assessments and alternatives in the collegiate setting

Assessments and Alternatives in

the Collegiate Setting

Matt Shadeed, M.S., SCCC, NASM-CES

Thanks

� Dr. Michael Webster – Associate Professor of Exercise Physiology, USM

� Melissa Moore – Director of Olympic Sports, LSU

� Juan Pablo Reggiardo – Sports Performance Coach, Stanford

� Gayle Hatch – Senior U.S. International Coach

� Shelton Stevens – Assistant Strength Coach, USM

� Bill Foran – Director of Strength & Conditioning, Miami Heat

� Paul Jackson – Head Strength Coach, Ole Miss

� Dr. Chuck Stiggins – Executive Director, CSCCa

The Ah-Hah Moment

� If I can do it, everybody should be able to do it

� Relentless cueing and visual stimulus should eventually fix the problem

� Let’s skip this exercise and find an alternative (great option, but does it identify a problem and introduce a plan to change it?)

� Sleeping through Kinesiology I & II really hurts right about now

The Ah-Hah Moment

� Every athlete is built differently

� Every athlete moves differently

� Every athlete is wired differently

� A single exercise effects every athlete differently

The Ah-Hah Moment

� Cueing comes to a dead end with certain athletes who have poor structural and/or neuromuscular integrity

� Allowing dysfunction to limit exposure to new stimulus brings the S&C coach short of main physical goals

� Recognition of basic movement dysfunction is a tool that is invaluable (short of full screen/assessment)

� If a problem is identified, introduce a strategy to create a positive change

� Corrective exercise is supplemental at best and will remain a secondary option to a well designed training protocol that addresses individual differences

Why is movement so important?

� Most philosophies at the collegiate level are centered around injury reduction and improving athletic performance

� High correlation between acute and chronic musculoskeletal pain/injury and joint dysfunction as a result of muscular imbalance

� Efficient Movement = a form of athletic ability

� MAXIMIZING trainable attributes such as speed and power require a FIRM base built around balance in the movement system

The Movement System

� Balance in the movement system requires harmony between a series of components that are related to and dependent on one another for optimal function

� Neuromuscular

� Myofascial

� Articular

� Optimizing function of the movement system increases neuromuscular efficiency, allowing the CNS to select the correct muscle synergies that coordinate the dynamic ability of the body to produce and reduce force

The Movement System

� There are many mechanisms for developing a muscular imbalance within the movement system

� Desk Jockey

� Right-Handed Pitcher

� Basketball Player

� Static and dynamic postural positions that are LESS THAN OPTIMAL compromise length-tension and force-couple relationships, promote a loss of joint centration, and cause a decrease in neuromuscular efficiency

The Movement System

� The sensorimotor system detects the LESS THAN OPTIMAL postural positions the body repeatedly assumes and sends a signal to the brain to facilitate or inhibit certain musculature in an attempt to maintain homeostasis

� Vladimir Janda notes that the changes in muscular tone are responsible for “embedding” the imbalance

� The imbalance creates dysfunction across the system

� Damaging and altering soft tissue

� Adding unwanted stress to the nervous system

� Increasing the risk for injury

Janda’s Layer Syndrome

Assessing Movement

� Where is the problem?

� Orthopedic Evaluation

� Manual Muscle Testing

� Functional Movement Screen

� As strength coaches at the collegiate level, our setting is the limiting factor in what we can accomplish related to assessing movement due to given restraints

The Collegiate Setting (fantasyland)

� 55 coaches to 110 athletes

� No time restriction from NCAA

� Sport Coaches allow you to take your time with movement testing, as they feel it is important and are in no hurry to begin their off-season program

� Entire S&C staff is certified to administer a full movement screen

The Collegiate Setting (realworld)

� 4 coaches to 110 athletes

� Time restriction from NCAA

� Head Coach wants off-season program to begin as soon as possible, huge room for improvement in mental and physical capacities

� S&C staff has no one certified to perform a full movement screen

Our Setting

� We live in the trenches and work on the fly where adjustments are made daily based on numerous factors

� It is possible to apply a simplistic approach to assessing movement that resembles the way we operate everyday by recognizing gross dysfunction and implementing alternatives and strategies to improve the problem

� Gain the ability to continually challenge the athlete who has some dysfunction through progressive alternatives while simultaneously working to fix the problem

Ongoing Assessment

� Static postural positions

� Dynamic postural positions

� GAIT

� Dynamic Warm-Up (general)

� Movement Preparation

� Barbell Warm-Up (specific)

The Bodyweight Squat

� Ankle Mobility

� Hip Mobility

� Vertical Core Strength

� Thoracic Spine Extensibility

We find a problem, then what?

� Use modifications or alternatives to continually apply new stimuli to an athlete’s program based on individual needs

� Can follow majority of planned exercise selection if we are willing to put in the effort to “tweak” it

� Implement some basic strategies outside of the training protocol that can help aid the creation of a positive change

� Make it fit for YOUR athletes and YOUR program

Myofascial Release

� Use of foam roller or other implement offers athletes a convenient and inexpensive way to improve overall muscle quality

� Improved mobility and ROM

� Reduction in scar tissue/adhesions

� Decrease tone in overactive muscles

� Autogenic inhibition

� Smaller surface area = increased pressure

If you don’t use it, you lose it

� Where did he get that

from?

� Mobility first approach

correlates to early stages in

child development

� Knowledge of Joint by

Joint Theory

� Every joint requires mobility

AND stability

Make it Stick

� Integrate newly achieved mobility and ROM into the entire system

� Create a high neuromuscular demand by training in an environment that challenges proprioceptive ability while LOADING efficient patterns in a given ROM

� Charlie Weingroff - “Get Long, Get Strong, Train Hard”

Understanding Hot Spots

� The Ankle Complex

� Propulsive, extension-based movements

� Footwear

� Taping and Bracing

� The Hips

� Athletic Position, Quad Dominance

� Sitting in class, in a car, at a desk

� Foot and ankle have large effect here

� The Thoracic Spine

� Overworking upper body mirror musculature

� Underestimating the capacity of the T-Spine

� Poor use of hips and lumbar region disrupt optimal use

Understanding Hot Spots

� The Ankle Complex

� Loss of dorsiflexion or inability to create positive shin angles while maintaining contact between heel and ground

� Lack of ankle mobility negatively effects the knee and drives quad dominance up the chain

� The Hips

� Overactive hip flexors pull the lumbar spine down and increase anterior pelvic tilt

� APT compromises position of the spine and inhibits musculature we need to utilize in the posterior chain

� The Thoracic Spine

� Kyphosis or rounding of the upper back

� Inability to extend and rotate properly at the T-Spine will have implications on cervical and lumbar spine stability, ribcage positioning, and scapular stability

Practical Application - Ankle

� Is the shin able to create a positive angle against the ground while maintaining heel contact and resisting pronation and abduction?

� Compensation Patterns� Toes Out

� Foot Flattens

� Implications up the Chain

� Tibial and femoral internal rotation

� Compound APT due to femoral position

� What is needed?

� Ideally 25 to 30 degrees dorsiflexion

Investigate with…

� Half-Kneeling Ankle Dorsiflexion

� Basic, will give you better idea of closed chain capability

� Single Leg Step Down

� Advanced, Dynamic

� Gives you more integrated response

� Feedback from Lateral Subsystem

Alternatives for Poor Dorsiflexion

� Program exercise where the need for dorsiflexion is minimal

� There are plenty of closed chain exercises that allow an athlete to train with a focus on vertical tibia

� Rack Pull

� Box Squat

� Single Leg RDL

� Static & Dynamic Split Stance (single leg) Variations

Introduce Positive Change - Ankle

� Inhibit overactive tissues in posterior lower leg musculature

� Gastrocnemius

� Soleus

� Peroneal Complex

� Introduce ROM via lengthening techniques

� Closed chain ankle mobilizations

� Focused around movement at talocrural joint

� If you add length in one place, you must add stiffness in another

� Banded Dorsiflexion

� Manual Dorsiflexion (both targeting ant/post tib)

� Heel Walks (incorporated into movement prep)

� LOAD integrated movements within parameters of given ROM for “STICK”

Practical Application - Hips

� Is the lumbar spine getting pulled down when hip flexion occurs during closed chain activity (bodyweight squat)?

� Compensation Patterns� Substitute lumbar flexion for hip flexion at end range

� Excessive forward lean of torso


� Tight Hip Flexor Complex = Anterior Pelvic Tilt

� Compromises optimal position of spine

� What is needed?

� 120 degrees of hip flexion in seated or supine position

Anterior Pelvic Tilt

Investigate with…

� Thomas Test

� Immediate feedback about tissue quality on the front and lateral aspects of the hip

� Perfect Test = With a neutral lumbar spine, ankle falls below knee while hamstring is touching table and ankle/knee/hip are in line from anterior view

� Ankle below knee with no hamstring contact = Psoas restriction

� Ankle in front of knee with hamstring contact = Rectus Femoris restriction

� Out-toeing or lateral movement of foot and knee = Tensor Fasciae Latae restriction

Alternatives for Overactive HF Complex /Anterior Pelvic Tilt

� OPPOSE the problem

� Program a higher ratio of hip dominant movements to knee dominant movements as the system will begin to regain balance

� Split stance exercise is 2 for 1 as it teaches proper lumbopelvic mechanics and actively lengthens the hip flexor

� Important to understand relationship between tone and strength

Introduce Positive Change - Hips

� Inhibit overactive tissues in hip flexor complex

� Psoas

� Rectus Femoris

� TFL/IT Band

� Introduce ROM via lengthening techniques

� Half Kneeling Stretch w/ Reach

� Add knee flexion to focus on RF


� Glutes (primary local hip extensor)

� Rectus Abdominus/External Oblique

� Plank/Bridge/Hip Lift Variations (movement prep)


Practical Application – Thoracic Spine

� Is the thoracic spine capable of extension and rotation against a somewhat neutral lumbar region?

� Compensation Patterns

� Lumbar hyperextension

� Decrease in ability to posteriorly tilt and upwardly rotate the scap

� Upper Trap dominance


� Scapular Instability

� GH joint dysfunction

� What is needed?

� 25 degrees or more for extension

� 35 degrees or more for rotation

� 20 to 40 degrees for lateral flexion

Investigate with…

� Shoulder Flexion/T-Spine Extensibility Test

� Gives immediate feedback on tissue quality that could limit

movement around the T-Spine

� Elbows remain extended w/ thumbs short = Pec Minor

restriction

� Elbows flex = Latissimus Dorsi restriction

� Shoulders shrug = Upper Trap/Levator Scapulae restriction

� Palms open up = Posterior Rotator Cuff restriction (teres

major/minor, infraspinatus)

Alternatives for Poor Overhead Mechanics

� Push-up variations are a great way to elicit enhanced scapulohumeral rhythm and can be progressed for days

� Use caution when selecting pulling movements, remember most problems w/ overhead mechanics center around restrictions at the pec and lat

� Horizontal pulls are shoulder friendly and promote optimal postural alignment when done correctly

� Medicine Ball tosses and throws can help with thoracic mobility when done correctly

Introduce Positive Change – T-Spine

� Inhibit overactive tissues in the chest and upper back areas

� Pec Minor

� Latissimus Dorsi

� Posterior Rotator Cuff

� Introduce ROM via aggressive T-Spine mobility and lengthening strategies

� Extension based mobility drills, followed by rotation

� Actively working on pelvic positioning will help the problem


� Rhomboids (downward rotator of the scap)

� Mid/Lower Trap


Closing

� Practical application of these invaluable tools (assessments, alternatives, modifications, etc.) allows us as coaches to challenge our athletes while we simultaneously challenge ourselves

� It’s easy to watch somebody move well, however, we should be obsessed by what our athletes cannot do

� If we really understand how efficiency in the movement system can help us/hurt us, these simple methods should be of the utmost importance

Contact

�[email protected]

�(c) 205-240-8253

assessments and alternatives in the collegiate setting

Documents