Training & Conditioning 22.9

Is it Time to Retire? n Florida State Baseball Workouts

December 2012 Vol. XXII, No. 9, $7.00

CENTERED STRENGTH How to best develop the core

Circle No. 100

December 2012, Vol. XXII, No. 9

contents 29

12 Comeback Athletes

Chris Davis & Alfred Ramsby 3 Colerain High School, Cincinnati, Ohio

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Bulletin Board Managing pre-competition stress … New concussion research … Looking at ACL injuries 10 years later.

Sponsored Pages 25 Balanced Body

32 Power Systems Product News

Core Training 40 42 Therapy Technologies 42 Topical Analgesics 44 Plyometrics 44 More Products 46 State of the Industry

50

Advertisers Directory

49

CEU Quiz For NATA and NSCA Members

Cover photo by AP Photos/David Stluka TR AINING-CONDITIONING.COM

35 Leadership

Fishing 12 Gone How do you know when it’s time to retire? We asked three athletic trainers to share why they decided to do so.

By Anthony Ortolano, Kim Blackburn, & Sanford Miller Optimum Performance

Strength 17 Centered Though experts continue to disagree about some aspects of

core training, our author says it’s the points they see eye-to-eye on that are most important.

By Michael Boyle Nutrition

Problems to Solutions 21 From A runner with anemia. A field hockey athlete with celiac disease.

A swimmer with changing dietary needs. Those were the problems. These experts offer the solutions.

By Dr. Christine Rosenbloom, Caroline Mandel, & Jennifer Brunelli Treating the Athlete

Danger 29 Quiet As football players’ sizes have crept up in the past decade, so have the number of athletes diagnosed with metabolic syndrome.

By Dr. Linda Lee & Dr. John Helzberg Sport Specific

Movement 35 Smooth When you’re a new strength coach working with an already

successful team, one of the keys to a smooth transition is how you implement your training philosophy and programming.

By Adam Ross

T&C DECember 2012

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Editorial Board Marjorie Albohm, MS, LAT, ATC Director, Ossur Americas Past President, NATA

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

Jon Almquist, ATC Athletic Training Program Administrator Fairfax County (Va.) Public Schools

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

Jim Berry, EdD, ATC, SCAT, NREMT Head Athletic Trainer Myrtle Beach (S.C.) High School Christine Bonci, MS, LAT, ATC Associate Athletics Director Sports Medicine/Athletic Training University of Texas Leslie Bonci, MPH, RD, CSSD, LDN Director of Sports Medicine Nutrition Center for Sports Medicine University of Pittsburgh Medical Center Cynthia “Sam” Booth, PhD, ATC Visiting Assistant Professor SUNY Brockport Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center Cindy Chang, MD President, American Medical Society for Sports Medicine Dan Cipriani, PhD, PT Associate Professor Deptartment of Physical Therapy Chapman University Gray Cook, MSPT, OCS, CSCS, RKC Clinic Director Orthopedic and Sports Physical Therapy Dunn, Cook and Associates Keith D’Amelio, ATC, PES, CSCS Nike Sparq Training Bernie DePalma, MEd, PT, ATC Assistant Athletic Director Head Athletic Trainer/Physical Therapist Cornell University Lori Dewald, EdD, ATC, CHES, F-AAHE School of Public Safety and Health American Public University 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 Athletic Trainer/Conditioning 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, Liberty High School, Colo.

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

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T&C decEMber 2012

Allan Johnson, MS, MSCC, CSCS Sports Performance Director Velocity Sports Performance Tim McClellan, MS, CSCS Strength and Conditioning Specialist Rehab Plus Sports Performance and Injury Rehabilitation Timothy Morgan, DC, CCSP Professor of Exercise and Health Sciences University of Massachusetts Jenny Moshak, MS, ATC, CSCS Assistant AD for Sports Medicine University of Tennessee Steve Myrland, CSCS Owner, Manager Myrland Sports Training, LLC Director of Coaching, Train-To-Play Tim Neal, MS, ATC Assistant Director of Athletics for Sports Medicine Syracuse University Mike Nitka, MS, CSCS Director of Human Performance Muskego (Wis.) High School Bruno Pauletto, MS, CSCS President, Power Systems, Inc. Stephen M. Perle, DC, MS Professor of Clinical Sciences University of Bridgeport College of Chiropractic Brian Roberts, MS, ATC Director of Sports Medicine and Business Operations, Xcelerate Physical Therapy Ellyn Robinson, DPE, CSCS, CPT Assistant Professor of Exercise Science Bridgewater State College Kent Scriber, EdD, ATC, PT Professor/Clinical Education Coordinator Ithaca College Chip Sigmon, CSCS*D Speed and Agility Coach OrthoCarolina Sports Performance Bonnie J. Siple, EdD, ATC Assistant Professor, Department of Exercise and Rehabilitative Sciences Slippery Rock University Chad Starkey, PhD, ATC, FNATA Division Coordinator, Athletic Training Program, Ohio University Ralph Stephens, LMT, NCTMB Sports Massage Therapist, Ralph Stephens Seminars Jeff Stone, MEd, LAT, ATC Head Athletic Trainer, Suffolk University

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

Fred Tedeschi, ATC Head Athletic Trainer, Chicago Bulls

Gary Gray, PT President, CEO Functional Design Systems

Terence Todd, PhD Lecturer, Kinesiology and Health Education University of Texas

December 2012 Vol. XXII, No. 9 Publisher Mark Goldberg Editorial Staff Eleanor Frankel, Director Abigail Funk, Managing Editor R.J. Anderson, Patrick Bohn, Kristin Maki, Mary Kate Murphy, Dennis Read Circulation Staff David Dubin, Director Erin Stewart Art Direction Message Brand Advertising Production Staff Maria Bise, Director Neal Betts, Trish Landsparger Business Manager Pennie Small Special Projects Natalie Couch Dave Wohlhueter Administrative Assistant Sharon Barbell Marketing Director Sheryl Shaffer Advertising Sales Associate Diedra Harkenrider (607) 257-6970, ext. 24 Advertising Materials Coordinator/Sales Mike Townsend (607) 257-6970, ext. 13 T&C editorial/business offices: 20 Eastlake 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., 20 Eastlake Road, 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© 2012 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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ComebackAthlete

Chris Davis & Alfred Ramsby Colerain High School, Cincinnati, Ohio

By Patrick Bohn

Teammates push each other in the weightroom all the time. But when Colerain High School junior football players Chris Davis and Alfred “L.A.” Ramsby both went down with serious knee injuries in the span of two weeks during the 2011 season, Jason Taylor, ATC, Head Athletic Trainer at Colerain, took that motivational concept one step further by having Davis and Ramsby rehab together to aid in their return to the field.

Davis’s injury occurred on Sept. 2 during Colerain’s second game of the season. In the third quarter, the starting running back took a handoff and began running to his left. Just as he hit his stride, Davis’s knee buckled and he went down.

“It looked like he hyperextended his right knee,” Taylor says.

The injury had occurred on a non-contact play and at first glance, didn’t appear to be severe. But when Davis didn’t get up, Taylor grew concerned. “Chris isn’t the type of kid who stays on the ground after a play,” he says. “When I got to him, he was screaming. I put my hand on his knee and felt something I shouldn’t have been feeling—his tibial plateau had rotated around.”

The pain from the injury was excruciating. “I thought my career was over,” Davis says. “I’d never experienced anything like that before. When Jason came out on the field, he was talking to me, but I couldn’t concentrate on what he was saying because it hurt so much.”

The team physician was able to reduce Davis’s knee on the field, which lessened the pain, but Davis was upset as he was taken off the gridiron. Taylor tried his best to keep the running back focused on the positive. “Every athletic trainer gets a pit in their stomach when they see a season-ending injury,” he says. “But my goal was to keep Chris from worrying about it too much. I kept telling him that whatever the injury was, we were going to take care of it.”

In the hospital, Davis got grim news: he had dislocated his right kneecap, completely torn his ACL and LCL, and partially torn both his PCL and MCL. While it was a serious injury, there was no arterial or nerve damage—something Taylor stressed to Davis and his parents shortly after the diagnosis.

“I didn’t want to get too far ahead of myself, but I told Chris and his parents that the injury was fixable, and we could rehab Patrick Bohn is an Assistant Editor at Training & Conditioning.

He can be reached at: pb@MomentumMedia.com.

TR AINING-CONDITIONING.COM

Colerain High School’s Chris Davis (top) and Alfred Ramsby both returned to the field this season after suffering knee injuries within two weeks of each other in 2011. it,” Taylor says. “I also told them that the lack of nerve and artery damage was a benefit not just when it came to Chris returning to play, but to his life after football as well. That helped reassure them it was going to be okay.”

Davis was scheduled for surgery on Sept. 23, when he would receive a cadaver allograph to repair his ACL and posterial lateral corner, and reinforce his LCL. Davis was looking at a lost season and a long rehab. In a twist of fate, however, he would soon have his teammate and closest friend there to help him through it.

Exactly one week before Davis’s surgery, during Colerain’s fourth game of the season, Ramsby, the team’s starting quarterback, rolled out looking to pass. When he attempted to make T&C DECEMBER 2012

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ComebackAthlete a jump cut, he felt his left knee give out and fell to the ground.

“Like with Chris, it didn’t look like anything serious when it first happened,” Taylor says. “In fact, when I met L.A. out on the field, the first thing he told me was, ‘My knee feels funny, but I think it’s okay.’ I did a Lachman test, and his knee felt very loose, so I told him we needed to take him into the athletic training room to get a better look at it.”

The team physician told Ramsby he had torn his ACL and surgery was scheduled for Oct. 18. While his injury wasn’t as extensive as his teammate’s, he too had immediate concerns about his playing career. “The first two days after the injury, I was pretty down,” he says. “I didn’t think I’d be able to play the way I had before. But Jason kept telling me it was going to be okay.”

“I told L.A. to watch some NFL games and see how many quarterbacks were using functional braces—that some of those quarterbacks wear them because they had a previous ACL injury,” Taylor says. “It was pretty easy to find examples of players coming back from an ACL tear.”

While Ramsby began preparing for his surgery, Davis was beginning his rehab. Although Davis’s injury was complex, Taylor had him follow a relatively standard knee injury rehab protocol.

The first few weeks focused mainly on neuromuscular re-education of Davis’s right leg. He did quad sets, heel slides, and leg raises, and had Russian e-stim performed on his quad.

“I also focused on swelling and pain reduction in those first few weeks,” Taylor says. “I wasn’t as concerned with getting his knee straight at that point. I wanted to make sure the posterial lateral corner had adequate time to heal.”

Davis was non-weight bearing immediately following surgery, but after a few weeks, Taylor began to introduce a lot of weight shifting by having Davis catch a ball while standing on his right leg.

He also had him balance on it while reaching down to pick objects up off the ground. Glute and hip strength was developed through exercises like clam shells and bridges, and Davis worked his core with planks and leg lifts.

With a month of Davis’s rehab be­4

T&C DECEMBER 2012

hind him, Taylor began planning for the next step. At the same time, he was welcoming Ramsby into the athletic training room and planning his rehabilitation.

That’s when the idea of a rehab partnership was formed.

“The concept of working with two people on the same rehab isn’t that uncommon,” Taylor says. “People in a clinic come in with the same injuries all the time. However, I had never tried it at the high school level and I was a bit worried about how they would handle all the distractions other athletes presented because I could really only watch one of them at a time. But they were good friends, and I knew they would be motivated to get healthy for their senior years. We all know players benefit when they’re doing a workout with someone, so why wouldn’t that philosophy apply to rehab?”

Both players immediately bought into the idea. “Working with Chris was great,” Ramsby says. “Sometimes when I’m alone, I may slack off a bit, but with him there, I knew I wasn’t going to get bored doing the work. For me, the mental aspect of the rehab was challenging, but Chris was always there, keeping me accountable, telling me, ‘You’re going too slow, you’ve got to keep working and push yourself.’”

“L.A. is like my brother,” Davis says.

“We’ve grown up together and played together for a long time. Every day I was excited to come in and do the work because I knew he would be right next to me. I couldn’t take a day off.”

Ramsby began his rehab in late October, doing much of the same exercises as his teammate, such as leg raises, wall squats with and without a physio ball, and step-ups. Although Davis’s injury was more severe, because his surgery had occurred nearly a month sooner, the two players were at similar stages in their rehab timelines by the time Ramsby was ready to work.

As fall turned into winter, it became apparent that having the players do their workouts together was providing major benefits. “For example, when they progressed to leg presses in December, I wanted to keep the weights light and focus on their form,” Taylor says. “And if I had to correct the form of either one of

Chris Davis Position: Running Back Injury: Right knee dislocation, ACL and LCL tears, partial MCL and PCL tears

Alfred “L.A.” Ramsby Position: Quarterback Injury: ACL tear Result: Both players successfully returned to play their senior years. At press time, the team was 12-0 and ranked first in the state.

them during the exercise, the other one would get on them about it quickly as well. It served as a great motivator.”

Taylor admits it was tricky keeping Davis and Ramsby from lifting heavier weights at first, but he often let the results speak for themselves. “One of them might have said, ‘I can’t believe you’re only going to let me do 20 pounds on the leg press while my teammate is watching,’” he says. “But by the time they got to the end of the exercise, their leg would be shaking.”

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ComebackAthlete In January, Taylor allowed the two players to do upper body and core work with the rest of their teammates four days a week before doing lower body and plyometric work with him. “The guys were interested in more than just getting back on the field,” he says. “They were going to be senior leaders on the team, and they needed to forge that dynamic and get the younger players looking up to them.”

In mid-January, Taylor wanted to see how the rehab was progressing, so he had the players do a single-leg hop test on their injured leg. Both scored over 80 percent, well above the normal level.

At this point, their workouts intensified. Ramsby and Davis began doing step-ups while holding weights ranging from 15 to 40 pounds before progressing to a 45-pound bar. By February, the players were doing squats until they hit the top of a box set at a specific height.

The box gradually got lower as the players increased their range of motion to 90 degrees. Both players were progressing so quickly that each week Taylor added 25 to 50 pounds to their squat weight.

Taylor also introduced agility ladder and plyometric box work to the rehab programs at this time. The box work provided the players more opportunities to push each other. “I started them on a six-inch box and had them jump on it 20 times,” Taylor says. “That progressed to 12 inches, and then 24. Each time we did it, whichever one of them went second would try to do it just a little faster.

“I think it also helped them to have someone to watch,” he continues. “If they were doing the agility ladder, they could watch the technique the other one used and improve on their own. Sometimes, they would even criticize the other’s technique before I had a chance to bring it up.”

Taylor was in constant communication with the Colerain coaching staff regarding both players’ return-to-play status.

While the initial goal was to have them back for August workouts, by late April, Ramsby and Davis were both cutting and running on the field. A checkup with their orthopedists around this time resulted in a clear to return to practice with the team in June.

TR AINING-CONDITIONING.COM

Both Ramsby and Davis made successful returns to the gridiron this past fall and helped the Cardinals remain one of the best teams in the country.

Ramsby says his leg feels stronger now than it did before the injury. “I am playing at 195 pounds as a senior after playing at 188 at the beginning of my junior year, but I feel like I am faster and more athletic now,” he says.

And Davis is back running with confidence following his devastating injury. “I wasn’t nervous getting back on the field

because I knew Jason had done a great job helping me through my rehab,” he says. “I don’t have any pain in my knee and I’m thankful to him for that.”

Taylor says this rehab experience got him to appreciate the importance of thinking outside the box. “I don’t think I ever imagined there would be a benefit to approaching a rehab like you would a traditional workout,” he says. “But Chris and L.A. both attacked their rehabs and strove to be better than each other, and that really paid off.” n

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Bulletin

Board

Stress Ball for Improved Performance?

Athletes everywhere dream of sinking a buzzer beater or scoring on a penalty kick to win a game. According to a study published in the September issue of the Journal of Experimental Psychology: General, investing in a stress ball—and squeezing it in their non-dominant hand—may help athletes turn those dreams into reality.

Lead researcher Jürgen Beckmann, PhD, Chair of Sport Psychology at the Technical University of Munich, came to this conclusion after conducting experiments with righthanded athletes who compete in soccer, taekwondo, and badminton. He found that when the athletes squeezed a ball with their left hand prior to a stressful competition they were less likely to “choke.”

In Beckmann’s first experiment, 29 semi-professional male soccer players kicked a series of penalty shots at predetermined targets. Points were awarded for each shot based on accuracy. The next day, the players were split into two teams and kicked the same shots in front of 300 people. Before each participant’s turn, he squeezed a soft ball for 30 seconds—one team with their left hands and the other with their right. The players who squeezed with their right hand saw their average score drop by 2.40 points. Those who squeezed with their left, however, saw a lower decrease in their average score—a drop of only 0.14 points.

The second experiment included 19 taekwondo athletes (13 men and six women) who completed 20 kicks on a sandbag. To test accuracy, a point was given every time an athlete hit a specified area on the bag. The athletes were told their next 20 kicks would be videotaped and evaluated by their coaches. In this pressure phase, they squeezed a ball for 30 seconds before beginning. Athletes who squeezed with their left hand saw their scores increase by an average of 1.22 points, while those who squeezed with their right saw their scores decrease by 1.60.

In the final experiment, 18 badminton players (12 men and six women) began by practicing 10 serves. Again, points were awarded for accuracy. To isolate a pressure situation’s effects without the athletes squeezing a ball prior to serving, the researchers divided the group into two competing teams. A video camera was set up and the athletes were told coaches would evaluate their technique.

The athletes then completed a second set of 10 serves.

Before a third set of serves, researchers had the athletes squeeze a ball for 30 seconds, half with their right hands and half with their left. The left-squeezing squad saw scores go from 47 pre-pressure, to 38.33 during pressure, to 49.22 after squeezing a ball. Their opponents’ scores decreased from 49.11 to 44.67 to 38.67.

Beckmann chalks the findings up to rumination—focusing too much on movement, which is controlled by the left ­8

T&C decEMber 2012

side of the brain, instead of letting muscle memory take control, a function of the right side of the brain. “Rumination can interfere with concentration and performance of motor tasks,” he told Science Daily. “Athletes usually perform better when they trust their bodies rather than thinking too much about their own actions.”

The left side of the brain controls rumination, while the right side manages muscle memory. When the athletes in the experiments squeezed a ball with their left hand, they activated the automated movement management controlled by the right side of the brain. In doing so, the muscle memory they had developed through years of practicing their sport controlled their movements. Conversely, athletes who squeezed with their right hands activated the left side of the brain, which over-thinks movements. This caused tension, and the athletes choked under pressure.

The study, “Preventing Motor Skill Failure Through Hemisphere-Specific Priming: Cases from Choking Under Pressure,” can be downloaded from the American Psychological Association’s press release, found by searching the study title at: www.apa.org.

Using Treadmills to Gauge Return to Play Researchers at the University at Buffalo’s Concussion Clinic have been awarded a $100,000 grant from NFL Charities. The research team plans to use the money for return to play research over the next 18 months.

The Concussion Clinic will use treadmill tests on 35 to 50 male athletes from the Buffalo Bills, Buffalo Sabres, and local colleges to help determine a safe, objective return to play protocol. Over the 18 months, when any of the athletes suffers a concussion, he will go to the Concussion Clinic for testing.

During the testing process, the athlete will walk on a treadmill at a slow pace. His heart rate, blood pressure, pulmonary ventilation, and cerebral blood flow will be carefully monitored. Then, the speed of the treadmill will gradually increase. If the athlete can continue exercising to his VO2 maximum capacity—reaching a heart rate of 220 minus age—without exacerbating any symptoms of concussion, he may be ready to return to play. Regular MRIs will reinforce treadmill results, and the concussed subjects will be compared to healthy subjects.

The treadmill tests are groundbreaking in their use of exercise to evaluate concussion, as conventional wisdom recommends physical rest. According to Barry Willer, PhD, co-principal investigator for the grant, exertion tests can be very effective for determining if an athlete should return to play because the data is objecTR AINING-CONDITIONING.COM

Bulletin

Board tive. “An athlete cannot ‘fake’ their results or lie about symptoms,” he says.

With their findings, the team of researchers will formulate a three-step plan for deciding when an athlete can return to play. They hope the plan will give a clear indication of when an athlete is ready to play, and help prevent future injury.

To view UB’s statement on the grant, visit: www. buffalo.edu/news/13660. To view videos of previous concussed athletes undergoing treadmill testing, visit: concussion.buffalo.edu/links.html.

ACL Surgery: Ten Years Later How well do soccer players who have ACL reconstruction fare in the decade following surgery? In a study published in the September issue of the American Journal for Sports Medicine, researchers from Washington University in St. Louis found that the answer is, quite well.

The researchers interviewed 100 players, 55 male and 45 female, who underwent surgery in either 2002 or 2003. At the time of surgery, the players ranged in age from 11 to 53. Seventy-two of the athletes had returned

to play within a year after surgery, and half of those athletes were still playing seven years later.

Although both genders returned to play in similar timeframes and both were still playing at equal rates a decade later, there were differences between the two groups. Overall, male players were more likely to return to play (42 male vs. 30 female), particularly if they had surgery when they were young. Male players who didn’t return were more likely to cite ACL injury as the reason they stopped playing, compared to females who didn’t return.

Twelve of the 100 study participants, nine female and three male, underwent a second ACL surgery within the decade after their initial reconstruction. Athletes whose initial ACL reconstruction was on their non-dominant limb had a higher risk of future injury to their dominant limb, compared to athletes who had injured their dominant side (16 percent vs. 3.5 percent).

To view the abstract of the study, “Return to Play and Future ACL Injury Risk After ACL Reconstruction in Soccer Athletes From the Multicenter Orthopaedic Outcomes Network Group,” go to: ajs.sagepub.com and search the study title.

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Circle No. 107

LEADERSHIP

GONE FISHING

When Anthony Ortolano retired, one of the first things he did was go on a fishing trip to Alaska.

How do you know when it’s time to retire? We asked three athletic trainers to share why they decided to say goodbye to the athletic training room.

By Anthony Ortolano

A

fter 26 years as the Head Athletic Trainer at Rensselaer Polytechnic Institute, I retired last spring. When you’ve spent more than a quarter of a century at one place, moving on is not a simple decision. Many factors come into play.

First, can you actually afford to retire? The majority of athletic trainers I know did not go into the profession to make money, so this is an important piece to figure out. I met with a financial services company, RPI’s retirement planner, and our family’s personal financial consultant to make sure that we’d still be able to live comfortably after my retirement.

Anthony Ortolano, MS, ATC, was the Head Athletic Trainer at Rensselaer Polytechnic Institute for 26 years. Prior to that, he was an athletic trainer at Union College and athletic trainer and professor at SUNY Plattsburgh. He is a winner of the Tom Sheehan Award, which is given annually to the athletic trainer who has done the most for the advancement of the profession in New York. He can be reached at: ortola@rpi.edu.

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T&C DECEMber 2012

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Everyone talks about how retirement gives you time to do the things you want to do, but you need to make sure you have things you truly want to do. I am fairly confident that my so-called idle time will not be idle.

I am a new grandfather and an enthusiastic hunter and fisherman. I would like to become good at all three of those things. My wife and I live on a beautiful 118-acre tree farm that could use more work than I would be able to do in three lifetimes. And for the first time in a long time, I was able to spend the summer providing a service to studentathletes without having to maintain an administrative posture when I worked the North Star and Nike Blue Chip lacrosse camps at the Lake Placid Summit tournament.

The decision to retire is truly personal. I recently read Colin Powell’s book on leadership and the last few chapters were about him retiring. A lot of what he said really resonated with me, including: “You need to get out before your expiration date” and “When you’re done pumping, let go of the handle.”

I had something left in my tank, but I also wanted to leave before my expiration date. I had been grooming an assistant athletic trainer for seven years to take over as the Head Athletic Trainer and it was time for him to do that.

I also sought advice from others. My most important advisor in this decision was my best friend: my wife. We talked about the financial aspects and her biggest worry—that I’d be underfoot once I left RPI. But I’m paying her back for the past 27 years she spent raising our four kids. They are all successful professionals and I’m sure that if she weren’t there, I would have screwed that up. Now, I cook dinner every night and have a glass of wine ready for her when she walks in the door. I’m trying to make up for at least some of those years.

Another factor to consider is whether retiring means stepping away completely or simply cutting back. Although I was ready for retirement, it is not yet time for me to stop working completely. I have a new job close by at Siena College, which offered me a per diem position covering the men’s lacrosse team during the fall.

Schools are beginning to recognize that with a collision sport like men’s lacrosse, an athletic trainer is needed even during the nontraditional season.

When I decided to retire, I called Siena and another nearby school because I

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LEADERSHIP knew they both offered per diem positions. Once the fall season is over, I will continue to work a few days a week and maybe in the spring as well. Working at Siena also gives me the opportunity to work with Head Athletic Trainer Greg Dashnaw, LAT, who was one of my first athletic training students in the 70s when I worked at SUNY Plattsburgh.

Has it been hard to let go of the handle completely? Sometimes, yes. I don’t

go to RPI football games because I know if I were there, the players would ask me why their shoulder or back still hurts. So I just check the scores online for now.

My identity is not fully based on my profession. I am a husband, dad, grandfather, volunteer, someone who cares about personal fitness, an outdoorsman, and a friend. And I will continue to be all of those things long after athletic training is in the rearview mirror.

Kim Blackburn volunteers at a Teammates for Life silent auction.

By Kim Blackburn

I

f anyone had asked me 20, or even 10, years ago when I was going to retire, I would have answered, “Are you crazy? I will be here forever.”

But life changes, sometimes quickly, and we can be forced to think about retirement much earlier than we ever thought we would.

I had a couple of reasons for retiring. The biggest was my health. I was not able to give my job my best performance because my knees couldn’t sustain me being on my feet day after day. Second, my mother is getting older and I want to be able to spend some

quality time with her. We all know that athletic trainers work ridiculous schedules sometimes, and our families often suffer as a result.

In the end, my health issues made the decision to retire easy. I was not recovering quickly enough from long days on my feet. And my knees were so painful at night that I wasn’t getting good, restful sleep. My assistant athletic trainers had to pick up the slack on tasks I could no longer physically perform. I want our athletes to get the best care possible and when I asked myself if I was still doing that

Kim Blackburn, MSEd, ATC, was the Head Athletic Trainer at Strongsville (Ohio) High School for 27 years. She received the Ohio Athletic Trainers’ Association Service Award in 2010 and can be reached at: kblackburn015@gmail.com. ­14

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Yes, I miss the camaraderie of my staff, mentoring new athletic trainers, and interacting with 600 athletes every year. But for the first time since 1973, I did not spend August working a preseason camp. And when I was asked to contribute to Training & Conditioning, I was actually in Alaska preparing to go fly fishing. I wholeheartedly consider retirement not an end, but a beginning. n

for our athletes, the honest answer was no.

Though this made the decision simple, it was not easy to accept. To my colleagues who are having a difficult time figuring out when to retire, I believe that, above all, you need to be honest with yourself. I have a “type A” personality—I need to control things around me. But the fact that I could not control my health made me take a hard look at myself.

Although my retirement so far has included two surgeries, including one knee replacement (the other is scheduled for next year), it hasn’t all been negative—not by a long shot. Even with the time in the hospital, I’ve still kept busy. I have continued teaching CPR at our local hospital part-time and increased my hours there by adding classes and filling in for other instructors when needed.

I also do pharmaceutical audits and closeouts for an out-of-town company I have been involved with since 2000. I am a field inventory specialist, a third party who goes to a pharmaceutical representative’s storage site and performs an inventory count, or “audit” of their pharmaceutical samples. Most of the time, this also involves an additional inspection of the storage site.

In addition to my paying jobs, I continue my volunteer work with our area Kiwanis Club. I am the secretary for the Foundation of the Kiwanis Club, and I chair the scholarship committee. I have assisted our club in various fundraising projects, like selling raffle tickets, working our golf outing, and helping with service projects like “Read around the World” and “Memory Bags,” a program for children who have had a parent, sibling, or grandparent pass on.

I also recently started volunteering with the service group Teammates for TR AINING-CONDITIONING.COM

LEADERSHIP Life with my college teammates. The group raises money for former teammates who need financial help for a medical need, like cancer. Though all of my volunteering roles are rewarding, this one is at the top of the list.

It’s helped me get back in touch with my former teammates, and the support and camaraderie we’ve rekindled with each other has been amazing.

There’s nothing like having an old teammate call to ask if I want to go to an Indians game or a party.

And I’m staying involved with Strongsville High School by continuing my work with the athletic boosters. I recently became a member of the high school’s Athletic Hall of Fame Committee, too. This is my first year and I’ve been part of planning the induction dinner and surrounding festivities. I am enjoying seeing old faces and getting involved in our community in another way.

In terms of athletic training, I’m still active in the Ohio Athletic Trainers’ Association, continuing my service on the legislative committee. And I am preparing to teach in the Athletic Training Education Program at Baldwin Wallace University. I’ll be taking over temporarily for a colleague going on her maternity leave.

Strongsville has been a clinical site for Baldwin Wallace athletic training students since 1987. The college students get a chance to experience a rotation with high school athletic trainers through us. Teaching these students on a more individual level using real world application was wonderful. I have also taught at the University of Akron and at Strongsville, so when a friend there called and said that I was her choice to fill in, I felt honored. In all those years, I must have made a positive impact on some of those individuals in their learning journey. This opportunity and new adventure is really exciting.

What I miss most about not being an athletic trainer at Strongsville is the athletes. I enjoyed being around them and helping them achieve their goals. We had some of the best athletes around, and it was a true pleasure to be a part of their success.

What I don’t miss are those days of unpredictable weather that plague Northeast Ohio. Standing outside in the elements and getting soaked through my rain jacket or not being TR AINING-CONDITIONING.COM

able to feel my toes after a Friday night football game was never my idea of fun. I also don’t miss loading or carrying all those water and ice coolers. No matter what size—three, five, six, or 10 gallons—they were all heavy and I always ended up with a wet shirt, no matter what.

I’ve now been able to replace those not-so-great times with gardening, lawn care, fishing, working out, and just having fun when I want to. I thought I would miss my job more, but I don’t have time to. With no regrets about my decision to retire, I am looking forward to my next adventure. n

Sandy Miller poses with his family at his retirement party.

By Sanford “Sandy” Miller

I

had been thinking about the big “R” word for several years before I decided to do it. I had always told myself that I would retire at age 62, but as that birthday approached, I really thought long and hard about whether it was truly time.

I spoke about it with some of my closest friends in the athletic training world who were already retired, other close friends not involved in the profession at

all, and most of all, my wife. She understands this profession and what we do very well because she has lived it with me for 39 years.

I knew that I did not want to continue working if it meant that the job got stale and I was no longer challenged, and I could feel this beginning to happen. It would not have been fair to the student-athletes or our athletic training students if they couldn’t see

Sanford Miller, MSEd, LAT, ATC, was the Head Athletic Trainer at Stephen F. Austin State University for 31 years. He is a member of the NATA and Southwest Athletic Trainers’ Association Halls of Fame and an NATA Most Distinguished Athletic Trainer. He won the Gatorade Tim Kerin award in 2011 for outstanding service by an athletic trainer and can be reached at: smiller@sfasu.edu.

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LEADERSHIP my passion for our profession in my daily duties. In the end, my internal clock told me it was time to go on with the rest of my life, so I said goodbye to the athletic department at Stephen F. Austin State University at the end of the summer.

However, I knew that I couldn’t stop working completely. It would drive me— and my wife—crazy. So I looked at several part-time employment options.

Since my SFA contract was a 50/50 split between teaching for the department of kinesiology and health sciences while

serving as Associate Athletics Director for Sports Medicine, I asked about continuing my teaching duties. Our graduate entry-level athletic training curriculum director asked me to continue teaching six hours each semester.

I also work as a physician extender for our team orthopedist three days a week during clinic hours. He suggested this mutually beneficial option when he knew I was contemplating retirement, and I really enjoy doing it.

It’s been neat to get a different picture of how athletic training services can

LEADERS. INNOVATORS. EXPERTS

I loved what I did as an athletic trainer, but I’m looking forward to living at a different pace. I will spend time fishing, playing golf, hunting, and most of all, enjoying my grandchildren.

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be incorporated into a doctor’s office.

And both jobs help keep me in touch with our students.

When you start thinking about retiring, the first thing you have to figure out is whether you can afford to do it. I cannot stress how important it is for young athletic trainers to make sure they plan for the future. Luckily, I got some good advice about my finances in my early years, and I’m glad I listened to it.

I have been asked what I will miss about athletic training and what I won’t.

I do miss my job, especially the interactions with student-athletes, fellow staff, and the athletic training students.

What I don’t miss are the endless hours. As head athletic trainers, we

WWW.SPRI.COM

tend to think that the athletic training room and athletic training education program cannot run without us, which makes us our own worst enemies when it comes to our hours on the job.

Both of my sons grew up without me in many aspects of their lives due to my job, although my wife brought them to the athletic training room and athletic events as often as possible so they could spend time with me. Their elementary school was just over the fence from our practice field so they often spent time after school at the fieldhouse until their mother picked them up after work.

I also don’t miss the year-round practice plans we are seeing in college athletics now. There is no time off for the athletes or the athletic trainers.

The “powers that be” need to examine this issue because both athletes and athletic trainers need rest and recovery following a season.

I loved what I did as an athletic trainer, but I’m looking forward to living at a different pace. I will spend time fishing, playing golf, hunting, and most of all, enjoying my grandchildren. It just might be fun to be a fan as well, to see how the other half lives. n TR AINING-CONDITIONING.COM

optimum performance

CENTERED STRENGTH

Though experts continue to disagree about some aspects of core training, our author says it’s the points they see eye-to-eye on that are most important.

By Michael Boyle

AP PHOTOS/david sTLUKA

T

here may be no topic discussed more in the field of strength and conditioning than core training. How important is core training? What constitutes the core?

What is the best way to train the core?

Who is right about core training?

The answer to the first question has become very clear: Core training is extremely important.

A strong core is the key to transferring strength developed in the weightroom to all sport movements. In addition, a strong core also helps guard against low back pain, a common complaint in athletic training rooms.

We’ve also been able to definitively answer the second question. Though we used to refer to the core as the “abs,” we now realize it constitutes not only the rectus abdominis, but also the external and internal obliques, transverse abdominis, hip flexors and adductors, gluteus minimus, medius, and maximus, erector spinae, and multifidus.

It’s the third and fourth questions that have plagued our profession. The purpose of this article is to attempt to clear up some misconceptions and disagreements about core training. This can be done by highlighting what has been proven about core anatomy and function and by looking for similarities instead of differences in competing philosophies.

Michael Boyle, MEd, ATC, is a strength and conditioning coach and consultant based in Boston and co-founder of Mike Boyle Strength and Conditioning.

He has been training athletes, from amateurs to Olympians and professionals, for over 25 years and is the author of Functional Training for Sports. He can be reached at: mboyle1959@aol.com.

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optimum performance TRAINING APPROACHES Over the past decade, many strength coaches who work with healthy athletes may have had their approaches to core training over-influenced by physical therapists who work with athletes who have back pain. Early on, we were having our healthy athletes spend a great deal of time on the floor, just as the injured athletes were, working to engage and control individual core muscles that were probably

single-leg movements are usually sport specific and functional—and therefore more valuable to an athlete.

From an anatomical perspective, everything changes when an athlete stands on one leg. The absence of a second foot on the ground triggers the core stabilizers to kick in.

Some strength coaches believed that if an athlete performed squats and deadlifts with heavy weights, core training

This is the sort of information that people like Paul Chek, Gary Gray, and Vern Gambetta challenged us with.

It questioned much of what we thought to be true, and at least for me, has forever changed the way I approach core training with my athletes. already working just fine. We learned a lot about anatomy, but we were wasting time on unnecessary exercises.

As we learned more about functional training, a lot of strength and conditioning coaches faced a conundrum. Physical therapists were fascinated by small muscles. However, some in the strength training crowd were saying that those same small muscles were of no concern.

They thought functional training was the way to go instead, because the entire core could be trained all at once.

We were at the intersection of two concepts and two fields: core training in a physical therapy setting to rehab back injuries, and functional training in a strength and conditioning setting.

Physical therapy and strength training are so linked as to be inseparable (we all know it is difficult to decipher at what point rehab morphs into performance training), so which field knows the best way to train the core?

As is usually the case, the answer lies somewhere in the middle of the two approaches. Core strengthening can be done by training the small muscles, but this approach is most effective for injured athletes or athletes with chronic back pain who are prehabbing to avoid injury. As strength coaches, when we are training healthy athletes, the best approach to core training is through functional movement exercises.

This can be illustrated by comparing single-leg and two-legged movements.

Two-legged movements are generally static and not sport specific (with the exception of rowing, where both feet remain flat throughout competition), while ­18

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was not necessary because the stress placed on the core musculature by the heavy loads in a bilateral stance was sufficient to properly train the core. However, as we have learned more about functional anatomy, it has become clear that performing exercises on two legs does not engage the core musculature in the same way that working on one leg does. In other words, exercises like squats and deadlifts, no matter how heavy, are not the proper stimulus to engage core muscles that are so critical for single-leg functional activities like jumping and sprinting.

This is the sort of information that people like Paul Chek, Gary Gray, and Vern Gambetta challenged us with. It questioned much of what we thought to be true, and at least for me, has forever changed the way I approach core training with my athletes.

DRAWING IN VS. BRACING Another issue that has come up in core training is how to stabilize the core muscles in order to train them most effectively. Researchers like Paul Hodges, PhD, MD, Director of the Centre of Clinical Research Excellence in Spinal Pain at the University of Queensland, have directed us toward a “drawing in” technique where a patient pulls their belly in toward their spine. Hodges also supports training the small muscle through exercises in supine, even using tools like blood pressure cuffs. I must admit that I was one of many who experimented with these exercises years ago and even extolled their virtues in my writing.

On the other hand, Stuart McGill,

PhD, Professor and Director of the Spine Biomechanics Laboratory at the University of Waterloo, was one of the first to challenge Hodges’s technique. McGill’s approach is what he refers to as “bracing” instead of “drawing in.” I personally think that the difference between bracing and drawing in is a bit of a tempest in a teapot scenario. McGill’s bracing concept emphasizes co-contraction of all the abdominal muscles while the drawing in concept focuses on the transverse abdominal and internal obliques. The key is in the similarity. Both McGill and Hodges want a stable core, but they disagree on the best way to do the stabilizing.

Again, the conundrum for strength and conditioning coaches was that we had another intersection of the fields: Hodges is a physical therapy researcher interested primarily in back pain. McGill is a researcher as well, but an engineer, not a physical therapist. Where Hodges focuses on patients afflicted with back pain, McGill has recently focused on athletes like Strongman competitors.

COMMON DENOMINATORS You may be asking yourself, “Why can’t these very smart researchers agree on core training?” But instead of focusing only on the differences between theories and approaches, perhaps more value can be found examining the common denominators. Hodges and McGill’s research agrees on a very important point: The muscles of the core are stabilizers, not movers.

Although these experts might debate the exact method of stabilization, both advocate the importance of decreasing motion from the lumbar spine and increasing motion from the hips and thoracic spine. While in years past, many strength coaches and personal trainers seemed to be trying to develop a core that was both stable and mobile, today’s core training may be more about the prevention of motion rather than the creation of motion—hence the term “stable core.”

Most back pain experts are in agreement on this. Attempts to increase rotational range of motion of the lumbar spine only serve to create motion in inherently stable segments. Rather, the places that should be gaining motion are in the hips and thoracic spine—two areas designed to generate movement.

Another point of agreement is that an inability to move the hips both actively and passively can lead to back pain.

From a hip standpoint, there are two TR AINING-CONDITIONING.COM

optimum performance fundamental mistakes that trigger back pain. The first is the substitution of lumbar extension for hip extension. Weak or inhibited glutes (what McGill calls gluteal amnesia) and tight hips cause athletes to extend at the lumbar spine instead of the hip. This is the root cause of many extension-related disorders.

The solution to this problem is simple in theory but difficult in practice. We need to teach athletes how to differentiate hip motion from lumbar motion, and then give them the active ability to do so.

This is where some of the floor-based, rehabilitation-type movements like quadruped exercises and bridge variations may be useful in the short term.

The second mistake is the reverse of the first: substituting lumbar flexion for hip flexion. In this case, weak or inhibited hip flexors cause athletes to flex the spine instead of the hip. Again, the solution is simple. We need to teach athletes how to differentiate between hip flexion and lumbar flexion, and teach them the correct movement patterns to do so. This can be as simple as performing planks with hip flexion on a slideboard.

What we have is a multi-factorial

problem that we have been addressing all wrong. Think of the spine as an unwilling victim being stressed or injured by the presence of tight hips and weak anterior abdominals. The key to solving a low back issue is to attack the hips and anterior core while “sparing the spine,” something McGill has advocated on many occasions.

THE THREE ANTIS As mentioned above, the best way to approach core training is through prevention of movement, not the creation of it.

In the same way that McGill talks about sparing the spine, the core muscles should be viewed more as brakes than accelerators and as stabilizers rather than movers.

Therefore, the best core training is about the three antis: anti-extension, anti-lateral flexion, and anti-rotation.

Anti-extension: The goal in the following progression is to teach the anterior abdominals to stabilize against increasing extension forces. Initially, there will be a simple period of motor learning before increasing stresses.

• Front plank • Stability ball rollout

• Ab wheel rollout • Bodysaw In our programs, each exercise (excluding planks which are held for time) is progressed weekly. In my first book, Functional Training for Sports, we called this a bodyweight progression.

The load remains constant and reps increase. The rollouts would progress from 3x10 to 3x12 to 3x14.

Anti-lateral flexion: We must view training of the lateral muscles not as “side benders,” but as lateral stabilization. For lateral stability, we use a progression of side planks.

• Side plank • Feet elevated side plank • Side plank row • Suitcase carry (moving side plank) Planks are a bit more varied from a progression standpoint. Side planks would work in a progression from a 10second hold to 20 to 30. The side plank row combines an isometric hold (side plank) with a resistance component. You can increase either load or reps in the row portion. Suitcase carries are generally done with five- to 10-pound increases in load every week with distance

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Circle No. 110 TR AINING-CONDITIONING.COM

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optimum performance remaining constant.

Anti-rotation: I think that for at least 10 years, we have been barking up the wrong tree when it comes to rotational training. The initial mistake was confusing hip internal and external rotation with spinal rotation. Many early attempts at rotational exercise stabilized the hips

between each segment from T10 to L5 is reported to be just two degrees. And the greatest rotational range is between L5 and S1, at five degrees. As a result, our anti-rotation progression consists of patterns designed to teach stability and/or movement through the thoracic spine.

• In-line chop

Weak or inhibited glutes and tight hips cause athletes to extend at the lumbar spine instead of the hip ... The solution is simple in theory but difficult in practice. We need to teach athletes how to differentiate hip motion from lumbar motion, and then give them the active ability to do so. and rotated or flexed the trunk. We must remember to train the core by moving the hips or extremities without any compensatory movement of the spine.

This does not mean that we don’t want the spine to move. It means that we want the spine to move correctly within its established limits. It is important to note that according to many experts, the overall range of lumbar rotation is approximately 13 degrees. The rotation

• In-line lift • Tall kneeling push-pull • Tall kneeling anti-rotation press In diagonal patterns (chop, lift, pushpull), we keep the reps at 10 and progress in two ways: Each week we change loads, increasing by 2.5 to 5 pounds. And in each training phase, we use a progression of postures or positions. Phase one is in line, phase two is in a lunge position, phase three is standing, and phase four

consists of single-leg variations.

STILL LEARNING Ten years ago, I was asked a question about the function of the transverse abdominus at a seminar and quickly realized I didn’t know what this muscle was supposed to do, or even exactly where it is located. A look at my 1970s copy of Gray’s Anatomy was of no help. The muscle was referred to as the transversalis and merited very few words.

The question at the seminar and subsequent embarrassment sparked a huge period of learning for me, and I know I’m not the only strength coach who has sought to enhance their knowledge about core training over the years. We have come a long way in terms of understanding core training, but surely there are more miles to travel.

When developing a core training program, look to the wisdom of the experts. They have a lot to teach us, and the key is in how we apply what we learn from these great teachers. Embrace change, embrace the knowledge of experts, and reap the benefits in both performance and health. n

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Circle No. 111

NUTRITION

to Solutions A runner with anemia. A field hockey athlete with celiac disease. A swimmer with changing dietary needs. Those were the problems.

These experts offer the solutions.

By Dr. Christine Rosenbloom, Caroline Mandel, & Jennifer Brunelli

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IMAGES: AP PHOTOS

From Problems

A

thletes may sometimes feel as if their body is working against them when it comes to nutrition. The effects of deficiencies, allergies, and aging can be great. A diet that was once helping to optimize performance may now be causing performance to suffer.

But athletes should not fear. Once recognized, anything the body throws at an athlete can be handled with careful changes to their dietary regimen. It may not be easy at first, and the athlete may need to relearn how to fuel their body, but if their diet is tweaked correctly, performance will improve.

In the following case studies, three sports dietitians share how they each helped an athlete conquer a dietary issue. In all three cases, the athletes got back on track to athletic success.

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NUTRITION

Running Low on Iron

By Dr. Christine Rosenbloom

A

high school cross country and track and field athlete, Miranda became a vegetarian because she read about the health benefits associated with a plant-based diet. She also hoped it would help her lose five pounds and get her to her selfdetermined “ideal” body weight.

However, after successful sophomore and junior seasons, Miranda was struggling in her senior year of high school.

The 5,000- and 10,000-meter specialist complained of fatigue, shortness of breath during exercise, cold intolerance, and an inability to fully recover between training runs.

Miranda’s physician diagnosed her with an iron deficiency (her hemoglobin was 10.3 g/dL, hematocrit 34 percent, transferrin 371 mg/dL, and ferritin 8 ng/ mL) and suggested she see a Registered Dietitian for a nutrition consultation.

When I initially met with Miranda, I reviewed her complete blood count and asked her to write down everything she ate for three days.

Along with revealing a lack of iron from food choices, her food record showed she was not eating enough carbohydrate and protein to sustain her training. She did have normal menses and was taking calcium carbonate gummies (500 mg/day). I explained to her that because she was not getting enough iron, her body was not able to carry enough oxygen to her muscles (hemoglobin) or make enough oxygen reserve in muscles (myoglobin), resulting in early fatigue and lack of energy.

Iron depletion in tissues can also cause cold intolerance and reduced exercise endurance. By not eating enough carbohydrate and protein, her body was not able to provide the building blocks to make the iron-carrying proteins or replenish glycogen stores in her muscles after a workout.

I recommended she do the following: Increase calorie intake. Miranda was consuming just 1,600 calories per day, but based on her age, training volume,

and frequency of competitions, a calorie range of 2,600 to 2,800 per day was much more appropriate. We started by increasing her intake to 2,100 calories a day by adding snacks between meals.

After two weeks, we bumped it up to 2,350 calories by increasing the portion sizes of her meals.

Increase carbohydrate intake. Miranda was consuming 192 grams of carbohydrate per day, which equaled 3.9 grams per kilogram of her body weight.

The goal was to up that to 5 g/kg, and possibly to 6 or 7 g/kg as her training increased. We added carbohydrate-rich snacks between meals to help her accomplish this goal. Her favorites were dried fruit, granola bars, yogurt, and whole grain fruit muffins.

Increase protein intake. Miranda was taking in 56 grams of protein per day, which translates to 1.1 grams per kilogram of her body weight. She needed 1.5 g/kg to provide adequate protein for endurance exercise and for hemoglobin synthesis. She added yogurt smoothies after workouts, snacked on nuts, and we identified vegetarian protein-rich options like beans, lentils, soy nuts, and veggie burgers that would fit her dietary restrictions.

Increase iron intake. This was the main area of concern for Miranda, and probably the most difficult. Her average dietary iron intake was 8.2 milligrams per day and it needed to be 15 mg/day to reach the Recommended Dietary Allowance. She was prescribed 325 milligrams of ferrous sulfate once daily for three months. But she also needed to learn how to increase iron in a vegetarian diet. One strategy was to simply eat more iron-rich plant foods. I gave her this list for ideas: • Instant oatmeal • Fortified breakfast cereals • Long-grain enriched rice • Vegetarian baked beans • Lentils • Soy crumbles and soy burgers

Christine Rosenbloom, PhD, RD, CSSD, is the Sports Dietitian at Georgia State University and Owner of Chris Rosenbloom Food & Nutrition Services. She is also Professor Emerita at Georgia State and was the Editor in Chief of Sports Nutrition: A Practice Manual for Professionals, 5th edition. She can be reached through her Web site at: www.chrisrosenbloom.com. ­22

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• Trail mix with raisins • Bean burrito • Chili with beans • Chick peas • Hummus • Black beans • Fat-free refried beans • Clam chowder • Lima beans.

A second strategy was to add more vitamin C (ascorbic acid) to her diet since it is a potent enhancer of iron absorption. It can change iron to a more absorbable form, giving the body up to three times more iron than when taken without vitamin C. Easy ways to add vitamin C include drinking orange juice with breakfast, adding peppers and salsa to a bean burrito, slicing strawberries into cereal, and eating a citrus fruit salad with a bowl of vegetarian bean chili.

We also talked about foods that can block iron absorption. Tea, coffee, and cocoa contain polyphenolic compounds that have some health benefits, but can block non-heme iron absorption. To get the most iron from her meals, I advised Miranda to choose beverages that don’t fight iron absorption such as water, citrus-based sparkling waters, and fruit juices. I told her to enjoy her coffee, tea, or cocoa only between meals.

Another discussion was about an “ideal” weight for a runner. Miranda was 5-foot-3 and 108 pounds, which is at the low end of the body mass index but still a healthy weight for her height and sport. We discussed that there is no “ideal” weight for an athlete and that performance is not tied to a specific body weight or body fat level.

What was most important was how she was performing. She acknowledged that she was eating too little to maintain 108 pounds and that she ran better when she weighed 112 pounds.

Miranda reversed her iron deficiency anemia through supplementation and changes to her diet. She began to feel better and reported having more energy as the weeks progressed. She remained a vegetarian, but occasionally included fish in her diet and stuck with five to six small meals a day to boost calorie and nutrient intakes. Miranda was able to regain her endurance and energy and was a valuable part of the cross country and track and field teams.

She is currently a college freshman and running on her university’s team. n TR AINING-CONDITIONING.COM

NUTRITION

Going Gluten-Free

By Caroline Mandel

B

ailey is a field hockey player who was ex p er ienci ng stomach pain, gas, bloating, and diarrhea during her senior year of high school. She was losing weight, feeling fatigued, and not playing well.

Her personal trainer suggested she eliminate gluten from her diet, and within a few weeks, Bailey’s symptoms disappeared. Fast forward to the start of her freshman year here at the University of Michigan, when she asked to meet with me for help planning gluten-free (GF) meals as a college athlete.

At our initial consult, we discussed gluten intolerance and athletic performance. Gluten is a combination of two proteins (gliadin and glutenin) found in grains such as wheat, rye, and barley.

Gluten issues range from a sensitivity to an intolerance to an allergy to celiac disease—which affects one to two percent of the population.

Celiac disease is a chronic inherited T-cell-mediated autoimmune intestinal disorder, which causes damage to the villi of the small intestine. Symptoms vary from person to person and include stomach pain, gas, bloating, diarrhea, weight loss, and inability to concentrate.

Individuals with celiac disease are at risk for arthritis, joint pain, dermatitis herpetiformis (a chronic blistering skin condition also known as Duhring’s disease), fatigue, nutrient deficiencies such as iron deficiency anemia, and osteoporosis.

Bailey had not been diagnosed with anything before she arrived here at Michigan. She only knew that she felt better when she didn’t eat gluten. In order to be tested for celiac disease, a person must include gluten in their diet for four to six weeks and then undergo blood tests that detect specific antibodies (deaminated gliadin peptide, anti-endomysial, and anti-tissue transglutaminase), as well as a biopsy of the small intestine. I consulted with the team physician, and we decided that, in order to not disrupt her season, Bailey would follow a GF meal plan until the off-season, when she Caroline Mandel, MS, RD, CSSD, is the Director of Sports Nutrition at the University of Michigan. She can be reached at: chmandel@umich.edu.

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would eat gluten for four weeks so she could be tested for celiac disease.

The first thing Bailey and I did was contact the dining hall manager and head chef on campus. We learned that our dining halls are quite friendly to students who need to follow a GF diet.

GF foods are marked with a special icon

and Bailey could check menus, nutrition information, and ingredients online to identify food choices for the day.

The dining halls stock GF bagels, pasta, breads, and cereals and even prepare GF meals in a separate area of the kitchen to prevent cross-contamination. Bailey also gave the dining hall staff her weekly schedule to make sure they had food ready for her when she came in to eat.

From there, I helped her plan meals that would meet calorie, macronutrient, and micronutrient requirements for her sport based on nutrient-dense choices

I am running faster and longer without pain.

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Circle No. 112 T&C december 2012

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NUTRITION of starches, lean proteins, colorful vegetables and fruits, and healthy fats. At 5-foot-5 and 140 pounds, Bailey required approximately 2,400 calories per day: 318 to 445 grams of carbohydrate (2.3-3.2 grams per pound of body weight), 76 to 108 grams of protein (0.54-0.77 g/lb), and 64 grams of fat (0.45 g/lb).

Bailey aimed to include starch from GF oatmeal or other GF cereals and breads, lean protein (milk, yogurt, eggs), and fruit at breakfast. At lunch and dinner, she included starch, lean protein (often a meat alternative such as beans), fruits, and vegetables. She used snacks such as fruits, vegetables, additional servings of dairy, and healthy fats from nuts and seeds to fill nutrition gaps. Bailey’s favorite meals included: Breakfast: A vegetable omelet for protein with hash browns and fresh fruit for carbohydrates and fiber Lunch: A GF wrap for carbohydrates containing GF lunchmeats for protein and vegetables for nutrients and fiber Dinner: Stir-fry with chicken for protein and vegetables for nutrients and fiber over brown rice

Snacks: Homemade trail mix made with dried fruit, almonds and GF cereal or GF pretzels and a cheese stick.

Before her season started, I contacted the field hockey team’s director of operations to plan Bailey’s meals when the team was on the road. We arranged with hotels to provide GF meals made up of items like a baked potato without seasoning, grilled chicken with garlic and lemon, salad with a GF salad dressing or olive oil and vinegar, and steamed vegetables. I also searched online for restaurants with GF options.

I designed a card for when the team went to restaurants. The front had a definition of celiac disease and a description of Bailey’s nutritional needs, and the back had a list of gluten-containing foods and ingredients and a request to prepare her meal separately with clean pans and utensils to avoid cross-contamination. All Bailey had to do was hand the card to the server and ask that he or she give it to the chef.

Bailey had a great freshman year, appearing throughout all 22 games in both the regular and postseason. After the season, Bailey ate gluten for four

weeks so she could be tested for celiac disease. Unfortunately, she had to withstand severe digestive symptoms, but we knew this was a possibility. We were not surprised when her blood tests came back positive for the antibodies associated with celiac disease. Her intestinal biopsy was positive for celiac disease as well, meaning Bailey would need to follow a GF diet for life.

Bailey moved off-campus to an apartment with a teammate her sophomore year. We worked on menu planning, grocery shopping, and label reading, and found a variety of GF foods in local grocery stores. Her roommate came to one of our nutrition meetings so we could educate her on how to avoid cross-contamination in their kitchen by keeping food preparation, pots, pans, utensils, sponges, dishtowels, and even toaster ovens separate. Bailey stored most of her food, silverware, plates, and cups in plastic bins with lids to prevent contamination.

As with any drastic diet change, there can be roadblocks. Bailey hit one during her sophomore season when she started experiencing constipation. Without consulting me or a doctor, she decided

Sponsored By:

from Training & Conditioning and Sports Health:

To honor: High school athletic trainers who have become MVPs in their athletic departments by going above and beyond their job duties to deliver the best sports medicine care to their athletes.

Why: Because high school athletic trainers are the unsung heroes of interscholastic sports and many work countless hours to help young people become the best they can be. We would like to honor those who put their heart and soul into helping studentathletes on a daily basis.

Criteria: To be considered, an athletic trainer must work with high school athletes (in either a school or clinic setting) and have the following qualities: • Have earned the respect of coaches they work with and studentathletes they care for • Go beyond their job description to support student-athletes • Put in extra effort to make the athletic training program the best it can be • Serves the local or larger community through community service

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T&C december 2012

Nominations: Please provide us with a 400-800 word description of how the nominee fits the above criteria. Any supporting materials are welcome. Full contact information for both the nominee and the person nominating must be provided.

Winner: Will be featured in the April issue of T&C and honored at the NATA Convention. He or she will also receive a plaque and productrelated prizes.

Questions: Please feel free to contact us with any questions: Eleanor Frankel, 607-257-6970, ext. 18 ef@MomentumMedia.com Send to: Most Valuable Athletic Trainer Award Training & Conditioning, Momentum Media Sports Publishing 20 Eastlake Rd., Ithaca, NY 14850 or MVatc@MomentumMedia.com Deadline: December 31, 2012

TR AINING-CONDITIONING.COM

Space Saving Equipment Revisited

by Ken endelman

Many professional and collegiate athletic programs are turning to mindbody exercise like Pilates as a valuable adjunct to their training programs.

And why not? Pilates has proven to increase athletic performance while decreasing the chance of injury for so many of our customers who either are elite athletes or train them.

But one of the biggest concerns I hear when talking to athletic trainers interested in putting together a program is “I’ve got limited space and I don’t think I can fit a Reformer. Are there alternatives?”

While Reformers are the most popular piece of Pilates equipment, they can take up a little space. So I thought I’d revisit some pieces of Pilates equipment that don’t take up much floor space yet are still extremely effective, along with specifications so you can see how much room you might need.

Please also note that most of these pieces come with an accompanying workout DVD.

EXO® Chair The EXO Chair provides a challenging strength Pilates workout for athletes within a small floor space footprint.

The EXO Chair includes attachments for resistance bands, letting users do many of the exercises on the Chair that you could formerly do only on a Reformer but in a fraction of the space.

The EXO Chair is also lightweight and easy to stack and store.

Specifications: Weight: 36lbs, Height: 22.5”, Length: 29.5”, Width: 23.5”.

Arm Chair No better tool exists for developing scapular stability and functional upper body strength, and for improving upper body posture then the Arm Chair. Great for athletes at any level, the Arm Chair develops upper body strength with scapular stability, and effectively integrates core and upper body work.

Specifications: H: 39”, L: 39”, Width of Base: 14”, Width of Rod: 30, Weight: 54 lbs.

Springboards Springboards provide athletes with an invigorating full-body workout. They are bolted to the wall, so it doesn’t take up floor space. You can mount several Springboards along a wall. If you do have a Reformer you can move it against the Springboard, giving it the capabilities of a Tower.

Specifications: W: 20”, H: 72”.

Pilates Arc™ The Pilates Arc has a gentle curve on one side and a steeper curve on the other, so its asymmetrical shape is extremely versatile for different uses and body types. It is made of high-density foam and is a very lightweight (less than four pounds!), and low-cost piece of equipment.

Specifications: L: 38”, H: 10.5”, W: 15.5”.

Orbit™ Orbit exercises include both circular and linear movements, and range from mild to complex. It’s an amazing core workout for athletes because their abdominal muscles are always engaged.

They will also see increases in upper body and lower body strength, and improved flexibility and balance.

Specifications: L: 22.75”, W:15”, H: 6.25”.

To learn more about any of these pieces of equipment, please visit pilates.com.

Ken Endelman is the Founder and CEO of Balanced Body, the worlds largest provider of Pilates equipment and education.

NUTRITION to eat small amounts of gluten-containing food because she knew they usually caused her diarrhea and would therefore solve her constipation problem. She also purchased a fiber supplement without reading the label and realizing that it contained gluten.

When Bailey told me about her “solutions,” I realized she did not fully understand the disease. We had a long talk. I explained how these strategies are dangerous for patients with celiac disease because the ingestion of gluten damages and inflames the intestines, decreasing absorption of nutrients, and possibly leading to long-term complications. Even if she wasn’t experiencing symptoms, the gluten was wreaking havoc on her body.

But we still needed to solve the constipation problem. We checked her dietary intake, which revealed that she was relying on many low fiber GF foods in her meal plan such as bagels, cereals, bars, breads, and pasta, and was not consuming enough fruits, vegetables, GF whole grains, and beans. Her dietary fiber intake was only 15 to 18 grams per day— inadequate compared to the Institute of Medicine’s recommendation of 25 grams

per day for women under 50. We revamped her meal plan to include eight to 10 servings of fruits and vegetables per day plus beans, potatoes, quinoa, wild or brown rice, and snacks that included fewer processed GF products. I also recommended she take a GF fiber supplement daily and increase her fluid intake. Her constipation resolved within a few days.

Bailey and I continue to follow up at the beginning of each semester to plan eating strategies around her class and training schedule. Following a GF meal plan that is nutrient-dense will help Bailey heal intestinal damage, keep her healthy, support her athletic performance, and prevent future complications of celiac disease. n

Changes with Age

By Jennifer Brunelli

I

t is possible for athletes today to be high level competitors well into their 30s and even 40s. This fact has become increasingly obvious in the sport of swimming over the past decade.

However, if these athletes want to remain competitive with their younger counterparts as they age, they often need to restructure their diet. This can include examining overall calorie in-

take, ratio of carbohydrate to protein to fat, hydration, recovery nutrition, and supplements. James, a swimmer who chose to compete professionally after college, knew this and sought me out for help with his nutrition plan.

James had a great track record when it came to the pool, but not such a stellar one when it came to his diet. At 14, he qualified as a senior national

Jennifer Brunelli, RD, LDN, is the Owner of RDpro and former Director of Sports Nutrition at North Carolina State University. She can be reached at: SportsRDpro@gmail.com.

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NUTRITION sprinter, and at 17 was an Olympic trials qualifier. But his diet during his high school years lacked in overall calories and carbohydrates.

James’s high school coach valued high volume training—10,000-plus yards daily—that required a lot of calories. I think it would be reasonable to say that he should have been eating upwards of 6,000 calories per day. Had James and I been working together at the time, I would have suggested that he get so many calories from quality sources such as whole grains, fruits, and vegetables. His meals should have been well balanced at 55 to 60 percent carbohydrate, 15 to 20 percent protein, and 20 to 25 percent fat.

Unfortunately, he instead ate whatever he wanted to, including a lot of high fat, high sugar choices, like fast food. On the days that he hit the drive-through, his calorie count approached 5,000, but his intake looked more like 40 to 45 percent carbohydrate, 10 to 15 percent protein, and 30 to 40 percent fat. Regardless of his insufficient diet, James continued to improve his times in the pool.

Not much changed when he went to college. Consistency in nutrition is

something I push for with my collegeage clients. This was James’s biggest hurdle at the time. Some days he was too tired between classes and practice to get to the dining hall, so he resorted to low calorie options such as cereals and prepackaged noodles.

As in high school, James saw con-

morning before he went to practice and a recovery meal within 30 minutes of completing his workouts. Eating breakfast allowed him to have fuel available for immediate delivery to his muscles for a 6 a.m. workout after he had been fasting through the night while sleeping.

Post-workout, I like to think of the

By the 2012 Olympic trials, at the age of 30, he was 6-foot-2 and 181 pounds and yet again, as strong in and out of the water as he had ever been. He swam times comparable to his previous performances as a 22- and 26-year-old. tinued success throughout his college career. He was an NCAA finalist and Olympic trials finalist in 2004. Because of his success, he was offered funding from several sponsors and decided to continue competing professionally.

Only then did he begin to focus on what he was fueling his body with. James came to see me in 2005 and made some changes to his diet, focusing on consistency and the timing of his meals.

One of the things we changed was making sure he had breakfast every

body as an open door. The fuel and nutrients needed to benefit from the exercise are more easily absorbed and utilized within 30 minutes after a workout. After 30 minutes, the door starts to close and athletes don’t get the full benefit from any carbohydrate or protein consumed.

James was also able to break one of his bad habits formed in high school: He decreased his fast food consumption. After maintaining these changes for about six months, James remarked that he was stronger than he had ever been in the

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NUTRITION weightroom and swimming faster than ever in the pool.

Unfortunately, James suffered a shoulder injury in 2006. He was told his career would be over after surgery, but was determined to recover and come back stronger. While James was injured, I helped him understand that he needed to alter his diet because of the circumstances.

We agreed that he would decrease his calorie intake while his workout schedule was lighter than normal, but keep protein intake up to help with the healing process. He also supplemented with omega-3 fatty acids to help decrease inflammation for accelerated recovery. After 10 months of rehab, his hard work showed in competition when he broke an American record.

In 2008, he was an Olympic trials finalist again at 26 years old, but missed making the Olympic team by a tenth of a second. Determined to continue training for one more chance to make the team, James moved to the Southeast and saw the combination of his age and different environment affect his training in new ways. He was now in a humid climate, training indoors only, and

working a full-time job while competing—and approaching 30.

His work schedule meant that he was often only able to train once a day, and he found it harder to time his meals for optimum recovery. Our solution was to prep his meals the night before and prepare large amounts of food over the weekend so he would have fuel available quickly when he needed it during the week.

When James began feeling increasingly tired and started having trouble recovering despite his decreased training load, it was determined he was iron and vitamin D deficient. To increase his iron stores, I had him start consuming iron-rich foods such as red meat, eggs, dark green leafy vegetables like spinach, dried fruit mixed in with trail mix, and beans in salsa, chili, and hummus. He also began taking ferrous sulfate to keep his iron levels up.

For his vitamin D deficiency, James started supplementing with D3 at 5,000 IU daily. Vitamin D can be made in the body from sunlight as well, so James also made sure to spend 30 minutes a day outside in the sun with his skin exposed when he had time. He soon found himself with increased energy levels and

2012: an Olympic year!

improved recovery times.

Because of the drop in training, his body fat percentage began increasing.

James also found it hard to maintain core strength, so we decreased his calorie intake to more closely match his decreased training load.

By the 2012 Olympic trials, at the age of 30, he was 6-foot-2 and 181 pounds and yet again, as strong in and out of the water as he had ever been. He swam times comparable to his previous performances as a 22- and 26-year-old.

Though he didn’t make the Olympic team, he was able to retire with confidence that he had done all he could to give himself the best opportunity possible. He had no regrets.

It was necessary for James to consider numerous factors throughout his career. His physical output decreased through the years, his injury changed his needs for several months during what should have been his prime, and his metabolic needs varied with his increasing age. Without making the changes that he did, he would not have been as successful as he was through the age of 30. n

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T&C december 2012

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treating the athlete

ISTOCK.COM

Quiet Danger As football players’ sizes have crept up in the past decade, so have the number of athletes diagnosed with metabolic syndrome—a precursor to health issues that can result in early death.

By Dr. Linda Lee & Dr. John Helzberg

T

he United States is facing an obesity epidemic—our children, adolescents, and teenagers are at risk. In fact, one in three teens is currently classified as obese or overweight. And unfortunately, athletes are not immune.

The problem is most prevalent in football, especially among linemen. In 2005, 552 NFL players weighed over 300 pounds, compared to only 39 in 1992. The average weight of an NFL player in 2006 was 248 pounds.

Once a rare sight in the NFL, extra large linemen are now not unusual—even in high school football. Younger athletes are impressionable, and if their favorite NFL play-

Linda Lee, MD, is a Gastroenterology Fellow at the University of Missouri-Kansas City School of Medicine. John Helzberg, MD, is a Physician in the Division of Gastroenterology and Liver Disease Management Center at Saint Luke’s Hospital of Kansas City. He can be reached via post mail at: 4320 Wornall Rd., Suite 240 Kansas City, MO 64111.

TR AINING-CONDITIONING.COM

T&C DECEMBER 2012

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treating the athlete er is overweight, they might think it’s appropriate that they are, too. Recent data suggests that linemen ages eight to 15 have a higher incidence of obesity and are generally overweight when compared to the other players on the team.

In many cases, already obese players are encouraged by their coaches

old, prevalence doubles to approximately seven percent.

RESEARCH ROUNDUP Multiple research studies have been conducted investigating the health of football players, including their rates of obesity, metabolic syndrome, and cardiovascular disease. The following

Although overall mortality was no higher in the retired football population than the general population, the investigators found that defensive and offensive linemen had a 52 percent greater risk of dying from heart disease than the general population. to get even larger in order to become more competitive linemen. Unfortunately “bigger, faster, stronger” has been an accepted dogma in football for many years.

But there are dangers in “fattening up for football.” At the top of the list is metabolic syndrome, a precursor to many health problems, including diabetes, obstructive sleep apnea, nonalcoholic fatty liver disease, and stroke.

The good news is that athletes diagnosed with the condition can alter their nutrition and workouts to counteract its effects while still succeeding on the field. Athletic trainers and strength coaches can play an important role by being vigilant to the signs and symptoms of metabolic syndrome.

DEFINING THE DANGER The American Society of Endocrinology and the World Health Organization state that metabolic syndrome is defined by the presence of at least three of the following five clinical parameters: • Blood pressure ≥ 130/85 mm Hg • Fasting glucose ≥ 100 mg/dL • Triglycerides ≥ 150 mg/dL • Waist circumference ≥ 100 cm (40 inches) • High-density lipoprotein ≤ 40 mg/ dL. Metabolic syndrome has been studied extensively in adults and the findings can be applied to the adolescent population. The overall prevalence of metabolic syndrome in children and adolescents is approximately three to four percent. In adults 20 to 29 years ­30

T&C DECEMBER 2012

studies demonstrate the prevalence of these health issues among football players.

NFL: A 2008 study from the National Institute for Occupational Safety and Health evaluated the health of 510 retired N FL players who played between 1972 and 1988. Although overall mortality was no higher in the retired football population than the general population, the investigators found that defensive and offensive linemen had a 52 percent greater risk of dying from heart disease than the general population.

players from the 2003-04 season, 56 percent had a BMI of at least 25 kg/m 2 (the “classic” definition of being overweight), and 26 percent had a BMI of at least 30 kg/m 2 (the “classic” definition of obesity). Overall, the players had similar cardiovascular disease profiles when compared to the general population, but a higher prevalence of prehypertension and hypertension.

Waist circumference and waist-toheight ratio may be more accurate parameters to assess obesity in muscular football players. However, even when researchers used these measurements in addition to BMI, the results were similar to the BMI-only studies.

For example, in a retrospective analysis of 69 N FL players, only linemen were found to have metabolic syndrome. They also had higher BMIs, waist circumferences, and waist-toheight ratios, and increased visceral obesity than non-linemen. Current data suggests that visceral obesity may predispose individuals to early onset coronary artery disease and carry an increased risk of malignancy.

College: A 2011 study of 39 college football players compared linemen to non-linemen and found that 14 percent of the linemen had metabolic syndrome while none of the non-linemen did. Another study of NCAA Division

A 2007 study that analyzed over 3,000 Iowa high school linemen found that 45 percent of them were overweight.

An additional nine percent of the linemen were classified as severely obese. The average BMI increased by grade to a high of 28.5 kg/m2 for seniors.

In addition, 28 percent of obese players (classified in this study as having a BMI of at least 30 kg/m 2) died before they reached the age of 50, while only 13 percent of non-obese players died before their 50th birthday. The cardiovascular mortality of linemen from congestive heart failure or heart attacks was three times that of non-linemen. And players in the largest BMI category showed a six-fold increase in their risk of heart disease. It was concluded that an increased risk of death was associated with a greater BMI. Unfortunately, professional football players are becoming larger and heavier. In a review of 1,168 N FL

I football players from 2009 demonstrated a strong association between obesity, the presence of metabolic syndrome, and insulin resistance.

Twenty-one percent of the players on the team in the 2009 study were classified as obese and nine percent of them had metabolic syndrome. All of the linemen were obese and had metabolic syndrome. The odds ratio for the development of insulin resistance in players who were obese was 10.6 times greater than that in non-obese players.

High school: A 2007 study that analyzed over 3,000 Iowa high school linemen found that 45 percent of them were overweight. An additional nine TR AINING-CONDITIONING.COM

treating the athlete percent of the linemen were classified as severely obese (BMI greater than 35 kg/m 2). The average BMI increased by grade to a high of 28.5 kg/m 2 for seniors.

TAKING ACTION Despite the fact that these athletes with metabolic syndrome engage in strenuous exercise, the health problems associated with unhealthy weight gain are not erased. We advise those professionals who work with athletes at risk for metabolic syndrome to encourage them to continue exercising, but also see a sports dietitian who can stress the importance of a low-fat, low-carbohydrate, weight reduction nutrition plan.

This should be emphasized as a long-term change and not a temporary diet, because an athlete’s cardiovascular disease risk rises after their athletic career has concluded.

In addition, counseling should stress the importance of continued exercise and cardiovascular conditioning to miti-

The larger the player, the higher his risk for development of metabolic syndrome, hypertension, diabetes, sleep apnea, nonalcoholic fatty liver disease, and heart disease. These risks increase when their football careers have concluded. gate these cardiometabolic risks. Some athletes may be “pushed” by their coaches and/or parents to gain weight with the intent of obtaining a collegiate scholarship. These adults also need to be advised of the potential significant health risks associated with marked weight gain in their child.

Multiple studies have looked at the various types of diets that may be beneficial in reducing risk factors associated with metabolic syndrome. A low glycemic index diet is preferred over a high glycemic index diet. Total fat reduction (25 percent of calories should come from fat) and a balanced calorie restriction (500 to 1,000 fewer calories per day) can be beneficial to maintain weight loss.

And 150 minutes of moderate physical activity per week is recommended. These guidelines are safe and recommended in the Physical Activity Guidelines for Americans from the U.S. Department of Health & Human Services.

The prevalence of metabolic syndrome among football players, particularly linemen, is a real danger. The larger the player, the higher his risk for development of metabolic syndrome, hypertension, diabetes, sleep apnea, nonalcoholic fatty liver disease, and heart disease. These risks increase when their football careers have concluded, particularly if they continue to consume a high calorie diet and don’t engage in enough physical activity.

“Fattening up for football” is usually not healthy, and changes in diet and exercise often must be made to reduce the risk of disease. Though following through on the changes is up to the athletes, athletic trainers and strength coaches have the ability to be of great assistance. n To view references for this article, go to: www.TrainingConditioning.com/references.

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equipment solutions

HydroPower™ Bag The HydroPower™ Bag can take your strength gains to a whole new level. Easily change stability level and resistance of your activity by adding or removing water. Includes removable handles that increase the functionality for Olympic-style lifts, curls and rows. Available in two sizes.

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Farmer Walks

• Affix the handles on to the bag in the proper location.

• Begin with feet hip to shoulder width apart. Using one or two bags, perform a slight squat to grab the handles keeping the chest upright and back in a strong neutral position.

• Once you are completely standing upright begin walking for a desired distance or amount of time.

• Sit weight down and rest or exchange arms and repeat the exercise.

• Once you are complete lower the bag back to the floor being careful not to drop

Clean

• Affix the handles on to the bag in the proper location.

• Begin with feet hip to shoulder width apart. Perform a slight squat to grab the handles keeping the chest upright and back in a strong neutral position.

• The first movement should be to explosively extend at the ankles, knees and hips while simultaneously pulling with the arms up to about chest height. In a fluid motion allow the bag to rotate above the hands slightly while dropping the elbows underneath and squatting slightly.

• Flip the bag back over to lower back to the floor.

• Repeat for the desired number of repetitions. Once you are complete lower the bag back to the floor being careful not to drop.

Deadlift

• Affix the handles on to the bag in the proper location.

• Begin with feet hip to shoulder width apart. Perform a slight squat or with straight legs grab the handles keeping the chest upright and back in a strong neutral position.

• Engage the hip extensors and lift the bag off the floor until full hip extension is complete. Pause and then lower the bag back to the floor and repeat exercise.

• Repeat for the desired number of repetitions. Once you are complete lower the bag back to the floor being careful not to drop.

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Dead Row

• Affix the handles on to the bag in the proper location. Begin with feet hip to shoulder width apart.

Perform a slight squat grab the handles keeping the chest upright and back at approximately 45 degree angle.

• Engage the back and hip muscles to maintain stability, while at the same time pulling the bag toward your ribcage. Your elbows should be moving directly toward the back wall. Lower the bag back until your arms are almost extended and repeat movement.

• Repeat for the desired number of repetitions. Once you are complete lower the bag back to the floor being careful not to drop.

Front Squat

• Begin with feet hip to shoulder width apart.

Perform a squat to grasp the bag by putting your hands and forearms underneath. Roll the bag upward until it stops in the crook of the arms and chest. • • Stand upright and reposition the bag if necessary.

Once you are stable perform a squat by leading with hips and lowering the body downward until your thighs are approximately parallel to the floor. It is important that the upper body remains upright and not leaning forward.

• Repeat for the desired number of repetitions. Once you are complete lower the bag back to the floor being careful not to drop.

Overhead Press (no handles)

• Begin with feet hip to shoulder width apart. Perform a squat to grasp the bag by putting your hands and forearms underneath. Roll the bag upward until it stops in the crook of the arms and chest.

• Stand upright and reposition the bag with your hands underneath the bag and pressing up to shoulder level.

With a strong base of support engage the shoulders and press the bag overhead. With control lower the bag back to shoulder height and repeat exercise.

• Repeat for the desired number of repetitions. Once you are complete lower the bag back to the floor being careful not to drop.

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sport specific

Justin Gonzalez connects during a game last season, which marked author Adam Ross’s first full year working with the Florida State University baseball squad.

By Adam Ross

S

Smooth Movement Larry Novey

When you’re a new strength coach working with an already successful team, one of the keys to a smooth transition is how you implement your training philosophy and programming.

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tarting a new job as a strength and conditioning coach always presents challenges. But my arrival at Florida State University was truly a whirlwind experience. I came on board two games into the 2011 baseball season and had to hit the ground running. Not only had the team already started its competitive schedule, I was coming in to work with a program that had been very successful for many years.

I didn’t want to implement any significant changes to the training schedule because of the timing of my arrival.

And the players did not need me to remodel their workouts because they were already following an established program that helped them be successful.

Instead, I did my best to make the transition as seamless as possible for all involved. That meant introducing small adjustments here and there, explaining my philosophy to the team, and most importantly, earning the trust of the players and coaches.

That spring, I watched the team advance to an NCAA Division I Super Regional. And the following season, I enjoyed being part of a squad that made its 21st College World Series appearance. This year, we aim to do even better.

PHILOSOPHY A lot of my philosophy has been shaped by the coaches who have mentored me, including Mike Boyle, Charlie Melton, and Gene Coleman. I am humbled to have been mentored by some truly bril-

Adam Ross, MSEd, CSCS, is an Assistant Strength and Speed Coach at Florida State University, where he is responsible for training the baseball and women’s golf teams. He spent the 2010 baseball season working in the Houston Astros’ organization as the strength and conditioning coach for their AA affiliate and can be reached at: aross2@admin.fsu.edu.

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sport specific liant people in the world of strength and conditioning, and my experiences with them were invaluable in helping build my proverbial “strength and conditioning house” on solid rock.

The most important thing these three coaches taught me was to never stop learning. Strength and conditioning for baseball players has come a long way since Dr. Coleman became Major League Baseball’s first strength coach in 1979, and he is the first to admit it did not evolve without growing pains. In 20 years, I may look back at what I’m doing now and say, “What was I thinking?” But that’s part of continuing to learn in this profession.

When I arrived at Florida State, I had already learned that athletes need to be trained as individuals. This is a major piece of my coaching philosophy. Each player has his own genetic makeup and predispositions, orthopedic history and concerns, personality, strengths, weaknesses, and so on.

Therefore, my goal is to recognize individual needs in each player and implement what is best for him.

When working with the players, I follow a general template for everyone, but there is room for flexibility within that template in the form of exercise substitutions, additions, and subtractions to suit the needs of the individual. For example, if a player needs to put on some size during the off-season, I add more functional hypertrophy to the end of each week to sneak in some extra volume. The work is added at the end of the week so the player does not fatigue his neuromuscular system when we have a full week of workouts to go and instead has the weekend to recover.

Another example of adjusting for individual needs is a pitcher with chronic elbow pain. I immediately limit heavy loaded vertical pulling, which puts stress on the elbow. The next step is to work with our team’s athletic trainer

PITCHER VARIATIONS Our pitchers and position players train together almost all the time. They are not separate units or entities. But sometimes, pitchers do different exercises than position players.

For example, while the position players are performing dumbbell bench press variations at certain times during the year (like the in-season when the number of training days is limited), the pitchers do pushup variations, at times using weighted vests, bands, sandbags, or chains. Dumbbell bench variations are great for both pitchers and position players, but when we are limited to one upper body push movement per week, I choose pushups over dumbbell presses for pitchers in order to use a closed chain exercise while working torso stability.

Another example includes pulling movements. During the season, when position players are performing vertical pulling exercises, pitchers usually perform horizontal pulling movements instead. With the increased throwing loads of the season, the pitchers’ elbows and backs experience trauma, and loaded vertical pulling movements would just compound that toll.

Instead, the pitchers do some variations, but we load them fairly light and go through full range of motion to work on scapular tracking.

Finally, our pitchers never do the direct shoulder work in the weightroom that our position players do. Instead, they perform a comprehensive shoulder program daily in the athletic training room with our athletic trainer, Cory Couture, MS, LAT, ATC. Cory does an outstanding job implementing a program that gives the pitchers a great chance to enjoy a long and healthy season. His arm care program uses many different modes of training, such as lightweight tubing, plyometrics, dumbbell exercises, manual resistance exercises, and stretching.

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T&C DECember 2012

to look at possible mechanisms for the pain. Does it arise out of shoulder dysfunction that distributes forces of the throwing motion toward the elbow?

Is it mechanical? Knowing the mechanism helps the athletic trainer and I see which exercises or modes of training may be contraindicated for the athlete and which will best address the problem.

This individualistic approach gives the athlete a great deal of pride in what they are doing during our weightroom and conditioning sessions. They know their program has been developed and implemented based on their own strengths and limitations and no one else’s.

Another part of my philosophy is to instill great work ethic in our players. Most Seminole baseball players hope to be drafted and get the chance to make a career out of the game they love. One way I can help them is to encourage the formation of great training habits.

A quote from Stephen Covey, author of The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change, has always stuck with me: “Habit is the intersection of knowledge (what to do), skill (how to do), and desire (want to do).” My goal is to explain the most effective and efficient way for our athletes to train (what to do). I try to teach them in an understandable way they can replicate (how to do). And I strive to find motivating factors that will help push them toward their goals with relentless pursuit (want to do).

EARNING TRUST Every strength coach has been the new kid on the block at least once in their career. From the few times that I’ve been in this situation, it’s become clear that earning the trust of the coaching staff and players is paramount to successfully implementing a training program.

Two strength coaches can implement the exact same program, but the coach who gets the team to trust in his or her ideas has a higher chance of success.

Both coaches and athletes know that strength and conditioning levels can be a game changer, so implementing an overall training program is an easy sell.

However, their trust that your program is the best one is the x-factor.

With our players, it helped a lot that I was a college baseball player myself. I TR AINING-CONDITIONING.COM

sport specific came in with an intimate understanding of how many games teams play per season, the travel involved, and how to balance that with the rigors of the classroom. I had a lot of common ground with the players that helped me develop relationships with them early on.

There were a lot of small things that went into earning the players’ trust, starting with my demeanor. As a new coach, I needed to come to work filled with a passion for what I was doing each day. Attitude is contagious, so I always try to be enthusiastic.

I also knew that I needed to be firm, but fair. I demand the best from our players every day, but I know that I may not always get it. Empathy for an athlete is not a weakness, but rather a sign that I truly care.

Part of caring is being accessible. As strength and conditioning coaches, we frequently play the role of counselor. I found that once I gained the trust of our athletes, they in turn entrusted me with their problems. I have learned that these personal interactions not only help the athlete, but help me grow as a coach and a person.

The coaches and support staff here at FSU immediately welcomed me. I think my relationships with the coaches grew naturally because for the remainder of my first season, I continued to implement the program that was in place.

Though I made some small changes, the overall program held true to what the team was accustomed to.

Then, after the season, I sat down with the coaches for a thorough discussion about what they and I had seen during the season, and we came up with a list of areas that needed improvement.

This list became my training goals for the team’s 2012 season. Through the development of a program based on these goals, I was able to explain my training philosophy to the coaches, including the importance of addressing individual needs.

Nothing I was aiming to do with the team was groundbreaking, but it was based on what I felt was best for the Seminoles baseball team as a whole and for each individual player. The coaching staff was very receptive to what I wanted to do, which I believe tied back to the x-factor of trust that we had established with each other. It is truly a privilege to work with an unbelievable coaching staff that confirms this trust in me every day.

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Communication was the key to earning the coaches’ trust. Whenever there was a question or concern, the solution always arose from communicating with the staff. Whether it was scheduling, program design, or disciplinary action, there was always an open door to discuss what needed to be done for the good of the team.

TRAINING THE SEMINOLES The collegiate baseball off-season is short due to the length of the spring season, summer leagues, and fall ball. Be-

cause the fall and winter holiday breaks occur during the off-season, we must focus on maximizing the time we have together so that each athlete makes strides. That is why our program challenges the players from day one.

Upon the athletes’ arrival in the fall, they go through a testing process that includes a physical assessment, functional movement screen, performance test, strength test, and conditioning test. The results of these assessments help us set individual off-season goals for each player.

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sport specific Fall baseball starts just two weeks after the first day of classes, so once the assessment process has been completed, my goal is to get each athlete prepared for the diamond as quickly as possible.

We accomplish this through lower intensity strength circuits and conditioning sessions.

During the six-week fall season, the players complete a mesocycle of the annual plan that addresses strength and power at higher intensities and lower volume to accommodate the increase in sport specific work they are getting on the field. We use the same group of exercises (or variations) as found in our off-season program.

During the 12-week off-season, the

team works out five days a week—three strength days and two conditioning days.

The three strength days look like this: Day one • Explosive movement performed in the lower extremity sagittal plane paired with a prehab mobility exercise for the lower body • Bilateral knee-dominant exercise • Unilateral horizontal push-pull combo • Unilateral hip-dominant exercise • Anti-rotation movement for torso development paired with a hip circuit • Stabilization exercise for torso development.

Day two • Explosive movement performed in

the upper frontal/transverse plane paired with a prehab mobility exercise for the upper body • Bilateral horizontal pull exercise • Bilateral horizontal push exercise • Bilateral hip-dominant exercise • Anti-extension movement for torso development paired with a unilateral horizontal pull • Rotation exercise for torso development.

Day three • Explosive movement performed in the lower extremity frontal plane paired with prehab mobility exercises for the upper and lower body • Bilateral knee-dominant exercise paired with a bilateral vertical pull • Eight-station metabolic circuit (body-

EXERCISE BANK The table below outlines some of the categories of movement that we use in our program, along with some examples of exercises we use. We do not employ all exercises at the same time, but rather a progression for each category.

Explosive movement in the lower extremity frontal/transverse plane: Heiden jumps progression Bounding Explosive movement in the lower extremity sagittal plane: Bi/Unilateral box jumps Bi/Unilateral hurdle jump progression Med ball vertical tosses Med ball scoop tosses Explosive movement in the upper extremity frontal/transverse plane: Unilateral med ball chest pass progression Unilateral med ball side toss progression

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Bilateral horizontal push: Pushup variations Bilateral dumbbell bench press variations Bilateral horizontal pull: Inverted rows Low/high cable/plate loaded rows Barbell rows Face pulls Bilateral vertical pull: Bilateral varied grip pull-downs Pull-ups Neutral grip pull-ups Chin-ups Cable crossover pull-downs

Bilateral hip-dominant: Trap bar deadifts Bilateral Romanian deadlifts Bilateral hamstring curl variations Bilateral hip bridges Pull-throughs Glute-ham raises

Unilateral hip-dominant: Unilateral Romanian deadlifts Unilateral hamstring curl variations Unilateral hip bridges

Bilateral knee-dominant: Back squats Front squats Safety squats Pit shark squats Dumbbell squatting variations

Unilateral horizontal pull: Unilateral dumbbell rows Unilateral cable row progression

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Unilateral horizontal push: Unilateral dumbbell pressing variations

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sport specific weight or light weights) the players complete three cycles of for time.

As we progress through the offseason, the three-day template might change slightly. For example, we might add or substitute in a unilateral strength exercise to address an athlete’s deficiency. (See “Exercise Bank” on page 44 for lists of exercises that would fit some of the above categories.)

We use the two conditioning days to supplement the lifting sessions. We do this by addressing the mobility and flexibility of the joints and muscles that were used in the previous day’s lifting session. The players also perform movement drills to keep up on their mechanics, and we always finish the day with lumbar stability and thoracic mobility exercises to train the athletes’ postural control. Here is an example of a conditioning day: • Ground-based mobility series • Low level footwork warmup • Upper body mobility series • Dynamic flexibility • Movement training • Resistance band lower extremity stretching

t

• Postural torso development During the off-season, I limit the athletes’ change of direction and sprint work. They have just spent the past eight to nine months sprinting, changing direction, and performing other activities as fast as they can, so I like to shift gears during the off-season and

ally fairly similar. But it is important to remember that it’s the little things that matter. For an athlete, this might mean great nutrition, regular sleeping patterns, and extra post-practice stretching.

In the end, a team’s success comes down to the athletes. With 21 College World Series appearances by the Semi-

On conditioning days, we address the mobility and flexibility of the joints and muscles that were used in the previous day’s lifting session ... And we always finish with lumbar stability and thoracic mobility exercises to train postural control. take them back to absolute strength work. Later in the off-season, we reintroduce some strength-speed work with a medicine ball. Then at the end of the off-season and into the early preseason, we incrementally add sprinting and change of direction drills because the work is sport specific and gets the players ready for the diamond.

UP TO THE ATHLETES When looking at strength and conditioning programs, the nuts and bolts are usu-

noles, our players know they can be successful. They know they get great support from the coaches, the support staff, and even the fans, but the rest is up to them.

As Thomas Jefferson said, “If you want something you’ve never had, you must be willing to do something you’ve never done.” These players have shown they are willing to do whatever it takes to bring home a national championship, and I hope our training program will help them do just that. n

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Core Training Equipment Comfortable and Sturdy

Perform Better’s new Single Leg Squat Stand is perfect for working your hamstrings, glutes, quads, and low back. It allows you to perform all single-leg exercises comfortably with its tubular top and vinyl-encased foam covering. Its sturdy design is made with a diamond-plated platform and it measures 18 inches high. There will be no more searching for a bench to do your lower body work once you’ve tried the Single Leg Squat Stand. For more information, contact Perform Better.

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

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The Arm Chair is a traditional piece of Pilates equipment originally designed by Joseph Pilates himself. It is an excellent tool for developing an athlete’s scapular stability, functional upper-body strength, and upper-body posture. Its comfortable, stable seat provides support and proprioceptive feedback—all with a small footprint. It also comes with a solid and sturdy maple frame, two sets of springs, and transport wheels for easy moving and storage. Learn more by going to the company’s Web site.

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Higher Jumps, Lower Risk

The Performance Plyo Cushion Set #3231 has three pieces of varying heights that can provide seven height options, ranging from six to 42 inches. It is crafted from very firm, dense foam and heavy-duty, rip-stop tarp material. It also has just enough “give” to employ more stabilizing muscles, but is low-impact, and won’t scrape shins. Its rounded design eliminates the risk of landing on an unstable corner, and encourages users to attempt higher jumps for greater gains.

Legend Fitness • 866-753-4363 www.legendfitness.com

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Target Abs from All Angles

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The 82655-Back Extension Machine with equal stroke resistance features an adjustable foot-pad and hand grips, as well as a step for easy access and three-inch top pad for comfort. This commercial-quality unit’s weight carriage rides on chrome-plated rods, and has pre-stretch built into foot placement pads. The machine is available plate-loaded with 150-, 200-, and 250-pound weight stacks. It is 58” x 64” x 83”H and 300 pounds (plate-loaded).

New York Barbells of Elmira, Inc. • 800-446-1833 www.newyorkbarbells.com Circle No. 504

Solves Problems

Develops Stability and Strength

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Quality Back Extension Machine

Exertools is excited to introduce the Rubber Rope Gym R2X. The R2X is a multiposition wall-mounted machine that uses variable resistance rubber ropes in place of traditional weights. This machine solves a number of problems inherent with weightstack equipment—such as cost, weight, space, inadequate resistance, and inertia. Its features include a small footprint and quiet operation. Plus, it adjusts to user’s fitness level and provides a workout for the arms, legs, and core. To learn more, visit Exertools online.

Exertools • 800-235-1559 www.exertools.com

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Portable and Effective

The Lebert EQUALIZER™ is a portable and effective bodyweight strength and core training product used around the globe. With over 75 compound exercises like dips, pull-ups and push-ups, the LEBERT EQUALIZER™ can help make athletes proficient at moving their body for increased strength, enhanced kinestetic awareness and better athletic performance. Made from powder coated steel and built to last the EQUALIZER™ can also be used for agility drills, plyometrics and stretching. For more please visit www.LebertFitness.com Lebert Fitness Inc. • 905-785-0626 www.lebertfitness.com

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Virtually Immovable

SPRI Hanging Ab Straps are ideal for hanging leg raises and abdominal work. These sweatand rip-resistant nylon straps help target the abs from all angles. The generous eight-inchwide straps allow for even weight distribution and they feature extra foam cushioning for comfort, while steel slips allow straps to be attached to any secure overhead bar up to 1 1/4-inches in diameter.

The Rogue Fitness Monster Series Rigs are the ultimate gym accessory.

Built with the collegiate athlete in mind, the Monster Rig is a classic example of Rogue’s “over-built” construction that will suit any affiliate or gym with its immovable capacity. The standard Monster Rig is built with 11-gauge, 3 inch x 3 inch steel tube uprights. This is a virtually immovable piece of American-made training equipment.

SPRI Products • 800-222-7774 www.spri.com

Rogue Fitness • 614-358-6190 www.roguefitness.com

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Case Study

Athletic Trainer Applies Master’s Degree in Sports Management Clayton Gropper MS, ATC, 2011-12 South Dakota Athletic Trainers Association Athletic Trainer of the Year

S

ports have always played a central role in Clayton Gropper’s life. After graduating from Dakota Wesleyan University in 2000, Gropper became a certified athletic trainer for the Mitchell, South Dakota school district through an outreach program managed by Avera Queen of Peace Hospital. With this job came added duties and Gropper earned his state teaching certification. In addition to guiding the athletic training program, he teaches sports medicine, health occupations, and survey health. Despite his packed schedule, Gropper hoped to take the next step in education by completing a master’s degree in sports management. The challenge was juggling education with his most important priority—family.

“I wanted a degree that was beneficial for my career path if I decided to become an athletic or activities director in a high school or college program,” says Gropper.

“My wife and I started our family, and with my job commitments, I knew I didn’t have the time to go to a traditional institution.”

Mitchell High School was one of the first statewide schools to participate in the One-to-One Laptop Initiative, which offered students and teachers laptop computers. “I started doing a lot of research,” Gropper says. “My goal was to find a university that allowed me to go to school while still working.”

American Military University, which is part of American Public University System, moved to the top of Gropper’s list. “I took my time before enrolling and did a little more

exploration to make sure it was the right fit for me,” he says. “I was looking for a school that offered a sports degree in management, with a concentration in athletic administration—something I was truly interested in.

“I wanted a university that gave me a lot of ideas for my future,” he continues. “But one that would make me more effective in my current duties, as well. As an educator myself, once I learned it was accredited by NCA (The Higher Learning Commission, North Central Association) I felt very comfortable with its academic quality.”

Additionally, American Public University System, which is also comprised of American Public University, has a formalized agreement with the National Strength and Conditioning Association (NCSA) Certification Commission.

Despite working nearly two full-time roles providing sports medicine and athletic training coverage, traveling with the football team, and helping raise his family, Gropper found a window in his afternoon schedule to take online classes. “I taught in the morning, then worked from 3:00 until 7:00 p.m.,” he says. “But I used my afternoon break as my own class time. It took me about 18 months to graduate. The degree prepared me for future administrative opportunities, but I also found that the skills I learned help me utilize my time wisely and be more efficient in my current jobs. I couldn’t have been happier with my educational experience.”

American Public University System | 877-777-9081 |

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www.apus.edu

T&C december 2012

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Therapy Technologies Impressive Simplicity

The Dynatron Solaris® Plus 709 has seven-stim waveforms, three-frequency ultrasound, and a revolutionary Tri-Wave Light that uses red, infrared, and blue wavelengths. Plus, it can deliver up to five channels of stim, ultrasound, and light simultaneously. The 13-pound Solaris® Plus 709 is impressively simple, yet it offers almost unlimited flexibility. This product is portable with an optional battery/adapter, and it has a two-year warranty.

Dynatronics • 800-874-6251 www.dynatronics.com

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SAFE AND EFFECTIVE

The MR4 ACTIV uses 25,000 mW of power, which is greater than most class IV lasers, and has a higher degree of safety. It also has six treatment programs that can be used in combination—you can use red or blue alone, or pulse intermittently.

It is cordless and has a light, portable rechargeable battery that works for eight continuous hours.

Multi Radiance Medical • 800-373-0955 www.multiradiance.com

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Relieves Pain

The MR4 ULTRA by Multi Radiance Medical includes the LaserStim and LaserShower (LS50) emitters. It uses four super pulsed GaAs diodes, four infrared light emitting diodes, and four red light emitting diodes. Its 20-square-centimeter LaserShower area covers more area than the standard SE25 emitter, making it ideal for stimulating greater systemic effects and treating the spine or large muscle groups.

The Dynatron Solaris® Plus 709 includes Tri-Wave Light Therapy, to deliver any combination of three-wavelengths of light—red, infrared, and blue—with the TriWave Light Probe or two robust 5” x 7” Tri-Wave Light Pads. This product can help relieve muscle and joint aches, pain or stiffness, muscle spasms, or minor pain and stiffness associated with arthritis—along with increasing circulation. It has a two-year warranty, and is portable with an optional battery/connector.

Multi Radiance Medical • 800-373-0955 www.multiradiance.com

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IDEAL FOR SYSTEMIC EFFECTS

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Topicals Analgesics Fast, Lasting Relief

Since 1987, Ari-Med has marketed Flexall® pain relieving gels to sports medicine professionals worldwide. Flexall gels have proven to be effective, versatile supplements to any therapy protocol— including ultrasound—by delivering fast, lasting relief from painful muscles and joints. The unique, mentholated aloe vera formulas are enriched with natural oils and Vitamin E to moisturize and soften skin. Flexall gels absorb quickly, are greaseless, non-staining, and are available in professional sizes.

Ari-Med Pharmaceuticals • 800-527-4923 www.ari-med.com

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Pain Relief

Thera-Gesic® is many athletic trainers’ brand of choice for relief of muscle soreness, aches, and stiffness. This water-based, greaseless formula does not stain clothing or equipment, and contains one-percent menthol and 15-percent methyl salicylate. When applied evenly in a thin layer, Thera-Gesic becomes colorless and transparent. Once it penetrates the skin, the area may be washed, leaving it dry and fragrancefree without decreasing Thera-Gesic’s effectiveness.

Mission Pharmacal Co. • 800-373-3037 www.missionpharmacal.com

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Fast Results, Less Strain

Gebauer’s Spray and Stretch topical anesthetic skin refrigerant provides a fine stream spray that effectively manages myofascial pain and trigger point release when used in conjunction with the spray and stretch technique. It is also used to treat muscle spasms, restricted motion, and minor sports injuries. Spray and Stretch is non-flammable and non-ozone depleting.

Get fast results with less strain and damage to your hands during manipulation. Purchase Spray and Stretch from your local medical supplier, wholesaler, or directly from Gebauer Company. This product is by Rx only.

Gebauer Company • 800-321-9348 www.sprayandstretch.com

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Effective Relief

Hyland’s Muscle Therapy Gel and Hyland’s Arnica tablets provide effective relief of muscle and joint soreness, bruising, and swelling due to overexertion or injury.

Containing Arnica—the number one natural remedy for swelling, bruising, and trauma—Muscle Therapy Gel provides natural, safe, and effective pain relief—and it absorbs quickly and is never greasy. This formula is FDA regulated with an unsurpassed safety profile and nocontraindications or drug interactions.

Treatment Options • 800-234-8879 www.txoptions.com

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Case Study

Winning the War Against Tissue Stress

I

t was an honor to attend the 2012 Olympic games as a Performance Physical Therapist and a member of the support team for several individual athletes, including Koji Murofushi who is the 2012 bronze medalist, current World Champion, and 2004 Olympic Gold Medalist in the Men’s Hammer Throw event.

Being an older athlete with a history of musculoskeletal injuries, Murofushi’s thresholds from one tissue response to another was lower than the average Olympian, and his ability to adapt these thresholds between loads was less. On the road to London, Murofushi’s support team developed specific measures to ensure that he stayed below his tissue’s injury threshold.

A few of those keys included minimizing the stress placed on the tissues through emphasizing proper movement; allowing for recovery time in the training schedule; and taking measures to stimulate faster tissue recovery. Each of these steps was researched and implemented carefully, in order to assure the best results.

One of these was from, Diagnosis and Treatment of Movement Impairment Syndromes, in which Shirley Sahrmann PT, PhD, FAPTA, states that sustained postures and repetitive movements result in tissue adaptations and a susceptibility to move in specific directions.

This repetitive, impaired movement places excessive stress on certain tissues, without allowing time to adapt and eventually resulting in injury.

Sahrmann clearly identified and described these specific directional susceptibilities into what are known as Movement System Syndromes. From our first evaluation, Murofushi and I have worked to identify and correct his syndromes. Everything we’ve done has been designed with those in mind.

Additionally, we drew upon the Physical Stress Theory, which illustrates how athletes’ bodies wage a continual war against the physical stresses that accompany each workout, repetition, and preliminary competition. Those who are able to train, adapt, and compete while staying between “increased tolerance,” and “injury” thresholds will succeed.

Murofushi and I also carefully utilize measures to facilitate his body’s ability to recover.

Over the last year, I have integrated the MR4ACTIV Laser from Multi Radiance Medical.

Due to its portability, it has been easy to keep with me on the road and has been a “go-to” modality in instances of acute muscle strains or local inflammation.

As always, it is very gratifying to leave a competition with a medal in hand, and as part of Murofushi’s support team, this past Olympics was no exception. However, the journey to get him there was the best part of all. I look forward to learning and implementing more strategies—and accompanying tools—to help my athletes succeed.

Robbie Ohashi PT, DPT, OCS, ATC, CSCS is a Performance Physical Therapist and the President of Performance in Motion, based in Chicago, Ill. He is a Board Certified Orthopaedic Clinical Specialist with the American Physical Therapy Association, and Item Writer for the APTA’s Specialist Academy of Content Experts. Ohashi also serves on the Board of Directors for the American Dry Needling Institute and teaches multiple continuing education courses in the U.S. and overseas.

For the complete article with footnotes and references visit: http://www.multiradiance.com/articles/Winning_the_war_against_tissue_stress.pdf

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Multi Radiance Medical 800-373-0955 www.multiradiance.com

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Plyometrics Durable Convenience

The SPRI Plyo Boxes are perfect for the explosive movements in plyometric training exercises. These steel-construction Plyo Boxes are sturdy with durable, non-skid rubber surfaces. The stable, wide base and angled construction also prevents tipping. Plus, the Plyo Boxes are stackable for convenient storage and are available in a variety of six different heights. Contact SPRI for more information.

SPRI Products • 800-222-7774 www.spri.com

Circle No. 513

A Solid Choice

With a stable square frame and a large landing area, this heavyweight plyo box is a solid choice for plyometric training for athletes of all sizes and abilities. The platform of the Premium Power-Plyo Box™ is covered with an extra-thick mat and the perimeter is rounded for added safety. Featuring square tubular steel construction, the tops are reinforced 3/4inch plywood covered with a 1/8-inch solid rubber mat. This product is stackable, can be used indoors or outdoors, is black, and comes with a five-year limited warranty.

Power Systems, Inc. • 800-321-6975 www.powersystems.com

Circle No. 539

Safe Plyometrics

The Titan Plyometric Platforms feature heavyduty 1 1/4-inch by 14-gauge square steel tube construction. The top has a 3/4-inch CD plywood base with 3/4-inch American-made, non-toxic, non-skid rubber. An extended base on two sides reduces the risk of tipping, while rubber pads on four corners of the base prevent markings on floors.

New York Barbells of Elmira, Inc • 800-446-1833 www.newyorkbarbells.com Circle No. 514

Perfect Rebounders

Perform Better’s PB Extreme Jam-Balls are the company’s most popular non-bouncing medicine ball. These durable balls are soft and feel like a gel-filled ball. Their textured shells allow for easy catching, gripping, and throwing—and are great for when you do not want the ball to bounce. These Jam-Balls are perfect for using with rebounders or for doing medicine ball slams. They are now available in 12 different weight increments and two diameters—and they are only available through Perform Better. For more information, contact Perform Better.

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

Circle No. 515

More Products Supports Muscle Rebuilding

G Series Protein Recovery Beverage is a protein and carbohydrate beverage formulated with the consistency of a thirst quencher. It has an effective amount of protein that contains essential amino acids needed to help support muscle rebuilding after training or competition. G Series Recover should be consumed within about 60 minutes after exercise for maximum muscle benefit.

Gatorade • 800-884-2867 www.gatorade.com

Circle No. 517

Drops of Energy

Cytomax Energy Drops™ are a portable and chewable means to deliver a precise blend of carbohydrates and essential electrolytes. Cytomax Energy Drops™ may be used before and during training.

Each portable pouch provides 10 individual chews. Cytomax Energy Drops™ are available in two great-tasting flavor options: Tropical Fruit+Pomegranate Berry (non-caffeinated) and Orange+Tangerine (50 mg of caffeine per pouch). Tropical Fruit+Pomegranate Berry is collegiate compliant.

CytoSport, Inc. • 888-298-6629 www.cytosport.com

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Circle No. 516

Concussion Prevention

Mission Competition Fitness Equipment created and manufactures The Halo, a dynamic rotary neck strengthening cable attachment. The Halo works the neck out by applying horizontal resistance during neck rotation. The company’s goal is to help in the prevention of concussions and neck injuries by increasing the athlete’s neck strength. Greater neck strength equals greater force dissipation upon head impact, which equals far fewer neck injuries and concussions. For more information, please e-mail info@halostrong.com.

Mission Competition Fitness Equipment • 310-776-0621 www.halostrong.com Circle No. 527

National Recognition

American Public University (APU) offers more than 100 online degree and certificate programs that are designed for sports and health sciences professionals, coaches, athletic directors, and working adults like you. APU has been nationally recognized by the Sloan Consortium for its effective practices in online education. For more information, call or go online.

American Public University • 877-777-9081 www.studyatapu.com/tc

Circle No. 518

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More Products Full Speed Ahead

Improve linear speed, agility, and power with the TurfCordz® Modular Speed Belt. Designed for speed-assisted and resisted running exercises, this two-person system allows the lead to run against resistance provided by the trailing runner. It also enables athletes to change running positions quickly without removing belts. The system includes a modular 20-foot heavy rubber tube with Safety Cord, mounting loop, and two two-inch adjustable Velcro® closure belts that fit up to a 52-inch waist. TurfCordz resistance tools are designed to meet the extreme demands of high-level athletic training.

NZ Manufacturing • 800-866-6621 www.turfcordz.com

The Elite Seat® is a portable kneeextension device designed for the non-operative treatment of degenerative knee conditions. By evenly distributing force across the leg, the Elite Seat provides effective full-knee hyperextension and reduces pain in bent knees caused by any of these conditions: acute ACL injury, inadequate post-operative rehabilitation after ACL reconstruction, total-knee arthroplasty, arthrofibrosis, deconditioned knee with a flexion contracture, and arthritis.

Elite Seat ® • 866-756-3706 www.eliteseat.com

Circle No. 537

Circle No. 519

Customizable Equipment

Samson Equipment now makes custom weight stack shields with your school or organization’s unique logos and color schemes incorporated. Never before has a customer had more custom options from Samson Equipment than now. Call the company today to see how you can not only custom-design each piece of equipment, but also customize those pieces to include your graphics.

Samson Equipment • 800-472-6766 www.samsonequipment.com

Elite Knee Care

Circle No. 520

Ultra-Concentrated Formula

Monster Amino™ is an ultra-concentrated BCAA formula that delivers an 8:1:1 ratio of leucine to isoleucine to valine. Recent university research shows that a leucineenriched beverage consumed with exercise synergistically activates and prolongs activity of the mTOR signaling pathway, which increases muscle anabolic potential (muscle growth). The mTOR pathway is the “trigger” that signals the very genesis of muscle protein synthesis.

CytoSport, Inc. • 888-298-6629 www.cytosport.com

Circle No. 524

Explosive Training

Utilize explosive training anywhere with the Economy Power Jumper™. This product adds approximately 32 pounds of resistance at 100-percent elongation. Its user-friendly design and portability make it ideal for training athletes in role-specific situations. Perform resisted squats, lunges, leaps, and jumps with this unit. It includes two sets of resistance tubing—two 45-inch tubes on each side—with nylon loop anchors and harness, or belt. It may be used for indoor or outdoor training. The price for the Economy Power Jumper™ is $62.

Power Systems, Inc. • 800-321-6975 www.powersystems.com

Circle No. 521

Measures Strength

The T-16K Back, Leg, and Chest Strength Tester will measure the strength of a subject’s back, leg or chest. The chain adjusts for height differences, or to vary the point of force application. The strength indicator remains at the subject’s maximum reading until it is reset. The measuring range is 0 to 300 kilograms. For more information on the T-16K Back, Leg, and Chest Strength Tester, contact Creative Health Products.

Creative Health Products • 800-742-4478 www.chponline.com TR AINING-CONDITIONING.COM

Circle No. 522

Pre-Game Fuel

G Series Energy Chews are a pre-game fuel in a convenient form. They are designed to be used about 15 minutes prior to training or competition to provide energy from a concentrated blend of carbohydrates to fuel athlete performance. G Series Energy Chews help make carbohydrate energy rapidly available to working muscles for the start of activity, so athletes might feel the difference at the beginning of training or competition.

Gatorade • 800-884-2867 www.gatorade.com

Circle No. 525

Reduces Strain

Accu-Stretch motorized stretching equipment gives your athletes the ability to perform static stretching without the aid of an assistant. It can be used for both upper and lower body stretches, plank and isometric exercises, and as a passive motion device.

Using the Accu-Stretch will take strain off your back and shoulders, free up your hands, and save you hours of valuable time.

Accu-Stretch • 914-237-5592 www.accu-stretch.com

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state

of the

industry

Legend Fitness 865-992-7097 www.legendfitness.com

Power Systems, Inc. 800-321-6975 Circle No. 505

Industry Trend:

A recent trend the company has recognized is the practice of offering weightlifting racks with an integrated pin select device. As today’s coaches learn more about total conditioning, their equipment needs increase—while their floor-space often does not. Legend has answered the call with its new Pro Series Fusion System. It is one of the only commercial-strength racks with an internal lat pulldown/low row. This differs from other racks in offering cable exercises within the cage—instead of merely bolting this functionality onto the back—allowing quicker superset transitions and further enhancing the concept of getting the most out of limited floor space.

Circle No. 506

Industry Trend:

Suspended Training is one of the hottest training modalities in our industry. Most facilities are just not designed to provide a location, or anchor points, for this style of equipment. Power Systems recently created several designs known as the SpaceStation™, allowing many users to work out at one time. The SpaceStation™ includes anchor points for suspension devices, including training rings and heavy bags, as well as monkey bars that can provide workout opportunities for up to 20 people at one time—all on a single rack. Power Systems offers various designs to fit space and budget requirements for the company’s customers.

Benefits:

Benefits:

• More functionality at each cage station without increasing specification or space design • Ideal for heavier athletes to incorporate back exercises into traditional lifting routines

Medi-Dyne Healthcare Products 817-251-8660 www.medi-dyne.com

www.powersystems.com

• Three size options to fit most any budget or space limitation • SpaceStation™ Frontier units may be used indoors or outside • Limited five-year warranty

PRO Orthopedic Devices, Inc. 800-523-5611 Circle No. 507

Industry Trend:

Muscle strength and flexibility imbalances have been found to play a major role in athletic injuries—and due to the nature of the inter-connective chain of muscles, ligaments, and tendons, the “domino effect” of an imbalance may result in a series of injuries. Designed with the input of medical and sports professionals, including collaboration with the sports medicine staff at the Mayo Clinic, Medi-Dyne has developed an array of stretching, strengthening, and support products that help maintain flexibility and reduce the risk of injury.

www.proorthopedic.com

Circle No. 508

Industry Trend:

Tubular compression bandages have become increasingly popular, with a variety of uses ranging from skin protection to joint compression.

Today’s athletes require sizing that is different from traditional offerings, which PRO has brought to the marketplace.

Benefits:

• Consistent compression • Disposable • Easily applied by the athlete • Latex-free for safe use

Benefits:

• Easy-to-use products • Mitigates flexibility imbalances • Addresses and engages all major muscle groups • Straps provide alternatives to repeated taping

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T&C DECEMBER 2012

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state Treatment Options 800-234-8879 www.txoptions.com

Circle No. 532

As athletes and athletic trainers become more knowledgeable about the potential downside of allopathic medicines, the trend toward more holistic, non-toxic therapies is driving the industry to rethink what people put into their bodies. Homeopathic medicines that can reduce recovery time and increase performance without side effects, contraindications, or drug interactions are becoming increasingly sought after.

Homeopathic products that contain arnica—the premier medicine for reducing swelling, bruising, and muscle soreness from injury or overexertion—fit the bill perfectly. Formulas like Hyland’s Muscle Therapy Gel, which heals sprains, strains, and joint pains are even more beneficial.

www.samsonequipment.com

Circle No. 534

New Technology:

Samson Equipment has built some of the highest quality, custom designed equipment on the market since 1976.

Now the company is implementing cutting-edge design software to make this process quicker and easier than ever before. Every product is built from the ground up, so the customer has unlimited options to design each piece exactly to their needs. Talk with Samson’s representatives about your equipment goals and they’ll create and email a 3-D drawing exclusively for you. Nothing is out of bounds—just let Samson know what you want to accomplish and they will help you get it done.

Benefits:

Benefits:

• Helps the body recover quickly, safely, and naturally • Provides efficacy without side effects, drug interactions, or contraindications • Allows athletes to spend more time on the field and less time in the athletic training room

Balanced Body®,Inc. 1-800-PILATES Circle No. 535

New Technology:

The Allegro® 2 Reformer from Balanced Body® was designed in collaboration with fitness professionals to be intuitive and simple to use, while enhancing the flow and effectiveness of Pilatesbased or functional athletic training sessions. It features an EasySet Footbar that adjusts vertically by lifting it up and moving it—even with the feet—and it slides the entire frame-length to accommodate different body sizes. The Allegro 2 can also make instant, one-touch rope adjustments—even while users are lying on the carriage. This product comes with a durable, state-of-the art frame; a quiet and seamless carriage ride; and easy storage.

Benefits:

• Increased strength, flexibility and agility • Sessions are easier on an athlete’s body—particularly the joints • Pilates on the Allegro 2 gives athletes an even musculature—key to avoiding injury • Helps create a strong core, which enhances athletic performance

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industry

Samson Equipment 800-472-6766

Industry trend:

www.pilates.com

of the

• Every customer can custom design any of Samson’s equipment • See every inch of the design’s image—zoom in or out, and rotate in 3-D to see it all • Clients see everything to scale and provide immediate feedback

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

Circle No. 536

Industry Trend:

The ViPR, the evolution of new weights, is the trend in functional training merchandising. It provides an effective full-body workout, builds muscle, and burns calories through strength and movement training. Users can lift, drag, throw, or step on their ViPR—any movement is suitable for all ages and abilities. Made of rubber, this product is virtually indestructible and incredibly functional.

Benefits:

• Faster, meaningful full-body workout • Burns calories through strength and movement training • Ideal for all age groups

T&C december 2012

47

Looking for a fast, easy way to get CEUs BEFORE the end of the year?

You can take CEU quizzes of T&C issues online... both this issue and all 2012 issues!

➤

No pencil, envelope, or stamp needed. Just fill in the easy-to-use online form.

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Your results will be tabulated immediately, and your CEU certificate of credit will be made available as a PDF within minutes.

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You can also take CEU quizzes from back issues online. Read past issues and take the quiz all in one sitting!

Click on “CEUs” on the toolbar at the top of the page at:

48

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T&C DECEMBER 2012

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Circle No. 125

Q

CEU QUIZ

T&C December 2012 Volume XXII No. 9

uicke You c an no r&E w tak and g asi e our et yo ur CE CEU q er!

U res ults a uizzes on www li C .train lick on “CEU nd credit ins ne... tantly s” at: ing-c . o nditi o

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

ning

.com

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.

Instructions: Go to www.training-conditioning.com and click on “CEUs” to take the quiz online. You may also mail your

quiz to us: Fill in the circle on the answer sheet (on page 52) that represents the best answer for each of the questions below.

Include a $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 22.9 Quiz, 20 Eastlake Road, Ithaca, NY 14850. Readers who correctly answer at least 70 percent of the questions will be notified of their earned credit by mail within 30 days.

Bulletin Board (pages 8-9)

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

1. How long did athletes in the three stress ball experiments squeeze a ball prior to competing? a) 20 seconds b) 30 seconds c) 40 seconds d) 50 seconds 2. The left side of the brain controls rumination, while the right side manages _____. a) Sense of smell b) Muscle memory c) Pain inhibitors d) Movement 3. How are researchers determining an athlete’s VO2 max during the treadmill test? a) Heart rate of 220 minus age b) Heart rate of 250 c) Heart rate of 220 minus height d) Heart rate of 250 minus age 4. How many players in the ACL study returned to play within a year after surgery? a) 42 b) 53 c) 72 d) 100 5. How many of the soccer players underwent a second ACL surgery within the decade after their initial reconstruction? a) 12 b) 10 c) Six d) Five

6. At which point after the race was the mean edema score for runners highest? a) The next day b) 98 minutes c) 55 minutes d) 19 minutes

Centered Strength (pages 17-20) Objective: Discover the best ways for athletes to train core strength.

7. The absence of a second foot on the ground is what causes the _____ to kick in. a) Upper back muscles b) Calf muscles c) Balance receptors d) Core stabilizers 8. Paul Hodges subscribes to the _____ technique. a) Bracing b) Single-leg c) Drawing in d) Double-leg 9. Stuart McGill subscribes to the _____ technique. a) Bracing b) Single-leg c) Drawing in d) Double-leg 10. What are the two areas that should be gaining motion? a) The hips and lumbar spine b) The hips and thoracic spine c) The thoracic spine and abs d) The abs and back

Questions continue on page 51 and answer sheet is on page 52 or take this quiz online and get instant results:

training-conditioning.com click on CEUs TR AINING-CONDITIONING.COM

T&C december 2012

49

Directory

Advertisers Directory Circle #. Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page #

Circle #. Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page #

110. American Public University . . . . . . . . . . . . . . . . . . . . . . . . . 19 112. Balanced Body® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 101. Cho-Pat. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 117. Creative Health Products. . . . . . . . . . . . . . . . . . . . . . . . . . . 28 123. Dynatronics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC 103. Elite Seat®. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 121. Exertools. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 106. Flexall®. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 107. GAMEDAY (Multi Radiance Medical). . . . . . . . . . . . . . . . 10-11 102. Gatorade. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 115. Gebauer Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 105. Lebert Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 120. Legend Fitness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

124. Muscle Milk® (CytoSport). . . . . . . . . . . . . . . . . . . . . . . . . . . BC 119. New York Barbells of Elmira. . . . . . . . . . . . . . . . . . . . . . . . . 34 113. Parents’ Guide to Concussions . . . . . . . . . . . . . . . . . . . . . . 26 108. Perform Better. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 118. PRO Orthopedic Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . 31 100. Rogue Fitness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC 111. Samson Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 109. SPRI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 125. T&C Online CEUs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 104. The Halo (Mission Competition). . . . . . . . . . . . . . . . . . . . . . . 7 122. Thera-Gesic® (Mission Pharmacal) . . . . . . . . . . . . . . . . . . . 39 114. Treatment Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 116. TurfCordz®/NZ Manufacturing. . . . . . . . . . . . . . . . . . . . . . . 28

Circle #. Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page #

Circle #. Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page #

526. Accu-Stretch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

518. American Public University . . . . . . . . . . . . . . . . . . . . . . . . .

511. Ari-Med (Flexall®). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

535. Balanced Body (Allegro® 2 Reformer) . . . . . . . . . . . . . . . . .

501. Balanced Body® (Arm Chair). . . . . . . . . . . . . . . . . . . . . . . .

522. Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . .

516. CytoSport (Cytomax Energy Drops™). . . . . . . . . . . . . . . . . .

524. CytoSport (Monster Amino™). . . . . . . . . . . . . . . . . . . . . . . .

509. Dynatronics (Solaris® Plus 709). . . . . . . . . . . . . . . . . . . . . .

510. Dynatronics (Tri-Wave Light Therapy) . . . . . . . . . . . . . . . . .

537. Elite Seat® (Kneebourne Therapeutic) . . . . . . . . . . . . . . . . .

531. Exertools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

525. Gatorade (Energy Chews) . . . . . . . . . . . . . . . . . . . . . . . . . .

517. Gatorade (Recovery Beverage) . . . . . . . . . . . . . . . . . . . . . .

512. Gebauer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

533. Lebert Fitness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

502. Legend Fitness (Plyo Cushion Set). . . . . . . . . . . . . . . . . . . .

505. Legend Fitness (State of the Industry). . . . . . . . . . . . . . . . .

507. Medi-Dyne Healthcare. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

527. Mission Competition (The Halo). . . . . . . . . . . . . . . . . . . . . .

530. Multi Radiance Medical (MR4 ACTIV). . . . . . . . . . . . . . . . . .

529. Multi Radiance Medical (MR4 ULTRA) . . . . . . . . . . . . . . . . .

504. New York Barbells (Back Extension Machine). . . . . . . . . . . .

514. New York Barbells (Plyometric Platforms) . . . . . . . . . . . . . .

515. Perform Better (Extreme Jam-Balls) . . . . . . . . . . . . . . . . . .

500. Perform Better (Single Leg Squat Stand). . . . . . . . . . . . . . .

536. Perform Better (State of the Industry) . . . . . . . . . . . . . . . . .

521. Power Systems (Economy Power Jumper ™). . . . . . . . . . . .

539. Power Systems (Premium Power-Plyo Box™). . . . . . . . . . . .

506. Power Systems (State of the Industry). . . . . . . . . . . . . . . . .

508. PRO Orthopedic Devices. . . . . . . . . . . . . . . . . . . . . . . . . . .

538. Rogue Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

520. Samson (custom weight stack shields). . . . . . . . . . . . . . . .

534. Samson (State of the Industry) . . . . . . . . . . . . . . . . . . . . . .

513. SPRI (Plyo Boxes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

503. SPRI Products (Hanging Ab Straps) . . . . . . . . . . . . . . . . . . .

523. Thera-Gesic® (Mission Pharmacal) . . . . . . . . . . . . . . . . . . .

528. Treatment Options (Muscle Therapy Gel/Arnica). . . . . . . . . .

532. Treatment Options (State of the Industry). . . . . . . . . . . . . . .

519. TurfCordz®/NZ Manufacturing. . . . . . . . . . . . . . . . . . . . . . .

Products Directory

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CEU QUIZ

11. The author says that when it comes to anti-rotation, the initial mistake was confusing hip internal and external rotation with _____. a) Hamstring flexibility b) Quadriceps strength c) Spinal rotation d) Shoulder rotation

16. What did Bailey do to avoid cross-contamination in the kitchen? a) She didn’t cook at home b) She moved off-campus c) She stored most of her silverware and plates in plastic bins d) She wore plastic gloves when cooking

21. An athlete’s _____ rises after their athletic career has concluded. a) Cardiovascular disease risk b) Exercise plan intensity c) Exercise session length d) Appetite

12. According to many experts, what is the overall range of lumbar rotation? a) 10 degrees b) 11 degrees c) 12 degrees d) 13 degrees

17. How many grams of fiber does the Institute of Medicine recommend for women under 50? a) 25 b) 18 c) 15 d) 50

Objective: See how a new strength coach eased his way into working with a team that was already successful.

From Problems to Solutions (pages 21-28)

18. What did James supplement with when he was rehabbing from a shoulder injury? a) Creatine b) Vitamin D c) Calcium d) Omega-3 fatty acids

Objective: See how three athletes faced with nutrition issues worked with sports dietitians to fix them.

13. Iron depletion in tissues can cause _____ and reduced exercise endurance. a) Cold intolerance b) Food intolerance c) Heat intolerance d) Gluten intolerance 14. For Miranda, what is the Recommended Dietary Allowance for iron? a) 15 mg/day b) 325 milligrams c) 8.2 mg/day d) 1.5 g/kg of body weight 15. Gluten is a combination of the two proteins gliadin and _____. a) Wheat b) Glutenin c) Oatmeal d) Rye

Quiet Danger (pages 29-31)

Objective: Learn about metabolic syndrome, which a lot of football linemen are being diagnosed with.

19. What was the average weight of an NFL player in 2006? a) 200 pounds b) 248 pounds c) 275 pounds d) 300 pounds 20. The 2011 study of 39 college football players found that while _____ of the linemen had metabolic syndrome, none of the non-linemen did. a) Two b) 14 percent c) Two percent d) Nine

Smooth Movement (pages 35-39)

22. If a pitcher has chronic elbow pain, the author immediately limits _____. a) Heavy loaded vertical pulling b) Heavy loaded horizontal pulling c) Practice time d) All lifts 23. What does the author refer to as the “x-factor”? a) Good habits b) Individualized programming c) Trust d) Enthusiasm 24. The players’ testing process includes a physical assessment, _____, performance test, strength test, and conditioning test. a) Timed two-mile run b) One rep max squat test c) Sit-up test d) Functional movement screen 25. What does the author limit during the off-season? a) Upper body lifting b) Change of direction and sprint work c) Conditioning runs d) Lower body lifting

Answer sheet is on page 52...or take this quiz online and get instant results:

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