Sports Specific Movement?

Nikki and I did a "core" talk for a Vanderbilt Athletic Trainers camp. The attendees were all high school kids and I was very much amazed by how much they already know about movement.

We spoke about what is the core, what it entails and the main function of the core. These kids all picked up very quickly. We spoke about the crunch and the plank and the difference between the two. We talked about how important it is to train, not only the front of the core, but the lateral sides as well as the backside.

At the end of the day alot of the questions were asked about, "I am in this sport" what should I do? It is pretty simple actually. The majority of sports all have the same fundamental movement patterns. EVERYONE should train the squat, the deadlift, the lunge, the push up, the pull up, some type of vertical press and some type of horizontal pull.

You should train what you are not good at and maintain the movements that you have already mastered. Simple as that.

My Proud Little Soldier Alex

Alex came to VOI in September of 2008 referred by her MD for physical therapy for tendonitis on both Achilles tendons. She is a Level 7 gymnast and had not participated in gymnastics since July of 2008. Before she stopped due to pain, Alex was practicing an average of 4 hours per day 5-6 days per week.

She was seen by Shane, a licensed physical therapist in VOI and she spent the next 7 weeks working with Shane on getting her inflammation eliminated and was then passed onto myself for a Functional Movement Screen to determine her readiness to return to gymnastics.

I met with Alex and her mother and took her through the functional movement screen. Here were her results: (0=pain, 1=unable to perform, 2=movement performed but with asymmetry, 3=movement performed with required technique)

Test
-Overhead Squat=2

Total Score=0

Pain in R hip

-Hurdle Step L leg over=2
-Hurdle Step R leg over=2

Total score=2

-Inline Lunge L foot forward=0

-Inline Lunge R foot forward=0

Total Score=0

Pain in both knees with movement

-Shoulder mobility, L arm behind
head, R arm behind back=2
-Shoulder mobility R arm up, L
arm behind=3

Total Score=0

due to L Sh pain with clearing test

-Active Straight Leg Raise L=3
-Active Straight Leg Raise R=3

Total Score=3

-Trunk Stability Push Up=3

-Rotary Stability Test L=2
-Rotary Stability Test R=2

Total Score=2

Total Overall Score 7/21

Alex had pain with the squat, lunge, and shoulder mobility. The funny thing was that she had no present pain in either of her Achilles but had hip, knee and shoulder pain during the screen. What was found during the screen was Alex demonstrated that she needed to improve on her thoracic spine mobility as well as her dynamic stability of all her joints.

In plain English, Alex just lost the ability to fire her stabilizing muscles at the correct times when she performed dynamic movements. Thus the load was taken in other areas including her joints and tendons. A rule with the functional movement screen is to work on mobility before stability. So the scores were reviewed with her mother and they both decided to meet with me one time per week for 4-5 weeks and then rescreen. She was asked not to return to gymnastics until she can perform the screen pain free and with no scores of 0 or 1.

Then we performed 4 total 60 minute workout sessions with exercises designed for her to improve on thoracic mobility and then practice using the stabilizers of her hips, trunk and shoulders to work in unison to perform the movement properly and pain free. Every week she was given new “homework” which meant stretches and exercises that would help her to progress to the next level.

Every session came with a quick assessment of her mobility followed by a chat on how her exercises were going and if she had any questions. Her first “aha!” moment came in the second session when she tried to perform a lunge and felt pain in her knees. Then we practiced with a band that required core activation which was pain free. After that set, I asked her to perform the lunge again but to pretend that she was still pulling on the band. Guess what! She had no pain with the movement and her lunge looked much better.

He continued with this aspect over the next few weeks and then had her come in for her follow up FMS in January after the holidays were all done and finished. This is how she scored.

Test

-Overhead Squat=2

Total Score=2 (pain free)

-Hurdle Step L leg over =2
-Hurdle Step R leg over =2

Total Score=2

-Inline Lunge L foot forward =2

-Inline Lunge R foot forward =2

Total score=2 (pain free)

-Shoulder mobility, L arm behind
head, R arm behind back =3
-Shoulder mobility R arm up, L
arm behind =3

Total Score=3

-Active Straight Leg Raise L 3
-Active Straight Leg Raise R 3

Total Score=3

-Trunk Stability Push Up=3

-Rotary Stability Test L =2
-Rotary Stability Test R =2

Total score=2
Total Score 17/21
Not only was she able to move pain free with all tests, but she moved so much better than she did 6 weeks prior. She was now allowed to work back into gymnastics as tolerated and given a final worksheet of things to continually work on to keep her healthy.

I was just recently informed by Alex’s mother that she performed her first meet on 2/28 after 6 months of no gymnastics and finished 4th in the all around, the next two meets in March she finished first in the all around. And finally, at the state meet she won 1st place on floor and vault, third place on bar, ninth place on bean and fifth all around for level 7 in the state of Tennessee! Way to go Alex!

Training for Runners for Improved Performance & Injury Prevention- Part 2 - Self Assessment

The first thing you SHOULD do if you are going to train the RIGHT way towards your race is to perform a individual body assessment. This assessment is a way to try and determine if muscle imbalances are present within you body. Trust me those imbalances are there. Some are hidden deep within your body, some are more apparent. These imbalances may not be noticeable now but during your training those mild imbalances might pop up at any time and bite you right in the ass (sorry to be harsh, but that is what it feels like).

When I perform the Functional Movement Screen (FMS) it consists of seven total tests and usually takes me a total of 20-30 minutes to be able to determine what muscular imbalances exist and the best way to tackle them. EVERY runner should have a FMS performed once per year. This is the type of screen they run at Athletes Performance Institute for all of their athletes and many pro & college teams take all of their athletes through the screen at least once per year. (To learn more about it and to find FMS certified specialists in your area, check out www.functionalmovement.com)

I am going to explain to you an assessment you can perform on yourself to give you some idea of what muscle imbalances you might be dealing with.

SINGLE LEG STANCE

Stand in front of a mirror and place one foot straight ahead and pick the other leg up so you are flexing your hip, knee and ankle joint to a 90 degree angle.


Hold that pose for 60 seconds, then perform the exercise on the other side.

Note if you are having trouble anywhere. Can you hold the 90/90/90 position for the whole time without losing your balance? 

Were you able to hold the position with your waist line level and the hip, knee, and foot all in a straight line?

Most people have some problems arise in this position. 1-they cannot keep their balance, 2- their foot rotates outward towards their body, or 3- they cannot keep their thigh parallel to the floor.

How did you grade on one side compared to the other? Was one side fairly easy but the other side was completely difficult? If the answer is yes, then I am afraid you have a significant muscle imbalance present within your body. This imbalance needs to be cleared up before you start getting into heavy mileage.

LUNGE

Again in front of a mirror or better yet have someone video record you performing a stationary lunge. Keep both feet pointing straight ahead and take a large step out in front. Now in that position with good posture, drop the back knee to the floor and touch lightly and come back up. Perform about 6 reps each side if you can.

How did you do? Did you have trouble keeping your balance? Did either of your knees move in or out to help stabilize you? Did either of your feet turn outward in an attempt to provide you with more stability? This will be what happens when you are running, especially when you get tired or "hit your wall".

STRAIGHT LEG RAISE

lay down on your back in a doorway. Have the doorway line up directly middle the distance of your thigh muscle. Both toes pointing towards the ceiling.


Now place a rolled up towel underneath your knee joint on one leg

The leg that has the towel placed underneath your knee you are going to try and keep your foot, knee and hip all in a straight line and pressure onto the towel roll. With the other leg you are going to lift it as high as you can without bending your knee or losing a straight line with your foot, hip and knee

Were you able to get your heel on the up leg past the doorway without having to cheat on either leg? No? Then were you able to get your heel past your knee joint of the down leg?

How was one side compared to the other?

Next stand up and try and touch your toes without bending your knees. Was it easy or hard? Were you able to perform it?

Which one of these tests did you do the absolutely worst at? Better yet, was there one side that you rocked on and the other side was terrible? Then that is the movement you need to improve to make you a better/less injury prone runner.

Why are these movement important to running? Let me tell you.

SINGLE LEG STANCE-this movement mimics a runners actual running gait. The exercise helps to test stabilization on one leg while it is in a weight bearing position (closed chain), while the other leg is stabilizing in a non-weightbearing position. If you had trouble balancing on the down leg or have trouble keeping the up leg in proper alignment then the test is telling you that you will not be running with optimal technique and are subject to problems developing due to this imbalance. Now think about how many times you run... If each time you step you perform it wrong think how that adds up. Think of it this way. What would happen if you hit 10,000 golf shots incorrectly one right after the other? This is the same thing only with running.

LUNGE-the importance of the lunge is that your body is trying to use its stabilizers during the movement but now the exercise is more dynamic than the single leg stance assessment. Now your body also has to resist a rotational force put upon your body. This helps to tell if your muscles can dynamically stabilize while you are moving

STRAIGHT LEG RAISE- Many of you probably think that this is a test of how flexible your hamstrings are. It is to an extent. Actually your hamstrings don't usually get "tight" they just get overused alot. This is a great test to see how one leg can stabilize while the other is moving dynamically and stabilizing as well. Yes the hamstring needs to work correctly and be able to lengthen. But sometimes the hamstring is not the one to be blamed, at times it is a tight hip flexor on the opposite side.  This is why I have you try and touch your toes after performing the test.  If you were able to do so with not too much trouble then it is not the hamstring to blame.

If you are not all too sure which movement/assessment was the worst then start with the straight leg raise and move your way to the single leg stance and finally the lunge. Feel free to video record yourself and send it to me. Probably the best way to do this is sign up for a youtube account and upload the video and then send me the link to it.

Need more?  Feel free to contact me at mark.snow@vanderbilt.edu and ask about the Injury Prevention & Human Performance Program (IPHP).   There are also package options available that can either include a FMS screen and 30 minute corrective exercise session or you can also get 60 minute workout sessions as well. 

Not close enough to be screened?  You can again check the FMS directory at www.functionalmovment.com.  Other resouces include: the Atheltic Body in Balance by Gray Cook which includes a more specific self screen procedure (5 movements) or Core Performance for Endurance Athletes by Mark Verstegen. 

The active straight leg raise and lunge were taken from the Functional Movement Screen developed by Gray Cook and Lee Burton.  The Single Leg Stance test was taken from the Core Performance for Endurance Athletes by Mark Verstegen.