training & conditioning 17.2
DESCRIPTION
March 2007TRANSCRIPT
March 2007 Vol. XVII, No. 2, $7.00
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TRAINING-CONDITIONING.COM T&C MARCH 2007 1
Nutrition
13 Winning and Losing Can athletes win and lose weight at the same time? In this article,
we discuss the delicate issue of losing weight in-season.
By Michelle Rockwell
Optimum Performance
24 The Better To SeeFrom having Lasik surgery to catching bean bags over their shoul-
ders, athletes are opening their eyes to enhancing their vision.
By R.J. Anderson
Treating The Athlete
30 Ready for Prime TimeWhen a minor league pitcher sought treatment for back pain, this
rehab team helped propel him into the big leagues and a pennant.
By Dr. Micheal Clark and Marty Miller
Sport Specific
37 A Strong SeasonAt the University of Wisconsin, the men’s basketball team uses a
focused but flexible plan to keep its players strong all season long.
By Scott Hettenbach
Special Focus: Preventing MRSA
43 Are You Protected?MRSA can wreak havoc on an athletic team. Here’s how to
help prevent an outbreak—and also how to deal with one.
By Greg Scholand
50 Educational Posters
66 Products and services to fight MRSA
Q&A
4 Brian J. Smith
Rancho Buena Vista High School, Calif.
Student Corner
10 Your Expert Opinion
How to evaluate new treatments and
training tools
By Dr. Greg Frounfelter
Sideline
19 All Day Fueling
Reconditioning Solutions
20 Shoulder Dislocation
Product Pages
70 Aquatic Exercise
71 Product Launch
73 Catalog Showcase
75 Hot & Cold Therapy
80 More Products
72 Advertisers Directory
CEU Quiz
76 For NATA and NSCA members
On the cover: A specialized off-season training program gave Zach Miner the strength, coordination, and stability he needed to secure a spot on the Detroit Tigers’ roster. Story begins on page 30. Photo ©Getty Images.
March 2007, Vol. XVII, No. 2
CONTENTS3724 43
2 T&C MARCH 2007 TRAINING-CONDITIONING.COM
Publisher Mark Goldberg
Editorial StaffEleanor Frankel, DirectorR.J. Anderson, Kenny Berkowitz, Nate Dougherty, Abigail Funk, Dennis Read, Greg Scholand, Laura Ulrich
Circulation Staff David Dubin, DirectorJohn Callaghan
Art DirectionMessage Brand Advertising
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T&C editorial/business offices: 31 Dutch Mill RoadIthaca, NY 14850 (607) 257-6970Fax: (607) [email protected]
March 2007 Vol. XVII, No. 2
Marjorie Albohm, MS, ATC/LDirector of Sports Medicine and Orthopaedic Research,Orthopaedics Indianapolis
Jon Almquist, ATCSpecialist, Fairfax County (Va.) Pub. Schools Athletic Training Program
Brian Awbrey, MDDept. of Orthopaedic Surgery,Massachusetts General Hospital,and Instructor in Orthopaedics,Harvard Medical School
Jim Berry, MEd, ATC, SCAT/EMT-BDirector of Sports Medicineand Head Athletic Trainer,Myrtle Beach (S.C.) High School
Leslie Bonci, MPH, RDDirector, Sports Medicine Nutrition Program, University of PittsburghMedical Ctr. Health System
Christine Bonci, MS, ATCAsst. A.D. for Sports Medicine,Women’s Athletics, University of Texas
Cynthia “Sam” Booth, ATC, PhDManager, Outpatient Therapyand Sportsmedicine,MeritCare Health System
Debra Brooks, CNMT, LMT, PhDCEO, Iowa NeuroMuscular Therapy Center
Cindy Chang, MDHead Team Physician,University of California-Berkeley
Dan Cipriani, PhD, PTAssistant Professor, Dept. of Exercise and Nutritional Sciences, San Diego State Univ.
Gray Cook, MSPT, OCS, CSCSClinic Director, Orthopedic & Sports Phys. Ther., Dunn, Cook, and Assoc.
Keith D’Amelio, ATC, PES, CSCSHead Strength & Conditioning Coach/Assistant Athletic Trainer, Toronto Raptors
Bernie DePalma, MEd, PT, ATCHead Athl. Trainer/Phys. Therapist,Cornell University
Lori Dewald, EdD, ATC, CHESAthletic Training Program Director and Associate Professor of Health Education, University of Minnesota-Duluth
Jeff Dilts, Director, Business Development & Marketing, National Academy of Sports Medicine
David Ellis, RD, LMNT, CSCSSports Alliance, Inc.
Boyd Epley, MEd, CSCSDirector of Coaching Performance,National Strength & Conditioning Association
Peter Friesen, ATC, NSCA-CPT, CSCS, CAT, Head Ath. Trainer/ Cond. Coach, Carolina Hurricanes
Lance Fujiwara, MEd, ATC, EMTDirector of Sports Medicine,Virginia Military Institute
Vern Gambetta, MA, President, Gambetta Sports Training Systems
Joe Gieck, EdD, ATR, PTDirector of Sports Medicine and Prof., Clinical Orthopaedic Surgery, University of Virginia (retired)
Brian Goodstein, MS, ATC, CSCS, Head Athletic Trainer, DC United
Gary Gray, PT, President, CEO, Functional Design Systems
Allan Johnson, MS, MSCC, CSCSCoach, Speaker, Consultant
Maria Hutsick, MS, ATC/L, CSCSHead Athletic Trainer, Boston University
Christopher Ingersoll, PhD, ATC, FACSM Director, Graduate Programs in Sports Medicine/Athletic TrainingUniversity of Virginia
Jeff Konin, PhD, ATC, PTVisiting Associate Professor,University of South Florida
Tim McClellan, MS, CSCSDirector of Perf. Enhancement,Makeplays.com Center for Human Performance
Michael Merk, MEd, CSCSDirector of Health & Fitness,YMCA of Greater Cleveland
Jenny Moshak, MS, ATC, CSCSAsst. A.D. for Sports Medicine,University of Tennessee
Steve Myrland, CSCSOwner, Manager, Perf. Coach, Myrland Sports Training, LLC, Instructor and Consultant,University of Wisconsin Sports Medicine
Mike Nitka, MS, CSCSDirector of Human Performance,Muskego (Wisc.) High School
Bruno Pauletto, MS, CSCSPresident, Power Systems, Inc.
Stephen Perle, DC, CCSPAssociate Prof. of Clin. Sciences, University of Bridgeport College of Chiropractic
Brian Roberts, MS, ATC, Director, Sport Performance & Rehab. Ctr.
Ellyn Robinson, DPE, CSCS, CPTAssistant Professor, Exercise Science Program,Bridgewater State College
Kent Scriber, EdD, ATC, PTProfessor/Supervisor of Athletic Training, Ithaca College
Chip Sigmon, CSCSStrength and Conditioning Coach,Carolina Medical Center
Bonnie J. Siple, MS, ATCCoordinator, Athletic Training Education Program & Services, Slippery Rock University
Chad Starkey, PhD, ATCVisiting Professor, Athletic Training Education Program, Ohio University
Ralph Stephens, LMT, NCTMBSports Massage Therapist,Ralph Stephens Seminars
Fred Tedeschi, ATCHead Athletic Trainer, Chicago Bulls
Terrence Todd, PhD, Co-Director, Todd-McLean Physical Culture Collection, Dept. of Kinesiology & Health Ed., University of Texas-Austin
Training & Conditioning (ISSN 1058-3548)
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Editorial Board
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4 T&C MARCH 2007 TRAINING-CONDITIONING.COM
For Smith, working at the high school level has turned out
to be a great move. “Being able to influence young athletes
is a huge advantage to this setting,” he says.
Brian J. Smith Rancho Buena Vista High School, Calif.
wanted to do with it. So my older brother, who was a senior in
the athletic training program, took me to see the athletic train-
ing room, and everything just clicked right then and there. I
realized that by becoming an athletic trainer, even though I
couldn’t play football anymore, I could still be part of a team
and interact with athletes. It gave me a chance to put my love
of sports together with my love of medicine.
How did you wind up at Rancho Buena Vista?
To tell you the truth, the whole time I was studying to be an
athletic trainer, I never considered working at the high school
level. When I was a graduate assistant at Indiana University,
where I worked with the football and women’s rowing teams,
I was convinced I wanted to work at the collegiate level. But
my first job out of grad school was working at the US Olympic
Training Centers in Chula Vista and Lake Placid. After that
year, I really wanted to return to the San Diego area, so I took
In the five years since graduating from Calif-ornia State University-Chico, Brian J. Smith, MS, ATC, NREMT-B, has rehabbed football athletes at Indiana University, worked with the USA Mogul Ski Team, covered an NCAA Women’s Rowing Championship, treated on-the-job injuries at a shipbuilding factory, and coordinated outreach for 11 high school football teams in and around Chula Vista, Calif. But he’s truly found a home as Head Athletic Trainer and Sports Medicine Teacher at Rancho Buena Vista High School, located about seven miles from the Pacific Ocean in Vista, Calif., near San Diego.
After arriving at Rancho in January 2004, Smith encoun-
tered and successfully treated his first near-fatality during
football two-a-days that summer, quickly earning the respect
of athletes, parents, coaches, administrators, and neighbor-
ing athletic trainers. Later, he spearheaded a successful
campaign to purchase an automated external defibrillator for
the athletic department, and helped lead efforts by the Far
West Athletic Trainers Association (FWATA) to publicize the
lack of athletic training coverage at area high schools.
Working in one of six states that doesn’t register its certi-
fied athletic trainers, Smith has consistently advocated for
the profession and was named the 2006 FWATA Secondary
School Athletic Trainer of the Year. In this interview, he talks
about working in the high school setting, acting quickly dur-
ing an emergency situation, and promoting athletic training to
a wider audience.
T&C: When did you know you wanted to become an
athletic trainer?
Smith: Like a lot of athletic trainers, I had an injury playing in
high school. Sophomore year I tore my ACL during football,
junior year, I came back, and halfway through my senior year
I tore my meniscus. We didn’t have an athletic trainer, but I
spent a lot of time in the physical therapy setting, and began
to think it might be worth pursuing as a career.
My first semester in college at Chico State I declared a
major in exercise physiology, but I didn’t really know what I
QA&&
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6 T&C MARCH 2007 TRAINING-CONDITIONING.COM
At the college level, athletic trainers are usually dealing
with just one team. At the high school level, I’m one person
responsible for 2,000 athletes. So the challenge is to pri-
oritize everything I do, communicate clearly with athletes and
coaches, and make sure I don’t favor one sport over another.
Luckily, coaches here recognize I can’t be everywhere at
once, so if the athletic training room is full of athletes and I
can’t get to their practices on time, they understand.
What have you learned about working with coaches?
The big thing is communication, and to always be up front
with them. I don’t sugarcoat anything because at this level
coaches are a big part of the sports medicine team. I can’t
attend every practice and every game for every team, but if
there’s an emergency, they need to know they can call me
and trust me to do my best for their athletes.
How about working with athletes’ parents?
I hold a parents’ meeting before the start of every season,
where I talk about my approach and emphasize that my high-
est priority is their children’s safety. If kids get hurt, I’m not
going to put them back on the field unless I know they’re
ready to return. And every time I say that, I see the parents
smile and nod their heads because they know how competi-
tive high school sports can get. I tell them I’m not here for the
wins and losses, I’m here for their kids’ safety.
What was your most challenging rehab?
It was a senior starter on the boys’ basketball team, who
had a meniscus tear. The doctor was adamant he’d be able
to play in a couple of weeks, the coach wanted him back as
quickly as possible, and his teammates were all pushing to
a clinical job at a physical therapy clinic, which is where I met
my wife, who’s a physical therapist.
Throughout those years, I kept thinking about what my grad-
uate advisor told me: Plan your professional goals around
your personal life. So as my relationship grew more serious,
high school started to look like a good fit because I’d be able
to go home every night, which would be important if we were
going to have kids.
I’ve been at Rancho going on three years now, and it’s
turned out to be a great move. My athletic director offers
nothing but support and my principal backs me on everything
I do. When the administration asked if I would be interested
in teaching a sports medicine class, I jumped at the chance.
I also have some great kids here, which is very rewarding.
And I have a top-notch athletic training room—it’s a lot like the
room I worked in when I was an undergrad. I don’t have all the
high-tech equipment we had at the Olympic Training Center,
but I have everything I need to do my job efficiently and give
the kids the best care possible.
What are the challenges of working at the high
school level?
I miss the camaraderie of being around other athletic trainers.
When I was going through school or working at the Olympic
Training Center, there were always people I could bounce
ideas off. If I needed a second opinion, I could get it immedi-
ately. Now, if there’s an injury, everybody turns to me. When I
first accepted this job, the athletic director said, “Here’s the
key to your athletic training room—it’s all yours.” It was a chal-
lenge to come in and hit the ground running, create the pro-
gram I wanted, and prove myself to all the athletes, parents,
coaches, and administrators.
Brian J. SmithHead Athletic Trainer, Sports Medicine Teacher,Rancho Buena Vista High School, Vista, Calif.
BS, California State University-Chico, 2001; MS, Indiana University, 2002
Previous Positions: Fellowship Athletic Trainer, US Olympic Training Center, Chula Vista, Calif., and Lake Placid, N.Y., August 2002-June 2003
Sports Medicine Director, Sweetwater Union High School Outreach Program/Lead Physical Training Aide, Edward Ayub Physical Therapy Clinic, Chula Vista, Calif., June-December 2003
Athletic Trainer, National Steel and Shipbuilding Company, San Diego, Calif., August-December 2003
Honors: 2006 Far West Athletic Trainers Association Secondary School Athletic Trainer of the Year
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TRAINING-CONDITIONING.COM T&C MARCH 2007 7
he wasn’t getting any worse and kept his airway clear.
His heart rate was going through the roof. I was trying to
take his pulse and couldn’t keep up with it, that’s how fast it
was. Once the paramedics got there, they gave him an EKG
on the field and saw his heart rate was over 200 beats a min-
ute. They got him to the hospital, stabilized him, and after
some tests they diagnosed it as superventricular tachycar-
dia, a pre-existing condition we hadn’t known about and was
probably exacerbated by the heat. When it was reported in
the newspaper, they made it seem like I’d diagnosed this pre-
existing condition, which I hadn’t. But I knew it was an emer-
gency and got the ambulance rolling as quickly as I could.
The situation had a happy ending and the athlete made it
back to play three or four games that season.
What did that experience teach you?
I learned to always be prepared, because in this profession
you never know what’s going to happen next. I was thrown
“I was thrown into a situation where I need-ed to act quickly, and it made me really evaluate my program: Did I have everything I needed to save someone’s life?”
get him on the court again. It was a relatively simple surgery,
so the hard part wasn’t getting him back, it was getting ev-
eryone to keep the injury in perspective. I made it a point to
keep reminding everyone, “If we can get him back safely in
those two weeks, then we will. If we can’t, we won’t. He’s
got his whole life ahead of him, and we’re not going to rush
this.” If needed, I was prepared to be the bad guy. But in two
weeks he was back on the court to finish the season and
everybody was happy.
During your first football preseason at Rancho, you
helped save an athlete’s life. How did you respond to
that situation?
If people think I saved his life, that’s fine, but I don’t really look
at it that way. I recognized we were in an emergency situation
and I took the necessary steps to get the help he needed.
It was mid-August, we’d just started two-a-days in our new
football stadium, and this was the first real emergency situa-
tion I was thrown into at Rancho.
This particular athlete, who was a fairly hefty fullback, was
walking back from a huddle when he collapsed on the field.
I ran out and when I got to him his eyes were rolled back in
his head, his breathing was labored, and he was going in and
out of consciousness. I immediately threw my cell phone to
the head coach and said, “Call 911.” While we waited for the
ambulance to arrive, I monitored his vital signs to make sure
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Circle No. 104
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TRAINING-CONDITIONING.COM T&C MARCH 2007 9
into a situation where I needed to act quickly, and it made me
really evaluate my program: Did I have everything I needed to
save someone’s life? It took another two and a half years be-
fore I convinced the athletic department to get an AED, but
I pushed hard, raising funds through my physicals until we
were able to purchase one. That incident opened my eyes to
see that anything can happen, and we need to have the right
equipment on hand, even if we never have to use it.
What was your reaction to winning the FWATA’s Sec-
ondary School Athletic Trainer of the Year award?
When I first got the news, I thought someone was playing a
joke on me. I like to be involved and get my voice out there,
so I’m on the secondary school committee, and I think it’s im-
portant to promote the profession. But I really feel I do what
any other athletic trainer does.
What are some things you’ve done to promote
athletic training?
I did a survey where I called all the schools in the San
Diego area and asked the athletic directors, “Do you have an
athletic trainer on staff? Why or why not?” I found that of 90
schools, only 21 have a full-time athletic trainer and 41 have
no athletic trainer of any kind. The most common reason for
not having an athletic trainer was money—the school felt it
couldn’t afford one. It’s unfortunate that too often it takes a
catastrophic injury before people realize they can’t afford not
to have one.
I don’t believe in promoting the profession by standing on
a pedestal and saying, “Athletic training is the best career out
there and every high school needs to have an athletic trainer.”
Instead, I try to set an example. When I travel with the football
team to a school that doesn’t have an athletic trainer, or when
one of those 41 schools comes to play us, I make sure to
take care of the athletes on the opposing team as well as our
own. I do all I can in the hope that some parent or coach will
say, “Why don’t we have an athletic trainer at our school?” I
try to act professionally in everything I do, and I always tell
my students that whatever career they’re planning to pursue,
whether it’s athletic training or anything else, they need to be
proactive: “Don’t just punch a time clock—get involved.”
Do you ever think about working at the college level?
I do. My brother is on the athletic training faculty at James
Madison University, and sometimes when I hear him talk
about it, I miss my days as a graduate assistant at Indiana.
But at the same time, I have to pinch myself because my
job here at Rancho is great. Being able to influence young
athletes is a huge advantage to this setting, plus I get to go
home every night and spend time with my wife. I can live
the life of an athletic trainer and still have time to try to be a
good husband. ■
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Circle No. 105
DAILY
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10 T&C MARCH 2007 TRAINING-CONDITIONING.COM
Sponsored by
tabases. If I don’t get many results, I
do a standard Web search. I usually
use the MSN search engine, playing
with search phrases until I find some-
thing that looks worthwhile.
Ideally, I would like peer-reviewed
articles about the product, which
means a panel of academics in kine-
siology or sports medicine examined
the text before it was approved for
publication. It also means the article’s
authors must reveal any financial ties
with the manufacturer of the product.
I also see if any randomized, con-
trolled trial studies have been per-
formed, although this is less common
with newer products. These stud-
ies help us develop evidence-based
practices that allow us to determine
the best treatment and practice pat-
terns with the equipment.
Sometimes, I only find research
conducted by the manufacturer of the
product. Though these studies can be
biased, I don’t automatically assume
they are flawed. I look at how the study
was performed and how the research-
ers drew their conclusions. If their
methods and analyses are based in
science, I will take their conclusions
seriously.
If possible, I also take the time to
personally try out the equipment. This
gives me a hands-on feel for how the
product works. It can also help answer
any questions I have about content va-
lidity and the research I’ve read.
Finally, I will consider whether the
product is worthwhile for my clients.
Before purchasing, I ask: Does the
equipment fit in my facility? Will my
athletes and patients actually be able
to use and benefit from it? How much
does the product cost and will my bud-
get allow me to purchase or rent it?
How will staff learn to use the product
properly and teach others about it?
Let’s take kettlebells (KBs) as an
example. I had heard of KBs through
reading about Soviet sports training
programs, but I didn’t know their spe-
cifics until I saw a presentation about
them at the NSCA National Confer-
ence and Symposium. As I watched
the demonstration, I began to consid-
er their content validity.
Supporters claim KBs are a func-
tional, easy-to-use training modal-
ity that can produce resistance
training with cardiovascular effects.
The demonstrator showed that there
are two basic exercises, the swings
and grinds. On the swing motion, the
athlete lets the KB swing to the rear
between the legs and then uses the
leg and back muscles to explosively
bring the KB to the front. The weight
then falls back to the starting posi-
tion and the next rep starts. This can
be performed with one or two hands
holding the KB and there are many
variations on the swings. From this ba-
sic exercise, cleans and snatches can
be performed. As I watched, I found
this type of activity very specific to
sports performance and felt it could
easily be used in late-stage rehab or
with relatively lighter KBs to provide a
cardio workout.
The second basic exercises are
grind motions, which are performed in
a controlled manner without the ballis-
tics of the swings, and can be used for
general strengthening and condition-
ing. Exercises include various squats,
chest presses, overhead presses, and
F or anyone with a computer, an
almost unlimited amount of in-
formation about training modal-
ities is just a mouse-click away—and
that includes your future clients.
Ready or not, you will need to be able
to answer their questions about the
latest training ideas and equipment.
So how do you assess new training
modalities and establish recommenda-
tions about them? And how can you in-
corporate those thoughts into practice
as you serve your future clientele?
My strategy is to follow a series of
steps when evaluating a new training
product. First, I examine content valid-
ity by looking over the device and an-
alyzing whether it looks like it can do
what it claims to be able to do. I use
what I know about anatomy, movement,
and rehab to make this assessment.
If the product looks and sounds
feasible, I then read any reviews of it
that are available. I start by looking for
scientific research through Medline,
PEDRO, and the Cochrane Library da-
StudentCornerA special feature for your athletic training students
New treatments and training tools arrive on the market daily. As an athletic trainer, you will need to provide opinions on them.
Greg Frounfelter, DPT, ATC, CSCS, is
an Athletic Trainer and Physical Therapist
in the Physical Medicine Department at
Agnesian Healthcare-Waupun Memorial
Hospital in Waupun, Wis. He can be
reached at: [email protected].
Your Expert Opinion
BY DR. GREG
FROUNFELTER
Untitled-5 1 2/1/07 2:13:52 PM
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Circle No. 106
even Turkish get-ups or windmills. The
KB grinds seemed to be perfect for
core strengthening, especially when
done unilaterally. They also appeared
to be very valuable for training trunk
stability in patients with back pain.
I was impressed with how many ar-
eas the demonstrators were work-
ing when using KBs. I also was able
to see how the exercises could be in-
corporated into both training and re-
habilitation. The wonderful thing about
learning about KBs at a conference
was there were vendors at the exhib-
it hall who sold them. This allowed me
to try them first-hand, as well as check
out different styles. From the presenta-
tion and my own practice with them, at
that point, I was confident I had verified
the product’s content validity.
After the conference, I searched
the Internet and review-based article
databases to further investigate the
efficacy of KBs. The peer-reviewed ar-
ticles did not have much information,
but I did find out more about the use of
KBs through various fitness Web sites.
One of the sites also sold KBs, so I
was wary of the information. But I kept
searching and found two independent
Web sites that verified the claims. Al-
though I couldn’t find all the informa-
tion I wanted about KBs, I had enough
to keep thinking about their use.
Next, I determined whether KBs
would work with enough of our clien-
tele to make the investment worthwhile.
I concluded that:
■ Because they have many uses, KBs
would work well with our diverse
clientele.
■ Because they strengthen the core,
they would be a good tool for our
many patients with back injuries.
■ Because they come in small weights,
they would be a good fit with our pa-
tients with low strength thresholds.
■ Because they take up very little
space, they would work well with our
floor plan.
We have bought KBs and they have
worked well. But I am very glad I took
the time to analyze their validity and
uses beforehand. By following a logi-
cal progression when assessing new
equipment, you too will be able to make
solid recommendations based on fact
and physiological training principles.
In the midst of the information age, our
clients will expect nothing less of us as
allied health professionals. ■
By following a logical progression when assessing new equipment, you too will be able to make solid recommenda-tions based on fact and physiological training principles.
Untitled-11 1 1/11/07 4:46:54 PM
StudentCorner
Circle No. 107
TThe official position of the American College of Sports Medicine, which most sports nutritionists agree with, is that athletes should not try
to lose weight during their competitive season. That’s because dieting can very easily jeopardize energy and nutrients critical for training and performance. In addition, the mental stress of restricting calories can become all-encompassing and turn into a performance-distracter.
But what happens when an ath-lete shows up for preseason physicals with frantic weight-loss goals? The off-season, which is when weight loss was supposed to happen, went by too quickly and the athlete ended up relax-ing on their nutrition habits instead of making important changes.
Michelle Rockwell, MS, RD, is the for-
mer Coordinator of Sports Nutrition at
the University of Florida and now serves
as a nutrition consultant for several
sports teams ranging from youth to col-
legiate to professional. She has recently
helped launch RK Team Nutrition, at:
www.rkteamnutrition.net, and can be
reached at: [email protected].
BY MICHELLE ROCKWELL
Winning and LosingWinning and Losing
PHOTO COMPOSITION: ©MESSAGEPICS, PHOTO: ©GETTY IMAGES
Can athletes win and lose weight at the same time? In this article, we discuss the delicate issue of losing weight during the competitive season.
Can athletes lose weight during the season without compromising their training? The answer is yes, but it must be done carefully.
IS IT A GOOD IDEA?
Before any talk of dieting or calo-rie cutting begins, it’s critical to dis-cuss whether a particular athlete who wants to lose weight truly needs to. It’s easy to say, “No dieting now, let’s write a reminder to focus on it dur-ing the off-season.” But the reality is that excessive weight or body fat can impair athletic performance in some cases. The challenge is determining whether the risks of making weight changes in-season outweigh the po-tential performance benefits.
Therefore, to start, take the time to
talk to the athlete one-on-one about why he or she wants to lose weight. At least half the time, athletes’ weight-loss goals are inappropriate and unrealistic. Many times athletes want to lose weight for aesthetic reasons, not performance-enhancing reasons. I have worked with professional athletes, both male and female, whose weight goals are based strictly on how they will look in photo-
NUTRITION NUTRITION
NUTRITION
14 T&C MARCH 2007 TRAINING-CONDITIONING.COM
graphs and advertisements. Sometimes athletes have competing interests—a college volleyball player who models on the side is a good example.
Others have a “magic number” in mind that they believe is their ideal competition weight, but it’s not based on anything scientific. Take the exam-ple of a high school cross country run-ner I recently worked with. He was convinced that his optimal race weight was 142 pounds since that is how much he weighed when he scored at the state cross country meet his sophomore and junior seasons. At the start of his senior season, he weighed 156 pounds and was tremendously under-confident. His coach grew concerned when he started skipping meals and doing extra runs at night in an attempt to cut weight.
During our initial conversation, the athlete revealed that he had started lift-ing weights since last season and had grown 2.5 inches taller—both very good reasons for gaining lean mass! We ultimately created a meal plan that helped him get to 150 pounds, which he was content with, and he raced quite well at the higher weight. But the most important aspect was to get him to understand that 142 was not a magic number.
An intense desire to lose weight may
HOW HUNGRY ARE YOU?HOW HUNGRY ARE YOU?Below is a log entry in which a gymnast rated her hunger before
eating evening meals and snacks.
Time Food or Drink Hunger Score Commentsof Day (10= the hungriest
I’ve ever been,
1= not at all hungry)
6:45 p.m. 1 grilled chicken 7 I felt really hungry
sandwich with because it was right
mustard and pickles, after practice
20 oz. diet soda,
7 baby carrots
8:00 p.m. 24 animal crackers 7.5 While I was studying
9:30 p.m. 1 bag Skittles 4
9:45 p.m. 2 chocolate chip 2 I wasn’t even hungry
cookies but couldn’t stop
thinking about the
cookies in my room-
mate’s cabinet
also be a sign that something else is going on with an athlete. How many times have you heard a young female athlete say, “Everything would be fine if I could just lose 10 pounds.” So much emphasis is placed on weight and body image in our society (and in sports) that athletes may feel losing weight is the cure to all their problems. They could have personal issues or stressors they need to deal with, and may need the help of a mental health professional.
Athletes in sports with weight clas-sifications, such as wrestling and light-weight crew, are clearly in a different category as they typically have no choice but to try to achieve a specified weight. However, even with these athletes, it must be determined whether they can achieve the desired weight without de-creasing performance, or whether they need to move to a higher weight class or heavyweight crew for the season.
Here are six questions to ask athletes who want to lose weight in-season:• What is your weight-loss goal?• Is this realistic?• When is the last time you weighed
this amount?• Why do you want to lose weight?• How will this make you perform
better?• Is there any chance that chang-
ing your diet will detract from your training or performance, both physi-cally and mentally?A discussion based on the above ques-
tions should allow you to get a clear pic-ture of the athlete’s perspective. Then decide if his or her goals are realistic, appropriate, and can be reached with-out harm. Many times it’s beneficial to involve a sports dietitian or even a team physician in this process. Don’t hesitate to enlist further professional help if you detect signs of disordered eating.
GENERAL GUIDELINES
If you decide to help an athlete move forward with an in-season weight-loss plan, it’s important to put some strict guidelines into place. The first is to communicate often. Remind the athlete that there is a reason why the regular season is not the preferred time to focus on weight loss. Low energy levels, poor recovery, and poor concentration may occur on any restricted-calorie diet. Any physical or mental changes should be consistently communicated with the sports medicine team.
The second guideline is to start im-mediately. Initiate the weight-loss pro-gram as early in the season as possible, ideally in the early preseason when training volume and intensity are high and before competition begins. This will allow more time to space out the weight loss and lessen the chance it will have detrimental effects.
Third, keep it gradual. Athletes should lose no more than one to two pounds per week, and even that may be too fast in-season. Losing weight more rapidly is likely to cause loss of muscle tissue and potentially strength, speed, and power. Emphasize that drastic and rapid weight loss is always a health risk, but it is even riskier during intense training. Watch out for symptoms of inappropriately fast weight loss or ex-cessive calorie-restriction, including increased injury or illness, decreased energy levels, poor recovery, and de-creased performance.
Low-calorie diets are also more like-ly to lead to low intakes of important vitamins and minerals which can af-fect an athlete. For example, it is well known that iron deficiency impairs per-formance. Research has also shown a strong relationship between chronical-ly inadequate calories (“energy drain”) and amenorrhea (loss of the regu-lar menstrual cycle). Amenorrhea can
NUTRITION
TRAINING-CONDITIONING.COM T&C MARCH 2007 15
be a concern in terms of reproductive health, but also in terms of bone health. Athletes with amenorrhea are more likely to have low bone mineral densi-ty, which predisposes them to fractures and eventually osteoporosis.
Even athletes in sports with weight classifications should shed pounds gradually. A wrestler who is 10 pounds over his weight class is much better off losing two pounds per week throughout the beginning of the season than crash dieting to lose it all at the last minute. The best scenario is when you can con-vince these athletes to stick to low-fat, but consistent diets.
If you need to make a specific calorie recommendation to the athlete striving to lose weight, I recommend assessing what they currently eat on a typical day (not a “good day” but a “typical day”), and reducing that amount by 10 to 20 percent. For example, a female swim-mer who currently eats about 3,200 cal-ories per day should be able to achieve weight loss without jeopardizing train-ing and performance by cutting down to 2,500 to 2,700 calories per day.
DO’S AND DON’TS
Once athletes have committed to fol-lowing the above rules, they’ll want some specifics on how to lose the weight. Simple science says that eat-ing less calories than you expend will lead to weight loss. Friends and popu-lar magazine articles will tell athletes the latest secret to weight loss. But, for an athlete in-season, this advice could be dangerous. They need to limit intake much more carefully.
Since counting calories is foreign to many athletes and can also easily become obsessive, I advise more subtle dietary changes. I’ve found the following do’s and don’ts resonate well for today’s athletes:
Don’t Skip Meals …
Skipping meals may seem like an easy strategy to cut calories, but it’s also a sure way to slow metabolism and de-plete energy levels. Athletes should eat four to five times per day. The two most important fueling times are breakfast (within one hour of waking up) and re-fueling (within one-half to one hour of completing hard workouts).
… Do Practice Mindful Eating
However, athletes should identify times when they are consuming calories that aren’t contributing to beneficial fuel in-take. For example, if snacking on junk food during the evening is the athlete’s biggest issue, they can make a grocery list for healthier items to keep around. One athlete decided to start studying at study hall where food was not allowed to prevent snacking on her typical po-tato chips and candy. Another athlete reminded herself to drink water rath-er than snack at night—she realized she was mistaking thirst for hunger. A third athlete started going to bed one hour earlier—when he got more sleep, he was less hungry. He also stopped keeping coins in his dorm room to pre-vent visits to the vending machine.
I also try to get athletes in touch with when their bodies are actually hungry and when they’re full. I often start by having them keep a food log that in-cludes a hunger rating, which is a mea-surement of how hungry they feel when they start eating a particular food or beverage.
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Untitled-1 1 1/18/07 11:17:22 AM
Circle No. 108
Meal Original Drinks Substitution
Breakfast 2 20 oz. bottles orange juice 2 20 oz. bottles water and (480 calories) a fresh orange (60 calories)
Throughout 1 can soda (200 calories), 1 can diet soda, 2 bottles water or 2 the morning 2 large glasses fruit punch (700 calories) sugar-free flavored beverages (10 calories)
Lunch Large lemonade (300 calories) Large water (0 calories)
During training 72 oz. sports drink (135 calories), 72 oz. sports drink (135 calories), session water water
After training session Recovery shake (350 calories) Recovery shake (350 calories)
Dinner Restaurant soda with free refills 2 restaurant unsweetened teas, (650 calories) water (0 calories)
After dinner Large glass Kool-aid (400 calories) Water or sugar-free flavored beverage (10 calories) Totals 3,215 calories 565 calories
BEVERAGE BOARDBEVERAGE BOARDThis table shows how an NFL lineman was able to reduce his caloric consumption significantly
by changing his drink choices.
Rehabilitation & Conditioning Pools
Untitled-3 1 2/14/07 3:36:59 PM
NUTRITION
Circle No. 109
NUTRITION
TRAINING-CONDITIONING.COM T&C MARCH 2007 17
and athletic performance. Athletes should also continue to use
sports drinks before, during, and af-ter activity. Some athletes who are los-ing weight worry about the calories in sports drinks, but these should be the last calories they’re concerned about. Sports drinks provide a small amount of energy in the form of sugar that can help delay fatigue. These are not the calories to cut.
… Do Modify Drink Calories
However, during the day, it would be wise to substitute sports drinks with water or other calorie-free drinks (un-less the athlete has specific problems with dehydration or is in two-a-day practices). Many athletes are surprised to learn how many calories they are getting from beverages. An NFL line-man was able to cut over 2,500 calo-ries from his daily diet and lose two pounds per week just by changing his drink selections. (See “Beverage Board” on page 16.)
Any athlete trying to lose weight should also avoid alcohol. Calories from alcohol are not used as productive fuel and eliminating or reducing them is often very helpful in weight loss. In
ful. One athlete liked to have ice cream before bed every night. We determined that between ice cream and fudge sauce, she was getting 800 calories per night. Imagine how many calories she saved when she switched to a fudge pop (160 calories), low-fat frozen yogurt (180 calories), or an all-fruit popsicle (70 calories), which she ultimately found just as satisfying.
Another trick is to add more water to a diet. High-liquid foods such as fruits, vegetables, and soups (broth-based, not cream-based) can work wonders. They allow an athlete to eat until they’re full without getting a high volume of calories.
Don’t Risk Dehydration …
Some athletes are pleased by the weight they lose during training sessions. But they should not be. Weight lost during ex-ercise is almost exclusively fluid loss that must be replaced to support recovery.
Athletes should also understand that fluid needs are often higher dur-ing calorie restriction. Those watch-ing their intake sometimes make the mistake of restricting the amount they drink. But drinking plenty of water is an important part of both weight loss
For example, by filling out the log, a gymnast I worked with realized that she was snacking on sweets later in the evening partially because she didn’t find her dinner or 8 p.m. snack very satisfying. (See “How Hungry Are You?” on page 14.) By adding a baked sweet potato at dinner and substituting a high protein snack at 8 p.m. (yogurt), she satisfied her cravings for something sweet and felt full longer. She also rec-ognized that she was bored and lone-ly at 9:45, the time when she and her boyfriend used to talk on the telephone (they had recently broken up). Instead of snacking at this time, she decided to walk her dog and call a friend on her cell phone.
Don’t Eliminate Favorite Foods …
There is no reason to completely elimi-nate favorite foods or foods eaten fre-quently. This will just make the athlete crave them more.
… Do Modify Portion Sizes
Instead, advise the athlete to modify the portion sizes of favorite foods. Some-times it even helps to simply use small-er serving dishes. I have them try this experiment: Prepare a cup of pasta and put it on a regular dinner plate—it will look lost in the middle of that big plate. Put the same cup of pasta on a small plate, and it looks huge. Try the same thing with cereal or ice cream bowls and drink glasses. There is no harm in playing mind-games with yourself! (See “Portion Control,” at right.)
I also caution athletes to beware of “sneaky calories,” those foods that peo-ple eat throughout the day almost without realizing it—the bite of a friend’s dessert, the spoonful tastes while cooking dinner, the leftovers eaten as you do dishes. The athlete attempting to lose weight needs to become conscious of these calories, be-cause they really add up.
… Do Modify Nutritional Content
Others find success by modifying the nutritional composition of favorite foods. That way, they can still eat the foods they like and are used to with-out the undesired calories. For exam-ple, one athlete saved over 400 calories per day just by changing from regular ranch salad dressing to lite salad dress-ing. Changing from full-fat to lower-fat or fat-free versions of milk, other dairy products, condiments like mayonnaise, and creamy soups can also be very help-
PORTION CONTROLPORTION CONTROLHere are some examples of easy portion size changes. Look at the calorie differences!
McDonald’s Big Mac, large fries, large soda (1,380 calories)
VS.
McDonald’s Quarter Pounder, medium fries, large diet soda (800 calories)
King size Snickers candy bar (510 calories)
VS.
Regular size Snickers candy bar (275 calories)
VS.
Fun size Snickers candy bar (110 calories)
Regular size bagel (320 calories)
VS.
Mini bagel (100 calories)
Full bag of microwave popcorn (620 calories)
VS.
Single serving bag light microwave popcorn (100 calories)
Untitled-3 1 2/14/07 3:36:59 PM
TRAINING-CONDITIONING.COM
addition, alcohol is an appetite stimulant, which can lead to a larger intake of food calories.
Don’t Follow Fad Diets …
Fad diets, especially low-carbohydrate diets like Atkins, South Beach, and Sugar Busters, are extremely inappropriate for ath-letes training intensely because carbohydrates are the primary fuel for both exercising muscles and the brain. Any diet or meal plan that is extremely strict or excludes a major food group will wreak havoc on an athlete’s ability to train well.
… Do Eat a Sports Diet
A sports diet is one that focuses on carbohydrates, nutrients, and lowering fat. Carbohydrate intake should match the ath-lete’s training level. As the season progresses, training volume and intensity decrease, meaning the body is likely burning and requiring less carbohydrate foods. For example, a male lacrosse player should reduce his servings of carb-containing foods by about a third from start to end of a season—if he needed 14 servings of carbohydrate in the beginning of the season, he should cut down to nine by the playoffs. The drop isn’t drastic, but it should take place.
Protein is also important, and should be included in all meals and snacks. One reason for this is that protein needs are enhanced during weight loss to preserve muscle tissue. Second, including protein in meals helps prolong fullness. Examples of quality pro-tein foods include lean meats, egg whites, low-fat dairy products, beans, nuts/peanut butter, and soy/tofu products.
Fiber, vitamins, and minerals are another focus. Eating more high fiber foods will increase fullness. Good examples are whole grain breads and cereals, beans, nuts, fruits, and vegetables. Fruits and vegetables, along with meat, will lead to proper vita-min and mineral intake.
High-fat foods are the primary place for the athlete to cut back. Fatty foods are jam-packed with calories. Examples are fried foods, high-fat cuts of meat, meat with skin, whole dairy products, eggs, mayonnaise, cream cheese, sour cream, butter, snack foods, and desserts. Some athletes also get a lot of ex-cess calories through bacon, sausage, and butter at breakfast. Try ham or Canadian bacon instead of the higher-fat meats and either low-fat margarine, whipped butter, or real-fruit jel-ly instead of regular butter. Athletes may not even notice if they skip the butter on pancakes, waffles, or French toast.
Athletes should also decrease their intake of foods high in added sugar like candy, desserts, pastries, doughnuts, syrups, and sodas. These are “empty calories” that fail to provide nu-trients and long-lasting energy.
Changing one’s diet is difficult, no doubt about it, and ath-letes interested in losing weight in-season will need a lot of support from the sports medicine staff. Make a special effort to monitor the athlete’s progress without overemphasizing it. Monitoring should include not only how much weight is lost, but body composition changes, changes in energy level, training capacity, recovery, mood and mental status, menstrual func-tion, quantity and quality of sleep, and general well-being. And remind them that, next season, they need to plan ahead! ■
NUTRITION
Any diet that is extremely strict or excludes a major food group will wreak
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ThermaSplint_TCv6.indd 1 1/24/07 1:02:10 PM
Circle No. 110
GSSI_TC1702.indd 1 2/23/07 12:33:37 PM
Many athletes have schedules that may require them to play in the evenings and sleep late the next morning resulting in haphazard eating habits, which can impair performance and adversely effect
body composition. The key is maintaining an appropriate meal frequency, size, and composition to help keep blood glucose levels even throughout the day. Proper fueling distributes calo-ries, so many players can benefi t from eating fi ve times per day – three meals and two snacks.
Start RightSmart fueling starts with breakfast. Regardless of the time of day the player eats, breakfast is defi ned as the fi rst meal of the day. Breaking the overnight fast can improve exercise perfor-mance by as much as 15%1,2, so it’s important for athletes who workout in the morning to replenish energy and fl uid stores. Although some athletes will start practice or workouts without eating, at the very least, they should consume some fl uids and carbohydrates to rehydrate and fuel the body. For those ath-letes who have limited time to eat, they may choose an option like a sports drink or meal replacement shake. With a complete meal being the best choice, those athletes who eat break-fast are also less likely to eat high-calorie meals and snacks throughout the rest of the day, which aids weight control.3,4 In addition to minimizing impulsive snacking, eating breakfast may reduce total fat intake.3
Maintain EnergyContinuing to distribute calories evenly throughout the day helps to maintain stable blood glucose levels for training and may prevent overeating.4 An athlete who fasts from lunch through an evening practice or game can get hungry and run out of energy. By the end of the practice or game, the famished athlete may grab whatever food is handy, often a high-calorie fast food meal – generating a “back-loading” of calories. As a result, the athlete may eat more calories in this late meal than if these calories were spread over fi ve or six smaller meals.
Proper meal timing and frequency are critical for optimizing fuel availability to enhance athletic performance.5 The content of these snacks and meals is also important. Eating a meal or snack containing both carbohydrate and protein about every three hours helps maintain the athlete’s blood glucose level. Carbohydrate-rich foods raise blood glucose, while protein-rich foods help to keep blood glucose from falling and provide satiety.
Maximize RecoveryMuscles are most receptive to refueling and rebuilding during the fi rst 30 minutes after exercise. During this window, athletes benefi t from both carbohydrate to speed glycogen synthesis and protein to support muscle protein synthesis. A dedicated recovery plan can help this process and bridge athletes to their next meal. Athletes who fail to refuel or rehydrate after these
activities will not have the optimal level of energy for the next day. Athletes can follow these tips for smart recovery:
• To rehydrate -- weigh-out at the end of practices and games. Drink 20 to 24 ounces of fl uid for each pound lost.
• To refuel -- choose carbohydrate-rich snacks that are com-plimented with protein. If solid foods aren’t easily digested, choose a formulated recovery drink.
Recording food intake will help athletes fi ne-tune when they eat, what they eat, and how much they eat. The key is to fol-low breakfast, or the fi rst meal of the day, with frequent small meals or snacks so that the athlete isn’t ravenous and inclined to back-load calories later in the day. By distributing calories evenly throughout day, athletes will have energy available when they need it for optimum performance.
Sample meal plan:• Breakfast (600 calories):
- 1 poached egg- 1 piece whole grain toast (use added fat or jam sparingly)- ½ cup cooked oatmeal with ½ banana- 1 cup 1% fat milk- 20 oz of Gatorade
• Lunch: (600 calories):- Turkey sandwich on whole grain bread- 1 cup salad (lettuce, broccoli, caulifl ower, tomatoes) with
light salad dressing- 1 apple
• Pre-Early Afternoon practice: (350 calories)- 1 oz string cheese- 1 ½ oz pretzels- 20 oz of Gatorade
• Recovery Snack (350 calories)- 1 large Graham cracker with peanut butter- 20 oz of Gatorade
• Dinner (600 calories)- 1 ½ cups pasta with meat sauce- ½ cup cooked mixed vegetables- 1 cup mixed berries- 1 cup 1% fat milk
References1 Sherman, W.M., Brodowicz, G., Wright, D.A. et al. Effects of 4 hr pre-exercise carbohydrate feedings on cycling
performance. MSSE, 12:598-604, 1989.2 Sherman, W.M., Peden, M.C., Wright, D.A. Carbohydrate feedings 1 hour before exercise improves cycling
performance. Am J Clin Nutr, 54:866-870, 1991.3 Schlundt, D.G., Hill, J.O., Sbrocco, T. et al. The role of breakfast in the treatment of obesity: a randomized clinical
trial. Am J Clin Nutr, 55:645-51, 1992.4 De Castro, J. The time of day of food intake infl uences overall intake in humans. J Nutr, 2004; 134:104-115 Hawley, J.A., Burke, L.M. Effect of meal frequency and timing on physical performance. British Journal of
Nutrition,77 (Suppl 1):S91-103, 1997.
www.gssiweb.org
Fueling Athletes All DayBy Ellen Coleman, M.P.H., M.A., R.D.,CSSD Sports Dietitian for The Sport Clinic and consultant to the Los Angeles Lakers, Clippers, Angels and Kings professional sports teams.
GSSI_TC1702.indd 1 2/23/07 12:33:37 PM
When injury strikes, a professionalathlete must often place his or hercareer in the hands of an athletictrainer. That was the case when thenSan Diego Chargers quarterbackDrew Brees suffered a potentiallycareer-ending shoulder dislocationthat required immediate surgery. As 2005 season ended, many questioned whether he could returnto his original form.
The only people who didn’tquestion his comeback were Breesand his athletic trainer, Todd Durkin,M.A., C.S.C.S., owner of FitnessQuest 10, a health and human per-formance center located in San Diego, CA. From rehab to high-level athletic training, Durkin relieson the Total Gym PowerTower®—the electronic version of efi SportsMedicine’s® flagship incline training
apparatus Total Gym®—for its unparalleled convenience and effectiveness.
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“We put Drew on the PowerTowerearly in the reconditioning process,”says Durkin, “It was one of the manytools we used to get Drew back to ahigh level of performance. Weneeded to increase his range ofmotion before transitioning tohigher-intensity activities. ThePowerTower makes it easy to changepositions or adjust the intensity withjust the push of a button.”
Brees was able to start throwingagain just four months after surgeryand was back in top form for thestart of the 2006–2007 season.
All-in-One Machine is PowerfulTool for Athletic Trainers
Ask Durkin about the PowerTowerand he’ll give you a laundry list ofbenefits: improved strength, hyper-trophy, flexibility, balance, power,
Todd Durkin, MA, CSCS, NCTMB
2005 ACE Personal Trainer of the Year,2004 IDEA Personal Trainer of the Year,Owner of Fitness Quest 10 & ToddDurkin Enterprises in San Diego, CA
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endurance, joint integrity and corestrength. And he’s just getting started.
“The PowerTower is the ultimate all-in-one machine,” explains Durkin.“It’s well-designed, space-efficient andextremely versatile. And it uses anexerciser’s own body weight andprovides a wide range of intensities,which makes it ideal for everyonefrom high-level athletes to seniorcitizens.”
Durkin is one of countless athletictrainers who have discovered the advantages of training clients on the PowerTower. efi Sports Medicine,the trusted leader in functionalexercise equipment for the physicaltherapy and athletic training market,has created the number one piece of equipment for athletic trainers and physical therapists across thecountry. Designed, engineered andmanufactured to meet the rigorousneeds of the most demanding clinicalenvironments, the PowerTower wascreated for wellness centers, clinicaltherapeutic exercise, athletic training
and high-performance, functionalsports training.
Durkin knows a thing or two aboutthe specific training requirements of athletes—along with Brees, he counts 2006 NFL MVP and San Diego Chargers running backLaDainian Tomlinson, 2005 HeismanTrophy winner Reggie Bush, andsome 25 other NFL superstars asclients. In addition to increasingtotal-body strength, he uses thePowerTower to train his athletes fora variety of skill sets, includingpower and balance, and to enhancerange of motion and flexibility.
“There are so many different factorsthat can contribute to the success orfailure of an athlete,” Durkinexplains. “Rotation, for example, is ahuge factor in just about everysport, including tennis, baseball and,of course, golf. I can put a client onthe PowerTower and have themperform a variety of torso rotationexercises—incline or decline, whilelying down, seated, kneeling or
even standing. With so manyexercises, we can really maximizemuscle fatigue without having totransition between differentmachines.”
The PowerTower engages allmuscle groups with more than 200 strength, flexibility and Pilatesexercises on infinitely adjustableand calibrated levels of incline resistance. The PowerTower offersmulti-plane upper and lower-bodystretching and strengtheningexercises. The Total GymPowerTower’s ground-breakingdynamic pulley system adjusts to a client’s girth and height to allowfor optimum force angles specificto each individual.
Core Strength: The Foundation ofAthletic Training
When it comes to trainingathletes—or just about anybody, forthat matter—you can’t overlookcore training.
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“If you want to be successful in sportor life, you have to train the core,”Durkin explains. “It is the power-house of the body. In fact, sixtypercent of your power is generatedfrom your core. It provides a strongpillar in which you can be a strong,fast, powerful and explosive athlete.One of the advantages of a piece ofequipment like the PowerTower isthe significant amount of coreactivity in most all exercises.”
The PowerTower’s rolling inclineglideboard and cable pulley systemprovides an unstable, gravity-loadedenvironment that requires the clientto recruit core muscles of thestomach and back to maintainstability. This occurs during mostPowerTower exercises and is espe-cially beneficial for athleticperformance training.
PowerTower provides unlimited incremental increases in resistancefrom 3% to 72% of the user's bodyweight and 12 levels are pre-calibratedat 5 degree increments. At the pressof a switch, an athletic trainer canincrease or decrease the resistance
load during an exercise in progress,resulting in an efficient and cohesiveexperience for the client.
The PowerTower's Folding Platformand wide-based Telescoping SquatStand fold compactly against theglideboard during storage. TheFolding Foot Holder, used forhamstring curls, ab crunches andmore, locks into place for use andthen easily tucks away. It also adjuststo accommodate larger foot sizes.The Squat Stand adjusts to threeheight settings, facilitating correctbiomechanics for squats, bridges,calf raises and plyometric exercises.
The PowerTower is an ideal way to safely increase
fast-twitch musclefibers with much lessimpact on the joints.
“The PowerTower is an ideal way tosafely increase fast-twitch musclefibers with much less impact on thejoints,” says Durkin. “We can dosingle- and dual-leg plyometricexercises using a variety of footpositions to efficiently increase anathlete’s power output.”
PowerTower’s Time-efficientWorkouts Appeal to Athletes andNon-athletes Alike
Athletes aren’t the only ones whocan appreciate the effectiveness andefficiency of a PowerTower workout.Durkin regularly surveys his clientsabout their use of the Total GymPowerTower. “My clients, both menand women, really enjoy the versatil-ity of a PowerTower workout. Theyknow that they can get a greatworkout in just 30 minutes becausethey can quickly flow from oneexercise to the next.”
No matter what your clients aretraining for, whether it is forrestored function and mobility, performance training, endurance,stability, muscle mass or a lean
efi_TC1702.indd 2 2/19/07 3:49:10 PM
physique, PowerTower can offer the functional training you want.
Durkin agrees: “Whether your client is an older adult, a homemaker, a young personor an athlete, you can challengethem equally using thePowerTower.”
About efi Sports Medicine
After more than a quartercentury at the forefront of innovation in athletic training,physical therapy and homefitness, efi Sports Medicine hasbecome the most trusted brandin the world for functionalexercise equipment. “Our goal,”says Tom Campanaro, efi’sfounder and CEO, “is to providequality products that helppeople achieve their health,fitness and rehabilitation goals.We deliver results that changelives.”
efi’s products are well- established tools for physicaltherapy, athletic training, functional rehabilitation and a best seller in the home fitnessmarket. To date efi products are in more than 14,000 rehabclinics, schools, hospitals,athletic training centers, healthclubs and 2.5 million homesworldwide. Visit efi on the Webat www.efisportsmedicine.comor call 800.541.4900 for more information.
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OPTIMUM PERFORMANCE
24 T&C MARCH 2007 TRAINING-CONDITIONING.COM
BY R.J. ANDERSON
R.J. Anderson is an Assistant Editor
at Training & Conditioning. He can be
reached at: [email protected]
Eight years ago, golfer Tiger Woods was legally blind and frustrated by the contact lenses he wore to correct his severe
nearsightedness. So, taking the advice of several other players on the PGA Tour, he underwent Laser Assisted in Situ Keratomileusis (Lasik) surgery.
Before the surgery, Mark Whitten, MD, an ophthalmologist and Region-al Medical Director for TLC Laser Eye Centers in greater metropolitan Wash-ington, D.C., says Woods had “count-ing fingers vision,” meaning he could count the number of fingers someone held up only if they were within a foot of his face. After the 20-minute proce-dure, performed by Whitten, Woods walked away with 20/15 eyesight—slightly better than what ophthalmolo-gists consider perfect. And coincidence or not, Woods won the next five tour-naments he entered. Since the surgery, he has had 55 PGA Tour victories.
Though his post-Lasik eyesight was no better than when he wore contacts before the surgery, Woods told Golf Di-gest that it has definitely improved his game. Besides not having to deal with dirty, wind-dried contact lenses, Woods said both the golf ball and the cup look bigger now that he is lens-free. He also said it’s easier for him to read his putts.
Because the correction was so sig-
The Better To SeeFrom having Lasik surgery to catching bean bags over their shoulders, athletes are opening their eyes to enhancing their vision.
After undergoing Lasik surgery, Tiger Woods says the ball and
cup now look bigger to him.©GETTY IMAGES
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nificant in Woods’s prescription lens-es, Whitten says the cup may have been minified or distorted a bit when he fo-cused on it with contacts. “After his la-ser correction, his brain perceived the cup as looking bigger,” says Whitten, who has performed the procedure on many PGA players as well as profes-sional football, basketball, and base-ball players. “Most golfers tell me that when they putt after having the sur-gery, they can actually see which way the blades of grass are growing—and they couldn’t see that before.”
As today’s athletes search for any ad-vantage they can get, they are looking more and more to how their vision af-fects their performance. From correct-ing how their eyes judge distances to
strengthening their ability to focus, vi-sion enhancement is helping many ath-letes gain an edge. In this article, we’ll look at the most recent developments in this field.
LASER CRAZE
Since Woods’s success with Lasik, a long list of professional athletes have opened their eyes to an ophthalmolo-gist’s laser. Among them are Major League Baseball pitcher Greg Maddux, the NBA’s Amare Stoudemire and Rich-ard Hamilton, and NFL players Ray Buchanan and Tiki Barber. So what ex-actly is Lasik surgery? And what makes an ideal candidate for the procedure?
A form of refractive surgery, Lasik is relatively painless and known for its quick recovery times. Traditionally used to correct far-sightedness (myopia and hyperopia), Lasik can also improve some forms of near-sightedness and astigmatism. To qualify for Lasik sur-gery, patients need to be over 18 years old and have demonstrated consistent eyesight for at least a year. If a patient’s prescription changes after having Lasik surgery, he or she will need either a fol-low-up enhancement surgery or to wear corrective lenses.
To begin the procedure, a surgeon slic-es a thin, circular flap in the cornea us-ing either a tiny oscillating metal blade
called a microkeratome or a laser called a femtosecond microkeratome (a femto-second is one billionth of one millionth of a second). That flap is folded back out of the way and the surgeon uses an ex-cimer laser, which emits an ultraviolet light beam, to remove microscopic bits of corneal tissue, basically reshaping the cornea and removing its flaws.
Reshaping the cornea allows for a more even, more focused dispersal of light into the eye and onto the retina. When the re-shaping is completed, the flap is laid back in place, covering the area of correction. It heals in a matter of hours.
Lasik surgery was first performed in the U.S. in 1991, and in 2006, more than 1.4 million Americans had the
procedure, according to Market Scope, a St. Louis-based market research com-pany. Over the last eight years the field of refractive surgery has seen many technological innovations, which have led to different approaches to laser eye surgery and have made the procedure more effective.
The most significant advance, says Whitten, is Wavefront-guided software, which guides the excimer based on measurements from a wavefront sensor. This has made the procedure more ac-curate than it was 10 years ago, cutting down on flaws caused by irregularities between the lasered and the untouched part of the cornea. As a result, the night vision problems that used to plague some patients after Lasik surgery are largely a thing of the past.
“There’s a misconception that you’re going to end up with night-vision prob-lems, like glare and halos,” says Whit-ten. “But an FDA study found that with the Wavefront software, many patients actually had improved night vision fol-lowing the procedure. The software has been out for a few years, and now it’s very unusual for patients to complain of glare and halos.”
Whitten says the Wavefront technol-ogy has also dramatically cut down on the number of patients who have to re-turn for follow-up enhancements—once
a common drawback of the procedure. “I used to have between 15 and 20 per-cent of people come back for enhance-ments,” says Whitten. “The last few years it’s down to three percent.”
EYEING OPTIONS
Before your athletes jump on the Lasik bandwagon, however, they should un-derstand all their options. Other areas of optometry have advanced along with laser surgery, says William Harrison, OD, an optometrist who works with many college and professional athletes and teams.
“An athlete should not decide on lenses or surgery by only looking at that option,” says Harrison. “There are multiple choices that can be tailored to one’s needs depending on age, eye struc-ture, and sport and position needs.
“A lot of people went to Lasik be-cause they couldn’t stand contacts, but as Lasik has gotten better, so have con-tact lenses,” continues Harrison. “For instance, there is a new lens called a hy-brid. It’s a firm lens with a soft edge so it gives the comfort of a soft outer lens but the vision quality of an aberration-free firm lens—there’s no diminished vision under the lights or at dusk.”
Another alternative is surgically im-planted lenses, called phakic intra-ocular lenses, which are often a good option if a patient’s corneas are too thin for Lasik surgery. The implants, which resemble contact lenses, are placed be-tween the cornea and the iris or just behind the iris. Like Lasik surgery, the implants alter the way light rays enter the eye to achieve sharper focus.
Whitten says Lasik surgery is also not the best choice for athletes who risk being hit in the eye, such as boxers and martial artists, due to the destructive nature of the corneal-flap creation pro-cess. “In general, we try not to do Lasik on patients who might do something to cause the flap to move or be dislodged,” he says. “Although it’s highly unusual for that to happen, it is a minute risk that should be considered.”
For these athletes, Whitten says a bet-ter option may be Photorefractive Kera-tectomy (PRK) surgery, which provides basically the same results as Lasik, but does not involve cutting a permanent flap in the cornea. Instead, with PRK the outer layer of the cornea is removed and discarded before applying the laser to the retina. The drawback is PRK can be more painful, and visual recovery
Another alternative is surgically implanted lenses, called phakic intraocular lenses … Like Lasik
surgery, the implants alter the way light rays enter the eye to achieve sharper focus.
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takes longer than with Lasik—patients often need three to four weeks before they are 90 percent healed.
For athletes considering Lasik or any other correction, both Whitten and Harrison recommend scheduling a consultation with an experienced phy-sician. “They shouldn’t go to a doctor who does just one thing,” says Har-rison. “If a doctor specializes only in contact lenses, they might be biased. The same can be true for a Lasik sur-geon who does nothing else. Athletes need to find someone who can clearly give them all the options and explain the costs of each.”
If an athlete does choose surgery, Whitten strongly discourages bas-ing decisions solely on the price tag. “Even though a lot of these procedures are technology driven, it’s still the sur-geons themselves who make the most difference in a procedure’s success,” says Whitten. “You’ve got to think that somebody who charges $299 for a Lasik procedure is probably not as ex-perienced as those who charge more.”
How much experience is enough? “If a surgeon says they have done 500 to
1,000 eyes, that’s actually not a lot,” says Whitten, who has performed sur-gery on over 80,000 eyes since 1993. “Probably 75 to 80 percent of people who have the procedure will turn out well, no matter who does the surgery. However, you don’t want to be among the 20 to 25 percent who have a prob-lem. If you can lower your problem likelihood down to one percent, which is probably the lowest you can go in even the most experienced of hands, it’s worth spending a little more money.”
FIELD VISION
Along with correcting eyesight problems, enhancing an athlete’s ability “to see” also means working on their optical in-terpretation, also called “sports vision.” This is what allows a baseball hitter to pick up the spin of the ball more quick-ly and accurately when it leaves a pitch-er’s hand, a volleyball player to judge where a serve will land, or a football wide receiver to snatch a pass amid sev-eral defenders. While Lasik and correc-tive lenses improve visual acuity—what or how far one can see—sports vision training addresses how a person sees. It
is important to note that visual acuity must be addressed before any sports vi-sion training begins.
The premise behind sports vision training is similar to many strength-training principles—if an athlete trains and strengthens the tiny muscles in and around the eyes, his or her performance on the field or court will improve. Most vision training devices and programs address the following components:
Ocular alignment: the ability to properly fixate the eyes on a target, also known as aiming of the eyes. When a coach says, “keep your eye on the ball,” he or she really means, “work on your ocular alignment.”
Depth perception: the ability of eyes to see objects in three-dimensional space and judge the distance between oneself and the object. It’s how a quar-terback judges how far away his receiv-ers are from him.
Ocular flexibility: the ability to move one’s eyes inward (convergence) or out-ward (divergence) when following a tar-get. For instance, when a batter watches a pitcher’s release, his or her eyes are diverging from the target. Then, as the
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ball approaches, the eyes converge on it. The quicker a player can change his or her focus back and forth between far and near, the better their ocular flex-ibility will be.
Visual recognition: the ability of eyes to process information regarding the shape and direction of an object and then make correct motor movements to adjust to it. This might be a defensive back’s ability to turn and look for the ball when covering a downfield receiver.
Visual tracking: the ability of eyes to move properly to track objects as they move, and then react accordingly. One example is a wide receiver track-ing a ball that’s thrown to him. It’s also known as “see, think, react.”
At the University of Tennessee, Brian Gearity, MS, CSCS, ATC, an Assistant Strength and Conditioning Coach for the football and baseball teams, uses a wide assortment of vision training methods—both manual and computer-based—when working with his athletes. Gearity’s favorite is a software-based system that his Volunteer athletes have been using for the last couple of years.
The program addresses each of these
visual components within a 12- to 18-minute training session. It’s loaded onto four desktop computers housed in the strength coaches’ offices, and play-ers from Tennessee’s softball, baseball, and football teams typically use it for 20 minutes a day, twice a week, as part of their off-season strength and condi-tioning programs.
To start, the program tests each ath-lete on the different skills. From there, Gearity and the computer program’s administrators develop an individual-ized vision-training program based on the athlete’s weaknesses. The program also assesses each athlete’s progress af-ter every training session.
Staring at a computer, the players wear 3-D glasses while operating a joy-stick control pad. The on-screen exer-cises involve identifying and focusing on a series of rapidly moving shapes and arrows. In one exercise to test ocu-lar flexibility, players are directed to hit a control button when they see a dia-mond appear over a fuzzy background on the screen, then told to follow it and respond to successive commands.
Because the joystick mirrors those
used on mainstream gaming systems, athletes are comfortable with the pro-gram and look forward to training with it. “After I show them how to use it, it usually only takes two sessions before they know how to manipulate all the variables and make it harder as they improve,” says Gearity. “After a while, they’re basically administering the pro-gram on their own.”
Carlo Alvarez, CSCS, Strength and Conditioning Coordinator at St. Xavier High School in Cincinnati, is also us-ing a computer-based system as a train-ing pilot program with his school’s ice hockey, lacrosse, and baseball teams. He first became familiar with it while serving as a strength coach with the Cleveland Indians and Cincinnati Reds. He says the computer program allows him to customize each athlete’s visu-al workout based on their individual weaknesses and the sport they play.
“We go 15 to 20 minutes, twice a week, in the preseason,” says Alvarez. “We use the data from each session to assess and get them to improve at every workout. Then every week or two weeks we bump up the intensity of the session.”
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Alvarez says it doesn’t take much prodding to get his athletes to com-plete their vision training exercises. “We tell them why they’re using it and the program’s video game-like quali-ties keep the kids excited about it,” he says. “They love putting the goggles on, picking up the joystick, and competing against each other.”
EYE TOOLS
While computer-facilitated vision pro-grams may be the wave of the future, there are lower-priced alternatives. Thomas Wilson, OD, an optometrist who has served as a sports vision con-sultant with the U.S. Air Force Acade-my, USA Shooting, and the University of Colorado ski team, uses a combina-tion of inexpensive hands-on devices constructed of very basic materials.
Co-author of Sportsvision: Training for Better Performance, Wilson says some of his favorite exercises incorpo-rate a balance beam or a two-by-four piece of lumber and bean bags. Bal-ancing on the beam or board, athletes are tossed beanbags from different angles and told to catch them. An ad-vanced step involves having the ath-lete catch beanbags that are thrown from behind their shoulders. Wilson says these drills are especially benefi-cial for football receivers and defen-sive backs.
A similar drill involves tossing an athlete beanbags in a dark room illu-minated by a strobe light. The strobe light trains the athlete’s object track-ing ability and eye-hand coordination. To make the exercise more difficult, the strobe’s frequency can be de-creased, which increases the amount of time the room is dark while a bean-bag is in the air.
Perhaps the most widely used vi-sion training device is called a Brock String. A three to five foot long piece of string that holds three small, multi-colored beads set equal distanc-es apart, the Brock String addresses spatial localization and teaches the athlete how to aim his or her eyes to-gether correctly. It also illustrates the difference between convergent and di-vergent eye aims and indicates to the athlete if they are shutting off or sup-pressing an eye.
To use the Brock String, an athlete holds one end of the device against the tip of their nose while the other end is tied to a fixed point. When starting
out, the athlete is asked to focus on one bead at a time and name the col-or. The drill can be made more diffi-cult with gradual adjustments, such as moving the beads closer to the nose.
Along with computer-based training, Tennessee athletes also use manual ex-ercises as part of their off-season pro-gram. “For instance, our football wide receivers catch tennis balls that are shot out of a machine at different speeds,” says Gearity. “We also have colored bouncy balls that we throw at the play-ers. We’ll ask them to grab a certain
colored ball and identify the color or catch one color and drop the other.”
When implementing a program, Al-varez recommends starting with only a few teams or athletes. “And it should be sports where the athletes have to fo-cus on and recognize an object coming at them—hockey, lacrosse, baseball, tennis,” he says. “Once you do it with one or two teams, and you can show off their improved test scores, the athletes will talk about how they enjoy the sys-tem, and eventually the other coaches will buy in.” ■
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A specialized off-season rehab and strength program gave Zach Miner the power, coordination, and stability
he needed to secure a spot on the Detroit Tigers’ roster.
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When a minor league pitcher sought treatment for some back and shoulder pain, this rehab team helped propel him into the big leagues—and a pennant race.
Ready for Prime Time II
n professional baseball, every minor league player is waiting for one phone call: “Are you ready to play in the big leagues?” For Zach Miner of the Detroit Tigers,
that call came on June 4, 2006, after starter Mike Maroth was sidelined with an elbow injury. A 24-year-old right-handed pitcher, Miner had played in the minors for five years with limited success, but was pitching better than ever at the start of 2006, with a 6-0 record in Triple A ball.
Although Miner’s call-up was origi-nally for a fill-in stint, he ended up stay-ing—sometimes starting, sometimes relieving—and ultimately helping the Tigers win their first American League pennant in 22 years. On the season, he went 7-6 with a 4.84 ERA, and made the Tigers’ reduced playoff roster in September.
There are many steps in making it to the major leagues, but one that some players neglect is staying healthy. Un-derstanding this dynamic, Miner came to us after his 2005 minor league sea-son, complaining of mild pain in both his right posterior shoulder and lower back. He had never been sidelined with a major injury, but he wondered if his symptoms were slowing him down, and if any underlying problem had the po-tential to end his career before it ever truly got started.
Overuse and repetitive trauma inju-ries occur frequently in baseball. A ma-jor league season is 162 games long, and there’s also a month of spring training and possible postseason play. Players
Micheal Clark, DPT, MS, PT, CES,
PES, CPT, is President and CEO of the
National Academy of Sports Medicine
and Team Physical Therapist to the
NBA’s Phoenix Suns. Marty Miller, MS,
ATC, PES, CES, CSCS, is a former
athletic trainer for the Montreal Expos
and currently Director of Fitness at the
BallenIsles Country Club, where he con-
tinues to work with professional baseball
players during the off-season. Clark and
Miller can be reached at: www.nasm.org.
BY DR. MICHEAL CLARK AND MARTY MILLER
netic chain. If a breakdown or move-ment compensation occurs at any of the joints that make up the kinetic chain, the structural integrity of the muscles that control those joints will be evalu-ated. (See “Assessment Chart” on page 32 for check points.)
The purpose of this testing was to dis-cover any pre-existing muscle imbalanc-es, joint dysfunctions, or neuromuscular inefficiencies that could be leading to the discomfort in Miner’s shoulder and lower back. The tests were also chosen to discover any movement dysfunctions that could cause problems in the future.
Whenever there is excessive motion during the assessment, which can be caused by either overactive (short/tight) or underactive (long/weak) muscles, the nervous system will constantly elicit less then ideal firing patterns. A stra-tegic plan can then be created based on these findings. Once the corrective ex-ercise training plan is implemented, the imbalances will be corrected and opti-mal movement of the kinetic chain will be restored.
will perform the same repetitive tasks thousands of times over the season, leaving them at risk for breakdown and injury. However, with a specialized, in-tegrated conditioning program, injuries can be prevented and performance can be improved.
INITIAL EVALUATION
Miner began his integrated program with us at the end of the 2005 minor league baseball season. Previously, he had only used traditional strengthening programs that did not take into account any of his movement impairments. He had gone straight from high school into pro baseball.
Before initiating a program for Min-er, we performed a comprehensive eval-uation. When it comes to assessment, we feel an integrated approach is crit-ical. The combined efforts of the ner-vous, muscular, and skeletal systems are responsible for even the simplest movements in the human body, and collectively they make up the kinetic chain. If a small dysfunction occurs in any of these systems, the others’ ability to perform their functions will be sub-stantially reduced.
Therefore, we perform goniometric measurements, manual muscle testing, and most importantly, an Integrat-ed Movement Assessment. The move-ment evaluation includes an overhead squat and single-leg squat. Using our understanding of functional anatomy and biomechanics, we assess structur-al alignment and the neuromuscular efficiency (coordination) of the ki-
TREATING THE ATHLETE
32 T&C MARCH 2007 TRAINING-CONDITIONING.COM
ASSESSMENT CHARTASSESSMENT CHARTThe following findings helped us design Miner’s program. Results are included in bottom two tables.
Overhead Squat Assessment
Anterior View Right Left
Yes Yes
Foot Turns Out x x
Knee Moves Inward x x
Moves Outward
Lateral View (Right Side) Yes
LPHC Excessive Forward Lean x
Low Back Arches x
Low Back Rounds
Upper Body Arms Fall Forward x
Posterior View Right Left
Yes Yes
Foot Heel Rises
Flattens x x
LPHC Hip Drops
Hip Hikes x
Hip Shifts
Modified Heels Elevated Arms Down
Feet Improvement No Improvement
Knees Improvement No Improvement
LPHC No Improvement Low back arch improvement,
excessive forward lean increases
Upper No Improvement NA
Single-Leg Squat Assessment
Right Leg Left Leg
Foot Flattens
Knee Moves Inward x x
Moves Outward
LPHC Lateral Hip Shifts
Trunk Rotates In
Rotates Out
Goniometric Measurements
Pre Post % Improvement
Right Left Right Left Right Left
Ankle Dorsiflexion 11 12 17 17 55 42
Hip Extension 25 17 7 7 72 59
Hip Internal Rotation 10 17 41 40 76 58
Shoulder Flexion 140 146 162 160 16 10
Biceps Femoris (short head) 26 28 11 11 58 61
*All measurements are in degrees
Manual Muscle Testing
Pre Post
Right Left Right Left
Gluteus Medius 2 2 3 3
Gluteus Maximus 2 2 3 3
Posterior Tibialis 2 3 3 3
Anterior Tibialis 3 3 3 3
Lower Trap 2 3 3 3
*All measurements were graded on a 3 point scale: 1=weak, 2=compensation, 3=strong/optimal
TRAINING-CONDITIONING.COM T&C MARCH 2007 33
Restoring optimal movement is key, because if any seg-ment of the body functions in a less than ideal manner, the altered movement patterns that develop will place increased stress on the tissue around those particular joints. As we condition our athletes, we purposely place stress on their bodies. If there is optimal alignment of the kinetic chain, loads will be handled by the body efficiently and will elicit positive responses. But if the structural integrity of the ath-lete’s kinetic chain is compromised, the stress we place on them may actually leave them more susceptible to injury.
So how did Miner do on his assessment? During his over-head squat, his feet everted, indicating probable over-activity in his lateral gastrocnemius, peroneal complex, and the short head of his biceps femoris. Underactive muscles that likely contributed to this movement compensation included his me-dial gastroc, popliteus, and medial hamstring complex.
When Miner squatted, he ran out of available dorsiflex-ion in his foot and ankle complex in the sagittal plane. To continue descending further into the squat, his body found the path of least resistance. Miner moved his foot and ankle into the frontal and transverse plane (eversion and exter-nal rotation) to create the dorsiflexion he was lacking. An everted position of the foot and ankle moves the posterior tibialis, medial gastrocnemius, and medial hamstring into a lengthened position. To correct this movement compensa-tion, those muscles would need to be strengthened.
An everted foot and ankle may also cause the knee to ad-duct and internally rotate during movement. This indicates weakness in the gluteus medius, which is a key muscle for providing stability to the entire lumbo-pelvic-hip complex in the frontal plane. Along with the gluteus medius, the glu-teus maximus is also placed in a lengthened position if the knee adducts and internally rotates.
At Miner’s lumbo-pelvic-hip complex, we noted an exces-sive arch, along with the movement compensation of arms falling forward, which indicated probable overactivity in the latissimus dorsi, hip flexor complex, and erector spinae. The anterior-tilted position of his lumbo-pelvic-hip complex placed his latissimus dorsi in a shortened position, which can affect both the origin (thoracolumbar fascia) and in-sertion (anterior portion of the humerus). This decrease in length and extensibility prevented Miner from fully extend-ing his arms above his head without creating compensation in his glenohumeral joint.
Miner’s normal posture of protraction through the tho-racic spine would also mimic the above described move-ment compensations. These altered positions placed the rhomboids and middle and lower trapezius in a constant state of stretch. As a result, Miner was unable to main-tain the proper glenohumeral rhythm necessary during his pitching motion.
When we evaluated Miner’s compensations, we were able to correlate them to his shoulder and lower-back discom-fort. His most prominent compensations were the arch in his lower back and the fact that his arms fell forward upon the descent of his squat.
We then explained to Miner that his shoulder and lower back pain were being caused by the movement compensa-tions identified in his assessment, and he took a particular interest in correcting them. Besides obviously wanting to de-crease his current pain, he hoped to increase his overall per-formance and prevent injuries in the future.
TREATING THE ATHLETE
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34 T&C MARCH 2007 TRAINING-CONDITIONING.COM
AN INTEGRATED PROGRAM
The program we designed for Miner fo-cused on correcting his overactive and underactive muscles, increasing his body’s stability, improving coordination, and furthering strength and stamina to pre-pare him for the upcoming season. Each phase of his training was broken into three or four weeks, so the whole process fit into his five-month off-season.
Phase One: Our first priority was to ad-dress Miner’s movement compensations with an approach we call Corrective
Exercise Training (CET). This phase lasted three weeks. The goals were to inhibit the overactive muscles that were causing movement compensations, lengthen the overactive/short muscles, activate the underactive/weak muscles, and integrate optimal movement into functional movement patterns.
To inhibit the overactive muscles, Miner performed self-myofacial re-lease on the following muscles, doing one set for 30-60 seconds, and fol-lowing with static stretching on these muscles for 30 seconds:
• TFL/IT band• Adductor magnus• Lateral gastroc• Latissimus dorsi.
He activated the following weak muscles for 15 reps and two sets, with a tempo of 4/2/2:• Gluteus medius• Gluteus maximus• Popliteus/posterior tib combo• Medial gastroc.
To integrate these movements into functional movement patterns, he did the following:• Prone iso abs with hip extension,
with a five-second hold, 3x each leg, for 10 reps and two sets.
• Standing one-leg reach in the frontal plane, with a five-second hold, for 10 reps and two sets.
• Wall ball squat to scaption, with a tem-po of 4/2/2, for 15 reps and two sets.
Phase Two: Upon completion of the CET protocol, Miner moved into a four-week Integrated Stabilization Training (IST) program. The goals were to in-crease total body stability, endurance strength, and neuromuscular efficiency while improving inter- and intra-mus-cular coordination. We also started car-dio training three times a week.
For Warmup/Flexibility:• Hold tender spots for 20 to 30 sec-
onds of the: SMR lateral gastroc, IT band, TFL, adductor magnus, latissi-mus dorsi, and pecs.
• Conduct static stretching, with 30-second holds of the: lateral gastroc, TFL, adductor magnus, latissimus dorsi, and pecs.For Core and Balance:
• Ball bridges, 3x15, 4/2/2 tempo, no rest
• Prone iso abs, 3x1, 30-second hold, no rest
• Cable PNF, 3x12, 4/2/2, maintain neutral spine, arm movement only
• Single-leg balance and reach, 3x5, three-second hold, movement in all planes.For Reactive Work: Jump up to hold,
3x12, three-second hold, rest 15 seconds. Do one set in each plane of motion.
For Strength Training: The follow-ing exercises were done at a 4/2/2 tem-po for 15 reps and three sets, with no rest in between except for the step-up, which allows 60 seconds of rest. We added work for the biceps and triceps some days.• Ball squat w/scaption
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TRAINING-CONDITIONING.COM T&C MARCH 2007 35
• Standing band chest press, one leg (press until shoulders are fully pro-tracted)
• Standing cable row, one leg • Ball combo one (lying prone over a
stability ball, the athlete engages the core and lower body while mak-ing three distinct movement with his arms)
• Step-up sagittal plane to curl.Post-Workout Flexibility: foam
roll and conduct stretching as in the warmup.
Phase Three: With a platform of stability in place from Phase Two, the next phase was designed to build a solid founda-tion of strength. This program is called Stabilization Equivalent Training (SET) and is a hybrid form of training designed to increase strength endurance.
During this phase of training, the athlete completes one strength-based exercise, then immediately completes a stabilization exercise for the same body part. This helps the body to sta-bilize itself under heavier loads, han-dle increased training volume, improve metabolism, and increase motor unit recruitment, frequency of motor unit recruitment, and motor unit synchro-nization. Phase three lasted four weeks and also included speed, agility, and quickness training, plus cardio work.
For Warmup/Flexibility:• Hold tender spots for 20 to 30 sec-
onds of the: SMR calves, lats, IT band, and adductor magnus.
• Conduct active stretching, with three- to five-second holds, for five reps of the: lateral gastroc, hip flexors, ad-ductors, and lats.For Core and Balance: Two sets of
12 reps with a 2/0/2 tempo doing the following exercises:• Ball crunch w/rotation • PNF rotations • Ball cobra alt. arm • Single-leg squat
For Reactive Work: squat jump multi planar, 2x10, repeating with no rest.
For Strength Training: The follow-ing were conducted for 12 reps and two sets, with no rest except for 30 seconds between the squat-to-row sets. We added work for the biceps and tri-ceps some days.• Squat to row, two arms, 2/0/2• Incline DB alt. arm, standing, 2/0/2• Standing one-leg band chest press,
3/2/1• Standing cable row, two legs, 2/0/2
• Prone call DB row alt. arm, 3/2/1• Standing scaption, 2/0/2• Ball combo one, two-second hold each• Ball squats, 2/0/2• Single-leg Romanian deadlift, 3/2/1.
Post-Workout Flexibility: foam roll and conduct stretching as in the warmup.
Phase Four: Next up was Elastic Equiv-alent Training (EET). This phase fo-cuses on increasing the body’s ability to produce both force and velocity. A maximum strength exercise is complet-ed, followed immediately by an explo-sive movement for the same body part using little weight. We also continued to do cardio training and speed, agility, and quickness training.
For Warmup/Flexibility:• Hold tender spots for 20 to 30 seconds
of the: SMR lateral gastroc, IT band, adductor magnus, latissimus dorsi.
• Dynamic stretching of 12 reps and two sets by doing MP lunges, prison-er squats, and med ball lift series.
For Core and Balance: Two sets of eight reps of:
• Med ball crunch and throw, 15-sec-ond rest
• Med ball back extension throw, 15-second rest
• Single leg hop multi planar, 3-10 sec-ond hold, 30-second rest For Strength Training: The following
circuit was performed three times, with a two-minute rest in between. Work for the biceps and triceps was added some days.• Squat curl and press, 2x5• Arm DB snatch, 10x10 • DB press, 2x5• Med ball rotational pass, 10x10• Seated cable row, 2x5• Med ball throw, 10x10• Step-ups sagittal plane, 2x5• Power step-ups sagittal plane, 10x10
Post-Workout Flexibility: foam roll and conduct stretching as in the warmup.
Phase Five: The final phase of Miner’s training was a hybrid model where he
would complete one IST (stabilization) workout, one SET (strength) workout, and one EET (power) workout in the same week. This form of training is de-signed to sustain all of the adaptations of stabilization, strength endurance, and power as an athlete goes through a grueling baseball season. This is key, because if any of these adaptations de-creases, his ability to perform at the highest level will suffer and the likeli-hood of injury will increase.
IN THE BIG LEAGUES NOW
Miner was a high-rated prospect who was learning how to pitch in profes-sional baseball. Selected by the Atlanta Braves in the fourth round of the 2000 draft, he was traded along with Roman
Colon to the Detroit Tigers for Kyle Farnsworth in 2005.
Miner’s success in professional base-ball was incremental. He did well enough to stay on pace and move up the ranks season after season, but he failed to record a winning season until his 2005 stint with the Tigers’ Triple A club (3-1, 2.36 ERA).
After starting the 2006 season with a perfect 6-0 record (2.82 ERA) at Triple A Toledo, Miner was called up to add support to the Detroit Tigers’ pitch-ing staff. In his first year at the Major League level, Miner finished the season with a winning record (7-6), and helped the team secure the American League pennant and reach the World Series for the first time since 1984.
This off-season he is working with us again, following a very similar pro-gram. Some minor movement compen-sations did return by season’s end, but this is not uncommon after an athlete has played a long season. The good news is that they were much less pro-nounced than the year before and we were able to clean him up quickly. He won’t be a surprise rookie again this year, but we’re confident he will be strong, with a body ready to endure the challenges of major league baseball. ■
The final phase of Miner’s training was a hybrid model where he would complete one IST (stabilization) workout, one SET (strength) workout, and one EET (power) workout in the same week. It is designed to sustain all of the adap-tations of stabilization, strength endurance, and power.
Each year approximately eight hundred thousand teeth areknocked out (avulsed) during sports activities in the U.S. alone.Studies have shown that only 10% of athletes comply with rulesthat require wearing their mouthguards during all sports activities.Knocked-out teeth begin to die within 15 minutes, and teethknocked out during sports events have little chance of being savedunless prompt action is taken.
Why can knocked-out teeth be saved…
Every tooth is connected to its surrounding bone by a ligament,the periodontal ligament (PDL). (See figure on right.) The toothand surrounding cementum, bone, and gingiva receivenourishment from the blood supply through this ligament. When atooth is avulsed, this ligament is stretched and splits in half; halfstays on the tooth root and half stays on the socket wall. If thesetwo halves can be kept alive, the tooth can be replanted and thehalves of the ligament will reattach and the tooth will remain vital.The half that stays on the socket wall, since it remains connectedto the bone blood supply, is naturally kept alive. However, thePDL cells that remain on the tooth root must be artificiallymaintained. They must be protected from two potentiallydestructive processes: cell crushing and loss of normal cellmetabolism.
Although some dentists advise that the best treatment for anavulsed tooth is immediate replantation, for a variety of reasonsthis is often difficult. Often multiple teeth are avulsed and anathletic trainer may not know into which socket an individualtooth belongs. The athlete may have other more serious injuriesthat require more immediate attention such as a severe eye injuryor a severely lacerated bleeding lip or gum that prevent easyvisualization of the socket. Bone chips or debris may be in thesockets, which will prevent complete reimplantation.
If avulsed teeth are not reimplanted immediately, then alltreatment between the time of the accident and the ultimatereplantation must be focused on preventing further damage to theteeth and maintaining the PDL cells in the optimal condition.
Save-A-Tooth®…
In order to be prepared for these incidents, athletic trainers shouldhave Save-A-Tooth , emergency tooth preserving systems,available with their first aid supplies. Save-A-Tooth® contains apH-balanced cell preserving solution, called Hank’s BalancedSalt Solution, and a removable basket and net that suspendsknocked-out teeth in the solution preventing cell crushing.
According to Henry Rankow, DDS (from Pennsylvania), “Save-A-Tooth overcomes all of the obstacles encountered withavulsed tooth storage. It preserves and protects the tooth for 24hours successfully.”
A recent study showed that knocked-out teeth stored in Save-A-Tooth® showed 91% success and another study found that 20% ofSave-A-Tooth kits are used within the first year. One of thesekits was used by the Director of Health and Athletics forBaldwinsville Central School District, who wrote about hisexperience:
Athletic trainers must be prepared to institute the optimumtreatment for knocked-out teeth, and this includes having Save-A-Tooth available. In the case of knocked-out teeth, beingprepared and knowing what to do can mean the differencebetween athlete’s losing knocked-out teeth for life or keepingtheir own natural smiles.
Last year we had an unfortunate incident at one of ourboy’s varsity soccer matches where one of our students losta tooth during play. Luckily, we had one of the Save-A-Tooth kits in our medical box and the tooth was preservedand successfully implanted back into our player.
800,000 teeth are knocked out during sports each year!These teeth can be saved, but do you know what to do?
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Saving Knocked-Out Teeth During Sports
normal tooth PDL fi bers stretch PDL fi bers broken
alveolarbone
PDL
dental pulp
PDL
PDLhalves
Saveatooth_TC1702.indd 1 2/19/07 2:35:21 PM
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TRAINING-CONDITIONING.COM T&C MARCH 2007 37
For most NCAA Division I men’s basketball teams, in-season strength training is anything but routine. Be-cause each week’s schedule
of competitions and travel is unique, not to mention each player’s academic responsibilities, scheduling a perfor-mance training program during the sea-son is like trying to hit a moving target.
Here at the University of Wisconsin, our 2006-07 non-conference schedule had the team playing on any given day of the week in November and Decem-ber. During one stretch, we played seven games in 16 days. After our conference games started, we varied between play-ing on Tuesday or Wednesday nights and Saturday or Sunday afternoons.
This type of schedule makes it diffi-cult to construct a consistent in-season performance training program for our student-athletes. Communication with coaches and support staff, along with some creative program design, are the keys to keeping the changing schedule “routine.”
BIG PICTURE
Before I start designing any strength program, I take time to examine the sport coach’s goals and strategies for the season. For any performance train-ing program to succeed, the strength and conditioning coach, the athletic trainer, and the team’s head coach must work closely together to develop a co-hesive plan. They may not always agree entirely, but their level of communica-tion often determines how well a team performs on the court.
Scott Hettenbach, MS, CSCS, is
in his 12th year as the Strength and
Conditioning Coach for Men’s Basketball
at the University of Wisconsin. He has
worked with 15 different sports while
at Wisconsin, and can be reached at:
BY SCOTT HETTENBACH
A STRONG SEASONDesigning an in-season strength program for basketball is fraught with scheduling challenges. At Wisconsin, the men’s team uses a focused but flexible plan to keep its players strong all season long.
DAVID STLUKA
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38 T&C MARCH 2007 TRAINING-CONDITIONING.COM
Ryan and I work together closely on developing work capacity and increas-ing endurance.
IN-SEASON PLAN
Every design starts with a yearly plan, and we break ours into four distinct time periods: developmental, pre-com-petitive, in-season, and regeneration.
The goals of our in-season perfor-mance program are to:
1. Have zero starts missed due to in-jury for the entire season.2. Maintain body weight, with spe-cific goals for each athlete.3. Increase lean muscle mass (we use BodPod testing).4. Increase functional range of mo-tion and flexibility.5. Maintain approximately 88-94 percent of 1RM strength in our pre-season tested lifts (hang clean, front squat, bench). Redshirt athletes are tested in December and March for strength gain goals.6. Consistently train two to three days each week.7. Keep the intensity high while re-ducing the volume accordingly as the season progresses.8. Enjoy the process, while also making it challenging for our stu-dent-athletes.The trick is to make all of this hap-
pen while working around the prac-
tice, academic, travel, and competition schedule of our team. We plan two to three months ahead, and as each week approaches I communicate with the basketball coaching staff to see if any schedule changes or conflicts have aris-en. I have found it pays to write ev-erything in pencil and stay flexible, because almost every week during the season we end up having some type of change or scheduling conflict. Commu-nication is the key to overcoming these speed bumps, along with understanding my role within the program.
I am fortunate that Coach Ryan and
thusiasm on to others, especially in-sea-son when practices, travel, and academic workloads can wear players down men-tally. I think it is extremely important to be early, be organized, and be upbeat. If a workout is scheduled for 6 a.m., I want our athletes to walk into a weightroom that’s full of energy, not a dark building with no one around. Even the best-de-signed strength programs will fall short if athletes don’t bring a certain level of intensity to their workouts.
A team’s style of play is also part of the big picture and must factor into the per-formance training program design. We run the swing offense, which requires everyone on the court to be involved in
the movement of the ball, whether they are perimeter or post players. This is a patient style of play, meaning that we often use 25 to 30 seconds of each pos-session before finding the highest per-centage shot. Because this style involves
continuous movement by our players, it is important for them to have a high level of work capacity.
On the defensive end, we are predom-inantly a half court man-to-man team, which means very little down time while the players are on the floor. They need to be able to maintain an athletic de-fensive posture for long stretches, and generate explosive strength even while in a fatigued state. Much like in a hock-ey game, we substitute frequently, and routinely use 10 or 11 players per half.
Therefore, conditioning our players is a priority in our planning. Coach
The first thing Head Men’s Coach Bo Ryan and I talk about is the overall philosophy of the men’s basketball pro-gram and what his priorities are. From there, I develop a strategy specific to strength and conditioning, focused on making players successful on and off the court. This year, my plan was based on four goals:
1. Reduce the incidence of basketball-related injuries.2. Improve performance in the weight-room that transfers to the court.3. Build self-esteem and confidence in our student-athletes.4. Ensure that academics are a prior-ity when scheduling workouts.
Part of the team’s philosophy is to hold student-athletes to a high standard both in the classroom and on the court, and I make sure the same holds true in the weightroom. We expect them to be on time for scheduled workouts, and they are only permitted to wear team-issued practice gear. They are also re-quired to have their shirts tucked in at all times and no jewelry, cell phones, or iPods are allowed. We also demand that they bring a great attitude and a desire to improve, just as they do for a practice or game. These are simple concepts, but it’s amazing what happens when every-one is on the same page and buys into the routine.
Coach Ryan and I both believe that intensity and consistency are the keys to great training, and that’s at the foundation of everything we do on the court and in the weightroom. He follows a specific routine each day at practice. The drills he uses change, but the flow of the practice remains very consistent. Our players know what to expect, but each practice may present a new approach on how to accomplish it. I try to mimic that philosophy in the weightroom.
At the same time, I let my personality come through in our workouts. I really enjoy my job, and I try to pass my en-
Coach Ryan and I both believe that intensity and consistency are the keys to great training. He
follows a specific routine each day at practice. The drills he uses change, but the flow of the practice
remains very consistent. I try to mimic that philosophy in the weightroom.
I have found it pays to write everything in pencil and stay flexible, because almost every week during the season we end up having some type of change or scheduling conflict. Communication is the key to overcoming these speed bumps, along with understand-ing my role within the program.
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powerful ideas for powerful results™
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SAMPLE WEEKSAMPLE WEEKThe following is an example of our two-day, in-season weightroom workout:
DAY ONEDAY ONE
Foam Roll: focus on glute medius, TFL, IT band, and adductors
Movement Prep: dynamic movement warmup
Prehab: exercise prescription based on athlete imbalances or weaknesses
Core: med ball rotational wall throws or functional trainer rotational movement combinations along with static hold exercises
Bar Complex: using a 45-pound bar, may include muscle snatch, muscle clean, squat press, straight-leg deadlift (SLD), etc.
Dynamic Effort: Olympic movement or Vertimax, such as snatch, hang clean, rack clean, or push jerk ■ 2-4 sets of 2-3 reps @ 55-70% with 1.5-2 minutes of rest between sets
Max Effort: lower-body press, such as squat, front squat, or deadlift ■ 2-4 sets of 2-3 reps @ 80-95%
Paired with Repetitive Effort: upper-body pull, such as chin up, one-arm DB row, or bar row ■ 2-4 sets of 6-10 reps @ 60-75%
Rest 1-2 minutes between paired exercises
Repetitive Effort: DB upper-body press, such as DB standing military, DB incline, or DB bench ■ 2-4 sets of 6-10 reps @ 60-75%
Paired with Lower-Body Pull: SLD, one-leg SLD, or glute ham ■ 2-4 sets of 6-10 reps @ 60-75%
Rest 1-2 minutes between paired exercises
Stretch: may include foam roller, static, PNF, active stretching
Nutrition: hydration and nutrient replenishment within 45 minutes post workout
DAY TWODAY TWO
Repeat foam roll, movement prep, prehab, core, and bar complex work from Day One.
Dynamic Effort: Olympic DB movement, such as one-arm DB snatch, DB hang clean, or one-arm DB push jerk ■ 2-4 sets of 2-3 reps @ 55-70%, with 1.5-2 minutes of rest between sets
Max Effort: upper-body press, bench, or incline■ 2-4 sets of 2-3 reps @ 85-95%
Paired with Repetitive Effort: lower-body pull, such as one-leg SLD, SLD, or glute ham ■ 2-4 sets of 6-10 reps @ 65-80%
Rest 1-2 minutes between paired exercises
Repetitive Effort: lower-body press, such as one-leg box squat or backward overhead lunge ■ 2-4 sets of 6-10 reps @ 65-80%
Paired with Upper Body Pull: such as one-arm DB row, inverted row, or standing row ■ 2-4 sets of 6-10 reps @ 65-80%
Rest 1-2 minutes between paired exercises
Stretch and Nutrition: same as Day One
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TRAINING-CONDITIONING.COM T&C MARCH 2007 41
his staff fully support my efforts and those of our athletic training staff. Coach Ryan gives me complete control in designing the team’s weightroom ses-sions and we combine ideas on the con-ditioning portion of the workouts. This way, I have better control over the de-sign, timing, and sequencing of exercises in the weightroom, and I’m not worried about a high level of athlete fatigue that might occur if we combined them with practice or conditioning sessions.
In turn, I fully support Coach Ryan’s conditioning plan for the team. During the season, the team practices at a high level every day with a lot of full-court possessions and situational drills. Post-practice sprint sessions are rarely part of our routine as most in-season condi-tioning work is integrated into practice.
Some coaches I have worked with in the past had me arrive at the end of their practices two or three times each week to “run” athletes who had spent most of the last three hours standing around. This often made me the bad guy, because the only conditioning they received was courtesy of me and my whistle. I believe there is no better agil-ity and conditioning format for basket-ball athletes than having them compete in high-intensity, high-demand situa-tions and react to the unscripted move-ments that occur during the flow of the sport. This is difficult to duplicate by setting up some cones or running a se-ries of agility drills at the end of a prac-tice session.
SCHEDULING
I prefer to separate our strength train-ing workouts from our practices when-ever possible during the competitive portion of the year. Our routine is to train early on Monday mornings when our schedule allows—unless we play that day or the next. Ideally, I prefer to have a 36- to 48-hour break between a strength workout and a competition, and 72 hours between strength ses-sions. This schedule works well when we have two or fewer competitions in a week and if they are spaced three or four days apart.
For example, if we play on Wednesday and Saturday, our lifting days would be Monday morning and Thursday morn-ing of that week. This is the routine we try to maintain, but we are at the mer-cy of our game schedule. If we are com-peting Tuesday and Saturday, we lift on Sunday and Wednesday. If we play
three games in a given week, it may not be beneficial to do any strength training during that span, especially with those athletes logging the majority of the min-utes on the court.
Depending on academic schedules, we will either bring the team in to-gether or in small groups of four to six athletes. There are benefits to both—the team dynamic of having everyone together works well with our Mon-day early morning workout, while the
smaller groups allow the athletes more scheduling flexibility and individual-ized time with me.
One exception to this setup involves student-athletes who are taking a red-shirt year. For them, we treat a home game day as a strength and condition-ing day, usually taking them through a weightroom workout immediately fol-lowing our morning or early afternoon shootaround. Our redshirt athletes con-tinue to train two to three times each week during the entire competitive sea-son, and each one has his own unique goals. For some it may be integration back into strength training along with continued rehabilitation while recover-ing from an injury, while for others it may be increasing strength and adding lean muscle mass to prepare for next year’s season.
Because most of the team trains only two days per week, we conduct full-body workouts for both training days and follow a conjugate periodization plan utilizing max effort, dynamic ef-fort, and repetitive effort in varying combinations. We organize the workout around four to six exercises each day, varying them every two to three weeks (depending on our schedule) and then follow with an “unload” week.
We repeat this cycle for most of the competitive season, lifting some of our heaviest weight near the end of the sea-son but with very low volume by that point. The quality and intensity of effort is what we focus on during these work-outs, not the quantity of work done. Most sessions last between 50 and 60 minutes during the first three quarters
of the competitive season, then reduce to approximately 30 minutes once we start the second half of our conference schedule in February.
I like to pair up exercises during this phase, in which we train the up-per body immediately after the lower body and vice versa, with little rest in between. With this strategy, we accom-plish more in a shorter period of time, at a point in the year when efficiency is a top priority.
AN INDIVIDUAL APPROACH
Each of our student-athletes has an in-dividualized card for his week’s work-out. They all have nicknames on their cards, along with a weekly quote. This helps players stay focused on the goal for the week while having some fun along the way. We try to educate them on the benefits of becoming internally motivated when practicing, playing, or training, and that we are in this togeth-er to succeed as a team.
During our in-season training, ap-proximately 30 percent of the program is individualized with each student-athlete’s plan based on his position, minutes played, and individual needs (injury rehab, muscle imbalances, red-shirt, etc). Our style of play dictates that our athletes all perform many dif-ferent movements while executing our offensive or defensive schemes dur-ing practice or competition. But with-in these movements, each position has greater tendencies while on the court. I observe all of our athletes at every game and practice, and also watch game film each week to break down movement patterns and look for areas where each athlete can improve his performance.
For example, our perimeter play-ers tend to make more rotational chest passes, whereas our post players per-form more overhead movements while rebounding or passing. We take this into consideration while designing their individual programs. This might mean that medicine ball work with perimeter players would focus on using rotation-al throws, while post players focus on overhead throws.
During our in-season training, approximately 30 percent of the program is individualized with each student-athlete’s plan based on his position, minutes played, and individual needs (injury rehab, muscle imbalances, redshirt, etc).
SPORT SPECIFIC
42 T&C MARCH 2007 TRAINING-CONDITIONING.COM
Also, we conduct preseason func-tional movement screening. Through this process, we may uncover mobility or flexibility issues that require addi-tional attention. These deficiencies are addressed within the workout, with the help of our athletic training staff. For example, we may alter or limit overhead Olympic lifts with a particular athlete if he has mobility restrictions or a his-tory of shoulder injuries. Instead, we may substitute loaded box jumps or squat jumps, along with specific prehab shoulder exercises during that portion
of the program. We still achieve the goal of training the athlete explosively with a ground-based triple-extension move-ment, while reducing the risk of injury.
THE WORKOUTS
We begin each workout with a period of foam rolling to aid in our overall warmup. Then we move into dynam-ic movement exercises that mimic the movements our athletes do later. The focus is on increasing core body tem-perature and blood flow to the major muscles.
From there we perform several pre-hab exercises specific to each individual athlete’s needs. These could be an ex-tension of protocols the athletic train-ing staff has prescribed to address a specific imbalance or weakness, or it may be based on observations during past weightroom sessions.
We also emphasize ankle strengthen-ing and stabilization exercises, as this ac-counts for the highest percentage of our injuries. Examples include single-leg MB touches, the use of Airex pads or air disc pillows, and single-leg, eyes-closed drills.
Next, we move into the core exer-cises, focusing on the rotational and transverse plane movements—from completing a pass to grabbing a re-bound to turning to change direction defensively, basketball athletes are continuously making rotational move-ments. We use the concept of the verti-cal core, meaning that 90 percent of our core exercises are performed on our feet rather than lying down. We include a wide variety of medicine ball rotation-al movements and throws, along with functional trainer/Vertimax rotational pull-presses.
The Olympic movements we incorpo-rate include the snatch, clean, rack clean, and push/split jerk. During the second session of the week, we always use a dumbbell variation of these to change the stimulus and reduce the overall load on our athletes following a game.
The body of the program then in-cludes four exercises paired together with a different emphasis every two to three weeks. We usually do a max ef-fort lower-body movement on Day One and a max effort upper-body movement on Day Two. The combinations change depending on each player’s minutes played, position, training objectives, and level of fatigue. Then, following each lift and practice, we spend time static stretching, hydrating, and taking a nutrient recovery supplement.
Our program is always a work in progress. I have borrowed many ideas from others in the field—from Vern Gambetta to Todd Wright to Mike Boyle—and figured out how to make them work in my particular program, and I will continue to do so. Each year the program design evolves in some form or fashion. This is a never-ending process for me, and I am thankful to all the strength and conditioning profes-sionals who have been willing to share their ideas and knowledge with me. ■
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Greg Scholand is an Assistant Editor
at Training & Conditioning. He can be
reached at: [email protected].
BY GREG SCHOLAND
Are YouProtected?
You have heard about how MRSA can wreak havoc on an athletic team. Here’s how to help prevent an outbreak—and also how to deal with one.
As Jon Cochran, a senior guard on the Stanford University football team, climbed into bed the night after a game last October,
he felt the usual postgame soreness. He also noticed some tenderness in his cheek around what appeared to be a small pimple.
The next morning, he woke up to find half of his face severely swollen. On the advice of Stanford’s team phy-sician, Cochran was immediately ad-mitted to the hospital for intravenous antibiotics, and he’d miss the next two starts before he was healthy enough to return to action.
©GETTY IMAGES
Cochran is 6-foot-6 and weighs over 300 pounds, but he was sidelined by something smaller than a pinhead: methicillin-resistant Staphylococ-cus aureus, also known as MRSA. A MRSA outbreak this past season in-fected a handful of Stanford football players, sending a few to the hospital and causing several to miss playing time. It also gave Head Athletic Train-er for Football Charlie Miller, ATC, a hands-on lesson in managing this in-fectious disease.
“It was amazing how quickly the in-fection would hit somebody,” Miller says. “Our doctors would look at a tiny lesion and say, ‘All right, let’s keep an
eye on it.’ By the next day, it became something really significant. You could be doing all the right things to protect yourself and still get hit.”
If MRSA isn’t on your radar screen yet, it should be. It can strike any-where, and if not properly dealt with, the effects can be devastating. Athletic trainers who have faced this microscop-ic menace agree that vigilance, commu-nication, and common-sense preventive measures are the keys to keeping your athletes and your program safe.
TRAINING-CONDITIONING.COM
BACTERIAL BACKGROUND
It has been almost 10 years since MRSA first appeared in an athletic setting, and in that time, it has cropped up every-where from elementary school gyms to NFL locker rooms. In 2003, it made na-tional headlines when a football player at Lycoming College died of a blood-stream infection linked to MRSA bac-teria. But while more and more team physicians and athletic trainers are aware of the risks, an outbreak still of-ten catches programs by surprise.
What exactly is MRSA, and why is it so dangerous? For years, the anti-biotic methicillin (a synthetic form of penicillin) was a standard treatment for staph infections, which were com-mon in hospitals and nursing homes but rarely seen in the general public. Over time, some staph bacteria developed resistance to methicillin, and decades of doctors overprescribing antibiotics made the problem worse. Today, meth-icillin is no longer prescribed to treat infections, but the term “methicillin-re-sistant” is still used to describe staph strains that are immune to many com-mon antibiotics.
Because MRSA bacteria are harder to kill, the infections must be treated more carefully than ordinary staph cases (methicillin-susceptible Staphy-lococcus aureus, or MSSA). If someone with MRSA is prescribed a standard antibiotic, like penicillin or amoxicil-lin, the bacteria won’t be killed and the infection can spread and grow more serious. Untreated, MRSA can lead to organ damage, bloodstream infections, pneumonia, or, in extreme cases, nec-rotizing fasciitis (commonly known as flesh eating bacteria). However, if a di-agnosis is made quickly, MRSA can be treated fairly easily by debriding and cleaning the infection site and using special antibiotics such as vancomycin and teicoplanin.
“The real key to controlling MRSA is identifying it as quickly as possible,” says Jeff Hageman, MS, an epidemi-ologist specializing in staph infections at the Centers for Disease Control and Prevention (CDC). “The standard treat-ment procedures and drugs are very ef-fective, and the severe cases are usually the result of an infection not being rec-ognized early enough.”
A MRSA infection typically begins as a skin lesion containing a pustule, so it is often mistaken for a pimple, in-grown hair, or spider bite. As it devel-
ops, it expands and can present with painful discoloration and swelling, run-ning sores, boils, and sometimes seri-ous tissue damage.
Various forms of Staphylococcus bac-teria—and to a lesser extent MRSA—are all around us. The CDC estimates that between 25 and 30 percent of the U.S. population is “colonized” with staph, meaning the bacteria currently live on their skin, in their nasal pas-sages, or elsewhere on their body. Only about one percent of people carry a MRSA strain. The colonized almost never find out they are inhabited with staph, and most show no symptoms.
In athletic settings, infection usu-ally occurs when a colonized person’s bacteria come into contact with a cut, scrape, or other open wound. Sports in-volving frequent body-to-body contact, such as football and wrestling, pose the greatest risk since any small break in the skin can become an infection site. But the danger extends to locker rooms as well—MRSA can be spread when athletes share towels, razors, or even bars of soap.
AN OUNCE OF PREVENTION
Strategies for warding off MRSA range from the basic, like using the right kind of soap in locker room showers, to the high-tech—one company offers a met-al box that attaches to a wall and con-stantly filters the air in the room. But experts agree a major piece of the puz-zle is simply practicing good hygiene and proper wound care.
“Athletes can do a lot to minimize their exposure to MRSA just by fol-lowing standard cleanliness rules,” says A.J. Duffy III, MS, PT, ATC, Head Athletic Trainer at Widener Univer-sity and former President of the Penn-sylvania Athletic Trainers’ Association. “That means, for one thing, washing their hands regularly with antibacterial soap. It also means showering immedi-ately after practice—athletes shouldn’t change their clothes and head back to their dorm room to shower, though many prefer to do that.”
Basic hygiene standards should ap-ply to uniforms and equipment as well. “One thing we know is that bacteria love damp, moist environments, which means protective equipment is a poten-tial danger area,” Duffy says. “How many times do we see athletes finish practice and throw their pads in a bag or locker instead of letting them dry
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they can do is make sure everyone is aware of the dangers and knows how to protect themselves.”
EDUCATION IS KEY
Well-informed athletes are the best line of defense against outbreaks, so the most proactive programs place heavy emphasis on MRSA-related education. The programs’ message is extremely simple: When in doubt, get it checked out. But athletic trainers find this man-tra needs to be repeated constantly and in creative ways.
“I’ve learned to not assume athletes will recognize dangers on their own,” says Goforth. “We recently had an athlete with a wound on his knee who didn’t tell anyone for six days—it was ulcerated by the time we treated him. Here’s a college athlete with a hole in his knee, and he didn’t say anything. Luckily it wasn’t MRSA, but it could have been. We need to constantly re-inforce the message about getting ev-ery cut, scrape, pimple, and spider bite checked out and not leaving anything to chance.”
Whether it’s at preseason team meet-ings, during physicals, or in the athlet-ic training room, Goforth and his staff take every opportunity to talk about MRSA and keep it in the front of ath-letes’ minds. “The more ways they’re hearing about it, the better,” he says. “We’re even looking into purchasing a big flat-screen TV to use as a rotating message board for sports medicine top-ics. If we’re flashing pictures of untreat-ed MRSA cases up there and showing how bad it can get, that will grab their attention.”
Indeed, while they’re not for the squeamish, photos of MRSA infections can make for a very powerful warning. “We hung up a poster in the football locker room that showed some extreme cases, and it definitely had shock val-ue—which in this case is a good thing,” says Stanford’s Miller. “The guys kept asking us to flip the poster around. They said, ‘Look, we’ve got it, okay? We don’t need to see these pictures ev-ery time we go in and out!’ But there’s no doubt it raised their awareness.”
Another effective technique is to dis-cuss playing time. At Stafford (Texas) High School, Athletic Trainer David Edell, LAT, ATC, CSCS, talks to ath-letes about teammates who were side-lined with MRSA. “When I say to a team, ‘See this guy? He didn’t practice
No detail is overlooked—not even the athletes’ gloves. “We also provide a spray disinfectant at every practice for anyone who wears gloves on the field,” Miller says. “Bacteria can thrive on players’ sweaty gloves, so as they walk into the locker room we instruct every-one to spray their gloves down.”
Inside the locker room, Stanford in-stalled liquid soap dispensers in all its showers to prevent athletes from shar-ing bar soap, which provides an ideal growing environment for MRSA bac-
teria. “Nothing our athletes use in the locker room is shared—everyone keeps their own razors, towels, nail clippers, and whatever else they need,” says Miller. “We make sure the athletes are following that policy.”
Some programs are also looking to technology to boost their prevention ef-forts. Last year at Virginia Tech, Go-forth’s department hired a company to spray the Hokies’ synthetic turf fields, wrestling mats, saunas, and other ar-eas with a special antimicrobial coat-ing made of spear-shaped molecules that pierce MRSA and other microbes to kill them without chemicals. Other athletic departments have turned to air purifiers that claim to remove harmful bacteria from locker rooms and other common areas, and light therapy de-vices that kill bateria with therapeutic blue light. In the NFL, the Washing-ton Redskins went high-tech with their MRSA prevention by equipping their whirlpools with a filtering system that uses ultraviolet light, while several oth-er teams use a special sanitizing unit on all player equipment.
“There are many products out there making bold claims, and it’s important to do your homework before investing in any of them,” says the CDC’s Hage-man. “Some are backed up by research and registered with the Environmental Protection Agency to prove they’ll do what they say, and others are not as re-sponsible. For teams with very limited resources, the most important thing
out? It’s a simple step, but it can make a very big difference.”
Almost anything athletes touch on a daily basis—weightroom equipment, towels and washcloths, locker room benches, jerseys—can be a conduit for MRSA bacteria. Since it’s impossible to clean every surface daily, it helps to identify the most frequently contacted spots in your facilities (for instance, locker room doorknobs, treatment ta-bles, and shower areas) and single them out for more frequent cleaning.
Of course, even if MRSA is lurk-ing around your department, the bac-teria need an open wound to enter an athlete’s body, so keeping skin wounds covered at all times should be a top pri-ority. Some wound care products even have a special antimicrobial treatment that can help prevent infection.
Mike Goforth, MS, ATC, Head Ath-letic Trainer at Virginia Tech, says his staff’s close attention to cleanliness in the athletic training room sets an ex-ample that athletes take home with them. Each treatment table in his facil-ity is outfitted with germicidal wipes, which the athletic trainers use liberally throughout the day. “We’re real stick-lers with hand washing procedures,” Goforth says. “All the research says keeping your hands clean is one of the most important things you can do to prevent infection, so we’re extremely diligent about that.”
Hand washing is also now a major focus at Stanford, where Miller brings bottles of an alcohol-based hand sani-tizer out to the field for every football practice. “Each athlete does a waterless hand washing as practice ends before they head to the locker room,” Miller explains. “We have keypad locks on our doors, and since athletes will be touching those when they go back in-side, we want them to disinfect them-selves first. During practice, they touch the ball, wipe sweat off their faces, and make contact with one another, so we want their hands to be clean.”
“We also provide a spray disinfectant at every prac-tice for anyone who wears gloves on the field,” says
Stanford’s Charlie Miller. “Bacteria can thrive on players’ sweaty gloves, so as they walk into the locker room we
instruct everyone to spray their gloves down.”
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TRAINING-CONDITIONING.COM T&C MARCH 2007 47
yesterday because he’s got an infection, and he won’t be playing this week,’ that hits home for them more than anything else,” Edell says. “When it’s someone they know, a teammate who they can re-late to, they’re going to remember it and think to themselves, ‘Could that be me?’
“Above all, athletes want to partici-pate,” Edell continues. “The thought of having their season ended by something that’s preventable means more than any other warning or lecture they’ll get from me, their coaches, or anyone else.”
Athletes’ parents, too, should be part of the education process. The message is still very simple—parents should en-courage their children to practice good hygiene, cover all wounds, and report any suspicious skin problem, no matter how minor, to a sports medicine profes-sional. But keep in mind that MRSA is something many parents will be hear-ing about for the first time.
“We conduct a parents’ meeting at the beginning of our sports seasons, where we explain what MRSA is and talk about how they can help their chil-dren protect themselves,” says Tanya Dargusch, ATR, ATC, Head Athletic
Trainer at Washington Township (N.J.) High School, where two football play-ers were infected with MRSA last fall. “It’s mostly simple things like making sure uniforms get washed, or that kids wear their wrestling shoes only on the mats so they’re not bringing germs and bacteria from outside into the compe-tition area. And we always open it up to questions so parents’ individual con-cerns can be addressed.”
As an extra benefit, an up-front dis-cussion with parents about a serious subject like MRSA helps build trust, opens lines of communication, and bol-sters your credibility as a health care professional. “Parents always tell us how much they appreciate being edu-cated and say they’re glad we are so proactive about their children’s safety,” says Dargusch. “And if they have any concerns during the season, they know they can always come to us.”
HANDLING AN OUTBREAK
Even with the best education and pre-vention programs in place, your ath-letic department can still get hit with MRSA. If it strikes, there are some
concrete steps athletic trainers can take to minimize the impact and man-age the risk.
First, it’s important to tap into out-side resources as soon as possible. When Stanford’s outbreak began last fall, the athletic department called on team physicians and infectious disease specialists from the Stanford Hospital & Clinics to take the lead in developing a plan of action.
“The hospital immediately helped us decide what to do,” says Miller. “Any wound that was even remotely suspi-cious was cultured and tested, and any-one who came up positive had their wounds treated and received antibiotics that would kill the staph bacteria.”
The next step was decolonizing the infected players to prevent them from re-infecting themselves or others dur-ing and after treatment. “We had those players shower using Hibiclenz soap, which specifically targets MRSA and other bacteria on the skin,” Mill-er explains. “And to decolonize their nasal passages, we gave them Bactro-ban ointment to coat the inside of their nostrils with.”
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As a further precaution, the MRSA-positive athletes showered away from the rest of the team in a private bath-room, and their uniforms and other laundry were washed separately. Ac-cording to the CDC’s Hageman, normal washing with hot water and detergent will usually kill any bacteria found on clothing, but with an outbreak already under way, Stanford’s athletic depart-ment left nothing to chance.
Another step was eliminating poten-tial MRSA transmission sites, and that meant getting rid of the cloth couches in the locker rooms. “We had no reason to believe the couches were the culprit, but we decided to be safe and replace them with vinyl ones that could be cleaned more easily,” says Miller. “We were just trying to isolate and eliminate anything that could possibly be contributing to the spread of bacteria.”
At Washington Township High, as soon as the first case was confirmed, Dargusch worked with the school’s custodians to find a cleaning product that would be effective in combating MRSA. “We went through the entire school with it, focusing on any area
that athletes regularly come into con-tact with—door handles, lockers, locks, equipment in the weightroom. We were very thorough,” she says. “Our custo-dial staff also cleaned and disinfected all the football helmets, shoulder pads, and anything else the athletes used.”
Similar steps were taken at Stafford High when MRSA struck there last fall. “Before our maintenance staff cleaned the entire locker room, we told the foot-ball team, ‘Empty out your lockers—ev-erything goes home, and you can’t bring it back unless it’s clean,’” says Edell. “Our maintenance director used a clean-ing agent that kills microbials, and we went through all the lockers and pads.”
Edell also communicated a lot with athletes’ parents. “One thing that wor-ries me is that not all physicians follow the recommended guidelines for dealing with suspected MRSA cases, so I tell parents exactly what to request when they take their child to the doctor,” he says. “If I think the wound needs to be cultured to perform a type and cross for sensitivity to microbials, which is what Texas Children’s Hospital recommends for any suspicious wound, that’s what
I’ll tell the parents. If they call me back and say, ‘They stuck a Q-tip in it and sent it off to the lab,’ I know we’re on the same page.”
In the broadest sense, when respond-ing to any MRSA outbreak, “better safe than sorry” is the best approach. “Whenever I send a kid to the doctor, I tell the parents, ‘I hope I’m not wast-ing your time, but on the other hand, I hope I am wasting your time, because it’s great when I find out I was wrong and it’s not MRSA,’” Edell adds. “One thing I’ve learned from dealing with these cases is that it’s always better to know for sure.”
IN THE LOOP
A final piece of advice for keeping one step ahead of MRSA is to stay plugged in to all the resources around you. From maintaining open lines of communica-tion with colleagues in your conference to developing a working relationship with your county health department, there are many ways to be sure you’re in the loop.
“I talk quite often with the emergen-cy room at our local hospital, just to
and other germs
www.staphaseptic.com 1-800-ITCHING™ *In vitro studies show that StaphAseptic kills over 99.9% of methicillin resistant staphylococcus aureus (MRSA).
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A version of this article is also
appearing in Athletic Management,
a sister publication to Training
& Conditioning.
hear what kinds of things they’ve got coming through the door,” says Go-forth. “With something like MRSA, it can be a community problem before it’s an athletic department problem, so the hospital is a great source of informa-tion. Anytime something comes across their desk, they pick up the phone and call me, and vice-versa. If I hear about something from a colleague or read it in an athletic training publication, I’ll au-tomatically pick up the phone and ask what they know about it. When you’ve built those relationships, you’re much less likely to be caught by surprise.”
At Stanford, Miller’s advice for not being caught by surprise is even simpler. “You should never assume that it can’t happen to your program,” he warns. “It’s easy to say, ‘We’ve been careful, it will hit someone else.’ But the truth is, you could always be next.” ■
RESOURCESRESOURCESwww.cdc.gov/mrsa
The Centers for Disease Control and Prevention offers extensive Web resourc-
es for learning about MRSA, including advice for preventing and controlling
outbreaks, information for people who have been diagnosed, and downloadable
educational posters.
www.nata.org
Enter “MRSA infections” into the search window for a link to an official state-
ment on MRSA released by the National Athletic Trainers’ Association in March
2005. It contains recommendations for preventing and managing MRSA out-
breaks in an athletic setting.
www.ncaa.org/health-safety
Click on “Injury Prevention,” then click on “Skin Infection Prevention” for infor-
mation from the NCAA on MRSA. This includes the association’s own sports
medicine guidelines, articles on MRSA in athletic settings, and downloadable
educational materials such as posters and slide presentations.
www.mrsaresources.com
This privately maintained Web site contains multiple pages of MRSA information
and a section with links to a variety of MRSA resources on the Internet.
www.epa.gov/oppad001/list_g_mrsa_vre.pdf
The Environmental Protection Agency has released this list of antimicrobial
products that are effective against MRSA bacteria.
To help in the fi ght against MRSA, Training & Conditioning has teamed up with its
advertisers to offer readers nine educational posters.
Prevention Through Education
Warning Signs: How to spot the warning signs of MRSAHand Hygiene: Proper techniques for washing away MRSAKeeping Facilities Safe: Suggestions about MRSA and athletic facilitiesEquipment Management: Why equipment storage is criticalOn the Sidelines: Important gametime procedures for ATCsWound Care: How to treat and cover woundsTips for Parents: A special poster to educate parentsIn the Locker Room: Tips for athletes in the locker roomAthletic Training Room Procedures: A poster for athletic training rooms
Check them out on the next 16 pages:
You can also download any of these posters for FREEor you can receive all nine 12” x 18” color posters for $30 per set.
To order, visit: www.Training-Conditioning.com
Special Focus: Preventing MRSA
• Make sure padding and other equipment is
stored someplace where it can dry out after
each use.
• Clean athletes’ equipment regularly with a
product that will kill MRSA and other types of
bacteria.
• Don’t allow athletes to share equipment at
practice or during games.
• Whether your athletic department launders
athletes’ uniforms or athletes do it themselves,
make sure uniforms get washed after each use.
• If one or more athletes in your program are
infected with MRSA, launder their uniforms
and other washables separately from the rest
of the team’s.Sponsored by:
Athletic equipment is supposed to keep the wearer safe, but if it’s not
properly taken care of, it can create a serious health hazard. When
sweaty pads and uniforms are thrown into a bag or locker, the result is a
warm, dark, moist environment that’s perfect for MRSA bacteria to grow.
The problem can be exacerbated on equipment with large surface areas
that are difficult to dry out, such as shoulder pads and gloves.
Take these precautions to help prevent
equipment from harboring MRSA bacteria:
Equipment Management
To download as a printable poster visit: www.Training-Conditioning.com
™
Special Focus: Preventing MRSA
Sponsored by:
• Frequently touched surfaces should be cleaned and
disinfected on a regular basis. This includes weight-
room equipment, athletic training tables, lockers,
benches, and mats.• Implement a no-sharing rule. Athletes should not
share towels, toiletries, clothing, or athletic equipment.
• Encourage frequent hand washing among all athletes
and staff.• Pay attention to the storage of athletic equipment. A
dark, moist, warm environment is perfect for bacteria
growth, so storage areas for padding and other equip-
ment must be open and well-ventilated.• Products that prevent MRSA can be applied to many
surfaces, equipment, towels, and athletic apparel.
• The research is inconclusive on whether athletic
fields can harbor MRSA bacteria. Since some studies
have shown that the possibility exists, there are com-
panies that offer antimicrobial treatments for athletic
fields and other surfaces and substrates.
Everyone wants their athletic facilities to be safe environments. That’s
why you make sure gym walls are padded, fields are maintained, and a
spotter is always on hand in the weightroom. But some potential haz-
ards are harder to see: At the microscopic level, MRSA and other types
of bacteria could put your athletes at risk for infection.
Here are some tips about MRSA and
athletic facilities:
Keeping Facilities Safe
To download as a printable poster visit: www.Training-Conditioning.com
Special Focus: Preventing MRSA
Sponsored by:
To download as a printable poster visit: www.Training-Conditioning.com
• Launder workout clothing and uniforms after
each use, using hot water and detergent.
• If your child brings his or her equipment home,
designate a place where it can thoroughly dry out
after each use. Wet padding and other equipment
left in a gym bag creates an ideal environment for
MRSA bacteria to grow.
• Encourage frequent hand washing with antibac-
terial soap. Clean hands are a key defense against
the spread of infection.
• Tell your child to shower immediately after
practice or competition, especially if he or she
participates in a contact sport.
• Any time your child has a skin wound, make
sure it remains covered until it is fully healed.
MRSA usually enters the body through an unpro-
tected break in the skin.
• Make sure your child reports all skin wounds,
no matter how minor, to a coach, athletic trainer,
school nurse, or someone else who can decide
whether medical attention is warranted. If it’s in-
fected with MRSA, early detection is critical.
As the parent of a student-athlete, you’d do anything to keep your child
safe. When it comes to preventing MRSA, a potentially serious bacterial
infection, a few common-sense preventative measures can make a big
difference.
Here are some ways to help your child avoid the
risks of MRSA:
Tips for Parents
w w w . T r a i n i n g - C o n d i t i o n i n g . c o m
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SPECIAL FOCUS: PREVENTING MRSA
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Special Focus: Preventing MRSA
● Longer than normal healing time
● Any increase in size
● Unexplained or unusual pain or sensitivity
● The presence of pus or a pustule
● Induration (hardness)
● The sensation of heat
● Abnormal swelling or redness
● Red streaks around the lesion
● Abnormal coloration
Sponsored by:
It’s fairly common for athletes to have pimples, cuts, and abra-sions on their skin. So how do you know when it might be MRSA and should be referred to a doctor or hospital for a more complete evaluation?
Here are some warning signs to look for and ask about when deciding whether a wound requires medical intervention:
Warning Signs
To download as a printable poster visit: www.Training-Conditioning.com
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Circle No. 126
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Special Focus: Preventing MRSA
• When using an alcohol-based hand rub, apply the product to the palm of one hand and then rub both hands together, covering all surfaces of the hands and fi ngers, until hands are dry.
• When washing hands with soap and water, wet both hands fi rst, apply soap, then rub hands together vigorously for at least 15 seconds, covering all surfaces of the hands and fi ngers. Rinse hands with water.
• Thoroughly dry hands with a disposable towel or one treated with an antimicrobial solution. Use the disposable or treated towel to turn off the faucet.
• Avoid using very hot water, since repeated expo-sure to it may increase the risk of dermatitis.
• If your sink is equipped with bar soap, only use small bars and make sure your soap rack allows for drainage.
• In between washings, use antimicrobial solutions and products that inhibit the growth of bacteria.
Every athletic trainer knows the importance of hand cleanliness when treating athletes. However, studies of health care professionals in many different settings have found that proper hand washing procedures are not always followed, and the result may be an increased risk for transmit-ting infections such as MRSA.
Here are some helpful reminders on proper techniques for hand hygiene:
Hand Hygiene
Sponsored by:
To download as a printable poster visit: www.Training-Conditioning.com
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Circle No. 127
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Special Focus: Preventing MRSA
Sponsored by:
• Frequently touched surfaces should be cleaned and disinfected on a regular basis. This includes weight-room equipment, athletic training tables, lockers, benches, and mats.
• Implement a no-sharing rule. Athletes should not share towels, toiletries, clothing, or athletic equipment.
• Encourage frequent hand washing among all athletes and staff.
• Pay attention to the storage of athletic equipment. A dark, moist, warm environment is perfect for bacteria growth, so storage areas for padding and other equip-ment must be open and well-ventilated.
• Products that prevent MRSA can be applied to many surfaces, equipment, towels, and athletic apparel.
• The research is inconclusive on whether athletic fi elds can harbor MRSA bacteria. Since some studies have shown that the possibility exists, there are com-panies that offer antimicrobial treatments for athletic fi elds and other surfaces and substrates.
Everyone wants their athletic facilities to be safe environments. That’s why you make sure gym walls are padded, fi elds are maintained, and a spotter is always on hand in the weightroom. But some potential haz-ards are harder to see: At the microscopic level, MRSA and other types of bacteria could put your athletes at risk for infection.
Here are some tips about MRSA and athletic facilities:
Keeping Facilities Safe
To download as a printable poster visit: www.Training-Conditioning.com
MRSAFacilitiesBleed.indd 1 2/27/07 4:53:07 PM
Advanced Antimicrobial Protection of the SportsAide™ System.
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Introducing the
Your members may not be the only ones using your health club! On a microscopic level, bacteria, mold, fungi and algae are taking up residence on your equipment, towels or sharing the locker room facilities – potentially threatening your customers and your business.
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Be the rst to offer your members a Worry Free Workout… with the safe, reliable and consistent performance of the antimicrobial protection in the SportsAide™ system by SportCoatings™.
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Circle No. 128
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Special Focus: Preventing MRSA
• Make sure padding and other equipment is stored someplace where it can dry out after each use.
• Clean athletes’ equipment regularly with a product that will kill MRSA and other types of bacteria.
• Don’t allow athletes to share equipment at practice or during games.
• Whether your athletic department launders athletes’ uniforms or athletes do it themselves, make sure uniforms get washed after each use.
• If one or more athletes in your program are infected with MRSA, launder their uniforms and other washables separately from the rest of the team’s.
Sponsored by:
Athletic equipment is supposed to keep the wearer safe, but if it’s not properly taken care of, it can create a serious health hazard. When sweaty pads and uniforms are thrown into a bag or locker, the result is a warm, dark, moist environment that’s perfect for MRSA bacteria to grow. The problem can be exacerbated on equipment with large surface areas that are diffi cult to dry out, such as shoulder pads and gloves.
Take these precautions to help prevent equipment from harboring MRSA bacteria:
Equipment Management
To download as a printable poster visit: www.Training-Conditioning.com
™
MRSAequipBleed.indd 1 2/27/07 4:49:42 PM
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Circle No. 129
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Gear2000-Stromgren_AM1902.indd 1 2/6/07 2:25:58 PM
Circle No. 130
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Special Focus: Preventing MRSA
• Carry a bottle of an alcohol-based hand sanitizer and perform a waterless hand washing between athlete treatments.
• If possible, use disposable towels. If your program only has ordinary towels, never use the same one on multiple athletes.
• Follow the same sanitary practices with your sideline treatment table as you do with your ath-letic training room tables. Antibacterial wipes can be a convenient, effective cleaning aid.
• Watch for skin wounds that occur during the game. As soon as the wounded athlete is off the fi eld or court, clean and disinfect the wound site and apply secure bandages.
• Talk to athletes and coaches about these proce-dures before the season, and make sure everyone on your sideline knows the importance of proac-tive wound care.
If you’re an athletic trainer working the sidelines during a contest, you’ve got a lot to think about—treating injuries, massaging out muscle cramps, and making return-to-play decisions. But one thing should always be a priority: limiting athletes’ risk of contracting an infection such as MRSA.
Here are some tips for preventing the spread of infection during athletic events:
On the Sidelines
Sponsored by:
ICC Towel™
To download as a printable poster visit: www.Training-Conditioning.com
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The Infection Control Towel™ created and distributed by SportPharm,™ is designed to help combat MRSA skin infection outbreaks that are common among professional and collegiate sports teams.
Soft, custom inter-woven, cotton-like textureUltra-absorbing qualities that wipe away sweat that may contain bacteriaDisposable and intended for individual usageEasily and quickly discardedHelps reduce the risk of MRSA skin infection outbreaks
Hand Rub™ distributed by SportPharm,™ is formulated with aloe vera and a recognized antimicrobial to provide instant sanitization of hands without the use of soap and water. Helps comply with current OSHA and CDC recommendations.
Kills 99.9% of germs in 15 seconds Evaporates completely; no rinsing required Reduces risk of infection Helps prevent cross contamination Adds moisture to hands with aloe vera Meets OSHA or APIC standards
For more information on the ICC Towel™ and Hand Rub™ Sanitizer, please contact us by e-mail at: [email protected] or by phone at 800-272-4767.
If MRSA outbreaks are a concern for your team, then
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SP ad 03.indd 1 2/15/07 6:27:31 PM
Circle No. 131
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Special Focus: Preventing MRSA
• Make sure athletes know to report all injuries and open wounds, no matter how minor, to the athletic training staff, the team physician, or a school nurse for treatment.
• Thoroughly clean wounds by washing away debris and exudate without traumatizing fragile tissue.
• Cover all wounds, even very small ones, during and after activity and tell athletes to keep them covered at all times. Covered wounds heal faster.
• Use antimicrobial wound dressings to inhibit the growth and spread of bacteria plus reduce the potential for infection.
• If a wound looks suspicious or isn’t healing normally, send the athlete to a doctor or to the hospital to have it cultured and tested for MRSA.
• Educate athletes and coaches about fi rst aid for wounds and teach them how to recognize wounds that may be infected. Follow all other MRSA prevention guidelines and recommenda-tions issued by the NATA and the CDC.
Staph infections such as MRSA can proliferate in athletic settings. Skin-to-skin contact, moist environments, and the potential for scrapes and abrasions make athletes a prime target for infection. A big part of keeping athletes safe is proactive treatment for all skin wounds.
Follow these wound care rules to help protect your athletes:
Wound Care
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To download as a printable poster visit: www.Training-Conditioning.com
WoundCareSpread.indd 1 2/28/07 10:09:43 AM
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Circle No. 132
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Special Focus: Preventing MRSA
Sponsored by:
To download as a printable poster visit: www.Training-Conditioning.com
• Launder workout clothing and uniforms after each use, using hot water and detergent.
• If your child brings his or her equipment home, designate a place where it can thoroughly dry out after each use. Wet padding and other equipment left in a gym bag creates an ideal environment for MRSA bacteria to grow.
• Encourage frequent hand washing with antibac-terial soap. Clean hands are a key defense against the spread of infection.
• Tell your child to shower immediately after practice or competition, especially if he or she participates in a contact sport.
• Any time your child has a skin wound, make sure it remains covered until it is fully healed. MRSA usually enters the body through an unpro-tected break in the skin.
• Make sure your child reports all skin wounds, no matter how minor, to a coach, athletic trainer, school nurse, or someone else who can decide whether medical attention is warranted. If it’s in-fected with MRSA, early detection is critical.
As the parent of a student-athlete, you’d do anything to keep your child safe. When it comes to preventing MRSA, a potentially serious bacterial infection, a few common-sense preventative measures can make a big difference.
Here are some ways to help your child avoid the risks of MRSA:
Tips for Parents
ParentsBleed.indd 1 2/27/07 4:59:23 PM
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SportsHygienic_AM1902.indd 1 2/15/07 6:23:05 PM
Circle No. 133
Special Focus: Preventing MRSA
Sponsored by:
• Shower immediately after practices and com-petitions. If MRSA bacteria are present on your skin, you can wash them away before they have a chance to cause infection.
• Don’t share towels, razors, soap, and other personal items and toiletries.
• Get every skin wound, no matter how minor, checked out by your coach, athletic trainer, or team physician.
• Cover all wounds to help prevent infection, especially during practice and competition. If a bandage or wrapping falls off, have it replaced immediately.
• Dry out your equipment and padding after each use. Do not store in a dark, moist, warm environment.
• Wash your hands often. Frequent hand wash-ing with antibacterial soap is one of the best ways to prevent MRSA.
If you’re like most athletes, you enjoy the camaraderie in your team’s locker room. It’s a place to relax, feel safe, and bond with teammates. But a locker room can also be a harbor for MRSA, a type of staph infection that can be deadly if left untreated.
Here are some precautions for preventing the spread of MRSA in the locker room:
In the Locker Room
To download as a printable poster visit: www.Training-Conditioning.com
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Special Focus: Preventing MRSA
• Make frequent hand washing a standard practice for everyone who spends time in the room.
• Clean and disinfect treatment tables and other athletic training room apparatus frequently. Anti-bacterial wipes are a great choice because they’re convenient for day-to-day use.
• If your room has a waiting area, make it a clean environment. Any chairs or couches in the wait-ing area must be easy to clean.
• When an athlete visits the athletic training room with a skin wound, make sure it gets treated and covered immediately.
• If an athlete has a wound that looks infected, immediately refer him or her to a team physician, other doctor, or emergency room to have the wound tested.
In the athletic training room, preventing the spread of MRSA and other types of infection should always be a top priority. It’s a place athletes pass through frequently, and a few simple precautions can play a big part in keeping them safe.
Implement these rules in your athletic training room:
Athletic Training Room Procedures
Sponsored by:
To download as a printable poster visit: www.Training-Conditioning.com
mrsaTrainRoomBleed.indd 1 2/27/07 4:56:16 PM
66 T&C MARCH 2007 TRAINING-CONDITIONING.COM
Bac-Shield™, from Adams USA, is a bacteria inhibitor that disrupts the growth of odor-causing bacteria and fungi. Athletic facilities, equipment, apparel, towels, and playing
surfaces can be excellent host envi-ronments for odor-causing bacteria, fungi, mold, and mildew. Bac-Shield “fills the gap” and makes your hygiene program more effective by inhibiting the reproduction of harm-ful microbes between cleanings and disinfections. The active ingredient in
Bac-Shield, chitosan, has a long history of safe and effective applications. Use Bac-Shield for laundry, locker rooms, ath-letic surfaces, mats, and practically any place bacteria can be present. It is available in pint, gallon, and five-gallon sizes.
For more information on Bac-Shield, contact Adams USA at 800-251-6857 or visit them online at www.adamsusa.com.
Circle No. 500
The Sports Antimicrobial System (SAS) from SportCoatings offers antimicrobial protection for synthetic turf, athletic facili-ties, equipment, and towels. Get antimicrobial protection 24/7 throughout your athletic facilities—from training equipment to the locker room and towels—with the advanced SportsAide™ and SportsAide Fabric Conditioner. SportsAide combats microbial contami-nation and odor using the unique AEGIS Microbe Shield®, which creates a colorless, odorless layer of active antimicrobial pro-tection that’s effective against a very broad spectrum of all known bacteria, mold, fungi, and algae. One treatment lasts for years.
To learn more, contact SportCoatings by calling 888-510-2847 or by visiting www.csgsport.com.
Circle No. 501
Gear 2000/Z-Cool offers Z-Cool Shoulder Pads with anti-bacterial foam padding. These patented air- and moisture-trans-ferring shoulder pads feature antibacterial foam padding that
will not absorb moisture from perspiration. As a result, odor build-up is eliminated and the shoulder pads are 35 percent lighter and cooler for the wearer, which can contribute to enhanced performance on the field.
To find out more, call Gear 2000/Z-Cool at 785-625-6060, or visit their Web site: www.gear2000.com.
Circle No. 502
Kill the Hibigeebies with Hibiclens®. Hibiclens is an antimicrobial, antiseptic skin cleanser that can be an effective defense against the spread of MRSA and other staph infections. Its active ingre-dient, Chlorhexidine Gluconate (four percent), works in a unique way. It kills germs on contact and bonds with the skin to keep killing microor-ganisms even after washing. It’s ideal for clean-ing skin wounds, general skin cleansing, and personal hand washing. Hibiclens is a product of Molnlycke Health Care.
For more information on Hibiclens® call 800-843-8497 or go to www.hibigeebies.com.
Circle No. 503
Flex Pad™ from Stromgren Supports is a line of antimicrobial, moisture-wicking protective compression garments. The antimicrobial treatment found in Flex Pad provides a “zone of inhibition.” This zone is the area around the treated fabric, where the antimicrobial chemistry kills or inhibits microorganisms. The process attacks bacteria, fungi, mold, mildew, and algae that may cause health prob-lems such as staph infections, and also controls the odor that may result when various microorganisms are present in fabric.
Call Stromgren Supports at 800-527-1988, or visit them on the Web at www.stromgren.com.
Circle No. 504
STRAIGHT TALK
Antimicrobial
Products
Many of the companies that advertise in Training & Conditioning have products which can help
prevent MRSA and other microbial diseases. Below is information from several of these companies
on a few of their antimicrobial products.
TRAINING-CONDITIONING.COM T&C MARCH 2007 67
STRAIGHT TALK
Tec Laboratories, Inc. has created StaphAseptic First-Aid Antiseptic/Pain Relieving Gel, an antibiotic-free wound care treatment that helps prevent MRSA infections. Some strains of
staph, known as MRSA, have become resistant to commonly used antibiot-ics. MRSA can spread easily from per-son to person and can enter the body through cuts, scrapes, and abrasions. To help prevent skin infections caused by MRSA and other germs, it’s essen-tial to treat cuts and scrapes with StaphAseptic. In-vitro studies show
that StaphAseptic kills over 99.9 percent of MRSA bacteria.
For more information, call Tec Laboratories, Inc. at 800-482-4464, or visit www.teclabsinc.com.
Circle No. 505
The Infection Control Towel™, created and distributed by SportPharm™, is a disposable towel designed to help fight the battle against MRSA. The Infection Control Towel™ helps to combat MRSA skin infection outbreaks, which pose a threat to professional, college, and high school sports teams. Unlike cotton towels, which can eas-ily spread infection if they are shared or improperly laun-dered, The Infection Control Towel™ is disposable and intended for individual use only. It’s soft, custom-interwo-ven, and has a cotton-like texture with ultra-absorbent qualities to wipe away sweat that may contain bacteria. The towels can be discarded quickly and easily, thus helping to decrease the risk of MRSA outbreaks among sports teams and their facilities.
For more information on The Infection Control Towel™ con-tact SportPharm at [email protected] or by phone at 800-272-4767.
Circle No. 506
E-Lete™ Disinfecting and Deodorizing Products from Sports Hygienics are specifically formulated to meet all your sports hygiene needs. The E-Lete family of products offers a comprehensive solution for sports hygiene in your athletic department. For cleaning athletic equipment, weightroom machines, benches, floors, and other surfaces, E-Lete One-
Step Concentrate is an EPA-registered disin-fectant that kills staph/MRSA, fungus, and many other pathogens. For fabrics and padding, E-Lete Scentinel+™ is an instant deodorizer that’s tough on odor but
safe for skin and fabric. For waterless hand washing, E-Lete Athletic Hand Sanitizer kills more than 99.9 percent of harm-ful germs and contains moisturizers and vitamin E.
To learn more about these products and the rest of the E-Lete line (including artificial turf disinfectants and laundry sanitiz-ers), call 800-605-9538 or visit www.sportshygienics.com.
Circle No. 507
CleenFreek® SportsHygiene® manufactures patented anti-microbial performance products and solutions. CleenFreek SportsHygiene addresses the needs of athletic directors,
coaches, athletic trainers, and athletes at all levels by providing protection and prevention against MRSA, staph infections, athlete’s foot, and other infectious diseases. The company’s products and solutions feature pat-ented built-in antimicrobial technology that addresses cross-contamination of germs and offers protection for locker rooms, athletic training rooms, work-
out rooms, fields, courts, ice surfaces, and mats. CleenFreek SportsHygiene keeps athletes protected and in the game.
To learn more about CleenFreek SportsHygiene, call 800-591-3585 or visit www.cleenfreek.com or www.sportshygiene.com.
Circle No. 508
TELFA™ AMD™ antimicrobial wound dressings from Tyco Healthcare/Kendall are effective against MRSA and Staphylococcus aureus. AMD™ dressings contain PHMB (polyhexamethylene biguanide), an antimicrobial compo-nent proven to resist bacterial colonization within the dressing and also resist bacte-rial penetration through the dress-ing. At just pen-nies per day, this product offers inexpensive infection control. It is compliant with existing protocols, and clinically proven to kill bacteria, prevent bacteria proliferation, and limit cross-contamination. Studies have demonstrated AMD’s effectiveness against a host of bacteria, including Staphylococcus aureus and MRSA.
For more information, call Tyco Healthcare/Kendall at 800-962-9888 or visit www.kendallamd.com
Circle No. 509
You know about Staph. But, did you know the percentage of Staph infections caused by MRSA has almost tripled, from 1995 to 63% in 2004 (CDC)? Today we face the Panton-Valentine Leukocidin from community-acquired S. aureus, Methicillin-resistant and susceptible. What hap-pens tomorrow? An immediate zero-tolerance action plan for
combating Staph through sanitation and prevention is no longer an option. See the carefully-chosen products that Silver Leaf Solutions, Inc. offers at www.silverleafsanitation.com or call 800-292-3653 for advice.
Circle No. 510
68 T&C MARCH 2007 TRAINING-CONDITIONING.COM
ANTIMICROBIAL PRODUCTS
Shopping for Antimicrobial Products?
Training & Conditioning recently sent out an e-mail inquiry to companies in the athletics industry, asking if they offered any products or services related to antimicrobial protection. Each of the companies below either responded to the inquiry, or they prominently feature antimicrobial products on their Web site. This is not a comprehensive list, but it may be a helpful starting point for athletic departments in the market for antimicrobial products or services.
Adams USA www.adamsusa.com Exclusive distributor of Bac-Shield™ antimicrobial product for textiles and surfaces
American Dryer Corp. www.amdry.com AD 50 dryer with drying drawer for helmets and other equipment
Astroturf www.astroturfusa.com Synthetic turf with antimicrobial treatment
Clean Gear USA www.cleangearusa.com Athletic equipment sanitizing and reconditioning
CleenFreek® SportsHygiene® www.sportshygiene.com Antimicrobial towels, hand sanitizers, surface wipes, and equipment
Coatings Specialists Group www.csgsport.com Antimicrobial treatments for many applications, including surfaces, equip-ment, and facilities
Coretection Products Ltd. www.coretection.com Antimicrobial and antibacterial compression garments
Cramer Products www.cramersportsmed.com A wide selection of antiseptic ointments, antibiotic creams, and wound care products
Esporta Wash Systems, Inc. www.esporta.ca Cleaning, sanitizing, and reconditioning services for athletic equipment
Gear 2000 www.gear2000.com Z-Cool shoulder pads with 3-D Air Flow foam and antibacterial agents
Henry Schein, Inc. www.henryschein.com Antimicrobial cleaning products and sanitizers
Impact Protective Equipment www.impactpads.com Fully machine-washable athletic pads
Kendall Products www.dri-dek.com Self-draining interlocking floor tiles with antimicrobial properties
Kennedy Industries www.kennedyindustries.com Kenclean Plus athletic surface disinfectant and cleaner: kills MRSA and many other pathogens
Lonseal www.lonseal.com Synthetic flooring products treated with antimicrobial agents
Lyon Workspace Products www.lyonworkspace.com Lockers with an antimicrobial finish
Medco Supply Co., Inc. www.medcosupply.com Antimicrobial cleaning products and hand sanitizers
Molnlycke Healthcare www.hibigeebies.com/sports Hibiclens® antiseptic and antimicrobial skin cleanser
Mondo www.mondousa.com Synthetic sports flooring with antimicrobial properties
Mueller Sports Medicine www.muellersportsmed.com Whizzer® cleaner and disinfectant: kills MRSA, fungus, viruses, and many other pathogens
Preventec International, LLC www.germstopper.net A comprehensive approach to infection control and prevention
Reebok www.reebok.com Swimwear featuring an antimicrobial lining
Resilite www.resilite.com Mats with built-in antimicrobial technology
RG Medical Diagnostics www.rgmd.com Guardian Plus antibacterial hand sanitizer that won’t dry the user’s skin
Safe4Hours www.safe4hours.com Safe4Hours sanitizing skin lotion
School Health Corp. www.schoolhealth.com CleenFreek® antimicrobial cleaning product: kills MRSA, fungi, mold, and mildew
Shock Doctor www.shockdoctor.com Athletic equipment with SmartSilver™ antimicrobial and anti-odor technology
Silver Leaf Solutions www.silverleafsolutions.com Antimicrobial cleaning products
Speed Queen www.speedqueen.com/athletics Industrial washer and dryer systems
Spike Nashbar www.spikenashbar.com Liquid and powder cleansers for mats and other athletic surfaces
Sport Systems Canada www.sportsystemscanada.com Mats and wall padding treated with antimicrobial agents
SportPharm Enterprises www.sportpharm.com ICC Towel™ and Hand Rub™ antimicrobial products
Sports Hygienics, Inc. www.sportshygienics.com Antimicrobial treatment for equipment, facilities, laundry, and skin
Sports-O-Zone www.sportsozone.com Treatment for athletic equipment to kill MRSA and other bacteria, viruses, and mold
Stromgren www.stromgren.com FlexPad™ football compression girdle made with antimicrobial fabric
Taraflex® Sports Flooring www.gerflortaraflex.com Synthetic sports flooring with antimicrobial properties
Tec Laboratories, Inc. www.staphaseptic.com StaphAseptic pain relieving antiseptic gel
Tyco Healthcare/Kendall www.kendallamd.com Wound care products
UNX, Inc. www.unxinc.com Vanguard laundry detergent and Ally athletic equipment wash
TRAINING-CONDITIONING.COM T&C MARCH 2007 69
CASE STUDY
Methicillin-resistant strains of Staphylococcus aureus (MRSA) have become a serious clinical challenge. These community-acquired patho-gens are certainly capable of caus-ing quite serious disease (Moellering, 2006). Between 40 and 50 percent of Staphylococcus aureus isolates are resistant to methicillin (Kasper et al., 2006). Athletic trainers, along with all members of the health care community, are experiencing the challenges posed by MRSA. Like all health care profes-sionals, athletic trainers are evaluating prevention and treatment options to most effectively care for those who
make up their practice population. The challenge is serious.
We have long known that light, and particularly the ultraviolet (UV) spectrum of light, is capable of clearing skin ulcerations of microbial infestations. The use
of UV light, however, can be clini-cally difficult. Improper dosing can lead to ineffectiveness and/or harm to the patient. Realizing the potential value of UV, but fully aware of the clinical problems associated with it, Guffey and Wilborn (2006) examined the bactericidal effect of 405, 470, and 880nm light on Staphylococcus aureus and other organisms. In a lab setting, the 405nm light was found to yield a kill rate as high as 90 percent. Since 405nm light is within the visible spec-trum (yet outside the UV spectrum), the clinical risks are minimized. This work strongly suggests that 405nm light has a powerful bactericidal impact for common skin microbes and there-fore has significant clinical potential.
At least two studies are currently being undertaken to evaluate 405nm light in terms of its bactericidal effect
on MRSA specifically. This research is extremely important. Based on the Guffey and Wilborn (2006) results, there is reason to anticipate that light in the “blue” range will prove bactericidal against MRSA strains of Staphylococcus aureus. The instru-mentation to easily administer this treatment option already exists in the commercial market. We must all care-fully follow this research. Many who practice wound care have already begun to use light as a central part of their treatment protocols.
Therapeutic light is an emerging research area. We are beginning to match specific wavelengths of light to specific clinical applications. Instruments that safely and easily administer specific wavelengths are becoming available. The bactericidal potential of blue light is but one of the clinical applications that may soon be common. The future is bright.
Moellering, RC (2006). The growing menace of community-acquired methicillin-resistant Staphylococcus aureus. Annals of Internal Medicine 144: 368-370.
Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, Isselbacher KJ [eds.] (2005). Harrison’s Principles of Internal Medicine (16th edition), Chapter 120.
Guffey JS, Wilborn J (2006). Effects of combined 405nm and 880nm light on Staphylococcus aureus and Pseudomonas aeruginosa in vitro. Photomedicine and Laser Surgery 24: 680-683.
Guffey JS, Wilborn J (2006) In vitro bacte-ricidal effects of 405nm and 470nm blue light. Photomedicine and Laser Surgery 24: 684-688.
Blue Light and the Challenge of MRSA
By J. Stephen Guffey, PT,
Ed.D., President of Physical
Therapy Plus, Inc.
Dynatronics7030 Park Centre DriveSalt Lake City, UT [email protected]
Dynatron® 405
70 T&C MARCH 2007 TRAINING-CONDITIONING.COM
AQUATIC EXERCISE
AquaJogger800-922-9544www.aquajogger.com
AquaJogger® has introduced the new-est addition to its line of high-quality buoyancy belts. The Shape Pro model
was created with weight loss, athletic training, and injury rehabili-tation in mind. It offers imme-diate vertical
posture and lower-back support, as well as greater distribution of buoyancy. The Shape Pro is made of soft, durable, chlorine-resistant EVA foam. An adjust-able 48-inch black elastic belt with a side-release buckle is included. Longer lengths are available upon request.
Circle No. 511
NZ Mfg., LLC800-886-6621www.nzmfg.com
The StrechCordz line of swim train-ing products was designed by a group of competitive swimmers to improve
stroke, endurance, and strength. From in-water swimming tethers (the
StrechCordz Drag Belt/Tow Tether is shown), spa tethers, and grudge belts
to dry-land resistance training products, these items will meet the needs of both novice and serious swimmers.
Circle No. 512
Power Systems800-321-6975www.power-systems.com
Power Systems’ newest aquatic exer-cise equipment is made of non-abrasive closed-cell EVA foam and will not chip or absorb water. The Premium Water
Dumbbells are triangular in shape to offer variable resis-tance, and have textured grips
and removable end caps so they can be filled with water for added resistance. The Premium Water
Flotation Belt comfortably contours the body for long-lasting support, buoyan-
cy, and resistance. The Premium Water Cuffs can be used on the ankles or wrists to add buoyancy—not bulk—to water exercises.
Circle No. 513
Clean up your pool area and protect your equipment investment with the Power Systems Aqua Rack. This three-tiered rack can hold and trans-port most aquatic equipment by securely cradling the gear in mesh hammocks that allow for water run-off and ventilation. End posts can be used for hanging resistance tubing, swim bags, or towels. The Aqua Rack is constructed of sturdy two-inch PVC with swivel casters for smooth mobility. It measures 57” W x 29” L x 40” H and can easily roll through most doorways.
Circle No. 514
SwimEx, Inc.800-877-7946www.swimex.com
SwimEx has introduced a new motor-ized, integrated treadmill. When com-bined with the SwimEx wall of water, it creates one of the most challenging water conditioning workouts on the market today. Constructed of durable high-traction rubber with a non-cor-rosive frame, the treadmill is integrated into the SwimEx pool floor and features
variable speeds of up to eight miles
per hour, a speed indicator,
and a removable hand rail for optional support. Athletes enjoy high-intensity aquatic exercise in a low-impact environment.
Circle No. 515
SwimEx makes the only pool on the market today that combines a patented paddle-wheel water-propulsion system, molded fiberglass composite construction, multiple water depths, and built-in workstations to provide reli-able performance and a superior func-tional aquatic therapy session.
Circle No. 516Call For FREE Catalog • 800-752-2255 • www.fitball.com© 2007 Ball Dynamics International, LLC
FitBALL® Medballs with Strap:• Adjustable Straps • Substitute for Kettlebelltraining • Made of rubber - will bounce
FitBALL® Balance Trainer:• Holds shape for lunges • Inflatable and adjustable • Combines flat bottom and rounded top
FitBALL® SoftMeds:• Weighted balls with soft shell • Adjustablewith needle pump • Easy to grip
FunctionalTraining
Solutions• Power• Agility• Cardiovascular
Conditioning• Proprioception
FunctionalTraining
Solutions• Power• Agility• Cardiovascular
Conditioning• Proprioception
We’reMore
Than Just The #1
ExerciseBall!
We’reMore
Than Just The #1
ExerciseBall!
Untitled-6 1 2/19/07 3:17:45 PM
Circle No. 134
TRAINING-CONDITIONING.COM T&C MARCH 2007 71
NEW Product Launch
Unique features:
• Designed by athletic trainers, for athletic trainers• Swiveling spotter platforms and other features
make this line unique• The fi rst line of its kind from Nautilus
Benefi ts for the user:
• Intelligent XPLOAD design allows you to focus effort in the right place—on the workout
Nautilus877-657-7762www.nautilusXPLOAD.com
Circle No. 520
NautilusXPLOADRacks andPlatforms
Unique features:
• Aerodynamic design• Aluminum construction• Exclusive lateral handlebar• Powder-coated fi nish• Five different harness attachments
Benefi ts for the user:
• Develops explosive power• Offers two methods of resistive training:
Push and pull the sled
Gilman Gear800-243-0398www.gilmangear.com
Circle No. 519
Crab Sled
Perform Better800-556-7464www.performbetter.com
Circle No. 517
Swing Core TrainerUnique features:
• Hollow ball with inserted handles reinforced with PVC
• Available in fi ve color-coded sizesBenefi ts for the user:
• Ideal for gripping, throwing, or rotating• PVC inserts prevent the handles from fl attening
out during upper-body exercises• Ball sizes range from fi ve pounds to 14 pounds
with a nine-inch diameter
Rogers Athletic Co.888-765-3248www.rogersathletic.com
Circle No. 518
TredSledUnique features:
• Athlete drives non-motorized treadwhile braking system resists his movement
• Transforms workouts into competition• Allows maximum power on every repetition
Benefi ts for the user:
• Players improve ability to recover quickly be-tween plays
• Technique becomes second nature• Players grow accustomed to applying large
amounts of force in blocking/tackling positions
72 T&C MARCH 2007 TRAINING-CONDITIONING.COM
A D V E R T I S E R S D I R E C T O R Y
CIRCLE COMPANY PAGE CIRCLE COMPANY PAGE
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521 . . . Antibody . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
522 . . . AquaJogger (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
511 . . . AquaJogger (Shape Pro) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
500 . . . Bac-Shield (Adams USA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
523 . . . Ball Dynamics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
524 . . . Biofreeze/Performance Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
546 . . . California University of Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
525 . . . Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
508 . . . CleenFreek SportsHygiene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
526 . . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
527 . . . Dynatronics (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
545 . . . Dynatronics (Solaris D709) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
539 . . . efi Sports Medicine/Total Gym . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
528 . . . Gear 2000 (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
502 . . . Gear 2000 (Z-Cool Shoulder Pads) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
519 . . . Gilman Gear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
503 . . . Hibiclens (Molnlycke Health Care) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
530 . . . NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
531 . . . Nautilus (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
520 . . . Nautilus (product launch) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
512 . . . NZ Mfg. (StrechCordz) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
533 . . . OPTP (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
548 . . . OPTP (Kinesio Tape) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
549 . . . OPTP (White Foam Roller) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
529 . . . Perform Better (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
547 . . . Perform Better (PB Disc Pillow) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
517 . . . Perform Better (product launch) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
534 . . . Power Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
514 . . . Power Systems (Aqua Rack) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
535 . . . Power Systems (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
513 . . . Power Systems (Water Dumbbells) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
536 . . . Pro-Tec Athletics (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
542 . . . Pro-Tec (Ice-Up) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
518 . . . Rogers Athletic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
537 . . . Samson Weight Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
550 . . . Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
510 . . . Silver Leaf Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
501 . . . SportCoatings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
506 . . . SportPharm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
538 . . . Sports Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
507 . . . Sports Hygienics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
505 . . . StaphAseptic (Tec Labs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
551 . . . Stromgren (Basketball Girdle) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
504 . . . Stromgren (Flex Pad) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
516 . . . SwimEx (pool) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
515 . . . SwimEx (treadmill) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
532 . . . TurfCordz/NZ Mfg. (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
509 . . . Tyco Healthcare/Kendall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
540 . . . WerkSan Sports USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
541 . . . Whitehall Manufacturing (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
544 . . . Whitehall Manufacturing (moist heat) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
543 . . . Whitehall Manufacturing (ThermaSplint) . . . . . . . . . . . . . . . . . . . . . . . . . . 75
552 . . . Wobenzym N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
116 . . . Antibody (The BodyGuard) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
114 . . . AquaJogger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
126 . . . Bac-Shield (Adams USA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
106 . . . Biofreeze . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
115 . . . California University of Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
101 . . . Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
127 . . . CleenFreek SportsHygiene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
112 . . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
100 . . . CytoSport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IFC
136 . . . Dynatronics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC
134 . . . FitBALL (Ball Dynamics) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
102 . . . Gatorade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
129 . . . Gear 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
122 . . . Hibiclens (Molnlycke Health Care) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
121 . . . Hibistat (Molnlycke Health Care) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
107 . . . NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
103 . . . Nautilus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
105 . . . NSCA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
108 . . . OPTP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
104 . . . Perform Better . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
135 . . . Perform Better (seminars) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
119 . . . Power Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
117 . . . Pro-Tec Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
111 . . . Prossage Heat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
120 . . . Samson Weight Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
125 . . . Silver Leaf Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
128 . . . SportCoatings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
131 . . . SportPharm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
123 . . . Sports Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
133 . . . Sports Hygienics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
124 . . . StaphAseptic (Tec Labs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
130 . . . Stromgren . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
109 . . . SwimEx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
113 . . . TurfCordz/NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
132 . . . Tyco Healthcare/Kendall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
118 . . . WerkSan Sports USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
110 . . . Whitehall Manufacturing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
137 . . . Wobenzym N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BC
TRAINING-CONDITIONING.COM T&C MARCH 2007 73
CATALOG SHOWCASE
Antibody, Inc.401-581-0900www.antibodywear.com
Biofreeze®/Performance Health800-246-3733www.biofreeze.com
Dynatronics800-874-6251www.dynatronics.com
Ball Dynamics Int’l, LLC800-752-2255www.fitball.com
Creative Health Products, Inc.800-742-4478www.chponline.com
Perform Better800-556-7464www.performbetter.com
AquaJogger800-922-9544www.aquajogger.com
Cho-Pat800-221-1601www.cho-pat.com
Gear 2000, Ltd.785-625-6060www.gear2000.com
Gear 2000 offers a 16-page full-color catalog featuring the compa-ny’s lightweight Z-Cool line of shoulder pads with antibacterial foam systems. Also included in the catalog are Z-
Cool football accessories, Z-Cool per-formance apparel, and chin straps. The complete Gear 2000 line of moisture-management and air-release shoulder pads is illustrated in the catalog.
Circle No. 528
Cho-Pat designs and manufactures specific, innovative preventive and pain-reducing sports/medical devices for the arm, leg, and knee. Incorporating
unique design characteristics, excellent craftsmanship, and quality materials, the company’s products are effective, dependable, durable, and highly rec-ommended by medical professionals, physical therapists, athletic trainers, and athletes for their role in preventing or reducing pain and discomfort.
Circle No. 525
AquaJogger offers a 12-page color cata-log showcasing a full range of aquatic buoy-ancy belts, barbells, and aquatic footgear to meet all athletic training and rehabili-
tation needs. All products are shown complete with item numbers and descriptions to assist you in the proper selection of equipment to outfit your program. Call today for more informa-tion, or view the products online at the company’s Web site.
Circle No. 522
The new 2007 Rehabilitation Edition of the Perform Better catalog is a 40-page publication focus-ing on athletic train-ing products that help speed recov-
ery so that individuals can resume their normal activities. The catalog is neatly organized into 14 different categories, including Flexibility and Recovery, Balance and Stabilization, Strengthening, and Training Room Supplies. For your free copy, call today or visit Perform Better’s Web site.
Circle No. 529
Since 1976, Creative Health Products has been a leading discount supplier of rehabilitation, fitness, exercise, and athletic equipment, as well as health, medical, and fit-ness testing and mea-
suring products, all available at reduced prices. Creative Health Products offers heart rate monitors; blood pressure tes-ters; pulse oximeters; body fat calipers; scales; strength testers; flexibility testers; pedometers; exercise bikes; ergometers; fitness books and software; exercise bands; step benches; hand and finger exercisers; heating pads; and more.
Circle No. 526
Ball Dynamics’ catalog showcases its newly expanded FitBALL® product line. In addition to the FitBALL exercise ball—an industry-leading burst-resistant
fitness ball—new FitBALL profes-sional-quality products are available in a full range of training categories, including balance, strength, resis-tance, massage, mats, education, and more. Call or visit Ball Dynamics’ Web site today to order your free Ball Dynamics catalog.
Circle No. 523
Dynatronics manufac-tures, markets, and distributes advanced-technology medical devices, supplies, treatment tables, and rehabilitation equip-ment. The Dynatronics
catalog contains over 2,000 products offering unmatched technology and features at affordable prices. Spring 2007 marks the release of Dynatronics’ new product catalog. Look for new modular taping stations and innovative modalities that are essential for the rehab and athletic training markets.
Circle No. 527
Applied generously, Biofreeze® pain relieving gel and roll-on effectively relieves pain
from sore muscles, muscle spasms, strains, sprains, tendonitis, backaches, and sore joints. Biofreeze will also help minimize next-day aches and pains, and aid in reducing swelling and inflammation.
Circle No. 524
The patented BodyGuard line of compression sports-wear has revolutionized how muscle injuries are prevent-ed and treated. BodyGuard offers a unique combina-tion of muscle support and performance enhancement in easy-to-use, lightweight, comfortable sportswear products for the shoulder,
groin/thigh, knee, elbow, and ankle. The BodyGuard’s compressive energy transfer assists muscles in generating torque, reduces muscle vibration and tissue damage, delays muscle fatigue, and keeps muscles warm.
Circle No. 521
74 T&C MARCH 2007 TRAINING-CONDITIONING.COM
CATALOG SHOWCASE
NASM800-460-6276www.nasm.org
OPTP800-367-7393www.optp.com/ad
Pro-Tec Athletics800-779-3372www.injurybegone.com
TurfCordz by NZ Mfg., LLC800-886-6621www.nzmfg.com
Power Systems800-321-6975www.power-systems.com
Sports Health866-323-5465www.esportshealth.com
Nautilus877-657-7762www.nautilusxpload.com
Power Lift800-872-1543www.power-lift.com
Samson Equipment, Inc.800-472-6766www.samsonequipment.com
Since 1976, Samson Equipment has designed, manufactured, and sold heavy-duty industrial-strength weightlifting equipment to all five branches of the military, top high schools, col-
leges, and professional teams, health clubs, and recreational facilities all over North America, Europe, Asia, and the Caribbean. Samson’s equipment line includes a wide variety of freeweight racks and benches as well as selector-ized machines and plate-loaded equip-ment.
Circle No. 537
New Products 2007 is a brochure from Power Lift that includes the following new items: Uni/Bi-Lateral Leg Press, Full Body Squat, 4-Way Neck, Belt Squat, Uni-Lateral Bent
Over Row, the Performance Training Station, and the new Selectorized line. Featured Selectorized pieces are the seated chest press, incline press, shoulder press, seated bicep, seated tricep, lat pulldown, lateral raise, leg extension, and leg curl. For more infor-mation on Power Lift equipment, call the company or visit its Web site.
Circle No. 534
Nautilus offers a com-plete line of professional-quality strength and car-dio training equipment for high school and col-legiate athletic programs. The company has weight stack machines, plate-
loaded equipment, and a new line of racks and platforms. Nautilus also offers premium treadmills, bikes, elliptical train-ers, the legendary StairMaster StepMill, Schwinn Fitness indoor cycle bikes, and the new Nautilus TreadClimber cardio machine, which provides the cardio ben-efits of running at a walking pace. For more information, call today or visit the company online.
Circle No. 531
Sports Health, a divi-sion of School Health Corp., is a leading distributor of medical supplies and equip-ment to athletic train-ers, physical thera-pists, and other sports
medicine professionals. The company offers one-stop shopping for over 8,000 products, including taping sup-plies, trainers’ kits, defibrillators, qual-ity furniture, and training room sup-plies. Sports Health invites you to use its Web site to place your order online, access health information, and link to medical sites worldwide.
Circle No. 538
Power Systems is advancing physical performance with more catalog choices in 2007. This year, Power Systems introduces three new catalogs in addition to its Fitness Professionals and
Sports Performance catalogs. The new 104-page comprehensive catalog com-bines the Fitness and Sports catalogs into one convenient resource book. For specialized training, Power Systems now offers a soccer catalog and a strength catalog. With more than 1,000 innovative products and programs, Power Systems provides the quality you expect.
Circle No. 535
TurfCordz agil-ity and strength training products allow athletes to perform highly effective resis-tance exercises.
Used by leading professional football, baseball, hockey, and basketball teams for explosive start drills, power-building footwork exercises, and simulated play action, TurfCordz products offer versa-tility and performance. Also available are the top-quality MediCordz rehabili-tation products and StrechCordz swim training products.
Circle No. 532
Pro-Tec Athletics is a lead-ing sports medicine company specializing in ortho-
pedic supports and cryotherapy. The company offers unique and effective braces and supports for ligament, tendon, and muscle injuries. Pro-Tec’s newest introduction to the cryotherapy market is the Ice-Up portable ice mas-sager. Find out more at Pro-Tec’s Web site or by calling for a free brochure.
Circle No. 536
OPTP is an industry leader, providing qual-ity fitness and reha-bilitation products. For more than 30 years, the company has been building a worldwide reputation for offer-
ing excellent personal service, cut-ting-edge tools, and the resources that health and fitness professionals require. OPTP’s Volume 19 catalog features many new pages of Pilates products, foam rollers, and balance, core, and plyometric training tools and resources.
Circle No. 533
The online home of the National Academy of Sports Medicine (NASM) is newly redesigned and now includes an online storefront featuring more than 50 evi-dence-based edu-
cational health and fitness offerings. Professionals and students can view video samples of the NASM’s advanced specializations, the Performance Enhancement Specialist (PES) and the Corrective Exercise Specialist (CES). Because they are delivered entirely online, you can now try before you buy when you visit the NASM’s Web site.
Circle No. 530
TRAINING-CONDITIONING.COM T&C MARCH 2007 75
COMPANY NEWSHOT & COLD THERAPYCATALOG SHOWCASE
efi Sports Medicine/Total Gym®800-541-4900www.totalgym.com
WerkSan Sports USA877-WerkSanwww.werksanusa.com
Whitehall Mfg., Inc.800-782-7706www.whitehallmfg.com
Whitehall Mfg. pro-vides the health care industry with products of unsurpassed quality, functionality, and dura-bility. The company’s extensive experience in this industry pro-
vides great insight into the type of quality care necessary for patient reha-bilitation. This experience is reflected in the way Whitehall designs, manufac-tures, and supplies its products.
Circle No. 541
For safety and durabil-ity, count on WerkSan. WerkSan has a strong worldwide reputation for high-quality weight-lifting equipment. The company’s engineers are devoted to producing
safer, better-performing, longer-last-ing equipment. WerkSan is the official barbell of USA Weightlifting and is cer-tified by the IWF. The company stands behind its equipment: WerkSan bars are guaranteed for life and its bumper plates are guaranteed for two years from the date of purchase.
Circle No. 540
efi Sports Medicine® is a leader in functional training equipment. Its products are preferred by athletes and ath-letic trainers who want to enhance power,
strength, body composition, endurance, and range of motion. The company’s flagship product, Total Gym, uses body weight as resistance on a rolling incline glideboard and facilitates cable exercises in all planes of motion. With product attachments like the Closed Chain Platform, users can progress from unloaded rehab work to high-perfor-mance plyometric exercises.
Circle No. 539
Pro-Tec Athletics800-779-3372www.injurybegone.com
The Ice-Up portable ice massager by Pro-Tec Athletics stays frozen for up to 12 hours in a portable carrying cooler. You can take it anywhere to experience
the benefits of direct, active, immediate post-activity ice mas-sage. The Ice-Up is leakproof and offers effec-tive treatment
in five to seven minutes, not 15 to 20 minutes like passive ice packs. Enjoy quick deep-tissue relief for ligament, tendon, and muscle injuries. Immediate ice massage increases treatment effec-tiveness and speeds recovery.
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Whitehall Mfg., Inc.800-782-7706www.whitehallmfg.com
The ThermaSplint™ from Whitehall Manufacturing features dual voltage, an illuminated on/off switch, and quick heat-up time. The unit oper-ates on a solar-powered digital thermometer that allows the temperature to be adjusted with digital readouts for different splinting thermo-plastics. The ThermaSplint is construct-ed of heavy-gauge stainless steel.
Circle No. 543
Whitehall Manufacturing offers a complete line of moist heat-therapy treatment products that are conve-
nient and easy to use. Each heating unit is fabricated from heavy-gauge stainless steel and polished to a satin finish. Standard features include a snap-off thermal protector that pre-vents overheating
and a rounded bottom that minimizes bacteria build-up. The heating units are available in various sizes and colors.
Circle No. 544
CytoSport’s Nutritional Supplements Offer Time-Tested Quality
CytoSport was founded in 1998 and since that time has grown into apremier manufacturer of sports-orient-ed nutritional products that address the needs of athletes and active-life-style individuals at every level. With every product and every decision, quality, taste, and the athlete are at the forefront.
That’s why the Muscle Milk Collegiate line is rapidly becoming a key addi-tion to many weightrooms across the country, because they work. Taste, quality, and efficacy… what more can you ask for?
The motto at CytoSport is “Driven by Science—Inspired by Performance.” Thanks to athletes everywhere for the inspiration!
CytoSport, Inc.4795 Industrial WayBenicia, CA [email protected]
CEU QUIZ
76 T&C MARCH 2007 TRAINING-CONDITIONING.COM
T&C March 2007Volume XVII, No. 2
Training & Conditioning is pleased to provide NATA and NSCA members with the opportunity to earn continuing educa-tion units through reading issues of the magazine. The following quiz is based on articles that appear in this issue of Training & Conditioning. By satisfactorily completing the quiz and mailing it to MAG, Inc., readers can earn 2.0 BOC Athletic Training and 0.2 NSCA (two hours) continuing education units.
Instructions: Fill in the circle on the answer form (on page 78) that represents the best answer for each of the questions below. Complete the form at the bottom of page 78, include a $20 payment to MAG, Inc., and mail it by April 30, 2007 to the following address: MAG, Inc., ATTN: T&C 17.2 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850. Readers who correctly answer 70 percent of the questions will be notified of their earned credit by mail no later than May 15, 2007.
Winning and Losing (pages 13-18)Objective: To understand how athletes can lose weight safely during their competitive season.
1. What are the guidelines for in-season weight-loss?a) Starting immediately with a goal of losing three pounds
per week.b) Communicating often, starting immediately and keeping
it gradual.c) Implementing a low-calorie diet and beginning as soon
as possible.d) Waiting until the season is over.
2. What are the symptoms of excessive caloric restriction?a) Dry skin and brittle nails.b) Increased injury or illness, poor recovery, and decreased
performance.c) Water retention and easy bruising.d) Sunken eyes and decreased blood pressure.
3. Amenorrhea leads to:a) Increased risk of low bone mineral density and increased
fractures.b) Increased blood pressure and decreased RBC count.c) Loss of sleep and adequate REM.d) Poor protein absorption.
4. Reducing caloric intake by what percentage is recommended for an athlete trying to lose weight?
a) 5-10.b) 10-20.c) 20-30.d) 35.
5. The following may slow metabolism and deplete energy levels:a) Low carbohydrate diets.b) Low fat diets.c) Bingeing.d) Skipping meals.
6. In regard to in-season weight loss, sports drinks:a) Are the first item that should be eliminated from the diet.b) Are high in sugar and considered “empty” calories.c) Provide a small amount of energy and help delay fatigue.d) Improve weight loss.
7. An athlete’s diet should:a) Increase carbohydrates throughout the season.b) Encourage weight loss of 3-4 pounds per week.c) Have carbohydrate intake match the training level.d) Expect some fatigue and energy depletion.
The Better to See (pages 24-29)Objective: Learn about the latest developments when it comes to athletes’ vision repair and enhancement.
8. Before Wavefront-guided software, a complication of Lasik surgery was:
a) Blindness.b) Detached retina.c) Pain.d) Night vision problems.
9. Why is the hybrid lens beneficial?a) The cost is lower than other lenses.b) There is no diminished vision under the lights or at dusk.c) They may be worn for three weeks at a time.d) They are implanted and remain as long as necessary.
10. When are phalic intraocular lenses a good alternative?a) When Lasik or PRK has previously failed.b) When the patient wants to avoid all risks of surgery.c) When the patient’s corneas are too thin for Lasik surgery.d) When a stigmatism is present.
11. Lasik surgery may not be the best choice for those:a) Requiring highly accurate vision.b) Involved in daytime sports with glare from the sun.c) With risk of being hit in the eye.d) Involved in water sports.
12. How is PRK different from Lasik?a) PRK does not involve cutting a permanent flap in the
cornea.b) The long-term results are different.c) There is less pain with PRK than with Lasik.d) Vision corrections are much better with PRK than Lasik.
13. Sports vision training enhances:a) What an athlete can see.b) How far an athlete can see.c) How an athlete sees.d) Visual acuity.
14. Sports vision training may include ocular flexibility, which is defined as the:
a) The ability to move one’s eyes inward (convergence) or outward (divergence) when following a target.
b) Process of information regarding the shape and direction of an object.
c) Ability to judge the distance between themselves and the object.
d) Ability to fixate their eyes properly on a target.
TRAINING-CONDITIONING.COM T&C MARCH 2007 77
15. Another component of sports vision training may include visual recognition, which is defined as:
a) The ability of the eyes to process information regarding the shape and direction of an object and then make cor-rect motor movements to adjust to it.
b) Accurately and quickly moving the eyes forward and back in each direction.
c) The ability to fixate the eyes properly on a target.d) The ability of the eyes to move properly when tracking
objects.
Ready for Prime Time (pages 30-35)Objective: Learn how one baseball pitcher made it from the minors to the major leagues through a specialized rehab and training program.
16. The goal of the Corrective Exercise Training (CET) phase is to do what?
a) Improve core stabilization.b) Inhibit overactive muscles that were causing movement
compensations.c) Improve muscle firing recovery.d) Improve endurance.
A Strong Season (pages 37-42)Objective: See how the University of Wisconsin’s strength and conditioning coach for men’s basketball keeps the team in top shape through a season of scheduling hurdles.
17. The University of Wisconsin lifts weights approximately how many minutes per session during the second half of their season?
a) 15-20.b) 20-29.c) 30.d) 50.
18. To remain as efficient as possible during the late season, the athletes:
a) Lift one day per week.b) Use pairing exercises in which they alternate upper-body
lifts with lower body lifts.c) Lift prior to practice.d) Only lift on Sundays and Wednesdays.
19. Which is an example of emphasizing sports specific and position specific activities?
a) Post players that perform more overhead passes focusing on overhead throws using a medicine ball.
b) Perimeter players dribbling a lot so they will perform resisted knee extensions.
c) Lifts involving squatting positions to improve defensive stance.
d) Increased repetitions and decreased speed during late-season lifting.
Are You Protected? (pages 43-49)Objective: Get a comprehensive update on how MRSA is invading locker rooms across the country, and learn what you can do to prevent an outbreak at your school.
20. The key to controlling MRSA is:a) Using Amoxicillin or Penicillin as early intervention.b) Identifying MRSA as quickly as possible.c) Washing the skin thoroughly and on a daily basis.d) Performing cultures of cuts and scrapes one week after
they occur.
21. MRSA infection typically begins as:a) An ingrown hair.b) A bug bite.c) A skin lesion containing a pustule.d) A swollen area.
22. The CDC estimates that what percentage of the U.S. population is colonized with staph?
a) 10-15.b) 15-25.c) 25-30.d) 30-35.
23. What is one way athletes can minimize their exposure to MRSA?
a) Washing regularly with antibacterial soap.b) Only showering once they get back to their dorm room
after practice.c) Keeping their pads separated by placing them in lockers
or gym bags.d) Washing all fruits and vegetables prior to eating them.
24. Stanford did the following to address the spread of germs and infection:
a) Used an alcohol-based hand sanitizer on each athlete after practice before they were able to enter the locker room.
b) Provided each athlete with a bar of soap.c) Provided each athlete with a towel.d) Used an antibacterial air spray.
25. When Stanford had a MRSA outbreak last fall, they decolonized the infected players by:
a) Using Amoxicillin in high doses.b) Destroying all of their equipment and gear.c) Having those infected shower with Hibiclenz soap and
use Bactroban ointment in their nasal passages.d) Having athletes stay home until the infection cleared.
Answer sheet is on page 78
CEU QUIZ ANSWER FORM
78 T&C MARCH 2007 TRAINING-CONDITIONING.COM
Instructions: Fill in the circle on the answer form below that represents your selection of the best answer for each of the previ-ous questions. Complete the form at the bottom of this page, include a $20 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 17.2 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850, no later than April 30, 2007. Readers who correctly answer 70 percent of the questions will receive 2.0 BOC Athletic Training and 0.2 NSCA (two hours) CEU’s, and will be notified of their earned credit by mail no later than May 15, 2007.
Last Name ____________________________________ First Name _______________________________ MI______
Title ______________________________________________________________________________________________
Mailing Address ____________________________________________________________________________________
City ________________________________________________ State _________ Zip Code _____________________
Daytime Telephone ( _________ ) ________________________________________
E-Mail Address ____________________________________________________________________________________
Payment Information
❏ $20 check or money order (U.S. Funds only) payable to: MAG, Inc. (please note “T&C 17.2 Quiz” on check)
❏ Visa ❏ Mastercard ❏ Discover ❏ American Express
Account Number _______________________________________________ Expiration Date ____________________
Name on Card _____________________________________ Signature ______________________________________
A B C D A B C D
Winning and Losing 1. ❍ ❍ ❍ ❍
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Ready for Prime Time 16. ❍ ❍ ❍ ❍
A Strong Season 17. ❍ ❍ ❍ ❍
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19. ❍ ❍ ❍ ❍
Are You Protected? 20. ❍ ❍ ❍ ❍
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ADDITIONAL EDUCATIONAL PROGRAMS
TRAINING-CONDITIONING.COM T&C MARCH 2007 79
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2007LEARN-BY-DOING SEMINAR SERIESLEARN-BY-DOING SEMINAR SERIES
For More Information Call 800-556-7464
Request Your 2007PERFORM BETTER Catalog
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• Complete quizzes found in the NSCA’s Strength & Conditioning Journal
• Complete online quizzes at www.nsca-cc.org
EARN BOC CEUs
Toll-free: 888-746-2378 I Online: www.nsca-cc.org E-mail: [email protected]
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80 T&C MARCH 2007 TRAINING-CONDITIONING.COM
MORE PRODUCTS
Dynatronics800-874-6251www.dynatronics.com
The Solaris D709 offers ultrasound, seven stim waveforms, four optional infrared light probes, and an unat-
tended light pad, making it one of the most power-
ful and comprehensive devices in the industry. It features a battery-powered option for portability, and it is capable of providing TENS, MENS, NMS, high-voltage, interferential, direct current, biphasic, and Russian treatments. A timer is included, and the product is protected by a two-year warranty.
Circle No. 545
California University of Pennsylvania
866-595-6348www.cup.edu/go
California University of Pennsylvania’s Global Online programs offer an exceptional 100-percent online learn-ing experience with the convenience of an asynchronous format. Complete your coursework from anywhere, at any time that’s convenient for you—all you need is a computer and Internet access. For more information on Cal U’s Global Online programs, call or go online today.
Circle No. 546
Perform Better800-556-7464www.performbetter.com
Using a PB Disc Pillow can strengthen the muscles that stabilize an athlete’s ankles, knees, core, and shoulders.
This product is a ter-rific aid for developing joint stabilization and balance. Use one disc for single-leg exer-cises and sit-ups, or multiple discs for dou-ble-leg exercises and push-ups. These soft, unstable discs are 14 inches in diameter and can be found in the 2007 Perform Better
catalog. Get your free copy by calling the company or visiting its Web site.
Circle No. 547
OPTP 800-367-7393www.optp.com/ad
Kinesio Tape is specifically designed to be worn for extended periods of time, and during strenuous exercise or hydrotherapy. The adhesive is heat-activated and will not leave residue when the tape is removed. Kinesio Tape is latex-free and has an elasticity of 140 percent, matching the basic elasticity found in skin. As a result, it works comfortably and effectively with the athlete’s body. Get your free OPTP catalog by calling the company or vis-iting its Web site.
Circle No. 548
For many years now, OPTP has been a leading supplier of quality foam rollers. The newest addition to the company’s wide selection is the 18” x 6” Standard White Foam Roller. Made from the same material as other OPTP Standard White Foam Rollers, this new size makes it easier than ever to find the perfect roller for your needs, while still maintaining the same high quality you expect from OPTP foam rollers. Its size makes it ideal for self-massage, balance, and core stabil-ity exercises. Larger than the 12” x 6” roller and less cumbersome than the 36” x 6” roller, it is a favorite among runners and other athletes who perform IT band work. OPTP also carries foam roller exercise books, videos, DVDs, and more. Visit www.foam-roller.com to learn more.
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Save-A-Tooth888-788-6684www.save-a-tooth.com
Every year, 800,000 teeth are knocked out during sports activities, and only 10 percent of athletes consistently
wear mouth-guards. Knocked-out teeth begin to die within 15 minutes. Save-
A-Tooth can preserve and nourish knocked-out teeth for up to 24 hours and give athletes a 91-percent chance
of saving their smiles. Save-A-Tooth was developed by a sports dentist and professor at a leading dental school. Its scientifically proven six-component system includes a cell-preserving solu-tion and a suspension-and-removal basket that protects and saves tooth root cells. Save-A-Tooth is found in every Olympic medical bag. Visit the company’s Web site to learn more about knocked-out teeth and how Save-A-Tooth can help.
Circle No. 550
Stromgren Supports800-527-1988www.stromgren.com
Stromgren’s Basketball Girdle is a compression short with FlexPad™ pro-tective pads for the hip, tailbone, and thigh areas. FlexPad protective pads are lightweight, closed-cell, impact-absorb-ing EVA foam pads that are laundered into the fabric to provide a unique combination of pro-tection and perfor-mance. Also known as the “Bangin’ Machine,” this girdle is designed to help reduce injuries from aggressive play by absorbing impact, while also providing maximum com-pression and moisture management. As a new feature for 2007, it now fea-tures antimicrobial fabric.
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Wobenzym888-766-4406www.wobenzym.com
Let Wobenzym®N, the clinically validated enzyme formula for sports injuries, work for your patients and your reputation. Its proven bio-active enzymes get both elite athletes and
weekend warriors back into action more quickly and safely than ordinary non-steroidal anti-inflam-
matory drugs (NSAIDs) and corti-costeroids. During the
recent world soccer championships in Germany, several teams used Wobenzym®N with their athletes, and it helped get the world’s most elite soccer players back onto the field more quickly.
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706• Light therapy• 5 channels of electrotherapy• 7 stim waveforms
Accessories
• 3 channels (2 pads & 1 probe)• Generating a total of 16,000 mW of light
• Light therapy• 5 channels of electrotherapy• 7 stim waveforms • 3 frequency ultrasound
XP “Hands-Free” Light Pad (7,500 mW)
880plus Light Probe (1,000 mW)
880plus Light Probe (1,000 mW)
405 Blue Light Probe (500 mW)
XP “Hands-Free” Light Pad (7,500 mW)
Choose from a wide varietyof optional light accessoriesranging in power from 500mW to 7,500 mW.
880plus Light Probe (1,000 mW)
880plus Light Probe (1,000 mW)
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No other manufacturer offers so much exibility!
With the revolutionary Dynatron Solaris series,
you’ve got optionsand lots of them!
Dynatronics offers 7 different light therapy
units, 4 different light probes and an
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Dynatron SolarisDynatron SolarisYou’ve Got Options!You’ve Got Options!
Call today for more information
(800) 874-6251
™
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†These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
for the winning edge.™
Used by professional athletes to:
• shorten recovery time*• improve joint movements*• reduce muscle pain*• reduce swelling, immobility and tenderness*
Let Wobenzym®N, the clinically validated enzyme formula for sports injuries, work for your patients and your reputation. Its proven, bio-active enzymes get both elite athlete and weekend warrior patients back into action more quickly and safely, with less time on the sidelines due to injury, than ordinary non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. In Germany, Wobenzym®N is the second leading over-the counter brand, next to aspirin.
Recently, during the world soccer championship in Germany, several teams used Wobenzym®N for their participating athletes.
©2006 N
aturally Vitamins, a M
arlyn Nutraceuticals, Inc., Com
pany. Wobenzym
®N is a registered tradem
ark of Mucos Pharm
a Gm
bH, G
ermany.
*Wobenzym®N OTC Pain Relieving Crème: NDC31793-014-60. Wobenzym®N Tablets: a dietary supplement.
To learn more about Wobenzym®N, please visit www.wobenzym.com.
To receive a free sample of Wobenzym®N Crème,please call our customer service representative,
Sara @ 1-800-899-4499 ext. 427
(But, in the long-run, NATURAL is better for your patients and your reputation.)
For the short-term,anti-inflammatory drugs may be fine.
Wobenzym®N
t&c_ad.ai 8/14/06 12:18:00 PM
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