Training & Conditioning 19.6 by Momentummedia

September 2009 Vol. XIX, No. 6, $7.00

Examining Sports Drinks Eastern Sports Medicine Philosophy

Complex Forces The mechanics of shoulder function and dysfunction

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September 2009, Vol. XIX, No. 6

contents 39

31 Bulletin Boards 5 NCAA recommends sickle cell trait testing … Study explores female hormone cycle and joint laxity … Warning about doping with nitrites … Helping a school in financial need.

Q&A Tony Cox Henry County (Ind.) Sports Medicine

Sponsored Pages 21 Fitness Anywhere 37 Balanced Body 50 Life Fitness Product News 52 Nutrition Products 55 New Products 56 Leg Strengthening 61 Pilates Equipment 62 More Products

58 Advertisers Directory CEU Quiz 65 For NATA and NSCA Members

68 Next Stop: Web Site Cover Photo ©Getty Images. TR AINING-CONDITIONING.COM

Nutrition

13 From low cal to high sodium, today’s sports drink market is more Fluid Dynamics

diverse than ever. Are you prepared to help athletes navigate the sea of options and find the best product for their individual needs? By Michelle Rockwell Treating the Athlete

Forces 22 Complex A comprehensive shoulder training program can address key

deficiencies and provide targeted treatment for a wide range of dysfunctions. By B.J. Baker Optimum Performance

Alternate Route 31 An If traditional training methods leave your teams wanting more, maybe it’s time to consider another approach. At Northwestern University, some athletes look to Eastern sports medicine philosophy to gain an edge. By Darryl Aiken-Afam Leadership

the Right Place 39 In At the University of Vermont, athletic trainers are hired and overseen

by the campus health center, not the athletic department. Here’s an inside look at this organizational trend and the many benefits it offers. By Allison Shepherd Sport Specific

45 The University of Louisville women’s basketball team sees its On the Way Up

conditioning program as a pyramid. After developing a strong foundation, they keep working until they reach the top. By Teena Murray T&C september 2009

Editorial Board 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

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

Cynthia “Sam” Booth, ATC, PhD Manager, Outpatient Therapy and Sportsmedicine, MeritCare Health System Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center Cindy Chang, MD Head Team Physician, University of California-Berkeley Dan Cipriani, PhD, PT Assistant Professor Dept. of Exercise and Nutritional Sciences, San Diego State Univ. Gray Cook, MSPT, OCS, CSCS Clinic Director Orthopedic & Sports Phys. Ther. Dunn, Cook, and Assoc. Keith D’Amelio, ATC, PES, CSCS Head Strength & Conditioning Coach/ Assistant Athletic Trainer, Toronto Raptors Bernie DePalma, MEd, PT, ATC Head Athl. Trainer/Phys. Therapist, Cornell University Lori Dewald, EdD, ATC, CHES Health Education Program Director, Salisbury University Jeff Dilts, Director, Business Development & Marketing, National Academy of Sports Medicine David Ellis, RD, LMNT, CSCS Sports Alliance, Inc. Boyd Epley, MEd, CSCS Director of Coaching Performance, National Strength & Conditioning Association Peter Friesen, ATC, NSCA-CPT, CSCS, CAT, Head Ath. Trainer/ Cond. Coach, Carolina Hurricanes Lance Fujiwara, MEd, ATC, EMT Director of Sports Medicine, Virginia Military Institute Vern Gambetta, MA, President, Gambetta Sports Training Systems P.J. Gardner, MS, ATC, CSCS, PES, Athletic Trainer, Colorado Sports & Spine Centers

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T&C SEPTEMBER 2009

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 Co-Director of Athletic Training/Sports Medicine, Intercollegiate Athletics, University of Texas

September 2009 Vol. XIX, No. 6

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

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

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

Art Direction Message Brand Advertising Production Staff Maria Bise, Director Jim Harper, Neal Betts, Natalie Couch

Michael Merk, MEd, CSCS Director of Health & Fitness, YMCA of Greater Cleveland Jenny Moshak, MS, ATC, CSCS Asst. A.D. for Sports Medicine, University of Tennessee

Business Manager Pennie Small Special Projects Dave Wohlhueter

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

Administrative Assistant Sharon Barbell

Mike Nitka, MS, CSCS Director of Human Performance, Muskego (Wis.) 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. 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

Advertising Sales Associates Diedra Harkenrider (607) 257-6970, ext. 24 Pat Wertman (607) 257-6970, ext. 21 T&C editorial/business offices: 31 Dutch Mill Road Ithaca, NY 14850 (607) 257-6970 Fax: (607) 257-7328 info@MomentumMedia.com Training & Conditioning (ISSN 1058-3548) is published monthly except in January and February, May and June, and July and August, which are bimonthly issues, for a total of nine times a year, by MAG, Inc., 31 Dutch Mill Rd., Ithaca, NY 14850. T&C is distributed without charge to qualified professionals involved with competitive athletes. The subscription rate is $24 for one year and $48 for two years in the United States, and $30 for one year and $60 for two years in Canada. The single copy price is $7. Copyright© 2009 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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Bulletin

Board NCAA Recommends Sickle Cell Testing—Is a Mandate On the Way? In June, the NCAA released a new recommendation calling on member schools that don’t already test athletes for sickle cell trait to begin doing so. And if the association adopts proposed legislation, that testing could soon become mandatory. The recommendation was handed down by the NCAA’s Committee on Competitive Safeguards and Medical Aspects of Sports, and follows similar calls for more testing from the NATA and the College of American Pathologists. To help programs understand sickle cell trait and the danger it poses to athletes, the NCAA will also produce a video about the condition, which will be posted online and made available to all member institutions. “The recommendation will help because it gives us a very important point of information,” Scott Anderson, ATC, Head Athletic Trainer at the University of Oklahoma and co-chair of the NATA’s sickle cell task force, told the Orlando Sentinel. “Certainly from my perspective and my role in raising awareness toward sickle cell trait in the athlete, it makes absolute sense that we would have this [recommendation].” While the NCAA hopes its latest step will spur more schools to begin testing voluntarily (a recent NATA survey found that 36 percent of Division I Football Bowl Subdivision members still don’t test), a proposal from Rice University is aiming to force their hand. Rice will soon introduce legislation that would make testing mandatory for NCAA institutions, and it could be voted on as early as next year. Both the NCAA’s recommendation and Rice’s forthcoming proposal are part of the settlement in a wrongful death lawsuit brought by the family of Rice football player Dale Lloyd II, who died in Sept. 2006 following a team workout. The medical examiner’s report linked Lloyd’s death to sickle cell trait, which Rice did not test for at the time. Sickle cell trait testing is inexpensive—typically around $5 for an initial test and $35 for a confirmation. Athletes found to have the condition can still participate in any sport, but extra safeguards are recommended, such as special emphasis on hydration, progressive acclimatization, and adequate rest and recovery between bouts of effort. The NATA released a consensus statement on sickle cell trait in 2007, identifying it as the third-leading cause of nontraumatic sports deaths in high school and college athletes. To download the NATA’s sickle cell trait consensus statement, which contains information and advice on managing the condition, go to: www.nata.org/statements/consensus/sicklecell.pdf. TR AINING-CONDITIONING.COM

Menstrual Cycle Affects Knee Joint Laxity A recent study from kinesiology researchers at the University of Calgary found that a relationship does exist between a woman’s monthly hormone cycle and the laxity of her knee joints. However, this laxity occurs at different points in the cycle for different women, which may be why earlier research found little evidence of such a link. In the study, published as a series of papers in the British Journal of Sports Medicine and the American Journal of Sports Medicine, 26 women were monitored through the entire course of their monthly cycles. At each phase, the women performed a battery of athletic movements, such as quick jumps and sharp cuts. The researchers found that 14 subjects exhibited the greatest amount of laxity during ovulation, 10 showed it during the follicular phase (the roughly eight days immediately before ovulation), and two others had laxest joints in the luteal phase (the roughly 11 days immediately after ovulation). Based on these results, the researchers concluded there is a direct (though inconsistent) relationship between increased knee laxity and hormonal phase, suggesting that women are at greater risk for knee injuries at certain times during their monthly cycle. “What this shows us is that the connection between the hormonal cycle and knee laxity is not a cookie-cutter relationship,” Darren Stefanyshyn, PhD, Professor of Kinesiology at Calgary and one of the study’s lead authors, said in a statement. “Individuals have significant differences and I think that finding out why these differences occur could go a long way to helping athletes understand if they are more at risk and perhaps designing interventions to help prevent injury.”

A New Warning About Nitrite Doping Sports medicine professionals can add yet another drug to the list of potentially harmful performance-enhancing substances. Designed to treat heart and blood disorders, nitrites are also found in prescription drugs that treat erectile dysfunction, and according to several recent reports, they are fast gaining favor in the sports world as a performance enhancer. Currently, nitrites are not on the list of substances banned by the NCAA or any international athletic governing body, so they aren’t looked for in doping tests. But Declan Naughton, PhD, Professor of Biomolecular Sciences at Kingston University in England, warns that nitrite use—which some athletes believe improves blood flow to muscles during activity—could prove dangerous and even fatal. “Nitrite has enormous potential as a treatment for diseases characterized by inadequate blood supply, but if taken T&C september 2009

Bulletin

Board in supplement form without clinical supervision, nitrite may lead to a number of serious side effects, including cardiovascular collapse, coma, convulsions, and death,” Naughton told attendees during a May conference at Kingston called The Dark Side of Sport: Chemical Enhancement of Athletic Performance. “Based on current research on the levels of abuse of performance enhancing drugs by athletes, the future uptake of this drug by the athletic community is of real concern.” Andrea Petroczi, PhD, a public health researcher at Kingston, backed up Naughton’s concerns about athletes using nitrites. She recently examined the UK Sport Drug Information Database, a system that gives athletes, coaches, and team physicians access to information on pharmaceutical use, and found that in the months leading up to the 2008 Beijing Olympics, checks on medication for erectile dysfunction nearly doubled compared to the previous two years. The take-home message from this latest warning is simple: Athletes should be cautioned about the dangers of seeking performance enhancement through pharmaceuticals. In addition, they should be reminded that just because a substance is not banned by their sport’s governing body, that does not mean it’s safe for unsupervised experimentation.

Sports Med Group Returning Fees, Working Pro Bono In these tough economic times, many schools could use a helping hand. That’s exactly what Delaware Valley High School in Philadelphia recently received from the group that provides its athletic training coverage. Recognizing that the school is facing financial troubles, Orthopedic Associates of the Greater Lehigh Valley, based in Phillipsburg, N.J., and Easton, Pa., decided to work for free. In addition to waiving its coverage fee for the upcoming year, Orthopedic Associates also donated $6,000 to the school—a figure that represents what Delaware Valley had paid for services during the 2008-09 school year. Nicholas Avallone, MD, an orthopedic surgeon at the clinic who provides game coverage to the school’s football team, presented a check to the Delaware Valley school board in June. Avallone, who played football at Princeton University, told the Hunterdon County Democrat that when schools are struggling to pay their bills, he considers pro bono work to be part of his duty to the community. “Taking care of the kids is a top priority for us as physicians,” he said. “We’re fortunate to be a busy practice and can give back to the community we’re serving. I enjoy doing this very much … It’s a passion of mine to take care of athletes.” n

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Q&A Tony Cox

Henry County (Ind.) Sports Medicine For more than 20 years, Tony Cox, MA, ATC, LAT, loved his job at Ball State University. As an instructor in the School of Physical Education, Sport, and Exercise Science, he’d taught hundreds of athletic training education students. As Head Men’s Basketball Athletic Trainer, he’d built great working relationships with five head coaches, helped the team reach the NCAA Division I tournament, and traveled as far as Alaska and Hawai’i. But in the fall of 2006, Cox decided to make a change. He found it increasingly difficult to work with new Head Coach Ronny Thompson, who had been hired six months earlier. So Cox left Ball State, retiring at 55 as an Associate Athletic Trainer Emeritus, and moved to the clinical setting at Henry County Sports Medicine in New Castle, Ind., an affiliate of Henry County Memorial Hospital. As the Director of Performance Enhancement and Athletic Training Programs at Henry County, today Cox enjoys the new challenges of working with athletes as young as 13. Along with training athletes in the clinic’s performance gym, he provides coverage for basketball and volleyball games at Winchester (Ind.) Community High School. He’s also spending more time with his family, including his son, Kyle, who is pursuing a career as a basketball coach after playing on the Ball State team during Cox’s tenure, and his daughter, Caitlin, a sophomore volleyball player at Indiana University. In 2004, the Indiana Athletic Trainers Association named Cox Collegiate Athletic Trainer of the Year, and earlier this year he was honored as a Mid-American Conference Athletic Trainer Emeritus. In this interview, Cox talks about leaving Ball State, the transition to clinical work, and new trends in performance enhancement. T&C: What does your current job entail? Cox: As the Director of Performance Enhancement and Athletic Training Programs, I oversee a staff of two athletic trainers. During the school year, we provide game coverage to five local high schools. Year-round, we offer injury evaluation, rehabilitation, and performance enhancement, primarily for student-athletes but also for older folks who want to stay active. We work with some of the best athletes in East Central Indiana, ranging from 13 to 22 years old. When I first came 8

T&C SEPTEMBER 2009

Former longtime Ball State athletic trainer Tony Cox now works at a private clinic, where he helps athletes in their teens and early 20s improve balance, flexibility, and strength. here, most kids were doing performance enhancement in the summer only, and they wanted to know, “Do I have to stop when school starts?” The answer, of course, is no, so now we’re working with them all the time, which is a big improvement. How was the transition from college to clinic? I’ve really enjoyed it. I’ve watched this clinic grow over the last 15 years, and a lot of the athletic trainers who’ve worked here were students of mine at Ball State, so I knew I would fit in. Before I came here, I thought that working with 13-yearolds would be very different from working with college student-athletes, but it’s not. The kids who seek performance enhancement here want to be just like the student-athletes I worked with at Ball State. So I nurture them, instill a work ethic, and focus them on their goals. I find that I get a really good effort without much prodding. Where are you achieving the most success in performance enhancement? Basketball and volleyball are huge in East Central Indiana, so when kids first come here, they’re usually hoping to jump higher. They also say they want to get stronger. So we focus on those two areas, but really, we’re working to develop good, functional movement. If they can’t move their bodies correctTR AINING-CONDITIONING.COM

Q&A ly, making them stronger isn’t going to help them much. We incorporate a lot of core strength, hip movement, and flexibility work. Once those areas have been developed, their jumping improves because they can use their hips to incorporate more power—they’re not just jumping with their legs. The word I’m getting from their coaches is that their movements are quicker and their jumps are higher. And because they’re moving more effectively through the different planes of the body, they’re not getting injured as often. To me, that’s success. My first few weeks at the clinic, I did more observing and studying than anything else. I wanted to discover how these kids moved, and what their strengths and weaknesses were. I realized a lot of them hadn’t worked on balance, so we focus on that. I tell them that if their feet aren’t in good balance, that deficiency transfers up to their shins, knees, hips, and lower back. I also explain that if they don’t work on balance now, they may face problems later on. Because of my years at Ball State, I can foresee the stresses and strains these kids are going to encounter once they get to college. When they get to that next level, we want them to be ready. Was it hard to leave Ball State? I was miserable about it. I’d graduated from Ball State and been there my whole professional life. But I felt I was fighting a losing battle with Coach Thompson, and I was get-

ting no assistance from my administration on the issue. So I thought, “I’m going to move on.” For 23 years, I taught athletic training students how to deal with difficult coaches, but I couldn’t solve the problems that arose in this situation. Athletic training has come a long way over the years, and we deserve to be respected, because we’ve become an integral part of coaches’ success. But if coaches don’t understand that, it’s tough. The relationship between a coach and an athletic trainer is like a marriage—you give and take. But if a coach doesn’t

“For 23 years, I taught athletic training students how to deal with difficult coaches, but I couldn’t solve the problems that arose in this situation. We deserve to be respected ... But if coaches don’t understand that, it’s tough.” want you to be a part of what he’s doing, there’s not much you can do. I really wanted it to work out, but it didn’t. I was fortunate to work with five coaches—Al Brown, Rick Majerus, Dick Hunsaker, Ray McCallum, and Tim Buckley—who welcomed me into their lives, both as a friend and a teammate. They let me do my job, and I’m still close with all of them. But no matter how hard I worked, Ronny Thompson didn’t seem to want any part of me. So when this opportu-

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Q&A nity came up at the clinic, I decided it was time to start a new chapter of my life. I retired from Ball State, which named me a Ball State University Omega—that’s the most prestigious honor the school can give you—and became an Associate Athletic Trainer Emeritus. That was a good feeling. And after Ronny

“It’s about more than treating an injury. It’s about helping athletes become better people, because the way they deal with a setback has a lot to do with how they’ll overcome other difficulties down the road.” Thompson resigned the following summer, the new basketball coach, Billy Taylor, invited me to meet with him. He said, “I know what you meant to this program for all those years, and I want you to always feel welcome here.” I thought that was extremely classy. What were the highlights of your 23 years at Ball State? Watching the men’s basketball team beat UCLA and Kansas in 2001 and getting publicity as “giant killers.” Going to bowl games with our football team and to the NCAA tournament with our women’s volleyball team were really

T&C SEPTEMBER 2009

gratifying, too, and I still have pictures in my office of all those things. There’s nothing better than being part of something bigger than yourself, and when I look back on those years that were so successful, two things were always present: Everybody got along, and apart from some bumps and bruises, everybody stayed injury free. We worked hard, and when all was said and done, there was this wonderful sense of camaraderie. What’s the best part of being an athletic trainer? Fulfillment. Every time you work with an athlete, you know you’re touching his or her life. It’s about more than treating an injury. It’s about helping athletes become better people, because the way they deal with a setback has a lot to do with how they’ll overcome other difficulties down the road. Someday, they’ll call to say, “I just got my first job,” and you’ll know you made a difference, because they still want you in their lives. When I left Ball State, I found out I had touched a lot of people, and I felt I’d done my job. What’s the hardest part of being an athletic trainer? Being away from family. I was fortunate that the coaches I worked with always welcomed my family, and my two kids were always involved in my life as an athletic trainer. But I was not able to spend as much time with them as I

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Q&A would have liked. My son was one of the better basketball players in the state of Indiana—he’s still in the national high school record book for career free-throw percentage—and my daughter was volleyball player of the year in Indiana. Growing up, they understood when I couldn’t go to their games, but that didn’t make it any easier. Now I have more time. When I came here to the clinic, I had Thanksgiving with my family for the first time in 23 years. What do you miss about working at Ball State? I miss rolling up my sleeves and treating student-athletes three or four times a day. I miss traveling with the team, developing relationships, and sharing a common goal. And I miss the feeling I used to get in my stomach leading up to the tip-off. One of my former students is the Head Men’s Basketball Athletic Trainer for the University of Kansas, so when the team came to Indianapolis, he invited me to attend a closed practice. He was paying me back, just like I try to

“Growing up, [my kids] understood when I couldn’t go to their games, but that didn’t make it any easier. Now I have more time. When I came here to the clinic, I had Thanksgiving with my family for the first time in 23 years.” pay back my mentors, and you wouldn’t believe how appreciative I was. I got that feeling in my stomach as game time approached—my heart was racing, because I felt I was part of it. I really miss that. Being a collegiate athletic trainer was off-the-charts wonderful, both personally and professionally. But I enjoy very much what I’m doing now. I have the best of both worlds here, because I can continue working as an athletic trainer while still having some time at home. Do you ever talk to your daughter about the care she gets from the athletic trainers at Indiana? Yes, we talk a lot. She’s working with Adam Clemens, who’s a great athletic trainer, and Josh Eidson, who’s a great strength coach. When she talks about what they’re doing to make her a better player, I hear the appreciation in her voice. I met Adam and Josh when we were there on a recruiting visit, and as a parent, I felt very comfortable leaving my daughter in their hands. On the drive back home, I told my wife, “She’s going to be very well taken care of.” Before going to Ball State, what did you think you were going to do? I wanted to be a high school or college basketball coach, and I wanted to teach. But when I was attending school at Indiana University East—before I transferred to Ball TR AINING-CONDITIONING.COM

Tony Cox Director of Performance Enhancement and Athletic Training Programs Henry County Sports Medicine, New Castle, Ind. Previous Positions: Associate Athletic Trainer and Instructor, School of Physical Education, Sport, and Exercise Science, Ball State University, 1983-2006 Education: BS, Ball State University, 1982 MA, Miami University, 1983 Honors: Indiana Athletic Trainers Association Collegiate Athletic Trainer of the Year, 2004 Ball State University Omega, 2007 Mid-American Conference Athletic Trainer Emeritus, 2009

State—a friend of mine suggested I think about athletic training. He said, “It’s going to be really huge down the road.” Well, he was absolutely right. There’s nothing that would have been better for me. What are your current goals? I want to continue building my program here. Henry County Memorial Hospital gets a lot of recognition in the community, and even though athletic training is only a small part of the hospital, I want people to see it as a strong, positive, productive service we provide to athletes in our area. My goal is to keep giving, finish strong—and then play a lot of golf. n T&C SEPTEMBER 2009

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Fluid Dynamics From low cal to high sodium, today’s sports drink market is more diverse than ever. Are you prepared to help athletes navigate the sea of options and find the best product for their individual needs? By Michelle Rockwell

or several years, I have served as Team Sports Nutritionist for a competitive triathlon squad. Historically, each of the 16 athletes has been permitted to request their preferred sports hydration drink, and as recently as just a few years ago, all of the athletes chose one of two brands. The primary variation was simply which flavor they wanted. However, in the last few years, the requests have changed dramatically. Most recently, the athletes asked for nine different brands and countless flavors. Our team administrator responsible for supplying these products officially went on strike! And I realized I needed to become even more well versed on the many new sports drinks on the market. When I started my career, most athletes still drank the traditional lemon-lime Gatorade. Athletes can now find many different brands, flavors, nutritional components, and unique features in the sports drink world—and there is heightened competition among the various brands for loyal consumers. Competition often works to everyone’s benefit, but the vast number of options can be overwhelming to athletes. In today’s market-driven world, your athletes need to be sports drink savvy to get the most out of their workouts. POURING OUT OPTIONS The household names like Gatorade and Powerade may still be the biggest players in the industry, with the largest percentage of market share overall, but several newer brands are also becoming well-known and gaining a devoted following. In addition, athletes are asking if popular beverages like Vitamin Water can serve as a sports drink. Several organizations have come up with their own definition for sports drinks, and they don’t always agree. But for those of us working with competitive athletes, sports drinks have a very specific need to fill. They must: • Be designed for use during exercise as a way to rehydrate

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Michelle Rockwell, MS, RD, CSSD, is a Sports Dietitian based in Raleigh-Durham, N.C., and the former Coordinator of Sports Nutrition at the University of Florida. She offers sports nutrition consulting services in addition to educational products and workshops through RK Team Nutrition: www.rkteamnutrition.com. T&C september 2009

nutrition • Contain electrolytes, which are typically lost via sweat • Contain carbohydrates • Be sold in ready-to-drink, powder, and/or liquid concentrate forms. That means one of the first things we need to do is teach athletes what is not an appropriate sports drink. For instance, beverages like flavored waters, nutritionally enhanced beverages, and energy drinks are booming in popularity. There may be a place for these products in some athletes’ diets, but they should not be used for the purpose of hydrating during intense exercise. Here is how I categorize the expanding options in the sports beverage world: Sports drinks contain carbohydrates, electrolytes, and sometimes other added nutrients. They are appropriate for use before, during, and after intense exercise. Flavored waters usually contain very few calories (if any) and sometimes include artificial flavoring, vitamins, minerals, and/or herbs. Familiar names include Propel and Powerade Option. These can be used for general hydration in place of water, but not during long or intense exercise. Nutritionally enhanced beverages may contain carbohydrates, artificial flavoring, added protein, vitamins, minerals, and/or herbs. This category includes Vitamin Water, Special K Protein Water, and SoBe Lifewater. Such products do not work well as sports drinks. Recovery drinks frequently contain a combination of protein and carbohydrates along with other nutrients designed to support post-exercise energy replacement and muscle recovery. We know that consuming 10 to 20 grams of protein along with carbohydrates within 60 minutes of exercise completion is beneficial for athletes, and recovery drinks are often a convenient, appealing source. But they should not be confused with sports drinks. Many athletes also ask me about energy drinks. I would not categorize these as sports beverages and rarely recommend them for any athlete in any situation. They usually include caffeine and/or other stimulants, carbohydrates, artificial flavoring, and sometimes ingredients such as amino acids, vitamins, minerals, or herbs. The level of caffeine and other ingredients in some energy drinks has raised concern among many 4 1

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health and sports professionals, and it’s often difficult to determine exactly how much caffeine and other ingredients are in each drink. Energy drinks are definitely not appropriate as a hydration source. There’s further confusion over products that technically fit into multiple categories. For instance, is a traditional sports drink that contains caffeine an energy drink or a sports drink? I would not use it as a sports drink, because the caffeine can be detrimental to hydration. How about flavored water with electrolytes? While this may be good for hydrating the casual athlete, the lack of carbohydrates makes it a poor choice for competitive athletes doing long or intense exercise. With so many choices in the pure sports drink category, there really is no reason to use products that may compromise the proven effects of sports drinks. MAKING CHOICES With a firm grasp of what constitutes a sports drink, an athlete’s choices are certainly narrowed down. But there are still many options available, so how do you know what is the best sports drink for a specific athlete? As a sports dietitian, I base the practical strategies I provide to athletes on quality science. On the topics of hydration, electrolyte replacement, and carbohydrate consumption during exercise, we are fortunate to have a firm scientific platform from which to make recommendations. That science is the basis for all my advice to athletes. However, the magic of individualized sports nutrition involves taking into account the fact that all athletes are different. Each one presents unique goals, taste preferences, belief systems, and rituals. Furthermore, physiology, digestion, gastric absorption rate, sweat rate, and sweat composition can differ dramatically among individuals. Thus, it is important to take all these personal factors into account. I also believe in the value of experimentation with athletes and their nutrition choices. We start with science, discuss individual differences, and then use trial and error to arrive at the best results. THE SCIENCE Proper use of sports drinks during exercise can increase safety and enhance performance. When the temperature

rises, the risk of heat illness goes up and mental and physical performance deteriorate. Dehydration increases body temperature. Sports drinks have been shown to enhance hydration status by stimulating thirst, replacing electrolytes, and promoting fluid retention. Carbohydrates in sports drinks can replace energy stores (blood glucose and liver and muscle glycogen) and supply fuel to maintain intense, high-level exercise for extended periods. In general, sports drinks should be chosen over water for any exercise event lasting longer than one hour. I use the 3-H Rule as a guideline: It simply says to use sports drinks whenever exercise is Hard, Hot, or at least an Hour long. What the drink contains is also part of the science of sports drinks. The two major ingredients to understand are electrolytes and carbohydrates. In addition, we need to be well versed on the pros and cons of other added ingredients. Electrolytes. An effective sports drink should replace electrolytes lost in sweat—namely sodium, potassium, and chloride. Sodium is lost at the highest rate, with an average of one gram lost per liter of sweat. Considering that many athletes lose a few liters of sweat during a hard, hot exercise session, sodium replacement is obviously critical to preventing heat-related problems. The American College of Sports Medicine (ACSM) recommends that sports drinks contain 110 to 220 milligrams of sodium per eight ounces, and roughly 30 milligrams of potassium. There are no formal recommendations for chloride lost in sweat, as it is almost always paired with sodium in the form of sodium chloride. In other words, if you have enough sodium, you are also getting enough chloride. However, it’s important to recognize the extreme variations in individual sweat rates and the concentration of sodium and other electrolytes in each person’s sweat. Some athletes are “salty sweaters,” while others may not lose nearly as much sodium in their sweat, but tend to lose higher concentrations of other electrolytes. How do you measure an individual athlete’s electrolyte losses? Some companies have developed technology that can quantify sodium loss during exercise. A less scientific way is through trial and error. You can tell that an athlete is a salty TR AINING-CONDITIONING.COM

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nutrition sweater, I encourage a high salt diet and drinking plenty of sports drinks throughout the day. I also tell them to start with an extra one-quarter to one-half teaspoon of salt in 20 ounces of sports drink about 30 minutes prior to exercise and continue with the same formula during exercise (one teaspoon of salt is roughly 2,400 milligrams). Another solution is to use specialty endurance sports drinks or electrolyte supplements.

sweater if he or she frequently has a white film on his or her face or clothing after exercise. Another good indication is if an athlete has strong cravings for salty foods post-workout. Athletes who are clearly hydrating well—losing minimal weight during exercise sessions and producing pale yellow urine—but still struggling with muscle cramping or heat issues may also be salty sweaters. For someone known to be a salty

While sodium is the electrolyte most critically in need of replenishment, magnesium, calcium, and other minerals are also lost in sweat. Should you look for sports drinks with these ingredients, too? In general, the answer is no. However, if I’m working with an athlete who is hydrating well and who I’m certain is consuming sufficient sodium, yet they’re struggling with energy levels, I might recommend experimenting with in-

COMPARISON SHOPPING This table allows you to easily compare the key attributes of various brands of sports drinks and specialized endurance formulas. Product: 8 oz (or 1 cup/serving)

Carb content (%)

Carb (grams)

Type of Carbohydrates

Calories Sodium Potassium Protein (kcals) (mg) (mg) (grams)

Caffeine

Sports Drinks Gatorade 6 14

Sucrose Syrup, High Fructose Corn Syrup (HFCS)

110

Gatorade G2 3 7

Sucrose Syrup, HFCS, Sucralose, Acesulfame Potassium

Powerade ION4

HFCS

100

Powerade Zero

N/A

Accelerade 6 15 Sugar, Trehalose 80 120 15 Amino Vital 3 8 Fructose 35 10 35

Clif Shot

Organic Brown Rice Syrup Solids

200

Clif Quench

Organic Evaporated Cane Juice

130

Cytomax

Fructose, Dextrose, Maltodextrin

GU20

Maltodextrin, Fructose

120

Hammer HEED

Maltodextrin

100

Capri Sun Sport

HFCS, Sugar

Ultima Replenisher

Maltodextrin

150

CeraSport

Rice Syrup Solids

100

CeraSport EX-1

Rice Syrup Solids

200

100

GameOn MyoHydration

Maltodextrin, Fructose

110

130

Carbo-Pro

Glucose Polymers

224

Gatorade Endurance

Sucrose Syrup, HFCS

200

Perpetuem (2 scoops)

Maltodextrin

260

231

156

Powerbar Endurance

Maltodextrose, Fructose, Dextrose

165

Hammer Sustained Energy (3 scoops)

Glucose Polymers, Corn Solids

343

112

10.5

EnduroxR4

Dextrose, Fructose, Sucrose

180

140

Some flavors No Some flavors

Endurance Formulas

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nutrition creased consumption of these other minerals through diet (not sports drinks). Carbohydrates. Athletes, and particularly parents of younger athletes, often ask me, “Do we really need all that sugar in sports drinks?” If exercise is hard enough and long enough, the answer is definitely yes. Research has shown that carbohydrate beverages consumed during exercise enhance performance. In fact, our bodies respond so well to carbohydrates during exercise that one study found simply rinsing one’s mouth with a sport drink (and not swallowing it) enhanced performance in a cycling time trial. The key to consider is the type and concentration of carbohydrates in a sports drink. Most contain at least one source of simple sugar, such as glucose or fructose. Others contain sucrose (table sugar), which is a combination of glucose and fructose. Some contain high fructose corn syrup, which is also a combination of glucose and fructose and is often referred to as “sucrose syrup” or “glucose-fructose syrup” on sports drink labels. Research shows that a combination

of sugars, as opposed to a single sugar, maximizes absorption during exercise. One reason for this is that each sugar utilizes different intestinal transporters. Having more than one sugar enables two transport systems to work at once and decreases the likelihood that one transport system becomes saturated. Several newer sports drinks have incorporated some more complex carbohydrate sources, such as maltodextrin. The theory behind these is that slower absorption causes energy to be sustained longer during exercise, which would certainly appeal to endurance athletes. However, the slower absorption rate (especially when a more complex sugar is the sole carbohydrate source) may cause gastric upset. Some sports drinks tout more natural sources of carbohydrates, such as cane juice or brown rice syrup solids. Many athletes whose lifestyles emphasize a natural or organic diet find these options appealing. There is little research on how these carbohydrates are absorbed during exercise, so interested athletes should experiment with them during training sessions and take note

of the results. In terms of carbohydrate concentration in sports drinks, professional organizations have slightly different recommendations. The ACSM and American Dietetic Association recommend six to eight percent carbohydrate. The NATA recommends four to eight percent carbohydrate. And the Institute of Medicine recommends five to 10 percent carbohydrate. For many athletes, a carbohydrate concentration of greater than eight to 10 percent is likely to inhibit fluid absorption, so choosing a sports drink in the lower range and properly diluting powder or liquid concentrates is important. When an exercise event is very long or will require a lot of fluid consumption, a lower concentration can help prevent over-consumption of carbohydrates and gastric intolerance. To determine the carbohydrate concentration of a sports drink, divide the amount of carbohydrates per serving (in grams) by the serving size (in milliliters) and multiply by 100. So, if the serving size is 240 milliliters (eight ounces) and total carbs per serving is 11 grams, the

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nutrition sport drink contains about 4.5 percent carbohydrates. To figure out which carbohydrate source and concentration is tolerated best by individual athletes, I again use trial and error. To avoid unwanted outcomes, athletes should try different sports drinks during training—not during competition.

evaluate how it feels. Some athletes find these beverages helpful and appealing. Others find the taste chalky or unpalatable, or they experience gastrointestinal symptoms (likely because protein empties from the stomach more slowly than other substances). In order for a sports drink to aid in hydration and performance, athletes must be able to

If an athlete is interested in using a sports drink containing protein, my advice is to try it during several different training sessions and evaluate how it feels. Some athletes find these beverages helpful and appealing. Other Ingredients. Sports drinks containing protein have become more popular in recent years. Some researchers have shown that a small amount of added protein can improve exercise performance and speed muscle recovery, but other studies contradict those findings, and more research is still needed. In practical terms, if an athlete is interested in using a sports drink containing protein, my advice is to try it during several different training sessions and

consistently drink adequate amounts of it, so taste, appeal, and comfort are important factors. Some sports drinks are also fortified with vitamins and minerals. There is little evidence that consuming a specific vitamin or mineral during exercise provides any immediate benefit. However, they may contribute to helping an athlete meet his or her overall needs for critical vitamins and minerals. Sports drinks containing specific

amino acids, various herbal ingredients, caffeine, and other additives are also readily available. In many cases, there is too little of these ingredients to have much impact. HOW MUCH? Once an athlete has decided on which sports drink to use, the final factor to consider is the amount they should consume. This depends on several factors, including sport, workout intensity, environmental conditions, hydration opportunities, sweat rate, age, general diet, and individual habits and preferences. Starting exercise in a well-hydrated state is critical, because most athletes don’t drink enough during exercise. Athletes can pre-hydrate with water, sports drinks, or other non-alcoholic beverages. Many foods, particularly fruits and vegetables, also have a high water content and contribute to overall hydration. As the start of exercise nears, athletes should use either water or sports drink to pre-hydrate. According to the NATA, general preexercise guidelines are as follows: • Two to three hours before exercise,

Make an Informed Choice! INFORMED-CHOICE is a supplement testing and certiﬁcation organization that works closely with responsible nutrition companies by screening their products for banned substances against the World Anti-Doping list. Our mission is to provide athletes, coaches, advisors, parents, etc. with an INFORMEDCHOICE with regard to supplements, as part of a general approach to risk management. While it’s NEVER possible to guarantee that any product is absolutely free of contamination, the choice is simple: If you choose to take a supplement, ensure that what you take has been tested for contamination using appropriately accredited tests Log on to www.informed-choice.org to learn more about the organization and the companies who are testing their products for banned substances. Make sure your athletes are well INFORMED and download a FREE copy of our “Athlete’s Guide To Nutrition” and pass it onto your athlete’s today!

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nutrition drink 17 to 20 ounces of water or a sports drink. • Ten to 20 minutes before exercise, drink seven to 10 ounces of water or sports drink. During exercise, sports drink consumption should be based on each athlete’s unique sweat rate. Athletes should aim to lose less than two percent of

likely to meet an athlete’s fluid needs, but their carbohydrate needs as well. Athletes typically utilize 30 to 60 grams of carbohydrate per hour of exercise, but sometimes can use 100 grams or more. Since most sports drinks contain about 15 grams of carbohydrate per cup, three to five cups would equal 45 to 75 total grams of carbohydrates

I always tell athletes to drink early in their exercise sessions, prior to the onset of thirst. Drinking small amounts at very frequent intervals is helpful for achieving optimal hydration without impacting comfort level, and it also helps promote a consistent hydration level throughout a workout. their body weight via sweat during exercise. A loss greater than two percent has consistently been shown to jeopardize safety and performance. If you don’t know an athlete’s sweat rate, a general guideline is to have them drink seven to 10 ounces of sports drink every 10 to 20 minutes of exercise, for a total of about 24 to 40 ounces (three to five cups) of sports drink every hour. This level of consumption is not only

per hour. Note that if an individual requires more fluid to balance sweat loss, they may benefit from using a mix of sports drinks and water, or a sports drink with a lower carbohydrate concentration. This will help avoid gastric upset and over-consumption of sugar and calories. To calculate an athlete’s sweat rate, you can follow this procedure:

BETTER THAN WATEr For the most part, athletes need to use sports drinks instead of water only for very intense workouts and exercise events lasting longer than one hour. But there are other situations when sports drinks may be helpful. For example: • When an athlete is starting exercise on an empty stomach or hasn’t ingested adequate carbohydrates. • If an athlete is carbohydrate-loading—sports drinks consumed throughout the day can provide extra carbs to help boost stores leading up to an important competition. • If an athlete seeks weight gain—the extra calories can help shift their calorie count upward. • If an athlete has chronic dehydration or heat-related issues—to support pre-hydration and electrolyte intake before exercise. • For training at altitude, which increases fluid loss. • For training during very cold weather, when athletes tend to drink less and wear clothing with inadequate ventilation. • When suffering from vomiting or diarrhea—to replace lost fluids and electrolytes. • When water would be appropriate but the flavor, sodium content, and appeal of sports drinks is the only way an athlete will hydrate properly.

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1. Obtain body weight in minimal clothing and without shoes prior to exercise. 2. Record the amount of fluid consumed during the exercise session. 3. Obtain body weight in minimal clothing and without shoes after exercise. 4. Subtract the athlete’s post-exercise weight from pre-exercise weight. If the difference is less than two percent, they are consuming enough fluid. If it is greater than two percent, the athlete is not hydrating well enough during exercise. Assuming that one fluid ounce roughly equals one ounce of mass, the athlete should add 16 fluid ounces of sports drink to their hydrating plan for every pound of weight lost. For example, if Sam’s pre-practice weight is 175 pounds and his post-practice weight is 170 pounds after consuming two cups of sports drink during a two-hour practice, we know that he needs to up his intake. As a goal for the next practice, Sam must replace at least two more pounds of fluid, or about 32 fluid ounces. That should give him a fluid loss of just three pounds, which is less than two percent of his body weight. Conversely, what if an athlete gains weight during exercise? That means they are drinking too much, which increases risk for hyponatremia, a potentially fatal condition in which sodium concentration in the blood becomes dangerously low. Athletes also want to avoid the sluggish feeling of carrying around excess fluid. The advice here is simple—drink less during the workout, but not so much less that dehydration comes into play. I always tell athletes to drink early in their exercise sessions, prior to the onset of thirst. Drinking small amounts at very frequent intervals is helpful for achieving optimal hydration without impacting comfort level, and it also helps promote a consistent hydration level throughout a workout. Today’s athletes have a daunting array of sports drinks to choose from. If they understand the science and claims behind the various products on the shelf, and they’re willing to engage in a bit of trial and error, they can find the one that best meets their hydration needs and suits their personal tastes and preferences. Once they’ve done that, achieving and maintaining optimal hydration is, well, no sweat. n TR AINING-CONDITIONING.COM

SUSPENSION TRAINING: FUN & FUNCTIONAL FOR YOUTH TRAINING By Scott Moody

Scott Moody founded Centers for Athletic Performance, Inc. (CAP) in 1999. Moody also owns the educational resource site, AthleteFIT.com, and acts as the CEO for the 501c3, not for profit, Soccer FIT Academy.

For years, CAP, Centers for Athletic Performance, has been looking for shoulder, hip and core progressions (done in a group setting) that would work for athletes 10-14 with no prior training experience. For almost 10 years we have been creating progressions off of body weight squats, step ups and lunge exercises, but found that many of our younger athletes had positioning and body control issues that delayed their progression through the program. Lack of shoulder stability and core strength made it hard to get into good athletic positions with medballs and dumbbells which limited us in our exercise selection. We were desperately searching for something that could lay a foundation in core strength, shoulder stability, postural control, glute and hamstring strength without the use of dumbbells… until we discovered TRX® Suspension Training®. The TRX makes this all possible, as we have been able to progress (and digress) exercises to add intensity by simply changing their body position. This ability to increase intensity, variety and complexity within a group setting has not only set the athletes up with a stronger foundation, but it has also increased their knowledge of their own body and how to control, balance and stabilize in various positions. We have selected a few common areas of concern from our youth population, and the table below shows how we have modified some of our standard body weight exercises to incorporate the TRX. The table also refers to the progressions and digressions that can be made off of each exercise within a group setting to progress each individual at their own pace: Area of Concern Hip: (knee tracking incorrectly in frontal and sagital plane)

Shoulder: (mobility/stability with arms extended overhead)

Posture: (core and upper back strength and control)

Standard Exercise Lunge

Military Press or Upright Row

Bent Over Row

TRX Exercise

Progression

Suspended Lunge

Suspended Lunge (dynamic)

Suspended Lunge (pause at parallel)

Rhythmic motion focus on balance

Quick eccentric to concentric transition

Pause at parallel, then come up under control

TRX Isolated Y’s

Kneeling Rollout

TRX Isolated I’s

No rocking or swinging the hips

Control posture with pelvic tilt

No rocking or swinging the hips - straight arms

Table Top Row

Straight Leg Pull Up

Standing Row

Straight line from knees to shoulder

Body at a 45 degree angle

Digression (youth)

The ability to progress and digress these exercises has not only allowed us to train strength with our younger clientele, but it has also added a new found enthusiasm and competition to the training as athletes try to out perform others in the group by doing more reps in the push up, pull up and lunge based activity. The limitations of physical education classes, tumbling and body weight training, in combination with the reduction in unsupervised active play (tree climbing, swimming, jungle gym play, etc) has created a weaker, less coordinated youth population. This fun and simple training solution could be the answer you have been looking for!

ÂŠ getty images

TREATING THE ATHLETE

COMPLEX FORCES Proper shoulder function depends on intricate relationships between muscle groups, tendons, bone structures, the spinal cord, and more. A comprehensive shoulder training program can address key deficiencies and provide targeted treatment for a wide range of dysfunctions.

By B.J. Baker

s it possible to keep an athlete’s shoulder—a joint with great potential for extreme functional ranges of motion—mobile, stable, strong, powerful, and healthy? Is that a realistic goal given the complex demands of sports and the detrimental effects over time of gravity, poor posture, imperfect mechanics, and overuse? Like many sports medicine clinicians who work in performance training, I have been challenged by this shoulder conundrum. In the past 20 years, I’ve worked with many types of shoulder injuries—a Major League Baseball pitcher with dead arm syndrome, a college swimmer with an impingement syndrome, a middleaged client with a torn rotator cuff, and countless others. Regardless of the dysfunction, there are common threads in shoulder training programs that produce a complete, speedy recovery. Comprehensive shoulder assessment and treatment should focus on the thoracic spine, scapula, rotator cuff, and glenohumeral joint, while also addressing posture and energy transfer throughout the entire kinetic chain. By addressing all these components in a progressive manner, I have found success treating a range of simple and

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complicated shoulder injuries. In this article, I’ll provide a detailed look at the main anatomical components of successful shoulder training, and offer exercise strategies that not only restore full function, but can also help make the shoulder more powerful and injury resistant. KEYS OF ANATOMY Thoracic spine. If an athlete has limited mobility in the middle 12 vertebrae of the spinal column, collectively known as the thoracic spine, the scapula won’t have a sound foundation from which to operate, increasing risk for a wide variety of shoulder problems. Thoracic extension is critical to athletic movement, but in today’s seated, backpack-toting, computer-dependent society, a head-forward and kyphotic (“hunchback”) posture has become commonplace. Consistently holding the thoracic spine in this forward position decreases its ability to move fully in other directions, and makes the scapulae much more likely to abduct and tilt anteriorly, closing down on the subacromial space. That space already offers tight quarters for the rotator cuff tendon, biceps tendon, and subacromial bursa to per-

form their intended functions. Further decreasing it can lead to bone spurs on the underside of the acromion (a portion of the scapula) due to irritation and pressure from the impinged structures over time. In fact, failure to keep this space open results in some of the more common shoulder pathologies, including rotator cuff fraying, subacromial bursitis, and impingement syndrome. To further complicate matters, there are three distinct types of acromions: flat (type one), smoothly curved (type two), and hooked (type three). Each functions a bit differently, and a type three acromion increases the likelihood of impingement and anterior bone spurs. The thoracic spine is the most flexible spinal region for rotation—it has roughly eight degrees of rotation available at each segment. But if that mobility is limited, the body compensates by increasing rotation in the lower lumbar region, producing instability in a segment that’s meant to be stable. This is B.J. Baker, ATC, CSCS, is Head Athletic Trainer at Train Boston and former Strength and Conditioning Coordinator for the Boston Red Sox. He can be reached at: BJBaker@trainboston.com. T&C september 2009

TREATING THE ATHLETE a common reason for low back injuries in golfers with inadequate thoracic turning. Thoracic rotation should be as symmetrical as possible. Asymmetry can be addressed with corrective exercise, though it may be unrealistic to expect perfect symmetry in athletes whose sport requires unilateral rotation, such as pitchers, golfers, and tennis players. Severely asymmetrical thoracic spine rotation and extension compromise scapular stability and can wreak havoc on the kinetic chain, affecting everything from the glenohumeral joint to the subacromial space. Asymmetry also interferes with efficient energy transfer during the throwing motion, and leads to losses in core strength. Scapula. Ideally, the scapula is positioned on a rib cage that’s mounted on a fully functioning, symmetrical thoracic spine. Any scapular dyskinesis, or alterations of normal position or motion, directly affect the glenohumeral joint

ments with an unstable scapula is like trying to shoot a large cannon from a small, untethered boat—the lack of a firm base will result in much wasted energy, unwanted movement, and inefficiency. Transferring powerful forces up the kinetic chain from the lower extremities through the hips, lumbar fascia, and thoracic spine, only to find a leak in the system at the scapula and glenohumeral joint, is an injury waiting to happen. Force couples, mobility, and stability all help maintain the instantaneous center of rotation (ICR) of the humerus in the glenoid. Having an ICR helps ensure proper biomechanical function in the joint, which in turn helps avoid labral fraying and tears. Simply put, when joints are centered, they perform optimally and injury risk is reduced. Some patterns of dyskinesis related to labral tears in the throwing shoulder are linked to inflexibility of the pectoralis major and minor, and weakness of

Attempting powerful shoulder movements with an unstable scapula is like trying to shoot a large cannon from a small, untethered boat—the lack of a firm base will result in much wasted energy, unwanted movement, and inefficiency. and overall shoulder positioning. Dyskinesis can be caused by inflexibility, weakness, or muscle imbalances. Pathologies associated with a poorly functioning scapula include glenohumeral instability leading to arthritis, impingement, rotator cuff tendonitis or tendinosis, rotator cuff tears, labrum injuries, and medial elbow pain and injury. In fact, studies have shown that poor stability in the scapula is found in 68 percent of athletes with rotator cuff problems, and 100 percent of those with glenohumeral instability. An athlete’s scapulae must be proficient at protraction, retraction, elevation, depression, upward and downward rotation, and anterior and posterior tilting. No less than 17 muscles affect scapular stability and ability to provide a platform for the rotator cuff and glenohumeral joint. In addition, the glenoid portion of the scapula must be positioned and stabilized in threedimensional space to act as an appropriate receptor for the humeral head as it rotates at the high velocities needed for activities like throwing. Attempting powerful shoulder move24

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the lower trapezius and serratus anterior. When you examine an athlete, dyskinesis may present as the inferomedial (lower middle) scapular border being abnormally prominent at rest. Other signs include lack of acromial elevation and lack of full retraction in the throwing motion. Weakness in the upper and lower trapezius and rhomboids can also lead to winging of the entire medial border of the scapula at rest. Both patterns create excessive scapular protraction and decreased scapular retraction and acromial elevation during throwing. Dysfunctions like these highlight the importance of activating and properly training the peri-scapular musculature, especially the lower trapezius and serratus anterior. Glenohumeral joint. Due to the high stresses and forces created by overhead throwing, there are some pathologies and compensations commonly found in throwing populations. The glenohumeral joint, rotator cuff, and capsule are subjected to tremendous acceleration, deceleration, and distraction forces. Glenohumeral internal rotation defi-

cit (GIRD) is one of the most common adaptations that can affect throwers. GIRD develops due to the great deceleration forces placed on the posterior capsule and rotator cuff, which cause shortening of the muscles, tightness in the posterior-inferior capsule, and a shift of the glenohumeral rotation point. This migration and changing of the posterior capsule contributes to decentration, or loss of the ICR of the glenohumeral joint. For example, research has shown that Major League Baseball pitchers lose internal rotation in their throwing shoulder due to GIRD. To evaluate the level of GIRD in a throwing athlete, clinicians perform a goniometric measurement of the total range of motion of both shoulders, adding internal and external rotation. Ideally, the values should be the same on both sides, but in most cases, the throwing shoulder lacks internal rotation and has greater external rotation. The greater external rotation capacity might be partially explained by retroversion, or a bony adaptation of the humerus due to high volumes of throwing during the developmental years. However, GIRD is mostly caused by shortening of the posterior capsule and rotator cuff musculature. The restriction of internal rotation should be roughly equal to the increase in external rotation in the same shoulder, and the internal rotation deficit should not be greater than 25 degrees when compared to the non-throwing shoulder. A GIRD above the 25degree differential raises the likelihood of elbow pathology, pain, and labral tears. If the total range of motion of the throwing shoulder is lower than that of the non-throwing shoulder, addressing GIRD through stretching the posterior capsule and strengthening the posterior musculature of the rotator cuff is the best way to resolve the dysfunction. POSTURAL CONCERNS We’ve gotten through the tough part— the anatomy lesson. Now, let’s explore some specific factors that athletes can address through training and targeted intervention to improve shoulder performance and reduce injury risk. One of the biggest of these factors is posture. Ideal upright posture involves equal co-activation of flexors and extensors, abductors and adductors, and internal and external rotators. In my setting, we have had great success correcting poor TR AINING-CONDITIONING.COM

TREATING THE ATHLETE posture by focusing on the balance between these muscles, which can be dramatically improved through proper education and corrective exercise. As mentioned earlier, a kyphotic or forward head posture (FHP) has become very common among athletes and the population at large. The literature suggests that postural changes associated with FHP follow specific patterns, including an increase in the thoracic kyphosis angle and downwardly rotated, anteriorly tilted, protracted scapulae, which in turn lead to increased compression in the subacromial space. All these elements of postural dysfunction are linked to an imbalance in the localized musculature. FHP also affects the function of the thoracic spine, decreasing its ability to extend and rotate, which is critical for symmetrical scapular function. Regular soft tissue work and thoracic mobilizations are highly effective in helping to manage this problem. In particular, we know from electromyographic (EMG) studies that lower trapezius activation increases when performing self-myofascial release work

and simple self-mobilizations using a foam roll. Since the lower trapezius and serratus anterior muscles play a critical role in proper scapular positioning and mobility, exercises to strengthen those muscles should be a top priority when addressing FHP. A variety of protraction/retraction progressions can successfully activate and strengthen the serratus anterior. Exercise choices include straight-arm punching and retractions, including supine on a foam roll and in quadruped and standing positions using gravity, cables, and dumbbells for resistance. Push-ups are also an integral form of serratus work. Whenever you put a hand in contact with the floor in a closed-chain upper-body position, you get optimal activation of the serratus anterior as well as other scapular stabilizers and rotator cuff musculature. Lower trapezius activation and strengthening progressions include such exercises as prone Y, W, and I shoulder raises, scapular wall slides, 90/90 scapular retraction rope pulls (“face pulls”), lat pulldowns, horizontal rowing, and D2 patterns.

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In her text  Diagnosis and Treatment of Movement Impairment Syndromes, Shirley Sahrmann discusses a phenomenon called  scapular downward rotation syndrome. She argues that frequent exposure to low-amplitude postural loads (in particular the force of gravity) during improper sitting, poorly constructed training programs, and other negative postural and behavioral influences causes the scapular downward rotator muscles to become short and weak. Thus, one of the most important scapular force couples for improving posture is the upper trapezius, lower trapezius, and serratus anterior, since they are responsible for upward rotation of the scapula. To break the cycle of poor posture, athletes should be encouraged to regularly interrupt any long sedentary periods throughout the day—for instance, to break up long study and computer sessions by simply getting up, moving around, and doing things like stretching their pecs and performing arm circles. Some researchers believe that when we are in a sub-optimal postural position, the body begins to make negative

TREATING THE ATHLETE soft tissue adaptations in as little as 15 minutes. Again, the serratus anterior and lower trapezius are the key players here, so in addition to the aforementioned activation and strengthening progressions for these muscles, using a foam roller placed longitudinally along the spine while performing various scapular patterns can correct many postural issues. Positioning the body supine along a six-inch round foam roll allows gravity to facilitate the stretching of restricted pecs. It also helps re-establish full ranges of motion for the scapular patterns, and aids in the proper activation of all involved musculature. Common patterns used for this type of exercise include straight-armed protraction/retraction, horizontal ab/adduction, D2, alternating shoulder flexion/extension, and dual shoulder flexion/extension. SLEEP POSITIONING Of course, for roughly one third of an athlete’s life, upright posture and muscle use patterns don’t apply. Learning about nightly sleep positioning can provide valuable information when ad-

dressing shoulder issues. In our clinic, we have cleared up several cases of shoulder pain simply by improving the way a person positions their body at night, particularly with respect to the shoulder girdle and neck. When conducting an initial assessment of an athlete who’s experiencing shoulder problems, you should always ask when the pain is at its worst. If they say there’s frequent discomfort upon rising in the morning, sleep positioning should absolutely be reviewed. For the health of the shoulders and spine, sleeping on a side is best, followed by sleeping on the back. Sleeping on the stomach is generally the least advantageous, since it increases the lordotic curve of the lower back and usually strains the neck. If an athlete is a side sleeper, they should fall asleep with the unaffected shoulder down, because that shoulder can best support the spine in its natural alignment and let the back muscles fully relax. This position also prevents compression forces from being placed on the problematic shoulder. A supportive and comfortable mat-

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tress is obviously important, and for added alignment support, side sleepers can place a pillow between their knees, back sleepers can place one under their knees, and stomach sleepers (if they can’t be convinced to change their primary sleep position) can put one under the hips. Also, side sleepers will find that a knees-bent position helps keep the spine and hips aligned, which sometimes relieves back pain. For the upper body, one of the best ways to improve sleep positioning is to provide better support for the upper torso, neck, and head. Instead of just one pillow under the head, athletes should consider sleeping with two to four pillows (depending on thickness) distributed around the body in front of the chest and under the chest, neck, and head, creating a support structure that improves comfort and alignment while helping to keep both shoulders from falling into an internally rotated position. The pillow(s) under the neck should be large enough to fill all the space between the head, shoulders, and mattress. Generally speaking, the larger an ath-

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TREATING THE ATHLETE lete is, the broader their chest is and the more pillows they’ll need for adequate support. For broad-chested side sleepers in particular, placing several pillows in front of the chest at night is one of the most important adjustments that can be made to improve sleep positioning—it will prevent forward rolling and in turn help protect the down shoulder from impingement under the weight of the torso. In addition, the top shoulder will avoid falling across the chest into an uncomfortable, horizontally adducted, internally rotated position. Ideally, an athlete falls asleep on their side with their chest completely perpendicular to the mattress, and the shoulders in an anatomically neutral position. Of course, position changes unconsciously several times a night to relieve pressure areas and promote equal blood flow, but the use of extra pillows can help ensure improved alignment and positioning throughout the night. SOFT TISSUE The goal of soft tissue work is to decrease muscle tension, myofascial adhesions, and trigger points to improve overall tissue quality. Most sports medicine professionals understand at least the basics of manipulating soft tissue to promote these effects, but getting athletes into the treatment facility for regular massage is a major challenge. And of course, the real benefits of soft tissue therapy only come when it is applied regularly over time. For that reason, I believe all athletes should learn to perform their own self-care to enhance soft tissue function and prevent injuries. Self-myofascial release (SMR) is an easy, inexpensive, and effective way to address common tissue restrictions and trouble spots. Putting pressure on tender areas of muscle tissue triggers the relaxation of the muscle spindles, helping to dissipate adhesions, increase blood flow, and improve overall mobility. Foam rollers, rolling sticks, and tennis balls are commonly used to assist in this type of therapy. One thing athletes must learn in order to perform effective self-treatment is how much pressure to apply. Appropriate pressure should invigorate the tissue and produce some discomfort, but not intense pain. When they come to an area of increased tension, or an area that creates referred pain (felt in a different place on the body than the one being manipulated), they should learn to stay on that site with direct pressure for 10 to 30 seconds. Back-and-forth rolling movements with the aid of a roller or ball will promote blood flow to the area and break up myofascial restrictions. Whether you are massaging an athlete or they’re doing it themselves, soft tissue work should always be the first part of a treatment session or workout—completed before stretching, corrective exercise, sprinting, conditioning, or strength work. A muscle will not activate to its potential or stretch properly when trigger points are present. Instead, this part of the muscle will attempt to protect itself by restricting movement and increasing stiffness in the surrounding tissue to offset pathological instability. These effects must be diminished or eliminated before any type of quality work can be performed. Clinically, I have found SMR to be valuable in reducing the

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TREATING THE ATHLETE treatment and rehabilitation time for conditions such as shoulder impingement syndrome, rotator cuff strains, labral tears, subacromial bursitis, and bicipital tendinosis—essentially, any condition that would benefit from improved soft tissue quality and function. In fact, I believe therapeutic or corrective exercise aimed at structures riddled with trigger points or compromised soft tissue is ineffective unless the soft tissue quality is first improved through activation and lengthening. I often instruct my athletes to “bookend” their days with SMR, performing it first thing in the morning and right before bed. I also tell them to find time for one to three more sessions during the day, especially before workouts. Along with SMR, they use this time to activate the serratus anterior and trapezius muscles as discussed earlier, and to do range of motion work using scapular patterning with a foam roll. There are a few hypersensitive soft tissue problem areas that often need special attention—in particular, the upper trapezius, levator scapulae,

rhomboids, infraspinatus, and lateral border of the scapula just behind the axilla (armpit). In fact, inserting a tennis ball into this area while performing a side-lying sleeper stretch (passive internal rotation for the posterior capsule performed in a side-lying 90/90 position), then actively rotating the humerus into external rotation as the ball “rides” the localized area of sensitivity, is a very effective soft tissue mobilization technique. Sensitivity will decrease over time and it’s not unusual for athletes who follow a daily SMR schedule to be relatively comfortable doing it within just one to two weeks. And it is not a coincidence that the growing ease of activation, strength of involved muscles, and function of those muscles will be accompanied by steady improvement in tissue quality. THE TOTAL-BODY UNIT Anytime you watch an athlete perform an intricate task involving the shoulder complex, you can appreciate the diverse interactions and contributions of the lower extremities, core muscles, spine,

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and upper torso musculature. When treating any type of shoulder dysfunction, corrective exercise shouldn’t isolate the joint and ignore these pivotal relationships. A comprehensive, totalbody approach is the only way to address all the relevant components of the kinetic chain. For example, during the throwing motion, in order for force to be passed efficiently along the kinetic chain to the distal segments, each bone and joint needs to be positioned properly to receive its portion of the force load. In the normal kinetic chain, the ground, legs, and trunk generate the force, the shoulder acts as a force conduit and attenuator, and the arm delivers the outcome. Thus, we cannot ignore the hips and core when addressing shoulder function. Often, a throwing athlete’s hip on the non-dominant side has mobility, stability, or strength issues, or the knee, ankle, and foot have strength imbalances relative to their counterparts on the other side. While they’re anatomically far from the shoulder, weaknesses in these areas can greatly affect

TREATING THE ATHLETE overhead movement mechanics. To be more specific, research has identified several kinetic chain alterations as being associated with shoulder impingement, rotator cuff injury, and instability. In addition to the aforementioned GIRD and scapular dyskinesis, all these conditions have been directly linked to shoulder injuries: • Inflexibility in the lower back • Non-dominant single-leg stance instability • Pelvic instability during step-up movements • Decreased internal rotation of the non-dominant hip (sometimes known as HIRD: hip internal rotation deficit) • Decreased dorsiflexion and ankle mobility on the non-dominant side • Loss of knee flexion or hamstring flexibility on the non-dominant side. Sometimes, the effects of one of these conditions are observable during activity. For instance, in baseball pitchers with HIRD, the decreased internal rotation causes the pitcher to “fly open” earlier in the delivery (the upper body, shoulders, and arms open with the stride leg and front hip). It also interferes with

the consistency of his arm slot positioning and release point. Flying open causes the arm to drag, because the stronger and larger muscles of the legs, hips, and trunk have already fired and are not available to create torque. As a result, most of the pitch velocity has to come from the shoulder and arm musculature, which greatly increases the likelihood of an injury to the rotator cuff, labrum, or medial elbow. But other times, lingering instabilities and mobility limitations can only be identified through movement screens and other testing. Once identified, these problems can be addressed with individualized corrective exercise, and the end result is often an improvement in shoulder performance, even if the shoulder wasn’t the primary focus of the corrective work. For the same reason, it’s also valuable to incorporate full-body exercises that develop the entire kinetic chain when designing strength programs for throwing athletes. In my setting, I make medicine ball training an integral component of conditioning progressions because it’s an excellent

way to build core strength, stabilization, and explosive power along the entire kinetic chain. We use a variety of stances, such as facing a wall, split stance, perpendicular to a wall, parallel, half-kneeling, and tall kneeling. Overhead throwing for non-throwing athletes serves as anterior core work, and overhead throwing for throwers is deceleration work for the posterior cuff and scapular stabilizers. We incorporate as many compound movements as possible for multi-joint activation. The ultimate objectives of a sound shoulder training program are to build strength, symmetry, functional movement, and alignment mechanics. Athletes will never tell you, “I want better internal rotation in my glenohumeral joint and increased subacromial space.” They just want to throw harder, be more durable, and experience full functionality without pain. With a comprehensive approach that addresses the key muscles, joints, and structures while developing the entire kinetic chain, you can help them reach those goals. n

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Optimum performance

An Alternate Route If traditional training methods leave your teams wanting more, maybe it’s time to consider another approach. At Northwestern, some athletes look to Eastern sports medicine philosophy to gain an edge.

AP PHOTO/CHARLES REX ARbOGAST

Despite appearing trapped, Northwestern wide receiver Eric Peterman found an escape route and reached paydirt on this play last season. Northwestern football players use this author’s sports yoga program to hone their physical and mental skills. TR AINING-CONDITIONING.COM

By Darryl aiken-afam

ou tell the athletes to relax by breathing deeply from their hara and to identify the tsubos that are overly sensitive. Once they’ve done so, you focus your treatment on specific areas along the body’s metal and water meridians to provide pain relief, increase flexibility, decrease recovery time, and help them perform at their best. Does this sound like nonsense to you? If so, you’re not alone—traditional Western approaches to sports medicine and athlete development don’t recognize or accept concepts like those mentioned above, and most athletic trainers in North America are completely unfamiliar with the philosophies of Eastern medicine. But I’ve seen firsthand how these philosophies offer diverse and surprising benefits to athletes looking to maximize performance and enjoy optimum health. Over the past six years at Northwestern University, I’ve put the concepts of Eastern sports medicine to work for athletes on the football, soccer, crew, basketball, and tennis teams with excellent results. Using a system I’ve developed called Meridian Touch Sports Yoga (MTSY), I’m introducing athletes to a whole new movement paradigm and a training approach that emphasizes total-body awareness, openness Darryl Aiken-Afam, HFA, CPT, is a certified personal trainer, veteran martial artist, and shiatsu practitioner. He is the creator of Meridian Touch Sports Yoga™, and is the lead Sports Yoga Coach at Northwestern University. He can be reached through his Web site at: www.meridiantouch.com. T&C september 2009

Optimum performance to essential biofeedback patterns, and tapping into the energy channels that flow throughout the entire body. In this article, I’ll explain this unique approach and describe what the Eastern philosophy can offer to athletes of all ages and ability levels. EAST vs. WEST To fully understand the Eastern approach to sports medicine, you must appreciate the specific ways it differs from Western training philosophy. Traditionally, Western strategies for performance training are built around a general belief that more is better—more workouts, more drills, and more resistance, looking to make measurable progress in quantifiable performance factors, such as 40-yard dash times, one-rep max, and

STRONG AND EMPTY In Meridian Touch Sports Yoga (MTSY) partnerassisted movements, both athletes are required to be “empty”—that is, to feel soft and relaxed—so they can sense what is happening in their partner’s body and give proper support and feedback. It’s a symbiotic exchange that requires presence, alertness, and yielding at the same time. Many athletes are not familiar with this concept of emptiness, so I use martial arts demonstrations to help them understand it. For example, I sometimes use the Japanese martial art of Aikido and the “unbending arm” technique. This demonstration of emptiness involves me inviting the biggest, strongest guy in the room to bend my outstretched arm while I use all my muscular strength to try and prevent him from bending it. In this state I’m using tension and force to resist his force with my fist tightly clenched. The athlete is younger, stronger, and usually bigger than me, so they overpower me pretty quickly—no surprise there. After they collapse my arm, I stretch it out again, but this time I relax my body, breathing deeply from my hara, softening my extended arm and unclenching my hand so it is open and “empty.” I invite the same athlete to bend my arm again. Without fail, he cannot do it the second time, and those watching are astounded at the difference. They quickly grasp the idea that there’s more to true power than brute muscle force, and they want to tap into that power. As a result, they become open to the idea of allowing their bodies to be “empty,” which lets them take full advantage of the MTSY program’s alternative approach to physical and mental development.

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Optimum performance vertical jump height. Training programs are judged by how much they help athletes improve their numbers in those isolated, individualized measures. Of course, performance goals are important and necessary. But the Eastern philosophy holds that too often they become the sole focal point of a training regimen, at the expense of considering the athlete as a whole person—at least in the realms of movement and energy. The Eastern approach attempts to strike a better balance by devoting some of an athlete’s training time to activities that develop the entire body in ways not easily measured. The athlete is not asked to achieve a certain benchmark or perfect a specific move, just to perform an activity for the activity’s sake with inner awareness instead of outward performance as the goal. In a very short time, the benefits of those activities show up in the form of faster recovery, fewer injuries, and overall improved performance. Another part of the Eastern philosophy is an emphasis on true rest as a key element of recovery. True rest means

effects of this lifestyle change are cumulative but can be felt quickly, and the athletes find that when they commit to it, a little time each day goes a long way. I also recommend that athletes seek regular massages to assist in the rest and recovery process. The MTSY system addresses a key

more than simply time away from the weightroom and practice field. For the athletes at Northwestern, their “rest time” usually isn’t really rest—it’s filled with academic work, social or family commitments, part-time jobs, and other activities that don’t give them the physical and mental relax-

The Eastern approach attempts to strike a better balance ... The athlete is not asked to achieve a certain benchmark or perfect a specific move, just to perform an activity for the activity’s sake with inner awareness instead of outward performance as the goal. problem in traditional training programs: Many athletes, particularly at the college level, don’t have anything built into their training schedules to provide the therapeutic, relaxing, restorative, and flexibility enhancing effects they need for optimum performance and health. MTSY accomplishes this and gives athletes the physical and mental tools they need to feel more energized, rejuvenated, and pre-

ation they desperately need. The kind of rest I talk about when I work with a team involves a genuine break from active engagement—a deeper sense of “letting go” that translates to all aspects of a person’s life. To reduce fatigue and stress, I encourage them to set aside time every day to do some of the sports yoga activities I’ve taught them, a practice that offers true rest for both mind and body. The

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Optimum performance

Figure One: Individual Basic Water Exercise

Figure Two: Partner-Assisted Basic Water Exercise pared to face the challenges of their sport and everyday life. CHANNELS OF ENERGY A central concept of Eastern medicine holds that the body contains channels called meridians, through which life energy (called ki or chi) and blood are constantly flowing. Acupuncture, yoga, martial arts, and many other Eastern practices are based on tapping into and manipulating these meridians to achieve various physiological

(or tsubos in Japanese) that are linked to various muscles, MTSY assists athletes in activating and moving their ki. The system also emphasizes breathing, supportive touch, and easy-to-perform natural movements, helping optimize energy flow through the various elemental meridians. Before I begin working with any team, I first assess the athletes’ sportspecific needs and priorities, and work with the coaching staff to understand the physical and mental demands of

According to the Eastern philosophy, energy within the body must move and flow in a balanced way at all times, or else disease and malfunctions such as stiffness, injury, and slow recovery will occur. The meridians that allow this flow are named for the five elements of Oriental medicine. and psychological effects, including improved relaxation and flexibility, heightened body awareness and sensitivity, enhanced healing, and shortened recovery time. According to the Eastern philosophy, energy within the body must move and flow in a balanced way at all times, or else disease and malfunctions such as stiffness, injury, and slow recovery will occur. The meridians that allow this flow are named for the five elements of Oriental medicine: earth, metal, water, wood, and fire. By activating specific spots called acupoints 3 4

T&C september 2009

their training and competition schedule. I also learn about the types of injuries the athletes are currently dealing with, any they’ve suffered in the past, and which ones they are most predisposed to. Then, I begin to apply the fiveelement paradigm of Eastern medicine to determine how to proceed. For example, let’s say a baseball or softball team wants to improve grip strength for better bat control and swing power. Traditional Western training would suggest relying on repetitive strength exercises for the hand and wrist. But

the Eastern system teaches that grip strength is related to the metal element meridian. Rather than focusing only on the hand and wrist, I’ll prescribe exercises that increase flexibility and function in the hamstrings, lateral torso, pectoral muscles, down the length of the arms, and out to the thumbs and index fingers—all of which are located along that same metal meridian. By making the energy meridians a focal point of training, the athletes will develop greater grip strength while also becoming more flexible and stronger overall, and they may experience other metal-meridian benefits as well, including better lung function and digestive function in the large intestine. These associations may sound difficult to believe, but they’re based on over 2,000 years of Eastern medicinal practice and supported by much anecdotal evidence. They also follow the same principles used in acupuncture, which offers benefits that have been backed up by scientific research. PUT INTO PRACTICE So what does an MTSY session actually look like? To give you a sense for what this innovative training method consists of, I’ll explain a session I’ve performed with the Northwestern football team. When the players come into the training space, they grab a mat and a pair of tennis balls and lie supine on the floor. After they’ve had a moment to relax and clear their minds, I instruct them to begin finding their active tsubos— sensitive points where they feel soreness or tightness—running along the water meridian, which passes through the erector spinae muscles and extends into the sacral area. They place the tennis balls at the sites of their tsubos and lie down over them, while at the same time initiating deep breathing from the hara (lower abdominal region). The pressure created by lying on the tennis balls activates ki and blood flow, which relieves sensitivity and tightness in those areas. Once they feel a spot becoming less sensitive, they move the balls as many times as needed to hit each tsubo they can identify. This initial stage of MTSY activates the parasympathetic nervous system, which governs relaxation, restoration, and repair of the body. As they go through this process I ask the players TR AINING-CONDITIONING.COM

Optimum performance which areas of their bodies they feel need attention that day, and I’ll customize the rest of the session based on their responses. Like many forms of Eastern medicine, MTSY combines elements of art and science, and I frequently improvise during the session based on my knowledge of the five elements and other Eastern concepts to ensure that I’m meeting the most urgent needs at that particular time. Next, following the five-element framework, I begin directing the players through various MTSY solo movements. I’ll also have them perform partner-based exercises designed to address our main priorities for that session. For example, one of the most popular MTSY exercises is called the Basic Water movement (see Figure One on page 34). This exercise, which is helpful for athletes in a wide variety of sports, looks to the uninitiated like a standard seated forward bend in which the athlete stretches their hamstrings and lower back. But with a focus on the meridian concept, the goals are much broader than simply trying to stretch hard, stiff, and sore muscles using force. The body’s twin water meridians run from each foot through the calves, behind the knees and hamstrings, throughout the sacral area, up the spine on both sides of the erectors, up the neck adjacent to the cervical vertebrae, through the base of the skull, over the top of the head, and down the forehead, ending in the medial corner of each eye. The Basic Water move stretches this meridian, activating the full length of the water channels throughout the body. This is accompanied by kenbiki, a movement technique that involves small rocking movements that relax and loosen the body and mind. The Basic Water exercise does function as a stretch, but musculoskeletal mechanics are not the top priority. Stretching the water meridians produces subtle effects that are difficult to fully appreciate without experiencing them directly, but athletes who perform this movement report feeling benefits that range from mental release to increased energy along the meridian, activation of the parasympathetic nervous system, and balancing and toning effects. For an even more powerful experience, I have the athletes use a partnerassisted version of the same Basic Water TR AINING-CONDITIONING.COM

movement (see Figure Two on page 34). With a partner, they gain the extra benefits of body heat from contact, unique pressure and gravity effects, mutual kenbiki, effortless support, and the chance to move the body in the opposite direction from the original Basic Water movement, thus activating other meridians and promoting even deeper relaxation, improved circulation, and greater touch awareness and sensitivity. Effective partner work requires athletes to fully grasp the concept of “emptiness,” so they can sense what is happening in

their partner’s body and give proper support and feedback. (To see how I teach athletes about this concept, see “Strong and Empty” on page 32.) The activation of tsubos, a key facet of MTSY, continues throughout the session as needed, and I incorporate it into a wide variety of movements. During the Basic Water, I might have the athletes place tennis balls at specific points, such as a tsubo called BL-36, located in the center of the upper hamstring right below the gluteus maximus, and one called BL-57 lo-

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Optimum performance cated in the middle of the calf muscle. Concentrated pressure on these spots makes a huge difference in how much an athlete can relax and increase range of motion in the forward bend almost immediately. These tsubos are also linked to relaxation and reducing pain in the hamstrings, glutes, lower back, and calves. Sometimes, a team’s coaches will tell me in advance about the training schedule so I know which body areas are most likely to be sore, fatigued, or otherwise in need of attention. I’ll also watch team practice sessions to gather this information. As I observe the players moving and performing drills, knowing the functions of meridians and locations of various tsubos throughout their bodies, I can quickly determine who needs what types of intervention. And during the MTSY sessions, it’s of course essential for the athletes to communicate openly with me about how they’re feeling and what their bodies are telling them. At the end of our time together, I frequently send athletes away with “body homework” they can do to

them the principles of MTSY, I give them a new dimension of body awareness, reaching the realms of energy, contact, and movement that they gen-

help with individual dysfunctions. The homework is typically something very simple, such as repeating an MTSY movement with the corresponding

With their newfound focus on body awareness, I believe the athletes take away far more from this training approach than the immediate physical benefits. By learning to open their eyes to all the messages they receive from their bodies, they gain new perspective on the true meaning of health. erally don’t learn about in traditional athletic training. With their newfound focus on body awareness, which is central to virtually all forms of Eastern medicine, I believe the athletes take away far more from this training approach than the immediate physical benefits. By learning to open their eyes to all the messages they receive from their bodies, they gain new perspective on the true meaning of health, and discover that everything their bodies tell them has its place in promoting overall wellness and optimum performance. n

tsubo activations we did during a session to address a particular need, like relaxing and increasing flexibility in tight muscle areas. When players do this homework, they are being proactive with their own recovery, so the results come faster and they learn how to effectively take care of themselves. The college athletes I work with are strong and tough, and they’ve learned to push through pain, discomfort, and fatigue. But I want them to look beyond the walls of pain tolerance they’ve built up and truly listen to what their bodies are telling them. By teaching

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Circle No. 125

The Evolution of the Pilates Chair By Daniel Wilson Pilates is becoming a critical component in the training regimens of many college, professional and Olympic athletes. As its principles of core strength and creating an even musculature are known to improve athletic performance while decreasing the chance of injury, it has become an increasingly important tool for athletic trainers. The Chair has become popular because it is considered to be the most challenging piece of Pilates equipment in terms of building strength in the legs and shoulders while still giving the benefits of added core stability. Athletic trainers also laud its space saving capabilities. On average, a Pilates Chair stands just over two feet tall with a physical footprint of approximately five square feet. It is a great alternative for trainers who want to utilize equipment-based Pilates but may not have the room for larger pieces of Pilates equipment like Reformers. However, the Pilates Chair comes in many variations. Here’s a quick look at the types of Chairs available, and the latest innovations to this versatile piece of equipment.

The Wunda Chair with chair “back” and handles.

Traditional Chairs The traditional Pilates Chair is also known as the Wunda Chair, Combo Chair or Low Chair. It is made of wood, with a padded top and a split or single pedal. Some, like

the Wunda, have optional vertical “backs” that can be attached. Users can sit, lie or stand on the chair or the floor and push the pedal with their hands or feet. Springs attach the pedal to the chair, creating varying degrees of resistance. Exercises can focus on core strength, leg strength, shoulder girdle stability, mobility and strength, plus functional movements such as standing, climbing, pushing and lifting. Modern Chairs Over the past few years, many Pilates equipment manufacturers have streamlined The Pilates Chair to make it lighter and even easier to move and store than more traditional Chairs. Typically these chairs are made of lighter wood or metal and do not include chair “backs”. These types of Chairs include the EXO Chair from Balanced Body and the MVe from Peak Pilates. It is these chairs that have caught the eye of the athletic training world. Mark Mayall is the head athletic trainer for the University of Nebraska Cornhusker football team. “When I first brought (the EXO Chair) in, many of the players were a little skeptical – they had heard of Pilates but hadn’t done core exercises on a chair before.” Mayall explained to them that it would help them learn to transmit energy through their core and out through their hands and feet to help stabilize the different forces that would apply to them in a game or at a practice. “Whether it is a lateral, front or rotational movement, I told them to look at the chair exercises as not just one dimensional but from a 360 degree standpoint. It’s been really successful.” Split pedal capabilities A new innovation on modern chairs is the addition of a split pedal. The split pedal adds the dimension of rotational and reciprocal movement of the extremities for expanded performance and a more robust exercise repertoire. Some of these total-body movements include: scapular mobility, reciprocal exercises for the legs, and stability challenges for the shoulders and pelvis. A Reformer on a Chair Quite possibly the biggest development in the evolution of the “modern” Pilates Chair has been the decision by some manufacturers to include attachment points that allow the use of resistance tubing. Users

can now do many exercises on the Chair that were previously possible only on a Reformer.

The EXO Chair with split pedal and resistance bands.

“On all traditional and most modern Pilates Chairs and you can push the pedal with the arms or the legs but you can’t do much pulling,” says Nora St. John, Director of Education for Balanced Body University. “But by adding attachments for resistance bands, athletic trainers can create a workout that touches every muscle group from every angle. This flexibility also allows you to create specific programs targeted toward a specific sport.” “And when you add in the split-pedal capabilities you basically end up with one of the most versatile and effective training tools available in the industry.”

Where to buy?

Here is a list of the major Pilates equipment manufacturers. Many also provide educational training for athletic trainers.

Balanced Body http://www.pilates.com Gratz Pilates http://www.gratzpilates.com Peak Pilates http://www.peakpilates.com Stott Pilates http://www.stottpilates.com

Daniel Wilson is a freelance writer specializing in fitness related articles.

Circle No. 126

LEADERSHIP

Sally McCay, UVM Photos

Author Allison Shepherd collaborates with Head Team Physician Christian Verry (seated) and Senior Associate Athletic Trainer Grant Wilson.

In the Right Place By Allison Shepherd

hink about the tasks that college athletic trainers perform on a regular basis. On any given day, we might find ourselves diagnosing and treating injuries, directing rehabilitation programs to prevent future ones, and helping athletes cope with chronic physical conditions and functional limitations. We counsel individuals with nutritional problems, massage, wrap, tape, coordinate coverage for a wide variety of events—the list goes on. As medical professionals, our responsibilities, priorities, and the issues we face every day are vastly different from those of sport coaches, strength and conditioning coaches, equipment managers, sports information directors, and everyone else who makes the athletic department run. Does it make sense, TR AINING-CONDITIONING.COM

At the University of Vermont, athletic trainers are hired and overseen by the campus health center, not the athletic department. Here’s an inside look at this organizational trend and the many benefits it offers. then, that all of us should be governed by the same leadership structure? At the University of Vermont, we don’t think so. Unlike at most schools, where sports medicine is overseen by the athletic department, our athletic training staff is a unit of the Center for Health and Wellbeing. The CHWB is our campus’s student health center, committed to the concepts of wellness and prevention and focused on helping our students achieve lifelong optimal health. The athletic medicine staff answers to the medical director for the

university—not the athletic director— and everything about the way we do our jobs is shaped by this medicalmodel structure. We feel this model is the best possible arrangement for many reasons, ranging from logistics to professional development and from resource allocation to autonomy in decision-making. But most Allison Shepherd, MA, ATC, is the Athletic Medicine Services Director at the University of Vermont. She can be reached at: allison.shepherd@uvm.edu. T&C september 2009

LEADERSHIP importantly, we believe it helps ensure that the student-athletes we serve receive the best possible medical treatment and healthcare. STREAMLINED SERVICE Vermont is a school of 10,000 students, and our athlete population numbers just under 500. Our sports medicine

tants, lab technicians, registered dieticians, psychologists, counselors, health educators, and various other medical support staff. On the most basic personnel level— how we as athletic trainers define ourselves professionally—this arrangement makes a lot of sense. It sends a clear message to everyone in the school com-

We’re closely in tune with the strengths and specialties of all our campus’s healthcare providers, and know exactly who can best solve an athlete’s problem, whether it’s a knee injury, a bout with depression, or a gastrointestinal bug. This system also makes following up with an athlete’s progress much more efficient. munity that we are trained healthcare staff consists of an Athletic Medicine workers with specialized skills. Services Director, two Senior Associate We consider all the healthcare providAthletic Trainers, one Associate Athleters within the CHWB to be our closest ic Trainer, and four Assistant Athletic co-workers. We have excellent working Trainers. All of us are certified athletic relationships with them, allowing us to trainers employed by the CHWB, the 160330 ppc_TandCmag_steve_lehman_v1.qxp 3/25/09 2:17 PM Page 1 easily make referrals for athlete care same entity that houses our campus’s when necessary, and to take a team apphysicians, nurses, physician’s assis-

proach to treating athletes who need services beyond our scope. We’re closely in tune with the strengths and specialties of all our campus’s healthcare providers, and know exactly who can best solve an athlete’s problem, whether it’s a knee injury, a bout with depression, or a gastrointestinal bug. This system also makes following up with an athlete’s progress after the referral much more efficient. Many athletic trainers spend a lot of time traveling with athletes to and from appointments with off-campus specialists. Since we have such a great working relationship with all of our campus health resources, 90 percent of our athletes’ referral-based appointments are made with providers within the CHWB. In addition to saving money, this keeps us from spending our time on the road and in the waiting room, and the athletes miss fewer classes, study halls, and practices. Another major logistical benefit involves record keeping. In many programs, the athletic trainers keep their notes and patient files on athletic department computers and/or paper

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LEADERSHIP charts, and other healthcare providers can’t access the information without tedious paperwork, transferring of files, and an authorization process. At UVM, the athletic trainers use an electronic record system that’s shared among all CHWB providers. This way, we can ensure that everyone involved in an athlete’s care is on the same page, while still protecting the individual’s privacy. If one of our physicians sees an athlete with a broken ankle, he can immediately learn about any previous injuries that individual sustained, what their rehabilitation consisted of, and any other observations, notes, and medical data the athletic training staff may have collected. Likewise, if one of our counselors meets with an athlete who’s showing signs of an eating disorder, she can easily access information on the athlete’s past weight, medical history, and any dietary intervention they may have received from the athletic medicine staff during their college career. The counselor doesn’t lose time playing phone tag with us (or us with them) trying to share this vital information. The electronic record system also allows all providers to access one another’s schedules. This greatly streamlines the process of getting student-athletes in to see a provider. Instead of calling an office manager to inquire about the next opening in someone’s schedule, we can find it ourselves, which proves quite useful when trying to work around student-athletes’ hectic schedules. Once we schedule the appointment, we can drop that provider a quick note through the system explaining why we are referring the athlete, any special needs or instructions, and how best to reach us with their thoughts. With everything from x-ray services to mental healthcare practically at our fingertips, athletic medicine is seamlessly linked to all the other health services an individual may need, whether it’s directly related to their sport participation or not. With the built-in efficiency created by these close-knit relationships, we can make the best possible use of our time every day, which further improves athlete care. INDEPENDENCE FACTOR When athletic trainers are on the athletic department’s payroll, there’s sometimes the possibility for conflicts of interest to arise in an athlete’s treatment. If an athletic trainer’s closest ties are to coaches and athletic directors whose job security is linked in part to on-field success, there may be pressure to get athletes back into action before they are truly ready. To be clear, I don’t believe that type of thing happens very often. As athletic trainers, we understand the importance of making decisions based solely on our best medical judgment, and the vast majority of us adhere to that principle without compromise. But under UVM’s medical model for athletic training oversight, the possibility for such pressures is virtually eliminated. Even at programs where there are strict rules preventing undue interference with athletic medicine, there’s still the risk for a perceived conflict of interest. Those who don’t understand the inner workings of the athletic department may assume that athletic trainers who work for the same supervisor as sport coaches have conflicted priorities. In our setting, that perception is not an issue. On many occasions, I’ve had an athlete’s parents tell me how happy they are to learn that we are not part of the athletic department and weren’t brought in at the request of their child’s coach. Within our medical model, we continue to have excellent working relationships with the athletic director, coaches, and athletic support staff, but parents can sleep better at night TR AINING-CONDITIONING.COM

Circle No. 128

LEADERSHIP knowing we have complete autonomy from the athletic department when it comes to making medical decisions. Another benefit of our independence from athletics is job security. In tough economic times when athletic programs are forced to make cuts, support staff positions are often the first to go, and many programs unfortunately place athletic trainers in that category. Because we are part of the medical services unit on campus, we don’t have to worry about losing personnel or facing budget cuts due to an economic downturn or an “off year” for

athletic fundraising. In addition, our contracts are not renewed annually like at many programs. Our continued employment is based on regular performance reviews, which also dictate the yearly increases in our salaries. Overall, our salaries are higher than those at many comparable institutions, because our pay scale is based on our status as healthcare professionals, not athletic department employees. Our independence from the athletic department also helps shape our work schedule. Most athletic trainers work

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very long hours, but in athletics, this is often just seen as part of the culture and can easily be overlooked—everyone from the top-level administrators down to the first-tier employees puts in long days. Under our medical model, however, the CHWB administrators pay close attention to our work schedules and ensure that we have enough people and man-hours to cover all the program’s needs without overextending ourselves. This affords us the opportunity to develop a sound work-life balance. No one is on the road with a team for consecutive seasons, overtime days are reduced, and everyone gets a day off when they need it, even during their primary team’s season. In addition to improving our athletic trainers’ quality of life, this also prevents burnouts and helps promote staff stability. There are other scheduling benefits as well. For example, our athletic training staff recently decided that the work we were doing with athletes on nutrition planning and counseling wasn’t as effective as it could be. We wanted specialized help with meal planning, weight management programs, and handling special populations, such as athletes with eating disorders, thyroid conditions, and diabetes. We knew just what we needed: more support from registered dietitians. If we were part of the athletic department, we might have put in a request for a new staff member who could tailor his or her schedule around the needs of our athletes, but the funding probably wouldn’t be there for it. In our setting, however, we were able to discuss our needs with the CHWB director, and with his support, we changed the working hours of the two registered dietitians already employed by the university. As a result, they started spending more time with the athletic teams. They set up one-on-one meetings with athletes, educated entire teams about eating habits and fueling strategies, and truly added a new dimension to our athletic medicine offerings. Working together with the dieticians, we have been thinking outside the box to teach athletes about nutrition and its role in performance and health. We’ve made short nutritional videos for our Web site, organized a cooking class for student-athletes who live off campus, and gone grocery shopping with teams to help them pick out affordable, healthy TR AINING-CONDITIONING.COM

LEADERSHIP options. All this was made possible by a simple scheduling change, which might not have happened if we were tied to the athletic department. Similarly, some of our coaches like to have a sports psychologist work with their teams. Many had been “hiring” their own professional to assist in this area, which was costly for the athletic department and didn’t lend itself to maximum communication among healthcare providers. The CHWB already employs two counselors who have expertise in sports psychology, so on a trial basis, we recently increased the hours these individuals spend in athletics and gave them a space in which to meet with individual athletes. There are still a few kinks to work out, such as deciding just how many hours is enough, but the response so far has been great and we are excited about adding this extra facet of healthcare and performance enhancement to our offerings. WIN-WIN SITUATION You might be wondering, with all the benefits outlined above, if there are any drawbacks to working for the university

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health center instead of the athletic department. Does it short-change athletics in any way? Are we less accessible to coaches because our closest ties are to other healthcare workers? Most people unfamiliar with this type of structure assume there must be some downside, and I’ll admit I thought so myself before I started working here. In reality, however, we see no significant drawbacks to our model. Coaches of course want us readily available to them and involved in the daily activities of their teams, and we accomplish that by being physically located in the athletics portion of campus, where we spend most of our hours in close proximity to our athletic department colleagues. Even though we are part of the CHWB in every way, we still attend athletic department meetings, serve on committees, develop policies, and provide input on decisions that affect athletes. Practices, games, and travel are covered just as you would expect at any NCAA Division I institution. If pressed to come up with something negative about the way we operate, I might point to all the meetings we

must attend. Between committee work, staff meetings, and extra training and continuing education programs for the CHWB and the meetings we participate in on the athletics side, it sometimes feels like there aren’t enough hours in the day to fit everything in. But I’d guess that most athletic trainers in the college setting—particularly those with some administrative duties—struggle with time spent at meetings, even if they don’t follow a model like ours. Overall, we feel our system is best for everyone. The athletic department enjoys the benefits of having a comprehensive medical services group looking out for its student-athletes, without the cost of funding such a large entity. The CHWB has confidence that all the athletes are cared for through a team approach in the most complete way possible. As athletic trainers, we feel respected and enjoy our jobs. And most importantly, the student-athletes know they are surrounded by people who care for them from every angle and give them every opportunity to succeed on the playing field, in the classroom, and in all their future endeavors. n

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Circle No. 130

Made in USA

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T&C september 2009

Circle No. 132

sport specific

On the Way Up

Louisville’s Angel McCoughtry lifts off during the 2009 NCAA Division I Women’s Basketball championship game.

AP PHOTOS/mark humphrey

By Teena Murray

hen do great seasons begin? For the University of Louisville women’s basketball team, the memorable 2008-09 season, which culminated in an NCAA Division I national championship game appearance, started with a devastating loss a year earlier. Within hours of falling to the University of North Carolina in the Sweet Sixteen of the 2008 tournament, the players began asking about workout times for the following week. The loss was on a Saturday afternoon, and by Tuesday, led by juniors Angel McCoughtry and Candyce Bingham, our team was back in the weightroom, ready to begin preparing again. As a strength and conditioning coach, you always want your athletes to finish the season strong. Doing so creates an opportunity for quantum leaps in athletic development during off-season

TR AINING-CONDITIONING.COM

The University of Louisville women’s basketball team sees its conditioning program as a pyramid. After developing a strong foundation, they keep working until they reach the top. training. Despite a disappointing end to the 2007-08 season, our returning players were healthy and strong—and more importantly, committed to making great gains as athletes during the off-season. Their determination was palpable. The challenge for me was creating a program that harnessed their motivation and capitalized on their physical readiness. KNOW THY ATHLETE At Louisville, the Sports Performance Program’s motto is “Building Athletes, Preparing Champions.” Since our pro-

gram is assessment-based, the construction process for all our teams begins with a detailed blueprint for the year based on screening and testing data. This is especially important for our women’s basketball program due to the length of the season, the extensive impact stress associated with the sport, and the vast physical differences between players. Screening. Our basketball screening protocol is administered three to four times a year, usually in April, June, August, and December. It includes a functional movement screen (FMS), a single-leg force absorption assessment using a vertical hop-and-stop test on a mat, and gait analysis performed by the Teena Murray, MS, CSCS, CSCCa, USAW, is Director of Olympic Sports Performance at the University of Louisville. She can be reached at: teena.murray@louisville.edu. T&C september 2009

sport specific team’s athletic trainer. The screening also extends to a detailed assessment of diet and lifestyle factors using a health checklist and personal interviews. The checklist asks about everything from the timing, quantity, and quality of meals to sleep habits and alcohol use (see “Twenty Questions” on page 48 for the complete list of questions). The results shape our team and individual performance nutrition education, which is managed by the sports performance staff. Based on what each athlete tells us about their personal diet and habits, we provide them with tailored eating plans, grocery lists, and recipes. We’ll even take the players on grocery store trips and teach them how to read labels and prepare simple, healthy dishes. Performance testing. When we perform the screening, we also assess each athlete in several key performance factors. This gives us a sense for what the team’s greatest strengths and weaknesses are during the off-season, preseason, season, and postseason. For this evaluation, we use a combination of several tests that target specific attributes: • Power: vertical jump, standing long

jump, four-jump test • Strength: front squat, bench press, pull-ups • Speed: 10- and 20-yard sprints, pro agility test with flying start • Conditioning: 10 x 150-yard shuttle runs, two half-mile runs separated by three minutes’ rest. After each testing period, we calculate a performance score for each player using our Women’s Basketball Performance Index (shown below). This 10point index lets us compare athleticism in each tested area across the entire team and serves as a great motivational tool—the two athletes with the highest total scores during the preseason receive the highly coveted distinction of Iron Cardinal. It also helps us track short- and long-term progress in each player within a year and throughout her college career. CLOSING THE GAP Once data on the entire team is collected and analyzed, my first priority in program design is what I call closing the gap. Compared to most female athletes arriving at Louisville, our basketball players typically show up with greater performance skills like strength,

speed, and lower-body power, but they often lack fundamental movement skills like body awareness, coordination, mobility, and stability. Our FMS testing in recent years has revealed two common areas of deficiency and asymmetry—ankle mobility and core stability—and our vertical hopand-stop test often shows deficiencies in force absorption and landing mechanics. The limited ankle mobility is not surprising, since most of our players arrive having lived in taped or braced ankles. And core strength deficiencies are generally the result of never having learned to activate the core stabilizers prior to initiating movement. Addressing these deficiencies through corrective exercise and closing the gap between basic movement and advanced performance skills is essential for creating a foundation on which to build great basketball players. Our corrective exercise system is based on Gray Cook’s FMS recommendations, and progresses from active isolated stretching and soft tissue mobilization using foam rollers, lacrosse balls, and power plates (which provide vibration) to isolated singlejoint movements and muscle education, and finally to integrated multi-plane

Performance Index We use this chart and point system to track our women’s basketball players’ progress on key conditioning tests, and they compete among themselves to see who can earn the greatest number of points overall. Points Long Vertical Front Bench Pull-Ups 10-Yard 20-Yard Pro Jump Jump Squat Press Dash Dash Agility Drill inches inches % of % of reps secs. secs. secs. body body weight weight 10 96 28 150% 120% 16 1.70 2.95 4.20 9 92 27 140% 110% 14 1.75 3.00 4.30 8 88 26 130% 100% 12 1.80 3.05 4.40 7 84 25 120% 90% 10 1.85 3.10 4.50 6 80 24 110% 80% 8 1.90 3.15 4.60 5 76 23 100% 70% 6 1.95 3.20 4.70 4 72 22 90% 60% 5 2.00 3.25 4.80 3 68 21 80% 50% 4 2.05 3.30 4.90 2 64 20 70% 40% 3 2.10 3.35 5.00 1 60 19 60% 30% 2 2.15 3.40 5.10

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150-Yard Run avg. in secs. over 10 runs 26 27 28 29 30 31 32 33 34 35

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sport specific movements based on individual needs. Another way to help close the gap is through what we call base training. This concept centers around a pyramid that we’ve created to illustrate athlete development, with mobility, stability, and work capacity as the foundation, strength and speed in the middle, and power at the top. We believe starting at the foundation—the base of the pyramid—is the best way to develop the type of athleticism that will elevate performance and reduce injury risk. Our base training phase is a cornerstone of our off-season conditioning program, and it typically lasts four to 12 weeks depending on team and individual needs. To simultaneously develop the three base factors of mobility, stability, and work capacity, all the workouts at this time consist of high volumes of complex multi-joint, multi-plane, totalbody movements using body weight and light loads, with minimal rest between sets and exercises. Movement and plyometric work concentrates on landing and deceleration mechanics, along with isometric loading in various sportspecific positions.

Base training allows lifting and movement techniques to be refined in an unloaded state, setting the stage for the strength and speed building (the middle layer of the pyramid) that will follow. It also prepares connective tissue for heavier loads, and helps the athletes increase their muscle endurance and aerobic capacity. In addition, these workouts provide a way for us to incorporate creativity, variety, and competition into the activities. For example, last year we conducted a “strongwoman” competition that included tire flips, keg throws, and tug-of-wars. We’ve also used obstacle courses, conditioning scavenger hunts, modified triathlons, adventure races in nearby parks, and Cardinal Challenges that test a combination of athleticism, tactics, and toughness—with the winning team exempt from bear crawls in our sandpit. By taking our players out of their comfort zone mentally and physically during these base training workouts, we develop the physical attributes we want while also teaching work ethic, leadership, unity, and toughness—intangible qualities that are not innate

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in many athletes, but can make a huge difference in the locker room and on the court. IN-SEASON TRAINING Once the season begins, sustaining performance comes down to effective planning, daily communication, and consistent tracking. Navigating the delicate balance between fitness and fatigue is one of our main challenges. We want to overload each player enough to induce a positive training effect while managing total training volume to avoid overstress. With the high demands of the practice and competition schedule, doing this successfully requires a team approach with the athletic trainers and sport coaches. I’m fortunate to work with an exceptional group, led by Head Coach Jeff Walz and a talented team of health and wellness professionals, all committed to the same vision of keeping our athletes at the top of their game. It’s practically impossible to know exactly how each player’s body is responding, adapting, and recovering to training and competition. So to minimize injury

sport specific risk and keep performance on track, we pay close attention to a few priority areas throughout the season. First, every player weighs in before practice and weighs out after practice

instance, if someone is having trouble maintaining her weight, two to three cups of trail mix a day can become her best friend. Second, every week we conduct low-

When power output drops below 90 percent of the athlete’s baseline, we’ll talk to her individually and look at all relevant factors—body mass, rating of perceived exertion, sleep habits, diet, and on-court performance—to determine what’s wrong. each day, which allows us to monitor hydration status and short-term changes in body mass. In addition, body composition is measured using a seven-site skinfold test every four to six weeks. Since we place a major emphasis on adding lean mass during the off-season and maintaining it in-season, we take any negative changes in this area very seriously. When necessary, we’ll make immediate adjustments to training, supplementation, and diet. Usually, an athlete needs only a minor tweak—for

er-body power testing after the players’ day off. For simplicity and efficiency, we use a vertical jump test on a mat and compare the findings with baseline scores collected in the preseason. When power output drops below 90 percent of the athlete’s baseline, we’ll talk to her individually and take a closer look at all relevant factors—body mass, rating of perceived exertion, sleep habits, diet, and on-court performance—to determine what’s wrong. If fatigue appears to be the issue, we’ll reduce that ath-

lete’s practice time and prescribe extra regeneration work. Non-impact conditioning in the pool or on a bike may be substituted for more strenuous work, and extra rest is encouraged. Finally, we use FMS testing to track changes in movement quality at the midpoint of the season in December. This helps us ensure that the first half of the season has not created any new mobility or stability deficiencies or asymmetries. If it has, we’ll work with players on an individual basis to correct them. From a training standpoint, we continue to push physical development on and off the court during the first half of the season. We lift three to four times a week, with the schedule varying to accommodate games, and we incorporate corrective and prehab work into pre-practice warmups. In addition, we manage each player’s list of individual priorities based on body composition, minutes played, FMS results, and special conditioning and strength needs. During final exams and the holidays

twenty QUESTIONS Several times a year, we evaluate players’ off-court nutrition and lifestyle habits to help us determine whether they are setting themselves up to optimize performance. Part of that evaluation involves asking each individual these 20 questions. Each “yes” earns the athlete one point—16-20 points is optimal, 11-15 is fair but needs improvement, and 10 or fewer requires a major overhaul. 1. Do you eat breakfast seven days a week? 2. Do you eat foods from three different food groups at breakfast (e.g. fruit, whole grain, and protein)? 3. Do you eat two to three balanced meals at approximately the same time each day? 4. Do you eat a nutritious mid-morning and midafternoon snack that includes at least one serving of protein? 5. Do you eat at least two pieces of fresh fruit each day? 6. Do you eat at least three servings of fresh vegetables each day? 7. Do you choose only high-fiber breads and cereals? 8. Do you eat lean or low-fat protein sources at each meal? 9. Do you limit your intake of saturated fat from meats, cheeses, dairy products, butter, and egg yolks? 10. Do you eat at least two servings of “good fat” each day, such as nuts, seeds, extra-virgin olive oil, olives, avocados, and fish? 11. Do you limit your intake of processed and refined

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foods, foods made from white flour, foods high in sugar and sodium, and packaged foods? 12. Do you eat and drink adequately to maintain your body weight? (This should be your goal unless you are on a fat loss or weight gain program.) 13. Do you eat a post-workout/post-practice snack within 15 minutes after activity? 14. Do you eat a post-workout/post-practice meal within 2 hours? 15. Do you drink half your body weight (in pounds) in fluid ounces of water each day (not including fluid intake during exercise)? 16. Do you sleep at least seven to eight hours per night? 17. Do you go to bed at approximately the same time each night and get up at approximately the same time each morning (within 30 minutes)? 18. Do you take a multivitamin rich in antioxidants each day? 19. Do you take 1,000 milligrams of fish oil (omega 3 fatty acids) each day? 20. Do you limit or avoid alcohol consumption?

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sport specific in December we have limited games, no classes, and an opportunity for performance testing and concentrated loading. We use this three-week period to intensify work in the weightroom and re-establish or enhance strength, power, and conditioning levels for the second half of the season. When Big East competition begins in early January, travel intensifies and game frequency increases. The top priority becomes maintaining lower-body power and lean mass while minimizing impact stress. We shorten lifting sessions to 15 to 25 minutes and reduce the frequency to twice per week, typically two days before each game. Exercises are also modified to limit eccentric loading—we’ll do quarter and half squats rather than full squats, pulls but no catches on Olympic lifts, and minimal plyometrics. We use more unilateral lower-body exercises for strength development, and rely on cluster sets to keep quality high and volume low. While speed-strength lifts predominate during preseason and early inseason phases, max strength workouts become the priority during the late

in-season phase. The game of basketball itself provides players with adequate high-velocity stress from repeated jumping and sprinting during practices and games. Thus, we focus on maintaining power output through loading at 80 to 90 percent of personal max during strength-based movements. Another priority during in-season work is regeneration. We teach a fivestep regeneration protocol to our athletes, and implement it immediately after workouts, practices, and games. It consists of: • Active isolated stretching • Self-massage, augmented with vibration when possible • Recovery nutrition (post-exercise recovery shakes) • Cold water immersion • Nutrient timing (post-exercise meal). Our nutrition plan also includes the athletes consuming cherry juice before practices and games. This antioxidantrich “precovery” tool helps to minimize exercise stress and inflammation and accelerate recovery between sessions. During and after workouts and games,

we also use a variety of supplements to sustain energy levels and boost recovery, and post-workout meals are carefully planned to provide the right mix of carbohydrates, protein, and fat within the post-activity window when refueling is most critical. MISSION ACCOMPLISHED In the end, the success of any team depends on execution. The players’ ability to follow a game plan on the court at critical moments depends in part on how well they’ve followed our game plan off the court throughout the entire training year. From conditioning to corrective exercises to the eating and regeneration plans, each athlete’s consistency and level of commitment either positions her to succeed or keeps her from reaching her highest potential. For the 2008-09 Cardinals, commitment to the long list of game plans paid big dividends. Our team made it to the national championship game and earned much respect. And with the returning players renewing their commitment, we continue to expect great things. n

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www.FruitAdvantage.com 1-877-746-7477 www.TraverseBayFarms.com Circle No. 134

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S P E C I A L A D V E R T I S I N G F E AT U R E

Performance Points

brought to you by

Focus on Olympic Lifting With Jason Loscalzo, CSCS, SCCC, USAW-1, SPN, Director of Football Strength and Conditioning, Boston College Why are Olympic lifts a priority in your football strength program? We do some type of Olympic movements every day we lift, and the reason is simple: Power is the ultimate physical attribute we’re trying to achieve in our athletes. Raw strength is important, but if you can’t apply that strength quickly, it’s useless to you on the field. The Olympic lifts develop power by teaching the body to apply strength as efficiently as possible. Football speed is not about your 40 time. It’s about your reaction strength, how fast you can change direction and get to top speed, and how quickly you can apply the maximum strength load you have. Why is Olympic lifting the best way to develop those attributes? The majority of our Olympic lifts start from the floor, which forces the players to accelerate the bar using football-specific movement patterns. For instance, in a clean from the floor, the athlete is crunched into a down position, and when he picks up the bar, he’s engaging the hamstrings and glutes in a way that translates directly to the field. No other lifts in the world can develop explosive power, especially in the hips, better than the Olympic lifts. They also require a lot of coordination, concentration, and focus on proper technique. We’re very careful to make sure all our athletes perform the lifts correctly. Do most football players need to be coached on proper lifting technique? Yes. You can’t just tell an athlete to do some Olympic lifts and expect him to perform them perfectly on his own. You have to teach the lifts and provide consistent coaching and supervision, because there are so many elements to doing the lifts properly: Where is the bar positioned? What is his stance, and where is his grip? Is he exploding at the right time? Is the timing of the lift correct? Some players come from high school teams that emphasized strength training, and they enter our program with good technique. Others have barely set foot in a weightroom when they first arrive. Either way, we want each athlete to perform the lifts with the best possible technique, so we start them all from

square one and teach each lift from the ground up. What common flaws do you see among athletes who are new to Olympic lifting? Often, younger guys don’t understand how to pick a bar up off the floor correctly. There are several things to look at: Are the bar and the hips coming up at the same time? Are the hips rising faster than the bar? Is he exploding at the right time? Just picking up the bar properly is one of the main points we emphasize from the start. Another common flaw is a lack of flexibility. Some guys won’t catch the bar with their elbows out because they don’t have adequate flexibility in the forearms, elbows, wrists, or shoulders. In the hips, some guys have trouble squatting to depth, with the hip joint going below the knee joint. To correct these problems, we use a progression of front squats, back squats, flexibility exercises, and core strength work. In the first two or three days after the players arrive, it’s my job to identify who needs individualized work in any of those areas. I’ll watch them lift with an empty bar at first, because that’s the best way to analyze technique and identify any weaknesses. What other unique benefits do Olympic lifts offer football teams? Football is about doing the little things right—if you concentrate on those, the big things will take care of themselves. I think Olympic lifting trains our players to focus on the details, and that carries over to the field. The more precise we can be with teaching lift technique and getting our players to focus on that in the weightroom, the more they’ll concentrate on all the minute details that make successful football players.

Great training makes powerful athletes Experience the Seattle Seahawks training facility — one of the newest and most elite in the NFL— from an insider’s perspective with exclusive video content from Hammer Strength.

View the video at www. hammerstrength.com/seahawks

hammerstrength.com Circle No. 136

©2009 Life Fitness, a division of Brunswick Corporation. All rights reserved. Hammer Strength is a registered trademark of Brunswick Corporation. NFL and the NFL shield design are registered trademarks of the National Football League.(USV-013-09)(04.09)

Nutr ition Products

Fueling Performance

Protein Without Extras BiPro, an unflavored whey protein isolate, is 100-percent natural and contains no carbs, fat, sugar, or lactose. It is the ultimate anabolic food for building and sculpting strong, lean muscles. With 20 grams of protein per serving, BiPro can easily be added to your favorite beverage or recipe. Call or go online to order your two-pound jar today. BiPro USA 877-MY-BIPRO • www.biprousa.com Circle No. 500

Sustained Hydration CeraSport and CeraSport EX1 rice-based hydration and performance drinks were developed along with Johns Hopkins University physicians. Cera’s patented brown rice-based carbohydrate is natural, free of gluten and fat, and includes short, long, and very long carbohydrate chains to provide energy and quick yet sustained hydration. CeraSport’s low osmolarity offers sustained absorption of key balanced salts—sodium, potassium, chloride, and citrate—helping to correct acidosis. Available in powder, concentrate, and ready-to-drink, CeraSport can be delivered to your home or office. CeraSport 1-866-237-2770 • www.cerasport.com Circle No. 501

For Growth and Recovery Muscle Milk is a lactose-free, proteinenhanced functional beverage that contains four key ingredient blends to promote healthy, sustained energy, increased strength, lean muscle growth, and enhanced recovery from exercise. It has premium, multi-functional proteins for fast and sustained release; healthy fats (MCTs) that are more likely to be used as an energy source than stored as fat; complex carbohydrates to recharge muscle glycogen levels; and vitamins and minerals to support the body’s nutritional and metabolic needs. CytoSport, Inc. 888-298-6629 • www.cytosport.com Circle No. 502

Goes Down Like Milk Egg Whites International’s 100-percent pure liquid egg whites are heat-pasteurized and tested for salmonella, making them “liquid” but not “raw.” They are double-filtered to achieve the smooth consistency of milk, and they’re completely tasteless and odorless for making the perfect protein drink. An eight-ounce serving supplies 26 grams of protein with no fat, no choles52

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terol, two grams of carbs, 120 calories, and all the essential amino acids. Egg Whites International • 877-EGG-WHITES www.eggwhitesint.com Circle No. 503

Knowledge Is Power Informed-Choice is committed to helping ensure the purity of nutritional supplements, and it relies on HFL Sport Science to conduct product tests. HFL Sport Science has been testing supplements for banned substances against the World Anti-Doping Agency list to ISO17025 standards since 2002. The lab tests more than 3,000 products annually, and currently works with more than 90 companies worldwide, including 35 American and Canadian brands. HFL works closely with supplement manufacturers and suppliers to reduce the risk of contaminated products finding their way into sport, thus helping ensure that athletes know exactly what they are putting into their bodies. This track record has earned HFL the support of UK Sport, the United Kingdom’s equivalent to the U.S. Anti-Doping Agency. Informed-Choice • 720-289-2401 www.informed-choice.org Circle No. 504

Rest Easy BioZzz Alpha-lactalbumin, an isolated whey protein, is the purest commercially available form of alpha-lactalbumin. BioZzz is rich in tryptophan, an amino acid that has been shown in studies to improve sleep and morning alertness. BioZzz is 100-percent natural and contains no fat, carbs, sugars, or lactose. Each scoop contains 18 grams of protein and one gram of tryptophan. One scoop of BioZzz before bedtime is the perfect addition to strawberry milk. BiPro USA 877-MY-BIPRO • www.biozzz.com Circle No. 505

Same Benefits, Fewer Calories Muscle Milk Light 100 Calorie is a convenient way to get all the great taste and performance of Muscle Milk with only 100 calories and zero sugar. It provides the same blend of premium proteins, complex carbohydrates, functional fats, vitamins, and minerals found in regular Muscle Milk. Adopt a smarter way to respond to snack cravings by enjoying Muscle Milk Light 100 Calorie as a protein-enhanced snack alternative. CytoSport, Inc. 888-298-6629 • www.cytosport.com Circle No. 506 TR AINING-CONDITIONING.COM

Fueling Performance

Nutrition Products

Antioxidant Power

Energy and Vitality

Fruit Advantage offers tart cherry juice, tart cherry juice concentrate, tart cherry capsules, tart cherry powder, and Cherry Prime. Cherry Prime is a patented formula combining tart cherries with glucosamine and chondroitin. The company specializes in offering antioxidant-rich “super fruit” products made from tart cherries, wild blueberries, pomegranates, cranberries, and more. Fruit Advantage/ Traverse Bay Farms • 877-746-7477 www.traversebayfarms.com www.fruitadvantage.com Circle No. 507

Efusjon Energy Club took the market by storm less than a year ago and is on its way to becoming the leading energy drink company in the U.S. Efusjon’s products offer a remarkably rich, smooth flavor, pack tremendous energy, and deliver health and vitality. They give the body exactly what it needs to thrive, completely guilt-free. Made from 100-percent natural ingredients with no preservatives or additives, Efusjon is the perfect answer for healthy energy for professional athletes, weekend warriors, and everyone in between. Efusjon Energy Club • 866-620-4569 www.myefusjon.com/dnsmarketing Circle No. 509

Nature’s Protein Drink Research suggests that lowfat chocolate milk, with its unique mix of nutrients, is a naturally nutrient-rich protein drink that can help you refuel and rehydrate within the critical two-hour recovery window after exercise. Drinking lowfat chocolate milk after exercise not only provides the carbohydrates and protein to refuel and repair muscles, it also helps replenish fluids and electrolytes like calcium, magnesium, and potassium that are lost in sweat. Visit www.milkdelivers.org to find out more about the science behind nature’s protein drink. Milk Processor Education Program • 202-737-0153 www.milkpep.org Circle No. 508

Supercharged Recovery Max ARM (Anabolic Recovery Matrix) from Max Muscle Sports Nutrition was designed to follow rapid recovery and anabolic science. Created to be the ultimate post-workout formula, Max ARM provides the necessary nutrients to support maximum muscle mass activation, restore fluids and electrolytes, replenish glycogen, and accelerate overall muscle recovery and repair. Max ARM is the total package for complete recovery science. Max Muscle Sports Nutrition • 714-456-0727 www.maxmuscle.com Circle No. 510

Web NEWs A Convenient, Natural Liquid Protein Source Egg Whites International offers an all-natural, 100-percent bioavailable source of protein and pure amino acids. Visit the company’s Web site to learn about this fat-free and cholesterol-free product, which contains 26 grams of protein per cup. At the site, you can read about the safety and effectiveness of liquid egg whites as a protein source. There’s an FAQ page, customer testimonials, and even recipe ideas. Once you’re convinced of the benefits of egg whites, you can place your order using the secure online form. www.eggwhitesint.com

See the Products, and Learn How to Use Them SPRI’s Web site is designed for ease of use. The products are broken down by category, making everything easy to find. With more than 400 products on the site, SPRI offers solutions for many different needs, from general fitness to rehabilitation to sports conditioning. If you’re looking for a place to learn how to use some of the products, or are interested in learning new exercises, the free video downloads at the top of each page are very convenient and educational. Watch them on your computer or download them to a digital media device and take them with you to the gym or the field. www.spri.com

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Case study

A New and Effective Way to Tape Your Athletes Joey Hall is the Advertising & Public Relations Coordinator at OPTP. As a member of the company’s New Product Review Board, she helps evaluate new products and resources to ensure that they meet OPTP’s stringent quality standards. First, can you tell our readers a little about your company? OPTP has been around for more than 30 years, providing affordable rehab and fitness tools, plus the knowledge to achieve healthy living. We have established relationships with the most renowned names in fitness and healthcare, many of whom trust only OPTP to offer their products and publications. Since you work so closely with industry experts, what is an area that you have noticed is increasing in popularity? Kinesiology taping has become very popular for both treating and preventing injuries. Although there are many types of kinesiology tapes out there, SpiderTech™ taping products seem to be among the most popular choices. What is SpiderTech tape and what does it do? SpiderTech is a new line of pre-cut therapeutic kinesiology tape developed to facilitate a functional medicine approach to pain modulation and myofascial dysfunction. The ready-to-apply tapes are designed for clinical use, providing pain reduction, injury prevention, and performance enhancement. The pre-cut designs make application faster and easier than before.

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What kinds of injuries can SpiderTech tape help treat? SpiderTech taping is a great modality for many conditions, including carpal tunnel syndrome, plantar fasciitis, and even chronic swelling and lymphoedema. Because the tape is pre-engineered into specific patterns, the most effective taping methods for each injury can be achieved without the hassle of cutting and arranging many pieces of tape. What are the different pre-cut designs of SpiderTech tape? SpiderTech is available in 13 different pre-cut applications, the most popular of which are the full knee, shoulder, and postural butterfly products. The entire assortment is available to view and purchase at www.optp.com. Do you carry other kinds of tape, too? Yes, we carry Endura Sports Tape, Endura Fix Tape, LeukotapeP, Cover-Roll Stretch, Kendall Wet-Pruf waterproof tape, and Kinesio Tape.

OPTP 3800 Annapolis Ln. #165 Minneapolis, MN 55447 800-367-7393 Fax: 763-553-9355 customerservice@optp.com www.optp.com TR AINING-CONDITIONING.COM

New ProductS

NASM Corrective Exercise Specialist (CES) Advanced Specialization Muscle Milk® Light 100 Calorie Unique features: • A convenient way to get all the great taste of Muscle Milk with only 100 calories • Precise blend of 15 grams of premium protein • Sugar free, lactose free, gluten free

Unique features: • Provides 11 chapters of cutting-edge, scientifically valid education to successfully work with clients suffering from musculoskeletal impairments, imbalances, and post-rehabilitation concerns • Applicable corrective exercise techniques and programming using the proprietary OPT™ model

Benefits for the user: • Perfect as a protein-enhanced zero-sugar snack • Amazing flavor-rich taste

Benefits for the user: • Gain recognition as an elite professional by expanding your human movement science knowledge and abilities • Earn the preferred injury prevention and recovery credential of professional athletes and teams

CytoSport™ www.musclemilk.com 888-298-6629 Circle No. 515

National Academy of Sports Medicine www.nasm.org 800-460-6276 Circle No. 516

N e w

P r o d u c t s

Bac-Splash™ Waterless Sports Shower Unique features: • Pre-moistened towels— no need for water • Removes sweat, dirt, grime, and germs from skin • Safe for use anywhere on the body • Eight disposable towels per pack

TD SpeedCord Plus Unique features: • Four strands of Tuff Tube braided together for strength • Padded waist pad and handles enhance comfort during use

Benefits for the user: • Offers the benefits of a shower, plus added protection, when showers aren’t available • Cleans, protects, and hydrates

Benefits for the user: • Helps athletes develop sprinting strength and power, specifically in the acceleration phase • This method of contrast training helps build top-end speed and first-step quickness

iFan Health Products www.beatsuperbugs.com 877-677-2999 Circle No. 517

SPRI Products www.spri.com 800-222-7774 Circle No. 518

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T&C September 2009

LEG STRENGTHENING

Building from the Ground Up

Outstanding Selection

Built to Last

Creative Health Products offers a variety of rehabilitation products at discounted prices. Items include resistance bands, hand and finger exercisers, vinyl-coated dumbbells, thermophore heating pads, step benches, medicine balls, physioballs, goniometers, flexibility testers, strength testers, heart rate monitors, spirometers, anthropometers, and posture and alignment grids. Creative Health Products 800-742-4478 • www.chponline.com Circle No. 519

The Premier Leg Press is mounted on eight heavy-duty rollers and features an extra-wide steel deck foot plate. The deluxe three-inch-thick stitched padding and heavy-duty stoppers ensure athlete comfort and safety. This unit is 49”W x 47”D x 75”H and weighs 196 pounds. It has a 1,000-pound capacity to accommodate all levels of strength training. New York Barbells of Elmira, Inc. • 800-446-1833 www.newyorkbarbells.com Circle No. 523

By Athletes, For Athletes

Enhance Explosiveness

Hammer Strength is a top brand of plateloaded equipment worldwide, and the Plate Loaded Iso-Lateral Leg Extension is one reason why. It was developed in collaboration with athletes and coaches to ensure the most ergonomically correct path of motion. Iso-lateral technology allows the athlete to train each leg independently for equal strength development. Its two resistance loading positions provide dual strength curves depending on the exercise goal. Hammer Strength • 800-634-8637 www.hammerstrength.com Circle No. 520

Professional sports teams and international Olympians train and condition with TurfCordz to increase speed, endurance, and flexibility through explosive start drills, footwork exercises, and simulated play action. Developed by NZ Mfg., a leader in resistance training and physical rehabilitation products, TurfCordz provide maximum function and comfort while withstanding the rigorous demands of team, clinic, and personal use. NZ Mfg. also engineers StrechCordz and MediCordz resistance products. NZ Manufacturing, LLC • 800-886-6621 www.nzmfg.com Circle No. 524

Smart Protection The 6570 Power Jumper leg sleeve has true compression fabric to keep leg muscles warm and decrease buildup of lactic acid for less muscle fatigue, soreness, and cramping. HydraVent hDc wicks moisture away from the skin, keeping athletes dryer and cooler for enhanced performance. This product also protects the legs from cuts and scratches, and can be worn above or below the knee. McDavid • 800-237-8254 www.mcdavidusa.com Circle No. 521

Push and Pull The Sled Dawg Elite has added push handles to allow for powerful hip and leg drive. Its multi-point harness attachment allows for even load distribution during pulling, while the rear handle is great for pushing. It’s designed with heavy-duty 11-gauge steel and welded construction to create an extra-strong frame. The plate mount allows for standard or Olympic plate use. See it in the 2009 Perform Better catalog—call or go online to request your copy. Perform Better • 800-556-7464 www.performbetter.com Circle No. 522 56

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Beef Up Your Bookshelf The Exercise Ideas book set is perfect for health and fitness professionals who are trying to vary workout routines or enhance their knowledge of exercise possibilities. The set of four books includes: Exercise Ideas for Core Strengthening, Exercise Ideas for Conditioning on the Ball, Exercise Ideas for Upper Body Strengthening, and Exercise Ideas for Lower Body Strengthening. The books are also sold separately. For more information or a free OPTP catalog, call the company or go online. OPTP • 800-367-7393 www.optp.com Circle No. 525

More Comfort for Better Workouts With the Monster Leg Press machine, athletes can work out longer with less fatigue because of the adjustable seat with lumbar support. Coaches and athletic trainers will appreciate the built-in safety features. The versatile, open design allows athletes to work one leg at a time. The foot plate has a cut-out so athletes can also develop their calves. Rogers Athletic • 800-457-5337 www.rogersathletic.com Circle No. 526 TR AINING-CONDITIONING.COM

Building from the Ground Up The Name You Trust All resistance bands and tubing are not created equal. Thera-Band resistance exercise bands and tubing are supplied in a color progression system that includes levels from beginner to highly advanced. Thera-Band resistive exercise systems cost much less than other exercise equipment and achieve similar results, plus they are portable and versatile, with virtually unlimited uses. Recognized worldwide as the industry standard, Thera-Band products have been referenced in more than 640 published articles and abstracts. Performance Health • 800-321-2135 www.thera-band.com Circle No. 527

More Motion, More Options Power Lift’s Full Body Squat is the latest addition to the company’s lower-body strength training equipment line. The design of this unit provides for a broader range of motion through the hips than traditional leg presses. Users can perform explosive movements due to the low inertia created by the four-bar linkage design. Adjustable shoulder pads allow users of all heights to properly align themselves in the unit. Single-leg movements can be performed by lowering the single-leg isolator to the proper position. Standard features include weight storage, four-weight loading horns, band attachments, the single-leg isolator, and an oversized angled footplate. Power Lift 800-872-1543 • www.power-lift.com Circle No. 528

Great Results, Less Intimidation The kor™ Kettleball is constructed of pliable material and is an attractive, userfriendly alternative to cast iron kettlebells. The kor Kettleball is designed for use in group exercise or personal training. These unique, non-scuffing kettleballs are uniformly sized for consistent technique development and feature a 1 1/4-inch durable, molded polypropylene handle for a solid grip and smooth rotation. The kor Kettleball has a color-coded handle and highly visible weight label. Power Systems • 800-321-6975 www.power-systems.com Circle No. 529

Sprinting Toward Strength The new Samson Sprinter is yet another way Samson Equipment is leading the way in heavy-duty custom equipment. This unique TR AINING-CONDITIONING.COM

LEG STRENGTHENING

piece allows your athletes to perform a sprint motion while in a biomechanically sound running position. Adding resistance is made easy with the plate-loaded weight horns that are designed to prevent any plate movement. Created with comfort, durability, and adjustability in mind, the new Samson Sprinter will fit every athlete comfortably, and just like any other Samson piece, it will last a lifetime. Go online for a video demonstration. Samson Equipment • 800-472-6766 www.samsonequipment.com Circle No. 530

Power Meets Affordability WerkSan’s elite-quality plates and sets are now available in pound denominations. This equipment exceeds the rigorous standards of the International Weightlifting Federation and is manufactured with the same materials and processes used for WerkSan’s IWF-certified products. Thanks to the deflation of raw materials prices, the equipment is now available at a surprisingly low price. WerkSan Barbells 877-937-5726 • www.werksanusa.com Circle No. 531

Build Strength Evenly The Hammer Strength MTS Iso-Lateral Leg Extension incorporates the biomechanical integrity of patented Iso-Lateral technology with the ease and convenience of selectorized weight stacks. The isolateral motion provides a diverging path, which allows better knee joint alignment for optimal biomechanics. Its independent motion provides the added variety of training one leg at a time and is ideal for balancing. Maximize your athletes’ performance with this durable and reliable machine. Hammer Strength • 800-634-8637 www.hammerstrength.com Circle No. 532

Broaden Your Strength Horizon Favored by many professional teams, collegiate programs, and strength coaches worldwide, Keiser Racks allow users to train at any speed, from controlled to explosive, for improved power development. The difference is in the unique hybrid design, combining pneumatic and free weight resistance. Unlike standard racks, Keisers Racks emphasize not only strength, but stability as well. This gives users an increased training spectrum, enhancing power and stability. Keiser • 800-888 7009 • www.keiser.com Circle No. 533 T&C September 2009

Director ies Circle Company No.

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124. . . Balanced Body. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

109. . . MilkPEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

121. . . Biofreeze速/Performance Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

100. . . Mueller Sports Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC

102. . . BiPro. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

139. . . Muscle Milk (CytoSport) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BC

135. . . California University of Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

107. . . NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

113. . . CeraSport. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

126. . . New York Barbells of Elmira. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

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

123. . . OPTP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

111. . . Cleveland Chiropractic College. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

106. . . Perform Better . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

138. . . Clinton Industries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC

116. . . PowerCranks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

130. . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

132. . . Power Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

110. . . Efusjon Energy Club. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

127. . . Pressure Positive Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

114. . . Egg Whites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

128. . . PRO Orthopedic Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

134. . . Fruit Advantage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

122. . . Pro-Tec Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

136. . . Hammer Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

115. . . Rogers Athletic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

125. . . Hibiclens/Hibistat. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

133. . . Samson Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

112. . . Informed-Choice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

137. . . Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

120. . . Jump Stretch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

129. . . STOTT PILATES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

105. . . Keiser. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

131. . . TurfCordz/NZ Mfg.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

104. . . Kneebourne Therapeutic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

118. . . UCS, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

108. . . Max Muscle Sports Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

119. . . WerkSan Barbells. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

103. . . McDavid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

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545. . . Balanced Body (EXO Chair). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

523. . . New York Barbells (Premier Leg Press). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

549. . . Balanced Body (Pilates Arc). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

556. . . NUCAP Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

500. . . BiPro. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

525. . . OPTP (Exercise Ideas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

505. . . BiPro (BioZzz). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

546. . . OPTP (Stretch Out Strap Pilates Essentials). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

501. . . CeraSport. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

535. . . Perform Better (Plyo-Safe G2 boxes). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

551. . . Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

522. . . Perform Better (Sled Dawg Elite). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

552. . . Cleveland Chiropractic College. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

557. . . Performance Health (Prossage Heat). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

563. . . Clinton Industries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

527. . . Performance Health (Thera-Band) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

519. . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

537. . . Power Lift (Fixed Pad Glute Ham Bench) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

502. . . CytoSport (Muscle Milk). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

528. . . Power Lift (Full Body Squat) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

506. . . CytoSport (Muscle Milk Light) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

529. . . Power Systems (kor Kettleball). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

515. . . CytoSport (new product). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

548. . . Power Systems (Pilates Versa-Tube) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

509. . . Efusjon Energy Club. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

560. . . Pressure Positive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

503. . . Egg Whites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

558. . . PRO Orthopedic (420 Tennis Elbow Unit) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

507. . . Fruit Advantage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

562. . . PRO Orthopedic (450 Shoulder Support). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

532. . . Hammer Strength (MTS Leg Extension) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

559. . . Pro-Tec Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

520. . . Hammer Strength (Plate-Loaded Leg Extension). . . . . . . . . . . . . . . . . . . . . . . . . . 56

526. . . Rogers Athletic (Monster Leg Press). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

517. . . iFan Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

534. . . Rogers Athletic (Pendulum Power Squat Pro) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

504. . . Informed-Choice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

539. . . Samson (Belt Squat) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

553. . . Jump Stretch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

530. . . Samson (Sprinter). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

540. . . Keiser (Air300 Squat). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

518. . . SPRI Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

533. . . Keiser (Racks). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

550. . . STOTT PILATES (Injuries and Special Populations). . . . . . . . . . . . . . . . . . . . . . . . 61

510. . . Max Muscle Sports Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

547. . . STOTT PILATES (Pilates Edge). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

521. . . McDavid (6570 Power Jumper leg sleeve). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

524. . . TurfCordz/NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

554. . . McDavid (Power Shooter arm sleeve) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

538. . . UCS, Inc. (Elite Plyo-Safe boxes). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

508. . . MilkPEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

541. . . UCS, Inc. (Plyo-Safe G2 boxes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

555. . . NASM (NASM-PES) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

561. . . WerkSan Barbells (custom plates). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

516. . . NASM (new product) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

531. . . WerkSan Barbells (pound denominations). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

536. . . New York Barbells (Leg Curl/Extension). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

T&C September 2009

TR AINING-CONDITIONING.COM

Building from the Ground Up

LEG STRENGTHENING

Targeted Power

Plyometrics Made Safer

The Pendulum Power Squat Pro offers the feel of free weights in a proven strengthbuilding machine. It builds incredible leg mass and strength, targeting the hips and glutes with its top load and quads with its bottom load. Just as importantly, it lets users comfortably maintain full control of their movement throughout the workout. Rogers Athletic • 800-457-5337 www.rogersathletic.com Circle No. 534

UCS Strength and Speed’s fully padded Elite Plyo-Safe boxes offer the ultimate combination of durability, stability, and safety, providing protection from common plyo box injuries. The understructure is made of 3/4-inch oak covered in a dense foam and upholstered in tough 38-ounce vinyl. A raised lip on all the boxes allows for stacking and locking of the lids. The 24-inch box is bottomed with 3/4-inch high-density rubber for stability. UCS, Inc. 800-526-4856 • www.ucsspirit.com Circle No. 538

Choose Your Sizes Combining durability, stability, and safety was the design goal of Perform Better’s new lineup of Plyo-Safe G2 boxes. Constructed with a 100-percent foam core, they will not break down or soften over time. Each Plyo-Safe box is fitted with three two-inch strips of Velcro™ to prevent slipping when stacked. Handles on the larger boxes allow for easy repositioning. There are five sizes: three, six, 12, 18, and 24 inches. Order a set of three, a set of five, or individual sizes. Custom colors and logos are available. See them in the 2009 Perform Better catalog or online. Perform Better • 800-556-7464 www.performbetter.com Circle No. 535

Two Machines in One The Leg Curl and Extension features a contoured rear seat to promote proper body alignment and an extra-wide front seat. It’s made with heavy-duty 2” x 4” construction and designed for Olympic and standard plates. Hold-down rollers, an adjustable and removable T-bar, and easy pull-pin adjustment let you switch from leg extensions to leg curls quickly and conveniently. There’s also a rotary rangeof-motion adjustment to enable various starting positions. New York Barbells of Elmira, Inc. • 800-446-1833 www.newyorkbarbells.com Circle No. 536

Strength Priorities The purpose of the Power Lift Fixed Pad Glute Ham Bench is to develop the hamstrings, gluteus maximus, gastrocnemius, and erector stabilizers for pelvic stability. Unique features include an adjustable-angle foot plate, injection-molded pads for user comfort, and an oversized foot plate. Power Lift 800-872-1543 • www.power-lift.com Circle No. 537 TR AINING-CONDITIONING.COM

Ideal for Everyone The new Samson Belt Squat’s brand new design limits the amount of floor space needed for this unique piece, while making it easy for athletes of all different sizes to use. It features adjustable handles, a unique load release that brings the athlete’s hands closer together while performing the exercise, an adjustable yoke that allows the athlete’s hips to stay in their natural range of motion, and an adjustable chain with three different size belts. Samson Equipment • 800-472-6766 www.samsonequipment.com Circle No. 539

Control Your Resistance Combining low-impact technology with the ability to move safely at higher speeds, the Air300 Squat enhances explosive power— the key to superior athletic performance. The machine features conveniently positioned thumb-button resistance control on the ends of the hand grips, allowing the user to increase or decrease resistance without leaving the machine. With self-adjusting comfort pads and a sturdy, wide base, the Air300 Squat suits a wide variety of users. For additional safety, a range-limiting feature helps prevent ligament and knee injuries. Keiser • 800-888 7009 • www.keiser.com Circle No. 540

Safety That Lasts UCS Strength and Speed’s Plyo-Safe G2 boxes provide a lightweight, safe, and sturdy option for your plyometric routines. An extra-large landing surface (30” x 36”) is covered in durable 21-ounce vinyl. The 100-percent foam core will not break down, delaminate, or soften over time. Handles allow for quick repositioning. Each box has three twoinch strips of Velcro™ to enable stacking and prevent slipping during use. UCS, Inc. 800-526-4856 • www.ucsspirit.com Circle No. 541 T&C September 2009

Case study

Adding a New Dimension to Athlete Care With Barclay Dugger, MEd, ATC, LAT, Coordinator of Athletic Training Services and Assistant Professor in the Athletic Training Education Program, Springfield College

How did you first hear about The PolarPool? I first heard about it from our main medical supplier, Wally Collins from Collins Sports Medicine. He knew we were looking for a cold-plunge type pool because we could not get a built-in therapy pool for our new athletic training room and facility. He recommended The PolarPool, which has been a great piece of equipment for us. The PolarPool is semi-portable and fit right into our hydrotherapy room, and the cost was significantly less than a built-in pool. As an athletic trainer, what is it about The PolarPool’s service that convinced you to use this product? Because it is semi-portable, Scott and his staff could roll it into its new home. The salt water was another attraction that’s growing in popularity. The PolarPool has been very good about answering any questions about maintenance of the pool, and mainly about managing the salt water, which was new to me. It eliminated having to fill up large ice tubs for ice baths during the preseason, which keeps us from running out of ice. It also reduced our workload, because the athletes can use the pool instead of ice bags. How has cryotherapy helped your athletes recover from training, working out, and rehabilitation? How is it noticeable during their athletic performance? I have seen it help in all areas of our student-athletes’ health—with recovering from practices, games, and double sessions. Student-athletes can get in the pool and do early range-of-motion work after injury, and they tell me how refreshed they are after using it. Athletes have also said that the pool reduces their soreness. I can’t say if it has helped improve performance, but it has definitely helped with keeping our student-athletes on the field daily instead of missing practice time or games. Our quarterback used the pool daily during the season last year and missed no time on the field. He was banged up at times, which you can expect running an option-style offense, but he credits The PolarPool treatments with helping him bounce back each day.

T&C September 2009

When and how often do your athletes use this product? The PolarPool pool is a big hit with many of our teams, such as football, wrestling, men’s and women’s track and field, women’s basketball, women’s soccer, and lots of others. It is so popular we have to limit time in the pool so everyone gets their treatments. I’ve seen as many as eight student-athletes in it at a time. Which features of the pool do your athletes find most beneficial? They like that it’s easy to use—you push the jets button once or twice, depending on how strong you want the water to come out of the jets, and in you go. The student-athletes are required to shower before entering the pool, which helps with overall hygiene. How do your athletes feel after using the The PolarPool? They feel very refreshed and have stated that it improves their recovery between practices by reducing soreness. Once a student-athlete uses the pool, they usually end up using it daily in some form. Why do you recommend The PolarPool to other athletic trainers, especially in the college setting? The company offers a great way to help athletic trainers manage their student-athletes’ health. The pool also helps decrease our workload.

The PolarPool 576 Lowell St. Lynnfield, MA 01940 617-480-7683 scott@thepolarpool.com www.thepolarpool.com

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PILATES EQUIPMENT

Testimonial

Reciprocal and Rotational

Balanced Body’s EXO® Chair delivers a unique and challenging Pilates-based workout. It offers even more exercise choices with the new split-pedal option, which allows for both reciprocal and rotational exercises. Add in a Functional Resistance Kit and gain even more exercises, including many that could previously be done only on a Reformer. The unit includes a dowel for conversion to singlepedal. Balanced Body, Inc. • 800-745-2837 • www.pilates.com Circle No. 545

By the Book

Stretch Out Strap® Pilates Essentials, by Angela Kneale, OTR, targets dynamic exercises that both lengthen and strengthen the body while challenging core stability and control. Using the Stretch Out Strap during exercise provides sensory feedback that helps develop better posture, flexibility, muscular balance, and body symmetry, as well as core strength and shoulder stability. These exercises heighten body awareness and relieve stress, focusing on deep breathing and quality, controlled movements. OPTP • 800-367-7393 • www.optp.com Circle No. 546

Get the Edge

The Pilates Edge is a dense foam triangle designed to add strength and stability to the torso, arms, and legs while adding variety to any athletic workout. It improves balance and coordination, and the change in angle allows for increased programming options. It can be used alone or in combination with other accessories, including toning balls or the Flex-Band exerciser for additional resistance and increased intensity. STOTT PILATES • 800-910-0001 • www.stottpilates.com Circle No. 547

No Reformer Needed

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

Fire up your “powerhouse” core muscles while increasing flexibility and postural alignment. The Pilates Versa-Tube allows you to experience Pilates-style resistance workouts without the heavy equipment. Four equal-length resistance tubes (two with padded handles and two with foot/ankle cuffs) connect to a center nylon strap, allowing you to simulate Reformer or Cadillac-style workouts in a mat-based setting. Power Systems • 800-321-6975 www.power-systems.com Circle No. 548

“Thanks to the Arch Pro-Tec, the plantar fasciitis in my foot has completely disappeared.” —Christina Cambra, Third-Place Finisher, Ironman Austria

Making Pilates Easier

“I use the Pro-Tec Foam Roller and the Pro-Tec Roller Massager to help me get stretched out and to loosen up before practice. They’re great because I have them at home, so anytime I’m sore or feeling a little tight, I break out my foam roller.” —Roman Harper, Pro Football Player

Economical in cost and floor space, the Pilates Arc™ from Balanced Body® is a versatile training tool that can be used as a classic spine corrector and as an exercise arc. Lightweight yet very durable, its asymmetrical shape can accommodate many different body types. The Pilates Arc comes with a free instruction booklet and a 23-minute workout DVD. Balanced Body, Inc. • 800-745-2837 • www.pilates.com Circle No. 549

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

Useful Addition to Your Library

The STOTT PILATES Injuries and Special Populations manual details structural anatomy, muscle classifications, an integrated model of motor control, and dysfunction and optimal function for specific areas of the body, including the lumbo-pelvic region, hip, knee, cervical spine, and shoulder. A wide range of musculo-skeletal injuries and conditions and special populations are covered, with a breakdown of exercise guidelines and examples. STOTT PILATES 800-910-0001 • www.stottpilates.com Circle No. 550 TR AINING-CONDITIONING.COM

Pro-Tec Athletics 2743 152nd Ave. N.E. Redmond, WA 98052 800-779-3372 pro-tec@injurybegone.com www.injurybegone.com T&C September 2009

MORE PRODUCTS

Great Ideas, Great Value

Pressure to Heal Cho-Pat’s Compression Sleeve combines warmth, compression, and reinforcement to help reduce pain and discomfort in the calf and enhance healing. The four-way stretch knit material contours anatomically for maximum fit, comfort, and effectiveness. The material is also breathable and facilitates movement of moisture away from the skin. This American-made sleeve does not contain neoprene or latex and is available in three sizes to provide specific and effectual results. It’s available in white and black. Cho-Pat 800-221-1601 • www.cho-pat.com Circle No. 551

Expand Your Horizons Cleveland Chiropractic College (CCC), with campuses in Kansas City and Los Angeles, has been educating healthcare professionals for more than eight decades. More than one in every 10 doctors of chiropractic practicing in North America is a Cleveland graduate. CCC offers a Bachelor of Science in Human Biology and a Doctor of Chiropractic degree. In 2010, Cleveland begins the first in a series of university programs offering a Master of Science in Health Promotion. Cleveland Chiropractic College • 800-467-2252 www.cleveland.edu Circle No. 552

Rethinking Sprains “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. Jump Stretch, Inc. 800-344-3539 • www.jumpstretch.com Circle No. 553

Wrapped in Support The 656 Power Shooter arm sleeve and 6500 Power Shooter arm sleeve with HexPad offer true compression fabric to keep muscles warm and decrease buildup of lactic acid for less muscle fatigue, soreness, and cramping. HydraVent hDc wicks moisture away from the skin, keeping athletes dryer and cooler for enhanced performance. The 6500 62

T&C September 2009

includes revolutionary HexPad protection on the elbow for faster recovery from falls and player-to-player contact. McDavid 800-237-8254 • www.mcdavidusa.com Circle No. 554

Enhance Your Credentials An elite training program for fitness and enhanced athletic performance, the NASM Performance Enhancement Specialist (NASM-PES) is designed for athletic trainers, chiropractors, physical therapists, coaches, and other sports professionals who want to work with players at all levels, from the secondary education and university tier to professional and Olympiclevel athletes. Con-Ed approved: NASM 1.9, ACE 1.8, NSCA 1.6, BOC 27 CEUs. National Academy of Sports Medicine 800-460-6276 • www.nasm.org Circle No. 555

Crossing the Ocean Europe is about to get taped in an entirely new way. NUCAP Medical, developer of SpiderTech pre-cut tape-based therapeutic supports, has partnered with K-Active Europe for the European distribution of SpiderTech products. Made from the proven Nitto-Denko tape—the original kinesiology tape from Japan—SpiderTech will be distributed through K-Active Europe’s extensive network of providers and medical product distribution groups under the brand name K-Active Tape PreCut. NUCAP Medical 416-494-1444 • www.nucapmedical.com Circle No. 556

Heat that Heals Prossage Heat is an all-natural therapeutic warming ointment specifically designed with a unique, controllable glide for areaspecific sports injuries, orthopedics, and deep tissue massage. It is used by massage therapists, physical therapists, athletic trainers, and other hands-on healthcare professionals who perform deep tissue, trigger point, and myofascial release therapy. More information on Prossage Heat can be found online. Call today to locate an authorized dealer. Performance Health 800-321-2135 • www.prossage.us Circle No. 557

TR AINING-CONDITIONING.COM

Great Ideas, Great Value

MORE PRODUCTS

Customized Support

Important Relief

The 420 Tennis Elbow Unit offers a practical approach to relieving tennis elbow pain. The 1/8-inch-thick neoprene band provides heat to the upper forearm while a 1/4-inch orthopedic felt pad applies pressure over the tendon insert point. A new space-age elastic band wraps around the neoprene to provide extra pressure to the pad and comfortable support to the forearm. Hook-and-loop fastening allows for comfortable adjustment and personalized fit. PRO Orthopedic Devices, Inc. 800-523-5611 • www.proorthopedic.com Circle No. 558

The 450 Shoulder Support is a universalfit product that’s simply designed to increase therapeutic heat at the shoulder area, providing symptomatic relief for strains, bursitis, arthritis, and tendonitis. The wrap is easy to slide on and adjust, and it fits the right or left shoulder. PRO Orthopedic Devices, Inc. • 800-5235611 • www.proorthopedic.com Circle No. 562

Soft-Tissue Solution The Pro-Tec Roller Massager is a great tool for reducing muscle tightness, soreness, and pain. It also maximizes muscle performance and flexibility. Raised sections “sink” into soft tissue to roll out tightness, and the rounded grip ends provide precision trigger-point release to loosen knots in the muscle. It’s ideal for rolling your arches to alleviate conditions of plantar fasciitis, heel pain, and foot pain. An instruction manual containing a number of exercises is included. Pro-Tec Athletics • 800-779-3372 www.injurybegone.com Circle No. 559

Target Your Trigger Points The Original Index Knobber II is a simple device designed to let you apply deep pressure to yourself or others. It’s the ideal instrument for clinic or home use, allowing for firm, sustained pressure on painful trigger points. Its unique patented design allows it to be used in several hand positions and by the right or left hands comfortably and interchangeably. It’s virtually indestructible and easily cleaned between uses. The Pressure Positive Co. • 800-603-5107 www.pressurepositive.com Circle No. 560

The Finishing Touch Now, you can get custom plates with your organization’s name or logo made to the same high specifications as WerkSan’s IWFcertified products. Plates can be made in a variety of colors with any font and color of printing. WerkSan embeds a groove on the edge of the plate, then paints the groove with the appropriate color for the weight of the plate, so coaches can easily determine the weight on the bar. WerkSan Barbells 877-937-5726 • www.werksanusa.com Circle No. 561 TR AINING-CONDITIONING.COM

Go Modular Clinton’s Style Line Laminate Taping Station is packed with value for large and small athletic training rooms. With easyclean 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. Units are available with 14 options, four depths, and a modular design allowing multiple stations to be joined in a row. Clinton Industries, Inc. 800-441-9131 • www.clinton-ind.com Circle No. 563

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

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 Circle No. 137 T&C September 2009

Case study

Quality Weight Room Solutions at IndustryLeading Prices

With Mark Takkinen, Assistant Football Coach and Head Softball Coach, Fullerton (Calif.) High School What products have you purchased from New York Barbells of Elmira, and why did you choose that company? We’ve bought benches, power racks, running sleds, plyo boxes, kettlebells, and more. One of the main reasons we chose New York Barbells was the pricing—even though the shipping costs were significant to send the equipment from upstate New York to California, we still got a better deal than we could have received from anybody else. The best part is that we didn’t sacrifice quality to save money. The company’s products are very sturdy. Our equipment is used by four weightlifting classes and all of our school’s athletic teams, so it’s occupied for roughly eight to 10 hours a day, and everything has held up incredibly well. Do you ever have questions or concerns about the equipment, and if so, how does New York Barbells handle them? The service, before and after the sale, is outstanding. If we ever have any questions, I just call the company and they take care of us. For instance, because we use the equipment so much, we occasionally wear out the cables for our lat pulldown machines and pulleys. I just call them and tell them what we need, and in two days, we’ve got new cables. And if I didn’t know how to install them, I’m sure they’d walk me through that as well. Is there anything about New York Barbells’ product offerings that sets them apart from others in the industry? One big thing was their ability to customize our equipment. Our weightroom has limited space, so we need to plan our layout very carefully. I asked them to make our power racks with slightly less width than their standard models, and they created the racks to my exact specifications without charging extra for the custom work.

T&C September 2009

Another thing I like is the ability to get practically everything we need for a strength and conditioning program from one company. In addition to our racks and the rest of the strength equipment, we bought our rubber weightroom flooring from them as well. It’s a very thick, high-quality mat—no one else could match the price on a product of the same caliber. What has the response been like since your new equipment was installed? Our kids love using the equipment. They love going into the weightroom, and they love the versatility of the equipment, which allows us to do practically anything in order to build their strength. I’ve had other strength coaches in the area come out to look at our weightroom, and they’ve been very impressed. Some of them have even ended up equipping their own weightrooms with stuff from New York Barbells because of what they saw and heard from me about our great experience. For a company from so far away to get into Orange County, Calif., is pretty difficult, because we have a lot of weightlifting suppliers in our area. It shows you just how good they are at providing great products and service. I only wish I could get them to open a store out here.

New York Barbells of Elmira, Inc. 160 Home Street Elmira, NY 14904 800-446-1833 info@newyorkbarbells.com www.newyorkbarbells.com TR AINING-CONDITIONING.COM

CEU QUIZ

T&C September 2009 Volume XIX, No. 6

Training & Conditioning is pleased to provide NATA and NSCA members with the

icke You c a and g n now tak r & E a et yo e our ur C CEU q sier! uizze Click EU results s on www o a .train n “CEUs & C nd credit in line... s ourse ing-c s” at: tantly. ondi tio

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, readers can earn 2.0 BOC Athletic Training and 0.2 NSCA (two hours) continuing education units.

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Instructions: Go to www.training-conditioning.com and click on “CEUs & Courses” to take the quiz online. You may also mail your quiz to us: Fill in the circle on the answer form (on page 67) that represents the best answer for each of the questions below. Complete the form at the bottom of page 67, include a $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 19.6 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850. Readers who correctly answer 70 percent of the questions will be notified of their earned credit by mail within 30 days. Bulletin Board (pages 5-6)

Objective: Learn about recent research, current issues, and news items of interest to athletic trainers and other sports medicine professionals.

1. A recent NATA survey found that ______ percent of NCAA Division I Football Bowl Subdivision teams do NOT test their players for sickle cell trait. a) 12 b) 19 c) 36 d) 45 2. In a recent study on joint laxity and the female hormone cycle, most study subjects exhibited the greatest amount of knee laxity during which part of their cycle? a) Ovulation b) Follicular phase c) Luteal phase d) Pre-luteal phase 3. Nitrite drugs are designed to treat: a) Ankle joint laxity b) Mental illness c) Iliotibial band syndrome d) Heart and blood disorders 4. Two possible side effects of nitrite abuse are: a) Cardiovascular collapse and coma b) Joint pain and increased laxity c) Dizziness and nausea d) Gastric upset and dehydration

Fluid Dynamics (pages 13-20)

Objective: Understand the wide variety of sports drinks available and how to help athletes meet their hydration and biochemical needs.

5. The author states that consuming ______ grams of protein along with carbohydrates within 60 minutes of exercise completion is beneficial for athletes. a) 10 to 20 b) 30 to 40 c) 50 to 60 d) at least 80 Continued on page 66—with answer sheet on page 67...

Or take this quiz online and get instant results:

www.training-conditioning.com click on CEUs & Courses

TR AINING-CONDITIONING.COM

6. The American College of Sports Medicine recommends that sports drinks contain roughly ______ milligrams of potassium per eight ounces. a) 20 b) 30 c) 40 d) 50 7. The author says that ______ is the electrolyte most critically in need of replenishment for athletes. a) Potassium b) Sodium c) Chloride d) Magnesium 8. Research shows that a combination of sugars, rather than a single sugar, maximizes absorption because the different sugars utilize different: a) Glucose ratios b) Amino acid pairings c) Osmolarities d) Intestinal transporters 9. In sports drinks, a carbohydrate concentration of greater than ______ percent is likely to inhibit fluid absorption for many athletes. a) Two to three b) Four to six c) Eight to 10 d) 12 to 14 10. The NATA’s pre-exercise hydration guidelines recommend that athletes consume ______ ounces of water or a sports drink two to three hours before exercise. a) 10 to 12 b) 17 to 20 c) 20 to 24 d) 30 to 32

Complex Forces (pages 22-29)

Objective: Learn about the mechanics of proper shoulder function, common sources of shoulder injuries, and ways to keep athletes’ shoulders healthy through training.

11. The three distinct types of acromions are flat, smoothly curved, and: a) Hooked b) Impinged c) Scapular d) Bifurcated

T&C September 2009

CEU QUIZ 12. Weakness in the upper and lower trapezius and rhomboids can lead to: a) Upper cross syndrome and spinal stenosis b) Tears of the ulnar collateral ligament c) Winging of the medial border of the scapula at rest d) Vertebral disc slippage 13. Research has shown that Major League Baseball pitchers lose internal rotation in their throwing shoulder due to: a) Glenohumeral internal rotation deficit (GIRD) b) Instantaneous center of rotation c) Asymmetrical thoracic spine rotation d) Microtears within ligaments 14. Electromyographic (EMG) studies show that ______ activation increases when performing self-myofascial release work. a) Sartorius b) Quadriceps c) Triceps d) Lower trapezius 15. In Diagnosis and Treatment of Movement Impairment Syndromes, Shirley Sahrmann discusses a phenomenon called: a) Upper cross syndrome b) Scapular downward rotation syndrome c) Scapular instability syndrome d) Stabilizer deterioration syndrome 16. For the health of the shoulders and spine, the author says it’s best for athletes to sleep on their: a) Back b) Stomach c) Side d) Feet

An Alternate Route (pages 31-36)

Objective: Follow a practitioner of sports yoga and develop an understanding of how Eastern concepts of sports medicine can provide athletes with a mental and physical edge.

17. A central concept of Eastern medicine holds that the body contains channels called ______ through which life energy and blood flow. a) Haras b) Fluires c) Tsubo canals d) Meridians 18. Which of the following is NOT one of the five “elements” of Oriental medicine? a) Wood b) Sunlight c) Fire d) Water

20. The Basic Water exercise resembles a standard ______. a) Push-up b) Seated forward bend c) Plank d) Romanian deadlift

In the Right Place (pages 39-43)

Objective: Learn about the unique oversight structure for athletic training and sports medicine services at the University of Vermont (UVM).

21. The author estimates that ______ percent of UVM athletes’ referral-based appointments are made with providers within the campus’s Center for Health and Wellbeing (CHWB). a) 60 b) 70 c) 80 d) 90 22. According to the author, one advantage of athletic trainers being independent from the athletic department is that it virtually eliminates the potential for: a) A perceived conflict of interest b) An injury to be misdiagnosed c) Negative interaction between coaches and athletic trainers d) Violations of HIPAA

On the Way Up (pages 45-49)

Objective: Follow the University of Louisville women’s basketball team through the strength and conditioning regimen it uses to optimize athletes’ health and performance.

23. The “construction process” for teams at Louisville begins with a detailed blueprint based on: a) Last year’s team statistics b) Screening and testing data c) Athletes’ self-reported weaknesses d) Preseason performance 24. In recent years, two common areas of deficiency and asymmetry revealed by Functional Movement Screen (FMS) testing of the Louisville women’s basketball team are: a) Leg strength and hip strength b) Knee joint integrity and balance c) Ankle mobility and core stability d) Hip mobility and shoulder rotation 25. In the pyramid concept used for athlete development at Louisville, the “foundation” of the pyramid consists of: a) Strength, mobility, and power b) Explosiveness, strength, and speed c) Mobility, stability, and work capacity d) Power, explosiveness, and balance

19. The author tells athletes to breath from their ______, or lower abdominal region. a) Tsubo b) Ki c) Hara d) Chi 66

T&C September 2009

TR AINING-CONDITIONING.COM

CEU QUIZ Answer Form Instructions: Go to www.training-conditioning.com and click on “CEUs & Courses” to take the quiz online. You may also mail your quiz to us: Fill in the circle on the answer form below that represents your selection of the best answer for each question. 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 19.6 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850. 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. Questions? Problems? E-mail: CEU@MomentumMedia.com.

Bulletin Board

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Fluid Dynamics

5. 6. 7. 8. 9. 10. 11. 12. 13.

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An Alternate Route

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T&C September 2009

Next Stop: Web Site Our editorial continues on Here is a sampling of what’s posted right now:

Soon, University of Notre Dame athletes like Jimmy Clausen will reap the benefits of the school’s new Athletic Performance Division.

MONTHLY FEATURES Fighting Irish Stepping It Up The University of Notre Dame recently announced the creation of an Athletic Performance Division with the goal of enhancing athlete development by further addressing areas like sports medicine, strength training, nutrition, and sports psychology. T&C talked to Associate Athletic Director Mike Karwoski, who heads up the program, about synchronizing those elements to help Fighting Irish athletes get the most out of their abilities.

www.training-conditioning.com/features.php

NUTRITION WEB EXCLUSIVES A Closer Look At Vitamin D

By Randy Bird, MS, RD, CSSD, CSCS

Previously believed to be conquered, vitamin D deficiency is making a comeback. Currently considered an epidemic in the United States, we take a closer look at the different types of vitamin D and provide recommended dosages for athletes.

Recovery Nutrition By Lisa Dorfman, MS, RD, CSSD, LMHC Refueling after training is like putting money in the bank. You don’t want to miss these hot tips for teaching athletes proper ways to keep their energy accounts balanced and their performance rich.

www.training-conditioning.com/nutrition.php

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