Training & Conditioning 18.5 by Momentummedia

July/August 2008 Vol. XVIII, No. 5, $7.00

Facing the Heat Setting policies to prevent heat stress

The Psychological Side of Nutrition Training Masters Athletes

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July/August 2008, Vol. XVIII, No. 5

CONTENTS 14

Bulletin Board A better way to repair the ACL … Warning about a new supplement … Research center tracks sports injuries … Exercise benefits of green tea. Comeback Athlete Chrissy Schoonmaker University of South Carolina

Special Section Supplier Web Site Directory

NATA Show Wrap-Up

62 65 66 69 72

Product News Heat Stress Products Product Launch Aquatic Therapy Ankle & Foot Care More Products

Advertisers Directory

CEU Quiz For NATA and NSCA members

Next Stop: Web Site Cover photo: AP Photos/Michael Patrick

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Optimum Performance

Golden Years Today’s baby boomers are remaining active as they age, so the ranks of masters athletes are growing fast. Are you prepared to work with this special population? By Vern Gambetta Leadership

the Heat 22 Facing More and more athletic programs are using written policies to govern practices and workouts in the hot, humid months. From getting everyone on board to deciding what rules to set, there are several critical steps to a successful policy-making process. By Abigail Funk Treating The Athlete

29 If an athlete’s lumbar pain won’t go away with time, the cause might be Back in Trouble

a serious spinal condition called spondylolysis. This article explains what it is and how to manage it. By Chris Gellert Nutrition

37 When advising athletes about their eating habits, you shouldn’t just talk Mind Over Menu

carbs, calories, and calcium. You also need to address the psychology behind their relationship with food. By Laura Ulrich Sport Specific

46 To keep pitchers healthy and on top of their game, you must prepare Arm Forces

specific muscles in the arm and shoulder for tremendous rotational force and repetitive stress. By Lenny Macrina & Dr. Michael Reinold TR AINING-CONDITIONING.COM

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EDITORIAL BOARD

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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

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Christopher Ingersoll, PhD, ATC, FACSM Director, Graduate Programs in Sports Medicine/Athletic Training University of Virginia

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

Allan Johnson, MS, MSCC, CSCS Sports Performance Director Velocity Sports Performance

Cindy Chang, MD Head Team Physician, University of California-Berkeley

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

Special Projects Dave Wohlhueter

Dan Cipriani, PhD, PT Assistant Professor Dept. of Exercise and Nutritional Sciences, San Diego State Univ.

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.

Marketing Director Sheryl Shaffer

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

Marketing/Sales Assistant Danielle Catalano

Brian Roberts, MS, ATC, Director, Sport Performance & Rehab. Ctr.

Advertising Sales Associates Diedra Harkenrider (607) 257-6970, ext. 24

Gray Cook, MSPT, OCS, CSCS Clinic Director Orthopedic & Sports Phys. Ther. Dunn, Cook, and Assoc.

David Ellis, RD, LMNT, CSCS Sports Alliance, Inc.

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Art Direction Message Brand Advertising

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Jeff Dilts, Director, Business Development & Marketing, National Academy of Sports Medicine

Patent-pending device affords protection from overuse injuries for individuals performing repetitive lifting.

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

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

Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center

Lori Dewald, EdD, ATC, CHES Health Education Program Director, Salisbury University

Bicep/TricepS Cuff

Circulation Staff David Dubin, Director John Callaghan

Production Staff Maria Bise, Director Jim Harper, Neal Betts, Natalie Couch

Bernie DePalma, MEd, PT, ATC Head Athl. Trainer/Phys. Therapist, Cornell University

Cho-Pat’s unique approach to help alleviate the pain and soreness caused by shin splits Sizes: Sm - L

Editorial Staff Eleanor Frankel, Director Greg Scholand, Managing Editor R.J. Anderson, Kenny Berkowitz, Abigail Funk, Kyle Garratt, Mike Phelps, Dennis Read

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

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

Keith D’Amelio, ATC, PES, CSCS Head Strength & Conditioning Coach/ Assistant Athletic Trainer, Toronto Raptors

Shin Splint Compression Sleeve

Publisher Mark Goldberg

Maria Hutsick, MS, ATC/L, CSCS Head Athletic Trainer, Medfield (Mass.) High School

Jim Berry, MEd, ATC, SCAT/EMT-B Director of Sports Medicine and Head Athletic Trainer, Myrtle Beach (S.C.) High School

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

July/August 2008 Vol. XVIII, No. 5

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

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 P.J. Gardner, MS, ATC, CSCS, PES, Athletic Trainer, Colorado Sports & Spine Centers

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

Administrative Assistant Sharon Barbell

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© 2008 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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Sponsored by

Board Improved ACL Reconstruction Reaches U.S. For almost as long as anterior cruciate ligament (ACL) reconstructions have been performed in the U.S., the single-bundle technique—reconstruction of only one of the ligament’s two bundles of fibers—has been the only available option. But complaints of weak knees and the early onset of arthritis have become common after the procedure, prompting surgeons to explore new and better ways to reconstruct the ACL. Enter the double-bundle technique: reconstruction of both the anteromedial and posterolateral bundles, a procedure that originated in Asia almost a decade ago and is now being performed by a handful of doctors in the U.S. “The doublebundle procedure more closely duplicates the normal anatomy of the knee,” says John Samani, MD, of the Michigan Knee and Shoulder Institute in Auburn Hills, where he and partner Thomas Perkins, DO, started performing the technique earlier this year. “Not only does it prevent abnormal motion front-toback, but it also prevents rotational movement that many athletes still experience after a single-bundle procedure.” Perkins says long-term studies have yet to be completed, but initial feedback from patients who have undergone the double-bundle surgery has been overwhelmingly positive. “In the short term, patients have said their knee feels more normal, especially if they had the single-bundle procedure on one knee and the double-bundle procedure on the other,” Perkins says. “We hope that by controlling both the front-and-back and rotational motion, we may be able to halt degenerative arthritis, and the indications so far are very encouraging.” The procedure typically doubles a patient’s time in the operating room, but rehab time is similar to that for the singlebundle technique and a rapidly growing number of doctors are interested in learning and refining the procedure. Samani and Perkins believe that if the research backs up the anecdotal evidence available thus far, this surgery will soon become the standard in ACL reconstruction. “It really is exciting to be able to tell a patient, ‘With this procedure, instead of 10 years of good function, we may be able to give you 30 years of great function,’” Samani says.

Not Safe For Use New drugs called myostatin blockers are showing great promise in the lab against muscle-wasting diseases like muscular dystrophy and Lou Gehrig’s disease. But even though they’re still being researched and are not yet approved for human use, they have created a buzz in the athletic world, and some bodybuilding Web sites are already hawking products touted as blocking myostatin. “I get angry about it,” Se-Jin Lee, MD, PhD, a Professor of Molecular Biology and Genetics at the Johns Hopkins 6

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University School of Medicine, told Bloomberg News. “The scientific potential to make people’s lives vastly improved is incredible. And all we can talk about is whether some athlete can use it to hit a baseball farther.” Myostatin is a naturally occurring protein that limits muscle growth in mammals. It occurs in differing levels in humans and is one factor that contributes to individuals’ ability to build new muscle. Myostatin blockers, in theory, can boost muscle growth by inhibiting myostatin production, but their overall effect on the body is not yet known. The World Anti-Doping Agency has banned myostatin blockers even before they’ve been fully tested, but athletes may be tempted by the promise of a non-steroid, hard to detect route to bigger muscles and better performance. Because myostatin blockers are injected directly into targeted tissues, they won’t show up in urine or blood tests. Lee, who discovered myostatin over a decade ago, said he has received e-mails and phone calls asking about the drugs from several athletes and coaches, including a bodybuilder from Brazil who already had a test version of one myostatin blocker in his possession. Other researchers have expressed concern that a lab could be built fairly cheaply to make the untested drugs and distribute them to athletes. For now, the bottom line is that myostatin blockers are not safe for human use and athletes should be strongly warned against taking them.

New Injury Data Center Launched A new non-profit research center is hoping to have a big impact on sports injury prevention. The Datalys Center, which opened in Indianapolis in April, was formed by the NCAA, the American College of Sports Medicine, and BioCrossroads, an Indiana initiative to grow the life sciences. The center aims to provide research and trend data to sports governing bodies and academic researchers looking to reduce the number of sports injuries suffered in the U.S. each year. “The Datalys Center is about trying to prevent, diagnose, and potentially even treat injuries more effectively,” says the center’s President, Troy Hege, MBA, also a Project Director at BioCrossroads. “Through our own research and by facilitating other organizations’ research, we’re looking to translate the data into useful information that can benefit athletes and athletic trainers.” The center’s first initiative involves taking over data collection for the largest ongoing collegiate sports injury database in the world—the NCAA’s Injury Surveillance System (ISS). Though the Datalys Center is a separate entity, the NCAA is its first collaborative partner and will share ISS tools and research. The two groups are currently working on a data transition plan to distribute to member institutions during the next academic year, and the Datalys Center aims to be collecting data from TR AINING-CONDITIONING.COM

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Board schools on behalf of the NCAA by the fall of 2009. “We aren’t taking ownership of the NCAA’s data,” Hege says. “Rather, we’re a vehicle to help the NCAA—and eventually groups like the NFHS and other sports governing bodies—to more efficiently and effectively promote athletes’ health and safety.” For more information on the Datalys Center for Sports Injury Research and Prevention, visit: www.datalyscenter.org.

Benefits of Green Tea Extend to Sports A small study published in the May issue of the journal Nutrition has found that regularly consuming green tea may counter some of the detrimental effects of resistance training. This adds to the growing body of evidence about green tea’s health benefits. Resistance exercise can increase the production of free radicals beyond the body’s antioxidant defense capacity, which causes oxidative stress and often leads to tissue damage. Antioxidant-rich green tea may protect the body in part by raising the level of glutathione, a protein that helps prevent oxidative damage. “There is evidence that supplementation with antioxidants may decrease the oxidation of blood glutathione after exer-

cise,” the researchers stated in the study. “Furthermore, our findings demonstrate that dietary strategies, such as daily green tea intake, may also benefit the glutathione system of athletes by elevating blood glutathione levels before and after effort.” The study, conducted by researchers from the Federal University of Santa Catarina in Brazil, required 14 healthy men ages 19 to 30 to consume either water or green tea (two grams of green tea leaves in 200 milliliters of water) three times per day for seven days. At the end of the week, they performed four sets of 10 to 14 bench presses, and researchers analyzed blood samples taken both before and after the exercise. The group that consumed green tea had on average 37 percent higher levels of glutathione, as well as a 64 percent reduction in lipid hydroperoxide—an indicator of oxidative stress—post-exercise. The group’s blood levels of polyphenols (another chemical thought to have antioxidant qualities) were also 27 percent higher both before and after performing the bench presses. To view the abstract of the study, “Consumption of green tea favorably affects oxidative stress markers in weighttrained men,” go to: www.nutritionjrnl.com and click on the May 2008 issue.

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ComebackAthlete

Chrissy Schoonmaker University of South Carolina BY R.J. ANDERSON

When Chrissy Schoonmaker was named to the 2008 Southeastern Conference All-Defensive Softball Team this spring, it was hard to believe that just 18 months earlier she’d been strapped to a spine board with multiple vertebra fractures. The University of South Carolina fifth-year senior had survived an injury similar to that which felled actor Christopher Reeve, and was finishing her college softball career at the top of her game. Erin Thomas, MS, ATC, SCAT, Athletic Trainer for softball at the University of South Carolina, says despite enduring all the trials and tribulations that came with a broken neck, Schoonmaker never wavered in her commitment to return to the diamond. “The first thing she told me was that she would come back the next year,” recalls Thomas. “So I wasn’t really surprised when she did—it was more a feeling of amazement and admiration. I don’t think many people could go through what she did and stay so positive and determined. To accomplish what she has is unbelievable.” Despite the obvious seriousness of the injury, Schoonmaker says she never had any doubts that she would be back. “Lying in the hospital on that first day, I decided that my comeback would start then and there,” she says. “My thoughts were, ‘Okay, I’m taking a little break. But I am going to play again.’ “I had to give myself a positive goal to work toward and I needed something to believe in,” Schoonmaker continues. “It seemed like my world was crashing down around me, so I needed to give myself that distant goal—something to shoot for. That’s what got me through it.” Schoonmaker’s story began on a sunny morning on I-95 near Daytona Beach, Fla. It was Nov. 26, 2006, the Sunday after Thanksgiving, and Schoonmaker and teammate Elly Gosby were driving back to campus from their families’ Florida homes. Schoonmaker navigated her Ford Explorer through heavy post-holiday traffic, chatting with Gosby about school, friends, and the Gamecocks’ upcoming season. Then, in the blink of an eye, everything changed. As the highway merged from three lanes into two, traffic came to an abrupt halt, catching Schoonmaker completely off guard. Surprised to see a tractor-trailer sitting stationary in front of her, she yanked the steering wheel to the right to avoid a collision. Veering off the road, the SUV turned sideways, rolling violently four times before coming to rest beside the highway. 10

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Chrissy Schoonmaker played five different positions in the 2008 season after coming back from a fractured vertebra, and earned SEC All-Defensive Team honors at second base. After unbuckling, Schoonmaker and Gosby were able to crawl through the crumpled SUV’s windows. The pair was eventually taken by ambulance to the emergency room at Ormond Beach Hospital, where Gosby was treated for a broken wrist and released. Schoonmaker’s situation, however, was much more dire. An initial CAT scan showed two fractures in the second cervical vertebra, and follow-up tests revealed a third crack. Not equipped to handle such a serious spinal injury, Ormond Beach doctors strapped Schoonmaker to a spine board and transferred her to the trauma unit at nearby Halifax Medical Center in Daytona Beach. Despite the cracks in her vertebra, Schoonmaker’s spinal cord was luckily undamaged—she had some minor bruising, but it was structurally sound. It was the best-case scenario in a precarious situation that could have resulted in paralysis R.J. Anderson is an Assistant Editor at Training & Conditioning. He can be reached at: rja@MomentumMedia.com. TR AINING-CONDITIONING.COM

ComebackAthlete or even death. “It was amazing that she was able to walk and had such a high level of body function,” Thomas says. Because Schoonmaker had movement in her arms and legs, doctors at Halifax chose to install a halo brace that immobilized her head and neck instead of performing surgery. The injury was described as a “Hangman’s fracture,” similar to the type of broken neck caused by a noose in a hanging death. The doctors also told Schoonmaker that softball was not in her immediate future, if at all. “They had asked me where I was headed and I told them back to USC, where I went to school and played ball,” says Schoonmaker. “I remember them telling me, ‘Not this year, honey. Not for a while you don’t.’” The news knocked Schoonmaker for a loop. “That’s when I knew it was serious,” she says. “I kept thinking, ‘This cannot be happening to me.’ “It was my senior season, and this was going to be our team’s year,” she continues. “The day before I was at home playing catch and running around. A week earlier I was practicing with my team. And now, they were telling me my neck was broken? I was in shock.” The halo brace, which would be attached to her skull for three months, allowed the bones in her neck to heal. However, the cumbersome three-pound device also made simple day-to-day functions, from getting out of bed to bathing and dressing, the challenges of a lifetime. After a week at home, Schoonmaker returned to Columbia

to resume her fall semester classes. Her mother Debbie also made the trip, staying for two weeks to help her daughter adjust to her new hardware. Schoonmaker says having to give up her independence and continually ask for help was extremely difficult. “It was humbling, but I learned so much from it,” she says. “I had to find new ways to do the simplest things.” During this initial phase of her recovery, Schoonmaker underwent basic physical therapy for dealing with day-to-day life. “Her rehab included re-learning how to perform basic activities of daily living like standing up, sitting down, and balancing while on her feet,” says Thomas. “She struggled at first with performing even simple tasks like buckling her belt or putting her hair in a pony tail.” Within the first few weeks, Schoonmaker began taking small steps to slowly improve her conditioning. “She had significant restrictions but she would find a way to work within them,” Thomas says. “In the weightroom, she would do biceps curls, triceps extensions, and calf raises using a fivepound weight and worked toward her goal of walking the stairs in the upper- and lower-level decks of the football stadium 50 times.” Toward the end of February, Schoonmaker said goodbye to the halo and was fitted for a cervical neck collar, which she wore until late May. Once cleared to remove the collar, she began working with Thomas on gentle strengthening and range of motion exercises for her neck. “We began with manual exercises in which I moved her

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ComebackAthlete

Chrissy Schoonmaker University of South Carolina Sport: Softball Injury: Fractured second cervical vertebra Result: Named to 2008 SEC All-Defensive Team 18 months after sustaining a serious injury in a car accident.

neck in flexion, extension, sideways, and rotationally,” says Thomas. “We also did some isometric strengthening for flexion, extension, side bending, and rotation. For example, I had her press her head against my hand for 10 seconds at a time. We did one set of 10 to start and progressed to three sets of 10 in each direction. As her range of motion increased, we would begin to do the exercises at different angles.” Initially, Schoonmaker’s ROM was very limited, and her neck and upper back muscles had atrophied significantly. After the muscles were activated for the first time in over five months, spasms were a regular occurrence. “I used basic massage to break up and relieve the spasms and to increase muscle elasticity,” Thomas says. “Most of the techniques were effleurage, which incorporated long, smooth strokes; myofascial release to spread the fascia that covers the muscles; and occipital release, which focused on relaxing the fascia that attaches at the base of the skull.” As more weeks passed, Schoonmaker’s recovery quickened and Thomas progressed to more active assistive ROM and manual resistance muscle strengthening. “We progressed her based on how she was feeling, her level of ROM increase, and how her muscles were responding to the previous day’s rehab,” Thomas says. “However, due to the increased intensity, she experienced headaches from time to time and we would have to back off. Also, her neck was hypersensitive to any manual resistance and ROM increases, so I had to be very careful.” Throughout the process, Team Orthopedic Physician Chris Mazoue, MD, had regular phone conversations with Schoonmaker’s neurologist. Through it all, Schoonmaker continued to steadily progress, and Thomas says a major asset in the process was the unique bond the two developed. “Her trust in me—literally 12

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putting her head in my hands and allowing me to be one of the first people to manually move her head and neck—was key,” Thomas explains. “She was also great at telling me how she was feeling and letting me know when she felt apprehensive, nervous, or excited. Our communication was excellent, and it really helped keep us on the same page.” All the while, Schoonmaker remained upbeat and was a consistent and helpful presence in the locker room and the dugout. “She was still the heartbeat of the USC softball team,” Thomas says. “She attended every practice, conditioning session, and weightroom workout, and went on every trip with the team during the 2007 season. During games she led cheers and continually offered encouragement, motivation, and inspiration.” But despite her tough exterior, Schoonmaker was hurting inside. “There were plenty of difficult days,” she says. “One major challenge was watching my team play and knowing that I couldn’t contribute on the field. There were days when it just broke my heart to not be in uniform. “It was especially tough on Senior Day,” she adds. “McKenna Hughes [the team’s only other senior] had been with me through everything for the previous four years, and all I wanted was to play just one more time with her.” The prospect of getting back to the diamond and having one more season with her teammates drove Schoonmaker to work even harder. She remained in Columbia over the summer, working with Thomas and taking summer classes toward a B.A. in psychology. Toward the end of the summer, doctors cleared Schoonmaker to begin more strenuous cardiovascular and strength work. “That’s when we worked her back into the team’s regu-

Before Schoonmaker ever set foot on the infield dirt, Thomas had mentally gone through every imaginable emergency scenario. “I made sure that all our athletic training students knew their role if we needed to activate her emergency action plan.” lar routine,” says Thomas. “She could do most of the exercises, but we kept the weight low and restricted her from doing exercises that would have put significant pressure on her neck muscles, like pull-ups and reverse bench presses.” In the fall, Schoonmaker’s neurologist judged the vertebra fractures to have healed and cleared her to return for the 2008 season. By the time Schoonmaker could begin softball participation, Thomas says the fifth-year senior had worked herself into great cardiovascular shape. “She was in the top three on the team in terms of strength and conditioning,” Thomas says. “All summer, Chrissy was very smart about her workload. Though she was driven to do as much as she could, as fast as she could, she did not push the envelope when it came to her neck.” TR AINING-CONDITIONING.COM

ComebackAthlete At the first preseason practice, Schoonmaker was very excited, and her teammates were abuzz with the return of their co-captain. “She was really nervous and a bit apprehensive at first, like she was a freshman all over again,” Thomas says. “For instance, she was a little reluctant to dive for ground balls right away. But after getting through that first dive in practice, she was fine.” Schoonmaker wasn’t the only one with concerns during those early practices. Her athletic trainer was also going through a gamut of emotions. “Nervous, scared, excited, hopeful—I was feeling everything when she took the field those first few times,” Thomas says. Before Schoonmaker ever set foot on the infield dirt, Thomas had mentally gone through every imaginable emergency scenario. “I made sure that all our athletic training students knew their role if we needed to activate her emergency action plan and that our team physicians knew about her first day back at practice,” she says. “I also made sure my supervisor was close to her phone during those first few weeks. Fortunately, I didn’t need to fall back on any of those plans.” Throughout the season, Schoonmaker worked with the team’s strength and conditioning coach on basic strengthbuilding workouts for her shoulders and neck. She also continued her pre-workout stretching program and received massage on a regular basis. Schoonmaker’s hard work was rewarded with an SEC

Speed

Agility

All-Defensive Team honor for her prowess at second base. During the season, she committed just two errors and was the ultimate team player, appearing in 32 games and spending time at five different positions. She also continued working toward a master’s degree in mass communication and journalism. Schoonmaker credits a lot of her 2008 on-field success to the time she spent on the bench in 2007. “Even though I wasn’t playing, I was still learning,” she says. “The sidelines provide a very different perspective, and I saw things in the game I never would have seen had I been playing. So although my accident was a setback, it contributed to my mental preparedness, which is my greatest asset as a player.” More importantly, says Schoonmaker, the accident also put her life into perspective. “I always think of how fortunate I am to be able to walk, let alone live a normal life again,” she says. “I have learned so much from this experience. I appreciate the simplest things. I am a better person because of what I have been through. I really do love my life, and I am able to see now that there really is a blessing in this whole thing.” ■

To nominate a Comeback Athlete, please send an e-mail to: rja@MomentumMedia.com.

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OPTIMUM PERFORMANCE

Today’s baby boomers are remaining active as they age, so the ranks of masters athletes are growing fast. Are you prepared to work with this special population?

Golden Years BY VERN GAMBETTA

was 26 years old, training for the decathlon while in graduate school at Stanford University, when I got my first introduction to a masters athlete. Stanford Head Track and Field Coach Payton Jordan was 58 years old, and in some of our sprint workouts, he could beat me. I was amazed at the time, and certainly humbled by his performance. I learned a lot watching how he trained, but it was what he didn’t do that taught me the most. His workouts were very focused, brief, and intense. He once told me that he couldn’t do as much as when he was younger, so he had to do it better. Jordan was a member of a world record-setting 4x110-yard relay team in college and a two-time collegiate national champion, and now holds many track and field world sprinting records in the 60-plus, 70-plus, and 80-plus age groups. He was a great example of someone who knew how to adapt his training as he aged, but still be an amazing athlete. (He’s finally “retired,” but still active at age 91.) Ever since that experience, I have been interested in training the masters athlete. Throughout my 39-year coaching career, I’ve observed a huge development

Vern Gambetta, MA, is the President of Gambetta Sports Training Systems in Sarasota, Fla., and a longtime contributor to Training & Conditioning. His daily thoughts on training athletes can be viewed on his blog: functionalpathtraining.typepad.com. 14

T&C JULY/AUGUST 2008

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DO’S & DON’TS Here are some tips to pass on to your masters athletes that I have learned from experience and observation: Find a routine. Be consistent in the time of day and the place you train. If you can find a training partner or a group to train with, that often helps with sticking to a routine. Get athletic amnesia. Forget what you did in college or your 20s, and be realistic in your expectations of what you’re trying to achieve now. It is futile to try repeating a workout you did at age 25, and most of the time it will result in injury. Know what you want. How competitive do you want to be? If you want to be a national class or international class masters athlete, you are going to have some uncomfortable workouts. If you are training to be athletically fit, then being uncomfortable is not necessary. Compete against yourself. This is true at any age, but seems especially appropriate for older athletes. Measure your progress against yourself. I have a certain lifting workout I use as a benchmark to gauge my overall strength and ability to handle my bodyweight. The same is true for cycling—I have a particular route I test myself on four times a year to gauge progress. Allow for recovery. As you age, it takes longer to recover from the stress of hard workouts. Build in more rest days. Strength train regularly. More frequent strength training is the closest thing there is to the fountain of youth. Leg strength and core strength will have a significant positive impact on posture. For both male and female masters athletes, the endocrine hormonal benefit is tremendous. A well designed strength-training program can stimulate growth hormone and testosterone production, which will help maintain lean muscle mass. In addition, it can slow the loss of type II muscle fiber. Stretch daily. We lose elasticity in our muscles and tendons as we age. Some researchers have identified the subsequent loss of flexibility as a factor in degenerative joint disease. Respect old injuries. They will come back to haunt you. Just like training, injuries are cumulative. The small, nagging injuries that you didn’t have to worry about in your 20s will now cause you to miss days of training, and if ignored, weeks of training. Learn to read and listen to your body.

T&C JULY/AUGUST 2008

in masters sports competition. I have enjoyed watching it grow from a collection of old geezers trying to relive past glories to a group of focused and dedicated athletes competing with vigor and class. I’ve also jokingly said that I have been conducting an ongoing aging study on myself. Over the years I have carefully recorded my workouts, trying different training methods to learn which ones work and which do not. I’ve studied scientific research and examined all the do’s and don’ts of training as one gets older. As usual, there is a gap between what the science says and what is happening in practice. Additionally, most of the research has focused on endurance athletes, and not very much attention has been paid to the power athlete or game sport athlete. It’s no secret that America is aging, and its population is rediscovering (or discovering for the first time) the joy of athletic competition. Whether we are strength and conditioning coaches or athletic trainers, knowing how to work with older athletes will only help our careers. And for some of us, it may also advance our own athletic goals. WHO IS A MASTERS ATHLETE? When talking about masters athletes, it’s the 55-and-over group that we think of first. But it is important to remember that masters competition begins as early as age 25 in some sports. For this article, I will define a masters athlete as anyone who is no longer competing at his or her prime. And I define an athlete as anyone who engages in a systematic training program in pursuit of specific competitive goals. For this population, sometimes the goal is to train for athleticism, not head-to-head competition. Athleticism is the ability to execute athletic movements with precision and grace in the context of the sport or activity the athlete is preparing for. I also tend to define an athlete as someone who has specific goals for improvement in their sport. Those goals can sometimes be very soft, and that’s okay. For example, a masters runner may have a goal of increasing his flexibility as he turns 60 instead of looking to improve his time. In many cases, a masters athlete is a person who’s entering a whole new world, which can be a lot of fun but challenging to coach. Female masters athletes, especially those over 55 who did not have the opportunity to participate in competitive sports while growing up, may be complete novices. They may also need to put more emphasis on strength training if they have no strength base. For the male boomers, there’s often a different kind of transition. Growing up, we were pigeonholed into football, baseball, basketball, track, and swimming. If you were not good at or interested in those sports, you had few participation alternatives. What’s exciting for the masters athlete today is that there are many more choices. But training for racewalking or judo will certainly be different than training for football. SIMILARITIES While there are important differences in training older athletes versus young and developing athletes, there are still many similarities. Whether you’re 15 or 85, fundamental movement skills don’t change. That’s why the basic philosophies and principles you use with a young population should be your starting point when working with masters athletes. Here are the key elements to consider when creating a training plan. Progression is very important, but is also the most often igTR AINING-CONDITIONING.COM

OPTIMUM PERFORMANCE they switch the activity or emphasis. Variation is essential for maintaining a freshness and zest for training. But it should have a purpose. I will switch up

training method or idea must have a specific function to justify its inclusion in a program. Constantly searching for secrets will cause chaos.

We tend to think of overload in terms of volume. But for the masters athlete who has accumulated years of training, increasing volume can lead to injuries and burnout … Overload through intensity and density shows better results with this age group. an athlete’s regimen to help them progress or overcome a deficit and to avoid stagnation. Variety can also work well with a masters athlete’s lifestyle. For example, I travel extensively at certain times during the year, so I build variation into my program with that in mind. When I’m at home I have a different program than when I am on the road. Context is what you do and when you do it. It is training with a purpose and a focus. In today’s world of instant information and overnight experts, it’s easy to jump from fad to fad. But any new

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Overload is applying a stress greater than that which the body has already adapted to in order to achieve further adaptation. We tend to think of overload in terms of volume. But for the masters athlete who has accumulated years of training, increasing volume can lead to injuries and burnout. Think quality, not quantity. Overload through intensity and density shows better results with this age group. As I have gotten older, more frequent but smaller 15- to 20-minute workout sessions around my work schedule have been better than fewer, longer sessions.

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nored. Too much too soon in a training plan can lead to stagnation or injury. For the masters athlete, a carefully designed progression that moves from simple to complex and easy to hard is the key to performance improvement and injury prevention. Also, remember you don’t have to start over each year. Part of progression is building upon what you did previously. Accumulation is the effect of training over time, which links to progression. It means that as the athlete trains from week to week, month to month, and year to year, you need to design the next phase of training to take advantage of their progress. This is especially true for masters athletes who don’t interrupt their training with long breaks or periods of inactivity. Think of training as climbing a staircase. To get to the next step, you must negotiate the one before it. Each succeeding step builds upon the previous one. Climbing the staircase may take longer with a novice masters athlete, which is why it’s important to not take a step back. Older athletes should be encouraged to continue training, even if

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OPTIMUM PERFORMANCE Recoverability is the athlete’s ability to recover from the stress of a workout. If the training is so difficult that the athlete is unable to quickly recover, then it is not effective training. Recoverability will vary greatly among masters athletes, so it is important to assess this for each individual. Recoverability must also account for general life stress. Specificity means training for the sport. A marathoner who decides to join the over-40 soccer league is sometimes surprised at how difficult this can be. If an athlete wants to train for stop-and-start sports, he or she must devote time to explosive training and force reduction. Movement skills are so important as we age, but are easily neglected. Make sure you’re working all three planes of movement. When a cyclist gets off the bike, he or she should do some frontal plane and rotational work in the cooldown and in strength training. A runner will need to work the transverse and frontal planes and do some backward movements. All those things will help balance out musculature, prevent injury, and increase body awareness. Assessment should be as thorough

with the masters athlete as with a younger athlete, and is essentially the same. Use an athletic profile that incorporates the three tiers of musculoskeletal assessment, athletic competencies, and performance indicators. Identify strengths and weaknesses as well as possible areas of concern. Do a thorough training and injury history. With this age group, I also suggest a thorough competition history. Find out how long it has been since the athlete trained. Find out what they actually did when they last trained, not what they think they did. Are they training in a sport similar to what they competed in previously, or are they starting in an entirely new activity? These factors should all be considered as you develop a training program for them. DIFFERENCES What are the key differences in training this group? Most obviously, the body of the masters athlete is just not as adaptable as that of a younger person, and this needs to be taken into account. I like to think of it as trying to fool the body into delaying the aging pro-

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cess. Gravity is always there, and the aging process is simply a matter of gravity gaining a bigger advantage. Consequently, we must devote significant attention to training the so-called “anti-gravity” muscles of the core. Increasing core strength will ensure good posture and control of dynamic alignment, which will allow the athlete to “beat gravity” and adapt to new training demands. Because it’s important to maintain fundamental movement skills in this age group, basic leg strength is also key. It may be a cliché to say an athlete’s legs are the first things to go, but it reached cliché status for a reason. Basic leg strength will build a strong foundation for movement. Less obvious for training masters athletes is the need to pay careful attention to the 24-hour-athlete concept. For the masters athlete, workouts need to fit around normal daily life, and the activity must be something that decreases life stress. Training is generally not the central focus of a masters athlete’s dayto-day existence. He or she often has family, relationships, and work that all take priority. In some ways, masters athletes must be more focused and ded-

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OPTIMUM PERFORMANCE icated than elite athletes, because they have so many other things to balance. The key is to have a detailed plan that’s more of a lifestyle plan than a training plan. The when of the workout is important—so it doesn’t interfere with other priorities. The who of the workout is important—for many, it must be with people they enjoy the company of. The how of the workout is important—they need to focus on training and then learn to let it go when they’re done. And the how long of the workout is important—recognize that more is not necessarily better, but a sharper focus on the task is best. The masters athlete should also be encouraged to take advantage of life’s rhythms—to go with them and not fight them. I use a 10-point rating scale to assess the training demand of my workouts, and I have been experimenting with factoring life stress into this score, simply because you cannot separate the rest of your life from training. I have learned to schedule “recovery” days when work stress is highest. On those days I go for an easy swim, long walk, or slow bike ride. Not only do those sessions recharge the body, they also lower my overall stress level. Another significant area is the loss of flexibility as we age. To address this, the masters athlete should schedule 10 to 15 minutes a day to stretch. This is best done post-workout to take advantage of the elevated body temperature. Some easy loosening and gentle stretching in the morning is also beneficial, as are stretches throughout the day. Warmup and cooldown are much more important as athletes age. Younger athletes can get away with cutting corners on their warmups and cooldowns, but a masters athlete cannot. Neglecting this aspect of training will show up in the next workout.

the NBA, or the soccer team dedicated to winning a league title. When you coach a masters athlete, remember that the competition is often less important than everything else. Find out what your athlete’s motivation is and steer your plan toward it. For some, that may mean finding a different sport for each season that provides them with new challenges. For others, it may mean working toward a fitness goal that makes them feel great about their body. The variations are endless. For me, at age 61, it is about the prepa-

QUALITY OF LIFE As you read this article, you are aging. Of course, we have no control over the process. But in reality, there are variables we do control that allow us to manage it, and one of the simplest is exercise. That leads me to my final point, which is to understand that many masters athletes have chosen their activity to improve their quality of life. They want to be healthy, look good, and have some fun in the process. And that is very different from the young basketball player whose dream is to make it to TR AINING-CONDITIONING.COM

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ration. I’m not into competing any longer, but I still train like an athlete. Athletic fitness is a distinctly different feeling from just being physically fit—it entails a certain intensity, concentration, commitment, and dedication that I find meaningful. I like the personal challenge of measuring my progress against myself. Coaching masters athletes is an upand-coming field that can be very rewarding. It involves different challenges and new solutions. And it can help our aging population be more productive and truly get more out of life. ■

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TRAINING REVOLUTION Turning Your School into a Pro-Caliber Sports Performance Training Center

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d Dudley, Head Football Coach for Walton High School in Marietta, Georgia faced a situation that plagues many coaches at top programs. He was conÀdent that his school had a good strength program, but he knew his team had to become faster and more agile in order to go deeper in the playoffs. “We had several players going to a few different trainers and you could see a big difference in their foot work. I knew we needed to Ànd the best speed and agility program that we could manage ourselves, and let all the kids beneÀt from it, not just the skill positions.” Dudley’s solution: invest in a revolutionary, self-contained speed and agility training program that brings the beneÀts of procaliber sports performance training directly to all of Walton’s athletes. The SpeedStation™, created by Atlanta-based Speed to Win, Inc., has built-in training stations along with additional equipment that allows a coach to set up drills for over 75 athletes. According to Dudley, the new program has had a major impact with his team. “The Speed to Win program has already made a big difference and now is just as important as our strength program.” The SpeedStation™ concept represents a major innovation in how athletes are trained; giving coaches capabilities and options that had only been available at expensive, off-site facilities. “Just as the traditional weight room has evolved from the early days of a single Universal gym to today’s multi-station facilities with top-caliber equipment, we think that the SpeedStation™ is the next step in the evolution of total sports performance training,” said Matt Thompson, CEO of Speed to Win. The SpeedStation™ product line ranges from the large outdoor “Pro” model to the mobile “Team” models, and the newly introduced Gym model for indoor training. This wide range of SpeedStations™ offers Speed to Win customers with a choice of models based on physical space, number of athletes, pricing, etc. Each SpeedStation™ provides the same elements of both attachment points for equipment as well as storage when not in use. Also, as part of a standard implementation, Speed to Win installs inÀll type synthetic turf for the Sports Performance training area. While being used, coaches

and PE instructors can utilize resistance bands for change of direction drills, hip Áexor and hamstring quickness drills, quad and glut explosion drills, and even upper body quickness and hand speed drills which are set up in stations that athletes use on a rotating basis. There are also eight additional stations that include a wide variety of training equipment like cones, ladders, sleds, hurdles, etc. and over two hundred different drills that are set up in the surrounding areas. While having all the training equipment housed in one central unit has been invaluable to programs like Walton, it is complemented with software which comes pre-loaded with pro-caliber training programs. Speed to Win has teamed with XPE Sports’ Tony Villani, who trains Pro Bowl players such as Hines Ward, Jamal Lewis, Takeo Spikes and others at his Atlanta facility, to design a comprehensive training regimen that is incorporated into the Speed To Win package. “Having the XPE program as part of our solution allows us to take a proven, NFL-caliber speed training program to schools everywhere. The drills are designed to take advantage of the SpeedStation’s™ unique capabilities and produce results that were formerly available only to elite athletes through expensive training facilities,” according to Jeff Jenkins, President of Speed to Win.

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thletic Director Billy Nicholson and Head Football Coach Measor of Centennial HS in Atlanta, GA wanted a to utilize the Speed to Win program for their on-campus Sports Performance training. However, like many schools, Centennial had many other priorities for their athletic budget. The solution for Centennial was the Partner Trainer Program, which allows a school to implement the Speed to Win program at no charge to the school. All equipment, software and synthetic turf are installed at no charge and teams can start training immediately based on a per session charge paid for by parents or boosters. This innovative

While the company is called Speed to Win, Thompson and Jenkins explain that there is much more to the program than producing faster athletes. “The equipment and drills that make up the Speed Station™ also improve athletes’ agility, Áexibility, power and explosiveness, while at the same time helping to prevent injuries,” according to Thompson. “Speed training is evolving along the same path as weight training and will soon be just as widespread,” he pointed out. “But the Àeld, and the speciÀc program we’ve developed for coaches to manage themselves, should really be known as sports performance training since athletes beneÀt in so many other ways in addition to increased speed. Our program builds and develops athletes for all sports and pushes them to the next level.” A key component of the Speed to Win program is the webbased, state-of-the-art software program developed speciÀcally to help coaches automatically identify training programs for each individual athlete, monitor and update their progress and organize and coordinate schedules with other coaches - allowing every athlete at the school to utilize the SpeedStation™. General PE and sport-speciÀc workout programs are included with the software, and coaches can access online videos that guide them through teaching and training methods to maximize the SpeedStation’s™ effectiveness. Each coach, team, or class has their own web pages for calendars, workout schedules and descriptions, and athlete tracking/progress charts. In practice, the software support program is the key to taking full advantage of the beneÀts the Speed to Win program can deliver. “The Speed to Win software has made managing the Speed training program easy,” said Strength, Speed and Conditioning Coach John Evans at Walton. “It provides me a calendar with a training schedule to follow. After registering online, athletes are tested for their sport and the software automatically generates the correct workout to follow. Plus, the demonstration videos with coaching tips have been a big help in demonstrating proper techniques.” Something unexpected has also happened at Walton; students are actually looking forward to and enjoying workouts. “Kids in my PE classes and on the football team really appreciate the Speed to Win program. Even though it is hard and really pushes them, they know it is more than just conditioning and that they are doing the

program provided all teams at Centennial with the opportunity to immediately impact their upcoming season. The Speed to Win system manages the enrollment, payments, and performance of each athlete through the software. The per session fee is a fraction of the price as charged by local specialty gyms. Centennial HS was quickly able to offer its student athletes and the surrounding community a pro-caliber sports performance training center on campus for all sports while using their athletic budget for other expenses.

same drills as the pros,” said Evans. Speed to Win’s Thompson believes that virtually any high school or college will beneÀt by having their own SpeedStation™. “It’s really a coming revolution in sports performance training,” he said. “Speed and agility are just as important to an athletic department’s success as strength, and the SpeedStation™ program is the most comprehensive program ever designed for on-campus training. It will beneÀt all students, not just football players. We have different models for different budgets and much of the cost can be recouped by sponsorships of the units and time-sharing arrangements with other area schools, feeder programs, or Park and Recreation organizations.”

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LEADERSHIP

AP PHOTOS/MICHAEL PATRICK

Facing the Heat BY ABIGAIL FUNK

More and more athletic programs are using written policies to govern practices and workouts in the hot, humid months. From getting everyone on board to deciding what rules to set, there are several critical steps to a successful policy-making process. 22

T&C JULY/AUGUST 2008

lmost three hours into the first practice of the 2007 football season, and just minutes before the coach planned to send everyone to the showers, 16-year-old Kenny Wilson collapsed on the field. The junior linebacker at Beckman High School in Irvine, Calif., was immediately put in an ambulance, but he went into cardiac arrest and died en route to the hospital. Speculation ensued that the 90-degree temperature and high humidity that day played a role in Wilsonâ&#x20AC;&#x2122;s death, and a few months later, the county coronerâ&#x20AC;&#x2122;s autopsy report confirmed that heat stroke was the cause. Wilson was one of several football players who made grim headlines in recent years after a heat-related death. In February, the National Center for Catastrophic Sport Injury Research at the University of North Carolina released its Annual Survey of Football Injury Research, reporting on data collected through 2007. The report says that since 1995, 33 football players have died from heat stroke, including 25 high school students and five college athletes.

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LEADERSHIP While those numbers suggest the odds of your program experiencing a heat-related death are quite low, they also show that heat illness is a serious threat that warrants serious action. Across the country, athletic programs have helped minimize the risk by implementing comprehensive heat policies, and by updating them regularly to reflect best practices and all available information and resources. These policies are more than just a set of guidelines spelling out when it’s too hot to practice in full equipment, when two-a-days have to be canceled, and who to call if an athlete is in distress— though they can include all those components and more. A well-designed heat policy is a statement of preparedness and awareness, and a way to show that your program’s primary goal is protecting student-athletes’ health and safety. “When an athlete dies from a heatrelated illness, a lot more scrutiny is placed on school and athletic department policies, and in turn, on athletic trainers,” says Jonathan Stinson, LAT, ATC, Head Athletic Trainer at Steele High School in Cibolo, Texas. “It’s very important to take an active role in developing and refining a policy—to be proactive and not reactive. If you have a policy in place and educate your coaches and players about it, you can avoid a lot of potential problems.” GETTING STARTED The first step in crafting a heat policy or revising one that already exists for your school, district, or conference is making sure all the right people understand that a policy is necessary. If sport coaches, athletic administrators, parents, school board members, and student-athletes are not aware of the dangers of heat illness and the effects of working out in extreme heat, you’ll have trouble garnering the support necessary to make the policy effective. “If I were in a high school setting, I would go to the parent organizations first,” says Sandra Fowkes Godek, PhD, ATC, Medical Coordinator at West Chester University and Director of the school’s HEAT (Heat Illness Evaluation Avoidance and Treatment) Institute. “If you educate parents about the potential problems—such as coaches being too aggressive with workouts early in the preseason—they have a way of making things happen. Parents can be great advocates for athletic trainers in building TR AINING-CONDITIONING.COM

momentum behind a heat policy.” What exactly should you educate people about? Jon Almquist, ATC, Athletic Training Program Administrator for Fairfax County (Va.) Public Schools, says a basic review of the published research on heat illness can provide a convincing case to any stakeholder in scholastic athletics. “There are many studies out there to give you scientific support,” he says. “It’s well estab-

think about presenting a policy draft to your school board.” As you gain supporters and momentum for implementing or revising a heat policy, be sure to determine the proper procedure for getting approval. “You have to know the correct protocol for developing policies within your setting,” Almquist says. “You can draft whatever you want, but if you don’t follow the correct procedure, it will not

“Coaches may tell you they’re on board, but once you’re on the field pulling athletes out of drills, they’ll be tempted to fight you. That’s when you need an administrator who can step in and say, ‘Hey coach, we have a policy and this is what it says.’” lished that precautions must be taken in extreme heat, or else the end result could be tragedy.” (See “Resources” on page 26 for some specific information sources.) Aaron M. Karlin, MD, Pediatric Sports Medicine Specialist with Ochsner Health System in Covington, La., used the awareness-first strategy as the medical advisor for a committee that created a district-wide heat policy in St. Tammany Parish (La.) earlier this year. “Some people in the group, which consisted of principals, assistant principals, a school board secretary, athletic directors, and parents, had misconceptions about what heat illness is,” he says. “Everybody knew on some level that practicing in the heat is dangerous and there needed to be certain precautions in place, but they were not educated about the real effects of extreme heat. “So for our first couple of meetings, I brought in 20 or 30 different research articles, reports from the American College of Sports Medicine and the NATA, and examples of policies from other states,” Karlin continues. “I bombarded the committee with information to show them the reality of heat illness. If I had just said, ‘This is what I think we should do,’ I would have gotten nowhere.” Sam Lunt, MS, ATC, Associate Director of Sports Medicine at Florida State University, agrees about the importance of spreading the word first. “You have to start in the right places,” he says. “Educate the coaching staff, take the issue to your athletic director or principal, and make sure those people are on your side before you even

be supported by the right people, and it’s ultimately not going to be followed. You will have done a lot of work for nothing in the end.” GROUP PROJECT Once you’ve demonstrated the need for a heat illness policy, it’s essential to keep supporters from various groups— such as administrators, coaches, and parents—involved in its creation and maintenance. They will help get the policy adopted, and once it’s in place, ensure that it is followed to a T. The first stop: your athletic department offices. “You must have your administrators involved in the drafting process because they’ve got the ear of every coach,” Lunt advises. “Coaches may tell you they’re on board, but in reality, once you’re on the field pulling athletes out of drills, they’ll be tempted to fight you. That’s when you need an administrator who can step in and say, ‘Hey coach, we have a policy and this is what it says. The athletic trainer or team physician makes the final decision, not you.’” Stinson says letting your athletic director and principal have a hand in writing the policy also helps them take ownership of the project. “Ask for their input and explain why certain aspects of the policy are important,” he says. “In the long run, their support will be vital to the policy’s success.” As the medical advisor for St. Tammany’s committee, Karlin wrote most of the policy himself. “But our adminAbigail Funk is an Assistant Editor at Training & Conditioning. She can be reached at: afunk@MomentumMedia.com. T&C JULY/AUGUST 2008

LEADERSHIP istrative members took care of the upfront wording, so they were involved in that way,” he says. “Everyone on the committee read the draft and made corrections and recommendations before we submitted our final proposal to the superintendent.”

approach is not to stop practices—it’s to alter them so they’re safe. So we have a flag system based on the heat index: Green means we’re good to go, yellow and red mean alterations will be implemented, and we don’t cancel practice until we hit black. Coaches and ath-

“You can’t simply say that when the temperature is 95 degrees or the humidity is above 80 percent, there will not be practice,” Lunt says. “We’d never have practice down here if that were the rule.” The St. Tammany committee met in person five times, and sent e-mails back and forth over the three months the group worked on the project. “It really came together pretty quickly,” Karlin says. “We didn’t try to reinvent the wheel—we pulled from policies already in place in other states and just kind of adapted them to our own environment. “For instance, some of the policies we looked at used a specific heat index reading to determine when to cancel practice,” Karlin continues. “But our

letes find a scale much more fair than a straight cutoff.” Perhaps the toughest group to win over is the coaches. While there are now fewer “old school” types who believe any accommodation for weather is a sign of weakness, coaches face conflicting interests that they can’t ignore. “Coaches are torn,” says Jeff Hopp, LAT, ATC, Head Athletic Trainer at Marietta (Ga.) High School. “There is pressure on them to win and have a successful program, but hopefully they

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have their athletes’ best interests at heart, too. In order to have your policy followed, you will need them to understand why it’s there in the first place.” Karlin found out quickly that coaches were a concern for the St. Tammany group. “I was surprised how worried some committee members were about potential backlash from coaches,” he says. “They thought that making these rules might cause problems. This is SEC country—high school football is big, and any restrictions put on our kids are viewed with suspicion. We really highlighted to the coaches and committee members that we were not trying to prevent practice, but protect practice.” Educating the sport coaches about the policy—before it was implemented—was at the top of Stinson’s list as he formed his school district’s policy last year. “Coaches can get a little apprehensive when you start messing with their practice times,” he says. “So I told them, ‘These procedures are not designed to make your players less successful. In fact, they’re designed to make them work even more efficiently.’” The last key group that must take

LEADERSHIP stock in a heat illness policy is the athletes themselves. “We are dealing with very highly motivated individuals,” Lunt says. “It’s not just the coaches doing the pushing. These athletes push themselves past the point where an average person would stop. They’re vying for a spot on the team or a starting position. The players need to know the signs of heat illness and be told to watch out for each other.” Preseason meetings are a great time to go over the signs and symptoms of heat illness, both orally and through a printed handout athletes can take home with them. Because one athletic trainer and one coach cannot keep an eye on every athlete at every moment, athletes can become your second set of eyes at practices and workouts.

can’t simply say that when the temperature is 95 degrees or the humidity is above 80 percent, there will not be practice,” Lunt says. “Coaches and players will have a fit—we’d never practice down here if that were the rule. A policy should be more general. For instance, say you will monitor weather conditions on a daily basis and make appropriate adjustments, not just cancel everything completely. That may mean changing the time practice starts, the type of gear players wear, the intensity of work, or the number and frequency

NUTS & BOLTS So it’s time to sit down and write a policy or update one that hasn’t been revisited in a few years—what should today’s policies look like? While each one will differ due to geographic location and corresponding heat and humidity levels, there are several key areas to address. The first is implementing an acclimatization period at the start of preseason. “If you look at the epidemiology, football players who die during preseason have all died within the first three days,” Fowkes Godek says. “It never happens during the second week because by day eight, players have expanded their blood and plasma volume by 10 to 12 percent. I have data showing core body temperatures the first, second, and third days versus the eighth to 10th days, and athletes are all significantly cooler that second week. “The NCAA rules do a great job forcing football athletes to go through a true acclimatization process,” she continues. “The first five days it’s one practice a day and players gradually get into full pads. The first couple of days they’re in shorts and helmets, then half pads or shells, and it’s not until the sixth day they’re in full equipment. Also, there are never consecutive days of two-a-days during preseason. I suggest looking closely at the NCAA’s policy before drafting your own. If you can somehow include early conditioning without full equipment, you can head off many potential problems.” Deciding what weather will trigger alterations to practices is another important aspect to clearly address. “You TR AINING-CONDITIONING.COM

of breaks. On a daily basis, you must communicate with the rest of the athletic training staff and the coaches to make these decisions together.” Most policies use either a wet bulb reading (which incorporates temperature and humidity) or wet bulb globe reading (which incorporates temperature, humidity, and solar radiation) to determine the risk level of weather conditions. “But a lot of it is common sense,” Stinson says. “Football coaches, for instance, need to know that when they’re not running a drill in practice, the kids

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LEADERSHIP

Thirsty?

should be encouraged to remove their helmets and must have access to water. Putting something that simple into writing can make a difference. You don’t necessarily have to say there must be formal breaks every X number of minutes.” One thing both Almquist and Karlin were very cognizant of when drafting their school systems’ policies was to not give any real decision-making power to coaches. “Our policy gives coaches no direct control over enforcement,” Karlin says. “It is specifically written that heat index readings are performed by the school’s athletic trainer or an administrator, and coaches are excluded from this responsibility.” Your policy should have clear educational material in it—not just a heat index chart and a cutoff point for canceling practice. And it’s your job to make sure the rest of the athletic training staff, coaches, and student-athletes understand all parts of the policy. “Our athletic training staff sees ev-

Hydration is our only Passion. It’s everything we do!

ery coach at every preseason meeting,” Almquist says. “They have the signs and symptoms of heat illness brought to their attention at that time, and we go over the policy so they’re aware we may be telling them they can’t use helmets or full pads on certain days, or maybe can’t even be outside. We inform the kids and their parents at our preseason meetings, and we also have the policy posted on our Web site.” Karlin and the head athletic trainer at Ochsner traveled around the St. Tammany Parish school district this past spring and summer, holding lectures for coaches and administrators. “They needed to know what the policy is all about,” Karlin says. “Some of them probably didn’t even know we had formed a heat policy. It’s as much an educational tool as anything else.” The final piece of an effective heat policy involves “what if” scenarios. Outlining the specific steps to be taken when an athlete exhibits signs of heat

RESOURCES NATA The NATA’s position statement and tips for recognizing, preventing, and treating heat illness can be found by typing “heat illness” into the search window at: www.nata.org. ACSM The American College of Sports Medicine’s consensus statements on heat illness and hydration are available by searching “heat illness” at: www.acsm.org. CDC The Centers for Disease Control and Prevention has an entire Web site devoted to extreme heat and the prevention of heat illness: www.bt.cdc.gov/disasters/extremeheat. NCCSI The National Center for Catastrophic Sport Injury Research’s most recent Annual Survey of Football Injury Research can be found at: www.unc.edu/depts/nccsi/SurveyofFootballInjuries.htm.

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NCAA To view the NCAA’s Out-of-Season Football Conditioning Educational Initiatives, go to: www.ncaa.org, select “Publications” from the “Media & Events” menu, and click on “Health & Safety.” NFHS Hydration recommendations to prevent heat illness, administrators’ duties regarding heat illness, and downloadable flyers on heat stress can be found by searching “heat illness” at: www.nfhs.org.

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LEADERSHIP illness is extremely important. “An emergency action plan must be part of the policy,” Lunt says. “When is it time to notify EMS? Who is going to make the call? Where are you going to take the athlete in the meantime? Who’s going to direct the ambulance and who will notify the parents? When we created our policy, we made sure those roles were clearly delineated.” Lunt also thinks proactively, flagging athletes who are at higher risk for heat illness and keeping a close eye on them early in the preseason. “That’s why a good preseason physical is extremely important,” he says. “At Florida State, our physical is extensive, including a full cardiac workup with EKGs so that we’re able to identify at-risk athletes. High body fat, for instance, is an indicator. It’s important that you know the people who tend to have issues with heat.”

ly as well, by going back to the policy and tweaking it when necessary. For example, if your existing policy doesn’t address acclimatization, the latest research suggests this is not acceptable. And if your policy stops at outlining the signs and symptoms of heat illness, make sure to add a clear emergency action plan. “I’ve gone back to our policy multiple times to revise something or add a new detail,” Almquist says. “A policy can almost always be tweaked and improved based on new research and

FOLLOWING UP Once your policy has been written, approved, and implemented, your work isn’t done. You need to make sure it’s being followed on a daily basis. Educating coaches and athletes is your best bet for enforcing the policy. “Throughout the first year I was going around to practices to make sure procedures were being followed, and coaches gave me a little grief,” Hopp says. “Our cross country team, for example, practices off campus. When I’d call the coach and say, ‘The wet bulb globe temperature is this high today,’ he’d just tell me he didn’t think it was that hot where they were. So I showed him how to read a wet bulb globe thermometer, which he now takes with him to practice. It was just a matter of making him understand the importance of following the policy.” Stinson uses a call list to enforce the guidelines effectively. “I have the cell phone numbers of coaches, band directors, and other athletic trainers in our district saved in my phone, and I check in with them whenever I feel it’s necessary,” he says. “I also send e-mail alerts throughout the day, pretty much every day, saying ‘It could get dangerous by practice time, so let’s keep an extra close eye on our players and take more breaks today.’” Remember that following up isn’t limited to making sure the heat policy is being effectively used by others. You need to follow up with yourself regular-

studies. And because the end result is a more effective strategy for keeping our athletes safe, I believe it’s always worth the effort.” ■

ON THE WEB... For updated heat illness prevention news, including the latest research and other useful resources, check out the August monthly Web feature at: www.training-conditioning.com.

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TREATING THE ATHLETE

AP PHOTOS/TOM GANNAM

Back in I Trouble

BY CHRIS GELLERT

If an athlete’s lumbar pain won’t go away with time, the cause might be a serious spinal condition called spondylolysis. This article explains what it is and how to manage it.

f you’ve worked with competitive athletes for any length of time, you have probably heard complaints of back pain. Repetitive, overloading compressive forces and extension movements are a regular part of training and competition in most sports, making some degree of back pain almost inevitable for many athletes. However, not all back pain is the same. Sometimes it’s a simple case of sore muscles or a sprain that resolves on its own in a few days. Other times, a more serious orthopedic problem is to blame. Spondylolysis is a type of back injury that will not simply resolve itself without intervention. It’s caused by a specific injury or defect in the spine, and young athletes are especially at risk since it is often caused by damage to growth cartilage—the weakest link in the musculoskeletal system from childhood through adolescence. Awareness is key to helping athletes deal with spondylolysis and to preventing it in the first place. If you understand why

Chris Gellert, PT, MPT, CSCS, CPT, is the President of Pinnacle Training & Consulting Systems, based in Germantown, Md., and the author of Synergy of Human Movement, an advanced continuing education program for personal trainers. He can be reached through his Web site at: www.pinnacle-tcs.com. TR AINING-CONDITIONING.COM

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Figure One: Demonstrating a neutral spine using the anterior superior iliac spine (ASIS). the condition occurs, how to identify it, and what types of intervention have been proven successful by research, you can reduce athletes’ back pain, cut time lost to injury, and help promote long-term spinal health. DEFECT IN VERTEBRA Surveys of athletes across all sports have found that as many as 30 percent suffer from some type of back pain. Not surprisingly, the highest rates of pain are clustered in sports that place the greatest stress on the lumbar region, such as football, wrestling, gymnastics, and weightlifting. When the pain is temporary, it is frequently diagnosed as a self-limited back sprain or back strain, and standard treatment protocols can be used.

Chronic back pain, however, often has a more serious cause. For some athletes, the problem is spondylolysis, a defect in part of one or more vertebrae known as the pars interarticularis. This defect can occur naturally (it is sometimes even present at birth), but in athletes it is most often the result of a stress fracture. The most common site of spondylolysis is the fifth lumbar vertebra, but it can also occur in the fourth lumbar vertebra, and occasionally elsewhere in the spinal column. How does an athlete sustain such a stress fracture? Overworking the lumbar region is a common cause among football players, wrestlers, weightlifters, and other athletes in traditional “power sports.” Gymnasts, soccer players, volleyball players, and dancers may place excessive stress on the spine through repetitive hyperextension and movements such as extension with side bending. An acute trauma can also lead to a spondylolysis fracture, such as when a wrestler lands on his or her side in a twisted position or when a football player suffers a direct blow to the spine. Adolescents are especially susceptible, because the pars interarticularis of their vertebrae have not yet fully matured. The most common symptom of spondylolysis is lower back pain that does not resolve in the normal healing time for a back sprain or strain. The pain is often described as a dull aching and cramping sensation in the lower back region, and it is typically aggravated during standing, trunk extension, and trunk rotation. Spondylolytic athletes also may stand with their hips and knees flexed, tilting their pelvis posteriorly (backward) and demonstrating a classic “swayback” posture. If the stress fracture weakens a vertebra so much that it

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TREATING THE ATHLETE

Figure Two: Quadruped alternating opposite arm and leg lift.

Figure Three: Quadruped alternate leg raise.

shifts out of place, the result is a condition called spondylolisthesis. This occurs only in a minority of individuals who suffer from spondylolysis, and its most common symptoms are stiffness and an increase in back pain. If too much slippage occurs, the vertebra may begin to press against nerves, and surgery may be necessary to correct the displacement. A physician can perform a variety of movement tests to help identify spondylolysis and spondylolisthesis, but the most reliable method of diagnosis is an x-ray of the lumbar spine. Sometimes, a specific type of radiography called a SPECT (single-photon emission computed tomography) image is used for a clearer picture of the lumbar region.

immediate concern is usually managing the pain and reducing inflammation. A physician will often prescribe NSAIDs and acetaminophen, and the athlete is typically told to avoid extension and twisting motions to reduce compression and shearing forces in the injured area. Hyperextension bracing and restriction of activity are also usually called for by a physician. Sometimes, immobilization using a specific type of brace called a thoracolumbosacral orthosis (TLSO) is prescribed. Spondylolysis fractures can most often heal with time. One recent study of 28 athletes with subtle fatigue fractures of the pars interarticularis found that conservative bracing allowed the injury to heal in the majority of cases, especially when the actual lesion on the vertebra was not severe. Ninety-two percent of participants in the study rated their outcome as good or excellent, and 89 percent were able to return to competitive

TYPICAL TREATMENT When an athlete is diagnosed with spondylolysis, the most

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TREATING THE ATHLETE athletics in an average of five and a half months after beginning treatment. Other research also supports the finding that bracing and cessation of activity usually result in successful healing. Sometimes, however, bracing and activity restriction do not result in a positive resolution. This is especially likely in severe cases where spondylolisthesis is present. For these athletes, a doctor may recommend surgery to repair the injured vertebra or vertebrae and to prevent interference with other parts of the spinal column. For the rare cases when an athlete requires surgery for spondylolysis, the two most common procedures are a laminectomy and a posterior lumbar fusion. In a laminectomy, a small portion of bone is removed from the vertebral arch to relieve pressure on nearby nerve tissue. In a posterior lumbar fusion, used mostly in cases of spondylolisthesis, loose or unstable vertebrae are fused together, typically with the help of bone grafts and sometimes plates or screws.

SPONDY-WHAT?

his article discusses spondylolysis, a defect in a specific part of one or more vertebrae, often caused by a stress fracture and associated with chronic low back pain. Spondylolysis should not be confused with these other, similar-sounding conditions, all of which derive from the same Latin and Greek root words for vertebra:

• Spondylosis, also known as cervical spondylosis or cervical osteoarthritis, refers to changes in the vertebrae, discs, and joints of the back in aging populations. It is not typically seen in competitive athletes.

• Spondylitis is a general term for inflammatory conditions that primarily affect the spine. Ankylosing spondylitis is a form of chronic arthritis that may occur in young individuals (typical onset is before age 35) and is usually linked to a specific inherited trait.

• Spondylolisthesis, described briefly in this article, occurs when one or more vertebrae actually slip out of place in the spinal column.

REHAB & PREVENTION For both surgical and non-surgical cases

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CERTIFICATION

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GO FARTHER

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TREATING THE ATHLETE of spondylolysis, an important first step in rehab is addressing postural issues that may have contributed to the injury. In particular, maintaining a neutral spine during exercise can prevent unnecessary stress to the lumbar region. Many athletes don’t know exactly what a neutral spine looks or feels like, so here’s an easy way to show them: Have the individual lie on their back with their knees bent, tilting the ASIS (anterior superior iliac spine) toward them and then away from them in a rocking motion (see Figure One on page 30). A neutral spine exists when the ASIS is “balanced,” as if you could balance a book on the athlete’s pelvic girdle. Athletes can then work on maintaining a neutral spine through lumbo-pelvic stabilization exercises, during which proper technique and repetition are essential. A quadruped alternating opposite arm and leg lift is one exercise that can be used for this type of training (see Figure Two on page 31). Once the athlete can maintain a neutral spine statically, dynamic lumbar stabilization exercises such as the quadruped alternate leg raise can be introduced (see Figure Three on page 31). Progression from static to dynamic lumbar stabilization work should occur when the athlete demonstrates proper form

Cross training is very valuable for preventing back injuries of all types, including spondylolysis … A challenging hike requires the synergistic use and control of the trunk, the abdominal muscles, and the core. and can increase the number of reps as they build muscle endurance. From there, athletes should progress to more complex dynamic lumbar stabilization movements to develop synergistic control of the core and lumbo-pelvic junction. As a former physical therapy patient, I know from experience that learning and practicing proper lumbo-pelvic stabilization not only helped me regain function, but also provided a sense of normalcy in my everyday movements. In addition to being a physical therapist, I am also an avid mountain biker and adventurer, and stabilization exercises were a key component in my recovery. Two good examples are the prone alternating arm and leg lift (see Figure Four on page 35) and the single-leg bridge (see Figure Five on page 35), both performed using a stability ball. Once stabilization has been addressed, the later phases of a typical spondylolysis rehab involve light progressive resistance exercises for the upper body to strengthen the rhomboids, latissimus dorsi, lower trapezius, and upper trunk/posterior muscle groups. Research has shown that these muscles in particular are often weaker than the surrounding musculature, and these strength imbalances could leave an athlete at risk for re-injury. The specific exercises and intensity levels for this resistance work should vary depending on the athlete’s progress, level of pain, and sport-specific demands. Of course, the best scenario is for an athlete to avoid suffering a spondylolysis injury in the first place. While there is no single surefire way to prevent this condition, a program based around athlete education, adaptation to sport-specific Circle No. 123

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Figure Four: Prone alternating arm and leg lift with stability ball.

Figure Five: Single-leg bridge with stability ball.

demands, and adequate attention to lumbo-pelvic stabilization training and periodized individual programming provides the best approach. In my experience, cross training is very valuable for preventing back injuries of all types, including spondylolysis. The activities don’t have to be complicated—in fact, one of my favorites is hiking. A challenging hike requires the synergistic use and control of the trunk, the abdominal muscles, and the core, providing a truly effective workout. Swimming is another excellent exercise that strengthens the entire body, including key connective tissues and supportive spinal musculature that

can help promote sound movement patterns and protect athletes from unnecessary lumbar stress. BACK TO ACTION Return-to-play decisions for athletes coming back from spondylolysis should depend on several factors. Once the symptoms, in particular back pain, have fully resolved, athletes are typically eager to return to full activity. As with any recovery from a bone fracture, a physician should decide when the athlete is ready to resume normal activity, and follow-up x-rays may be necessary to assess vertebral healing. Before engaging in activity that may

re-aggravate the injury site, particularly in high-extension sports like gymnastics and volleyball and high-impact sports like football and wrestling, athletes should be able to demonstrate pain-free range of motion with no sign of biomechanical compensation. They should also be able to perform sport-related skills without pain. Research has consistently shown that most cases of spondylolysis can be completely resolved within six months of the original diagnosis. Having successfully helped hundreds of spinal patients over the years, I know there is no universal template for bringing a spondylolytic athlete back to health. However, a full understanding of the condition and knowledge of the relevant research, rehab strategies, and prevention techniques can be the keys to minimizing your athletes’ risk of back pain and injury. ■

To view full references for this article, go to: www.training-conditioning.com/ references.

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NUTRITION

MIND Over Menu

When advising athletes about their eating habits, you shouldn’t just talk carbs, calories, and calcium. You also need to address the psychology behind their relationship with food. BY LAURA ULRICH utritionists who counsel the general population often focus on the mental side of eating. They help clients understand how thoughts and feelings affect eating behaviors, and explain concepts like “emotional eating” and “comfort food.” When it comes to the average person trying to eat right, nutritionists know that much of the process takes place in the mind. However, nutrition advice aimed at athletes tends to take a very different tone, focusing instead on grams of carbohydrate and protein, percentages of body fat and muscle, and technical advice for exactly what to eat and when. Since athletes are eating for their sport, it’s assumed they aren’t subject to the same cognitive struggles over food as the rest of us. “Sometimes we forget that athletes are human, too,” says Lisa Dorfman, MS, RD, CSSD, LMHC, Sports Nutritionist at the University of Miami. “On the one hand, performance nutrition is about the science—on paper, it does come down to grams and ounces. But an athlete’s thoughts and emotions can interfere with the wonderful formula you give them. Unless you address the psychological side of eating, you’re not going to be successful.”

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Laura Ulrich is a contributing writer for Training & Conditioning. She can be reached at: laura@MomentumMedia.com. T&C JULY/AUGUST 2008

NUTRITION In fact, Ingrid Skoog, MS, RD, Director of Sports Nutrition at Oregon State University, believes the emotional side of sports nutrition is actually the most difficult training challenge her studentathletes face. “If an athlete shows up to training and practice and puts in their best effort, they’re done for the day,”

going on with eating than meets the eye,” says Dorfman. “Nearly every time we select a food, emotions play a large role in that choice.” Dorfman refers to this concept as “food trajectories.” “Food trajectories are the feelings, connections, and ideas we bring to the table with us,” she says.

“Instead of understanding that they want apple pie because it reminds them of home and going and getting a great slice of pie,” explains Dorfman, “they end up eating apple tarts from a vending machine and then feeling guilty about it.” she says. “But food decisions have to be made all day long. Each scenario poses different psychological hurdles for making the right choices.” FOOD TRAJECTORIES Dealing with the emotional side of the nutrition formula starts with educating athletes about how their thoughts and feelings play a big role in the food choices they make. “It’s critical to help them understand that there’s a lot more

“They operate below the surface to influence our food choices and how we feel when we eat particular foods. An individual’s food trajectories are shaped by their family, their culture, and their own experiences.” For example, Dorfman recently worked with a swimmer who reported regularly veering from her eating plan to indulge intense cravings for chocolate. “She had recently moved to the U.S. from Switzerland,” Dorfman says.

“For her, chocolate meant home and happiness. It was perfectly obvious to me why she wanted to eat it often, but as far as she was concerned, it had simply become an off-limits food that she craved and then felt guilty for eating.” Counseling this athlete focused on helping her see the psychological connection. “I explained to her there is absolutely nothing wrong with having food connected to emotions—it’s human,” Dorfman says. “And once we uncover the association, we can make a conscious decision about how we handle it. “We decided that after a big meet or heavy training, there is nothing wrong with her having some chocolate,” Dorfman continues. “But I also told her, ‘If you’re going to do it, don’t settle for cheap drug store chocolate—go out and buy the best chocolate you can find and enjoy it. Acknowledge that it’s making you feel closer to home and relish the feeling. If you do that with awareness, just a small amount will satisfy you.’” The problems arise when athletes don’t realize why they crave the foods they do. “Instead of understanding that they want apple pie because it reminds them of

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NUTRITION home and going and getting a great slice of pie,” explains Dorfman, “they end up eating apple tarts from a vending machine and then feeling guilty about it.” One of the best ways to help athletes realize when their emotions are compromising their nutritional goals is asking them to track what they eat and how they feel while they’re eating. “I ask almost all of the athletes I work with to keep this kind of log,” says Nancy Rodriguez, PhD, RD, Sports Nutritionist at the University of Connecticut. “Seeing it on paper can really help them identify any emotional component to their diet. “For example, an athlete may come in and tell me they ‘blow’ their eating plan every night by snacking on chips or ice cream while they study,” she continues. “If they log how they’re feeling when they eat, they may discover that’s the time of day when they really miss their family. Then we’ll talk about things they can do at those times instead of snacking, like calling someone from home.” At Oregon State, an athlete who had lost 20 pounds asked Skoog what he could do to lower his body fat even more. Because the athlete had been

trying to lose weight, Skoog was impressed. But when she found out that a breakup with his girlfriend had lead to restricted eating, she changed her advice from scientific to psychological. “He’d discovered that restricting his food and losing weight were things he could focus on to avoid his feelings,” she explains. “The connection between food and feelings is something more often discussed with women, but men encounter the same issues.” Whether the issue is with calorie restriction or binging, Skoog works to help athletes understand that when negative emotions hit, food is a temporary distraction and not a permanent fix. “I talk with them about what’s going on in their lives and I tell them, ‘Let’s not get this confused with food,’” she says. “Food cannot cure depression or anxiety or lack of sleep. To fix any problems, we need to address the real issue.” BATTLING BODY IMAGE In addition to emotions, another psychological factor driving athletes’ food choices is how they feel about their bodies. When an athlete is struggling with

body image issues, it can present a big hurdle to implementing performance nutrition advice. “I see this issue frequently,” Skoog says. “Female athletes in particular can feel that the body they are being asked to have for their sport is at odds with the body they want. They compare themselves to their peers and decide they are too big or too muscular. They’re eating 1,200 calories a day and trying to get thinner, and when I tell them they need to eat 2,200 calories a day, they’re afraid to do it.” In sports where being thin is desirable, athletes can be at increased risk. “If they’re one of the larger athletes on the team, they look at the thinner athletes and decide they should look like that,” says Amy Freel, MS, RD, CSSD, Director of Sports Nutrition at Virginia Tech. “How body conscious the sport is and the type of uniform the team wears are factors. We see a lot of this among distance runners, volleyball players, soccer players, swimmers, and gymnasts.” Skoog has also noticed an increase in the number of male athletes battling body image issues. “It’s a disturbing

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NUTRITION

FOCUS ON FROSH Perhaps no other group of student-athletes faces more mental challenges when it comes to eating than college freshmen. “For the first time, these young people are completely responsible for deciding what to eat,” says Amy Freel, MS, RD, CSSD, Director of Sports Nutrition at Virginia Tech. “And at the same time, fueling for performance has suddenly become much more important, since they’re facing a higher level of competition.” Stress is also at its peak for freshmen, increasing the odds they’ll succumb to over-indulging in comfort foods or not be able to control negative eating habits. Female athletes can find their post-puberty bodies easily gaining fat and weightroom work adding muscles they don’t like the look of. “And social relationships take on a new importance in college, which can lead to a new level of concern over physical appearance,” says Gary Bennett, PhD, Sports Psychologist at Virginia Tech. The dynamics of college athletics can pose another hurdle. “In the preseason, they start training heavily, and they become leaner,” says Lisa Dorfman, MS, RD, CSSD, LMHC, Sports Nutritionist at the University of Miami. “Then the competition season starts, and if they’re on the bench, they might actually start gaining weight. That can be a risky time for young athletes who have issues with food and eating.” Helping freshmen establish healthy relationships with food and their bodies means sending them the right messages as soon as they hit campus. It also entails quickly identifying individuals who are struggling with eatingrelated concerns and getting them the help they need. Freel meets with all incoming freshmen during orientation. “I introduce myself and give them a lot of written information on fueling for performance and eating on campus,” she says. “I also make sure they know how to find me and that I am available if they have any concerns.” “One of my focuses with freshmen is to get them connected with counseling if they have any eating concerns,” says Ingrid Skoog, MS, RD, Director of Sports Nutrition at Oregon State University. “The right counselor can help them see the issue clearly right off the bat and confront it, and then we have three or four years to help them hone those mental skills.” Nancy Rodriguez, PhD, RD, Sports Nutritionist at the University of Connecticut, has three registered dieticians who screen athletes for eating concerns at pre-participation physicals. She also asks her school’s strength and conditioning staff to address the freshmen. “I like them to hear the same information again from the strength and conditioning coaches, so I’ve checked off on a presentation they give,” she says. “It’s important for everyone who works with freshman athletes to be aware of and empathetic to the pressure they’re under,” Rodriguez continues. “That pressure can set them up for eating-related issues, but with the right help and tools, those issues can be addressed quickly, before they become true stumbling blocks to health and performance.”

T&C JULY/AUGUST 2008

trend,” she says. “I have more men coming in and comparing their body shape to that of their teammates. It’s even happening in sports you wouldn’t expect— I’ve had this issue come up recently with football players and golfers.” Freel says there are ways to tell whether an athlete’s body image is getting in the way of his or her fueling habits. For example, self-reported eating patterns help find the symptoms: In addition to restricting calories, an athlete may hesitate to eat after working out and go long periods without eating during the day. Discussions with these athletes should center on helping them change their self-perception and appreciate their own body, and must be approached with sensitivity and compassion. “I focus on praising their body type and emphasizing the positives of it,” Freel says. “I help them think about the benefits that come from their shape and size—I might say, ‘Maybe it’s why you’re so good at your position.’ “I keep the focus solely on performance and try to get them to not dwell on appearance,” she continues. “Athletes with body image issues are often struggling to accept themselves on a very basic level and you need to be very sensitive to that and help them through it.” Skoog has another tactic that works well. “I point to role models who don’t fit the body stereotype—an athlete who has gone before them on their team or a professional athlete they respect,” she says. “I ask them to think about the selfconfidence that athlete embodies, and I tell them they can get there, too.” OTHER HURDLES Sports nutritionists point to several other mental stumbling blocks athletes face. Each comes with its own set of solutions. Eating perfectionism: Some athletes actually try too hard to eat exactly right. “These athletes become very preoccupied with the numbers,” Skoog says. “They get into the minutiae of weight and counting things. Male athletes can become very focused on their exact body comp—four percent body fat is okay, five percent is not. “The athlete with food perfectionism may not end up having anorexia or bulimia,” she continues. “But they’re obsessing about food, and as a result they’re not thinking about other things.” To help, Skoog addresses the issue TR AINING-CONDITIONING.COM

NUTRITION head-on. “I’ll ask them point-blank if they consider themselves a perfectionist,” she says. “Usually, they’ll say yes. It’s an aspect of their personality they’re proud of. Then we talk about what benefits it has for them. Most of them believe it causes them to work harder than they otherwise would. “From my experience, though, eating perfectionism is rooted in a deeply held belief that they are not worthy—that it’s a fluke that they’re successful,” she continues. “They secretly believe that if they let up even a little bit, everything will fall apart. They believe if they’re not 100 percent perfect, they’ll be a 100 percent failure.” Many times, simply helping an athlete uncover and articulate their subconscious beliefs about perfection and failure helps them relax eating rules. “It can take a while, because this is a

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“If an athlete tells me she follows a low-carb or low-fat diet, I’ll ask, ‘How is that working for you?’ … A lot of times athletes who are following these nutrition myths are performing below their high school level.” deeply rooted way of seeing themselves and the world,” Skoog says. “My job is to convince them that they have a lot more to lose by obsessing over being a perfect eater than they have to gain. I encourage them to try having some flexibility.” Peer pressure: Wanting to fit in with friends can pose another hurdle to performance nutrition. “Athletes tell me, ‘My friends go out for ice cream three nights a week and I want to go with them to be part of the group, but I know it’s causing problems for my nutritional goals,’” Freel says. “That’s a hard one. You want them to be social—that’s really important.” Dorfman encounters the same issue. “A football player trying to manage his weight who goes out for pizza with his teammates isn’t going to want to stick out by just ordering a salad,” she says. “So we work on options: He can eat fewer slices, or take the cheese off the second slice, or cut back a little bit during the day to leave room. I don’t recommend that on a daily basis, but occasionally it’s okay.” Ingrained misinformation: This is the athlete who holds strongly to certain beliefs about food that aren’t accurate. “Maybe he believes all carbohydrates are bad, tries to avoid all fats, or refuses to eat after 6 p.m.,” Dorfman says. “They’ve picked up a message and bought into it, and as a result, they aren’t open to hearing accurate nutrition advice.” Rather than arguing with an ingrained belief, Skoog first asks the athlete to evaluate his or her own performance. “If an athlete tells me she follows a low-carb or low-fat diet, I’ll ask, ‘How is that working for you? How do you feel after a workout?’” she says. “A lot of times athletes who are following these nutrition myths are performing below their high school level. When they analyze how their nutrition is affecting them, I can start to debunk the myths.” Rodriguez has had success by showing misguided athletes scientific studies that help dispel myths, particularly ones that reveal how their mistaken belief can damage performance. “When they can see the evidence right there in front of them, most will let go of the myths,” she says. Too many temptations: Today’s college campuses attract

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NUTRITION students by boasting of their great dining halls, but for student-athletes, the plethora of choices and easy access to comfort foods can be hard to resist. At UConn, athletes receive shopping lists, cookbooks, and handouts on making healthy choices when eating in dining halls. “Overcoming this hurdle is about making sure athletes are prepared,” Rodriguez says. Dorfman counters the problem by telling her athletes to plan ahead. “It’s hard to resist the temptation to eat a bag of chips when you’re hungry and it’s all you have around,” she says. “I teach my athletes to pack for the day like they’re going on a trip, and I give them lists of foods to put in their bags—a banana, a protein bar, pudding, a shake, an electrolyte drink. I make sure they have a collection of protein, carbohydrate, and fat and that the foods appeal to them. You can’t ignore the taste factor. If the dining hall offers their favorite comfort foods and what’s in their bag is unappealing, it’s going to stay in their bag.” RECOGNIZING RED FLAGS If it’s common for athletes to face men-

tal challenges to eating right, how do you know when that challenge represents a serious psychological problem? “Psychological issues with eating and genuine eating disorders exist on a continuum,” explains Gary Bennett, PhD, Sports Psychologist at Virginia Tech.

an athlete when their mental obstacle is still small. The longer the issue goes on, the harder it is to change.” Bennett suggests looking for certain red flags that indicate when an athlete’s food issues need immediate attention. “Look for lists of forbidden foods or

“I have had athletes tell me, ‘My high school coach said I was fat, and I’ve been struggling with that ever since,’” Bennett says. “High school and college athletes are incredibly sensitive to what is said to them about their bodies.” “It starts with a small issue and culminates in a diagnosable disorder. “An athlete who has taken the first step on the path to an eating disorder is usually struggling with body image and restricting calories or counting everything they eat and engaging in eating perfectionism,” he continues. That’s why it’s critical to quickly identify an athlete who is struggling and step in. “It’s incredibly important that these athletes get help early on,” Bennett says. “It’s much easier to help

rigid, highly specific lists of foods an athlete will and won’t eat,” he says. “When you’re eating with athletes on the road, that can be a good time to spot problems. Also look for athletes who are doing additional workouts on their own.” Other warning signs include performance that is highly variable and preoccupation with nutritional supplements, Skoog says. Shying away from social contexts involving food should also trigger concern.

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NUTRITION When Freel suspects an athlete’s food struggles range into disordered eating territory, she gathers as much information as she can. “I ask the athletic trainer, the strength coach, and the sport coach about what they’re seeing with the athlete,” she says. “Often, teammates will speak up with concerns as well. If I have any suspicion that the issue goes beyond my expertise, I refer out immediately to our on-staff counselor.” Skoog is quick to refer as well. “It’s far better to err on the side of caution,” she says. “If I have any doubts at all, I get them connected with a therapist. I tell them, ‘It’s just like when you go to practice and coach teaches you a new skill. Therapists have a box of tools they can share with you—it just happens in an office instead of on the field.’ Athletes tend to be very receptive to counseling when you present it that way.” A CONSISTENT MESSAGE Because the psychological side of nutrition can go under the radar, nutritionists’ last piece of advice is to get everyone in the athletic department on board with the program. One key is for everyone

who communicates with athletes to realize the power of the messages they send. “I have had athletes tell me, ‘My high school coach said I was fat, and I’ve been struggling with that ever since,’” Bennett says. “High school and college athletes are incredibly sensitive to what is said to them about their bodies, whether it comes from a coach, athletic trainer, or strength coach. “One of the biggest mistakes a coach or athletic trainer can make is to talk about the athlete’s size, shape, or weight,” he continues. “Instead, talk about performance. Does the athlete need to be stronger or faster? If so, how can he or she accomplish that?” Skoog believes nutrition advice must be consistent, whether it comes from a coach or an athletic trainer. “Everybody has to do a better job of working together to present a single, coherent message,” she says, “and everybody needs to work together on what they want that message to be.” At Virginia Tech, that effort includes a multidisciplinary team called the Nutrition and Performance Committee, which was formed about five years ago. Freel

and Bennett sit on the committee along with the team physician, members of the athletic training staff, strength and conditioning coaches, and sport coaches. “We meet monthly to share information, and anyone who has noticed an athlete struggling with food can bring it up,” Bennett says. “Anyone outside the committee who has noticed an issue can attend and talk about it as well.” In addition to their monthly meetings, the group works to educate the rest of the staff. “For example, we’ll give a presentation on eating-related issues during a monthly head coaches’ meeting,” Bennett says. “It really helps us make sure we’re all sending the same message about food—that the priority is fueling for performance.” And fueling for performance, instead of emotion, will get athletes eating right for life. “Most of our student-athletes won’t go on to play professional sports, but all of them will keep making eating decisions for the rest of their lives,” says Rodriguez. “If they leave our programs with an understanding of how their psychology affects those decisions, we’ve given them a wonderful tool.” ■

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SPORT SPECIFIC

Arm Forces

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To keep pitchers healthy and on top of their game, you must prepare specific muscles in the arm and shoulder for tremendous rotational force and repetitive stress.

BY LEONARD MACRINA & DR. MICHAEL REINOLD n baseball, pitching prowess is about consistency and repetition. Pitchersâ&#x20AC;&#x2122; success in games, practices, and bullpen sessions depends on their ability to produce the same overhead throwing motion many times in close succession. Other players on the diamond need to be able to repeat an efficient throwing motion, but no one subjects his arm and shoulder to as much stress and force as a pitcher. The repetition necessary for developing technique, accuracy, and power also creates a host of orthopedic concerns. The overhead throwing motion can lead to specific patterns of injury to the shoulder joint, and anyone who has worked with a baseball team is familiar with the most common end productsâ&#x20AC;&#x201D;rotator cuff tears, labral tears, and strained muscles. The good news is that we know more today than ever before about how the shoulder

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Leonard Macrina, MSPT, CSCS, SCS, is a Physical Therapist at Champion Sports Medicine in Birmingham, Ala. Michael Reinold, PT, DPT, ATC, CSCS, is the Rehabilitation Coordinator and Assistant Athletic Trainer for the Boston Red Sox and the Coordinator of Rehabilitation Research & Education in the Department of Orthopedic Surgery at Massachusetts General Hospital. TR AINING-CONDITIONING.COM

SPORT SPECIFIC operates and what we can do through training to improve function and reduce injury risk. A smart conditioning approach must address key muscle groups with appropriate exercises, which can be a major challenge, since it involves familiarizing yourself with a large and ever-growing body of research. In this article, we’ll discuss some recent findings and explain what they tell us about the mechanics of throwing, the causes of injury, and how to train more effective, healthier pitchers. OVERHEAD MECHANICS Let’s start with a simple fact: Effective pitching requires considerable glenohumeral joint (shoulder) mobility. One study that examined the total range of motion (ROM) of 372 pro baseball players found an average external rotation (ER) of 129 degrees and an average internal rotation (IR) of 61 degrees in the throwing shoulder at 90 degrees of abduction. In plain terms, that means elite players must have incredible flexibility in their throwing shoulder, supported by strong musculature and healthy, resilient ligaments and tendons. If you’ve ever worked with pitchers, this comes as no surprise. But a deeper look at the stresses created by the throwing motion reveals some less intuitive and more useful information. In our own recently published research, we examined players’ shoulder range of motion before and immediately after baseball pitching and noted a statistically significant decrease (9.5 degrees) in IR passive ROM after pitching. We hypothesized that this decrease was caused by the great eccentric forces placed on the external rotator muscles during the follow-through phase, which suggests that IR passive ROM must be addressed during training to lower a pitcher’s risk of injury. Other researchers have looked at the forces generated in both the shoulder and the elbow during the pitching motion and found both to be incredibly high. One study found angular velocity—a measure of rotational speed— at the shoulder joint to be greater than 7,000 degrees per second. During follow through, the elbow extended at 2,300 degrees per second, producing a medial shear force of 300 Newtons and a lateral compressive force of 900 Newtons. These figures essentially show that the arm and shoulder complex are under great stress during the act of pitchTR AINING-CONDITIONING.COM

ing, and the risk of injury from even minor strength imbalances, intrinsic or extrinsic weaknesses, or improper mechanics is high. And remember that movement integrity isn’t a static concept—throwers with great mechanics and a solid strength base can still put themselves at risk when muscle fatigue sets in, especially if it leads to movement compensations. PATTERNS OF USE An exercise program for pitchers should improve flexibility, dynamic stability, and strength while enhancing explosive power and endurance. You must provide careful supervision so the athlete maintains ROM but does not employ excessive motion. Strengthening exercises should improve muscle strength and endurance while avoiding possible side effects, such as tightness and inflexibility. A more specific goal is developing functional stability of the glenohumeral joint. This is accomplished through the interaction of the static stabilizers (joint capsule, ligaments, and glenoid labrum) and the dynamic stabilizers (shoulder musculature), and by training the integrated functions of neuromuscular control and dynamic stabilization of the surrounding muscles, particularly the rotator cuff as it blends with the joint capsule. Dynamic stabilization of the glenohumeral joint is achieved through interaction between several active mechanisms. The muscles primarily involved include the rotator cuff, deltoid, and biceps brachii. Secondary stabilizers include the pectoralis major, latissimus dorsi, and the scapulothoracic musculature (trapezius group, rhomboids, serratus anterior, pectoralis minor, and levator scapulae). Recent research has shed some new light on how these muscles work in concert during the overhead throwing motion. An electromyographic (EMG) analysis of pitchers, for instance, revealed the specific muscle-firing patterns involved in a fastball delivery: During the wind-up phase, there is relatively low muscle activity in the dominant arm, but during early “cocking,” the serratus anterior and trapezius actively stabilize the glenoid as the humerus is abducted to approximately 104 degrees. The supraspinatus and deltoids stabilize the humerus within the glenoid. During late cocking, the humerus maintains its level of abduction and gains much of its dynamic stability

Figure One: Full can exercise to best isolate the supraspinatus muscle. through activation of the middle trapezius, rhomboids, and levator scapulae. The serratus is also activated, to oppose the isometric contraction of the retractor group and maintain the position of the glenoid. In addition, the infraspinatus and teres minor are highly active to externally rotate the humerus. The upper fibers of the subscapularis also have increased activity, thus offering a compressive force for the externally rotated humerus. During the acceleration phase, the scapula stabilizers maintain relatively high activity (above 50 percent in the manual muscle test). The latissimus dorsi and upper fibers of the subscapularis are even more active (above 85 percent in the manual muscle test) as the humerus internally rotates and horizontally adducts. During the deceleration phase, all the scapula stabilizers are highly active, especially the lower trapezius. The teres minor serves as a key posterior restraint, and possibly a force couple, to the pectoralis major, which adducts and internally rotates the humerus. Throughout most shoulder movement, the rotator cuff is an important dynamic joint stabilizer. The surrounding structures also play a vital role by dynamically stabilizing the joint, allowing it to produce and dissipate the large forces generated during each pitch. Deficiency of these muscle T&C JULY/AUGUST 2008

SPORT SPECIFIC groups can lead to a variety of injuries to the labrum capsule or the rotator cuff itself. EXERCISE SELECTION How can all this data affect the exercise prescriptions you provide to pitchers? Obviously, the answer varies depending on training goals, existing symptoms of deficiency, weakness, or movement compensation, and past or present injuries. But in general, the research suggests special emphasis should be given to the supraspinatus, infraspinatus, and

teres minor, as well as the scapula stabilizer muscles. They lay the foundation upon which optimal power and sound technique are built. As for which exercises are best, there’s some controversy about the ideal way to position, isolate, and strengthen the supraspinatus muscle, and this has led several study authors to use EMG analysis in an attempt to resolve the issue. There is no consensus yet, and one of the main points of contention involves the relative value of “empty can” and “full can” exercises.

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Frank Jobe, MD, pioneer of Tommy John ligament replacement surgery, was the first to recommend empty can exercises for strengthening the supraspinatus. This involves elevation in the scapular plane (30 degrees anterior to the frontal plane) with glenohumeral IR to shoulder height only. Meanwhile, others believe in the full can position (see Figure One on page 47), which involves elevation in the scapular plane with glenohumeral ER to shoulder height. We recently conducted a study of the supraspinatus and deltoid musculature using EMG during full can, empty can, and prone full can exercises. We found that all three provided a similar amount of supraspinatus activity (ranging from 62 to 67 percent of maximal voluntary isometric contraction). However, we did observe one key difference: The full can exercises resulted in significantly less middle and posterior deltoid activity. This led us to conclude that the full can may be a superior exercise, since it is able to strengthen the supraspinatus while minimizing potentially damaging superior shear force due to deltoid activity. The two other key muscles targeted in the overhead throwing athlete are the infraspinatus and teres minor. These comprise the posterior cuff, providing glenohumeral compression and resisting superior and anterior humeral head translation by exerting an inferoposterior force to the humeral head. The posterior cuff muscles also provide glenohumeral external rotation, and pitchers rely on them to maintain adequate glenohumeral joint congruency during each throw. Some researchers have found that overhead throwers most often experience rotator cuff tears from the mid-supraspinatus posterior to the midinfraspinatus area, which they surmise is a result of compressive force produced to resist distraction, horizontal adduction, and internal rotation at the shoulder during arm deceleration. Thus, the external rotators often appear weak and affected by different shoulder pathologies such as internal impingement, joint laxity, labral lesions, and rotator cuff lesions—particularly in pitchers. To head off these potential problems, some studies suggest emphasizing ER strengthening for throwing athletes to enhance muscular strength, endurance, and dynamic stability. This is another area where the best exercises are not universally agreed upon, so we recently

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Figure Two: Side-lying external rotation to isolate the infraspinatus and teres minor.

Figure Three: Prone external rotation at 90 degrees of abduction.

conducted a study analyzing EMG of the infraspinatus, teres minor, supraspinatus, posterior deltoid, and middle deltoid of 10 healthy pitchers during seven different exercises. The exercises we studied were: • prone horizontal abduction at 100 degrees with full ER • prone ER at 90 degrees of abduction • standing ER at 90 degrees of abduction • standing ER at 45 degrees in the scapular plane • standing ER at 0 degrees of abduction • standing ER at 0 degrees of abduction with a towel roll • side-lying ER at 0 degrees of abduction. We found the greatest infraspinatus and teres minor activation with side-lying ER (see Figure Two at left), followed closely by ER in the scapular plane and prone ER at 90 degrees of abduction (see Figure Three at left). We also found that adding a towel roll to the ER exercise at 0 degrees of abduction consistently resulted in greater activity of the posterior rotator cuff—by an average of 20 to 25 percent (see Figure Four on page 51). OTHER PRIORITIES We’ve discussed how the supraspinatus, infraspinatus, and teres minor lay the foundation for optimal throwing. But to develop truly complete pitchers whose risk for injury is as low as possible, other specific muscles must be targeted as well. The trapezius, for example, provides scapular upward rotation and elevation (upper trapezius), retraction (middle trapezius), and upward rotation and depression (lower trapezius). In addition, the inferomedial directed fibers of the lower tra-

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SPORT SPECIFIC pezius may contribute to posterior tilt and external rotation of the scapula during arm elevation, which decreases subacromial impingement. For this reason, the lower trapezius is very important to pitchers, particularly during rehab from most shoulder injuries. Analysis of EMG patterns of the lower trapezius has found that the best exercises for developing this muscle area are the prone full can, prone ER at 90 degrees, and prone horizontal abduction at 90 degrees with ER. These findings come with one important caveat: The prone full can exercises should not be performed at a preset degree of abduction, but should instead be individualized based on the alignment of the lower trapezius fibers. A good starting point is 120 degrees of abduction, and you can make appropriate adjustments based on the athlete’s feedback and performance (see Figure Five on page 51). We have found that muscle imbalances often lead to shoulder pain, and a common culprit is an imbalance between the lower and upper trapezius, with the upper portion usually more dominant. To address this problem, the athlete must recruit the lower trapezius. At least one study has found bilateral ER at 0 degrees of abduction to be the most effective strategy when compared with other trapezius exercises. Another study found side-lying ER and prone horizontal abduction at 90 degrees with ER to help balance lower and upper trapezius activity. Other exercises that develop the lower trapezius include prone rowing, prone horizontal abduction at 90 degrees and 135 degrees with ER and IR, prone and standing ER at 90 degrees of abduction, proprioceptive neuromuscular facilitation (PNF) D2 diagonal-pattern flexion and extension movements, PNF scapular clock, standing high scapular rows, and scaption, flexion, and abduction below 80 degrees and above 120 degrees with ER. Research has shown that lower trapezius activity is relatively low below 90 degrees of scaption, abduction, and flexion, and increases exponentially from 90 to 180 degrees. One other important muscle, which works in conjunction with the upper and lower trapezius, is the serratus anterior—it too should be addressed when training and rehabbing pitchers. The serratus anterior contributes to all components of normal three-dimensional scapular movement during arm elevation, including upward rotation, posterior tilt, and external rotation. It also helps accelerate the scapula during the acceleration phase of throwing. The serratus anterior even helps stabilize the medial border and inferior angle of the scapula, thus preventing scapular IR (“winging”) and anterior tilt. To target the serratus anterior, the best exercises include PNF D1 and D2 diagonal-pattern flexion, D2 diagonal-pattern extension, supine scapular protraction, supine upward scapular punch, the military press, push-ups, IR and ER at 90 degrees of abduction, and flexion, abduction, and scaption above 120 degrees with ER. While serratus anterior activity generally increases as the arm is elevated, this also raises subacromial impingement risk, so always use caution when prescribing or supervising elevated-arm exercises. Of all the serratus anterior exercises, variations of the pushup are among the most simple and beneficial. During standard push-ups, push-ups on knees, and wall push-ups, serratus activity is greater when full scapular protraction occurs after the elbows fully extend, a variation commonly called “pushTR AINING-CONDITIONING.COM

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SPORT SPECIFIC ups plus.” Compared with the standard push-up, a push-up plus with the feet elevated produces significantly greater serratus anterior activity—an example of how positional challenges are central to making these exercises effective. SPECIALIZED ATHLETES Armed with a better understanding of how the key muscles and joints work during the throwing motion, you can make better judgments when designing training programs for healthy pitchers and rehab programs for those returning from injury. The research findings we’ve presented here should assist in prescribing exercise programs that can help your athletes achieve their performance goals. The overhead thrower is a unique athlete, with unique physical demands and injury risks. Thus, optimal training must be highly specialized, and you shouldn’t be afraid to create a plan that isolates specific muscles for extra recruitment. When your pitchers find that they can produce the same powerful, mechanically sound motion time after time, they’ll thank you for it. ■

Figure Four: Standing external rotation with towel roll.

To view full references for the research discussed in this article, go to: www.training-conditioning. com/references.

Figure Five: The prone position at 120 degrees of abduction is generally best for isolating the lower trapezius muscle.

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www.dynatronics.com Rehabilitation Equipment & Supplies Site includes: • Dealer locator for the U.S. and Canada • Catalog with images, measurements, and descriptions • Online warranty registration • Investor relations and company information Special features: • Home page features new images each time you log on • Video clips of featured products and applications See ad on inside back cover T&C JULY/AUGUST 2008

2008 Supplier Web Site Directory www.efisportsmedicine.com

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2008 Supplier Web Site Directory www.lifefitness.com Hammer Strength® Plate-Loaded Equipment Site includes: • Specifications for all products • Facility showcases with printable brochures • Retail information, including articles and press releases • Training and education information

www.hibigeebies.com Antimicrobial Antiseptic Site includes: • Product information • Clinical information • Product sample request • Reference articles Special features: • Downloadable educational materials • MRSA DVD

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www.informed-choice.org Supplement Testing & Certification Site includes: • Information about Informed-Choice and contamination in supplements • FAQ on testing and contamination • Information on how to register a product for testing • Testing specifications for banned substances Special features: • Free downloadable nutrition guides and booklets • List of products tested for banned substances See ad on page 43

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2008 Supplier Web Site Directory www.MET-Rx.com

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Products Debut at the NATA Show Didn’t make it to all the booths at the NATA show? Couldn’t attend the show this year? We’re pleased to provide information on products which made their debut at the convention. Braces & Sleeves New technologies in ankle braces and wraps The new Volt ankle brace from Active Ankle (www.activeankle.com) incorporates the latest carbon fiber technology in its polypropylene shell. It also features a molded bearing-design performance hinge for a smoother range of motion, strengthening ribs for a thinner profile, and fabric-backed EVA foam pads for durability and comfort. At the show Cramer Products (www.cramersportsmed.com) introduced the Power Lacer ankle brace, which features unique Y-shaped vertical stabilization straps, offering unprecedented control over both the forefoot and heel. In addition to totalcontrol lacing, four spring steel stays also help support the ankle and prevent heel release. The new design of the ASO EVO ankle stabilizer from Medical Specialties (www.medspec.com) incorporates unique stabilizing straps and a dynamic cuff to comfortably provide exceptional support and stability. The ASO EVO is also bilateral to fit either the left or right foot. The new 611 Ankle Anchor from PRO Orthopedic Devices (www.proorthopedic.com) comes to you from the makers of the very effective 610 Arizona ankle brace. Its nonelastic strapping system is anchored on the calf and is inversion-resistant, making it ideal for high-ankle sprains. Also new in wraps, Pro-Tec Athletics (www.injurybegone.com) showed its Calf-Sleeve Support Compression 60

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Wrap, which provides comfortable warmth, compression, and support to the calf area. It is an effective support for calf strains and tears, and provides moderate support for shin splints.

Rehabilitation Devices Greater options for electrotherapy, ultrasound, laser, and light therapies The compact, portable Intelect TranSport from Chattanooga Group (www.chattgroup.com) conveniently combines ultrasound and electrotherapy into one easy-to-use, portable unit for on-the-spot treatment. Its innovative compact design allows you to offer a broad range of therapies for the cost of one unit. Dynatronics (www.dynatronics.com) introduces the Dynatron X5, which offers highly effective treatment for both acute and chronic pain. Two independent channels and six treatment modes, as well as both large and small treatment probes are included. And you can’t beat a free two-year warranty on this lightweight and affordable device. The Omnistim FX2 Pro from Accelerated Care Plus (www.acplus.com) is a multimodality e-stim system with Patterned Electrical Neuromuscular Stimulation technology that extends traditional e-stim capabilities by simulating normal muscle-firing patterns for neuromuscular re-education. New from Multi Radiance Medical (www.multiradiance.com), comes the FDA-approved LaserStim combo modality emitter for the TerraQuant. The LaserStim is a patented hybrid

emitter that combines both light therapy and e-stim in one device. The Bio-Mat (www.thebiomat.com) is a unique, FDA-approved medical device that combines far infrared negative ions and amethyst crystals to deliver a molecular-level massage, increasing blood flow and lymph circulation. The Bio-Mat helps maximum cellular enzyme activity, which speeds lactic acid processing and soft-tissue injury recovery. K-LaserUSA (www.k-laserusa.com) is a leader in Class IV therapy lasers. Desktop and portable models deliver high-powered, dual-beam infrared laser therapy for superior clinical results.

Therapy Pools Discover a wider selection of aquatic rehabilitation equipment SwimEx (www.swimex.com) has come out with the 900T model, featuring an overall depth of 5.5 feet, and can be adapted with a raised inset floor for a second water level anywhere from 3.5 to 4.5 feet. The same pool can offer you workstations for shallow and deep-water exercises. The Polar Pool (www.thepolarpool.com) cryotherapy spa offers cold water, hot water, and saltwater therapy all in one. It’s portable, and athletes can sit or kneel in the Polar Pool while the purification, sanitization, and cooling systems keep the water clean and at the perfect temperature. And the HydroWorx 5000 Series of pools from HydroWorx International (www.hydroworx.com) are perfect for large-group hydrotherapy. The design TR AINING-CONDITIONING.COM

maximizes a facility’s efficiency by being able to hold up to 10 underwater treadmills or 12 underwater spinning bikes. HydroWorx now offers its InstaFit option with no construction needed.

Fighting Infectious Diseases New tools for preventing MRSA Goldshield from Viking Environmental (www.vikingenv.com) is a liquid, patented, antimicrobial surface protectant. It is EPA-approved for GI claims and is clinically proven effective against staph, MRSA-VRE, and other infectants. Durable with 99-percent protection, GoldShield’s application can last from 14 to 30 days. Clorox Pro Quaternary All-Purpose Disinfectant Cleaner, from the Clorox Company (www.cloroxprofessional.com), has a bleach-free disinfectant that is EPA-registered. It kills healthcare-associated and community-associated MRSA, as well as other common illness-causing bacteria, viruses, and fungi. And Myclyns from Union Springs Pharmaceuticals (www.myclyns.com) is the non-alcohol first response personal protection product that can be sprayed directly into your face. Independent lab tests show that the solution in MyClyns demonstrates a greater than 99.99-percent reduction in HIV-1, Hepatitis-C, and MRSA bacteria.

In The Athletic Training or Fitness Room

inches in diameter, allowing you to add more challenging stability and proprioceptive exercises to your programs. It’s larger size makes it easy for sitting, prone, and standing position work. The sturdy Airex Wall-Mounted Mat Storage Rack from Perform Better (www.performbetter.com) is made of top-quality stainless steel and serves as a practical way to store mats where space is limited. The storage rack and eyelets are sold separately, with eyelets installed upon request when ordering. Now PROTEAM by Hausmann (www.proteamtables.com) has the ability to dress up your training room by adding your school logo—embossed in full-color—to your taping station back rests, seats, and tabletops. The new SplitTopXL athletic trainer’s case from Wilson Case (www.wilsoncase.com) has twice as much inside height as the standard version and comes with two sets of removable dual trays. Six-inch turf tires make this case easily portable. Total Gym by efi Sports Medicine (www.totalgym.com) has an answer to effective abdominal work with its Scrunch accessory. The Scrunch accessory facilitates a simple progression of abdominal workouts, lengthening and sculpting muscles with proper posture support. Unlike a normal crunch, the athlete’s legs drive the abs in every Scrunch for overall function and correct biomechanics.

TapeWrap from Mueller Sports Medicine (www.muellersportsmed.com) is a great alternative to prewrap because it doesn’t trap moisture, which can cause slippage. It’s cohesive, breathable, sweat-resistant, and can be applied directly to the skin without adhesive spray.

The new Slanted Riser from SPRI (www.spriproducts.com) is an angled step riser designed specifically for use with the Original Step. From balance training to flexibility to aerobic training to strength conditioning, the Slanted Riser will transform your flat Step into an angled platform, offering unlimited versatility to your workout. Paired with the standard Risers, the Slanted Riser will also turn your Step into an incline/ decline bench.

The Shuttle 2000-1 from Shuttle Systems by Contemporary Design (www.shuttlesystems.com) allows treatment of virtually any lower extremity early on in the rehab process. A great transition tool for the steps from injury to full functional movement, it effectively addresses an athlete’s trunk and upper-body rehab, along with strengthening needs.

The Essentials of Strength Training and Conditioning textbook, developed by the NSCA Certification Commission (www.nsca-cc.org), is now available in its third edition, and is one of the most comprehensive references available for preparing for the CSCS exam. Its research-based approach with an extensive exercise technique section makes it unbeatable for studying.

OPTP (www.optp.com) has your answer to a larger balancing device with the inflatable Disco Sport. It is 22

And finally, the Athletic Trainer System (ATS) from Keffer Development Services (www.athleticsoftware.com)

Customized approaches to treatment

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is a multi-team, multi-sport system designed to assist athletic trainers with tracking injuries and related client information. ATS can be installed locally or hosted to make it accessible via the Internet.

For The Athlete Revolutionary products from head to toe AminoActiv from ProMera Health (www.aminoactiv.com) is an all natural anti-inflammatory that actively repairs strained muscles, joints, and tissue. It’s unique amino acid combination targets both inflammation and lactic acid buildup with no side effects. When it heats up, Aquality Water Systems (www.aqualitywater.com) offers cooling products for the sidelines, locker rooms, and at practices and games. Evaporative cooling and misting systems are more important than ever with rising median temperatures each year. Sportenine, new from Boiron USA (www.arnicare.com), is a homeopathic product with Arnica, helping to improve stamina, promote recovery, and reduce the risk of cramps, aches, pains, exhaustion, and muscle fatigue from prolonged workouts. The chewable lemon-flavored tablets are free of stimulants and taste great, too. The mouth protector from Denta-Gard (www.dentagard.com) doubles an athlete’s protection by covering both the upper and lower teeth. No impression is needed, and the mouth protector is safe to use with orthodontic braces. Denta-Gard is available in eight team colors, made in the USA. Buy these mouthguards direct and save. An innovative OTC topical product, Cramp 911 from Delcorean (www.cramp911.com) is a true muscle relaxer that will relieve a cramp in as little as 15 seconds, without the pain returning. Cramp 911 can be used for any muscle-related tightness issue, such as back spasms or tight muscles. State-of-the-art cad-cam technology allows Mile High Orthotics Lab (www.mholabs.com) to specialize in custom orthotics with a standard three-day in-house turnaround time. And Glyc’N Go, a revolutionary new food supplement from Lifexpand (www.lifexpand.com), has been shown in controlled clinical trials to truly increase levels of nitric oxide and enhance blood flow to exercising muscles. T&C JULY/AUGUST 2008

HEAT STRESS Outdoor Boss 888-463-5699 www.outdoorboss.com

General Tools & Instruments 800-697-8665 www.generaltools.com

Cramer Products, Inc. 800-345-2231 www.cramersportsmed.com Powerflo, Powerflo 50, Coil Cool

WBGT Handheld Heat Stress Monitor

Cramer Products offers three types of portable hydration units to help hydrate athletes. Cramer’s newest unit, the Powerflo 50, offers an impressive 50 gallons of portable hydration.

Designed to monitor environmental thermal conditions, this instrument represents an industry breakthrough for outdoor sports. Four measurement parameters—WBGT (wet bulb globe temperature), TG (globe temperature), TA (air temperature), and % (relative humidity)— make it invaluable for coaches, athletic trainers, athletic directors, and sports medicine practitioners.

Primary Advantages: Cramer’s hydration units are constructed of 100-percent water-portable and FDA-approved materials for drinking water. Circle No. 500

Primary Advantages: The new and highly accurate WBGT8758 determines true heat stress risk by accounting for air currents, relative humidity, and solar load in addition to air temperature. Circle No. 501

Aquality SYSTEMS

Outdoor Boss supplies a complete sideline of products for preventing

heat stress among your athletes, from hydration to misting to sports drinks. Primary Advantages: All of the company’s products are durable and field-tested. Outdoor Boss has been supplying quality products for more than 10 years. Circle No. 502 HQ, Inc./CorTemp™ 941-721-7588 www.hqinc.net CorTemp™ Ingestible Core Body Temperature Monitoring System The CorTemp monitoring system, featuring the CorTemp ingestible tempera-

Hydrate Your Athletes

WATER

Boss Drinking Systems, Cool Draft Blue Misting Fans, Stadion Sports Drinks

INC

“Specialists in creating a cooler and safer Environment for work and play!” • High Pressure Misting/Fogging Fans • Heat Stress Rehabilitation Products • Complete Sideline Cooling Systems • Phase Change and Evaporative Cooling Vests, Neckwear, and Headwear • Evaporative Cooling Fan Units • Heavy Duty Air Circulators • Portable Heating Units FOR USE BY: • Sports Teams/Athletes • Industrial & Commercial Facilities • U.S. Military • Law Enforcement, Fireﬁghters, and EMS Units

Hydrate Cart

Hydrate A-Frame

50-gallon tank with 8 drinking stations 8” opening at the top of the tank allows ice/water to be easily loaded Two battery-operated pumps Custom-built four-wheeled aluminum cart, built-in hitch All components FDA approved NO ASSEMBLY REQUIRED

Simply attaches to a water source (spigot) Provides unlimited water supply Water pressure controlled by easyﬂow nozzles A-frame legs adjustable/removable without tools Improved drinking nozzles with “never lose” tips and levers Lightweight -only 20 pounds

LIFETIME WARRANTY

Visit our website to view our wide range of products:

www.Aqualitywater.com

Phone: (210) 493-4545 Fax: (210) 481-9090

Alternate: (210) 336-2266 Email: info@aqualitywater.com Circle No. 139

jack@hydrate1.com

www.hydrate1.com Circle No. 140

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HEAT STRESS ture pill, has been marketed throughout the world for more than 17 years. Once ingested, the pill wirelessly transmits an athlete’s core body temperature to a handheld monitor, where the data is picked up and recorded. It’s realtime, easy-to-use, and convenient for stationary or mobile environments. CorTemp is FDA-cleared. Primary Advantages: Early intervention is an absolute necessity in the prevention, evaluation, and treatment of heat stress. Research indicates that external methods of monitoring core temperature are not always valid under conditions of intense exercise. The CorTemp system provides an internal, non-invasive, affordable approach for assessing elevated core temperature on the field, and for measuring the effectiveness of cooling methods on the sidelines. Circle No. 503

Hydrate, LLC 407-694-1034 www.hydrate1.com Hydrate Cart A-Frame The Hydrate Cart A-Frame can hydrate multiple athletes at the same time, without the need to fill bottles or cups. Primary Advantages: This product encourages athletes to hydrate themselves, while relieving athletic trainers from having to fill and transport coolers. Circle No. 504 Stromgren Athletics 800-527-1988 www.stromgren.com

heat and cold with Stromgren’s Polar Heat compression shirt. A cold/ heat pack is strategically positioned in a trap pocket between the athlete’s shoulder blades to cool or heat the body for more than three hours at a time. The shirt is made of moisture-wicking compression material to keep skin dry during long, intense workouts. Primary Advantages: Field tests prove that the Polar Heat compression shirt helps athletes maintain a safe core body temperature. It’s available in black or white in adult sizes at your local sporting goods store. For more information, go online or call Stromgren. Circle No. 505

Polar Heat Temperature-Controlled Compression Shirt Help your athletes stay safe and comfortable when working out in extreme

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HEAT STRESS Waterboy Sports, Inc. 888-442-6269 www.waterboysports.com Hydration Equipment Waterboy Sports is not just a single product, but an extensive product line designed to fit various price ranges and meet the specific needs of the athletic training community. Visit the company online to see its complete product line.

20 GALLON TEAM MATE

Primary Advantages: All Waterboy Sports products are designed to accommodate both the athlete and the athletic trainer. Each product is built to withstand the punishment of constant use and any abuse an angry athlete can dish out. Circle No. 506 WissTech Enterprises 800-809-8184 www.wisstechenterprises.com Hydration Station Portable Drinking Fountains

25 GALLON TANKER

50 GALLON MEGA TANKER

The Hydration Station line of portable drinking fountains is constructed of the finest components available. All carts are made of welded aluminum with industrial pneumatic wheels. The Hydration Station is designed for durability and longevity. Primary Advantages: The Hydration Station provides a convenient, easyto-operate source of portable fluids. Models are available for indoor and outdoor use. Circle No. 507 Aquality Water Systems, Inc. 210-493-4545 www.aqualitywater.com Misting Fans, Ventilation Fans, Personal Cooling Devices, Evaporative Cooling Units

NO-DRIP DRINKING CART P.O. BOX 1002 SUGAR LAND, TX (800)809-8184 (281)277-7238 FAX: (281)491-6319

www.wisstechenterprises.com

Aquality’s products are designed to cool athletes on the sidelines, in locker rooms, at practice, and on the field to create a safer and more comfortable environment. With median temperatures rising every year, keeping athletes cool is more important than ever.

Primary Advantages: Evaporative cooling and misting systems can create a space that’s typically 15 to 35 degrees cooler than the ambient air. It can protect your athletes from dangerous heat stress, protect your program from liability, and help keep athletes performing at their best in any climate. Circle No. 508 Port-A-Cool, LLC 800-695-2942 www.port-a-cool.com Port-A-Cool®, Küül Pads® Port-ACool® products can help keep your athletes safe and cool on the sidelines and in the dugout, gym, locker room, pool area, and weightroom. Primary Advantages: These products make the air an average of 15 to 25 degrees cooler than ambient air, using natural evaporative cooling. They produce no mist, just cool air for less than a dollar per eight hours of operation. Circle No. 509 AVAcore Technologies, Inc. 734-332-3777 www.avacore.com CoreControl Now there’s a way to actually increase playing time in the heat without sacrificing safety. Published research has proven CoreControl’s ability to improve endurance, increase strength, accelerate recovery, and reduce or eliminate muscle cramping. Primary Advantages: This is the new technology no team should be without. Heat should not be allowed to limit your team’s performance. Stay alert. Stay fast. Stay strong. Stay cool. Get the cutting edge on your competition with CoreControl. Circle No. 510

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NEW Product Launch Scientific Core Conditioning Correspondence Course

Big 100 Colossal Brownies

Unique features: • Top-of-the-line core-conditioning training, from corrective exercise to high-performance training • Includes section on assessing core function

Unique features: • Packed with 30 grams of protein, including MET-Rx’s exclusive Metamyosyn® • No trans fat

Beneﬁts for the user: • Earn CECs and CEUs with completion of this course • Many exercises and techniques used by amateur and professional athletes and sports teams worldwide

Beneﬁts for the user: • Microwave them hot in just eight seconds • Available in Super Chocolate Fudge and Peanut Butter Delight flavors • A dozen brownies per box

C.H.E.K. Institute www.chekinstitute.com 800-552-8789

MET-Rx Engineered Nutrition www.met-rx.com 800-996-3879

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Plyo-Safe G2 Boxes

The 900T

Unique features: • Made with a 100-percent foam core that will not break down or soften • Each box has three two-inch strips of Velcro™ to enable stacking and prevent the boxes from slipping apart • Handles on the 12-, 18-, and 24-inch boxes allow for easy repositioning Beneﬁts for the user: • Designed to offer the ultimate combination of durability and safety • Stack together or use alone to achieve desired training height • Order in the individual size desired (3, 6, 12, 18, or 24 inch), or as a three-piece set (12, 18, and 24 inch), or as the complete five-box set.

Unique features: • Deep-water depth of 5’ 6” • Additional second water depth available from 3’ 6” to 4’ 6” • Shallow-water workstations

Perform Better www.performbetter.com 800-556-7464

SwimEx, Inc. www.swimex.com 800-877-7946

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Beneﬁts for the user: • Deep-water exercise • Optional integrated motorized treadmill • Faster rehabilitation and conditioning

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AQUATIC THERAPY The Polar Pool 617-480-7683 www.thepolarpool.com The Polar Pool cryotherapy spa offers cold water therapy, hot water therapy, and saltwater therapy—all in one. It’s completely portable, so you can provide athletes with state-ofthe-art treatment and pain relief without installing new plumbing or redesigning your entire facility. Users can sit or kneel in the pool, and the purification and sanitization systems keep the water clean while the solidstate cooling system maintains the temperature you want. Circle No. 515 Are you tired of making and packing ice, or filling and draining tanks in your facility? Are you concerned about the health and safety of your athletes when they

use ice baths or heated therapy pools? The Polar Pool offers programmable filtration, automatic ozone oxidation, and digital water safety monitoring. Its advanced solid state cooling system allows for cold water therapy without the need for compressors or chemicals such as Freon®. Visit the company’s Web site today to learn more. Circle No. 516 Ferno Performance Pools 888-206-7802 www.fernoperformancepools. com Ferno Performance Pools offers an extensive line of therapy, rehabilitation, fitness, and conditioning pools. Choose from in-ground, partially in-ground, and above-ground models to maximize your athletes’

aquatic experience. Ferno’s leading line of performance pools offers a system to fit in any space, large or small. The optional swim-inplace swim current and underwater treadmill allow athletes to maximize their workout without the devastating effects of land-based conditioning. Circle No. 517 The Ferno Hydro Track underwater treadmill system is ideal for the smaller clinic or athletic training room with limited space. The Hydro Track offers a low-impact, high-resistance workout for athletes limited by pain or weightbearing restrictions, and for those

Overcome

Resistance

TurfCordz™ Safety Super Bungie • High-level athletic agility and strength training • Explosive start drills • Power-building footwork • Simulated play action • Available in 75, 150 & 200 lbs of pull

Patellar Tendinitis

Leading professional sports teams and international Olympians train with TurfCordz to increase speed, endurance, flexibility & enhance Performance through Resistance. Resistance SM

Chondromalacia Patella Osgood-Schlater’s Disease

Made in the USA 200lb Super Bungie is 5/8” thick

Brace International, Inc. Atlanta, GA

Toll Free

nzmfg.com (800) 886-6621

800 545-1161 Circle No. 144

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AQUATIC THERAPY who wish to maximize their cardiovascular workout. The Hydro Track features a variable-speed treadmill ranging from .5 mph to 7 mph, dual-speed resistance jets, and a digital display unit that includes speed, distance, and time to monitor performance. Circle No. 518 HydroWorx International, Inc. 800-753-9633 www.hydroworx.com HydroWorx, a premier manufacturer of aquatic rehabilitation and fitness products, offers innovation in every pool. These pools feature adjustable floors, underwater treadmills, resistance jets, deeptissue massage hoses, and options to fit every application and budget. The company’s pools have proven to be among

the most versatile for athletic trainers worldwide. HydroWorx’s new 5000 Series Recreation and Sports pools are revolutionizing large-group hydrotherapy with maximum dimensions of 25 feet wide and 39 feet long. They can be customized with up to 10 powered underwater treadmills or 12 underwater spinning bikes for treatment and exercise sessions. Circle No. 519 HydroWorx pools with the InstaFit option offer a convenient, plug-in answer for sports professionals who need immediate access to the benefits of aquatic therapy. The 500i and 600i units leave the company’s workshop skirted, prepackaged, and ready to perform. The 500i is up and running after being set in place and connected to an electrical source at its rehab and exercise destination. The 600i can

be carried through a standard doorway and quickly assembled and plumbed on site, so it can fit into virtually any spot too confined for the 500i. Circle No. 520 NZ Mfg., Inc. 800-886-6621 www.nzmfg.com The StrechCordz line of resistance swim training products was designed by competitive swimmers to improve stroke, endurance, and strength, and to offer exceptional safety and comfort. From in-water swimming tethers—like the StrechCordz Short Belt shown here— to dry-land training products, they fit the training and exercise needs of all types of swimmers. Call or go online to learn more about the entire StrechCordz line. Circle No. 521

Let Ferno Answer All of Your Aquatic Needs Training, Fitness, and Rehabilitation Ferno can provide you with all of your aquatic equipment. Whether it’s a fitness pool, rehabilitation pool, or an underwater treadmill, we have a unit that will fit your facility. There are over 250 custom and fiberglass pools from Ferno that you design to fit your rehabilitation program. We also offer the HydroTrack™ and AquaCiser ® aquatic treadmill systems for those facilities that have limited space. Or, to enhance your existing pool, just drop in an AquaGaiter™ underwater treadmill system.

To learn more, call 888-206-7802 or visit www.fernoperformancepools.com Circle No. 145

AQUATIC THERAPY

TESTIMONIAL

Sprint Aquatics 800-235-2156 www.sprintaquatics.com

The Pro-Roller: “Essential and Indispensable”

Elite Sports Professionals and Athletes Worldwide Excel with Aquatic Therapy Pools

Sprint Aquatics has been supplying the aquatics world for more than 36 years. The company’s combination of quality, price, and customer service makes Sprint an industry leader. The company has brought a myriad of innovative and thought-provoking products to the market over the years—products that have altered the course of aquatic therapy and helped set the pace for the entire field. Circle No. 522 SwimEx, Inc. 800-877-7946 www.swimex.com The 900T offers the ultimate in flexibility. With an overall depth of 5’ 6”, it can be adapted with a second floor to offer a second water level anywhere from 3’ 6” to 4’ 6”, with or without an integrated treadmill. Athletes gain the benefit of shallow workstations, an optional integrated motorized treadmill, and deep-water exercise all in the same pool. For more information on all of SwimEx’s pools, call the company or visit its Web site. Circle No. 523 The 800T from SwimEx offers the freedom of an open workspace. It has an overall depth of 5’ 6” throughout, with a 30-inch deep current flow. This model allows for a variety of non-weight bearing exercises, such as deep-water running and of course swimming. It can also be configured with an integrated treadmill and multiple open depths. Contact SwimEx for more information. Circle No. 524 68

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“The OPTP Pro-Roller is an essential and indispensable part of my practice. For rehabilitation of athletes, non-athletes, and my Pilates clientele, I cannot be without this roller. So many of my posture-correction exercises can be taken to a higher level of difficulty on the roller. It’s no longer a mysterious tool in the fitness field that just lies around the gym. In fact, the roller can help develop balance, postural alignment, and flexibility in the most elite athletes, not to mention its vital role in helping keep muscles relaxed and pliable when it is used as a massage tool. “The density and durability of this roller make it perfect for self-myofascial release and for standing balance activities. Many athletes have postural imbalances from habitual movements, and the Pro-Roller can be used to eliminate these imbalances. Proper postural alignment will undeniably help heighten performance and assist in preventing injury—which is what complete training is all about.” Donna Gambino, PT Certified Pilates Instructor Author of On a Roll @ Home: Home Exercises for Core Strength and Massage on the Foam Roller, and Age Perfected Pilates.

OPTP 3800 Annapolis Ln. #165 Minneapolis, MN 55447 800-367-7393 customerservice@optp.com www.optp.com

“Prior to the 2005 season, a HydroWorx 1000 Series pool was installed in the athletic training room. Frankly, it was better than we anticipated. I don’t think there is anything on the market that’s better. I would enthusiastically recommend the company and the product to anyone looking for a therapy pool.” John Norwig Head Athletic Trainer Pittsburgh Steelers “The HydroWorx pool provided the perfect platform for our players to prepare and recover quickly during such an intense season. Without this valuable facility, we may not have had such a large number of our first team squad available for selection. This has without question contributed to Manchester United successfully retaining the Premiership title and winning the Champions League final.” John Davin Physiotherapist Manchester United F.C. “With our HydroWorx pools, we have greater functionality than we had previously. Now we have the ability to rehab athletes even faster using the integrated treadmill along with the directional resistance jets. The versatility we can achieve with HydroWorx takes our athletic training to a new level.” J. Allen Hardin, PT, MS, PCS, ATC, CSCS Co-Director of Sports Medicine & Athletic Training University of Texas

HydroWorx International, Inc. 1420 Stoneridge Dr., Ste. 1 Middletown, PA 17057 800-753-9633 Fax: 717-902-1933 corporate@hydroworx.com www.hydroworx.com TR AINING-CONDITIONING.COM

ANKLE & FOOT CARE Active Ankle Systems, Inc. 800-800-2896 www.activeankle.com

Cho-Pat 800-221-1601 www.cho-pat.com

The new Volt ankle brace is engineered to include the latest carbon fiber technology. The polypropylene shell is reinforced with carbon fiber—the same high-performance material used in racing cars and bicycles. It also features a molded bearingdesign performance hinge for smoother range of motion, strengthening ribs for a thinner profile, and fabric-backed EVA foam pads for durability and comfort. Call today for more information. Circle No. 525

Developed in cooperation with the Mayo Clinic, the patented Achilles Tendon Strap is widely used by many sports medicine professionals, who recognize it as an effective addition to the traditional treatment procedures for Achilles tendonitis. The strap applies compression to the tensile forces pressuring the tendon and spreads them away to reduce stress. The strap also promotes an early heel rise, which helps reduce the stress placed on the tendon. Circle No. 528

Ankle protection isn’t black and white anymore. With the All-Sport Chameleon from Active Ankle, athletes can choose from eight bright interchangeable strap covers that come with each brace. The solid U-shaped frame ensures maximum strength, and the molded, fabriclined EVA padding provides lightweight comfort. Get great style and the same great protection that has made Active Ankle an industry leader. For more information, visit www.getchameleon.com. Circle No. 526 Antibody, Inc. 877-546-2639 www.antibodywear.com The BodyGuard compression ankle brace is designed to add comfort, stability, and performance enhancement to the sprained ankle. In the uninjured ankle it reduces the incidence of sprains, strains, and impact trauma, while adding stability and performance enhancement. As with all BodyGuards, it provides compression, support, heat circulation to the muscles and tendons, strain distribution, and impact absorption. Circle No. 527

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Cramer Products, Inc. 800-345-2231 www.cramersportsmed.com The Power Lacer ankle brace from Cramer Products features unique Y-shaped vertical stabilization straps to offer unprecedented control over both the forefoot and the heel in a lace-up brace. Total-control lacing allows for an even pull throughout the body of the brace, creating a better fit for a variety of foot shapes. Four spring steel stays (two on each side of the ankle) help support the ankle and prevent heel release by supporting the body of the brace. The circumferential strap helps stabilize the brace, preventing unwanted slippage and providing a comfortable fit. Circle No. 529

The G&W Clearly Adjustable Combination Lift provides up to 18 millimeters of comfortable elevation inside the shoe. The innovative design extends the length of a tapered 12-millimeter heel lift to the metatarsal and adds a full-foot insole lift of up to six millimeters. Elevation can easily be customized for accurate fit by removing and replacing layers of the insole portion, the heel lift, or both. The Clearly Adjustable material will quickly conform to the shape of the shoe for best fit and optimum comfort. This configuration minimizes the slope on which the foot rests and related changes in gait, foot pressure, and Achilles tendon length are reduced. Circle No. 531 Jump Stretch, Inc. 800-344-3539 www.jumpstretch.com “Don’t Ice that Ankle Sprain!” by Jump Stretch founder Dick Hartzell and Dr. Michael Shimmel will introduce you to the FlexBand Ankle & Strengthening Traction Technique, which is designed to reduce pain and swelling and to speed recovery time from ankle injuries. You will never deal with a sprain the same way again. This 85-page book includes a companion DVD, and covers horizontal traction, vertical traction, deferred pain, and more. It also includes testimonials from athletes and healthcare professionals. Circle No. 532

G&W Heel Lift, Inc. 800-235-4387 www.gwheellift.com

Med Spec 800-582-4040 www.medspec.com

The innovative Cluffy Wedge is a welltolerated and cost-effective method for improving foot function and enhancing biomechanical control of a shoe, sandal, OTC insole, or custom orthotic. The Cluffy Wedge controls the foot in late mid-stance and active propulsion. This provides overall foot comfort, as the foot functions in a much more stable position in the late stance and propulsive phases of gait. Circle No. 530

The ASO® EVO™ ankle stabilizer is an evolutionary step forward in ankle protection with its unique stabilizing straps and dynamic cuff. This new design enables the ASO EVO to comfortably provide exceptional ankle support and stability in the treatment of ankle injuries and to reduce the severity and frequency of future ankle injuries. The ASO EVO is bilateral and fits either the left or right foot. Circle No. 533 T&C JULY/AUGUST 2008

ANKLE & FOOT CARE PRO Orthopedic Devices, Inc. 800-523-5611 www.proorthopedic.com The PRO 610 Arizona Ankle Brace is the next evolutionary step in ankle brace technology. This brace features two figure-8 straps designed to fit either the right or left foot. It is constructed of heavy-duty nylon to create a low-profile, durable, and lightweight brace. The figure-8 lift straps encircle the foot to provide lateral and medial support, while the hook-and-loop fasteners allow quick and easy adjustment, even with the shoe on. A neoprene tongue provides a comfortable pad under the laces, eliminating instep irritation. Circle No. 534

Tired of Achilles tendon pain? Pro-Tec Athletics has the answer with the Achilles Tendon Support. This Achilles tendon brace offers comfortable compression to stabilize the tendon and reduce stress. It also features an elastic strap that provides a lift to the heel, preventing excessive stretching of the tendon. Comfortable and effective, the Achilles Tendon Support will help prevent further damage and enhance the healing process, allowing your athletes to get back into competition sooner. Circle No. 537 Stromgren Athletics 800-527-1988 www.stromgren.com

Starting with the popular and very effective 610 Arizona ankle brace, PRO Orthopedic has taken ankle support to a new level. By combining the ankle brace with a nonelastic strapping system that’s anchored on the calf, PRO has created the 611 Ankle Anchor, a very supportive inversionresistant bracing system. Ideal for chronic ankle conditions and high ankle sprains, the Ankle Anchor system is lightweight and machine washable. For more information, please contact PRO. Circle No. 535

The model 329 brace offers complete heel-lock ankle protection without tape, yet it has outstanding compression and moisturemanagement features. A Spandex sock applies comfortable and even compression to the entire foot complex, yet stays cool and dry because of the moisture-wicking properties of the fabric. Permanently attached heel-lock straps help control severe eversion and inversion of the ankle complex. This support fits both the left and right foot and is available in black or white. Contact your local team dealer or sports medicine distributor to learn more. Circle No. 538

Pro-Tec Athletics 800-779-3372 www.injurybegone.com

Swede-O, Inc. 800-525-9339 www.swedeo.com

Pro-Tec Athletics offers Arch Pro-Tec arch supports. These supports provide a slight lift to the arch by applying upward compression, alleviating plantar fasciitis and heel spurs. Targeted support reduces stress to the arch region and alleviates inflammation and tearing of the plantar fascia. Visit the Pro-Tec Web site to learn more about all of the company’s quality products. Circle No. 536

The new and improved Swede-O Strap Lok features a fully adjustable top strap to provide compression and stabilization to the ankle. The non-stretch figure-8 straps simulate a professional taping procedure. The ballistic nylon construction is thin and lightweight, yet very durable. The combination of the exclusive Ankle Lok lacing system and the figure-8 straps provides maximum support to the ankle. This product is competitively

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priced and comes protected by an industry-leading one-year warranty. Circle No. 539 The Tarsal Lok from Swede-O combines the greater support of a rigid brace with the superior comfort of a lace-up ankle brace. The support comes from the patented stabilizer design. The built-in stabilizer will actually mold to the shape of your ankle simply from your body heat for a more conforming and customized fit. The Tarsal Lok is a low-profile unit. It’s easy to apply and fits comfortably in almost any style shoe. Circle No. 540 Mueller Sports Medicine 800-356-9522 www.muellersportsmed.com Mueller Sports Medicine has introduced LifeCare for Her, a revolutionary new line of contoured body supports designed specifically for women. The soft, breathable, latex-free fabrics work with the muscles, providing uniform compression for comfortable all-day wear. The ultra-thin, flexible design doesn’t bind or bunch. It is also lightweight enough to be worn discreetly under clothes. For pain relief from arthritis, tendonitis, swelling, and joint pain, Life Care for Her is available for ankles, knees, elbows, and wrists. Circle No. 541 Mueller TapeWrap is the cohesive, breathable, sweat-resistant alternative to pre-wrap. TapeWrap doesn’t trap moisture so it won’t slip. Your tape job stays tight, and that means more support. Cohesive TapeWrap applies directly to the skin so you don’t need pre-wrap or adhesive spray. Thin, flexible, easy-to-tear TapeWrap will help you perform the most sophisticated taping techniques quickly and accurately. With its flexibility, it conforms to any body part and won’t inhibit the natural movements of the athlete while acting as a fixation bandage for pads or splints. Cold packs, blister care, bleeding— they’re all covered with TapeWrap. Circle No. 542 TR AINING-CONDITIONING.COM

CASE STUDY

Working on a Cure Using its HexPad technology, McDavid is working to prevent youth tragedies. For nearly 40 years, McDavid has been in the business of protecting athletes. Whether it’s the latest in wraps, cups, and athletic supporters, or the newest ankle and knee braces, the goal is always the same—keeping athletes safely on the field. With its innovative HexPad technology taking the market by storm over the past few years, and more recently its Dual Density HexPad, McDavid has developed a technology that provides a layer of protection that moves with the athlete. Athletes who experience body-tobody contact and body-to-ground contact are now making HexPad a regular part of their equipment. Today, McDavid is looking at possible new uses for HexPad, and one of the most interesting involves a piece of equipment that could be used to help prevent commotio cordis. According to a recent University of Maryland sports medicine study, there have been nearly 200 deaths, mostly to young athletes, attributed to commotio cordis over the past 10 years. Commotio cordis is a sudden disturbance of the heart rhythm, usually caused by a blunt, non-penetrating impact to the precordial region (the

McDavid 10305 Argonne Dr. Woodridge, IL 60517 800-237-8254 Fax: 630-783-1270 info@mcdavidinc.com www.mcdavidusa.com TR AINING-CONDITIONING.COM

sternum area), often from a ball, bat, or other projectile. “But it doesn’t have to be from a ball or bat,” says Mike May, Director of Communications for the Sporting Goods Manufacturers Association. “We’ve also heard of cases involving impact with the ground.” Impact is transmitted to the heart muscle, and depending on the timing in relation to the cardiac cycle, it may affect the heart’s electrical activity, resulting in arrhythmia: ectopic beat, ventricular tachycardia, or ventricular fibrillation. “The McDavid Sternum Shirt is a no-brainer for kids playing baseball, and it should probably be required by the governing bodies,” says Danny Mendel, Vice President of North Tampa (Fla.) Pony Baseball. “Not only does it offer tremendous protection from direct blows to the chest, but it also gives the kids tremendous confidence by alleviating their fear of injury and making them feel like a knight going into battle.” When the product team at McDavid put two and two together—this sudden physical condition and the capabilities of new HexPad technology—the company felt it might be able to help. The result is three compression tops that feature either HexPad or Dual Density HexPad in the sternum area. Available tops include the sleeveless Youth Dual Density HexPad Sternum Shirt, the Hexpad Sternum Shirt for both adults and youth, and the long-sleeve Youth HexPad Sternum Raglan Sleeve Top. All three conform and stretch with the body for continuous protection and feature McDavid’s HydraVent moisture-management technology.

Compression shirts like these are highly recommended as standard base-layer equipment for youth baseball, softball, lacrosse, and even soccer players. “From our experience working with professional, collegiate, and recreational athletes, we know HexPad has a proven level of protection that many athletes depend on,” says Ryan Farley, Marketing Coordinator at McDavid. “It’s a natural evolution of this technology to use it to help protect children from commotio cordis.” According to the University of Maryland study, there are four factors that influence the risk of commotio cordis: • Impact directly over the cardiac silhouette (just left of the lower breastbone) • Impact involving a small part of the chest wall (such as from a baseball) • Higher-energy impact • Impact occurring within a specific 10- to 30-millisecond portion of the cardiac cycle Commotio cordis is most prevalent in children—the median age of those stricken is 14.7—because their softer chest wall makes them particularly susceptible. As these shirts are a new product, significant testing will be required before McDavid can claim that this technology can prevent commotio cordis, but the company believes it has taken a significant first step that can help reduce the risk of this fatal condition. In theory, according to the University of Maryland study, a lightweight shoulder pad or chest protector with a hard protective shell and a soft padding undersurface over the front of the chest would spread the force of an impact to the chest wall over a wider surface area, thus reducing the amount of energy transmitted to the heart. This could reduce the risk of commotio cordis.

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MORE PRODUCTS Antibody, Inc. 877-546-2639 www.antibodywear.com Antibody offers the custom-made Double Shoulder Sleeve. It is designed to have a shorter arm on the existing (less severe) injury that covers only the shoulder itself, and a normal longer arm on the new (more severe) injury. It includes an abduction strap for the longer arm, and the compression ratio is increased on the shorter arm to compartmentalize the entire shoulder joint. Circle No. 543 Ball Dynamics International, LLC 800-752-2255 www.fitball.com Incorporate functional resistance into any group exercise with the new FitBALL® MedBalls with straps. These large traditional medicine balls (eight to nine inches in diameter) have an added twist—two strong, adjustable straps allow the user to grip them more easily or perform one-handed “kettle ball” exercises. Add extra challenge to lower-body and core workouts by strapping a MedBall to both ankles for leg raises. MedBalls have a hollow core, they bounce, and they are made with rubber. Each one weighs two to 10 pounds. Circle No. 544 Brace International, Inc. 800-545-1161 www.braceint.com The MAX™, represents a major advancement in the design of shoulder girdle supports. The snugfitting, lightweight material 72

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allows for comfort with movement while protecting the glenohumeral joint from subluxations and dislocations. Its strap design system offers many options for maximal stability where needed, allowing athletes to reach their required range of motion. Circle No. 545 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. 546 California University of Pennsylvania 866-595-6348 www.cup.edu/go California University of Pennsylvania has helped build the character and careers of its students for more than 150 years. Cal U’s dedication to providing highquality, in-demand programs to its students continues through the University’s Global Online 100-percent online programs of study. Through an asynchronous format, Global Online allows students the opportunity to complete coursework anytime, anywhere. All that’s required is a computer with Internet access. Go online for more information. Circle No. 547 Chattanooga Group 800-592-7329 www.chattgroup.com The economical Opti-Ice helps reduce athlete pain and swelling and speed rehabilitation. Its motorized, eight-quartcapacity system provides con-

tinuous, consistent cold therapy for up to seven hours through the patented semi-closed loop system. Opti-Ice has an easy-to-use external console and thermometer to help maintain an accurate, safe water temperature. Instructions are printed on the lid for easy referral, and the fill line is molded inside the cooler for accurate filling. Circle No. 548 The all-new Adapta Mesa and Adapta Summit Hi-Lo treatment platforms from Chattanooga Group look like no other, because they are like no other. With numerous bold colors to choose from, the Adapta iSkin’s antimicrobial molded polyurethane surface is firm enough for hands-on therapy, yet has a gently contoured edge to help keep your athletes comfortable and secure. Six easy-to-reach pedal controls attached to the table make raising and lowering it a snap. Circle No. 549 evoSHIELD 770-725-2724 www.evoshield.com evoSHIELD is the future of sports protection, providing a thin, airactivated molding pad that conforms to each individual’s body and permanently hardens after 20 minutes. Where traditional plastics and foam absorb impact, this padding technology maximizes surface area, forcing impact to disperse across layers. The company’s patented technology is accredited by one of the top sports science labs in the U.S. and is used by numerous professional and collegiate athletes. Circle No. 550

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MORE PRODUCTS NCCPT 800-778-6060 www.NCCPT.com The National Council for Certified Personal Trainers is a company that certifies personal trainers both nationally and internationally. The NCCPT curriculum focuses on preparing students to succeed and excel in the commercial environment. The council offers home-study courses as well as twoday seminars to prepare students to sit for the exam. The NCCPT is currently looking for qualified individuals to instruct those two-day courses. Call, visit www.NCCPT.com, or send e-mail to info@nccpt.com for details. Circle No. 551

product is non-flammable and available only by prescription. It can be purchased through your medical supplier or wholesaler, or directly from Gebauer. Circle No. 553 Informed-Choice 720-289-2401 www.informed-choice.org Informed-Choice is an industry-led approach to supplement testing and certification for the absence of steroids and stimulants. Informed-Choice

screens “registered” products using its ISO17025-accredited tests to ensure dependable results every time. The organization’s mission is to provide athletes, coaches, and advisors with an Informed-Choice with regard to supplements, as part of an approach to risk management. Results of these tests are posted on the Informed-Choice Web site and are updated every month. Circle No. 554

Gebauer Co. 800-321-9348 www.gebauer.com/tc Gebauer’s Instant Ice® non-prescription skin refrigerant can be used like ice for minor pain and swelling from sprains, strains, bruising, contusions, and minor sports injuries. Gebauer’s Instant Ice is ideal for facilities that restrict the use of flammable components. It is available in a mist spray or stream spray aerosol can, and can be purchased directly from Gebauer by calling the company or visiting its Web site. Circle No. 552 Gebauer’s Spray and Stretch® topical anesthetic skin refrigerant replaces Gebauer’s Fluori-Methane, which has been discontinued. Use Gebauer’s Spray and Stretch fine stream spray in conjunction with the spray and stretch technique to effectively manage myofascial pain, restricted motion, trigger points, muscle spasms, and minor sports injuries. The

FEELS LIKE SKIN … ACTS LIKE MUSCLE

Using Stored Elastic Energy Transfer (SEET), BodyGuards are a new generation of performance apparel that work with your body to alleviate muscle strains and pulls, delay fatigue and keep muscles warm while enhancing your performance.

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877 546-BODY (2639) www.AntibodyWear.com Sales@AntibodyWear.com Circle No. 146 T&C JULY/AUGUST 2008

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Active Ankle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Antibody (The BodyGuard) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Aquality Water Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Biofreeze®/Hygenic Performance Health® . . . . . . . . . . . . . . . . . . . . . .7 Brace International (FLUK) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Brace International (MAX) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 California University of Pennsylvania. . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Chattanooga Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Clinton Industries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Concentra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 CoreControl (AVAcore) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Cramer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Dynatronics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC Egg Whites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Ferno Performance Pools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 FitBALL USA (Ball Dynamics) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 G&W Heel Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Gebauer Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 General Tools & Instruments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Hibiclens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 HQ, Inc./CorTemp™. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Hydrate, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 HydroWorx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Informed-Choice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Jump Stretch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Kneebourne Therapeutic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Med Spec . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

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Mueller Sports Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IFC-1 Muscle Milk (CytoSport) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BC NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 NCCPT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 NSCA Certification Commission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 OPTP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Outdoor Boss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Perform Better . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Port-A-Cool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Power Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 PRO Orthopedic Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Pro-Tec Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 ProMera Health (AminoActiv) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 ProMera Health (Con-Cret) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 PROTEAM by Hausmann. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Samson Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Speed to Win . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20-21 Sprint Aquatics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Stromgren Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 Swede-O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 SwimEx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 TerraQuant (Multi Radiance Medical) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 The Polar Pool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 TurfCordz/NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Waterboy Sports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Whitehall Manufacturing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 WissTech Enterprises. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

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Active Ankle (All-Sport Chameleon) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Active Ankle (Volt ankle brace) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Antibody . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Antibody (Double Shoulder Sleeve) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Aquality Water Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AVAcore (CoreControl) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ball Dynamics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Brace International (FLUK) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Brace International (MAX) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C.H.E.K. Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California University of Pennsylvania. . . . . . . . . . . . . . . . . . . . . . . . . . . Chattanooga (Adapta treatment platforms) . . . . . . . . . . . . . . . . . . . . . . . . . . Chattanooga Group (Opti-Ice) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clinton Industries (Laminate Taping Station) . . . . . . . . . . . . . . . . . . . . . . . . Clinton Industries (Wood Taping Station) . . . . . . . . . . . . . . . . . . . . . . . . . . Concentra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cramer (Power Lacer ankle brace) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cramer Products (heat stress prevention) . . . . . . . . . . . . . . . . . . . . . . . . . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . evoSHIELD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ferno (Hydro Track) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ferno (product line) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G&W Heel Lift (Adjustable Combo Lift) . . . . . . . . . . . . . . . . . . . . . . . . . . . . G&W Heel Lift (Cluffy Wedge) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gebauer (Instant Ice) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gebauer (Spray and Stretch) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . General Tools & Instruments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hibiclens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HQ, Inc./CorTemp™. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hydrate, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HydroWorx (5000 Series) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HydroWorx (500i/600i units) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Informed-Choice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jump Stretch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kneebourne (Elite Seat). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lifexpand. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Med Spec . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Med Spec (Patellavator) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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MET-Rx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mueller (LifeCare for Her) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mueller (TapeWrap) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Multi Radiance Medical (LaserStim emitter) . . . . . . . . . . . . . . . . . . . . . . . . Multi Radiance Medical (TQ Solo) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NCCPT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NSCA Certification Commission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Outdoor Boss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Perform Better (Kettlebell Rack) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Perform Better (Plyo-Safe G2 Boxes). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Perform Better (Posture Ball) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Port-A-Cool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Power Systems (VersaDisc Ring) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Power Systems (VersaSteps) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PRO Orthopedic (611 Ankle Anchor) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PRO Orthopedic (PRO 610) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pro-Tec (Achilles Tendon Support). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pro-Tec Athletics (arch supports) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ProMera Health (AminoActiv) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ProMera Health (Con-Cret) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PROTEAM (Hi-Lo Taping Table) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PROTEAM (team logo) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SPRI Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sprint Aquatics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Stromgren (329 Ankle Support) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Stromgren Athletics (Polar Heat) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Swede-O (Strap Lok) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Swede-O (Tarsal Lok) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SwimEx (800T) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SwimEx (900T) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SwimEx (product launch) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Polar Pool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Polar Pool (cryotherapy spa) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Waterboy Sports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Wilson Case (SplitTopXL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Wilson Case (TablePro). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . WissTech Enterprises. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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MORE PRODUCTS Kneebourne Therapeutic 866-756-3706 www.eliteseat.com

Lifexpand 866-399-5433 www.lifexpand.com

Med Spec 800-582-4040 www.medspec.com

The Elite Seat by Kneebourne Therapeutic is a portable knee-extension device designed for the nonoperative treatment of degenerative knee conditions. By evenly distributing force across the leg, the Elite Seat provides effective full-knee hyperextension and reduces pain in bent knees caused by any of these conditions: acute ACL injury; inadequate post-operative rehabilitation after ACL reconstruction; total-knee arthroplasty; arthrofibrosis; deconditioned knee with a flexion contracture; and arthritis. Circle No. 555

Glyc’N Go is a revolutionary new food supplement shown in controlled clinical trials to truly increase levels of nitric oxide and enhance blood flow to exercising musculature. This product also contains the only form of carnitine that is able to shuttle fatty acids into the mitochondria to serve as an energy source. Glyc’N Go is available in tasty chewable tablets, which provide a significantly faster dissolution rate than standard capsules. Circle No. 556

The Patellavator knee orthosis has a unique design that applies variable pressure to the patellar tendon without creating a tourniquet around the leg or irritating the popliteal. This is achieved with an interlocking base strap made of Coolflex material, which is very comfortable and flexes with the knee. It offers a low-profile design that eliminates irritation to the opposite leg. Circle No. 557

800,000 Teeth are Knocked Out Each Year During Sports! Protect Your Athletes!

Club Solutions • Professional Quality Products • Exceptional Customer Service • Special Club Pricing

FitBALL® MedBalls with Strap: • Adjustable straps • Made of rubber - will bounce • Versatile - Use for lower body or one-handed exercises

FitBALL® Sport: • High-quality burst-resistant ball • Extra firm for more balance challenge • Weight-bearing capacity of 1,250 lbs FitBALL Sports are not recommended for heavy weight lifting

We’re More Than Just The #1 Exercise Ball!

Save-A-Tooth gives you time to treat more serious injuries and get athletes to the dentist or emergency room. Call (888) 788-6684 or visit www.Save-A-Tooth.com for more information

Comic by Raina Telgemeier

Call For FREE ‘08 Catalog • 800-752-2255 • www.fitball.com

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FitBALL® Wobble Boards: • 20” or 16” wood construction • Anti-slip surface • Incredible value

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MORE PRODUCTS Perform Better 800-556-7464 www.performbetter.com The new five-foot long Kettlebell Rack from Perform Better holds all sizes of Kettlebells. It is designed to keep your kettlebells off the floor and out of the way, and can store up to 30 kettlebells. A rubber base on the trays protects the kettlebells and reduces noise. This product, sold with a five-year warranty, can be found in the 2008 Perform Better catalog. Circle No. 558 Perform Better presents the new Posture Ball. Its small size helps release muscle tension in hard-

to-reach places. It is great for myofascial release and maintaining body posture. Made of closed-cell EVA foam materials, the Posture Ball is available in six- and eight-inch sizes. Durable and lightweight, it retains its shape after exercise. See the Posture Ball in the 2008 Perform Better catalog—you can request a free copy by calling the company or visiting its Web site. Circle No. 559 Hibiclens 800-843-8497 www.hibigeebies.com Hibiclens antimicrobial antiseptic skin cleanser can be an effective defense against the spread of MRSA and other staph infections. Its active ingredient, four-percent chlorhexidine gluconate, works in a unique way. It kills germs on contact, bonds with the skin, and keeps killing microorganisms for up to six hours. Hibiclens is used

for skin wounds, general skin cleansing, and as a hand wash. Hibiclens is a product of Molnlycke Health Care. Circle No. 560 Multi Radiance Medical 800-373-0955 www.multiradiance.com Multi Radiance Medical has introduced the new FDA-cleared LaserStim emitter for the TerraQuant. The LaserStim is a patented hybrid emitter that combines phototherapy and e-stim in one device. With the LaserStim, powered by Multi Radiance Technology, clinicians can now receive insurance reimbursement for this attended combination modality. The product provides 25,000 mW of super-pulsed laser peak power, resulting in five inches of tissue penetration with no risk of burning tissue. Circle No. 561

TAKE YOUR CAREER

TO NEW

HEIGHTS GLOBAL ONLINE 100% ONLINE MS in Exercise Science & Health Promotion • Four degree tracks - Performance Enhancement & Injury Prevention - Wellness & Fitness - Rehabilitation Science - Sport Psychology

• NASM certifications in PES, CES, and/or CPT

MS in Sport Management Studies • Three degree tracks - Intercollegiate Athletic Administration - Facility and Event Management - Sport Management

BS Program in Wellness and Fitness • NASM Certification in CPT Phone: 1-866-595-6348 or visit: www.cup.edu/go

California University of Pennsylvania Building Character. Building Careers. www.cup.edu A proud member of the Pennsylvania State System of Higher Education.

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MORE PRODUCTS The TQ Solo from Multi Radiance Medical is the only handheld portable device with exclusive Multi Radiance Technology, which synergistically incorporates four proven radiances to provide the ultimate phototherapy environment for relieving pain: a super-pulsed laser, infrared light, red light, and a static magnetic field. With up to 18 hours of battery power, the TQ Soloâ&#x20AC;&#x2122;s pain-relieving power is there when you need it. Circle No. 562

Developed by the NSCA Certification Commission, it is the most preferred preparation text for the Certified Strength and Conditioning Specialist (CSCS) exam. The researchbased approach, extensive exercise technique section, and unbeatable accuracy make it the text readers have come to rely on for CSCS exam preparation. Circle No. 563

NSCA Certification Commission 888-746-2378 www.nsca-cc.org

Power Systems now offers an airfilled balance ring that is more stable than traditional rings. The new donut-shaped VersaDisc Ring has a hole in the center to keep the air inside from shifting,

Now in its third edition, Essentials of Strength Training and Conditioning is one of the most comprehensive references available for strength and conditioning professionals.

Power Systems 800-321-6975 www.power-systems.com

giving users a more stable surface for performing balance-based exercises. The ring measures 14.5 inches in diameter and inflates to four inches high. One side is textured to keep the feet from slipping. Circle No. 564 Combine balance training and motor skill development with VersaSteps from Power Systems. These colorful air-filled steps can be arranged in various stepping patterns and placed face-up or face-down for different challenges. To keep the feet from slipping, one side is textured. A set includes six 6.5-inch (diameter) steps and a carrying bag. For training ideas, the new 55-minute VersaSteps Training DVD, featuring Gay Gasper, offers a variety of drills. Circle No. 565

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 FlexBandsÂŽ 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. 151 1 TRjumpstretch62v0v3.indd AINING-CONDITIONING.COM

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MORE PRODUCTS ProMera Health, LLC 888-878-9058 www.con-cret.com www.aminoactiv.com AminoActiv all-natural pain relief and anti-inflammatory actively repairs strained muscles, joints, and tissue. Composed of unique amino acids, AminoActiv targets the two main sources of pain: inflammation and lactic acid. Pain impacts active lifestyles and most people use ibuprofen, naproxen, aspirin, and analgesic creams that mask pain and are toxic to the kidneys, liver, and stomach. Studies prove AminoActiv is an effective alternative without side effects. Circle No. 566 Con-Cret from ProMera Health is a pure and concentrated creatine supplement that has no other ingredients—no sugars, additives, or stimulants. ConCret’s unique Micro-Dosing formula saturates the muscles, creating dramatic endurance and recovery that leads to strength building. One capsule or 1/4 tsp. per 100 pounds of body weight eliminates any need to preload or cycle off. There are no side effects from taking Con-Cret, and it’s designed for people who are serious about performance. Circle No. 567 PROTEAM by Hausmann 888-428-7626 www.proteamtables.com PROTEAM by Hausmann has introduced the new model A9098 “Back Saver” Crank Hydraulic Hi-Lo Taping Table. This table has a durable crank-based hydraulic system that allows for easy adjustment of the table height from 32 to 42 inches. Your back will thank you. It also features spacious storage for supplies and a heavy-duty 500-pound weight capacity. It comes in natural oak laminate and your choice of 12 PROTEAM vinyl colors. The company Web site also offers a wide selec78

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tion of modular taping stations, treatment tables, cabinets, and lockers. Circle No. 568

Wilson Case 800-322-5493 www.wilsoncase.com

PROTEAM by Hausmann now has the ability to dress up your athletic training room by adding your team logo to your taping station back rests, seats, or table tops. Your team logo can be embossed in multi-colored raised panels that really make your facility “pop,” or you can deboss a monochrome logo into your tables’ upholstery for a more subtle look. To see images of some of the company’s recent work download a PDF at proteamtables.com/ ProteamLogoEmboss.pdf. Circle No. 569

Wilson Case’s new SplitTopXL is a larger version of the company’s popular Athletic Trainer’s SplitTop Case. The SplitTopXL has twice as much inside height as the standard version and comes with six-inch turf tires that can go anywhere with ease and will never go flat. Just like the standard SplitTop case, the SplitTopXL is sold as a base unit with interior options available. Circle No. 572

Save-A-Tooth® 888-788-6684 www.save-a-tooth.com Without proper care, a knocked-out tooth begins to die in 15 minutes. The Save-A-Tooth emergency tooth preserving system utilizes Hank’s Balanced Salt Solution (HBSS) to not only preserve, but also reconstitute many of the degenerated cells. The patented basket and net container are designed to protect tooth root cells. This is the only system that keeps tooth cells alive for up to 24 hours. Circle No. 570 SPRI Products, Inc. 800-222-7774 www.spri.com “I am honored to work with the SPRI team to further develop the sports conditioning category,” says Todd Durkin, Personal Trainer, Athlete Performance Coach, and Owner of Fitness Quest 10 in San Diego. “I love working with a great company that is always striving to bring their customers more. I work with dozens of professional athletes, and I rely on SPRI products to challenge my clients and push them to their limits.” Circle No. 571

Wilson Case’s new TablePro is the ultimate portable treatment station, making it easy to bring the athletic training room to the field. The TablePro comes complete with tape spindles, removable trays, a drawer, and numerous tiltbins. The lid of the case turns into a treatment table with adjustable-height legs and a washable pad. The TablePro is built tough enough to handle the heaviest athletes. Circle No. 573 Clinton Industries, Inc. 800-441-9131 www.clinton-ind.com The Clinton Classic Wood Taping Station features the beauty of real wood in four popular finishes, famous Clinton durable construction, and desirable standard features— like leg extensions that save valuable space and comfortable adjustable back rests. With more than 14 available options, this product is sure to be on every athletic trainer’s wish list. Plus, Clinton’s modular design, available in four depths, allows the units to be configured to fit large or small sports training facilities. Circle No. 574 TR AINING-CONDITIONING.COM

MORE PRODUCTS Clinton’s Style Line Laminate Taping Station is packed with value for large and small athletic training rooms. With easy-clean laminates in 15 standard colors and custom laminates to match your school colors, Clinton’s Style Line Laminate Taping Station can complement any facility. Standard features include leg extensions and adjustable back rests. The units are available with 14 options, four depths, and a modular design allowing multiple stations to be joined in a row. Circle No. 575 Concentra 800-232-3550 www.concentra.com Concentra is currently seeking certified athletic trainers for positions in its onsite occupational health clinics and medical centers. As a leading provider of healthcare to the American workforce, the company operates more than 260 on-site facilities in 39 states and more than 320 medical centers in 41 states. You can earn a competitive salary and enjoy access to a complete benefits package. Visit Concentra online for more details on available positions and to submit your resumé. Circle No. 576

CATALOG SHOWCASE Creative Health Products, Inc. 800-742-4478 www.chponline.com Since 1976, Creative Health Products has been a leading discount supplier of rehabilitation, fitness, exercise, and athletic equipment, as well as health, medical, and fitness testing and measuring products, all available at reduced prices. Creative Health Products offers heart rate monitors; blood pressure testers; pulse oximeters; body fat calipers; scales; strength testers; flexibility testers; stethoscopes; pedometers; exercise bikes; ergometers; stopwatches; fitness books and software; exercise bands; step benches; hand and finger exercisers; heating pads; and more. Circle No. 577 TR AINING-CONDITIONING.COM

TESTIMONIAL

A Leading Choice for Minor Wound Care

A Growing List of Satisfied Customers

In a recent study performed by Oregon State University, StaphAseptic was tested against four strains of MRSA and compared with compounds made with neomycin and polymyxin, and polymyxin and gramicidin. StaphAseptic was the only compound to have genuine “bactericidal” effects against all four MRSA strains. Use StaphAseptic on cuts, scrapes, and abrasions to help prevent skin infections from MRSA, staph, strep, and other germs. StaphAseptic also contains lidocaine for pain relief.

SwimEx is a leading manufacturer of aquatic therapy pools for colleges, professional sports teams, physical therapy clinics, and hospitals. With more than 20 years of experience, SwimEx continues to provide some of the most versatile products in the industry. SwimEx pools offer a wide range of exercise and training options against an adjustable wall of water current, capable of challenging the most experienced swimmers. Pool models are available with a flat-bottom floor or can include workstations and different water depths to allow owners to get the most out of the pool for all their athletes.

Here is a list of some colleges and universities that have chosen StaphAseptic as part of their staph prevention programs: Albright College Austin Peay State University Avila University Belmont University Bethany College Concordia College-Bronxville Elizabethtown College Florida Gulf Coast University Gavilan College Haverford College Howard Community College Iowa State University Kentucky Christian College Limestone College Loyola University of Chicago Lycoming College Mercyhurst College Mid-America Nazarene University Mt. Mercy College Pearl River Community College Pennsylvania State University Pikeville College Santa Rosa Junior College Siena College Simpson College Southern Oregon University Southern Union State Community College Union University University of Pittsburgh Western Illinois University Wright State University

Tec Laboratories, Inc. 7100 Tec Labs Way S.W. Albany, OR 97321 888-MRSA-HELP Fax: 541-926-0218 info@teclabsinc.com www.teclabsinc.com www.staphaseptic.com

Here are just some of the customers using SwimEx pools: St. Louis University Montreal Canadiens New York Yankees U.S. Ski and Snowboard Association University of Puerto Rico Olympic Training Center Florida A&M University Boston University Boston College Phillips Exeter Academy New England Patriots U.S. Naval, Military, and Air Force Academies Utah Jazz Cleveland Cavaliers University of Maryland Michigan State University University of Colorado Los Angeles Lakers Kean University Texas A&M University Iowa State University Oregon State University University of Oklahoma Pittsburgh Pirates Boston Red Sox

SwimEx, Inc. 846 Airport Rd. Fall River, MA 02720 800-877-7946 Fax: 508-675-0525 info@swimex.com www.swimex.com T&C JULY/AUGUST 2008

CEU QUIZ

T&C July/August 2008 Volume XVIII, No. 5

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 82) that represents the best answer for each of the questions below. Complete the form at the bottom of page 82, include a $25 payment to MAG, Inc., and mail it by September 30, 2008 to the following address: MAG, Inc., ATTN: T&C 18.5 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 within 30 days. Bulletin Board (pages 6-8) Objective: Find summaries of the latest sports medicine news, research, and published studies. 1. What is the newest ACL reconstruction technique called? a) Single-bundle. b) Double-bundle. c) Tertiary bundle. d) Cross bundle. 2. The new technique prevents abnormal: a) Front to back motion and lateral movement. b) Front to back motion and rotational movement. c) Hyperextension and lateral movement. d) Hyperextension and posterior translation. 3. According to a new study, how does green tea protect the body? a) By raising the level of glutathione. b) By lowering the level of glucosamine. c) By lowering the level of glutathione. d) By decreasing the blood levels of polyphenols.

Golden Years (pages 15-19) Objective: Learn how to shift your approach to training masters athletes in their senior years. 4. How do you define a masters athlete? a) Over the age of 62 and excels at a sport. b) No longer competing at their prime, but engaged in a systematic training program. c) A high-level athlete and ranked in his or her sport. d) A geriatric athlete participating in exercise. 5. Progression is very important but: a) Not for masters athletes. b) A boring approach. c) Is often ignored. d) Can be sped up for masters athletes. 6. Recoverability is described as: a) What you do and when you do it. b) A technique to avoid boredom. c) Training for the sport you participate in. d) The athleteâ&#x20AC;&#x2122;s ability to recover from the stress of a workout. 7. What is specificity in the context of this article? a) What you do and when you do it. b) A technique to avoid boredom. c) Training for the sport you participate in. d) The athleteâ&#x20AC;&#x2122;s ability to recover from the stress of a workout.

T&C JULY/AUGUST 2008

Facing the Heat (pages 22-27) Objective: Get advice from athletic trainers on creating and implementing an effective policy for minimizing heat-related illnesses. 8. The article indicates football players that have died during preseason practices have all died: a) Within the first three days of preseason. b) After the second week of preseason. c) The first day of the regular season. d) In September. 9. Most heat related policies utilize a: a) Weather station heat index. b) UV Index. c) Time of day restriction. d) Wet bulb or wet bulb globe reading.

Back in Trouble (pages 29-35) Objective: Learn what spondylolysis is, how it may be affecting your athletes, and the best ways to treat it. 10. What is spondylolysis? a) Fracture of the pars interarticularis with slippage. b) Lateral curvature of the spine. c) Defect in the spine. d) Posterior rotation of the sacroiliac joint. 11. Spondylolisthesis is a: a) Fracture that weakens a vertebra so much it shifts out of place. b) Defect in the pars interarticularis with curvature of the spine. c) Lateral curvature of the spine that weakens it. d) Posterior rotation of the sacroiliac joint. 12. This article indicates that occasionally a specific type of radiology called what is used for a clearer picture of the lumbar region? a) SPECT. b) MET. c) MRI. d) US. 13. Spondylolysis treatment interventions may include: a) A lumbar compression wrap. b) Extension exercises. c) Manipulations. d) Thoracolumbosacral orthosis.

TR AINING-CONDITIONING.COM

14. Rehabilitation and prevention of spondylolysis should include: a) Training to maintain a neutral spine during exercise. b) Hamstring flexibility exercises. c) Prone press ups. d) Attaining the correct hamstring to quadriceps ratio.

Mind Over Menu (pages 37-44) Objective: Learn how to address the psychological side of eating with your student-athletes. 15. What are food trajectories? a) Feelings, connections, and ideas that influence our food choices. b) Foods that are unhealthy and lack nutrient content. c) Items found in vending machines. d) Foods that have a physiological connection to a nutrient deficit. 16. One of the best ways to help an athlete realize what may be compromising their nutritional goals is to: a) Verbally discuss nutrition with the athlete. b) Keep track of what they eat and how they feel while eating. c) Film the athlete during meals. d) Follow the athlete for 24 hours. 17. One way to address eating perfectionism is to: a) Address the issue of perfectionism head-on. b) Provide the athlete with a specific body fat percentage goal. c) Discuss a balanced diet. d) Create a detailed eating list. 18. To correct ingrained misinformation, one may begin by: a) Analyzing peer pressure. b) Limiting temptations. c) Providing cookbooks to athletes. d) Analyzing how their nutrition is affecting them. 19. What is an example of a warning sign an athlete may have an eating disorder? a) Highly variable performance. b) Not showing up for practice. c) Superior athletic performance. d) Happy and content demeanor.

Arm Forces (pages 46-51) Objective: See how two strength and conditioning experts prepare pitchers for the tough demands of their repetitive job. 20. One study on professional baseball players found an average external rotation of: a) 90 degrees. b) 100 degrees. c) 129 degrees. d) 140 degrees. 21. The same study found an average internal rotation of: a) 61 degrees. b) 90 degrees. c) 129 degrees. d) 140 degrees. 22. One study found angular velocity at the shoulder joint to be greater than: a) 3,000 degrees per second. b) 5,000 degrees per second. c) 7,000 degrees per second. d) 9,000 degrees per second. 23. The authors conclude that what exercise is superior because it is able to strengthen the supraspinatus while minimizing superior shear force due to deltoid activity? a) Prone full can. b) Empty can. c) Full can. d) Serratus punch. 24. The authors report the greatest infraspinatus and teres minor activation with: a) Side-lying external rotation. b) Standing external rotation at zero degrees of abduction. c) Standing external rotation at forty-five degrees in the scapular plane. d) Prone external rotation at ninety degrees of abduction. 25. What is a good starting point of abduction for prone full can exercises? a) 80 degrees. b) 90 degrees. c) 120 degrees. d) 150 degrees.

Answer sheet is on page 82 TR AINING-CONDITIONING.COM

T&C JULY/AUGUST 2008

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 $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 18.5 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850, no later than September 30, 2008. 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 within 30 days.

Bulletin Board

1. 2. 3.

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Golden Years

4. 5. 6. 7.

Facing the Heat

8. 9.

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Back in Trouble

10. 11. 12.

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13. 14.

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Mind Over Menu

15. 16. 17. 18. 19. Arm Forces

20. 21. 22. 23. 24. 25.

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

❏ $25 check or money order (U.S. Funds only) payable to: MAG, Inc. (please note “T&C 18.5 Quiz” on check) ❏ Visa

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T&C JULY/AUGUST 2008

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WEB NEWS Rehab and Fitness Equipment Showcased Online

Try a SwimEx Pool for Yourself Before Buying

Over the past 15 years, Contemporary Design Co. has worked tirelessly to design, manufacture, and market state-of-the-art rehabilitation and fitness equipment. The company’s Shuttle Systems machines are recognized worldwide for excellence in quality, versatility, and applicability to a diverse population of users. Visit the company online to see its wide array of products. The site features extensive product information, with specs and detailed photos, plus customer testimonials, downloadable manuals and brochures, videos, and more. There’s even a dealer locator and company contact info for when you want to learn more about any Shuttle Systems product.

The SwimEx Web site provides you with all the information you need to make an educated aquatic therapy purchase. You can view exciting videos of the company’s therapy pools in use, and read detailed descriptions of the features and benefits of each model. There’s even a page describing how a SwimEx pool can pay for itself, making it a great investment for any athletic facility. SwimEx wants you to make an informed purchase, so the site also offers information on the “Try, Buy, and Travel Free” offer: Visit the company’s showroom in Massachusetts, try out a pool, and if you buy within six months, SwimEx will deduct the cost of your airfare (up to $500) from your order. Go online to learn more.

www.shuttlesystems.com

www.swimex.com

Dive In to Extensive Aquatic Therapy Information HydroWorx believes it is important to educate consumers on the incredible benefits of aquatic therapy, and the HydroWorx Web site reflects this aim. Not only can customers and consumers discover the specific details of all HydroWorx products, but they can also read incredible stories of recovery and exercise involving the company’s pools. Moreover, the site’s Instructional Video Library provides nearly 100 intimate case study videos from around the country, showing new ideas and techniques in aquatic therapy. The main goal of the HydroWorx site is to inform current and future customers and the community about how therapy in a HydroWorx pool dramatically improves health and fitness.

www.hydroworx.com

Quench Your Thirst for Knowledge at Waterboy’s Site Waterboy Sports is an industry leader in sports hydration products, and the company’s Web site is full of information on a wide selection of quality drinking systems. Easy-to-use animated menus take you through the company’s product selection, highlighting the features of each unit, and there’s no guesswork when it comes to the price—it’s shown right below every product. You can also view accessories on the site, read a company history, and download an order form and product assembly instructions.

www.waterboysports.com

Stabilize Chronic Shoulder Dislocators, Separators, and Subluxators

Athletic Trainer

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

We are currently seeking athletic trainers for positions in our on-site occupational health clinics and free-standing medical center locations. As the leading provider of health care to America’s workforce, we operate more than 260 on-sites in 39 states and more than 320 medical centers in 41 states. We offer: Competitive salaries based on previous experience Access to a complete beneﬁts package for all colleagues regularly scheduled to work 30 hours or more on a weekly basis

We highly recommend its use for all sports.

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800-545-1161 Toll Free - www.braceint.com Circle No. 152 Circle No. 153 TR AINING-CONDITIONING.COM

T&C JULY/AUGUST 2008 Untitled-2 1

7/9/08 4:46:18 PM

OVERTIME

Next Stop: Web Site Our editorial continues on www.Training-Conditioning.com Here is a sampling of what’s posted right now:

WEEKLY BLOGS Jumping for Joy

MONTHLY FEATURES The Heat Is On

At Wayzata High School in Plymouth, Minn., Jordan Helgren, a three-time Minnesota girls’ state champion triple jumper, dislocated her patella three weeks before the 2008 state track and field meet. Ryan Johnson, CSCS, Coach Practitioner and Strength and Conditioning Coach at Wayzata, blogs about the team effort that got Helgren back on track and able to successfully defend her title.

The dog days of summer are officially upon us, which means athletic trainers need to be proactive about keeping their athletes safe from heat illness. As a supplement to this issue’s cover story, the August Monthly Feature will provide the most updated research and other useful resources for winning the battle against heat illness.

Supplement and Nutrition Notes Contributor Dave Ellis, RD, CSCS, a sports nutrition and recovery professional, provides a list of recent links to important health and nutrition news and studies from across the country.

T&C talks to Dave “DC” Colt, MSEd, LAT, ATC, Head Athletic Trainer at Northwest Missouri State University, about his induction into the NATA Hall of Fame. Colt shares his thoughts on his most recent honor and how the profession has changed during his 27 years in and on the field.

www.training-conditioning.com/features.html AP PHOTOS| PHIL COALE

www.training-conditioning.com/blogs.html

Q&A with Dave “DC” Colt

Florida State offensive lineman Tyler Graves cools off during a preseason practice. Check out the August monthly feature for bonus coverage on preventing heat illness.

WWW.TRAINING-CONDITIONING.COM

Soft-Tissue Oscillation Therapy Hear What They’re Saying. . . . We notice immediate reductions in acute edema and joint stiﬀness.

“My athletes love the X5 unit. It is user friendly and allows us to treat both acute and chronic injuries athletes with the dual channels is vital during preand post-practice treatments. You can actually see immediate results following treatment and more importantly, my athletes notice the diﬀerence.” David Gable, MS, ATC, LAT, CSCS Associate Director of Sports Medicine Head Football Athletic Trainer Texas Christian University

positive. Our athletes are impressed by the immediate decrease in joint stiﬀness after treatment of an acute injury.” Mike Cembellin, ATC Director of Sports Medicine Santa Clara University

my patients. I typically do not use modalities with my patients. However, after trying the X5 for a few weeks, I was convinced that it would become a permanent part of my treatment plan. Most patients feel the pain immediately after improvements v in motion and pai improvements are built upon each session. I’m glad that I added this to my bag of tricks.” tric Mike Dixey PT, T Ce rt. MDT, MDT NASM-PES, CSCS Cert. Clinic Direc Director r tor Ortho Rehab R Specialists Specialists, Inc. Eden Prairie, MN

Feeling is Believing! Call Dynatronics for a Free Demo

800-874-6251 THE TM

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IN HERE IT’S ABOUT RESULTS. YEAH, WE ARE TOO. You expect it from your equipment manufacturer, your uniform provider and everything else that goes into making your athletic program a success. So why compromise on your nutrition? Don’t settle for imitations or pretenders. Give them Muscle Milk® Collegiate.

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