Training & Conditioning 17.6 by Momentummedia

September 2007 Vol. XVII, No. 6, $7.00

Timing It Right A look at the when of nutritional intake

Rehab Plan for Bone Spurs Blending Class & Clinic

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September 2007, Vol. XVII, No. 6

CONTENTS

26 6

25 33 49 50 51 56 60

Q&A Kathy Schniedwind Illinois State University Student Corner Understanding Ethics By Dr. Greg Frounfelter Sponsored Pages Gatorade Balanced Body Product News Product Launch Nutrition Leg Strengthening Pilates More Products

Nutrition

It Right 17 Timing Making the most of athletes’ nutritional intake is as much about when as what. Here’s an in-depth look at nutrient timing and nutrition periodization. By Laura Ulrich Leadership

& Clinic 26 Class How do you balance the needs of a curriculum program and an athletic training department? Slippery Rock University has blended the two groups into one. By Bonnie Siple & Scott Zema Optimum Performance

the Season Begin 32 Let Once a sport season gets underway, strength and conditioning can easily be overlooked. That’s why you need a special plan for inseason weight training. By Abigail Funk Treating The Athlete

Starting at the Bottom

Advertisers Directory

CEU Quiz For NATA and NSCA members

39 When the complaint is recurring pain in the heel, bone spurs may be the cause. Treating this condition means looking at the full functional capability of the athlete. By Casey Smith & Dr. Micheal Clark Sport Specific

Strength to Spare

45 They may not strike you as athletes who need conditioning, but On the cover: Using the ideas of nutrient timing, University of Texas freshman phenom Kevin Durant was able to gain over 20 pounds of lean mass last season. Story begins on page 17. TR AINING-CONDITIONING.COM

bowlers can greatly enhance their performance with a progressive training program. By Tasha Weddle T&C SEPTEMBER 2007

Victories don’t always come at the end of the game.

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Marjorie Albohm, MS, ATC/L Director of Sports Medicine and Orthopaedic Research, Orthopaedics Indianapolis

Joe Gieck, EdD, ATR, PT Director of Sports Medicine and Prof., Clinical Orthopaedic Surgery, University of Virginia (retired)

Jon Almquist, ATC Specialist, Fairfax County (Va.) Pub. Schools Athletic Training Program

Brian Goodstein, MS, ATC, CSCS, Head Athletic Trainer, DC United

Brian Awbrey, MD Dept. of Orthopaedic Surgery, Massachusetts General Hospital, and Instructor in Orthopaedics, Harvard Medical School Jim Berry, MEd, ATC, SCAT/EMT-B Director of Sports Medicine and Head Athletic Trainer, Myrtle Beach (S.C.) High School Leslie Bonci, MPH, RD Director, Sports Medicine Nutrition Program, University of Pittsburgh Medical Ctr. Health System Christine Bonci, MS, ATC Asst. A.D. for Sports Medicine, Women’s Athletics, University of Texas Cynthia “Sam” Booth, ATC, PhD Manager, Outpatient Therapy and Sportsmedicine, MeritCare Health System Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center Cindy Chang, MD Head Team Physician, University of California-Berkeley Dan Cipriani, 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. Keith D’Amelio, ATC, PES, CSCS Head Strength & Conditioning Coach/ Assistant Athletic Trainer, Toronto Raptors Bernie DePalma, MEd, PT, ATC Head Athl. Trainer/Phys. Therapist, Cornell University Lori Dewald, EdD, ATC, CHES Health Education Program Director, Salisbury University Jeff Dilts, Director, Business Development & Marketing, National Academy of Sports Medicine David Ellis, RD, LMNT, CSCS Sports Alliance, Inc. Boyd Epley, MEd, CSCS Director of Coaching Performance, National Strength & Conditioning Association 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

September 2007 Vol. XVII, No. 6 Publisher Mark Goldberg

Gary Gray, PT, President, CEO, Functional Design Systems

Editorial Staff Eleanor Frankel, Director R.J. Anderson, Kenny Berkowitz, Nate Dougherty, Abigail Funk, Dennis Read, Greg Scholand, Laura Ulrich

Allan Johnson, MS, MSCC, CSCS Coach, Speaker, Consultant 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

Circulation Staff David Dubin, Director John Callaghan

Tim McClellan, MS, CSCS Director of Perf. Enhancement, Makeplays.com Center for Human Performance

Art Direction Message Brand Advertising Production Staff Don Andersen, Director Jonni Campbell, Jim Harper, Miles Worthington

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

IT Manager Julian Cook

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

Business Manager Pennie Small

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

Special Projects Dave Wohlhueter Administrative Assistant Sharon Barbell

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

Advertising Materials Coordinator Mike Townsend

Bruno Pauletto, MS, CSCS President, Power Systems, Inc. Stephen Perle, DC, CCSP Associate Prof. of Clin. Sciences, University of Bridgeport College of Chiropractic Brian Roberts, MS, ATC, Director, Sport Performance & Rehab. Ctr. Ellyn Robinson, DPE, CSCS, CPT Assistant Professor, Exercise Science Program, Bridgewater State College Kent Scriber, EdD, ATC, PT Professor/Supervisor of Athletic Training, Ithaca College 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 Visiting Professor Athletic Training Education Program, Ohio 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 Pat Wertman (607) 257-6970, ext. 21 T&C editorial/business offices: 31 Dutch Mill 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., 31 Dutch Mill 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 $7. Copyright© 2007 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. Periodicals postage paid at Ithaca, N.Y. and additional mailing offices. 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 Kathy Schniedwind Illinois State University

After three decades as an athletic trainer at Illinois State University, Schniedwind stepped down at the end of the 2005-06 season. Serving as Head Athletic Trainer for the final 17 years, she coordinated care for 19 sports with primary responsibility for the football team, and taught in the Department of Kinesiology and Recreation. Schniedwind earned a master’s degree from Indiana University in 1976, and then took a job as Illinois State’s first Head Women’s Athletic Trainer that fall. Six years later, the men’s and women’s athletics programs merged, and she served as Assistant Athletic Trainer before taking over the department in 1989. Over the next 17 years, Schniedwind gained national recognition working on the NCAA’s Committee on Competitive Safeguards and Medical Aspects of Sports, where she focused on drug education, and on the NATA College/University Athletic Training Student Committee. In 2004, she was inducted into the NATA Hall of Fame. In this interview, she talks about retiring at 54, how the profession has changed, difficult rehabs, and the importance of properly balancing work and life. T&C: How are you enjoying your retirement? Schniedwind: It’s been a great challenge. I miss the people I worked with and I miss the ability to make a difference every day with student-athletes, coaches, and athletic training students. But it was time for me to try some new things, and it was a good decision. On the one hand, I’m still involved in athletic training through teaching, but on the other, I’m also able to do things I never had time to do before, like volunteer at the humane society. And I’m spending more time with family and friends. It’s the best of both worlds. 6

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Lecturing at schools on behalf of the National Center for Drug Free Sport. Teaching a course in Illinois State University’s athletic training education program. Serving as an athletic trainer at Special Olympics events. Volunteering twice a week at the local humane society. This hardly sounds like a life of leisure, but for Kathy Schniedwind, MS, ATC, this is what retirement looks like.

Head Athletic Trainer for Illinois State from 1989-2006, Schniedwind covered the football team, along with teaching a class and serving on several national committees.

How has athletic training changed since you started in the field? When I began as the head women’s athletic trainer in 1976, we had a much smaller full-time staff and far fewer graduate assistants. We had separate men’s and women’s athletics departments, which were housed in two different buildings. Since then, the departments have merged, facilities have grown, and we have a new athletic training room, which I helped design. TR AINING-CONDITIONING.COM

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Q&A Technologically, the modalities we use to treat athletes have improved tremendously. Educationally, we’ve seen immense changes. As a profession we went through some growing pains, but I think our students are much better prepared now, with much closer supervision.

“There’s a lot of psychology in this job. On a long-term rehab, I tell athletes they’re going to have good days and bad days, and just because they go backward one day doesn’t mean they can’t go forward the next. The key is letting them talk and listening to them.” Why did you become an athletic trainer? My undergraduate degree was in physical education and health, but after spending a year as a high school health and physical education teacher in Norfolk, Va., I knew that wasn’t for me. I’d always loved athletics and medicine, so when one of my mentors suggested I look into the athletic training program at Indiana, it sounded like the perfect way to combine the two.

Was it difficult being a female athletic trainer for a football team? No, not really. Whenever you work with a coach for the first time, you have to prove yourself, whether you’re male or female. If you have the skills and communicate well, gender shouldn’t be an issue. Once people saw I could do my job, it wasn’t a problem. There were situations where it would have been easier if I were male. When I had to go into the locker room, someone had to call out, “A woman is coming in.” But that’s no different for male athletic trainers working with a female team. Plus, I’m 5’2”, so there were times when I’d have to stand up on the locker room bench to look a player in the eye. And sometimes, I’d intentionally do goofy things, like dancing to the radio—I’m not a good dancer—so we could all laugh together. What was your most difficult rehab? A football player totally dislocated his knee—not the kneecap, the entire knee—when it was hit straight on at full speed. He tried to run off the field and almost made it to the sideline before he collapsed. I literally had to hold his knee together, or it would have flopped around like a rag doll. We spent over a year rehabbing, and this young man worked extremely hard. He was in the athletic training room two or three times a day year-round, and ended up playing again, which was really impressive. Then, not even two years after he graduated, he was killed

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Q&A in a car accident. When you spend as much time with someone as I did with that young man, you get to know that person pretty well. It was devastating.

so it’s okay.” But they don’t understand that the Food and Drug Administration doesn’t regulate all supplements. They figure if they can buy it at a store, it has to be okay.

Are there other rehabs that stand out in your mind? Anybody who’s gone through a surgical ACL repair—that’s always a long process. Those are the athletes who need the most encouragement, because most of them just want to know, “When do I get to run?” They don’t see results quickly, and as athletic trainers, our biggest challenge is to keep motivating them. There’s a lot of psychology in this job. On a long-term rehab, I tell athletes they’re going to have good days and bad days, and just because they go backward one day doesn’t mean they can’t go forward the next. The key is letting them talk and listening to them.

What’s the hardest part of working as a collegiate athletic trainer? I have to admit that sometimes I got tired. I am a high energy person, but late in my career, I didn’t bounce back as easily as I used to, especially after working late nights. There were

Why are you a proponent of drug testing? It’s not necessarily the drug testing itself, it’s the message we’re sending to student-athletes: Do not try things just because someone says they will help you. One reason we started drug testing at Illinois State was to deter studentathletes who might want to experiment or feel pressured to use a certain drug. If they know they might be tested, they won’t try it. It’s also important to educate them about supplements. A lot of athletes will say, “I bought this at the nutrition store,

“By delegating work, you give ownership to your staff. It took a long time to get over feeling guilty about not being there when my assistants were. But once I did, I was able to take full days off, even when the sport I covered was in season.” times I thought I was burning out, mostly when I was really tired or things weren’t going well. But when I stepped back and talked about it with friends, I realized this was what I want to do—I love it. I always tell athletic training students that if they have a problem, talk about it. If you just keep it bottled up, it’ll get worse.

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Q&A ■ Kathy Schniedwind Former Head Athletic Trainer, Illinois State University Speaker, The National Center for Drug Free Sport Board Member, NATA Research and Education Foundation Board of Directors Instructor, Athletic Training Education Program, Illinois State University Advisor, The Collegiate Sports Medicine Foundation BS, West Chester State University, 1974 MS, Indiana University, 1976 Honors: Illinois Athletic Trainers Association Hall of Fame NATA Hall of Fame First sports medicine job: Women’s Athletic Trainer, Illinois State University

What have you learned about balancing work and life? Early on in our careers, my generation of athletic trainers made the mistake of thinking we needed to be in the athletic training room 24/7, whether anybody walked through the door or not. We had to learn that it’s okay to leave our assistants in charge. By delegating work, you give ownership to your staff. It took a long time to get over feeling guilty about not being there when my assistants were. But once I did, I was able to take full days off, even when the sport I covered was in season. What are you proudest of from your 30 years in the field? That I was there to help people. Early on, I learned from my parents that it’s important to give back to the community. That’s

“I think working with the Special Olympics makes me a better person because it helps me appreciate all the things we take for granted on a daily basis. It takes me outside myself and teaches me things I might not normally learn as a collegiate athletic trainer.” why my involvement with the Special Olympics is so strong. I’m also proud that I led by example and never asked anybody else to do more than I was doing. At the same time, I tried to be thankful and tell people when they did a good job. It always frustrates me when people say, “I don’t have to compliment them for doing their job.” So I ask my students, “How does it feel when someone says you’ve done a great TR AINING-CONDITIONING.COM

job? Is there a quickness in your step? Does it put you in a good mood?” We don’t always give enough praise, but hopefully they will. Does working with the Special Olympics make you a better athletic trainer? I think it makes me a better person because it helps me appreciate all the things we take for granted on a daily basis. It takes me outside myself and teaches me things I might not normally learn as a collegiate athletic trainer. It’s a different kind of care. We have more seizure issues with Special Olympians, and we can’t always communicate well with athletes or know their full history. But it’s really fun to be part of it and help the athletes compete. They’re so excited to participate, even if all they win is a seventh-place ribbon. It gives me a different perspective on things. What are the most pressing issues facing the profession? Athletic trainers need to keep working with other health professions, because the bottom line is that we’re all trying to do the same thing: rehabilitate physically active people. I would like athletic trainers to be able to bill for services through Medicare, regardless of setting. I’d like to see us treated the same as other allied health professions. And I’d also love to see every high school athletics program have an athletic trainer. That would be a huge change. What are your next goals? To stay healthy and have more time for friends and family, which is one of the main reasons I decided to retire from the intercollegiate athletic setting. I’m keeping an open mind. I don’t want a full-time job, but if someone approached me with a new opportunity, I might just give it a try. ■ T&C SEPTEMBER 2007

Student

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Corner A special feature for your athletic training students

A Moral Compass As an athletic trainer, you will undoubtedly face ethical decisions. Luckily, there is a source of help. BY DR. GREG FROUNFELTER

ersonal ethics are like snowflakes—no two are alike. What one person sees as just and right, another may view as unfair or immoral. Professional ethics, however, are different. Many professions—especially in healthcare—have established ethical standards for their practitioners. Most likely, you are already familiar with the National Athletic Trainers’ Association Code of Ethics. This is a powerful document with many ramifications for the ways athletic trainers practice. Once you become a Certified Athletic Trainer, the words in this code will take on greater meaning. No longer will they address purely theoretical concepts. They will become a tool to guide you through the ethical and moral decisions we all encounter in our profession. At its core, the NATA Code is based on four principles: Principle 1: Members shall respect the rights, welfare, and dignity of all. Principle 2: Members shall comply

Greg Frounfelter, DPT, SCS, ATC, CSCS, is an Athletic Trainer and Physical Therapist in the Physical Medicine Department at Agnesian Healthcare-Waupun Memorial Hospital in Waupun, Wis. He can be reached at: frounfelterg@agnesian.com. 12

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with the laws and regulations governing the practice of athletic training. Principle 3: Members shall maintain and promote high standards in their provision of services. Principle 4: Members shall not engage in conduct that could be construed as a conflict of interest or that reflects negatively on the profession. By becoming an athletic trainer, you agree to follow this Code of Ethics and use it as your moral compass as an athletic trainer. Even athletic trainers who are not members of the NATA may be bound by our Code of Ethics, because if an athletic trainer’s decision results in litigation, one of the questions at hand will be whether he or she acted in accordance with accepted professional standards, including the NATA Code. There is no way around it. Every athletic trainer needs to understand and follow the NATA Code of Ethics. It should also be mentioned that individual state practice acts, where appropriate, are another important tool in ethical decision making. Principle 2 of the NATA Code makes it clear that these guidelines should be followed at all times. However, state practice acts vary in approach and detail, so we will limit this discussion to the NATA Code of Ethics. Transport yourself to the time when you have passed your NATA-BOC Examination and are a full-fledged athletic trainer. Congratulations! You can now wrestle with ethical questions that come up in our profession. Here are four scenarios presenting ethical quandaries and how the NATA Code of Ethics can be applied

to make the proper decision. Case A: The quarterback of the high school football team is injured during a game. As you make your way to the locker room, a booster stops you and asks about his status. Resolution: You are faced with a request for privileged medical information from someone who has no need to know the information. Section 1.3 of the NATA Code states: Members shall preserve the confidentiality of privileged information and shall not release such information to a third party not involved in the patient’s care without a release unless required by law. As harmless as it may seem, you should not share patient information with a person who is not involved in his care unless you have received approval from the athlete, and in the case of a high school player, his parents. In addition, Federal HIPAA requirements may come into play here, which could make such disclosure illegal. Case B: In an effort to save on the cost of supplies, a freshman basketball coach asks you to tape the ankles of only players in the starting line up. He says the other players can use braces instead. Resolution: You face several ethical considerations here. First, Section 1.1 of the NATA Code states: Members shall not discriminate against any legally protected class. This means everyone on the team should receive the same level of care whether they’re starters or not. Section 1.2 states: Members shall be committed to providing competent care. So you have to determine whethTR AINING-CONDITIONING.COM

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Corner er taping or bracing would be the best treatment for each player. In addition, Section 3.4 states: Members shall recognize the need for continuing education and participate in educational activities that enhance their skills and knowledge. Searching for research in regard to this issue will help strengthen your position should you have to defend your decision to tape or brace. Case C: You know a fellow athletic trainer who is also employed as a physical therapist at a local clinic. You note that all of the injured student-athletes

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could appear to be a conflict of interest and should be avoided. This is often addressed by being open about your professional relationships with your employer and giving the athlete the choice of where he or she would like to go for further follow-up care. There’s another ethical consideration here—what action you should take. Section 2.3 of the Code says: Members shall report illegal or unethical practices related to athletic training to the appropriate person or authority. The NATA Web site includes instructions for reporting violations of its

The wrestler shows signs that strongly indicate a fifth metacarpal fracture and says he is experiencing decreased hand function. But the coach is adamant that he not see a doctor … In this scenario, there are a variety of ethical issues, and sometimes they may even conflict with each other. at her high school are being sent to the clinic where your friend then treats them as a physical therapist. This occurs even with injuries that could easily be addressed within the confines of the high school athletic training room. Resolution: Principle 4 makes clear that any conflict of interest should be avoided and an athletic trainer referring patients to themselves to treat as a physical therapist could certainly qualify as a conflict. While it may seem to be good business, Section 4.3 states: Members shall not place financial gain above the patient’s welfare and shall not participate in any arrangement that exploits the patient. In addition, Section 3.3 states: Members shall provide services, make referrals, and seek compensation only for those services that are necessary, which would not include services that could be handled in the athletic training room. Even if the referral is made without regard to financial considerations, there is still an ethical problem, since Principle 4 speaks of “construed conflict of interest” not just an actual conflict of interest. Though everything may be legitimate, an athletic trainer referring athletes to a clinic they work for

Code of Ethics. Reports can be made anonymously, if desired. Though it may be difficult to report a fellow athletic trainer, our profession relies on self-policing. Turning a blind eye to an athletic trainer who acts unethically can put the profession’s reputation at risk. Some athletic trainers may prefer to talk with the offending party first in an attempt to get them to change their ways. But if the problematic behavior continues, it should be reported. Case D: You are covering a wrestling match at a new high school. You find the coach has been using a soft splint and taping to help a varsity wrestler with a sprained hand for the last four weeks. The wrestler shows signs that strongly indicate a fifth metacarpal fracture, and says he is experiencing decreased hand function. But the coach is adamant that he not see a doctor because if the hand is fractured, the wrestler, who is ranked second in the state, will miss the state tournament. Resolution: In this scenario, there are a variety of ethical issues, and sometimes they may even conflict with each other. Principles 2 and 3 of the Code of Ethics speak to the need to main-

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Corner tain high standards in providing athletic training services. Pertinent sections of the NATA Code of Ethics include: Section 3.1: Members shall not misrepresent, either directly or indirectly, their skills, training, professional credentials, identity, or services. Section 3.2: Members shall provide only those services for which they are qualified through education or experience and which are allowed by their practice acts and other pertinent regulation. Section 4.1: Members should conduct themselves personally and professionally in a manner that does not compromise their professional responsibilities or the practice of athletic training. By not arranging adequate medical follow-up, there is a breach of duty to the athlete. An athletic trainer who allows this to continue and tries to nurse the athlete through the season could even be accused of practicing medicine without a license. Plus, if permanent injury or disability occurs as the result of competing with the injury, the school, coaches, or athletic trainer could be held liable. Ethics require that the athletic trainer explain to the coach and athlete—and if he’s a minor, to his parents—the seriousness of the injury and the importance of having it evaluated by a doctor. The athletic trainer also needs to make it clear that he or she will not participate in any plan to keep the wrestler in action without a physician’s approval. However, the athletic trainer cannot force the athlete to seek treatment. In the high school setting, this decision will usually be up to the parents. If they decline your guidance, all you can do is reiterate your concerns and have them sign off on their refusal to follow your instructions. These scenarios, all of which are based on ethical questions I have faced during my career, may seem to require little more than commonsense solutions. But anytime you get into a discussion of ethics, you will be amazed by some of the arguments you will hear. Some athletes and parents may feel a chance to win a state title

is worth taking the risk of permanent injury, and some people will never understand why an athlete’s medical information is none of their business. As an athletic trainer, you will be judged by the NATA Code of Ethics and state practice acts. By using these as the basis for your professional ethics, you will always be able to justify your decisions from a moral and legal perspective. They provide the tools

needed to be an allied health professional who can make the best decisions on a consistent basis. ■ The National Athletic Trainers’ Association Code of Ethics, and instructions for reporting an ethics violation, can be found on the NATA Web site at: www.nata.org/ codeofethics/index.htm.

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NUTRITION

Timing It Right

Making the most of an athlete’s nutritional intake is as much about when as what. Here’s an in-depth look at nutrient timing and nutrition periodization. BY LAURA ULRICH hen nutritionists talk to athletes, advice most often centers around what they should eat. Without the right mix of carbohydrates, protein, vitamins, and minerals, an athlete’s body will be unable to reach its potential. However, recent research shows that athletes who focus exclusively on what they eat are missing half the equation: When they eat is just as important. In fact, studies suggest that the timing of nutrition is so critical that if two athletes consume exactly the same diet and perform exactly the same training, the athlete who times his or her eating correctly will make more performance gains than the one who doesn’t. Todd Wright, CSCS, Director of Basketball Strength and Conditioning at the University of Texas, has seen this firsthand. By carefully timing his athletes’ nutrition intake last season, Wright saw one player drop 73 pounds, another player who needed to add lean mass gain 22 pounds, and his entire team perform better than anticipated, making it to the Big 12 championship game and finishing with a No. 16 national ranking. “Out of our regular seven-man rotation, five of our players were freshmen,” Wright says. “I firmly believe

W Using nutrient timing, University of Texas freshman phenom Kevin Durant was able to gain over 20 pounds of lean mass last season, helping him become the 2nd pick in the NBA draft this spring.

Laura Ulrich is an Assistant Editor at Training & Conditioning. She can be reached at: lulrich@MomentumMedia.com. TR AINING-CONDITIONING.COM AP PHOTOS

T&C SEPTEMBER 2007

NUTRITION that timing our nutrition gave them the edge to achieve more than anyone expected. It’s one of the best tools in our toolbox. We’ve taken advantage of it, and it’s made the difference for us.”

workouts well fueled and are able to maximize their recovery afterward, a concept known as nutrient timing. In the bigger picture, athletes need to know how to adjust their eating across

“Over 15 years, we looked at one main question: How does the timing of nutrition relative to exercise influence glycogen storage and protein synthesis? The answers became the basis for the nutrient timing system.” To truly benefit from timing their nutrition, athletes need to focus on both the small and large pictures. On one hand, they need to understand how to schedule their meals and snacks across each 24-hour period so they arrive at

the course of an entire year, so that whether it’s the off-season, preseason, or height of competition, their bodies are getting the right nutrition when they need it. This concept is known as nutrition periodization.

NUTRIENT TIMING John Ivy, PhD, Professor of Kinesiology and Health Education at Texas, has spent more than a decade studying how athletes can time their eating across the course of a day to optimize their bodies’ response to training. In 2004, Ivy and co-author Robert Portman published the results of this work in a book titled Nutrient Timing: The Future of Sports Nutrition. “Over a period of 15 years, we looked at one main question: How does the timing of nutrition relative to exercise influence glycogen storage and protein synthesis?” Ivy says. “The answers to that question became the basis for the nutrient timing system.” Ivy’s system breaks an athlete’s day into three phases: the energy phase, the

LOSS & GAIN

hen athletes need to lose or gain weight, conventional wisdom says that a calorie is a calorie and raising or lowering their intake should do the trick. In reality, however, timing those calories right can make a big difference. That strategy was key last season for Todd Wright, CSCS, Director of Basketball Strength and Conditioning at the University of Texas. When the men’s team reported for training the summer before the 2006-07 season, two freshmen athletes had big weight goals to accomplish. At 6-foot-10 and 367 pounds, Dexter Pittman needed to drop weight. And at 6-foot-9 and 200 pounds, Kevin Durant needed to bulk up. Both players saw remarkable results. By the end of the summer, Durant had gained 22 pounds. Pittman’s goal took a bit longer, but over the course of the season, he lost 73 pounds. “Neither of those things would have been possible without nutrient timing,” Wright says. “Both of them worked extremely hard, but applying nutrient timing was what allowed that work to pay off.” With Durant, Wright focused on getting him to eat frequently, adding 300 to 400 calories to his daily diet by having him take in high quality carbohydrate, protein, and fat at each meal, while also snacking often between meals. But the real key was getting him to capture the crucial window

T&C SEPTEMBER 2007

after each workout when his body was primed for protein synthesis. Wright did this by making sure Durant consumed carbohydrate and protein immediately after each of his summer workouts and a light meal containing both macronutrients about two hours later. “That was crucial,” Wright says. “If he hadn’t been capturing those windows, it wouldn’t have mattered how hard he worked. He would not have gained that much lean mass in just eight weeks.” With Pittman, Wright also focused on frequent eating, but with the goal of cutting down overall calories. “We had him eat six or seven small meals a day with a lot of water,” Wright says. “Except for during the post-workout window, we cut out high glycemic index foods, so the majority of the time, we kept his insulin and cortisol low, which helps with weight loss. “But post-exercise, we made sure he had a high-carb recovery food, because that was when his body was ready to convert the glucose to muscle glycogen, not store it as fat,” Wright continues. “His training volume was much higher than Durant’s, and with all that training, he started dropping weight like crazy. But if we hadn’t timed his nutrition, he wouldn’t have been able to recover from those intense sessions to sustain the workload that helped him lose 73 pounds.”

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NUTRITION anabolic phase, and the growth phase. Each comes with its own set of nutrition recommendations based on what’s happening within the athlete’s body. The energy phase: In nutrient timing parlance, the part of the day when an athlete is working out or competing is called the energy phase. During this time, the body is using high levels of three hormones—cortisol, catecholamine, and glucagon—to break down muscle glycogen, liver glycogen, and adipose tissue, sending them to hardworking muscles. This breakdown state is known as catabolism. The main advice for nutritional intake during this phase is no surprise. “First and foremost, hydration is important,” Ivy says. “Replacing carbohydrates and electrolytes is the next goal, so we recommend ingesting that fluid in the form of a sports drink containing four to six percent carbohydrate and a basic electrolyte combination. “More specific nutrition recommendations during the energy phase vary somewhat based on what kind of exercise the athlete is performing and how intense it is,” Ivy continues. “As a guide-

carbohydrate-containing sports drink that is two to three percent protein,” Ivy says. “It will reduce muscle damage and help protein synthesis post-exercise. During the workout, the athlete should continue hydrating by drinking water or a sports drink.”

line, if the athlete is practicing or playing at 70 percent of VO2 max, he or she needs to consume about 200 to 300 milliliters of fluid every 20 minutes.” Ivy’s next piece of advice, however, differs from standard protocol: He suggests focusing on drinks that contain

The body will not automatically transition from catabolism to anabolism when the athlete stops working out. “Post-exercise, catabolic hormones are still high and the body is still breaking down muscle protein. It won’t really start recovering ... until you put the right nutrients in.” The anabolic phase: While the athlete works out, three key things happen in his or her body that prepare it for a transition from catabolism to anabolism. First, a large number of glucose transporters move to the outside of the cells’ plasma membrane, ready to pick up any glucose that enters the bloodstream and transport it to the muscles where it can be used to replenish glyco-

some protein during exercise. “Not everyone agrees, but we’ve found that a small amount of protein during a workout helps reduce muscle damage and soreness and may actually improve performance,” he says. For an athlete in the weightroom, protein becomes even more of a focus. “Right before a weightroom workout, I recommend that athletes consume a

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NUTRITION gen stores. Next, the athlete’s sensitivity to insulin steadily increases, preparing muscles for even better glycogen storage. Lastly, the athlete’s body gears up

putting the right nutrients in. “If you provide the right nutrients immediately, you can convert the catabolic state to a highly anabolic state in

Two hours later, it’s important for the athlete to eat again. “This should be a light meal, and it should contain both protein and carbohydrate … This keeps the process of anabolism going.” to synthesize new proteins, a function it can perform faster post-exercise than at any other time. “Thanks to these factors, even when the body is in a catabolic state, it’s preparing for a period of intense anabolism, or rebuilding, right after exercise,” Ivy says. However, there’s a catch. The body will not automatically transition from catabolism to anabolism when the athlete stops working out. “Post-exercise, catabolic hormones are still high and the body is still breaking down muscle protein,” Ivy says. “It won’t really start recovering until you do something about it—and doing something means

which the athlete rapidly increases muscle glycogen and protein synthesis,” he continues. “But if you delay the nutrients, even if you provide them later on, you’ll never get the same effect. Once you miss the window, it’s gone.” The size of the window is not an exact science. “We know that waiting two hours to provide the nutrients is way too long,” he says. “But is half an hour better than 45 minutes? We’re not sure. My personal belief is, the sooner the better. The quicker you interrupt the catabolic state, the better.” What are the right nutrients? After practices and competitions that focus on

aerobic output, in addition to consuming enough fluid to replace 150 percent of what they lost, athletes need between 1.0 and 1.5 grams of carbohydrate per kilogram of body weight (depending on how hard they worked out). And they need 0.3 to 0.4 grams of protein per kilogram of body weight. After weightroom sessions, the recommendations are essentially the same, but with a slightly higher emphasis on protein—0.5 grams per kilogram of body weight. Two hours later, it’s important for the athlete to eat again. “This should be a light meal, and it should contain both protein and carbohydrate,” Ivy says. “This keeps the process of anabolism going. Over the two hours since their post-exercise nutrients, the concentration of amino acids in the athlete’s blood have dropped, along with insulin and glucose levels. The second meal causes them to spike again and keeps the recovery process going.” The growth phase: What about the rest of the day? Four hours post-exercise, the athlete should eat another light meal. Then, over the next 16 hours, he or she needs to eat every few hours,

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NUTRITION focusing on basic healthy nutrition. “Simply maintaining a balanced diet of carbohydrate, protein, fruits, and vegetables during that time is all that’s needed,” Ivy says. MAKING IT HAPPEN Wright’s first step in implementing the nutrient timing system with his athletes is educating them—but he doesn’t give a lecture on cortisol, glycogen, and metabolism. “When you start talking that way, you lose them,” he says. “Instead, I use analogies they can quickly understand and I break down the recommendations to make them simpler.” To encourage athletes to fuel throughout the day and during workouts, Wright tells them to think of their bodies as racecars. “A car needs to start the race fully fueled and the driver needs to keep fueling to maintain performance,” he says. “I explain the recommendations about carbs and protein by telling them they can’t just put anything in the gas tank—the fuel has to be the right formula or the car won’t run well.” To help athletes focus on fueling during the anabolic period, Wright

describes the post-exercise time as a window that’s closing. “I tell them, ‘At the end of your workout, all the windows in your muscles are wide open for about 45 minutes. When you put nutrients in then, they can accept them and replace all the energy you just used up,’” he says. “‘But as the 45 minutes tick away, the windows start to close. When you put nutrients in after that, it’s like trying to push them through a closed window—it just doesn’t work.’” To ensure that they take advantage of

ents they need,” he says. Bob Seebohar, MS, RD, CSCS, a dietician with the U.S. Olympic Committee who served as the University of Florida’s Director of Sport Nutrition in 2005-06, agrees that getting athletes to consume post-exercise nutrition can be difficult. “They don’t feel like eating, and scheduling can be a problem, too,” he says. “When they leave the field, they go to get treatments, sit in an ice bath, or take a shower—and then they’re ready to eat. But by then,

Seebohar provided liquid recovery meals immediately after practice, including powdered drinks and milkbased fruit smoothies. “A protein-containing energy bar also works great, and so does a lean-meat sandwich.” the window, Wright provides a sports drink with both carbohydrate and protein to each athlete immediately after practices and workouts and makes sure they drink it. “They’re thirsty and probably don’t feel like eating, so this is the best way for them to get the nutri-

they’ve missed the window. So it’s important to have something available with carbs and protein that’s easy for them to consume immediately.” Seebohar’s solution at Florida was to provide liquid recovery meals immediately after practice, including powdered

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NUTRITION drinks and milk-based fruit smoothies. “A lot of things will work, as long as they are convenient and the athlete can tolerate them,” he says. “A protein-containing energy bar works great, and so does a lean-meat sandwich.” Paul Goldberg, MS, RD, CSCS, CSSD, Strength and Conditioning Coach for the NHL’s Colorado Avalanche, believes it’s also important to focus on mental recovery during the anabolic phase. “If a player is stressed from an intense game, his cortisol lev-

els are going to remain high, which will hamper his physical recovery,” he says. “We focus on bringing those catabolic hormones down by getting players to relax through stretching, massage therapy, or talking about what happened during the game. The mind and body are connected, and if a player is still stressed from the game, his stress hormones are not going to come down.” For the growth phase, or the time period before the next workout or game, Wright reminds players to eat healthy

foods at regular intervals by asking them to envision their metabolism as a campfire. “We tell them they need to get the fire burning first thing in the morning by throwing some fuel on it,” he says. “And unless they put more nutrients in regularly, the fire will burn

“We wouldn’t think of asking an athlete to train the same way day in and day out over the course of a year. But when you look at an athlete’s nutrition, often you’ll find they’re eating the same way week in and week out, regardless of how their training changes.”

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out, so every two or three hours, they need to throw another log on by eating some healthy food. “It’s also helpful to provide them with some ideas for healthy meals and snacks that combine protein and carbohydrate,” Wright continues. “I give them lots of examples of foods to have two hours post-exercise, as well as tips on what to look for in a healthy dinner.” Goldberg has taken it a step further, gathering menus from 60 to 70 restaurants in the Denver area and other cities where his team frequently travels. “I keep them in my office,” he says. “My players come in and say, ‘We’re going here to eat,’ and I can tell them exactly what they should choose and what to avoid.” Giving athletes a chance to experience the results of properly timing their nutrients can often be the best way to convince them of its value. “If you can get them to give it a try, even for a short period, they’ll usually buy in,” Ivy says. “In the short term, they’ll see even after a few days that they’re recovering better from their workouts, are less sore, and have more energy for their next workout. In the longer run, after about three months, they’ll see big strength and performance gains.” NUTRITION PERIODIZATION The nutrient timing system provides

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NUTRITION guidance over the course of a day, but athletes also need to time their nutrition for the bigger picture. Different phases of the year place different demands on athletes’ bodies, and to respond optimally, they must adjust what they eat to match. Seebohar has been studying this concept for nine years, and in 2004, he authored a book, Nutrition Periodization for Endurance Athletes: Taking Traditional Sports Nutrition to the Next Level, to summarize his conclusions. “We’re all familiar with periodization as it relates to training cycles, and we wouldn’t think of asking an athlete to train the same way day in and day out over the course of a year,” says Seebohar. “But when you look at an athlete’s nutrition, often you’ll find they’re eating the same way week in and week out, regardless of how their training changes. That sets them up for trouble.” Seebohar suggests thinking of training cycles like waves, with times of higher volume and intensity as the peaks, and times of lower intensity as the valleys. If an athlete’s nutritional intake is a constant—a straight line through the

waves—they’ll be taking in too little nutrition during the peaks and then eating too much during the valleys. “An athlete who ignores nutrition periodization will often be left without enough energy to complete workouts, or they’ll be gaining weight and they won’t understand why,” Seebohar says. “Both can hurt their performance.

es daily preparation for workouts, urging athletes to fuel up one to two hours before a training session. He also emphasizes recovery using nutrient timing concepts. In-season: Once athletes are competing, their training volume usually goes down and the goal is to maintain the strength and endurance they have built. At this point, it’s time to reduce

“I can’t tell you how many high school and college athletes I meet who eat once a day. To recover from game to game, they need to eat every two or three hours. It doesn’t have to be a full meal—it can be a piece of fruit and a granola bar.” “To avoid those pitfalls, nutrition needs to vary along with training cycles,” he continues. “Whenever there is a volume or intensity change, you should implement a corresponding nutrition change.” Preseason: When athletes’ training volume and intensity are highest, the emphasis is on consuming enough nutrients to sustain the workload. Seebohar stress-

calories. However, athletes still need a steady stream of energy, so Seebohar recommends stressing smaller, more frequent meals and avoiding long periods without a meal or snack. “I can’t tell you how many high school and college athletes I meet who eat once a day,” Seebohar says. “To recover from game to game, they need to

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NUTRITION they aren’t drinking enough.” Off-season: Reduced training can easily lead to unwanted weight gain, so athletes need another plan for this time period. “If they have at least three to four weeks when they’re not doing very much training, it’s critical to alter their eating to reflect that,” Seebohar says. “That is the time when their weight can start creeping up, and if you don’t control the calories, they’ll arrive at preseason training needing to lose 20 pounds.” Preventing weight gain entails adding lots of fruits and vegetables to boost fi-

eat every two or three hours. It doesn’t have to be a full meal—it can be a piece of fruit and a granola bar. This works great during the competitive season, because frequent eating causes them to naturally curb their calories a little bit while still maintaining energy.” Hydration is another big focus inseason. “Athletes who were doing great with hydrating in the preseason can forget to maintain it in-season,” Seebohar says. “I tell them to carry a water bottle, and make sure they’re urinating every two to three hours. If they’re not,

Balance-pad

ber, which makes athletes feel full. It also means making sure they include a lean protein source every time they eat, rather than filling up on carbohydrates alone. “In the off-season, I tell athletes they should never be eating from just one food group,” Seebohar says. “Every time they eat, they need some carbs, some lean protein, and a fruit or vegetable.” Implementing nutrition periodization also requires communicating about it frequently. “Start by explaining the concepts—just the idea that their eating needs to vary with their training will be new to most,” Seebohar says. “Then keep them abreast of changes that are coming up and why. For example, a few weeks before the end of the season, give them a heads-up that you’re going to ask them to change the way they eat. Always give them a road map for where you’re going with their nutrition.” “Talking with athletes about this concept is key,” Goldberg agrees. “When it comes to nutrition, I have found that the more I educate my players and the more they know what to expect, the more likely they are to follow my recommendations.” ■

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Educating Athletes to be Supplement Savvy Ellen Coleman, M.P.H., M.A., R.D., CSSD Sports Dietitian for The Sport Clinic and consultant to the Los Angeles Lakers, Angels and Kings professional sports teams.

any dietary supplements, including vitamins, minerals, amino acids, and herbs, are claimed to aid health and improve the performance of athletes. While some dietary supplements may be safe and provide the beneﬁts claimed, others may be ineffective, dangerous, or contain ingredients banned by athletic organizations. Considering the plentiful and sometimes confusing information that is available regarding dietary supplements, it can be challenging for athletes to sort out trustworthy information. Sports health professional should educate athletes on how to evaluate dietary supplements and how to make knowledgeable decisions when choosing supplements.

The Food and Drug Administration (FDA) does not review dietary supplements for safety, effectiveness, purity, or potency before the supplements are marketed. As a result, athletes can never be absolutely sure of the purity or contents of the supplements. In addition, the wording on some supplement labels are often impressive to athletes seeking a performance advantage. Some products tout “natural” ingredients, but many athletes fail to realize that “natural” does not necessarily mean “safe”. Some product ingredients (even natural ingredients) may interact with prescription drugs, over-the-counter medications, or other supplements causing serious adverse effects.1 Athletic trainers and physicians should pay special attention to what their athletes are using because some supplements can have undesirable effects during surgery. Finally, some supplements may contain ingredients not declared on the label that could cause unsuspecting athletes to test positive for banned substances.2 There are several ways that supplement use can cause an athlete to unintentionally test positive for doping. In most cases, the contamination occurs during the production process due to poor manufacturing practices, but there is also evidence of deliberate alteration of products by manufacturers.2 The Medical Commission of the International Olympic Committee (IOC) found that of 634 non-hormonal nutritional supplements tested from 13 different countries, 94 (14.8%) contained substances that were not listed on the label and that would have led to a positive doping test.3

Generally, products are tested against four standards: • Identity – to ensure the supplement meets

recognized standards of quality; • Strength – to conﬁrm that the supplement contains

the amount of ingredient claimed on the label; • Purity – to verify that the supplement

is free of contaminants; • Availability – to make sure that the supplement breaks

apart properly so that it may be used by the body. Look for well-known and trusted brands. Nationally known food and drug manufacturers who also market supplements generally produce supplements under the strict quality control procedures they already have in place. Such manufacturers can be contacted by phone or via their web sites and should be able to demonstrate that the product passes tests for content potency, purity, and uniformity. If the company does not answer questions or address complaints, athletes should not use the product.2 Disregard supplements with unclear or confusing product claims. The supplement label should provide accurate and appropriate information. If statements are unclear or the label makes unlikely claims, it is doubtful that the company follows good quality control procedures. Athletes should be wary if the claims for the product sound too good to be true. No dietary supplement can guarantee that its use will result in measurable changes in an athletes individual performance.2 Sports health professionals should teach athletes to consider the total diet ﬁrst – no supplement can replace eating a wide variety of healthy food. Further, sports health professionals should recommend that athletes check with a doctor, pharmacist, or registered dietitian before using a supplement and encourage athletes to read the supplement label, follow all directions, and heed any warnings.2

References 1

National Consumers League. A consumer’s guide to dietary supplements. http://www.nclnet.org/ dietsuppsbrochure.pdf Maughan, R. Contamination of dietary supplements and positive drug tests in sport. J Sports Sci 23:883-9, 2005. 3 Geyer, H., et al. Analysis of non-hormonal nutritional supplements for anabolic-androgenic steroids - results of an international study. Int J Sports Med 25:124-9, 2004. 2

Tips for Choosing a Supplement: Do Research. Sports health professionals can guide their athletes to sources such as www.consumerlab.com, www. cfsan.fda.gov, and www.ais.org.au/nutrition/Supplements.asp to obtain information about supplements they are considering. Some independent labs provide test results and information to help athletes and sports health professionals evaluate and select dietary supplements.

LEADERSHIP

Slippery Rock University Athletic Trainer and Instructor Kimberly Keeley, MS, ATC, evaluates a softball athlete while athletic training student Christa George looks on.

Class & Clinic DAVE MILLER

How do you balance the needs of a curriculum program and an athletic training department? Slippery Rock University has blended the two groups into one. BY BONNIE SIPLE & SCOTT ZEMA

or better or worse, for richer or poorer, in sickness and in health … Here at Slippery Rock University, we sometimes joke that athletic trainers should take vows before joining our staff. Why? Because all five of us are committed to working together toward a lofty goal that takes a lot of dedication. Our mission is to educate future certified athletic trainers within accreditation standards and also provide medical coverage for an NCAA Division II athletic department. And we do this not by

T&C SEPTEMBER 2007

splitting tasks between medical coverage and teaching, but rather by blending them together. Many colleges and universities have separate athletic training education programs and athletic training departments. What we are attempting at SRU is to make the two programs one, without adding staff—or needing marriage counseling! Although this structure may take more communication, we are finding it benefits our students in a huge way. Our student-athletes receive medical care from an experienced staff and our

athletic training students gain a broader educational experience. OUR STORY Years ago, we employed a more traditional system. Two athletic training faculty members were housed in an Bonnie Siple, MS, ATC, is Coordinator of the Athletic Training Education Program and Athletic Trainer for women’s lacrosse, and Scott Zema, MEd, ATC, is Coordinator of Clinical Education and Athletic Trainer for football at Slippery Rock University. They can be reached at: www.sru.edu/ers. TR AINING-CONDITIONING.COM

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LEADERSHIP academic department. One taught and serviced a team, while the other taught and served as program director of our athletic training education program (ATEP). Two other athletic trainers were housed under athletics and serviced the athletic department only, with no teaching responsibilities. Like so many other colleges and universities, we dealt with the usual conflicts that arise between two sets of people who have differing responsibilities and goals. The shared desire to educate future athletic training professionals, as noble as it is, was not a sufficient glue to hold us together in the face of any disagreements that came up. As a result, the faculty and staff did not enjoy the healthiest of working relationships. Secondary to that, although our

ATEP students were successful, they did not enjoy the level of benefits they should have had from us. To resolve these conflicts, the administration created the opportunity for us to shift the paradigm of our program structure. Essentially, they took us off opposing teams and placed us on the same team: All athletic trainers became housed under the academic department responsible for our ATEP. The Pennsylvania State System of Higher Education helped with this endeavor by allowing all athletic trainers to fall under the umbrella of the faculty union. We all became faculty members housed within an academic department and under the guidance of a department chair. Additionally, we discarded the tradi-

tional terms “Head Athletic Trainer” and “Assistant Athletic Trainer.” No one individual was placed in a position of authority over another, thus leveling the playing field and forcing us to work collectively through our differences. Instead of adhering to specific titles, each of us assumed a role and set of responsibilities necessary for successfully implementing an accredited ATEP and servicing our athletics programs. One of us serves as ATEP coordinator, another as athletic training services coordinator, a third as medical services coordinator, and another as clinical education coordinator. The fifth person assists in coordinating the ATEP program. But all of us are responsible for coverage of one or more athletic teams, all of us teach classes, and all of us su-

CONFLICTS WITH COACHES

hen considering a structure where athletic trainers are not housed in the athletic department, an obvious question is, “How do you handle conflicts with the coaches?” This is probably one of our most consistent unresolved issues. We rarely experience conflicts with our more tenured coaches. They understand the athletic trainer’s role and tend to handle their concerns directly with whomever covers their sport. But we do sometimes run into problems with newer coaches. They have a tendency to play athletic trainer roulette when they don’t like the way their assigned athletic trainer is responding to them. In response, we are working hard to educate new coaches about how we work. We are taking the time to explain the athletic trainer’s role in general and how we work at SRU specifically. We are also addressing any coaching complaints as a team. If approached by a coach with a concern that involves another athletic trainer, we refer the coach back to his or her assigned athletic trainer for resolution of the conflict. If that doesn’t work, the coach is welcome to address his or her concerns with the athletic trainer responsible for coordinating athletic training services. It is always our goal to resolve conflicts with

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coaches at the lowest level and not involve the athletic director, our department chair, or especially our dean. As conflicts remain unresolved, we work our way up the chain of command until the conflict is resolved. Fortunately, that happens very rarely. Another strategy we are using is the development of a new policy and procedure manual for coaches. We have followed a manual for many years within the guidelines of our ATEP and university health center. However, those policies have not traditionally included the athletic department with any great detail. We are now in the writing stages of preparing a separate policy and procedure manual for the coaches, athletic department staff, and athletes to improve our relationship with them and create less opportunity for misinformation. Additionally, we attempt to participate in team building activities with the athletic department. For example, at the end of each academic year, the athletic department has a two-day retreat, which they include us in. Finally, the athletic director and our department chair meet annually to review and evaluate the “state of the union” between our two departments. Ultimately, communication is as critical to our relationship with the coaches and athletic administration as it is within our academic department.

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LEADERSHIP pervise athletic training students as Approved Clinical Instructors (ACIs). The difference between our structure and a traditional one may seem subtle, but how it plays out is not. It allows us to be united by the same goals of educating and providing healthcare, which leads to a different type of camaraderie on the sidelines and in the classroom. We all get to mentor our students in the classroom and clinical settings. And we all get to model appropriate behaviors and professional attributes. The educational goals then become clearer to our students, allowing them a deeper learning experience. BUILDING A TEAM In this structure, teamwork is paramount to our success. Relationships take work, and ours are no exception. Many of the ideas we now use to build teamwork were learned from mistakes we made along the way, especially with regard to communication. Breakdown in communication results in the breakdown of our team, so we have set up systems to communicate both quantitatively and qualitatively.

First, we make communicating a priority. All athletic trainers meet formally each week to discuss academic and athletic issues. We also communicate one-on-one almost daily in the athlet-

facilitating effective exchanges in our meetings. Although the coordinator of the ATEP runs these meetings, everyone works at making them an effective and efficient use of our time.

Next, we work at having quality communication. For example, something as simple as calling for agenda items from each member of the team before weekly meetings is extremely helpful. ic training facilities during sport coverage. And we donâ&#x20AC;&#x2122;t hesitate to pick up our cell phones, text message, or send an e-mail any time we have information to pass on or a question to ask. Just having the opportunity to talk with each other is not sufficient to create successful communication, however. Next, we work at having quality communication. For example, something as simple as calling for agenda items from each member of the team before weekly meetings, preparing an agenda, and then providing that agenda to each other ahead of time is extremely helpful in

We also work hard on communicating with those outside of our athletic training team. All athletic trainers attend departmental faculty meetings and college meetings in order to remain vested as faculty members within the department and the college. Additionally, the athletic training services coordinator attends all athletics department meetings and communicates with the athletic director as needed, relaying information to the rest of us. Along with focusing on communication, we have enhanced our teamwork by talking about our roles and work-

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LEADERSHIP ing relationships. For example, we have spent time as a group talking about the book, Good to Great: Why Some Companies Make the Leap … and Others Don’t, by Jim Collins. He compares an

ganization to arm and empower them to be successful. The wrong people in the wrong place doing the wrong things will not allow for a successful outcome. Even the right people in the right place

Overall, we have eliminated the black and white to operate in the gray. Yes, we still have our conflicts and failures … However, those challenges belong equally to all of us, thus we must resolve them equally among us. organization to a bus. You must put the right people on the bus, the right people in the right seats, and have everyone in agreement about the destination and the route you will follow to get there. That analogy has been a great outline in guiding our employment process and program assessment. Another valuable philosophy for us was found in the book, Soar with Your Strengths, by Donald Clifton and Paula Nelson. Their philosophy is to build on each person’s strengths in your or-

doing the wrong thing makes success difficult to achieve. To help us put the right people in the right place doing the right things, we have sometimes brought in a facilitator. This person administers the MyersBriggs Personality Inventory to each of us and then discusses with us the different ways we interact with each other based on our personality type. For example, because one of us has an interest in educational leadership and administration, this person serves

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as director of the ATEP. Because another person enjoys working with physicians and the health center (and has extensive experience in it), she has assumed the role of medical coordinator. When time and budget allow, we also try to employ team building projects. Our campus sponsors a leadership training program that includes outdoor adventure activities combined with teamwork exercises, which has helped us to grow as a group. EFFECT ON STUDENTS How does working on our relationships as athletic trainers benefit our students? Because we have the right people in the right seats on the bus, and because we know our destination and route, we are more successful in getting to that destination. Ultimately, our ATEP students are passengers on the bus with us, learning to become excellent athletic trainers themselves while we care for our student-athletes. A common thread of conversation during our athletic training faculty meetings revolves around the students, whether it be the general athletic train-

LEADERSHIP in our students a sense of importance for both their book learning and clinical skills. They can also directly observe that we practice what we preach. When it comes to gaining respect from coaches and athletic administrators, we’ve found it’s helped a lot that we are all faculty members. Athletic department staff appreciate the fact that we work within an accredited ATEP responsible for educating future certified athletic trainers. And they can also see that we are advocates for their teams and caring for their athletes every day. They recognize that our dual roles as teachers and practitioners do not come at the cost of the healthcare we deliver to their student-athletes. As our students start to look for jobs, our dual roles again assist them. It is to our students’ advantage that prospective employers receive recommendations from individuals who know the students very well. As faculty, we can address the students’ success in the classroom. As staff athletic trainers, we can address the students’ critical thinking, clinical skills, ability to react to any situation, and work ethic.

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EQUALLY AMONG US Overall, we have eliminated the black and white to operate in the gray. Yes, we still have our conflicts and failures. We struggle with how to maintain our accreditation and academic integrity, and how to achieve tenure and promotion, without sacrificing the quality of healthcare we deliver to our athletes. However, those challenges belong equally to all of us, thus we must resolve them equally among us. Just as important, our successes are celebrated together. When our students pass the Board of Certification (BOC) exam on the first attempt, we all celebrate. When one of our teams wins the conference championship, we all celebrate. At the end of the ATEP students’ ride with us, we hope they are prepared to pass the BOC examination with ease. More importantly, we hope they are prepared to competently, ethically, and professionally practice as certified athletic trainers. We feel that the blending of our roles allows them the greatest chance for success as they begin their careers, and as they continue them in the future. ■

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ing student population, the student-athletes, or one or two individuals who have inspired our focus. Student concerns (or successes) do not warrant only the attention of the program coordinator or that of the supervising ACIs—they warrant the attention of all the athletic trainers. By discussing these issues, everyone is on the same page on how to work with a student, tackle a specific problem, or emphasize a new idea. This helps us increase the quality of our interactions with students and student-athletes. Since our program does not distinguish between the traditional faculty and staff roles, SRU students have the unique opportunity to learn from the same faculty in both the classroom and clinical settings. This fosters a relationship between the student and athletic trainer that allows for the acculturation of the student into the profession. Additionally, it increases consistency between what is taught in the classroom and what is practiced in the clinical setting. We also think it’s advantageous for our athletic training students to see how their professors are able to meet the needs of both departments. It ingrains

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OPTIMUM PERFORMANCE

Let the

CHRIS MURPHY

Season Begin Once a sport season gets underway, strength and conditioning can easily be overlooked. That’s why you need a special plan for in-season weight training. BY ABIGAIL FUNK

hen teams are in the weightroom for offseason and preseason workout s , most strength coaches have a nicely scheduled progression in place. The athletes come in on specific days at specific times, conforming to a consistent schedule. Everything flows smoothly: each athlete is making strength gains, the sport coach is happy to see progress, and the schedule remains consistent. Then the season starts, and chaos ensues. One week, there is travel and several games, the next week, tough practices leave the players exhausted. Every week is a little different from the last, and sport coaches devote less and less time to thinking about strength training.

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So what is a strength coach to do? How are you supposed to help athletes stay strong and healthy when dealing with constant interruptions? During inseason training, keeping your weightroom schedule organized, remaining flexible, and communicating with the coaching staffs are absolute musts. PHILOSOPHY MODIFICATION As athletes and sport coaches adjust to their in-season demands, you should do the same. Addressing your training philosophy is a great place to start. Most strength coaches agree that once competitions and games begin, it is not an ideal time to target maximum strength gains. Instead, the main goals during this period should be maintenance and recovery. Some athletes will continue to

gain strength, and that’s great, but it’s no longer the top priority. “During the season, we reduce our volume in two ways,” says Bryan McGovern, MS, CSCS, Head Strength and Conditioning Coach at Binghamton University. “We decrease the number of days we work out—most of our teams go from three to two days a week. And we reduce the volume of work within the workout—if I have a team coming right from practice, I’m going to limit their volume to avoid fatigue. “In-season, I err on the side of doing too little rather than too much, no matter the sport,” McGovern continAbigail Funk is an Assistant Editor at Training & Conditioning. She can be reached at: afunk@MomentumMedia.com. TR AINING-CONDITIONING.COM

Pilates and the Elite Athlete: Finding that Extra Competitive Edge BY KEN ENDELMAN It’s that nth degree – a percentage point in increased power or a quarter second shaved off a qualifying time – that more often than not is the difference between victory and defeat, or between an excellent athlete and a truly elite one. But how to get that that little bit of extra strength or balance when training top-level athletes?

Assessing the Athlete

For Joerg Chabowski, ACSM, the secret to that competitive edge is Pilates. He has helped trained several world class athletes, including 2004 Olympic gold medalist boxer Andre Ward and U.S. junior champion figure skater Justin Dillon.

“Again it’s all about the intent of what you are trying to accomplish. I can be looking at two shoulder imbalances, one on a cyclist and one on a boxer. Even though they may have a similar ailment, I‘ll have to address each very differently based on each athlete’s sport and what their goals are.

When clients come to Chabowski, the first thing he does is give them a very thorough assessment, looking at flexibility, muscle firing, core integration, and muscular imbalances, and more. He then discusses the results with the athlete in the context of the client’s specific goals.

Chabowski‘s the founder of Pro-Function, a company specializing in Pilates and strength and conditioning coaching. He’s also co-founder of the Working Body, a Pilates, personal training, massage and chiropractic studio, and Integrated Teacher Training, a Pilates certification and continuingeducation program that features curriculum for instructors wanting to train top level athletes.

“An excellent training tool…” “Pilates as a method is an excellent training tool for athletes because it addresses the body as a whole instead of focusing in one area. It integrates the core and the dynamic muscles that are used to perform an activity. This helps athletes tap into their deeper layers of muscles and really maximize their performance.” When a trainer looks at an athlete – even top-tier athletes – they often find that strength can be lacking in the deep core muscles, despite being strong in the dynamic muscle areas such as biceps, triceps etc. “I find that athletes, more than any other type of person, have muscular imbalances. They are doing the same rigorous activity over and over again which leads to some muscles getting stronger while others weaken, “ says Chabowski. “Pilates, as a total body-conditioning tool, is great for correcting these imbalances. It brings everything together in the deep muscle layer, giving the body more stability so the outer or skeletal muscles can function better.” Chabowski also lauds the versatility of the Pilates method because the same exercises can be used for different outcomes depending on the sport and the athlete. “I use the techniques with the mind-set of intent. What exactly am I trying to accomplish here? You can do a Pilates exercise – the hundred, for example – but what is your intent for that client? That’s what your outcome is based on. For different clients you are going to have different outcomes even if it is the same exercise.” For the athletes he trains, Chabowski creates a tailored program designed to meet the best intention for each individual athlete. In that instance Pilates is the delivery method and the program he designs within the method’s parameters will provide the desired outcome. The first component in creating that program is evaluating the athlete.

Injury prevention Based on the nature of the sport and the degree of muscular imbalances (a primary cause of injury) an athlete might have, Chabowski adds exercises to diminish those imbalances. In fact, because Pilates stresses flexibility and an even musculature, it’s becoming a critical injury prevention tool for many teams in the NBA, NFL, MLB and NHL, as it helps an athlete stay on the field and out of the trainer’s room.

Working with Ward To illustrate how his Pilates and stability program worked for a particular athlete, Chabowski references his experience working with boxer Andre Ward before the 2004 Olympics.

He’s in good company. Many trainers of top-level athletes are turning toward Pilates. Originally a rehabilitation system devised by Joseph Pilates for WWI soldiers, it’s a form of exercise that emphasizes the balanced development of the body through core strength, flexibility, and awareness, in order to support efficient movement. The core consists of the deep abdominal muscles along with the muscles closest to the spine. Control of the core is achieved by integrating the trunk, pelvis and shoulder girdle as a single unit. For Chabowski there’s no doubt that Pilates and core strength can give a top level athlete that extra surge or push to put them over the top:

exercise as I did when we worked on stability. However, there ‘s a different emphasis, and the exercise may be modified for the best results within this emphasis.” Chabowski also makes sure to include various balance exercises as a complement to the strength and stability components of his programs.

“His trainer actually came in and took Pilates for himself first. He saw the benefits of core strength and stability and brought Andre in. He’s a tremendous physical specimen with an already successful strength and power development program in place. My piece of the puzzle was working with Ward on core integration and stability,” says Chabowski.

Examining the Sport The second component is to look at that athlete’s particular sport in order to determine proper body mechanics, how the sport is structured in relation to that person’s particular body movement, where it could cause injury, and possible trigger points that could lead to a potential injury. “You assess the athlete, you discuss their goals, and then assess the sport. From that you can begin to design the program,“ says Chabowski.

Designing the Program Stability In most of his programs, Chabowski first and foremost concentrates on core stability. “A stable body’s the center of all efficient movement,” says Chabowski. “Think of building a house, then think of the athlete as the house and a stable core as the foundation. With a weak core you going to end up with a beautiful looking house but it’s going to be shaky. It’s not going to have the substance it needs, and in the end you won’t get the results you want.” Stability is also absolutely critical for athletes, to maximize power transfer within each movement. For example, Chabowski says, take a high-end racing bike. On a stable bike the power that is transferred from the pedal into the wheel, and then from the wheel onto the road, is very direct and very strong. It’s done with maximum force without any loss of power because there is no wasted movement. It’s the same with the body; if it’s stable the power transfer for athletes will be much more efficient.

As an elite boxer Ward had good core stability but wanted more – that little extra edge that would allow him to be the best he could be. “By just having a tiny bit more stability you can generate more power in a punch using the same amount of strength. He just needed to increase his core stability by a little to maximize that performance.” Chabowski had Ward go back to the basics: “I basically had him pretend that that he didn’t know anything about moving his body the right way. He was very patient in trying to re-learn how to get “into” his body in order to get even more out of it.” The goal of the program was for Ward to attain muscular co-contraction of the pelvic floor, the transverses and multifidi, by integrating their movements as a single unit, thus providing Ward with optimal stability. Incorporating work on the Reformer, Trapeze Table and mat, Chabowski had Ward start by doing small movements using basic Pilates exercises like bridging and pulling the navel down to the spine. The next step was working on exercises that focused on taking that “first engagement” of the core and transferring it out through the rest of the body. The results speak for themselves. Ward won the gold medal in the light heavyweight division at the 2004 Olympics and is currently undefeated as a professional. “Pilates flat out works,” says Chabowski, “and not just for top-level athletes. Everyone from teens to grandparents will benefit from that type of foundational work, whether the goal is increasing strength and flexibility, alleviating back pain, or any of the other numerous health advantages Pilates offers.”

Strength and Balance

Ken Endelman is the CEO and Founder of Balanced Body Inc.

Next up in the program is increasing strength: “This is where the versatility of Pilates really shows its value as a training tool. When I work with athletes on strength or increasing power I might use the same Pilates

Want to learn more about how to incorporate Pilates into your training regimen? Visit: www.pilates.com

OPTIMUM PERFORMANCE ues. “Football, for example, is a very physical sport and there’s a lot of wear and tear on the body as the season goes on. With a sport like baseball, while there is no physical contact, overuse injuries are prevalent. In-season, focusing on recovery through lighter workouts is most important for us.” Derik Budig, MS, SCCC, Head Strength and Conditioning Coach at Northern State University, agrees.

room to see atrophy in the muscle,” Budig says. “When a team prepares so well then suddenly stops, the ‘use it or lose it’ adage comes in and poor performance results.” Keith D’Amelio, Head Strength Coach for the NBA’s Toronto Raptors, has the luxury of carefully tailoring an in-season plan for each player. “The team plays a game pretty much every other day of the week during the sea-

“We plan out what we want to do in-season and then take it week-by-week, remaining 100-percent flexible. I understand that depending on the coach’s whims, I will have to make changes on the fly.” However, he still wants his athletes to get stronger as the season progresses. “Often, the sport coach thinks lifting should take a back seat during the in-season, which is true to a certain degree, but it takes the average person only 72 hours away from the weight-

SEASONS CHANGE How should the intensity of workouts vary from offseason to in-season? Derek Budig, MS, SCCC, Head Strength and Conditioning Coach at Northern State University, offers his standard protocol for percentage increases (of rep max).

Off-Season Weeks 1-3: 57-65% Weeks 4-6: 70-85% Weeks 7-9: 90-97.5% Weeks 10-12: 85-105% In-Season Weeks 1-3: 55-60% Weeks 4-6: 62.5-77.5%

son, and when you factor in traveling, it’s very demanding for our veteran guys who play 35 to 40 minutes a night,” he explains. “More than anything, those guys need recovery time. However, for the younger guys and players who aren’t getting as many minutes, my in-season philosophy doesn’t really change from the off-season—they need to put in the

“It’s not uncommon for me to conduct an on-court workout immediately before or after practice. A handful of towels for manual resistance exercises is a quick and easy solution.” work to become stronger and improve. “It’s the in-between guys who play 20 minutes one night and zero minutes two nights later that are tough to plan for,” D’Amelio continues. “I don’t want to overwork them, but they can’t just slide by either.” You will also need to decide if your in-season training philosophy includes game-day lifting. Patrick McHenry, MA, CSCS*D, Head Strength and Conditioning Coach at Castle View High School in Castle Rock, Colo., is a proponent of the idea. “There is research out there that shows positive effects to lifting on gamedays,” he says. “We do a light workout with full range of motion to burn off some of that nervous energy. After the workout, the athletes should feel like they could walk right out onto that court or field and start playing.”

Weeks 7-9: 72.5-90% DEVELOPING A SCHEDULE Perhaps the most challenging aspect of administering in-season workouts is 34

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developing and maintaining a schedule. When putting together his master plan for a semester, McGovern schedules Binghamton’s in-season teams last. “We schedule our off-season teams first because they’re in at a set time three to four days a week, and their schedules do not change,” he says. “But our inseason teams’ schedules can be different every week—a weekend game and a Tuesday game, or no weekend game, but two weekday games—so we move their lifting days around to fit their game and travel schedules.” Mike Nitka, MS, CSCS, USAW, Head Strength and Conditioning Coach at Muskego (Wis.) High School, says his favorite scheduling tool is one very large dry erase board. “Before each season begins, I send every one of my coaches a letter in which I introduce myself and ask them to send me a calendar of their season along with when they would like to come into the weightroom. I also ask for their roster size, and whether their assistants will be helping me supervise,” he says. “Then I put all of their information on a dry erase board that

hangs behind my counter in the weightroom. Every team’s details are written in a different color.” The varying colors also help the sport coaches to keep things straight. “When a coach sees there are three different colors at their time slot but none at another, they might switch so they can have the room to themselves,” Nitka says. “If a team is not going to be able to meet at the allotted time, I ask that the coach send a manager over so I can erase the team from the board.” Along with a flexible schedule, you should also keep workout plans open to alteration. “We plan out what we want to do in-season and then take it week-by-week, remaining 100-percent flexible,” McGovern says. “I understand that depending on the coach’s whims, I will have to make changes on the fly. If a coach gives his team a day off and the athletes only get one lift in for the week, that does throw me off a little bit. But missing a training session TR AINING-CONDITIONING.COM

OPTIMUM PERFORMANCE is not the end of the world. “In that situation, it’s tempting to automatically say, ‘Okay, we’ll go at it harder next week,’” continues McGovern. “But that’s not always the right move because maybe they have three games the following week and need the extra rest. If the coach decides to skip a workout, it’s probably for a good reason.” Then, there’s the opposite scenario. “Say our men’s basketball team has a Wednesday road game, and Thursday’s practice is supposed to be light—maybe a shooting practice before their lifting session,” says Andy Zucker, Head Strength and Conditioning Coach at Old Dominion University. “But let’s say the game doesn’t go well. The coach didn’t approve of the team’s effort, so Thursday’s shooting practice turns into a grueling workout instead. Then when I get those guys after that practice, they’re exhausted. “So I’ll change what I had planned,” he continues. “For example, we’ll start with upper body instead of the lower. Or instead of six exercises, we’ll just do four. You’ve got to be able to adapt.” Another in-season problem can simply be finding adequate time for strength and conditioning. Budig counters by sometimes bringing his workout to the athletes. “If our basketball teams have multiple games in one week, it’s not uncommon for me to conduct a quick on-court workout immediately before or after practice,” he says. “A handful of towels for manual resistance exercises is a quick and easy solution.” When the Raptors are on the road for extended periods, D’Amelio still tries to work them out as regularly as possible. “If we’re on the road for a week straight, I’ll get the guys in the hotel gym or the host team’s facilities—even if it’s just a quick workout,” he says. When dealing with time constraints, McHenry starts by reevaluating the content of his workouts. “When I only have the athletes for a short period of time, I have to look at my program and say, ‘What exercises are going to give us the most bang for our buck?’” he says. “Usually it works well to just stick with the major muscle groups. And I know they’ll get sport specific exercises during practice.” During those stretches of bumpy road, McGovern says it’s important to keep in mind that student-athletes are students first. “Our student-ath-

letes’ first priority is school,” he says. “Strength and conditioning just happens to go along with their sport. We have to remember that the classroom comes first, then the court or the field, and finally the weightroom.” COACH COMMUNICATION Another key to getting the most out of the in-season months is being on the same page as the sport coach. This process has to start, of course, before the season rolls around. McHenry is moving to a new high

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school this year, and is re-evaluating his interactions with coaches. “As I assume my new position, I’m starting the entire process over of learning how to work with coaches,” he says. “I’ve been meeting with each of them to ask what they’d like me to help them accomplish. The girls’ basketball coach, for instance, has a team that plays at an elite level and would like to try something new with her girls in the weightroom. Meanwhile, the football coach is just trying to have his players understand intensity in the weightroom, so we’ll

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OPTIMUM PERFORMANCE stick with the basics there. “I work with each sport coach in a different way,” McHenry continues. “Some coaches say, ‘You know what you’re doing, it’s your job, you take care of them.’ Other coaches have their own ideas about strength training, so it’s better for us to work more closely together.”

Coach, we don’t have this, that, and the other piece of equipment you need for those exercises.’ Then I show them how we can work around those shortcomings and substitute exercises that will still get at the same goal. “I try to be as patient as I can with our coaches and remember that I once was that young guy just out of college,”

“Ideally, some of our ideas will overlap. Our volleyball coach, for example, uses some of the stretches and exercises I do in the weightroom as part of his warmup, and that supports what I do with his team when I’m working with them later on.” Nitka begins by asking each new sport coach for his or her training philosophy, which starts a season-long dialogue. “Many coaches will bring what they did in college to our level and tell me they want to do this, that, and the other thing in the weightroom,” he says. “Sometimes I have to say, ‘Well

Nitka continues. “I will never confront or embarrass a coach in front of his team. I will let them finish the workout and then ask to speak with them. I’ll say, ‘Here’s why I think this won’t work, and here’s what I think might be a better choice.’” In all his discussions with coaches,

Zucker makes sure his ears are open as well as his mouth. “Every head coach knows the ins and outs of their sport, and you have to listen to the objectives they want to achieve with their team,” he says. “It doesn’t work to be negative toward the coach and say, ‘No, this is what is right and this is what we’re going to do.’ You can still stand for what you believe in as long as you have professional flexibility.” Nitka agrees. “If a coach goes to a clinic over the weekend and brings me back something he learned that he thinks is just the latest-and-greatest thing in training, I’ll certainly look at it,” he says. “Then I’ll ask him or her, ‘How much better is it than what we’re doing?’ I’ll again listen to what they have to say. I’ve argued with a couple of coaches, but ultimately they’re the sport coach and I’ve got to let them do what they want—as long as their choice of exercises is safe.” McHenry tries to encourage backand-forth dialogue. “If I find a good research article, I’ll put it in the coach’s mailbox,” he says. “Sometimes a coach will bring back some literature from

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OPTIMUM PERFORMANCE a clinic and we’ll talk about the positives and negatives of the program. And sometimes a coach will come back from a workshop really excited about the great program they learned about, but it’s for a Division I college athlete, so I’ll suggest a modified, almost watered down version for our athletes instead. “Ideally, some of our ideas will overlap,” McHenry continues. “Our volleyball coach, for example, uses some of the stretches and exercises I do in the weightroom as part of his warmup, and that supports what I do with his team when I’m working with them later on.” Budig meets with each sport coach at mid-season to go over players’ strengths and weaknesses. He gives the coach a progress chart, equipped with a comment section for each athlete, and the two brainstorm ways to continue improving. Zucker feels it’s key to get the sport coaches on his turf as much as possible. “I encourage the coaches and assistants to give me a hand when I have minimal staff,” he says. “Having the coach in the weightroom is a huge symbol of accountability. It shows the

kids how important the strength training program is and that it’s part of the overall package. It doesn’t have to be the head coach, the entire coaching staff, or even for the whole session, but

about their grades or something else.” So what if you’re stuck with a head coach who doesn’t communicate their goals and philosophy ideas to you very well, or at all? “If a head coach is a poor

“If a head coach is a poor communicator, that shouldn’t make you one. I constantly communicate with our coaching staff on test results, performance, attendance, injuries, attitude, and effort when their athletes are working with me … If the head coaches choose not to respond, I still continue on.” the support of the coaching staffs is huge for my programs.” Budig also encourages Northern State’s coaches to at least stop in during team workouts. “If athletes see the sport coach at the workouts, they assume the coach buys into my program,” he says. “But I communicate to the coaching staff that if they come down to the weightroom, it’s only to help motivate and monitor progress—it’s not a time to pull kids aside and ask them

communicator, that shouldn’t make you one,” Budig says. “I constantly communicate with our coaching staff on test results, performance, attendance, injuries, attitude, and effort when their athletes are working with me. “If the head coaches choose not to respond, I still continue on,” he adds. “The in-season can throw you a lot of curve balls, but you’ve got to continue being patient and making choices that are best for that particular team.” ■

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TREATING THE ATHLETE

When the complaint is recurring pain in the heel, bone spurs may be the cause. Treating this condition means looking at the full functional capability of the athlete. BY CASEY SMITH & DR. MICHEAL CLARK

f you’re like most athletic trainers, your rehab cases typically deal with acute-onset injuries that have clearly defined parameters of structural damage, common etiology, and consistent presentation. Even chronic injuries such as stress reactions or tendonopathy usually have a predictable set of signs and symptoms. Rehabilitation protocols are common and available, and a timeframe for return-to-play can be set with relative certainty. But some cases are less straightforward: the aches and pains come at seemingly random intervals. When our athletes present with chronic conditions that they have always “just dealt with,” how do we assess and treat them? Sometimes the complaint is, “My knee always hurts.” Other times it’s “I have weak ankles,” or “I just always feel tight.” Often, the athlete gets by with some ice, electrical stimulation, and ibuprofen. But the chronic pain is a cue that there’s an underlying condition, and the way we evaluate and treat these complaints can significantly impact performance and longevity. In our constant effort to prevent injuries, not just react to them, this should be viewed as an important professional challenge. A good example involves the forma-

Casey Smith, MS, ATC, PES, CES, is Head Athletic Trainer for the NBA’s Dallas Mavericks. Micheal Clark, DPT, MS, PT, CES, PES, is President and Chief Executive Officer at the National Academy of Sports Medicine. They can be reached at: info@nasm.org. TR AINING-CONDITIONING.COM

Starting at the Bottom GETTY IMAGES

T&C SEPTEMBER 2007

TREATING THE ATHLETE tion of bone spurs. Some athletes compete successfully and consistently with a mild case of bone spurs, so there is a tendency to treat only the symptoms. And without a straightforward rehab protocol, there is usually not much professional guidance.

all desired outcomes that follow consistent patterns in a healthy person. But what about the physiological responses to stresses that are unwanted or not optimal for performance? Tension from structures that attach to bone is often met with increased bone production

Our evaluation revealed a bilateral cavus foot (rigid, high arch), normal inversion, limited bilateral eversion, limited bilateral dorsiflexion, and on the right, significant rigidity of the first metatarsal phalangeal joint. However, we must resist the urge to be satisfied with the status quo for athletes with this condition. Instead, we must develop unique rehab protocols that address the chronic pain and its root causes.

at the tension site as a protective mechanism, which can lead to the development of a spur. This is beneficial for maintaining the integrity of the attachment, but at some point it becomes detrimental to the function of the affected area. The spurring deviates from what is considered “normal” anatomy and can lead to a host of orthopedic problems. Bone spurs often occur in the heel. Other common sites in the athletic population are at the distal attachment of the quadriceps tendon, the proximal origin of the long head of the biceps brachii tendon, the adductor tubercle on the distal femur, and the proximal origin of the hamstring tendon. What underlying factors lead to bone spurs? Let’s use the heel as an example.

WHAT ARE BONE SPURS? As year-round training and competition have become more and more common, athletes’ bodies need to adapt. We know that the body responds to the stresses placed on it—this principle is the foundation for strength, endurance, and flexibility gains. Muscle hypertrophies follow strenuous loading, connective tissue aligns and lengthens with tension, and the inherent strength of bone is increased by repetitive loading. These are

BEFORE & AFTER The following table reveals the case study athlete’s joint motion (in degrees) during his initial evaluation, and after nine months of treatment. Optimal values are also shown. Initial

After Treatment

Optimal

R 1st MTP Extension

L 1st MTP Extension

R Talocrual

-4

L Talocrual

R Hip Int. Rotation

L Hip Int. Rotation

R Hip Ext. Rotation

L Hip Ext. Rotation

Joint

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Tightness of the gastrocnemius-soleus complex and the plantar fascia place longitudinal stress upon the attachments of the connective tissue to the calcaneus. This leads to a bone spur on the plantar aspect of the foot when the plantar fascia is involved, and on the posterior heel when the common tendon of the gastrocnemeus-soleus complex is involved. Spurring can also occur extra-articularly, with formations at the distal fibula and tibia along the lines of stress created by ligamentous structures. X-rays reveal that spurring in this area may limit ankle motion in eversion and inversion. Intra-articularly, spurs can occur at the talus within the sub-talar joint. They may occur anteriorly from contact with the anterior distal tibia, or posteriorly from contact with the calcaneus. Surgical intervention is sometimes required, but in many cases when the spurring is largely asymptomatic, the condition is treated with rest and conservative management. Reducing the tension in the connective tissue and musculo-tendinous unit is an important step in managing bone spurs, since it can prevent recurring pain and inhibit the further development of spurring. A DEEPER LOOK The anatomy of the ankle is complex, with multiple ligaments supporting bony structures, muscles attaching to and crossing the joints, and the arthrokinematics of the bony structures functioning in all three planes of motion. In preventative therapy, we must remember the full dynamic functional components of the musculature, not merely their function in moving the insertion toward the origin in a concentric fashion. For example, we must remain aware that the gastrocnemius and soleus perform not only force production in plantar flexion of the foot and ankle, as in a jumping motion, but also take on an even greater role in force reduction, for instance when landing from a jump. Likewise, the posterior tibialis not only performs force production in plantar flexion and inversion of the foot and ankle, but also has significant responsibility for force reduction and stabilization of the mid foot during the stance portion of gait. These are only two examples of how we must consider the function of the musculature as we look to control the mechanics of the foot and ankle. The TR AINING-CONDITIONING.COM

TREATING THE ATHLETE key is to be aware of all the functional mechanics of the muscles and joints before we formulate rehabilitation and strengthening programs. A program will only be successful if we can reduce the abnormal forces that are causing the bone spurs. How do we find those abnormal forces? In ankle function, there are two potential problems to look for. One is increased longitudinal tension at the tendinous or ligamentous attachmentâ&#x20AC;&#x201D; a tight Achilles complex causing a posterior calcaneal spur. The other is altered arthrokinematics that allow increased contact between the surface areas of adjacent bony structuresâ&#x20AC;&#x201D;spurring at the junction of the distal tibia and talus. Controlling these unwanted forces can help limit the formation of spurs. CASE STUDY We recently worked with a professional basketball player who suffered from bone spurs in his heels. A veteran who averages more than 35 minutes a game, his report revealed numerous past bilateral and lateral ankle sprains. He told us heâ&#x20AC;&#x2122;d â&#x20AC;&#x153;always had weak ankles.â&#x20AC;?

cavus foot (rigid, high arch), normal inversion, limited bilateral eversion, limited bilateral dorsiflexion, and on the right, significant rigidity of the first metatarsal phalangeal joint. Strength was normal throughout, and he did not present with significant ligamentous laxity. X-rays of the ankles revealed multiple sites of spurring at the distal fibula, distal tibia, and anterior portions of the tibia and superior talus. From there, we looked more closely at a few findings from his initial evaluation. The history of chronic lateral ankle sprains would indicate ligament instability, yet the objective examination revealed stable ligamentous structures. In fact, we even found decreased ligamentous flexibility in certain motions, even though we might guess it would be increased. What could be a predisposing factor? When the foot is dorsiflexed, the talus moves posteriorly to fill the space in the mortise of the ankle between the distal tibia and fibula. This places the talocrual joint in its most stable position. If the ankle lacks dorsiflexion, it can never get to its most stable position,

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He described sporadic effusion and pain, not related to trauma and seemingly unrelated to activity level, in both ankles. The right ankle was more symptomatic than the left. He had been told that this pain was most likely due to bone spurs. Past treatment had consisted of a reduction in physical activity, modality treatment, and the occasional use of NSAIDs. His traumatic lateral ankle sprains had been treated with RICE protocol, restoration of range of motion, strengthening of the musculature around the foot and ankle, and proprioceptive training. The athlete practices and competes wearing a very rigid tape job, and has worn lace-up ankle braces at times to provide additional support, although he prefers not to. When we began working with him, he was asymptomatic. We strongly believe in the benefits of proper screening to identify underlying problems, so that was our first step. In our screen, we look for biomechanical inconsistencies, strength deficits, and flexibility concerns. Our evaluation revealed a bilateral

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TREATING THE ATHLETE and may be susceptible to sprains. The motion restriction at the first metatarsal-phalangeal joint also needed to be considered. Because limited motion at a joint within the kinetic chain causes associated structures to incur a

ed joint mobilization of the subtalar joint, calcaneus, distal tibia, and fibula, and restriction of the right-side first metatarsal-phalangeal joint. Anytime there are limitations in range of motion, the antagonistic mus-

Muscles function optimally from a certain length. Therefore, if the length of one muscle is compromised by another muscle, then strength, ROM, neuromuscular control, and power will suffer. greater amount of stress, we wanted to make any related insufficiencies elsewhere in the kinetic chain part of our treatment plan. PLAN OF ACTION With an idea of the problem, we developed two goals for the athlete: to improve motion restriction and to strengthen any muscles inhibiting the full kinetic chain of motion. To address the first goal, we wanted to return the arthrokinematics to as near normal function as possible, so we implement-

cle will be functionally weak. This can be explained by the length-tension relationship that exists in all muscles. Muscles function optimally from a certain length. Therefore, if the length of one muscle is compromised by another muscle (making it either too short or too long), then strength, ROM, neuromuscular control, and power will suffer. For example, if an athlete lacks sagittal plane dorsiflexion, he or she will need compensatory motion in the frontal (eversion) and transverse (external rotation) planes during landing and running.

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Repetitive compensation in these planes leads to excessive pronation (eversion, external rotation, dorsiflexion). Repetitive pronation alters the length-tension relationship and changes joint arthrokinematics—the medial malleolus and distal tibia are forced into compressive contact with the medial talus. This compensation would functionally lengthen the posterior tibialis, anterior tibialis, and medial gastrocnemius. Therefore, these muscles have to be “retrained” to eccentrically control pronation (eversion, external rotation, and dorsiflexion) and isometrically control the talonavicular joint and talotibial joint to prevent abnormal joint arthrokinematics. The soleus is then forced to work too hard. This adaptively shortens the soleus, and a muscle that is shortened will also lack functional force production, force reduction, and stabilization. Therefore, the soleus needs to be re-trained in the proper ROM. Lack of ankle dorsiflexion causes the tibia to externally rotate and the femur to adduct and internally rotate. This leads to compensatory lengthening of the gluteus maximus and medi-

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TREATING THE ATHLETE us. Therefore, these muscles have to be re-trained to isometrically stabilize the sacroiliac and hip joints, as well as to eccentrically decelerate and control the femur during loading. To meet our second goal, we assessed the structures connected via the kinetic chain. Knee mechanics and general leg strength were within normal limits. Examination at the lumbo-pelvic-hip complex revealed a decrease in internal rotation at the left hip and similar talocrual restrictions right to left. Traditional Treatment: After acute incidents, we implemented regular use of ice every 90 to 120 minutes around the clock in an acute setting, and five to six times daily in a sub-acute setting. We did this via ice packs or a cold plunge after activity. We continued the daily taping for practices and games. Attention was paid to reducing the amount of tape that crossed the dorsum of the foot over the talocrual joint. As ascertained by the decreased range of motion, further restrictions at this area would continue to limit ROM. To accommodate the athleteâ&#x20AC;&#x2122;s prefer-

ence, there was minimal use of electrical stimulation or NSAIDs. He also did not want to wear an ankle brace, so we did not ask him to. Integrated Manual Therapy: During the next phase, primary attention was paid to motion restrictions at the following joints and associated mobilizations: â&#x20AC;˘ Right foot first metatarsal-phalangeal joint: passive mobilization increasing amplitude as functional range improved. â&#x20AC;˘ Bilateral subtalar: mobilizations supine and standing. This was particularly important prior to taping to establish optimal available range of motion. â&#x20AC;˘ Left tibio-femoral joint: passive internal rotation of the left tibia. â&#x20AC;˘ Left hip internal: rotation mobilization with lateral distraction via traction belt with concurrent passive internal rotation. Along with the motion restrictions, we started manual soft-tissue release of the following structures (distal to proximal): â&#x20AC;˘ Bilateral plantar fascia â&#x20AC;˘ Bilateral peroneal complex, L>R â&#x20AC;˘ Bilateral lateral gastrocnemius

â&#x20AC;˘ Left tensor fascia latae â&#x20AC;˘ Left distal biceps femoris â&#x20AC;˘ Bilateral gluteus medius â&#x20AC;˘ Bilateral piriformis, L>R â&#x20AC;˘ Psoas, bilateral, L>R Daily neuromuscular stretching of the following (all bilateral) was another important step: â&#x20AC;˘ Gastrocnemius â&#x20AC;˘ IT band, L>R â&#x20AC;˘ Hamstrings â&#x20AC;˘ Gluteus medius â&#x20AC;˘ Piriformis Corrective Exercise: As mentioned above, we wanted to work on inhibiting motion in certain areas and lengthening muscles in others. We implemented daily self myofascial release (bilaterally) pre and post activity in the following areas: â&#x20AC;˘ Peroneals â&#x20AC;˘ Lateral gastrocnemius â&#x20AC;˘ IT band â&#x20AC;˘ Gluteus medius â&#x20AC;˘ Piriformis Static stretching was performed after activity for optimal lengthening to the:

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TREATING THE ATHLETE • Bilateral gastrocnemius • Bilateral soleus • Left biceps femoris • Left piriformis For activation, we started isolated muscle strengthening for these structures: Bilateral Poster Tibialis • Thera-band plantar flexion combined with inversion and great toe flexion emphasizing eccentric control and endurance, performed in the supine position. • Single-leg balance with foot control. Maintain neutral subtalar position

and actively fire deep posterior musculature of FHL, FDL, and posterior tibialis by firing the toes into the floor or a balance pad. Difficulty is increased via typical mechanisms such as unstable surfaces, upper-extremity motion, and lack of visual input. Should be completed to fatigue. • Use of ankle isolator or similar apparatus for specific posterior tibialis strengthening. Bilateral Medial Gastrocnemius • Double- to single-leg calf raise with internal rotation. Concentrically raise

Circle No. 134

with both feet, slowly lower eccentric over five-second count with only one leg. Take care to fire through the great toe and not drift laterally over the four lateral toes. Gluteus Medius • Daily tubing walking—increase resistance with multiple bands if necessary. Emphasize upper-body control and force production from heels without external rotation of the lower extremity. Complete to fatigue. Gluteus Maximus • Bridging exercises initially. Progress to integrated gluteus maximus exercises in the next section. When exercises are designed to emphasize endurance, they should be performed to fatigue or loss of eccentric control. The demands of sport require certain muscles to fire thousands of times throughout a given competition or practice. This type of endurance is not gained with simple sets and reps. The final challenge is to take as many of the isolated activities listed above as possible and combine them into functional activities. Control of the torso and upper body during functional activity is based on the lower extremities, and in particular the foot and ankle, providing a stable platform or base for these movements. Here are some of the exercises we used: • Progress ball bridging to weighted Russian twist exercise on ball. Maintain hips level, knees and ankles at 90 degrees, and maintain foot contact. • Lunge with rotation. Emphasize foot control and force through great toe. • Quarter- to half-squats with the foot neutral and proper alignment of the knee in relation to the foot and ankle. Combined motion as it occurs in the loading phase of squatting (such as prior to a jump) should have the center of the patella moving in the frontal plane over the center of the foot, which is approximately the second toe. How did the athlete respond? His joint motion improved in every area (see “Before & After” on page 40). He also progressed well with no insidious onset problems, which had been common for him in the past, and no flare-ups in non-contact situations. While he has had a few exacerbations due to landing on opponents’ feet, each case was resolved functionally within 24-36 hours, with residual soreness lasting up to 7 days. In addition, a long-term issue with left side IT band irritation is no longer present. ■ TR AINING-CONDITIONING.COM

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SPORT SPECIFIC

Strength to Spare They may not strike you as athletes who need conditioning, but bowlers can greatly enhance their performance with a progressive training program. BY TASHA WEDDLE

owlers lifting weights? Even longtime strength and conditioning coaches are surprised when they hear that the Vanderbilt University women’s bowling team takes part in a strength and conditioning program. Despite being an NCAA championship sport since 2004, bowling is often viewed strictly as a recreational activity. And let’s face it, lots of bowlers, even professionals, are not in “peak” physical condition. While this stereotype is difficult to overcome, we are proving at Vanderbilt that bowlers are athletes too and can benefit greatly from strength and conditioning. To the skeptics, there is little correlation between physical conditioning and bowling success. But Head Bowling Coach John Williamson and his

Two years after beginning a strength and conditioning program, Vanderbilt University captured the 2007 NCAA Championship.

VANDERBILT UNIVERSITY SPORTS INFORMATION UK ATHLETICS TR AINING-CONDITIONING.COM

Tasha Weddle, CSCS, is an Assistant Strength and Conditioning Coach at Vanderbilt University, where she works with the women’s bowling, basketball, soccer, and lacrosse teams. She has also been an assistant strength coach at the University of Tennessee, Kent State University, and Purdue University. She can be reached at: natasha.d.weddle@vanderbilt.edu. T&C SEPTEMBER 2007

SPORT SPECIFIC athletes believe physical preparation has been an important part of Vanderbilt’s development. In addition to the tangible benefits of increased strength and flexibility, the bowlers—most of whom had never worked out before in their lives—leave the weightroom

with improved self confidence, mental toughness, and ability to compete. Combined with their natural talent, this helped lift the team to the 2007 NCAA National Collegiate Women’s Bowling Championship, the first national team title in Vanderbilt history.

PLANNING & DESIGN Working with bowlers the last two years has certainly been a learning experience for me. Previously, I had only a passing familiarity with the sport, and I shared many of the stereotypical views about bowlers. But the benefits of strength and

SAMPLE WORKOUT A sample in-season workout for the Vanderbilt University women’s bowling team is listed below. Movement Preparation Jog x 5 min. Walk-outs x 5 Walking Spiderman x 5 each side Lateral slides x 5 each side Reverse lunges with rotation x 5 each side Supine leg swings x 8 each leg Prone leg swings x 8 each leg Hamstring roll-overs x 5 each leg Single-leg hip bridges x 8 each leg Supermans x 12 Injury Prevention Scarecrows x 10 Front-V empty cans x 10 Bent-over lateral raises x 10 Lateral raise and rotation x 10 Banded knee lockouts 2 x 15 each leg Resistance Training Core Circuit x 2: Prone stabilization w/reach x 20 sec. each side, off-bench obliques x 10 each side, med-ball diagonal chops x 10 each side Set A x 3: Front squats x 6, med ball cleans x 6 Set B x 3: Step-ups x 6 each leg, incline bench press x 6 Set C x 3: Stability ball leg curls x 10, body rows x 8 Conditioning Tempo Run Run 100 yards/walk 30 yards

T&C SEPTEMBER 2007

Run 200 yards/walk 50 yards Run 300 yards/walk 100 yards Repeat 2-3 times Cardio Machine (interval workout) 5 min. warmup 30 sec. as hard as possible 60 sec. easy Repeat 9 times 5 min. cool down Med-Ball Tempo Squat-to-overhead press x 12 Run 50 yards & back Diagonal chops x 12 each side Run 50 yards & back Reverse lunge w/rotation x 8 each side Run 50 yards & back Overhead pressing sit-ups x 15 Run 50 yards & back Push-ups x 8 Run 50 yards & back Flexibility Standing V (middle-right-left) Seated V (middle-right-left) Half-hurdler Quad stretch Seated groin Prone back extension Kneeling hip flexor Cross-over quadruped Standing calf

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SPORT SPECIFIC conditioning for these athletes become obvious if you look for them. In any activity, physical fatigue hampers mental focus. Improved fitness delays the onset of fatigue, which is certainly a factor in any sport, including bowling. Each bowler throws a 16-pound ball 200 to 300 times during an average practice, and competitions can last for six hours or more. The better shape the bowlers are in, the more likely they are to perform up to their potential. From a more sport-specific standpoint, strength directly affects the ability to generate force during the pivot step, release, and follow through. Adding flexibility to this strength allows for a lower position at the point of release, which results in better leverage and more accurate shots. As I began to design a program for the bowling team, I followed the same principles I use for every sport—I placed primary focus on training movements rather than muscle groups with compound, ground-based exercises making up the majority of the workout. My intention was to build a solid foundation by first developing stability and then work-

ing toward strength, power, and speed. In any sport, a strength program only succeeds if the athletes put forth the effort and the head coach plays a big role in getting them to do so. I am fortunate to have the complete support of Coach Williamson, who is present at every workout, which has helped the athletes buy into the program. At the start, Coach Williamson spent a lot of time explaining to me the mechanics of the bowling motion and the physical demands faced by his athletes, and together we worked to set goals for the program. Along with developing overall athleticism and strength, we decided that increased leg and core strength would improve performance and help to prevent injury, so we made these focal points of the strength and conditioning program. Coach Williamson also wanted to improve his athletes’ mental toughness and believed weightroom workouts could help. We agreed that it is possible to prepare athletes to handle the stress of competition by creating stressful situations in the weightroom and during conditioning workouts. If we showed

the bowlers that they could handle pressure in the weightroom, they’d be more confident the next time they had to convert a tough split in the ninth frame of a close match. So even though many of the bowlers were novice lifters, once they were physically ready, we would start to challenge them with taxing and fast-paced workouts to help them learn to thrive under stress. Because of the nature of the sport and the coach’s observation of mental breakdowns during competition, this was a key factor in taking the team to the next level. TWO-YEAR PLAN For the first year, our workouts with the bowling team were very basic and minimal. It was really more of a general fitness program than a fullfledged strength and conditioning regimen, with little more than body weight resistance. In many cases, we even had to modify basic body weight exercises so the bowlers could complete them successfully. For example, if someone couldn’t complete a full set of standard push

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SPORT SPECIFIC ups, we would have them do as many as they could and then do double that number from their knees. For an athlete who couldn’t complete a set of pull ups, we would use assisted pull up machines or bands until she progressed enough to finish a set properly. Usually, these modifications didn’t last long—once the bowlers doing modified exercises saw their teammates completing standard sets, they became motivated to do the same. But we progressed each athlete individually, stressing the importance of proper technique in every exercise. Once we established a base level of fitness and knowledge that first season, we made two major changes going into the second season. The first

ers are only able to work out in the weightroom twice a week, since they spend a total of one hour each day getting to and from the lanes for practice. To make sure we cover everything, each workout is divided into five main components: movement preparation, injury prevention, resistance training, metabolic conditioning, and flexibility training. (“Sample Workout” on page 46 shows one day of inseason training.) Movement preparation consists of a general warmup of jogging for five minutes. The athletes then perform five minutes of dynamic stretches, typically consisting of a selection of walk-outs, walking Spidermans, lateral slides, reverse lunges with rotation, supine and prone leg swings, and ham-

Our bowlers were extremely limber by season’s end and doing stretches that few other athletes could complete. Not only can they now bend more deeply and develop more power on their shots, they also have greater body awareness and control. was incorporating accountability in the form of testing. The second was including more core lifts, such as back and front squats, Romanian deadlifts, and bench pressing variations, which elicited a tremendous positive response from the bowlers. With these two changes, the women started to feel like “real” athletes and embraced the challenge of learning new exercises. Additionally, seeing consistent strength gains increased their self-confidence, which kicked up their enthusiasm in the weightroom to new levels. THE PROGRAM To a large degree, the success of the program I designed relies on the principle of progressive overload. Progress is maintained by consistently monitoring each athlete’s improvement and making the necessary adjustments to ensure they are constantly being challenged. By watching each athlete perform her last set of each exercise, I am able to make modifications depending on the level of technique and strength demonstrated. There are a number of ongoing structural challenges in designing workouts for our bowlers. Not only are exercise choices limited by a lack of training knowledge and experience, the bowl48

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string roll-overs. Injury prevention is a major objective of any strength and conditioning program, even for bowling. Considering the repetitive nature of the sport, chronic injuries are a concern. Some of the common injury sites for bowlers are the wrists, shoulders, knees, and hips. The injury prevention exercises I use in the bowlers’ workouts include shoulder circuits, glute bridges, and single-leg partial squats. Resistance training work targets the whole body and is made up of one squat variation, one exercise to work the posterior chain, one single-leg exercise, and one upper-body pulling and pushing exercise. In addition, we start the resistance section of each workout with a core circuit consisting of a stability exercise, a rotation exercise, and some variation of abdominal, hip, or lateral flexion. I also regularly incorporate explosive medicine ball throws into the core circuit to develop power and speed. Once a foundation is established, I use an undulating form of periodization, incorporating one heavy-intensity, low-volume day and one lighter-intensity, high-volume day into each week. Because of the relatively minimal metabolic requirements of bowling, I am able to keep the intensity high during the in-

season workouts without risking overtraining. The only major modification I make in-season is to take out bilateral squats and use unilateral squatting exercises to avoid overloading the spine. Metabolic conditioning serves a dual purpose. First, it improves overall fitness, and second, it teaches the athletes to handle the anxiety that conditioning workouts produce. I am not as concerned with targeting any specific energy system as I am with making the workouts physically (and therefore mentally) challenging, so I typically use combinations of stadium runs, tempo runs, 100-yard repeats, track workouts, fartlek runs, interval cardio machine workouts, and plate circuits, with limited rest. To make up for the lack of weightroom time, we also ask bowlers to complete two cardio sessions on their own each week, usually consisting of either interval machine work or fartlek runs. We also have them perform a medicine ball cooldown routine at the bowling lanes immediately after practice once or twice a week. Flexibility receives a lot of attention in our program. In addition to the dynamic stretches included in the movement preparation portion of the workout, we finish each day’s sessions with a static stretching routine as a cooldown. But the greatest improvement to flexibility comes during the team’s early morning yoga sessions, which were arranged by the coach. After showing very little flexibility at the beginning of the season and struggling to finish even a basic stretching routine, our bowlers were extremely limber by season’s end and doing stretches that few other athletes could complete. Not only can they now bend more deeply and develop more power on their shots, they also have greater body awareness and control. The impact of physical preparation on performance isn’t always easy to ascertain, but with this team it was very apparent. We could easily see that our bowlers were stronger, more flexible, and generally more athletic at the end of the season than at the beginning. But beyond the obvious physical benefits, we also noticed improved self-confidence, mental toughness, and ability to compete. Although we may never know exactly how many pins fell because of the bowlers’ strength and conditioning work, we believe the national championship our team won—with two strikes in the final frame of a seven-game match—speaks for itself. ■ TR AINING-CONDITIONING.COM

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NUTRITION PRODUCTS CytoSport, Inc. 888-298-6629 www.cytosport.com

The Gatorade Co. 800-88 GATOR www.gatorade.com

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• Ideal for use as a highenergy meal replacement, or a pre-event or between-meal snack • Contains vitamin C, calcium, and iron • Provides great nutrition for recovery • High in protein for strengthening and building muscles • A balanced nutritional supplement • Available online • Favors: chocolate, vanilla, and strawberry

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Circle No. 508 Cera Products, Inc. 1-888-237-2598 www.ceraproductsinc.com

Circle No. 506 Circle No. 504

CeraSport Gatorade Endurance Formula

Muscle Milk® Collegiate Bars

• Meets compliance standards for collegiate athletics • Great taste and convenience • Perfect addition to any nutrition program • Good for both male and female athletes • Quantity discount pricing available • Available in two flavors: chocolate peanut caramel, and vanilla toffee crunch Serving Size 1 bar (40g) Calories 150 Total Fat 5g Saturated Fat 3.5g Cholesterol 0mg Sodium 150mg

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• More fully replaces what is lost in sweat during longer, more intense exercise • Unique five-electrolyte blend contains nearly twice the sodium and three times the potassium of Gatorade Thirst Quencher • Designed to meet athletes’ needs when fluid and electrolyte losses are substantial (e.g. marathons, triathlons, two-a-days, all-day tournaments) • Available in powder or liquid form • Global distribution • Available in three flavors Serving Size 8 fl. oz. Calories 50 Total Fat 0g Sodium 200mg Potassium 90mg

Serving Size 16 fl. oz Total Carbs. 14g Sugars 14g Protein 0g

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• Performance hydration drink • Available in fruit punch, citrus, and berry • Discount pricing available • Sold directly by the company and through distributors • Sustains energy delivery for enhanced performance • Restores essential electrolytes and fluids lost in sweat due to exercising • Maintains body hydration to prevent dehydration • Prevents electrolyte imbalance abnormalities • No cramping or nausea

Calories 80 Total Fat 0g Sodium 200mg Potassium 75mg

Total Carb. 19g Sugars 4g Protein 0g

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LEG STRENGTHENING Ball Dynamics International, LLC 800-752-2255 www.fitball.com The new FitBALL Deluxe Board has an extra-large surface—19.5” x 27”—to provide ample room for full-body training and leg-strengthening exercises. The heavyduty plastic construction is perfect for high-use fitness and rehab facilities. With a fulcrum height of five inches, the multidirectional base offers balance challenges for both beginners and advanced users. The FitBALL Deluxe Board is part of the newly expanded line of FitBALL brand professional-quality fitness and therapeutic products. Circle No. 510 Thera-Band®/Performance Health Products® 800-321-2135 www.thera-band.com The new Thera-Band® Resistance Band Dispenser Pack is the most convenient way to distribute individually wrapped, pre-cut Thera-Band latex resistance bands. It minimizes the potential for passing skin infections through common band usage. Each dispenser includes 30 fivefoot (1.5meter) bands in a single color. Each wrapped band includes safety information and refers users to www. Thera-BandAcademy.com for exercise examples. The bands are available in yellow, red, green, blue, and black. Circle No. 511 C.H.E.K. Institute 800-552-8789 www.chekinstitute.com The Tornado Ball’s medicine ball-rope construction combines the durability of a solid medicine ball with the comfort of high-quality sailing rope to withstand dynamic high-speed training. This functional training tool develops stability, strength, and power on a variety of surfaces. Exercises such as the lunge-with-chop specifiTR AINING-CONDITIONING.COM

cally target leg strength, but at high speeds are quite demanding on the body and should only be attempted by experienced fitness enthusiasts and athletes. Circle No. 512 Contemporary Design Co. 800-334-5633 www.shuttlesystems.com The Shuttle Balance from Contemporary Design functionally trains the neuromuscular systems of athletes and seniors alike. It has long been recognized that the body’s ability to negotiate unpredictable changes in force, direction, and placement in space at the neuromuscular level are critical building blocks for performance and skill development. The Shuttle Balance provides a safe platform for individuals to develop and hone proprioceptive responses while performing a variety of activities. Circle No. 513 From acute-phase closed-chain activities to end-stage plyometrics, the Shuttle MVP from Contemporary Design leads the way in progressive, functional rehabilitation and training. The Shuttle MVP’s horizontal-rebound technology utilizes smooth and predictable resistance, making it perfect

for unstable joints, while rapid nonweight-bearing rebounding improves the eccentric phase necessary for injury prevention and power development. Visit the company’s Web site for more information. Circle No. 514 Creative Health Products, Inc. 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 that measures leg strength and

is ideal for measuring the strength of the thighs, chest, back, and upper torso as well. It’s an innovative, easy way to measure an athlete’s improving strength and assess his or her overall fitness level. The device is now available with either a standard (pounds) or metric (kilograms) gauge. Circle No. 515 VertiMax 800-699-5867 www.vertimax.com The new VertiMax V6 is a revolutionary advancement in functional, sport-specific, total-body training. It is capable of applying asynchronous loading to the arms and shoulders while athletes perform explosive lower-body training. The V6 is strongly endorsed by many NFL, NBA, and NCAA Division I head coaches. Visit VertiMax’s Web site for more details and to read testimonials from satisfied customers. Circle No. 516 A new low-load, velocity-specific training program is now available for the ultimate in force development. The VertiMax PLUS series is a revolutionary advancement in functional, sport-specific, total-body training. It’s unique because it is capable of applying multiple loads at multiple body locations, including the ankles, knees, hips, shoulders, and arms, while the athlete is performing explosive lower- and/or upper-body training. The VertiMax PLUS series is strongly endorsed by many NFL, NBA, and NCAA Division I head coaches. Visit VertiMax’s Web site for more details and customer testimonials. Circle No. 517

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LEG STRENGTHENING Jump Stretch, Inc. 800-344-3539 www.jumpstretch.com Athletes are always looking for an edge—some way to vary their training routine and ramp up their workouts. The athletic trainers who worked with the actors in the movie “300” came up with a creative exercise: run out against the resistance of FlexBands, pick up a kettlebell, and run back. Now you can use this same technique with the Spartan Fireout Station. It consists of four bands—three long bands, with the fourth looped through to serve as a harness over the shoulders. Circle No. 518 Keiser Corp. 800-888-7009 www.keiser.com Keiser’s Air300 Squat combines lowimpact technology with the ability to move safely at higher 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 hand grips for greater control and stability during the exercise. In addition, a range limiting feature helps prevent ligament and joint injury to the knee. Circle No. 519 The Air300 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. 520 Kytec 800-732-4883 www.kytec.us Stretch Out delivers the benefits of PNF stretching without the need for a 52

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partner. Made of a one-inch web strap, it has various adjustment loops that provide increased range of motion during the stretch. The loops allow deep, gradual stretching of major muscle groups, resulting in a stretch that’s safer and more effective than other methods. An illustrated instruction book and a complete exercise list are included. Circle No. 521 Lebert Fitness, Inc. 905-785-0626 www.lebertequalizer.com The Equalizer trains athletes for strength, agility, plyometrics, and so much more. Originally developed for portable body weight compound strength training exercises, this product has many outstanding functions. For instance, when used for agility drills, the Equalizer makes a tremendous agility ladder that allows for unlimited designs, quick changes in layout, and any sport-specific configuration you want. Circle No. 522 Hammer Strength 800-634-8637 www.hammerstrength.com One of Hammer Strength’s most popular pieces of equipment, the Jammer, is part of the innovative Ground Base product line. This highly versatile machine is ideal for athletes who want to train explosive movements. To maximize athletic performance, users train with their feet on the ground, promoting total-body stabilization and better balance that transfers to movements on the playing field. In the standing position, the athlete’s body is able to respond naturally to the exertion of exercise and to gravity, spurring strengthening of the corresponding muscle groups and enhancing coordination. Circle No. 523

Life Fitness 800-634-8637 www.lifefitness.com Life Fitness has introduced its most innovative treadmills to date, thanks to a partnership with Apple. The new iPod-integrated 95 Series treadmills engage both body and mind. With their sleek, sophisticated design, they deliver a stunning lineup of features, including seamless iPod integration, a virtual trainer, extended running surfaces, USB connectivity for personalized workouts, and graphic workout landscapes displayed on a vibrant LCD screen. The new 95 Series treadmills are available in two models. Circle No. 524 NASM 800-460-6276 www.nasm.org NASM’s Corrective Exercise for Knee Impairments module covers the functional anatomy of the knee and teaches you how to become proficient in performing knee assessments. You will learn how to utilize exercises, programs, and tools to implement corrective strategies for the knee, as well as how to market your abilities in a clinic or health and fitness facility. Circle No. 525 NZ Mfg., LLC 800-886-6621 www.nzmfg.com TurfCordz Ankle Cordz are designed for abduction, leg curls, hip flexion, and other lower-body exercises. They can strengthen and rehabilitate after injury, or help prevent injury from happening in the first place. Ankle Cordz are easily portable and each unit includes two interchangeable eightinch tubes for two different resistance levels. To learn more about the full line of innovative TurfCordz products, go online or call the company to request a catalog. Circle No. 526 TR AINING-CONDITIONING.COM

LEG STRENGTHENING Perform Better 800-556-7464 www.performbetter.com Perform Better has introduced its new heavy-duty Drive Sled, made with 12gauge steel for intense pushing and pulling exercises. A cleverly designed rear handle lets you drive the sled from two different heights. Multiple plate storage stations allow for overload strength training while keeping the sled evenly balanced. Just add your Olympic plates to achieve the desired resistance. A heavy-duty harness lets you comfortably handle heavy loads. The Drive Sled is only available in the 2007 Perform Better catalog. Call or go online to request your free copy. Circle No. 527 To develop leg strength, Perform Better recommends its Shaw 360 training system, which offers dynamic resistance and 360 degrees of freedom to cut, spin, juke, and shake. It is an ideal product for

resisted and assisted exercises because it allows full range of motion. It comes complete with clip hooks for the athlete’s belt and five different sizes of waist belts, an adjustable coach’s belt, and 10 feet of resistive cord. This product is found in Perform Better’s special edition sport catalog. Call or go online to request yours today. Circle No. 528 Power Lift 800-872-1543 www.power-lift.com The Power Lift® 40-degree UniLateral/Bi-Lateral Leg Press features a uni-lateral/bi-lateral locking mechanism, an adjustable back pad with lumbar support, weight storage, sevengauge steel

construction, and an adjustable starting position. The uni-lateral motion is ideal for athletes with a lower-body injury, since it allows them to isolate and train their non-injured leg. Sixteen high-grade liquid cast polyurethane wheels guarantee smooth operation of the carriage. Alternative angles are also available. Circle No. 529 The Power Lift® Belt Squat is a great way to train the hamstrings, glutes, quadriceps, and hips while eliminating spinal compression. From a standing position, the user disengages the work arm to start the exercise. The Belt Squat attaches to the work arms on each side, over the user’s hips. Force is evenly distributed through the user’s heels, emphasizing the muscles in the hips, glutes, and hamstrings. The machine is ideal for rehabbing injuries and for teaching squats, one-legged squats, and lunges. Weight storage and three custom belts are standard. Circle No. 530

A Great Exercise and a Great Partner ALL IN ONE! MediBalls™ are NOT like other medicine balls. They are the original gel ﬁlled medicine balls that offer signiﬁcant performance advantages over other medicine balls. Their compact and perfectly balanced shape make them longer lasting, easier to see, and easier to catch. They can be used indoors, outdoors, and even in the pool! Try the MediBalls™ with the adjustable rebounder. With its round design you can be assured of consistent returns. It is the perfect training partner for medicine ball exercises!

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LEG STRENGTHENING Power Systems 800-321-6975 www.power-systems.com The L-Bands system is an innovative tool to improve speed, balance, control, and agility by promoting activation of the hip flexors to produce a faster stride. Condition and train the muscles to exert maximum effort. Bands help the athlete remain in an efficient running position while using the leg muscles to generate force and power during runs and agility drills. Adjustable nylon thigh and foot straps are connected by resistance tubing that’s available in three lengths depending on the athlete’s height. Circle No. 531 Pro-Tec Athletics 800-779-3372 www.injurybegone.com Offering outstanding comfort and effectiveness, the Shin Splints Compression Wrap by Pro-Tec Athletics alleviates symptoms of medial and anterior shin splints. It includes a compression strip to provide targeted compression and help prevent tearing of the soft tissue away from the tibia. In addition, the Shin Splints Compression Wrap absorbs stress to the tibia and helps stabilize the area. Its contoured design keeps pressure off the calf in cases of medial tibial stress syndrome. Circle No. 532 Samson Weight Training Equipment 800-4-SAMSON www.samsonequipment.com The Samson #112U Unilateral/ Bilateral Leg Press is one of the most user-friendly, most durable leg presses on the market today. It features adjustable foot pedals, swivel-action hand controls for easy release, and .188 seven-gauge stainless steel tubing that can be removed to allow one leg to work independently from the other. It 54

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operates on linear ball bearings for a smooth action that has to be felt to be believed. Call or go online today for more information. Circle No. 533 The Samson #107GH is one of the most durable glute ham benches in its class. This unique bench features a linear ball bearing system that allows for unbelievably easy foot-plate depth adjustments, .188 seven-gauge square tubing construction, heavyduty 12-pound closed-cell neoprene padding, and even three hooks in the front for band training. Check it out at Samson’s Web site. Circle No. 534 efi Sports Medicine®/Total Gym® 800-541-4900 www.totalgym.com The Closed Chain Platform from efi Sports Medicine® provides unloaded, early closed-chain exercise in a functional environment. The platform attaches to efi’s Total Gym® system and GTS incline resistance units to facilitate a number of lower-extremity exercises while allowing for a wide variety of leg and foot positions for sports-specific training and rehabilitation. Use it in combination with other products to safely and gradually challenge balance and mobility. Circle No. 535 efi Sports Medicine® 800-541-4900 www.efisportsmedicine.com efi Sports Medicine® has introduced the PlyoRebounder, a versatile tool for quick-response proprioception training, upper- and lower-body plyometric agility training, and cardiovascular

exercise. The trampoline unit serves as a low-compression, low-impact jogger for jumping, hopping, and running exercises that are easy on the spine and knees. Have athletes throw weighted medicine balls against the unit’s trampoline surface to develop core strength, agility, and improved reaction time. Circle No. 536 WerkSan Barbells 877-WERKSAN www.werksanusa.com For safety and durability, count on WerkSan. WerkSan Barbells has a strong worldwide reputation for highquality weightlifting equipment. The company’s engineers are devoted to producing safer, better-performing, longer-lasting equipment. WerkSan is the official barbell of USA Weightlifting and is certified by the IWF. The company stands behind its equipment: WerkSan bars are guaranteed for life, and its bumper plates are guaranteed for two years from the date of purchase. Circle No. 537 WerkSan Barbells is the official sponsor of the NSCA’s High School Coaches Special Interest Group. WerkSan is the official barbell of USA Weightlifting and is certified by the IWF. WerkSan engineers are devoted to producing safer, better-performing, longer-lasting weight training equipment. WerkSan bars are precisionmade from specially developed Scandinavian steel. WerkSan uses five carbon-fiber bearings—not just four steel bearings—strategically located at stress points to increase strength, durability, and performance. Circle No. 538

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TESTIMONIAL

PILATES EQUIPMENT

Certification Program Is Like No Other

Balanced Body, Inc. 800-PILATES www.pilates.com

“The NATA/CSCS combination is like no other when it comes to assistance in prevention, care, and treatment for the active population. This combination knows the body and how to care for it in many perspectives that are not found in any other combination.” Patricia J. Hubel, ATC, CSCS Academic Projects and Research Coordinator Minot State University “As an athletic trainer and strength and conditioning professional, two of my main objectives are to prevent injury and improve performance. The CSCS credential indicates that the individuals I hire possess this expertise, regardless of the sport or needs of the athlete.” Dan Wathen, ATC, CSCS*D, NSCACPT*D Head Athletic Trainer Youngstown State University “The CSCS credential identifies selfmotivated individuals who have taken it upon themselves to improve their knowledge and practical skills beyond undergraduate entry-level educational requirements in the strength and conditioning/physical rehabilitation domain.” James E. Campbell, MS, ATC, CSCS Head Athletic Trainer Overland High School, CO

Pilates on the Reformer has become an invaluable conditioning method for athletes at all levels, maximizing athletic performance while reducing the risk of injury. Balanced Body’s new Allegro Sport Reformer is a simpler version of the Allegro, with a durable design, easy storability, and an affordable price. It features an extremely stable frame and a virtually silent carriage ride. The Allegro Sport Reformer makes it easy for athletic trainers to add Pilates to their conditioning programs. Circle No. 539 Compact, durable, and lightweight, Balanced Body’s new EXO Chair provides challenging strength workouts while adding core stability. More than 28 exercise categories can be performed on the EXO Chair, including mobility, core, leg strength, arm strength, and shoulder girdle stability, plus functional movements like standing, climbing, pushing, and lifting. For any athlete needing to run and cut in different directions across the field, exercises on the EXO Chair provide exceptional leg and joint stability. Circle No. 540 OPTP 800-367-7393 www.optp.com/ad

NSCA Certification Commission 3333 Landmark Cir. Lincoln, NE 68504 888-746-2378 commission@nsca-cc.org www.nsca-cc.org 56

T&C SEPTEMBER 2007

Upgrade the most important piece of golf equipment you possess: your body. The Golfer’s Guide to Pilates contains easy-to-learn exercises with step-by-step programs for flexibility, core strength, stance, and rotation. Raise

your physical ability and transform your game into one of absolute control and power. This book is great for golfers of all fitness levels. It is illustrated, soft cover, and 144 pages long. Call or go online for more information and to request a free catalog. Circle No. 541 The OPTP Pro-Roller comes in a new color scheme: blue and white marble. The closed-cell design and heat-sealed engineering ensure that it will not break down after repeated use. The Pro-Roller is easy to wipe off with a sanitary solution. It can be used for myofascial release, muscular flexibility, and dynamic strengthening. Roller exercises enhance balance reactions, body awareness, muscle re-education, and core stability. The density of the closedcell foam provides firm support with a cushioned surface, making it more comfortable than hard foam rollers. Circle No. 542 Power Systems 800-321-6975 www.power-systems.com Combine the essence of Pilates training, balance, alignment, and core strength with myofascial release and build a stronger, more flexible body by incorporating the Premium EVA Foam Roller into your workout. This high-density, heat-sealed, closed-cell roller will not absorb moisture or trap odors and bacteria. The unique EVA material prevents this roller from getting lumpy or losing its shape. The Premium EVA Foam Roller will meet and exceed the demands placed on it during training, rehabilitation, and massage therapy. Four sizes are available: 6” x 12” L, 6” x 36” L, and a roller in 12 and 36 inches. Circle No. 543

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CASE STUDY

Bringing Back the Straight-Leg Sit-Up By Christine Romani-Ruby, MPT, ATC

Christine Romani-Ruby, MPT, ATC, is a licensed physical therapist, an assistant professor in the Physical Therapist Assistant program at California University of Pennsylvania, an AFAA certification specialist, an ACE faculty member, and a certified athletic trainer. An international presenter, Christine is the CEO of PHI Pilates. Presently she is a doctoral candidate in education at Indiana University of Pa.

In the late 1980s, like many other professionals, I abandoned the straight-leg sit-up as a method of core conditioning. At the time, we were all concerned about the risk of lumbar spine shearing due to the pull of the hip flexors. The concern was that athletes would use the hip flexors as the primary muscle group to sit up and would engage them before the spine reached the protective range of flexion (30 degrees). For the straight-leg sit-up to be performed correctly, there must be suf-

30 degrees of flexion and primarily engaged only the internal oblique muscles. I could see the change in my athletes by noting a wide costal angle and a hyperlordotic posture. With the recent popularity of yoga and Pilates, the straight-leg sit-up has returned with a new name: the roll up. Although I was happy to begin using this exercise again, I continued to have the same concerns Iâ&#x20AC;&#x2122;d had in the 1980s. I struggled to find a way to ensure that my athletes could gain all the benefits of the straight-leg sit-up without the risk of lumbar shearing. I recently incorporated the Core Challenge Roller by OPTP for this exercise. With this air-filled roller, I can be sure my athletes are not only safe, but are effectively working the core, even when I am not watching them.

ficient strength in both the abdominal musculature and the hip flexors. However, the timing of the movement and the flexibility of the lumbar spine are also important factors. A shearing effect can occur in the lumbar disc when the hip flexors are engaged too soon and the vertebral levels attached to the hip flexors are lifted first. Research demonstrates that at 30 degrees of spinal flexion, all the deep layers of the abdominals are engaged to fully protect the spine.

OPTP P.O. Box 47009 3800 Annapolis Ln., Ste. 165 Minneapolis, MN 55447-0009 800-367-7393 Fax: 763-553-9355 customerservice@optp.com www.optp.com/ad TR AINING-CONDITIONING.COM

Unfortunately, as I abandoned the straight-leg sit-up, I noticed that my athletes experienced declines in core and abdominal strength. The crunches that replaced the straight-leg sit-up never allowed the spine to reach

To use the Core Challenge Roller for the straight-leg situp, the athlete lies supine with his or her spine aligned along the device. As the athlete rolls up, he or she is unable to put the pelvis in an anterior tilt and is actually forced into a posterior tilt by the roller. This discourages any flexion at the hips until the athlete has attained a sufficient amount of lumbar flexion. This increases the challenge to the external obliques and puts the hip flexors at a disadvantage. In the upright position, the lower back and sacrum sink into the Core Challenge Roller, thus promoting additional lengthening of the lumbar extensors. Throughout the roll up, the Core Challenge Roller also provides an unstable surface, requiring the athlete to continually adjust the deep core musculature during the movement.

T&C SEPTEMBER 2007

ADVERTISERS DIRECTORY CIRCLE COMPANY NO.

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Airex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 American Red Cross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Balanced Body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Biofreeze®/Performance Health® . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Brace International (Fluk) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Brace International (MAX) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 C.H.E.K. Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 California University of Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 CytoSport (Cytomax) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 CytoSport (Muscle Milk). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IFC efi Sports Medicine/Total Gym. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 FitBALL USA (Ball Dynamics) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Fitnessrubber.com . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Gatorade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-3 Gebauer Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 General Tools & Instruments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Hammer Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Harbinger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 Jump Stretch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

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Keiser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Kytec Athletic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Lebert Equalizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Mueller Sports Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 NCCPT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 NExTT Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 OPTP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Outdoor Boss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Perform Better . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Power Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Powernetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC Samson Weight Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Shuttle Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Topaz Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 TurfCordz/NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 VertiMax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47 WerkSan Barbells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 WissTech Enterprises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 Wobenzym N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BC

PRODUCTS DIRECTORY CIRCLE COMPANY NO.

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Alcan Airex AG (Balance-pads) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Alcan Airex AG (mats) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 American Red Cross (CPR/AED) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 American Red Cross (Training Program) . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Avazzia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Balanced Body (EXO Chair) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Balanced Body (Reformer) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Ball Dynamics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 Biofreeze®/Performance Health® . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Brace International . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Cera Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 C.H.E.K. Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 CytoSport (Cytomax) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 CytoSport (Muscle Milk Collegiate Bars) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 efi Sports Medicine (Closed Chain Platform) . . . . . . . . . . . . . . . . . . . . . . . 54 efi Sports Medicine (PlyoRebounder). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Fitnessrubber.com . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Gatorade (Endurance Formula) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Gatorade (Nutrition Shake) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 General Tools & Instruments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Hammer Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Jump Stretch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Keiser (Air300 Runner) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Keiser (Air300 Squat) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Kytec Athletic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Lebert Equalizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Lebert Equalizer (Leg Strengthening) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Life Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Mueller (Hg80 ankle brace) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Mueller (Life Care for Her) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

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NASM (Corrective Exercise-Knee) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 NASM (Performance Enhancement) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 NCCPT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 NExTT Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 OPEN - Product Launch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 OPEN - Product Launch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 OPTP (Golfer’s Guide to Pilates) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 OPTP (Pro-Roller). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Outdoor Boss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Perform Better (New Product) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Perform Better (Drive Sled) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Perform Better (Shaw 360) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Power Lift (Belt Squat) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Power Lift (Leg Press) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Power Systems (Foam Roller) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Power Systems (L-Bands system) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Pro-Tec Athletics (Compression Wrap) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Pro-Tec (SI Back Belt) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Samson (107GH) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Samson (Leg Press) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Shuttle Systems (Balance) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 Shuttle Systems (Shuttle MVP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 Swede-O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Thera-Band®/Performance Health Products® . . . . . . . . . . . . . . . . . .51 VertiMax (PLUS series) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 VertiMax (V6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 WerkSan Barbells (official barbell) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 WerkSan Barbells (weightlifting equipment) . . . . . . . . . . . . . . . . . . . . . . . . 54 WissTech Enterprises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Wobenzym N (Creme) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

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TESTIMONIAL

TurfCordz™: A Four Products Popular Choice That Ease Athletes’ Pain

TurfCordz™ are used in high-level athletic training by professional football, baseball, hockey, and basketball teams. They’re great for explosive start drills, power-building footwork exercises, and simulated play action. Here are just a few satisfied TurfCordz users: Arizona Cardinals Cincinnati Reds Colorado Avalanche Denver Broncos George Washington University Indiana University Kenyon College McMaster University Ohio State University Pennsylvania State University Purdue University Stanford University University of California University of Denver University of Notre Dame U.S. Air Force U.S. Marine Corps U.S. Olympic Swim Team U.S. Olympic Speed Skating Team Texas Rangers Contact NZ Mfg. to request a free catalog.

NZ Mfg., LLC P.O. Box 2146 Stow, OH 44224 800-886-6621 Fax: 866-320-3653 www.nzmfg.com TR AINING-CONDITIONING.COM

“I’ve found Pro-Tec products to be a great addition to my patient care, as they are very patient-compatible.” Jim Whitesel, MS, ATC Former Seattle Seahawks Head Athletic Trainer (1976-1998) President, Whitesel Pro Therapy, Inc., Kirkland, WA “I have found the Iliotibial Band Wrap to offer unmatched effectiveness in alleviating conditions of iliotibial band syndrome. We are recommending it for our patients.” Dr. Shintaro Ohtake Aim Treatment Center “Finally, because of the Shin Splints Compression Wrap, I feel no pain in my shins during strenuous activity.” Lisa Duke Ballerina and Runner “Thanks to the Arch Pro-Tec, the plantar fasciitis in my foot has completely disappeared.” Christina Cambra 3rd-Place Finisher, Ironman Austria

TESTIMONIAL

Smart ATCs Carry Save-A-Tooth Athletic trainers should have Save-ATooth, the emergency tooth preservation system, available with their first aid supplies. Three sports medicine professionals understand why it’s important to take Save-A-Tooth on the field: “Last year we had an unfortunate incident at one of our boys’ varsity soccer matches—an athlete lost a tooth during

play. Luckily, we had a Save-A-Tooth kit in our medical box. The tooth was preserved and successfully implanted back into the player.” Director of Health and Athletics Baldwinsville Central School District, NY “I recently used your product to save a tooth on a member of the Boston Bruins hockey team. I don’t know why all athletic directors of high schools and colleges are not advised of this system.” Robert J. Thomas, DDS Wellesley, MA

“With Ice Up, the benefits of ice massage are ready for me anytime, anywhere.” Scott Jurek, PT Seven-Time Champion, Western States Ultra 100-Mile Marathon

“I plan to introduce Save-A-Tooth to the Professional Baseball Athletic Trainers Society. Seldom do truly worthwhile products appear for our scrutiny that have such a high degree of efficacy.” Gene Monahan, ATC Head Athletic Trainer New York Yankees

Pro-Tec Athletics 2743 152nd Ave. NE Redmond, WA 98052 800-779-3372 pro-tec@injurybegone.com www.injurybegone.com

Phoenix-Lazerus, Inc. 18 S. Roland St. Pottstown, PA 19464 888-788-6684 Fax: 484-941-0641 www.save-a-tooth.com T&C SEPTEMBER 2007

MORE PRODUCTS Alcan Airex AG 800-396-3130 www.bebalanced.net A well-trained sense of balance is very important for avoiding injuries from falls. Airex provides a great solution for training balance: Airex Balancepads. They are made from ultrasoft closed-cell specialty foam, which gently compresses as you stand on it, making you feel as if you were standing on a cloud. Airex Balance-pads are the perfect piece of equipment for balance training, coordination and reaction training, postural stability training, and balanced-motion cardio training. Circle No. 544 A key objective in physical therapy activities is to keep the patient as safe and comfortable as possible. Airex gymnastics mats provide maximum protection through their non-slip surface, superb cushioning, and soft and warm touch to the skin. Permanent hygiene is guaranteed through the company’s sanitizing process. In water, Airex products provide a safe and stable platform for a variety of hydrotherapy activities. Circle No. 545 American Red Cross 800-667-2968 www.redcross.org The Sport Safety Training Program is designed to help coaches, athletic trainers, and others identify and eliminate potentially hazardous conditions in various sports environments. It also trains you to recognize emergencies and make appropriate decisions for first-aid care. Flexible course options—including a stand-alone Sports Injury Prevention and First Aid course with additional training available in adult and child CPR, automated external defibrillation, bloodborne pathogens, and oxygen administration—allow you to design the course that’s right for you. Circle No. 546 60

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With CPR/AED for the Professional Rescuer, available from the American Red Cross, you can learn about responding to breathing and cardiac emergencies in adults, children, and infants; using an AED on an adult or child victim of cardiac arrest; and using personal protective equipment to stop bloodborne pathogens and other diseases from spreading. There are optional new lessons on epinephrine auto-injectors and asthma inhalers. Circle No. 547 Avazzia 214-575-2820 www.avazzia.com When the BEST™ microcurrent biofeedback electro-stimulation TENS device from Avazzia is applied to an athlete’s body, a high-voltage microcurrent signal is passed through the skin. With each signal, the electrical properties of the tissue change. The device detects the changes and responds, resulting in versatile, effective electrotherapy and pain relief. This battery-operated, handheld unit is easy to use and delivers outstanding results. Circle No. 548 Biofreeze®/Performance Health Products® 800-246-3733 www.biofreeze.com Applied generously, Biofreeze® pain relieving gel and roll-on effectively relieve pain from heel injuries, sore arches, muscle spasms, strains, sprains, and tendonitis, and will help minimize nextday aches and pains. Use it up to four times a day. It’s available in a 16-ounce spray bottle and 16-ounce, 32-ounce, and gallon gel pump bottles. Also available is a gravity dispenser box with 100 five-gram single-use application packets for clinical settings. Circle No. 549

Brace International 800-545-1161 www.braceint.com Brace International offers a full line of bracing and support products. The FLUK™ knee strap is ideal for treating such injuries as patellar tendonitis, chondromalacia patella, and OsgoodSchlatter’s disease. It applies compression to the knee area without restricting circulation. Circle No. 550 Cho-Pat 800-221-1601 www.cho-pat.com Cho-Pat’s newest product, the Bicep/ Triceps Cuff, affords protection from overuse injuries for individuals performing repetitive lifting in activities such as weight training. The patent-pending device applies dynamic circumference pressure to the upper and lower portions of the bicep and triceps muscles, particularly at the tendon attachments. This action spreads out the stress and direct pull on the muscle attachments, which helps reduce the likelihood of developing bicipital and tricipital tendonitis or tendonosis. Circle No. 551 Fitnessrubber.com 888-894-0204 www.fitnessrubber.com Fitness Rubber is a new Web fitness resource that offers “manufacturer direct pricing” for all your fitness rubber equipment needs. The company’s products include Kraiburg Solid Rubber Weight Plates, KraiburgSportec Rolled Rubber Flooring, Kraiburg-Sportec Interlocking Fitness Tiles, and FLEXGARD Rubber Coated Cast Iron Weight Plates, to name just a few. Make it a point to visit Fitnessrubber.com and receive immediate savings of up to 45 percent. Act now and receive a $20 discount on your initial Web site order over $100. Circle No. 552 TR AINING-CONDITIONING.COM

MORE PRODUCTS NCCPT Personal Training Certification 800-778-6060 www.NCCPT.org The National Council for Certified Personal Trainers (NCCPT) is much like a trade school, providing students with the tools they need to work as personal trainers. NCCPT instructors are in the trenches, training. The information is presented in a practical manner, so students can apply their academic knowledge to themselves and their athletes. The NCCPT constantly updates its materials to stay current with the latest cutting-edge techniques. Use this certification to recruit personal trainers. Both live courses and home courses are available. Circle No. 553 Outdoor Boss 888-463-5699 www.outdoorboss.com Outdoor Boss has been in business for more than 10 years and offers many great products for your team besides the popular Boss drinking system. Check out Frogg Toggs Chilly Pads and breathable raingear when visiting the company’s online store. There are also many quality, affordable misting fans and evaporative coolers. Outdoor Boss’s online store has many unique products that are must-haves for your team. Go online to see why the company believes that the “Possibilities are Endless.” Circle No. 554

chin-ups, push-ups, and dips. By using their own body weight, athletes can adjust the level of difficulty (usually by a simple change in foot placement) to suit their needs. The Equalizer is perfect for everyone from beginners to pro athletes. Made of long-lasting steel, the Equalizer is portable, versatile, and easy to store. It is a leading training tool for sports teams, boot camps, and athletes everywhere. Circle No. 555 Mueller Sports Medicine 800-356-9522 www.muellersportsmed.com Latex-free Life Care for Her ultra-thin supports are contoured and sized to fit a woman’s body. Antimicrobial technology controls odors, stains, and deterioration of the fabric. Unique gel pads provide soothing, targeted support. Life Care for Her discreetly fits under clothing with little bulk. Fashionable colors and smooth, breathable fabrics make it a stylish choice for women of all activity levels. Life Care for Her will soon be available for knees, ankles, elbows, and wrists. Circle No. 556 The new Hg80 ankle brace with straps from Mueller Sports Medicine provides superior protection and support with unique features to maximize comfort and performance. The Muellerexclusive moisture-wicking and antimicrobial HydraCinn fabric is latex- and neoprene-free, while the secure stirrup straps and longer elastic cross-

ing straps provide exceptional support through a heel-lock and figure 8 configuration. The figure 8 straps add tension as the ankle moves, offering greater support and a secure fit. This brace is lightweight, extremely soft to the touch, and comfortable. Custom sizes from XS to XL are available in black. Circle No. 557 NASM 800-460-6276 www.nasm.org The NASM Performance Enhancement Specialist (NASM-PES) advanced specialization offers professionals the ability to learn cutting-edge performance assessment techniques and sportspecific program design. Individuals with this credential deliver consistent results in rehabilitation, reconditioning, and performance enhancement. Learn to individualize integrated training programs to keep your athletes performing at the highest level, and utilize the OPT™ method for outstanding, measurable results. The PES offers scientifically valid, evidencebased applications that help you achieve remarkable results with top professionals and weekend warriors alike. CEUs: NASM 1.9; NSCA 1.6; ACE 1.8; NATABOC 27. Circle No. 558

Your athletes are counting on you!

Lebert Fitness, Inc. 905-785-0626 www.lebertequalizer.com When it comes to athletic conditioning, most coaches agree that athletes should master body weight training before using external loading. The Lebert Equalizer is the perfect tool for compound body weight exercises like

800,000 teeth are knocked out each year during sports! Is your dental kit ready?

This

NOT This

Save-A-Tooth® Emergency Tooth Preserving System (888) 788-6684 or www.Save-A-Tooth.com Circle No. 138

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MORE PRODUCTS NExTT Solutions, LLC 574-233-6695 www.nexttsolutions.com

pression pad applies additional compression to stabilize the sacrum. Circle No. 560

NExTT Injury Management© software has been servicing athletic training rooms for more than 24 years, incorporating methods and styles from a variety of staffs. This first-hand working knowledge is the foundation of the program and what sets NExTT Solutions apart from the competition. With quick filter views, a single-page treatment log, and an interactive episode history calendar, this software operates just like a real day in the athletic training room. Circle No. 559

Save-A-Tooth 888-788-6684 www.Save-A-Tooth.com

Pro-Tec Athletics 800-779-3372 www.injurybegone.com The Pro-Tec SI Back Belt is a new product designed to alleviate lowerback pain. It stabilizes the hips and sacrum, thus reducing strain to the lower back. It has a low profile to fit comfortably over the hips and provide effective relief for sacroiliac joint syndrome. A secondary exterior strap over the com-

Every year, 800,000 teeth are knocked out during sports and only 10 percent of athletes consistently wear mouthguards. Knocked-out teeth begin to die within 15 minutes. Save-ATooth can preserve and nourish knocked-out teeth for up to 24 hours. Save-A-Tooth is a scientifically proven system with a cell-preserving solution and a suspension basket that protects and saves tooth root cells. Protect your athletes by keeping a SaveA-Tooth on hand. Information about knocked-out teeth and Save-A-Tooth can be obtained at the Save-A-Tooth Web site or by calling the company. Circle No. 561 WissTech Enterprises 800-809-8184 www.wisstechenterprises.com WissTech Enterprises offers a complete line of indoor and outdoor portable drinking fountains. The company’s Hydration Station is manufactured

for durability and features an allwelded cart with industrial casters and wheels to ensure years of worry-free service. Durable chrome-plated brass drinking valves are easy to use and warranted against breakage. The Hydration Station is produced in 20-, 25-, and 50-gallon capacities. The new drinking cart is intended for indoor use. Circle No. 562 Wobenzym USA 888-766-4406 www.wobenzym.com/tandc Wobenzym®N Crème provides fast, penetrating relief for minor arthritis pain, back pain, muscle pain, and sports injuries. It incorporates traditional herbs used for centuries in Asia and Europe to help ease surface pain. Bromelain and Papain help promote robust circulation and normalize inflammation. This product has been validated by the latest research to interfere with COX-2 activity. Visit the Wobenzym Web site to learn more. Circle No. 563

WEB NEWS efi Offers a Site Worth Bookmarking efi Sports Medicine® has created an outstanding Web site for high-quality athletic training equipment and the latest industry knowledge. Discover a new and improved Total Gym® exercise library and choose the right equipment for you and your athletes. View product comparison charts, efficiently position equipment using the footprint calculator, and check out the interactive return-oninvestment calculator for group training sessions. The site is filled with tools to support your practice. There are Total Gym commercial models, accessories, and videos, plus functional training products like PlyoRebounder™, medicine balls, Cuff Link™, Super Swimflex Max, and more. Get listed with the online efi network—an opportunity for referrals and networking. Check it all out for yourself.

www.efisportsmedicine.com WerkSan Barbell’s Site Does Heavy Lifting for You Want an easy way to learn about WerkSan’s wide selection of high-quality weight training equipment? Visit the company’s Web site and see how all the information you need is just a click away. See photos and read product details for weight sets, racks and platforms, bumpers, training products, and even performance apparel for the serious lifter. The site also explains WerkSan’s guarantees and return policy, provides shipping info, and more. Go online today—you’ll be glad you did.

www.werksanusa.com Wish Publishing: Bringing the Experts to You for Nearly a Decade Wish Publishing was started in 1999 as the first women’s sports publishing company. Since that time, it has published a variety of books to help athletes make the most of their conditioning regimens. Wish Publishing has released conditioning books written by the best in the strength training business, including Matt Brzycki, Coordinator of Recreational Fitness and Wellness Programs at Princeton University, noted biomechanist and kinesiologist Dr. Michael Yessis, and respected fitness authors Joe Luxbacher and Lisa Wolfe. The company also publishes a diverse collection of sport skill development titles, covering everything from basketball to rugby. Discounts are available on most titles.

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CallingHere Cards is what these companies are most known for...

A leader in lifesaving training for more than 95 years. www.redcross.org

World-class manufacturer of adjustable, portable taping and treatment tables. www.oakworkspt.com

Equipment for training without straining. www.shuttlesystems.com

Winning taste... Championship results. www.cytosport.com

Supplier of quality tools and resources for more than 30 years. www.optp.com/ad

Created for the extreme demands of high-level athletic training. www.nzmfg.com

Manufacturer and distributor of advanced-technology medical and rehabilitation equipment, supplies, and treatment tables. www.dynatronics.com

Save-A-Tooth by Phoenix-Lazerus is an emergency knocked-out tooth preserving system. www.save-a-tooth.com

Radically increase game-winning intensity, first-step-quickness, and vertical jump. www.vertimax.com

Supplier of functional exercise equipment for rehabilitation and athletic training. www.totalgym.com

Customized taping stations and treatment furniture for athletic trainers, built PROTEAM tough. www.proteamtables.com

The leader in sports & industrial hydration. www.waterboysports.com

Educate...Motivate...Elevate. nccpt.com

Uniquely designed products with unparalleled comfort and effectiveness. www.injurybegone.com

WerkSan has a strong worldwide reputation for high-quality weightlifting equipment. www.werksanusa.com

Highly respected strength and conditioning and personal training certifications. www.nsca-cc.org

Building equipment for football champions for 35 years. www.rogersathletic.com

An excellent strength-enhancing, power-producing conditioning tool. www.thexvest.com

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T&C SEPTEMBER 2007

CEU QUIZ

T&C September 2007 Volume XVII, 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 to MAG, Inc., 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 MAG, Inc., and mail it by October 15, 2007 to the following address: MAG, Inc., ATTN: T&C 17.6 Quiz, 31 Dutch Mill 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 December 1, 2007. A Moral Compass (pages 12-15) Objective: Help your athletic training students to understand the NATA’s Code of Ethics and how to apply it to their professional life after college. 1. When asked by a booster for information on an athlete’s injury, the NATA Code of Ethics requires you to: a) Go to the coach and tell him the booster is asking too many questions. b) Treat the athlete’s medical details as privileged information. c) Tell whether the athlete will be able to start next week. d) Call a news conference to announce the athlete’s status. 2. In a scenario where a high school basketball coach requests the ATC to tape the starting players’ ankles and give the nonstarters ankle braces, what should the ATC be considering? a) NATA members shall not discriminate against any legally protected class. b) Following the coach’s request to save money. c) The fact that this is privileged information. d) Instant legal action and file a lawsuit. 3. The athletic training profession relies on _____. a) Other professions to police ATCs. b) Random audits and board visits. c) Consumer reporting of violations. d) Self-policing of ATCs by ATCs.

Timing It Right (pages 17-24) Objective: See what it takes to use nutrient timing during the season and nutrition periodization throughout the year to an athlete’s advantage. 4. Scheduling meals and snacks across a 24-hour period to be well-fueled for workouts and maximize recovery afterward is known as what? a) Periodization. b) Carb loading. c) Glycogen storage. d) Nutrient timing. 5. Adjusting eating across the year to maintain the appropriate nutrition status is known as what? a) Nutrient timing. b) Carb loading. c) Nutrition periodization. d) Glycogen storage.

T&C SEPTEMBER 2007

6. The part of the day when an athlete is working out or competing is referred to as the: a) Anabolic phase. b) Energy phase. c) Recovery phase. d) Catabolic phase. 7. What is the main recommended component for nutritional intake during the energy phase? a) Hydration. b) Protein. c) Calories. d) Fat. 8. An athlete playing at 70 percent VO2 max needs to consume _____ milliliters of fluid every _____ minutes. a) 100-200; 20. b) 200-300; 20. c) 100-200; 40. d) 300-400; 60. 9. When the body is in a catabolic state, it is preparing for a period of _____ right after exercise. a) Intense anabolism. b) Insulin sensitivity. c) Rehydration. d) Catabolism. 10. The body will not automatically transition from catabolism to anabolism after a completed workout until the athlete does what? a) Rehydrates. b) Performs a cool-down. c) Stretches. d) Ingests the correct nutrients. 11. After an aerobic workout, the athlete needs how many grams of carbohydrates per kilogram of body weight? a) .5-1.0. b) 1.0-1.5. c) 1.5-2.0. d) 2.0-2.5. 12. Todd Wright teaches his athletes to refuel within _____ minutes after exercise for optimal recovery and future performance. a) 45. b) 60. c) 90. d) 120.

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Class & Clinic (pages 26-31) Objective: Understand how Slippery Rock University overcame the obstacles of giving its athletic training students the right education and satisfying the athletic department at the same time. 13. This article indicates it requires _____ to blend the athletic training educational program with the athletic training clinical program. a) Teamwork and communication. b) The willingness to work longer hours. c) Access to e-mail and quick e-mail responses. d) Ability to anticipate all needs of co-workers.

Let the Season Begin (pages 32-37) Objective: See how strength coaches are working with sport coaches and athletes to continue strength training during their in-season months. 14. The main goals of strength training during the competition months are: a) Strength gains. b) Maintenance and recovery. c) Improved endurance. d) Toning. 15. It only takes _____ hours of no weight lifting to see the onset of muscle atrophy. a) 24. b) 48. c) 72. d) 96. 16. According to Patrick McHenry, there is research that shows: a) No effect to lifting on game days. b) Negative effects to lifting on game days. c) Positive effects to lifting on game days. d) Negative effects to in-season weight lifting.

Starting at the Bottom (pages 39-44) Objective: Learn how bone spurs may be the cause for complaint of recurring heel pain and how to treat it on an individual basis. 17. Besides the heel, what is another common site for spurring to occur? a) Insertion of the anterior tibialis. b) Insertion of the extensor digitorum. c) Distal attachment of the rotator cuff tendon. d) Distal attachment of the quadriceps tendon. 18. Tightness of the gastrocnemius-soleus complex may lead to what? a) Calcification within the soft tissue. b) Bone spur on the proximal talus. c) Bone spur on the posterior heel. d) Bone spur on the plantar aspect of the foot.

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19. Tightness of the plantar fascia places a stress on the connective tissue attachments that may lead to spurring at the: a) Proximal talus. b) Posterior heel. c) Dorsal aspect of the foot. d) Plantar aspect of the foot. 20. In jumping, the gastrocnemius and the soleus perform force production in plantar flexion of the foot and ankle as well as an even greater role in what? a) Inversion. b) Stabilization of the midfoot. c) Lateral movement. d) Force reduction. 21. One problem area to look for related to ankle function is: a) Weakness of the posterior tibialis. b) The Q-angle. c) Increased longitudinal tension at the tendinous or ligamentous attachment. d) Hyerflexion of the gastrocnemius. 22. When the foot is dorsiflexed, the talus moves _____ to fill the space in the mortise. a) Superiorly. b) Inferiorly. c) Posteriorly. d) Inferiorly. 23. Lack of ankle dorsiflexion causes what? a) The tibia to externally rotate and the femur to adduct and internally rotate. b) The tibia to internally rotate and the femur to externally rotate. c) The fibula to shift anteriorly. d) The sacroiliac joint to rotate anteriorly.

Strength to Spare (pages 45-48) Objective: Gain an understanding of what it takes to keep a bowling team in top shape. 24. Each Vanderbilt bowler throws a bowling ball how times during an average practice? a) 200-300. b) 300-350. c) 300-400. d) 350-450. 25. The _____ component of this program consists of a general warmup. a) Injury prevention. b) Movement preparation. c) Metabolic conditioning. d) Resistance training.

Answer sheet is on page 66

T&C SEPTEMBER 2007

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 MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 17.6 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850, no later than October 15, 2007. 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 December 1, 2007.

A Moral Compass

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Let the Season Begin

Timing It Right

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Strength to Spare

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Last Name ____________________________________ First Name _______________________________ MI______ Title ______________________________________________________________________________________________ Mailing Address ____________________________________________________________________________________ City ________________________________________________ State _________ Zip Code _____________________ Daytime Telephone ( _________ ) ________________________________________ E-Mail Address ____________________________________________________________________________________ Payment Information

❏ $20 check or money order (U.S. Funds only) payable to: MAG, Inc. (please note “T&C 17.6 Quiz” on check) ❏ Visa

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T&C SEPTEMBER 2007

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ADDITIONAL EDUCATIONAL PROGRAMS

EARN BOC CEUs • Complete quizzes found in the NSCA’s Strength & Conditioning Journal • Complete online quizzes at www.nsca-cc.org Toll-free: 888-746-2378 I Online: www.nsca-cc.org E-mail: commission@nsca-cc.org

Primary Care Sports Medicine Conference

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September 14-15, 2007

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2/27/07 5:08:47 PM

Presented by the Family Medicine Residency Program

St. Joseph’s Hospital Health Center, Medical Education 4104 Medical Center Drive, Fayetteville, NY For more information phone:

315-329-7177 Fax: 315-329-7182

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Ever wonder where the pro teams get those GIANT rubber bands they use for stretching?

Look no further! Jump Stretch has been supplying the large continuous-loop FlexBands® to high school, college, and pro teams since 1980. We have a total of seven sizes, but most teams use either the Light or Average bands for stretching. For more information, visit our website at www.jumpstretch.com or call 1-800-344-3539.

Jump Stretch, Inc. 1230 N. Meridian Rd. Youngstown, OH 44509 www.jumpstretch.com 1-800-344-3539 Fax: 1-330-793-8719 Circle No. 139 1 TRjumpstretch62v0v3.indd AINING-CONDITIONING.COM

1/3/07 1:39:01 PM T&C SEPTEMBER 2007

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

Keep your career in motion… NSCA Educational Events for 2007 • NSCA’s Performance Series Symposia

• Essentials of Weight Training • Periodization & Planning • Functional Performance Training

For dates, locations, and session information call 800-815-6826, or visit www.nsca-lift.org

National Strength and Conditioning Association ECA MIAMI SPORTS TRAINING, FITNESS CONFERENCE, AND TRADE SHOW, NOVEMBER 2007

The Voice of the Doctors who care for the Pros

1-800-ECA-EXPO

The PTP provides resources and services for all sports medicine professionals.

Visit www.proteamphysicians.com

OR REGISTER ONLINE

ECA M IAMI 2007

www.ecaworldfitness.com

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

SPECIALIST IN SPORTS CONDITIONING

ISSA Certification Program • • • •

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

CALL FOR FREE INFO:

1.800.892.4772

www.FitnessEducation.com

International Sports Sciences Association

Ide d[ i]Z a^cZ Zfj^ebZci [dg ndjg Vi]aZi^X igV^c^c\ XVgZZg# • Optimum Performance Training™ method • Performance Enhancement Specialist (PES) certification • OPT™ for Performance Enhancement workshops

Athletic Therapy. Rapid return to work and play.

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

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

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

• Continuing education for NASM, NATA and NSCA • Clinical Applications • Flexibility, core, balance, power, speed and strength training

NATA Bronze Corporate Partner

Call 1-800-460-6276 or visit www.nasm.org.

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T A E R G IT´S

Wobenzym®N. Swear by it. World-class athletes from across the globe rely on Wobenzym®N to support their bodies’ recuperation process, and as an essential part of regular training and maintenance programs.

Wobenzym®N

These athletes know that after an injury or muscle strain, damaged blood vessels cause swelling as a signal to the body to prevent further abuse. With adequate rest, the injury will normally recover, but who wants to wait?

is featured in the Physicians’

The sooner your clients recover, the better. By supplementing with Wobenzym®N, you can support nearly every metabolic and physiological process involved in recuperation – and help your clients get back in action faster.†

Desk Reference

For more information or to order literature for your clients, visit our website at www. Wobenzym .com/tandc †These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. ©2007 Naturally Vitamins, a Marlyn Nutraceuticals, Inc. company. Wobenzym®N is a registered trademark of Mucos Pharma, GmbH

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