The summer season is post-season for many of my collegiate athletes, the perfect healing time to rebuild and rebalance some of the overworked structures in their bodies with resistance training. This is an extremely important phase in the training cycle for injury prevention as well as for performance. Adhering to a resistance training program appropriate for your sport is essential during this period.
Utilizing a personal trainer to help tweak the program your CSCS provided you is my first recommendation for a successful post season. With their expertise and objective perspective they can detect dysfunctional patterns that we cannot see in ourselves and they have the tools to get the job done at their disposal. If your CSCS is also a personal trainer and has hours available to you, that’s even better since they have specifically studied your sport (and often participated in it in college!).
If you feel going it alone this summer with the training program you have been given is your only option, follow it carefully and consistently. Most of the resistance programs that have been brought to me to review make sense in their structure and frequency. They do seem to assume the athlete knows the correct exercise sequence. Correct exercise sequence is important not only for optimal development but also for injury prevention. Dysfunctional patterns can develop through compensation due to fatigue. Strains, and trauma due to accidents, can also occur as a result of trying to perform the wrong exercises in a fatigued state. Below is listed an exercise sequence designed to protect the athlete and allow them to develop their greatest potential by themselves. (1)
1. Explosive whole power body lifts: Power cleans, Snatch, etc.
2. Multi-joint exercises: Bench press, squats, shoulder press, seated row
3. Single joint exercises: Triceps extensions, knee extensions, biceps curl
This may seem trivial to some, especially with the complexity of some of the more elaborate functional exercises woven into their programs as they progress, but the sequence is extremely important.
A final note: great form is essential. One of the themes of post/off season training is to correct, to some degree, the dysfunctional patterns developed by the athlete during the season through repetitive movements and postures necessary for their sport. This is something we always must work to perfect. If you cannot afford the time or money to employ a personal trainer, please book an appointment with me for a functional movement screen. This is not a substitute for a good personal trainer, but it can identify your major functional weaknesses so you can work on them to help prevent injury. If a personal trainer is an option for you, I’ve listed some of the best local independent trainers (they work in training facilities – no membership required) in the Cambridge/Somerville area below.
Maren Kravitz and Heidi Brown, The Training Room, Porter Square, Somerville
http://thetrainingroomboston.com/tr/home
Callie Durbrow, Durbrow Performance, Central Square, Cambridge
http://durbrowperformance.com
References:
1. Essentials of Strength and Conditioning, second edition p.404-405
Baechle, Thomas; Earl, Roger Human Kinetics, Champaign, IL 2000
Monday, June 27, 2011
Tuesday, June 21, 2011
"Summer's Back!" - ouch!
As spring passes into summer and the bulk of my client population switches from student athletes to weekend warriors and garden gladiators, so do to the bulk of the "c/o's" from peripheral conditions to back pain, specifically low back pain. Three new cases just last week!
Back Pain is not easy to assess for the therapist or diagnose for the physician, either medical or chiropractic, and can be even harder to explain to the client or patient. This is because there can be, and usually is, more than one factor causing the pain. If there is one dominant factor directly causing the pain, then this is addressed first. Decreasing the major cause of pain allows for greater range of motion which will facilitate the natural healing process of the body as well as allow the therapist to address the imbalance that caused the pain, if this is possible. Sometime the lack of integrity in structures leaves no alternative but surgical intervention. Fortunately, this is usually not the case.
If your pain is locally sharp and disabling, it's my duty to refer you out to an orthopedic physician and I recommend that you pursue that course before you see me if those are the symptoms you are experiencing. Be sure your physician is paying close attention to your history and takes the time to perform manual clinical tests on you. MRI's are not enough. In fact, MRI's can present very clear but misleading images. In the case of herniated nucleus pulposus (HNP) they have a 25% false positive rate (1). Where the pain is being referred from and what structures are referring the pain (nerve, ligament, joint or joint capsule) can and should, in my opinion, all be tentatively identified before radiographs are ordered. Medication or injections to decrease inflammation may be options as well as, in severe cases, surgery. Most Physicians will prescribe the most conservative treatment possible.
If your pain is not is not disabling and the pain is local, chiropractic care has been shown to be very effective on acute conditions, especially within the first 6 weeks. A good chiropractor will educate their patient about their condition and provide them with advice about how to prevent the condition from returning, if that is possible.
If physical therapy has been ordered by your physician, it can be the best road to travel toward healing if the patient is compliant. This is because many of the causes of low back pain are due to weaknesses and imbalances that the physical therapist can address. The mantra "Everything heals in the presence of motion" is most relevant in the case of low back pain where inactivity is often one the greatest contributing factors to onset as well as one of the greatest obstacles to healing.
There is much controversy about the role of passive manual therapy, specifically massage therapy, with respect to severe low back pain. For example, in the case of HNP, it has been noted by some that massage is often engaged during the natural healing cycle in which the natural spontaneous re-absorption of the effused nucleus pulposis would have occurred with normal return to movement regardless of the techniques applied. I have to disagree. Is massage is not contraindicated for the pain I would encourage the patient to engage the services of a therapist. Skillfully applied massage will help decrease both inflammation and tension which will facilitate movement, which will in turn aid the natural healing process. Everything heals in the presence of motion - massage therapy can help you regain that motion.
Summer is short! So if you are having back pain, please schedule an assessment with me so we can find the right direction for you to heal the fastest.
References:
1. http://emedicine.medscape.com/article/1263961-overview
References utilized:
Hammer, Warren I. “Functional Soft Tissue Examination and Treatment by Manual Methods, 3rd Edition” Sudbury, MA Jones and Bartlett Publishers, 2007
Back Pain is not easy to assess for the therapist or diagnose for the physician, either medical or chiropractic, and can be even harder to explain to the client or patient. This is because there can be, and usually is, more than one factor causing the pain. If there is one dominant factor directly causing the pain, then this is addressed first. Decreasing the major cause of pain allows for greater range of motion which will facilitate the natural healing process of the body as well as allow the therapist to address the imbalance that caused the pain, if this is possible. Sometime the lack of integrity in structures leaves no alternative but surgical intervention. Fortunately, this is usually not the case.
Who do I see about my pain?
If your pain is locally sharp and disabling, it's my duty to refer you out to an orthopedic physician and I recommend that you pursue that course before you see me if those are the symptoms you are experiencing. Be sure your physician is paying close attention to your history and takes the time to perform manual clinical tests on you. MRI's are not enough. In fact, MRI's can present very clear but misleading images. In the case of herniated nucleus pulposus (HNP) they have a 25% false positive rate (1). Where the pain is being referred from and what structures are referring the pain (nerve, ligament, joint or joint capsule) can and should, in my opinion, all be tentatively identified before radiographs are ordered. Medication or injections to decrease inflammation may be options as well as, in severe cases, surgery. Most Physicians will prescribe the most conservative treatment possible.
If your pain is not is not disabling and the pain is local, chiropractic care has been shown to be very effective on acute conditions, especially within the first 6 weeks. A good chiropractor will educate their patient about their condition and provide them with advice about how to prevent the condition from returning, if that is possible.
If physical therapy has been ordered by your physician, it can be the best road to travel toward healing if the patient is compliant. This is because many of the causes of low back pain are due to weaknesses and imbalances that the physical therapist can address. The mantra "Everything heals in the presence of motion" is most relevant in the case of low back pain where inactivity is often one the greatest contributing factors to onset as well as one of the greatest obstacles to healing.
There is much controversy about the role of passive manual therapy, specifically massage therapy, with respect to severe low back pain. For example, in the case of HNP, it has been noted by some that massage is often engaged during the natural healing cycle in which the natural spontaneous re-absorption of the effused nucleus pulposis would have occurred with normal return to movement regardless of the techniques applied. I have to disagree. Is massage is not contraindicated for the pain I would encourage the patient to engage the services of a therapist. Skillfully applied massage will help decrease both inflammation and tension which will facilitate movement, which will in turn aid the natural healing process. Everything heals in the presence of motion - massage therapy can help you regain that motion.
Summer is short! So if you are having back pain, please schedule an assessment with me so we can find the right direction for you to heal the fastest.
References:
1. http://emedicine.medscape.com/article/1263961-overview
References utilized:
Hammer, Warren I. “Functional Soft Tissue Examination and Treatment by Manual Methods, 3rd Edition” Sudbury, MA Jones and Bartlett Publishers, 2007
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