities and can be reached through his Web site at: www.michaelboyle.biz. T&C SEPTEMBER 2005

45


SPORT SPECIFIC

TABLE ONE:

PRESEASON CONDITIONING

This chart details the preseason conditioning program we use at Boston University, in which athletes skate laps and work out on a stationary bicycle during each workout. Bike distances are measured in miles, and recovery from biking is measured in heartbeats per minute. Rest-to-work ratio is primarily 3-1, with some 2-1 work as we approach the start of the season. 1 2 3

4 5

Workout

# Laps/Distance

Work Time

Rest Time/Recovery

Skate Bike Skate Bike Skate

4x3 3x0.3 5x3 2x0.5 4x3 2x2 4x0.3 6x3 3x0.5 4x3 3x2 5x0.3 6x2 4x0.5 7x2 6x0.3 1x3 6x2 2x1.0 2x3 6x2 7x0.3

0:45 0:50 0:45 1:15 0:45 0:30 0:50 0:45 1:15 0:45 0:30 0:50 0:33 1:15 0:33 0:50 0:45 0:30 2:35 0:45 0:30 0:50

2:15 40-50 2:15 40-50 2:15 1:30 40-50 2:15 40-50 2:15 1:30 40-50 1:30 40-50 1:30 40-50 2:15 1:30 40-50 2:15 1:30 40-50

Bike Skate Bike Skate

8

Bike Skate Bike Skate Bike Skate

9

Bike Skate

6 7

Bike

prevention is to keep athletes extending the hips. With a good strength base and flexibility in the hips established, our preseason program concentrates on interval training for conditioning and total-body strength work. Our conditioning program has changed the most over the years, from running workouts to an on-ice and stationary bike regimen with no running at all. We do not train for aerobic capacity—only for the sprint demands found in the sport. USE OF VO2 MAX A major problem with many traditional hockey training programs is that they focus on developing aerobic capacity, in spite of an ever-increasing body of evidence that clearly refutes the “aerobic training for anaerobic sports” theory. Research done in Australia concluded that “elite and sub-elite players have about the same VO2 max scores but that elite players perform better on muscular strength and power tests.” An article 46

T&C SEPTEMBER 2005

in the Journal of Sports Medicine and Physical Fitness by A.R. Aziz concluded that “improving aerobic capacity further will only be expected to contribute marginally to improving repeated sprint performance of team game players.” Still, many coaches cite the value of aerobic capacity in recovery. However, S.R. Cooke, in the European Journal of Applied Physiology and Occupational Physiology, concluded that “VO2 max is a poor predictor of metabolic recovery from high intensity exercise … Differences in recovery rate observed between individuals with similar VO2 max imply that other factors influence recovery.” Last year, we decided to test the importance of VO 2 max with our own athletes by comparing physiological test results to actual performance results. We used a Korr Analyzer, which provides peak values for VO 2 and anaerobic threshold, for the physiological testing. For the performance testing, athletes completed a 10-10 test, a fivemile time trial on a stationary bike, and

a repeat 300-yard shuttle run test. The 10-10 test requires athletes to run to exhaustion on a treadmill at 10 mph and 10 percent incline. Although it requires close supervision in case the athlete falls while mounting the moving treadmill or from exhaustion at the end, it is a great test of fitness, strength, and willpower. We found no relationship between the results of the three performance tests and the results of the VO 2 max and anaerobic threshold tests. In fact, the top performer in most of the competitive tests had a measured peak VO2 of only 52 ml/kg. Ultimately, I think VO2 tests are too one-dimensional to be used in multi-dimensional sports. Performance testing produces results on functional movements and incorporates the combined functions of the athlete’s physiological, mental, and emotional systems. In other words, performance testing allows athletes to use their competitiveness as well as their heart and lungs. Scoring fitness based on physiological indicators ATHLETICBID.COM


SPORT SPECIFIC obviously rewards physiology over performance. In reality, physiological test results have little relationship to actual performance. Based on both the literature and our own experimentation, we have decided to disregard VO2 max as an indicator of performance. We do not strive to increase our athletes’ VO2 max during preseason training, and we do not use such measurements to assess fitness levels. However, we have not thrown peak VO2 testing out the window. Peak VO2 accurately measures maximum heart rates, which are critical to know when devising individual workouts for athletes. In our 2004 testing, heart rates at the conclusion of the peak VO 2 test ranged from 184 to 211 beats per minute. There was no relationship between maximum heart rate and performance, but based on the commonly used 220-minus-age formula, the athletes’ maximum heart rates had roughly a 10-beats-per-minute variation, plus or minus. If we had assumed that all our athletes had maximum heart rates of approximately 200 beats per minute and designed programs around this number,

we would have overtrained some athletes while undertraining others. Instead, the physiological data allowed us to design individual programs based on each player’s actual maximum heart rate and the heart rate at anaerobic threshold as provided by the Korr Analyzer. This let us design individual conditioning programs in which recovery was based on heart rate, not time. ICE & BIKE The NCAA allows strength and conditioning coaches to conduct on-ice conditioning in the preseason, provided no hockey equipment is used and no hockey coaches are involved. It would appear obvious that the most effective method of preparing athletes to perform in ice hockey would be to utilize a program of ice skating. Although this seems like a simple conclusion, many teams continue to follow preseason programs based primarily on running. Our preseason program utilizes both on-ice and off-ice workouts. Three days a week, the players perform on-ice interval work followed by off-ice interval training on a stationary bike. This

mix allows us to progressively and safely stress both the muscular and energy systems of the athletes. (See “Preseason Conditioning” on page 46.) The program is designed to acclimate the athletes to the demands of skating and at the same time avoid muscle strains. In preseason ice hockey conditioning, groin and adductor strains are a frequent problem. This is most likely due to a sharp increase in the use of the hip flexors and adductors in the recovery portion of the skating stride. The use of on-ice conditioning during preseason training helps athletes strengthen their muscles, while using the off-ice stationary bicycle ensures that they do not overtrain their groin or adductor muscles. The bike is great for energy system stress but produces little groin stress. The reason we do not use the bike in the off-season is the same reason we do use it in the preseason. Our on-ice work mainly consists of simply skating laps in clockwise and counterclockwise directions. Four groups of two or three skaters skate simultaneously, starting from opposite sides of the blue lines. The lap program

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SPORT SPECIFIC

TABLE TWO:

STRENGTH WORK The following depicts our strength training during the preseason. Note that exercises numbered 3 and 4 (both days) are tri-sets. We implement one-minute rests in the tri-sets. With several of the exercises, we increase the number of sets or reps each week. We also pay close attention to the tempo of the exercise (which is listed immediately after the exercise name). 4/0/4 indicates an eccentric emphasis with a four-second concentric contraction, no pause, followed by a four-second eccentric contraction—a number greater than zero in the middle indicates a pause. Exercises designed to be performed in an explosive manner are indicated by “Exp.”

DAY ONE: 1. Warm-Up and Ab Work 2. Snatch Pair, Exp. 3. Chinup, 4/0/4 Front Squat, 3/0/Exp. 4. Alt. DB Bench, 3/0/Exp. Slideboard Leg Curl, 2/0/Exp. 5. Side Twist Pass, 5K

4x5 with Quad/Hip Flexor Stretch 3x5 with Squat Toe-Touch Stretch 3x8 3x8 with Standing Hamstring Stretch 3x8 x10, x3

DAY TWO 1. Warm-Up and Ab Work 2. Clean Pair, Exp. 3. Sternum Chinup, 2/0/2 Leg Squat, Exp. 4. Bench, 3/1/Exp. Single-Leg Straightleg Deadlift, 2/0/2

can be preceded by an informal skating workout. If not, a proper warmup should be performed. Prior to skating laps, players may engage in short sprints and some change-of-direction skating. Bike work is done immediately after the skating workout, and our stationary bicycles have a couple of important features. They include an automatic system of accommodating resistance—increased effort yields increased resistance with no manual adjustment of tension. The bike also uses both upper- and lower-body action, thus more closely replicating the metabolic demands of skating. The bike allows for intervals based not only on time but also on distance. Players are required to ride a specific distance rather than a specific time interval. This forces greater accountability and greater effort. STRENGTH GAINS In order to comply with NCAA rules limiting preseason work to eight hours per week, athletes perform six 75-min48

T&C SEPTEMBER 2005

4x5 3x8 8x8 3x8 3x8

with Quad/Hip Flexor Stretch with Squat Toe-Touch Stretch with Standing Hamstring Stretch

ute workouts each week. Three of these are our conditioning workouts, leaving three days for strength and power work. We use two of those days for intense total-body strength workouts, while the third day is often a movement workout followed by some sort of competitive game. At this point in the calendar, strength development takes a back seat to conditioning, as conditioning will be a more limiting factor in game situations than strength. With only two days for strength training per week, we work hard to hone in on what is most important and make the most of every minute in the weightroom. (See “Strength Work,” above, for a sample protocol.) After warmup and ab work, one power movement is performed at the beginning of each workout. Each set of the power movement for that day, generally a variation of a clean or a snatch, is followed by an active isolated stretch of a problem area, such as the quads or hip flexors. After the power exercise are two tri-sets, consisting of

two multi-joint exercises with a stretching exercise in between. The concept of tri-sets is a variation on the old bodybuilding idea of supersets. Exercises are grouped together for a more efficient use of time—while the body is recovering from a lift emphasizing one group of muscles, it is performing a lift with another group of muscles. Inserted between each set of the strength exercise is an active isolated stretching exercise. Stretching occupies the athletes during the rest period and extends the rest between strength exercises, thereby facilitating strength gain. In the first tri-set sequence, an upper-body pulling exercise, like a pull-up or chin-up, is paired with some type of squatting movement. In the second triset, an upper-body pressing exercise is paired with what we would classify as a hip-dominant movement—a variation of deadlifts and straight-leg deadlifts. On our third day of strength work, we typically do some type of enjoyable outdoor activity. This gives the athletes a break from the usual workouts, and I feel I can develop what they need in two days a week in the weightroom. THE RIGHT FOCUS Because ice hockey has such unique demands, its training program must be carefully designed. The off-season should focus on strength training and keeping the hip flexors, adductors, and abductors loose, while the preseason should focus on conditioning, developing skating muscles, and injury prevention. I have found the keys to success include combining on-ice and off-ice work, both done in an interval format, and making the strength workouts simple and very efficient. While my teams have also benefited from preseason testing and using VO2 max rates for determining workout loads, they are not mandatory. Any coach at any level can use the basics I’ve described here to make their ice hockey players faster, stronger, and better conditioned. ■

■ For a look at a previous article published in T&C by Michael Boyle on slideboard training, you can access our archives by visiting: www.AthleticSearch.com. Type “slideboard” or “Boyle” into the search engine. ATHLETICBID.COM


Pilates: A Trainer’s Secret Weapon BY KEN ENDELMAN Developing an athlete’s core - the deep abdominal muscles along with the muscles closest to the spine – makes athletes more agile, helps prevent injury and increases performance. Trainers and coaches are discovering a secret weapon for developing optimal core control and flexibility in their athletes – Pilates. Pilates integrates the trunk, pelvis and shoulder girdle. It also emphasizes proper breathing, correct spinal and pelvic alignment, and complete concentration on smooth, flowing movement. Through Pilates, athletes become acutely aware of how their body feels, where it is in space, and how best to control its movement. Tom McCook, owner of the Center of Balance Pilates studio in Palo Alto, CA, has trained many athletes, including Olympic swimming medalists Natalie Coughlin and Jenny Thompson. McCook says that Pilates helps athletes learn how to individually access each part of their body, and become familiar with functional mechanics. “Pilates helps a body move the way it’s designed to move, from the center out. Athletes learn how to torque the body correctly, to avoid injury and increase performance.” Many professional sports teams are buying into that theory. “The reformer is a perfect piece of equipment for the NBA,” says Rich Dalatri, trainer for the New Jersey Nets. “We play up to five games a week. Fatigue and stress due to travel and the number of games can really mount up. It [the reformer] was a godsend, because it is much less stressful on the body than lifting weights, it’s safer, and you work both eccentric and concentric contractions. It’s a total body workout that increases flexibility, and from a

Tampa Bay Buccaneer Josh Bidwell on the Aleegro Performer

weight training standpoint there’s not a program we can’t do on it.” Pilates has become such an essential part of the Nets training program that the team takes a reformer on the road with them for all their away games.

“Pilates helps a body move the way it’s designed to move...to avoid injury and increase performance.” -Tom McCook, Center of Balance Pilates Studio Performance-wise, it’s hard to argue with the success New Jersey has had lately. After posting losing records from 1998 though 2000, the Nets have four straight playoff appearances, including two consecutive Eastern Conference championships. Pilates has made its way to the gridiron, too. “My training philosophy is to get the midline in shape and then make the circle a little larger and a little larger around the body,” says Garrett Giemont, strength and conditioning coach for the Tampa Bay Buccaneers. “When you look at that philosophy and then at Pilates, a trainer can see that it is a great adjunct to what he or she is trying to accomplish from an overall conditioning standpoint.”

One Buccaneer who has seen a difference is punter Josh Bidwell. Bidwell began doing Pilates mat exercises during the 2004 season and statistically had his best overall season. This year he began working on a reformer. “As a punter I put tremendous pressure on my hamstrings, my lower back and my glutes,” says Bidwell. “I’m not the most flexible person but Pilates has definitely lengthened my muscles and increased my agility. I can really feel it in the way I move.” Bidwell had also been bothered by periodic, painful flare-ups in his lower back. But since he started Pilates that trouble has disappeared. “It is completely gone,” says Bidwell. As costs of amateur and professional sports continue escalating, keeping an athlete on the field and off the injured list becomes paramount. Trainers who implement Pilates as a component to their conditioning programs will see increased results in flexibility, durability and strength. Says Giemont: “When you take an athlete with a tremendous skill level and then give them the tools of length, strength and balance on a continual basis, it elevates their performance to an entirely new level.” Ken Endelman is Founder and CEO of Balanced Body Inc. To see an expanded version of this article, or for more educational materials on Pilates, please visit www.pilates.com/ TrainingAthletes.


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Significant Source Of: Vitamins: A, B1, B2, B3, B5, B6, B12, biotin, C, D, E, folic acid Minerals: Calcium, chromium, iodine, iron, magnesium, manganese, potassium, selenium, zinc and 49 trace minerals

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PRACTICAL RESEARCH YIELDS IMPOR TANT LESSONS FOR ATHLETES E. Randy Eichner, MD, Team Internist, Oklahoma Sooners

SODIUM AND HEAT CRAMPING

ELECTROLYTES MAINTAIN BLOOD VOLUME

Major heat cramping involving widespread painful spasms of muscles can take athletes out of the game. In the past, some have recommended increasing potassium intake as the key to preventing heat cramps1. But forget the bananas and oranges. New research has shown sodium, not potassium, is critical in preventing major heat cramping in sports2. Research with the University of Oklahoma football team shows that sodium loss in sweat is a key culprit in heat cramping in athletes. Through on-field studies of Sooner football players in action, researchers measured sweat rates and sweat electrolyte losses in two-a-day practices in August. In hot and humid conditions, they compared cramp-prone players with teammates who had no history of heat cramping.

Although athletes should avoid overdrinking, athletes in action tend not to drink enough fluid to stay fully hydrated. Sodium in a sports drink helps keep athletes hydrated. ឣ Beverages containing sodium are better retained by the body because the blood sodium concentration is maintained. This helps hold fluid in the bloodstream, preventing a fall in blood volume. ឣ In contrast, sodium-free beverages like SODIUM NEEDS OF ATHLETES water are eliminated more quickly in the Intensity and duration of workouts can add up to substantial sodium loss. urine, because they rapidly dilute the blood sodium concentration7. ឣ The sodium in sports drinks like Gatorade also helps maintain the physiological drive to drink, so athletes drink more and hydrate better.

FLUID TURNOVER AND HOMEOSTASIS

Results showed both groups lost small and Research shows that Sooner football players Data from laboratory and field research on typical amateur and professional athletes to similar amounts of potassium in sweat, but turn over huge amounts of fluid during twogauge sweat sodium loss during typical workouts for each sport. Sweat sodium loss in their sweat sodium losses were starkly difa-day practices8. Basically, they lose and football is represented for noncrampers; cramp-prone players lose twice this much sodium. ferent. need to replace an average of 10 quarts of ឣ Crampers were “salty sweaters,” losing fluid a day. Up to 70% of this daily fluid twice the sodium in sweat as noncrampers. loss is sweat; the rest is mostly urine. ឣ In one day of two-a-day practice sessions, the crampers lost an average of ឣ Sweat comprises more than just water. It also contains electrolytes, mainly five teaspoons of salt (sodium chloride). In an extreme example, one athlete sodium and chloride, but also potassium, magnesium, and calcium. ឣ Replacing the fluid and electrolytes lost in sweat is vital to maintain proper lost nine teaspoons. ឣ Football crampers also had higher sweat rates and dehydrated more than hydration and cardiovascular control, help regulate body temperature, and noncrampers. ensure top athletic performance9.

THE WATER HAZARD If an athlete does “lock up” with major heat cramping, athletic trainers and other sport professionals should think twice before instructing the athlete to drink plenty of plain water. Over-ingestion of plain water can worsen the problem by diluting the blood sodium concentration and causing hyponatremia. Proper treatment protocol involves administration of sodium chloride through fluid, either orally or intravenously. Fluids taken orally are the first line of defense. If drinking is impaired or it is an emergency situation, fluids can be administered intravenously. ឣ Athletic trainers and other sport professionals should never treat heat cramping with only plain water. ឣ To prevent heat cramping, encourage athletes to salt their food and consume sodium-rich foods like tomato juice, canned soup, and pretzels. Further prevention should include weighing athlete pre and post practice to determine fluid weight loss. ឣ During on-field situations, the use of sports drinks containing sodium, like Gatorade, will continue to help athletes meet their electrolyte needs.

ELECTROLYTES BEAT PLAIN WATER IN THE ATHLETIC ARENA ឣ

Sodium is vital to prevent major heat cramping in athletes. Beverages with sodium stay in the body better than sodium-free fluids. ឣ Electrolytes are imperative to maintain a healthy fluid balance and keep athletes performing at their peak. ឣ

For more information, please visit www.gssiweb.org. REFERENCES 1 Arnheim, D, &,Prentice, W. Principles of Ahletic Trianing (9th ed).St. Louis: McGraw-Hill (1997): 266. 2

Stofan JR, ZAchwiega JJ, Horswill CA, Lacambra M, Murray R, Eichner ER, Anderson S. Sweat and sodium losses in NCAA Division 1 football players with a history of whole-body muscle cramping. In Press: J Sports Nutr Exer Metab.

3

Maughan RJ, Merson SJ, Broad NP, Shirreffs SM. Fluid and electrolyte intake and loss in elite soccer players during training. Int. J. Sports Nutr. 14:333-346, 2004.

4

Maughan RJ, Shirreffs SM, Merson SJ, Horswill CA. Fluid and electrolyte balance in elite male football (soccer) players training in a cool environment. J. Sports Sci. 23:73-79, 2005

5

Phanke MD, Trinity JD, Batty JJ Zachwieja JJ, Stofan JF, Hiller WD, Coyle EF. Variability in sweat rate and sodium concentration in ultra-enduracne athletes during exercise. Texas-chapter ACSM meeting, February 2004.

6

GSSI in house research on Olympic marathon runners.

7

Maughan RJ, Leiper, JB, Sodium intake and post exercise rehydration in man. Eur. J. Appl. Physiol Occup. Physiol. 71(4):311-9, 1995.

8

Montain SJ and Coyle EF. Influence of graded dehydration on hypertension and cardiovascular drift during exercise. J. Appl. Physiol. 73:1340-1350, 1992.

9

Stofan JR, ZAchwiega JJ, Horswill CA, Lacambra M, Murray R, Eichner ER, Anderson S. Fluid turnover during two-a-day practices in college football. MSSE, 37:S168, 2005.


Leg-Strengthening Products Antibody, Inc. 301-782-3700 WWW.ANTIBODYWEAR.COM

athletes’ improving strength results and to assess their overall fitness. Circle No. 518

The BodyGuard compression shorts prevent and accommodate lower-body injuries to the groin, hamstring, quadriceps, hip flexors, and hip pointers. Because of their inner surface and custom design, they attach to the wearer and transfer their stored elastic energy to the muscles, creating torque and assisting with muscle flexion and extension. They also provide constant compression, strain distribution, impact absorption, heat circulation, and absorption of fatigue-inducing muscle vibrations caused by repetitive use. Circle No. 516

Exertools, Inc. 800-235-1559 WWW.EXERTOOLS.COM

Compex Technologies 888-826-6739 WWW.COMPEX.US/TC Compex Sport is a portable electrical muscle stimulation (EMS) device that delivers proven results. For years, athletes have used Compex, with its proprietary Swiss technology, to increase muscle strength, size, power, and endurance, and to promote faster muscle recovery. The electricity produces powerful, exhilarating contractions—putting muscles through training programs that adhere to the principles of training physiology. This device is FDA-cleared for sale and available in the United States. Circle No. 517 Creative Health Products 800-742-4478 WWW.CHPONLINE.COM Creative Health Products is a leading discount supplier of rehabilitation, fitness, exercise, and athletic testing and measuring products. The company offers a unique testing device to measure the strength of the legs, and is ideal also for measuring the strength of the thighs, chest, back, and upper torso. Its device is easy to use and is an innovative way to measure

ATHLETICBID.COM

Exertools is proud to introduce the Magnum Motion 4000 Leg Press, an eight-in-one machine that uses an athlete’s weight resistance to perform exercises such as leg extensions, leg curls, supine bench presses, and more. Its patented technology allows five different resistance settings to enhance both slow and high-speed concentric and eccentric movements. Magnum Motion is fun, safe, portable, and meets the needs of those training, conditioning, and rehabilitating. Circle No. 519 Human Kinetics 800-747-4457 WWW.HUMANKINETICS.COM Athletic Strength for Women specifically addresses the physiological, biomechanical, and anatomical needs of female athletes in developing optimal speed, strength, and power. In-season, off-season, and preseason programs are included for the most popular sports, and more than 120 targeted exercises and drills are provided. Exercises and programs for the lower body will improve hamstring and quadriceps strength ratios, providing enhanced takeoff power and landing strength, and better protection for the knee. Circle No. 520 Jump Stretch, Inc. 800-344-3539 WWW.JUMPSTRETCH.COM The goal at Jump Stretch is to provide equipment that simulates actual game conditions to improve performance, such as anaerobic training. Most sports require short bursts of explo-

sive power. Squats and squat thrusts performed with Flex Bands® provide a safe and highly effective method for improving explosiveness. Jump Stretch has been helping pro, college, and high school teams improve vertical jump, speed, and power since 1980. Circle No. 521 Keiser Corporation 800-888-7009 WWW.KEISER.COM Keiser’s 300 Squat combines low-impact technology with the ability to move safely at high speeds. The result is unmatched, explosive power—the key to superior athletic performance. Thumb buttons for resistance control are conveniently positioned on the ends of the handgrips for greater control and stability during the exercise. In addition, a rangelimiting feature helps prevent ligament and joint injury to the knee. Circle No. 522 The Air 300 Runner from Keiser is a unique and innovative product designed for the athletic performance market. It allows athletes to train the lower body for power by using the components of speed and resistance. Developed specifically for sports teams to improve acceleration and explosive power, this unit will improve the power and performance of any individual looking for a competitive edge. Circle No. 523 Kwik Goal 800-531-4252 WWW.KWIKGOAL.COM The Kwik Goal Speed Harness provides resistance training for acceleration drills while strengthening the legs of an athlete. The speed harness can also help improve quickness in all directions. An adjustable belt ensures that all athletes can use the speed harness. A page containing training drills is also included. Circle No. 524

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Leg-Strengthening Products Kwik Goal 800-531-4252 WWW.KWIKGOAL.COM

Perform Better 800-556-7464 WWW.PERFORMBETTER.COM

OPTP 800-367-7393 WWW.OPTP.COM

The Kwik Goal Ankle Speed Bands are designed to help athletes improve their lateral agility and balance while building upper leg strength. The bands use a bungee cord as resistance when exercises are being performed. The bands are adjustable, ensuring that all athletes can use them. A page containing training drills is included. Circle No. 525

Perform Better has added 18” and 24” sizes to its popular line of Banana Steps for intermediate to advanced plyometric exercises. These portable, lightweight units are perfect for hopping, stepping, jumping, bounding, or lateral speed and agility drills. They can also be used in rehabilitation to improve gait. For more information or to request a copy of the 2005 Perform Better catalog, call tollfree or check out Perform Better’s Web site. Circle No. 528

The Power Medicine Balls from OPTP are perfect to strengthen and tone muscles during leg exercises. Use these multi-functional balls as traditional medicine balls or attach handles for an intense workout. The Power Medicine Balls are available in two-, four-, six-, eight-, and 10-pound weights, and have removable handles to make them excellent for total body resistance training. Circle No. 531

New in the 2005 Perform Better Catalog is the G1 Extreme Athletic Training System. Use the system as a multi-directional training apparatus or as a traditional slide board to develop lateral speed, agility, coordination, and balance. The extra-long 5’x 8’ surface allows for a variety of sport-specific exercises. Six rotating discs swivel to allow unrestricted change of direction and side movement when contacted, forcing the body to balance and stabilize. For more information, contact Perform Better or visit online. Circle No. 529

The Multi Challenge Board from OPTP is an adjustable wobble board that provides two levels of balance challenge. Simply pull out and turn the sphere base to adjust the board from a 14inch angle to a 17-inch angle. You can use it in a sitting position for core, trunk, and pelvic girdle stability exercises. Grasp the Multi Challenge Board to add an unstable dimension to push-ups. Circle No. 532

Hammer Strength 800-634-8637 WWW.HAMMERSTRENGTH.COM The Hammer Strength Olympic Heavy Duty series now includes a 6’x 8’ Olympic lifting platform that features a finished oak surface and rubber impact mats. Also available are finished oak inserts to use with the platform and an Olympic Heavy Duty Rack. Circle No. 526 The new Hammer Strength Olympic Heavy Duty Combo Rack gives collegiate and high school athletic facilities the ultimate training variety in the most space-efficient combination. It offers two training stations, two flip-up, nonslip spotter stands, and two Dock ‘N Lock stations, which secure two optional benches in the proper position. Like all Hammer Strength products, the Heavy Duty Combo Rack provides premium durability, functionality, and ease of use, providing optimal team training for enhanced sports performance. Circle No. 527

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NZ Mfg., LLC 800-886-6621 WWW.NZMFG.COM Leading professional football, baseball, hockey, and basketball teams use TurfCordz® for explosive start drills, power-building footwork exercises, and leg strengthening. All TurfCordz resistance-training products offer the safety, security, and reliability professional athletes demand. To learn more about the entire innovative TurfCordz line, call toll-free, or visit the company online. Circle No. 530

Power Lift 800-872-1543 WWW.POWER-LIFT.COM The Combo Power Rack from Power Lift combines two lifting stations into one space-saving rack. It is available in eight- and nine-foot heights, and comes with all of the following: two pairs of safety spot bars, two pairs of patented “Rhino Hook” bar catches, and two dual-grip chin-up bars. The unit also includes storage for bars, weights, and bumper plates. The space inside the rack accommodates two people, for spotting two bench press stations at once. The Combo Power Rack can be customized with Power Lift’s patented “Lever Action” benches and Olympic lifting platforms. Circle No. 533

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Leg-Strengthening Products Power Lift offers a unique method of exercising the glute and hamstring muscles with the Rotating Glute-Ham Bench. This machine more effectively works the hamstrings, gluteus maximus, gastrocnemius, and erector stabilizers for more pelvic stability than traditional methods. The large rotating pads greatly reduce discomfort on the thighs, allowing for complete stretches and contractions of the hamstrings. An Easy Glide sliding mechanism effortlessly adjusts the machine so lower kneepads can properly position the body for a more fulfilling workout. Circle No. 534 Power Systems, Inc. 800-321-6975 WWW.POWER-SYSTEMS.COM Drive home the power and develop explosive lower body strength with the Power Systems Power Sled. Utilize the body harness to target stride length and acceleration, or use the handles to push the sled to develop a powerful hip and leg drive. The waist belt can be used for backward, forward and lateral running drills, adjusting easily to any body type. Add weights to increase difficulty and challenge acceleration. The Power Sled instructional manual and VHS or DVD are also available. Circle No. 535 Powering Athletics 866-672-1700 WWW.POWERSKATER.COM The PowerSkater teaches proper skating techniques, speed, and stride power all at the same time. This revolutionary dry-land skating system forces athletes to memorize specific motor programs while improving their balance, strength, endurance, quickness, body control, and anaerobic conditioning. The PowerSkater is used by the NHL’s Vancouver Canucks, Ottawa Senators, Montreal Canadians, St. Louis Blues, Carolina

Hurricanes, and Tampa Bay Lightning, plus college and junior teams throughout North America. Circle No. 536 PowerPlyos from Powering Athletics does the work of four different exercise machines because it adjusts into four positions: plyo boxes, V-box, Russian side-jump angle box, and resisted vertical leaper (RVL). The RVL allows hundreds of different exercises to develop strength, quickness, endurance, and explosive power. PowerPlyos offers extremely functional applications of lateral and multi-directional movement. It teaches athletes that by being aggressive with their arms and legs, they can bring the whole body into the exercise. Circle No. 537 efi Sports Medicine 800-541-4900 WWW.EFISPORTSMEDICINE.COM As the preferred functional training device for athletes and trainers, the Total Gym 26000 offers an array of accessories that enhance and improve stretching, agility training, and injury prevention for the lower body. The Total Gym is often used as a basis for measuring leg strength and activity potential, and with product attachments such as the Closed Chain Platform®, users are able to go from unloaded rehab to high performance plyometric exercises. Circle No. 538 efi Sports Medicine’s Ergometric Multi Cycle (emc™) adds the aerobic advantages of cycling to the movements of Total Gym’s incline glideboard for unparalleled performance and proprioception training. The emc lets you measure strength deficiencies and train to improve symmetrical leg strength and endurance at the same time with its LCD display that monitors elapsed workout time, distance, speed, and calories burned. Or, use it as a stand-

alone leg or arm cycle with its fully adjustable cycle tension. Circle No. 539 Total Therapy, Inc. 541-510-8681 WWW.USGYMSTICK.COM The new Gymstick is a complete body workout tool developed and manufactured in Finland that’s designed as the ideal rehabilitation tool to improve muscular strength and endurance, muscular balance and posture, metabolism and cardiovascular fitness, body control and coordination, and to enhance weight loss. The Gymstick is a fiberglass stick over 50 inches long with a strong exercise band attached to each end, offering four different resistance levels. It is suitable for all fitness levels, young or old, fit or with room for improvement. Circle No. 540

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523 . .Keiser (Air 300 Runner) . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 525 . .Kwik Goal (Ankle Speed Bands) . . . . . . . . . . . . . . . . . . . . . 56 524. . .Kwik Goal (Speed Harness) . . . . . . . . . . . . . . . . . . . . . . . . 55 510 . . .MET-Rx (AMPED ECN) . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 511 . . .MET-Rx (RTD 51) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 552 . .NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61 554 . .NSCA Certification (CEU Quiz Packets) . . . . . . . . . . . . . . .61 553 . .NSCA Certification (online quiz) . . . . . . . . . . . . . . . . . . . .61 530 . .NZ Mfg., LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 532 . .OPTP (Multi Challenge Board) . . . . . . . . . . . . . . . . . . . . . . 56 531. . .OPTP (Power Medicine Balls) . . . . . . . . . . . . . . . . . . . . . . . 56 528 . .Perform Better (Banana Steps) . . . . . . . . . . . . . . . . . . . . . 56 529 . .Perform Better (G1 Training System) . . . . . . . . . . . . . . . . . 56 533 . .Power Lift (Combo Power Rack) . . . . . . . . . . . . . . . . . . . . . 56 534 . .Power Lift (Glute-Ham bench) . . . . . . . . . . . . . . . . . . . . . . 57 515 . . .Power Systems (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . 53 547. . .Power Systems (Pilates Ring/Ring Plus) . . . . . . . . . . . . . . . .59 535 . .Power Systems (Power Sled) . . . . . . . . . . . . . . . . . . . . . . 57 537 . .PoweringAthletics (PowerPlyos) . . . . . . . . . . . . . . . . . . . . 57 536 . .PoweringAthletics (PowerSkater) . . . . . . . . . . . . . . . . . . . 57 556 . .Prossage Heat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61 512 . . .Q-Blast (Medco Sports Medicine) . . . . . . . . . . . . . . . . . . . . 53 557 . .Spencer Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61 548 . .Stott Pilates (DVD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59 549 . .Stott Pilates (Group SPX Reformer) . . . . . . . . . . . . . . . . . . .59 540 . .Total Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

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Pilates Equipment

The Pilates Allegro® Reformer is ideal for sports training, to improve core strength and flexibility, and help prevent injuries that can sideline top athletes. The New Jersey Nets, Green Bay Packers and Tampa Bay Buccaneers, as well as Olympic athletes, all use the Pilates Allegro Reformer for highperformance training. The most versatile Reformer on the market, it folds down flat, stacks or stands for storage, and sets up in 60 seconds. The product comes with a five-year warranty. Circle No. 545 Add the Tower of Power™ to your Allegro® Reformer, and gain even more programming. In addition to exercises for the Reformer, you get new programming possibilities with the Tower (Half Trapeze), as well as the new Integrated workout, which combines the moving Reformer carriage with the Tower. The complete system includes Reformer, the Half Trapeze, and mat. It’s simple to set up, easy to move and store. Retrofits all existing Allegros. Start with Allegros and add Towers later, or kick off your program with the complete system. The system includes a five-year warranty. Circle No. 546 Power Systems, Inc. 800-321-6975 WWW.POWER-SYSTEMS.COM Integrate Pilates’ style exercises into workouts using the Power Systems Pilates Ring and Pilates Ring Plus. Begin with the Pilates Ring for moderate flex resistance to activate and strengthen deep core muscles. With regular use, the body becomes stronger and muscles elongated without creating bulk. As strength

increases, advance to the more resistant Pilates Ring Plus. The Pilates Ring is foam-covered fiberglass with padded grips. The Pilates Ring Plus is three bands of steel with fixed molded handles and a synthetic rubber coating for comfort. The molded handles are covered with removable slip-resistant neoprene pads. Circle No. 547 Stott Pilates® 800-910-0001 WWW.STOTTPILATES.COM Stott Pilates has released 10 videos from its Professional series on DVD, covering Stott Pilates’ repertoire on the mat, Reformer, BOSU, and more. These DVDs are suitable for instructors and advanced exercisers as its training programs are internationally recognized as educational materials. Bonus content, including a “try the next level” option, gives viewers a glimpse into the

Perform Better With ProCordz!

Balanced Body, Inc. 800-745-2837 WWW.PILATES.COM

next level of programming. DVDs can be purchased directly online, or call Stott Pilates’s toll-free number for more information. Circle No. 548 The new Group SPX Reformer by Stott Pilates is designed for facilities with multipurpose group exercise rooms. At only 100 pounds, this portable unit offers unparalleled safety, durability, and versatility as it facilitates dozens of exercises, such as cardiobased plyometrics. It also converts to a mat, can be rolled away, stacked sixhigh, or hung on a convenient racking system. Inquire about the Stott Pilates Group SPX Reformer online or call its toll-free number. Circle No. 549

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S P ECI A L A D VER TI S I N G F EATU R E

Sports Nutrition

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Fast & Slow Proteins When it comes to comparing different proteins, several factors can be used to determine the overall quality of various sources. Standard measures such as Biological Value, Nitrogen Protein Utilization, and Amino Acid Score are generally used by Nutritionists to determine the quality of a protein for human use. But when it comes to hard-training athletes, these standard measures may not be sufficient for assessing protein quality, especially if the goal is to maximize performance and recovery. Research into “fast” and “slow” proteins has shown that proteins with varying digestion rates may have synergistic effects on important factors such as muscle mass, strength and bodyfat percentage. So just what is a fast or slow protein? These terms are generally given to proteins to describe the rate at which they are digested. Two proteins that have had their digestion rates compared in scientific studies1-4 are whey and casein, both of which are milk-based proteins. The consensus of these studies is that casein proteins empty from the stomach slower than whey proteins. This appears to be due to two separate factors. The first significant factor is casein’s physico-chemical properties, which causes the protein to fall out of solution in the stomach. Once this occurs, amino acids from casein will slowly be released for continued absorption. The second factor pertains to biologically active peptides within the sequence of casein. These peptides are believed to interact with opioid receptors, which in turn slow down the movement of all contents in the stomach. So what is the relevance of fast and slow proteins to athletes? While whey proteins have been shown to be effective for stimulating protein synthesis, casein proteins are effective for decreasing protein degradation and promoting overall nitrogen balance1-3. These differing but synergistic effects appear to be related to each protein’s unique structure, composition and biological properties.

Based on this knowledge of fast and slow proteins, MET-Rx researchers developed a specialized blend known as Metamyosyn® protein. This blend is designed to take advantage of whey’s and casein’s unique properties. In a randomized study5, subjects were given either a MET-Rx supplement containing Metamyosyn protein or a whey protein supplement, twice per day. Total protein intake for both groups was 1.5g/kg body weight. A third group was not given any protein supplement and maintained a lower total daily protein intake. After 12 weeks, it was found that both groups receiving the protein supplements gained more muscle mass and strength than the control group. More impressively, the Metamyosyn group gained significantly more muscle mass and strength while losing more overall bodyfat than the whey protein group. Average lean mass and strength gained for the Metamyosyn group was 2x greater as compared to the whey protein group. The Metamyosyn group also lost 67% more bodyfat than the whey protein group. A University study6, conducted with the Arizona State football team in conjunction with its Strength and Conditioning program, found that consumption of Metamyosyn protein helped those tested to achieve greater physical conditioning as well. Athletes supplementing with the MET-Rx Collegiate Series Nutrition Shake while following an intensive training program were able to increase muscle mass, maximal bench press, squat, and vertical jump height. Decreases were found in body fat percentage and time in the 40 yard dash. The results of these studies confirm the ability of MET-Rx’s fast and slow protein blends to support strength, muscle mass and maximal performance.* 1. Beufrere, B., et al. Proteins, Peptides & Amino Acids in Enteral Nutr. 2000. 3: 121-133. 2. Dangin, M., et al. Am J Physiol Endocrinol Metab. 2001. 250: E340-E348. 3. Dangin, M. et al. J Nutr. 2002. 132: 3288-3233 4. Mahé, S., et al. Am J Clin Nutr. 1996. 63: 546-552. 5. Demling, R. Ann Nutr & Metab. 2000. 44(1): 21-29. 6. MET-Rx Collegiate Series Study. Unpublished. Arizona State University. 2003.

*Results may vary. Use in conjunction with an intense daily exercise program and a balanced diet including an adequate caloric intake. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.


More Products Exertools, Inc. 800-235-1559 WWW.EXERTOOLS.COM

NSCA Certification Commission 888-746-2378 WWW.NSCA-CC.ORG

Exertools is pleased to announce a special program for readers of Training & Conditioning. For a limited time, Exertools will provideT&C readers with a 20-percent rebate for any purchase of non-capital equipment they make on the Exertools Web site. For example, you can save on such products as Dyna Discs, Plyobacks, medicine ball racks, rocker boards, foam rollers, and gym balls. Furthermore, five percent of the cost for each order placed will be donated to Special Olympics. To receive the savings, go to the Exertools Web site and put in the coupon code “T&C” in the appropriate box on their shopping cart page. Circle No. 550

The NSCA Certification Commission online quiz process is quick, easy, and flexible. Each online quiz consists of a professional journal-style article with 10 corresponding questions, which can be printed prior to taking the quiz. Online quizzes are a great way to earn 0.5 CEUs, which qualifies you for Re-certified with Distinction credit. Processing fees apply to members and nonmembers, so visit the NSCA Certification Web site for more details. Circle No. 553

Gebauer Co. 800-321-9348 WWW.GEBAUERCO.COM Gebauer’s Spray and Stretch®, an instant topical anesthetic, is for use with the Spray & Stretch Technique in the management of myofascial pain, restricted motion and muscle spasms, providing temporary relief of minor sports injuries. Available in a convenient aerosol can, Spray and Stretch is nonflammable and features a fine stream spray and a cooling effect equivalent to Gebauer’s FluoriMethane®. Circle No. 551 National Academy of Sports Medicine 800-460-NASM WWW.NASM.ORG Learn NASM’s Optimum Performance Training for Performance Enhancement™ in a new one-day workshop coming to your area. In this comprehensive, hands-on workshop, you’ll earn 0.8 NASM CEUs and develop the skills necessary to assess and design programs to enhance athletic performance and decrease the risk of injury for just about any athletic client. Circle No. 552

ATHLETICBID.COM

CEU Quiz Packets for the 2003-2005 reporting period are now available. These packets are a quick and easy way for CSCS® and NSCA-CPT® certificate holders to earn 0.5 CEUs before the December 31, 2005 re-certification deadline. Each packet contains six previously published articles—authored by leaders in the industry—and their corresponding quizzes. CEU quizzes are also an excellent way to earn CEUs for Re-certified with Distinction credit. Visit the NSCA Certification Web site for pricing information. Circle No. 554 Biofreeze 800-246-3733 WWW.BIOFREEZE.COM The Biofreeze® family of pain relieving products includes a soothing gel, a convenient roll-on, and the new natural Cryospray™. Biofreeze effectively relieves pain from athletic injuries, muscle injuries, strains, sprains, and stiff joints. Apply before, during, and after workouts to reduce swelling and stiffness, and enable greater range of motion and flexibility. Biofreeze gel is available in

16-oz., 32-oz., and gallon professional pump bottles; 16-oz. spray bottles; and gravity dispenser boxes with 100 fivegram doses. The 4-oz. gel tubes, 4-oz. spray bottles, and 3-oz. roll-ons are for patient self-care at home. Biofreeze is endorsed by the World Olympians Association of the Americas and the United States Taekwondo Union. Circle No. 555 Prossage Heat 866-4-PROSSAGE WWW.PROSSAGE.US Prossage™ Heat is a uniquely blended, area-specific, non-slip, controllable-glide warming ointment that’s 100-percent natural. It’s formulated specifically for deep-tissue work, myofascial release, and trigger point therapy. Prossage Heat makes it easier to “hook” the deep fascia, allowing you to work faster and more efficiently, with less pain for the athlete. Heating the tissues with Prossage Heat reduces spasms in muscles, ligaments, and joint capsules. Prossage Heat is available in 3-oz., 8oz., and 16-oz. bottles. Call Prossage today for a free sample. Circle No. 556 Spencer Medical, Inc. 877-348-6692 WWW.SPENCERMEDICAL.COM Athletic trainers and strength coaches have long recognized the importance of accurately measuring the body fat and hydration levels of their athletes. With the FUTREX®’s patented near-infrared professional body composition analyzer, measuring your athletes is as easy as 1-2-3. Most importantly, it measures hydration levels within 60 seconds. The FUTREX system is accurate and portable, enabling you to measure your athletes anytime, anywhere to help achieve optimal performance. Circle No. 557

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Company Q & A

Oakworks® Sets Standard with The BOSS™ Sideline Treatment Table

Rodger Hyle attended Towson State University on a full football scholarship, graduating with a B.S. in Business Administration and Marketing. Initially hired as the Business Development Manager for Oakworks’ Medical Imaging Products, Rodger currently serves as the Director of the Rehabilitation and Athletic Training Products Division for Oakworks.

Oakworks, Inc. is one of the country’s largest manufacturers of bodywork tables for the athletic training, physical therapy, medical, massage therapy, and spa professions. Earlier this summer at the NATA Convention in Indianapolis, Training & Conditioning asked Rodger Hyle, Director of the Rehabilitation and Athletic Training Products Division at Oakworks, Inc., to tell us more about the company’s sideline treatment table, The BOSS, that has taken the athletic training industry by storm. Here’s what he had to say.

How did Oakworks come up with this concept?

Oakworks P.O. BOX 238 SHREWSBURY, PA 17361-0238 800-916-4603 RHYLE@OAKWORKS.COM WWW.OAKWORKSPT.COM 62

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Athletic Trainers often have it tough during away games because, so often, they have to make do with whatever training tables and equipment are available when one of their athletes gets hurt. First, they must find a place where they can treat the athlete, and often that is on the end of one of the benches. Then it seems like forever before they are able to diagnose the problem because they spend so much time putting the player in the right position. And that takes even longer on days when it is raining or cold. Often, enough time will go by that the athlete’s injury will begin to swell, and the so-called “Golden Period” will

pass. Having made therapeutic tables for almost 30 years, Oakworks figured there must be a better way. And The BOSS Portable Treatment Table was born. Why is the BOSS Portable Treatment Table so special? It’s special in a number of ways. First, it is the only portable table made for sideline treatment of athletes. We made sure it is the strongest and most durable portable table on the market because it has to accommodate large athletes and has to withstand a lot of physical abuse. The BOSS is covered in Tufflex™ upholstery with sealed seams, has a water-resistant undercoating, and is a solid performer in even the harshest outdoor conditions. And it has independently adjustable legs and wide field feet that’ll tackle any uneven surface or rugged terrain without a problem. We all know that everything on the athletic field takes a beating. How does an Athletic Trainer know The BOSS Portable Treatment Table will last? It’s simple: Nobody else tests like Oakworks. Every table we make goes through a four-part testing protocol, and those results are verified by a thirdparty. We know that The BOSS will face some really hard use and we rigorously put it through its paces before it has to. That’s why we stand behind all our products with a warranty.

ATHLETICBID.COM


Web News BEACON’S WEB SITE HAS EVERYTHING YOU NEED Beacon Athletics has been improving athletic performance for more than 50 years. The company’s Web site is designed to provide valuable information and easy online ordering. It features secure online purchasing 24/7, information on custom designs that can give your field that unique look, and extensive details on netting, padding, windscreens, tarps, batting cages, and turf protectors. A newsletter on the site includes featured articles on athletic training and field maintenance, tips of the trade, interviews with industry leaders, and notes from research and development. Educational materials are also available, along with information on seminars. Visit the site today to check out all these great features.

www.beaconathletics.com GO TO EAS.COM FOR ALL YOUR SPORTS-NUTRITION NEEDS After extensive research and testing, the one-stop destination for ever ything you need to know about elite training, nutrition, and supplementation has been updated with more essential information. The new eas.com includes several enhanced features: articles from experts in the industr y; tips from pro athletes on all facets of sport; supplement recommendations specific to your fitness goals; exclusive content from the elite Athletes’ Per formance training centers; information on the latest EAS product stacks; and much more. Log on today for all your training and nutrition needs.

www.eas.com FUNCTIONAL DESIGN SYSTEMS UPDATES ITS SITE The newly redesigned Web site for Functional Design Systems, the industr y’s leader in continuing education and functional fitness products, features a new appearance with the ability to order online. The online product information offers a comprehensive review of Functional Design System’s products: Functional Video Digest Series, TrueStretch, Tri-Stretch, BAPS Board and Accessories, Quest Videos, and many other products. Consumers have access to testimonials of how our products have impacted fellow colleagues. Visitors can also use the contact information to get in touch with a Functional Design Systems representative to ask more detailed questions.

www.functionaldesign.com PREPAK UPGRADES SITE FOR ORDERING CONVENIENCE PrePak Products, a manufacturer of fitness and rehabilitation products, is upgrading its Web site, which is expected to debut September 2005. Secure and convenient online ordering will be available for the entire PrePak product line, including the Web-Side Exercise Rail System, ExerBand products, the Home Ranger Shoulder Pulley, and Free Up Massage Cream. Online customers will find a downloadable PDF catalog and price list, company history and contact information, trade show schedule, industry notices and announcements, and a regional dealer locator. Visit PrePak online at www.prepakproducts.com

www.prepakproducts.com EXPANDED SITE FEATURES MORE SPORTS-MEDICINE TREATMENT OPTIONS

Testimonial

BioMedical Life Systems Announces Winners BioMedical Life Systems, Inc., has been manufacturing portable electrotherapy devices and accessories for over 20 years. Athletic trainers and physical therapists have used BioMedical Life Systems’ product line to treat pain relief, muscle re-education, and edema reduction. The company offers an extensive array of electrodes and accessories for all environmental conditions that may affect the performance of the devices. The devices’ manufacturing designs include surface mount, microprocessing technology, and touch-proof lead wire. The Transcutaneous Electrical Nerve Stimulators (TENS), Microcurrent Devices, Muscle Stimulators, Interferential, and High-Volt Pulsed Stimulators are a few of the company’s popular battery-operated devices. This past June, BioMedical Life Systems attended the NATA’s Annual Meeting in Indianapolis, IN, and raffled off a BioStim® NMS+ device, a digital muscle stimulator/TENS combination unit. Tickets were located in the May/ June NATA show issue of Training & Conditioning magazine, and the winners were drawn at the company’s booth. Winners are: Adrienne Jester, Rochester NY Melissa Huey, ATC, LAT, Jeffersonville, IN Mark Hanak, Brunswick, GA

Pro-Tec Athletics’s www.injurybegone.com Web site has been expanded to include more information on sports-medicine injuries and treatments. Enhancements include new information on additional eight soft-tissue injuries and 10 new products. The site also offers improved navigation and graphics and features articles by professional athletes on training and nutrition. Despite the listed improvements, the Pro-Tec Web site does not abandon its core purpose—being your sports-medicine information source.

www.injurybegone.com BioMedical Life Systems, Inc. P.O. BOX 1360 VISTA, CA 92085 800-726-8367 INFORMATION@BMLS.COM WWW.BMLS.COM ATHLETICBID.COM

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CEU QUIZ

T&C September 2005 Vol. XV, No. 6

Training & Conditioning is pleased to provide NATA and NSCA members with the opportunity to earn continuing education units through reading issues of the magazine. The following quiz is based on articles that appear in this issue of Training & Conditioning. By satisfactorily completing the quiz and mailing it back to T&C, readers can earn 2.0 BOC Athletic Training and 0.2 NSCA (two hours) continuing education units.

INSTRUCTIONS: Fill in the circle on the answer form (on page 66) that represents the best answer for each of the questions below. Complete the form at the bottom of page 66, include a $20 payment to Training & Conditioning, and mail it by October 15, 2005 to the following address: Training & Conditioning, ATTN: 15.6 Quiz, 2488 N. Triphammer Road, Ithaca, NY 14850. Readers who correctly answer 70 percent of the questions will be notified of their earned credit by mail no later than November 30, 2005. Running on Empty (pages 17-23) Objective: To understand the findings of a new study, which reveals that athletes are drastically underfueling their bodies. 1. The article reports that what percentage of Division I athletes studied consume adequate carbohydrates? a) 10% b) 15% c) 20% d) 25% 2. The article reports that what percentage of Division I athletes studied consume adequate protein? a) 20% b) 26% c) 30% d) 36% 3. What percentage of athletes (male and female) are not consuming enough calories to fuel their energy needs? a) 50-55% b) 60-65% c) 70-75 % d) 80-85% 4. The recommended daily carbohydrate intake is _____ grams per kilogram of body weight. a) 6-10 b) 10-12 c) 12-14 d) 14-20 5. The recommended daily protein intake is _____ grams per kilogram of body weight. a) .5-1 b) 1 c) 1-1.5 d) 1.5-2 6. A low intake of carbohydrates causes: a) Water retention. b) The athlete to be susceptible to the immunosuppressive effects of exhaustive exercise. c) An increase in the glycogen stores and the lactate threshold. d) Increased mental function.

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7. Hypothyroidism may cause: a) Bradycardia and postural hypotension. b) Tachycardia. c) Atrial fibrillation. d) Tachycardia and hypertension. 8. When trying to improve food intake with an athlete that has been under-eating, it may be helpful to: a) Monitor the athlete’s weight. b) Monitor the athlete’s heart rate, blood pressure, energy level, and mood. c) Completely overhaul the athlete’s current diet. d) Increase the athlete’s fat intake to control hunger. 9. A key warning sign of an athlete that has gone from a chronic dieter to one with an eating disorder is when: a) The athlete becomes more talkative and displays concern for his or her athletic scholarship safety. b) The athlete is wearing bulky clothes and hiding his or her physique. c) The athlete is unable to correct his or her eating pattern despite a decrease in performance. d) The athlete prefers to be with the group and does not like to be alone. 10. One way to get athletes to improve their food intake is to: a) Review their food preferences and have them try new foods. b) Provide a nutritional lecture during preseason. c) Have the athlete log their food intake for 3 days and then go to: http://www.mypyramidtracker.gov. d) Have the team athletic trainer monitor food selection and intake of each of their athletes for one month.

Ready to Lift? (pages 33-37) Objective: To understand the benefits of movement preparation, a new technique for warming up muscles before weight lifting. 11. The purpose of a stabilized static stretch in a movement prep exercise is to: a) Help increase muscle length. b) Warm up the muscle. c) Prepare the athlete to use both sides of his or her body. d) Prepare for complicated movement patterns.

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12. The purpose of the dynamic movement with stabilization aspect is to: a) Help increase muscle length. b) Prepare the body for complicated body movements. c) Warm up the muscle. d) Prepare for plyometrics. 13. Balance drills are utilized in a movement prep exercise to: a) Strengthen the core. b) Get an athlete focused and in-tune with their body. c) Address right-left symmetry. d) Prepare for complicated movement patterns. 14. According to the author, movement prep exercises are effective because: a) They are a form of corrective exercise and focus on the neuromuscular system. b) They require little time to complete. c) They involve straight plane movements. d) The risk of injury is low.

Point of No Return (pages 39-43) Objective: To learn how to work with athletes who have suffered career-ending injuries. 15. The following individuals should be a part of the decision-making team for career ending injuries: a) Student-athlete, team captain, attending physician, certified athletic trainer. b) Student-athlete, attending physician, certified athletic trainer, coach, parents. c) Coach, certified athletic trainer, athletic director, attending physician. d) Student-athlete, athletic director, certified athletic trainer, parents. 16. Ravizza indicates that it is important for athletes with career-ending injuries to understand: a) That parts of their personality that made them successful in their sport are still there when they are no longer playing. b) How the injury occurred. c) The extent of tissue damage resulting from the injury. d) That they will never play sports again after a career ending injury. 17. Ravizza and Max make sure that during the rehab process, coaches: a) Understand the mechanism of injury. b) Keep teammates informed of the athlete’s status. c) Stay in touch with the injured athlete. d) Stay in touch with the injured athlete’s parents. 18. Rice, Max, and Ravizza agree that the key to motivating an athlete who is no longer playing is to: a) Explain the purpose of each exercise or intervention. b) Structure rehabilitation during practice time. c) Involve the athlete in setting new goals that are specific, measurable, and meaningful to the athlete. d) Allow the athlete to choose from a list of exercises for his or her specific injury.

19. An athlete with a sudden career-ending injury is often more difficult to deal with because: a) The injury is acute and difficult to give a prognosis. b) The athlete has intense pain. c) Athletes are very competitive and enjoy the challenge to return to play. d) The athlete may feel that he or she will be the one to go against the odds and return to play. 20. Athletes may go through a stage of ___________ with a career-ending injury. a) Grief and loss. b) Tranquility. c) Emotional highs. d) hysteria. 21. Another stage an athlete may go through is: a) Improved social relations. b) An identity crisis. c) Fatigue and complacency. d) Being domineering over teammates.

Before the Puck Drops (pages 45-48) Objective: To understand one strength coach’s preseason training approach for an NCAA Division I ice hockey team. 22. When discussing the off-season training program, Michael Boyle says to avoid stationary bike riding because: a) Schools have limited bikes available. b) Stationary cycling does not have any functional carry-over to hockey. c) Stationary cycling may shorten hip flexors and make players prone to hip flexor injuries. d) Stationary cycling does not create enough resistance for conditioning. 23. Boyle focuses on __________ training in the preseason. a) Aerobic. b) Anaerobic sprint. c) Upper body endurance. d) Shoulder strength. 24. Boyle utilizes the following exercise during preseason training to prevent hip flexor injuries: a) Lunges. b) Stationary cycling. c) Squats. d) Straight leg raises. 25. For preseason workouts, this author prefers: a) A stationary bike with accommodating resistance and upper and lower body action. b) Tubing exercises for hip musculature. c) Interval running. d) Scheduling two-a-day practices to allow for a more ample recovery time.

ANSWER SHEET IS ON PAGE 66 ATHLETICBID.COM

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CEU QUIZ

ANSWER FORM

INSTRUCTIONS: Fill in the circle on the answer form below that represents your selection of the best answer for each of the previous questions. Complete the form at the bottom of this page, include a $20 payment to Training & Conditioning, and mail it to the following address: Training & Conditioning, ATTN: 15.6 Quiz, 2488 N. Triphammer Road, Ithaca, NY 14850, no later than October 15, 2005. Readers who correctly answer 70 percent of the questions will receive 2.0 BOC Athletic Training and 0.2 NSCA (two hours) CEU’s, and will be notified of their earned credit by mail no later than November 30, 2005.

Point of No Return

Running on Empty

A 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍

B ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍

C ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍

D ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍

Ready to Lift?

11. 12. 13. 14.

A

B

C

D

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❍ ❍ ❍ ❍

❍ ❍ ❍ ❍

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15. 16. 17. 18. 19. 20. 21.

A

B

C

D

❍ ❍ ❍ ❍ ❍ ❍ ❍

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Before the Puck Drops

22. 23. 24. 25.

A

B

C

D

❍ ❍ ❍ ❍

❍ ❍ ❍ ❍

❍ ❍ ❍ ❍

❍ ❍ ❍ ❍

Last Name______________________________________First Name________________________________MI______ Mailing Address_____________________________________________________________________________________ City _________________________________________________State_________________Zip Code________________ Daytime Telephone______________________________E-Mail Address____________________________________

Payment Information __ $20 check or money order (U.S. Funds only) payable to: Training & Conditioning __ Visa

__ Mastercard

__ Discover

__ American Express

Account Number_____________________________________________Expiration Date______________________ Name on Card_____________________________________Signature_______________________________________

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ADDITIONAL EDUCATIONAL PROGRAMS

SETTING the STANDARD

EARN BOC CEUs

• Complete quizzes found in the Strength & Conditioning Journal • Complete online quizzes at www.nsca-cc.org Phone

402-476-6669

Toll Free

888-746-2378

E-mail

commission@nsca-cc.org

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Company Q & A

Cho-Pat Supports Knees for over 25 Years “As a long distance runner, I developed a kneecap disorder known as runner’s knee. I wasn’t able to find anything in the marketplace specifically for this disorder, and decided to use my background to make a device that would allow me to stay active.” —George Gauvry, Founder and Director of Research and Development, Cho-Pat, Inc.

Please tell readers about Cho-Pat®. Cho-Pat’s philosophy is to provide the ultimate in support devices—devices that are specific, effective, and dependable. George Gauvry, an orthotist, started the company in 1980 and used the principles of orthotics, the clinical treatment of injuries and deformities involving the musculoskeletal system, to create his first support device, the original Cho-Pat Knee Strap. Mr. Gauvry’s design for the original Knee Strap uses the force of compression upon the patellar tendon below the kneecap to stabilize and strengthen the joint and to alleviate various symptoms associated with degenerative knees and inflammation/tendonitis of the kneecap. The idea for the Knee Strap eventually helped to revolutionize the treatment of certain knee disorders, and the product was rewarded with U.S. and Canadian patents for its design and mechanics. This treatment for chondromalacia patella also became the basis for the company name. What distinguishes Cho-Pat from others in the sports-medicine field?

Cho-Pat P.O. BOX 293 HAINESPORT, NJ 08036 800-221-1601 SALES@CHO-PAT.COM WWW.CHO-PAT.COM

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T&C SEPTEMBER 2005

Today, Cho-Pat is recognized as a leader in the sports-medicine field for the innovation, effectiveness, quality, and dependability of its products. Since the introduction of the Knee Strap, Cho-Pat has championed new concepts for the treatment of common anatomical/biomedical conditions such as shin splints, biciptal/triciptal tendonitis,

tennis elbow, lower back pain, Achilles tendonitis, subluxation of the kneecap, and iliotibial band syndrome (ITB). Cho-Pat distributes and sells its American-made products worldwide. They are widely accepted and endorsed by medical professionals, physical therapists, athletic trainers, professional athletes, and active individuals, reflecting the company’s reputation for effectiveness, integrity, history, and strong customer service. Please comment on the Dual Action Knee Strap. Cho-Pat’s most popular product, the Dual Action Knee Strap, builds on the successful foundation of the original Knee Strap. First, it applies pressure upon the tendon below the knee to reduce patellar subluxation and improve patellar tracking and elevation. Then, by adding pressure on the tendon above the knee, the strap further strengthens and provides an additional level of support and stability to the joint. Like the Original Knee Strap, the Dual Action Knee Strap has received a U.S. patent reflecting its unique attributes. How can our readers learn more about Cho-Pat products? One source is our Web site; www.chopat.com. The site provides a description, picture, and sizing information for each of our products, as well as basic knowledge about various ailments and suggested Cho-Pat products. Also, individuals may contact Cho-Pat Customer Service to speak with our knowledgeable representatives.

ATHLETICBID.COM


Circle No. 138


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800.916.4603 © 2005 O AKWORKS ®, Inc.

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