Systematic Core Training for the Junior Athlete

I was one of the speakers at the Building a Better Athlete Summit: A Strength and Conditioning Summit for Middle & High School Coaches and Personal Trainers at the Park School in Brookline this past weekend. Mike Reinold, Jen Brickey and Susan Altman joined me as presenters. Mike’s session was Preventing Injuries and Enhancing Performance in Overhead Athletes, Jen spoke on Training the Female Athlete and Susan’s topic was Fueling the Athlete.

My session was titled Systematic Core Training for the Junior Athlete. Low back pain might not be as prevalent in the youth population, but dysfunction in the core region of the body most certainly is. From growth spurts, to poor and prolonged sitting posture in school, to nutritional triggers to over and under training there are many factors that can prevent the center of a young person’s body from working optimally.
Some challenges exist when programming for the junior client, especially if they are working in groups instead of 1:1. Complicated techniques are often ineffective. Try and keep things simple and fun, probably good advice for working with the adult population too. I also find that the younger athletes are more run down at the end of the school day compared to adults at the end of the work day. Maybe it is a nutritional deficit or just the fact that they are kids and need some down time.
I find better results easing into the program with some Self Myofascial Release (SMR), flexibility
or diaphragmatic breathing. However there are the times when working with groups of 8-12 year olds that I need to get them moving ASAP for everyone’s sanity. Scientific program design gets bent a bit when 15 hyper tennis players wound up from a long day at school and a hard session on court get dumped into your lap for some fitness training. I can see why my old coaches or P.E. teachers made us take the seemingly arbitrary “lap”. I know they weren’t texting, tweeting or posting pics on Instagram. They were probably just taking a deep breathe and trying to settle us down a bit.
Ideally I follow this flow:
1-SMR
2-Static Stretching/Mobility
3-Core Stability
4-Dynamic Flexibility and then either SAQ, Conditioning or Resistance Training, sometimes all three depending on the situation.
The basics work. Teaching pelvic tilts, finding neutral, creating congruity between the pelvis and the ribcage and then practicing disassociating the; spine from the pelvis, the pelvis from the hip, the spine from the humerus and the humerus from the scapulae from different positions with progressive acute variables is the plan.
Acute variables can be sets, reps, rest, tempo, recovery etc.
Body positions can include; prone, supine, quadruped, 1/2 kneeling, tall kneeling, split stance, standing and single leg.
Proprioceptive modalities (balance toys) can be used judiciously. Form and technique dictate all. If there is a slight wiggle, shaking, learning or subtle instability let the athlete continue to learn. If they are flailing or can not can control of their pelvis, ribs etc. regress the exercise.
Once there has been some neuromuscular “uptake” and activation, you can improve endurance, strength and conditioning of the core. Then you can get them moving, lifting and training with greater efficiency and lower risk of injury.
Thanks for reading!
Eric Beard
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TOPO Train//RX Shoe Review: Stability and Mobility?

TOPO
What? TOPO Athletic is a footwear company. To learn more about them and their mission check out their website.
I am posting tonight to share my experiences with a pair of their shoes the Train//RX.
I have worn a handful of minimalist shoes over the last few years and have personal experience comparing and contrasting several brands and models. With anything I have found pros and cons with each of them.
The Train//RX at first glance looks like many of the shoes on the market that have a toes or toes separated from each other. However, the Train//RX is quite unique. The big toes are separated from the other four toes in the shoe. Not for bad behavior or anything like that, but to promote natural foot mechanics similar to the Japanese Tabi shoe. This approach is supposed to provide greater agility and connectivity to the ground. It does requires special socks, courtesy of Injingi.
When looking for a shoe the three basics that I look for are; zero drop, a wide toe box and minimal arch support. The “drop” of a shoe refers to the difference in height between the heel and the forefoot. Most shoes have an elevated heel, even the ones that you don’t expect like Nike Free for example. These kicks have zero drop. The toe box is the front of the shoe. It is where the toes live and many shoes are restrictive and do not let the forefoot and toes move properly during gait. Topo’s “Anatomic Toe Box” does just the trick. In regards to arch support, I prefer a non invasive shoe that let’s me pronate and supinate naturally though the foot. I found that to be the case with the Train//RX.
I eased into my “RXs” wearing them first while I worked with a couple of clients one day.  Then I sported them for a couple of flexibility, core and upper body workouts over the next few days before moving to total body and leg training workouts. Within minutes of putting the shoe on for the first time I felt greater activation of my left VMO and left hip lateral rotators. I was not expecting this over such a short period of time. I have pretty good self awareness, but didn’t realize I needed that. It felt good!
Over the next couple of bouts wearing the shoes, weird, but the my big toes had some separation anxiety from the other toes. Now I regularly wear other minimalist shoes that separate each individual toe, but this was different. During the first two times I wore them the medial aspect of each big toe almost felt aggravated form rubbing against the material but by the third time I wore them, that sensation disappeared. It was almost as if the big toe was accepting the new position, mobility and support the individual slot was providing it.
This next part sounds hokey but from the minute I put them on I wanted to run, jump, climb, pounce, explode! I felt the urge to move and felt more athletic. I kept the horse in the barn for the first few days mainly because I had a few ice hockey games to play in and wanted to have fresh legs on the ice. I also like to take my time getting used to changes in footwear without progressing to sharply in duration of usage, frequency or application of load.
When I did train total body and legs I felt great. My lifts or vertical leap did not shoot up, but I felt great. During walking lunges my back foot stayed straighter. My feet gripped the ground. My hips got better activation. Landing multiplanar plyos felt easier too. I did truly feel more connected to the ground and I didn’t read that as a claim from Topo until after the workout.
I liked that there was something between me and the floor. There is a time and place for being barefoot like running on the grass or playing in the sand etc but in the gym with a thin-ish rubber mat over a concrete floor, I like to have some cushioning. I don’t want to be bouncing or floating, but something to make the unforgiving concrete…well…more forgiving.
Not only did I feel great, but the shoe felt great. You can tell it is well made. The seams, the breath-ability, the edges of the shoe that contacts the skin around the calve and side of the ankle were all comfortable. It is sturdy. The laces are thicker and seem like they will hold up through gym based workouts, outdoor runs and adventure races. I am not sure that I would want to be wearing the RXs for a full workday however. I am not sure there is enough breath-ability for that. The other Topo products may breathe better and truth be told this is a shoe of action. I am not sure it was designed to be worn training clients all day.
I am considering the Run//RT shoe for my daughter for cross country this season. I will have her try a pair on.
Here is the tale of the tape on the Train//RX:
// 3 MM REMOVABLE EVA FOOTBED
// PERFORATED AND AEGIS LINED FOR BREATHABILITY AND ODOR RESISTANCE
// 4 MM RUBBER OUTSOLE / 6 MM EVA MIDSOLE
// MEN’S WEIGHT: 7.8 OZ (SIZE 9)
// WOMEN’S WEIGHT: 6.3 OZ (SIZE 7)
If you are looking for an athletic shoe to train in that is built to let you move the way you’re built, then I suggest you try the Topo Train//RX. The separation of the big toe might be much for someone with an adducted big ray (big toe). Some corrective exercise work work in the foot, lower extremity and hip may be required prior being able to wear this shoe comfortably. This shoe is potentially a safer transition from an overbuilt shoe to some of the more minimalist shoes on the market today due to the depth of the sole and Tabi-style. I look forward to more adventures with the RX soon.
Thanks for reading,
Eric
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Posted in achilles tendonitis, corrective exercise, fascia, foot pain, knee pain, overuse injuries, plantar fasccitis, Product review, running shoes, Uncategorized | Tagged , , , , , , , , , , | Leave a comment

Secrets and Staples: Calve Stretching Secret

The slant board calve stretch is the most effective way that I have found to have clients add some length to this often shortened structure. I like to use multiple techniques, but will review the static stretch for the calves in today’s post. This can be an effective corrective exercise technique for those who demonstrate reduced dorsiflexion. I may use an over-head squat, active range of motion test or goniometry to assess motion at the ankle. If there is muscular tightness,  then more often than not I will recommend this technique early on in their programming.

Goniometry Ankle Dorsiflexion

Staples to keep in mind for the corrective exercise specialist or personal trainer:
make sure the slant board is set at the proper angle. If a client has only six degrees of dorsiflexion, don’t set the slant board at a 15 degree angle or you will only further exacerbate the impairment.
make sure the slant board is the proper distance away from a wall or supporting structure for client comfort, control and consistency.
check for good alignment throughout the rest of the kinetic chain. Even the head and neck. 
walk around your client to see the big picture and get in close to check the little details, especially around the lower extremity.
 (get it?)
have the client only stretch one side at a time to maximize the load going into the calve complex and account for asymmetries.
Here are the key cues for clients:
heel down
toes straight
quads engaged
squeeze glutes
align ear-shoulder hip-knee-ankle
Once they have the basics, check to make sure that the arch of the foot is neutral. You can manipulate the arch of the foot with supportive footwear, a rolled up face cloth etc., and by supinating the foot using the gluteal complex. I will have a video out on this soon.
Pronation is a total body movement and if the arch of the foot is collapsing, we need to make sure the related joints are mobile and the associated muscles are providing dynamic stability. Don’t get lost in the intrinsic musculature of the foot. That’s why it is so important to see the big picture and monitor the entire kinetic chain.
Thanks for reading,
Eric
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Secrets and Staples: Calve Stretching Secret

When setting a client up on a slant board to stretch their calves, you might want to pay attention to what they have on their feet. In a backlash against overbuilt, pronation control, elevated heel running shoes I have seen many trainers and corrective exercise specialists remove clients footwear prior to beginning the stretch.
At a glance this might seem like a good idea. Remove the elevated heel that is placing the client in plantar flexion to allow for greater dorsiflexion, right? Maybe so. If an individual has a pure sagital plane restriction at the ankle joint (as evidenced by an excessive forward lean in an overhead squat assessment for example) then this could work if the individual can maintain the alignment of the longitudinal and transverse arch of the foot while weight bearing.
Barefoot training in the fitness arena has slowly gained momentum over the last 12 years or so, unless you have been practicing yoga or martial arts for the past few thousand years and you have been doing that barefoot for a very long time.   However, many people do not have the extensibility of the calve complex or stability of the muscles and joints in the plantar surface of the foot to maintain a neutral alignment of their arches during a weight bearing stretch for the calve complex.
If a client pronates excessively during transitional (squatting) or dynamic (walking) movements or static posture (standing calve stretch) when they are barefoot then you might want to let them wear their sneakers. Especially if they wear a custom fit orthotic.
They might need the artificial support to hold the arch in place with all that load coming down into the lower extremity during the stretch. This will allow proper joint alignment and lengthening of the appropriate aspects of the calve complex. If compensations are allowed, then dysfunction will perpetuate itself. clients will spend day after day lengthening the WRONG tissues, making them more prone to injury.
If you don’t have adequate arch support (ie. wearing a minimalist shoe or are barefoot) then you can fold up a small towel or wedge something else under the arch to help hold it into place.
I hope this little “secret” is helpful.
Thank you for reading.
Eric Beard
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Rest, Recovery and Regeneration Part IV

Before I go any further with this series of posts, I want to take the time to post a link to another blog.
 
Patrick Ward is also an LMT and ran a series of similar, okay almost identical blog posts, back in 2010. Now our content is slightly different but our tittles are the same. I know there are many of us who discuss these topics, I just felt weird stumbling across one of his post the other day when I was preparing this one. I don’t want to be Rob…or Fab here…I bet most of my reader’s don’t even remember Mili Vanilli???
They were lip syncing long before Jessica Simpson or Beyonce were singing into their hair brushes.
 
Enough with the disclosure stuff!
 
We were talking about the three R’s, rest, recovery and regeneration. I stopped last time with the promise to cover contrast therapy next. Contrast therapy is another recovery tool used in rehabilitation, performance and wellness programs. 
 

“The Turks, Russians, Finns, Romans and Chinese have all used the idea of contrast therapy, transferring the body from very warm temperatures to very cold temperatures, as part of a regular health and wellness routine. The theory behind contrast therapy is simple—the heat from a hot sauna brings blood (and its nutrients) to the surface, which can soothe pain and ease sore muscles, then shocking the body in a cold plunge, which in most modern bathhouses remains at about 50 degrees Fahrenheit, increases circulation and pushes that nutrient-rich blood back into the body’s core.”-Erika Allen.

Contrast therapy works off of the principle of convection, the transfer of heat from one place to another via the movement of fluids. 

There is literature available on this subject due to it’s inclusion in physical therapy and athletic training protocols. Here are links to a few abstracts:
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1320244/ It may not impact deep muscle temperature as much as we thought.
http://www.ncbi.nlm.nih.gov/pubmed/3133668 Following an ankle sprain, ice reduces swelling better than heat and contrast therapy.
http://www.jsams.org/article/S1440-2440(07)00007-2/abstract Decreases blood lactate level and heart rate after sprinting better than active recovery.
The best time to apply contrast therapy may be within 20-30 minutes of a workout to maximize recovery even though it can be used on off days as part of a regeneration or injury rehabilitation program. There are many approaches to applying these treatments. 

Dr. Wnornowski suggests applying hydrotherapy as the use of a hot tub or whirlpool which ideally includes turbulent flow with water at 38-45 degrees C for 20-30 minutes. Whole body immersion should be avoided at temperatures greater than 40 C (normal body temperature being <38 C), due to the potential for hypotension. This can lead to light “headedness” pretty quickly. Contrast baths induce alternating periods of vasoconstriction and vasodilation and are useful for relatively subacute afflictions of joints and extremities, e.g.- ankle sprains. The affected body part is alternated between hot (38-45 C) and cold (10-18 C) baths, usually spending about 10 minutes in hot water, and then 1 minute in cold water then progressing to a cycle of 4 minutes hot, and 1 minute cold. This can be continued for up to 30 minutes total.

Don’t have a $1500 a year membership to a swanky health club? There are other ways to experiment with this type of therapy. A hot pack, hydrocollator pack, hot shower or hot water bottle can be substituted for a hot tub and ice cups, cold shower, frozen vegetables and cold packs can be substituted for a cold bath or cold plunge in a pinch.

Ice alone can be used after a pulled muscle, joint sprain, or traumatic tendonitis. When swelling is noted, a good rule of thumb is to use cold therapy for the first 48-72 hours (acute period), or until after swelling and pain have peaked. Thereafter, heat or contrast therapy may be more advisable, as one enters the subacute phase (3-7 days), or for prolonged symptoms lasting beyond a week.

Cryotherapy (ice therapy) dates back to Hippocrates and the ancient Greeks but it took until the 1940’s for cold/ice therapy to be used extensively for the treatment of acute and subacute injuries, and rehabilitation. It works off of constriction. Temperatures of 10-25 degrees Celsius  are common when applying ice packs or submerging tissues in water. 
 
Using ice alone has advantages, especially immediately following an injury. Tissue damage sustained during an injury can cause uncontrolled swelling. This swelling can increase the damage of the initial injury and slow the healing process. Applying ice immediately following a musculoskeletal injury will reduce the amount of swelling. Ice decreases: swelling, tissue damage, blood clot formation, inflammation, muscle spasms, and pain. At the same time, the ice enhances the flow of nutrients into the area, aids in the removal of metabolites (waste products), increases strength, and promotes healing.
According to Laurel Freeman ice initially constricts local blood vessels and decreases tissue temperature. This constriction decreases blood flow and cell metabolism, which can limit hemorrhage and cell death in an acute traumatic injury. After approximately 20 minutes of ice, blood vessels in the injured area then dilate (open) slowly, increasing the tissue temperature, an effect which is termed “reactive vasodilation.” A study reported in the Journal of Orthopedic Sports Physical Therapy in 1994, found that, despite the reactive vasodilation, there was a significant sustained reduction in local blood volume after ice was applied. On the other hand, some people may argue that this can slow the healing process…more on that debate another day.
 
Submersing a body part, or entire body, during hydrotherapy may increase the effectiveness of the treatment. Areas with large blood vessels, particularly around the head, neck, chest and groin, are more susceptible to heat loss because those blood vessels don’t constrict as effectively as the smaller ones near the skin. Reaching these areas with ice or heat packs may take longer to achieve the desired effect. I would avoid submersing the head in hot or cold water however, for obvious reasons. 
 
Yes the ice can hurt, but hey if this guy will give you a shoulder rub while you sit in a trash barrel full of ice and cold water, what the heck?
Using heat first then ice second is thought to enhance the flushing effect, shuttling metabolites and toxins out of an area and fresh blood and nutrients back into an area with even greater speed. The thought process is to end with the ice to minimize inflammation.  You may find the traditional approach of heat pre-workout and ice post workout to prove effective. I know for a fact that heat helps me get ready for a workout and a study has indicated that ice prior to exercise may decrease a joint’s proprioceptors ability to work optimally, I stay clear of ice before unless I am in significant pain or I am utilizing contrast therapy.
No time for the ratings I alluded to in my last post, guess I’ll get to that next post!
Thanks for reading!
Eric Beard
A-Teamer
Corrective Exercise Specialist
Integrated Manual Therapist
Have you seen my SMR DVD? Click below for a short excerpt.
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