Tag Archive: physiotherapist

1. 13 lessons from Musculo skeletal screenings

   30th April 2016 3:54 pm Leave a Comment

   The purpose of the screenings is to gauge an athlete’s readiness to train

   Having conducted over 80 musculo skeletal screenings with athletes from a huge variety of sports in the last year with a physiotherapist  it is time to offer some reflections.

   Establishing a rapport is key for the screening to go well, and I would say that in all but 2 of them, we have managed between us to do that.

   We have adapted our feedback over time so that we give the athletes something simple to do at home without specialist equipment. It usually involves working on sitting and standing posture and practising some form of controlled movement such as squats, press ups or warm up.

   The thing about doing a comprehensive screening is that you realise not only how different every person is, but also how similar they all are.Although every athlete is an individual and every sport is different, there are many similar traits. A few that come up regularly are:

   • Poor posture from sitting at a computer or in the classroom lazily.
   • Lop sided shoulders from the dominant arm sports.
   • Inability of female athletes to sit down on a chair- compared to falling down.
   • Low back pain in athletes who have gone through a recent growth spurt and are overspecialising in one sport.
   • The early risers and multi- taskers have brilliant organisational skills and get things done.
   • The University students with 3 hours of lectures a week “don’t have enough time” to eat breakfast, bring a water bottle, do 10 mins of body management exercises a day.

   What is refreshing is that with over 40 years of combined experience, myself and the physiotherapists always manage to learn something new from each athlete. It is hard work, but very rewarding.

   

   Sharing information with physiotherapist

   13 lessons learnt so far:

   1. Establishing rapport is essential.
   2. Certain phrases set off alarm bells in our minds “core stability” and “power cleans” are worrying from athletes who can not stand up straight or who have back injuries.
   3. Never assume that because a 15 year old boy is a national champion at sport x that he can do an unloaded squat, let alone weight training.
   4. Doing the plank 3 times a week has yet to show  that the athlete can move fast and with balance in their sport.
   5. Simple messages are effective- then repeat them again and again.
   6. Flexibility of all young athletes is horrific.
   7. Most young athletes are keen and willing to learn, but self discipline to apply the lessons comes with maturity- some have it, some don’t.
   8. There is a reason why athletes who keep getting injured- either overtraining, or lack of planning from Coach\Athlete\parent.
   9. Most athletes are unable to plan their training for the next week- let alone month or year.
   10. Every athlete is different, but there are a lot of similarities also.
   11. What they do in daily activities such as school and home has a big impact on their body.
   12. We learn something new at every screening.
   13. Mum or Dad usually knows best with young athletes- but the teenager often ignores the parent!

   If you would like to know the detail behind the screening process read this: what we currently do with athlete assessments.

2. How to reduce the risk of ACL injury for females.

   16th March 2016 10:47 am 16 Comments

   Why are Females at Higher Risk of ACL Injury?

   “Female athletes have a 4-6 times higher incidence of ACL injury than do male athletes participating in the same landing and pivoting sports” (1)

   Hormonal changes: Hormonal changes during the menstrual cycle can have a direct effect on neuro-muscular performance.

   Anatomical differences: Females have a smaller intercondylar notch, therefore a smaller ACL.

   An Increased Q Angle will influence landing technique negatively.

   Slower reaction times: Females have slower and less efficient reaction times due to different neuro-physiology i.e.differences in spinal motor control.

   Poor landing mechanics: Reduced leg power will cause an increased reliance on the quadriceps and ligamentous structures at the knee and ankle .An increased Q angle in females has a direct impact on landing mechanics.

   Less power: Females have reduced power and muscle development.

   “Implementation of practical neuro-muscular warm-up strategies can reduce lower extremity injury incidence in young, amateur female athletes.” (2) 

   Reducing the risk of ACL injury

   This diagram summarises the key factors found in recent research on preventing ACL injuries in female athletes.

    

   Screening: Musculo-skeletal screening can help identify specific problem areas for each individual athlete

   Footwear: Wear appropriate and good quality footwear to facilitate good foot/ankle mechanics and help control ground reaction forces.

   Conditioning: Functional conditioning work, related to individual screening outcomes and specific to sport requirements. To include stretching, strengthening, plyometrics, review of landing techniques, sports specific drills and balance exercises.

   Warm Up: Use practical neuro-muscular warm-up strategies (see conditioning work).

   Oral Contraceptives: Use of oral contraceptives pre-competition has been shown to have an effect. Reearch is hampered by ethical concerns.

   Further Reading: 

   • Strength and Conditioning for Females Free ebook
   • What is causing pain at the front of my knee?

   References:

   1. Hewett et al American Journal of Sports medicine March 2006 34(3) 490-498
   2. Herman et al BMC Medicine July 2012 19 10(75)
   3.  Stojanovic et al Research in Sports Medicine July 2012 20(3-4) 223-238
   4.  Walden et al British medical Journal May 2012 344 e3042
   5.  Irmischer et al Journal of Strength and Conditioning Research November 2004  18(4) 703-707

    Sarah Marshall  Chartered Physiotherapist

3. Athlete screening: Reduce injury risk and improve performance

   23rd January 2015 9:08 pm 19 Comments

   What is athlete screening?

   By Sarah Marshall, Chartered Physiotherapist.

   The screening of an athlete is used to identify the current musculoskeletal condition of that individual. If carried out initially during the pre-season period, it can provide a set of baseline values for the athlete’s database or personal physical profile.

   Repeat screenings throughout the season can then identify any physical changes. This is particularly important with a growing and developing skeletal system.

   At Excelsior, we use a baseline screening of 5 different exercises that assess the individual’s ability to move in 3 dimensions in a coordinated fashion. We are looking to find out what a person CAN do as opposed to what they CAN’T do.

   We look at Posture, Balance, Stability and Mobility and this helps us gauge the movement efficiency of the athlete.

   

   Why do we screen?

   A functional screening assessment will identify an individual athlete’s musculoskeletal strengths and weaknesses. From these results, an accurate rehabilitation/conditioning programme can be implemented.

   Historically, screening would involve observation of static posture and a normal gait pattern. Non-functional assessment of joint movement, muscle strength and flexibility would be carried out. This might include various single joint assessments in sitting or lying positions.

   This is good for identifying individual areas of weakness.

   However, sportspeople rarely use single-joint movements in these positions; instead, the body works as one unit. By looking at the overall movement we can see the context in which any problems occur.

   Sport Specific Screening?

   

   Prolonged periods at a desk or gaming can lead to shoulder and back problems

   Whilst it is important to understand the needs and demands of the sport, we do a screening that is Athlete specific, not sport-specific.

   An assumption is often made when designing training programmes that the athlete is able to perform basic movements and then start loading them.

   Unfortunately, experience has shown that this is the exception rather than the norm.

   Anecdotally less than 10% of the sportspeople we screen have been able to perform the basic movements well.

   Sportspeople are a product of their environments and posture is affected by daily living (driving, sitting, lying) or by their sport (racquet sports and throwers being one-sided for example).

   Prolonged exposure to poor posture can lead to problems. By improving an individual’s movement patterns first, injury risk will be reduced.

   Then we can address the needs of the sport and performance can be enhanced.

   Repeat screenings can be especially useful post-injury to help determine an athlete’s return to competition.

   If you would like more information on screening for you or your athletes, I am happy to answer your queries: we are based in Willand, near Cullompton & Tiverton.

   You contact me here  

4. Books of 2013

   27th December 2013 12:17 pm 3 Comments

   One of my goals in 2013 was to read 40 books this year.

   Whilst this may seem modest to some, it is in conjunction with working, looking after my family, trying to stay fit and also doing 6 MOOCs.

   I have managed so far to read 43. Some of them have been very weighty tomes: Cureton’s encyclopedia of physical education, fitness and sports and Doherty’s track and field omnibook for example.

   Others have been really thought provoking: Taleb’s Antifragile, Lederman’s thinking fast and slow, Plato’s The Republic.

   Then some is just for fun: Jonathan Strange and Mr Norrell, Ace of Skulls, plus Total Recall were all page turners.

   Here is the full list:

   1. Muck City : Bryan Mealer. High school football in Florida.
   2. The back of the napkin: Dan Roam. Portraying ideas visually and simply.
   3. The White Lioness: Henning Mankell. Swedish crime thriller.
   4. Courage and Other broadcasts: Field Marshal Sir William Slim. Leadership, courage and other virtues.
   5. It’s not about the coffee: Lessons on putting people first at Starbucks. Howard Behar. Leadership from Starbucks.
   6. Brave New World: Aldous Huxley. Classic sf novel.
   7. Brave New World Revisited: Aldous Huxley. Look at social events and future of society.
   8. Daemon: Daniel Suarez. SF techno thriller.
   9. Excel 2010 Simplified: Paul McFedries. Useful graphic book.
   10. What the plus: google+ for the rest of us. Guy Kawasaki. Tips on using google+.
   11. Jonathan Strange and Mr Norrell: Susanna Clarke. Alternate reality of 19th century magical England novel.
   12. Freedom: Daniel Suarez. Poor sequel to excellent Daemon.
   13. Developing Children: Their changing movement. Mary Ann Roberton, Lolas E Halverson.
   14. Kim: Rudyard Kipling. Classic adventure novel.
   15. D:Day: The Battle for Normandy. Antony Beevor. Historic account of the battle.
   16. Dodger: Terry Pratchett. Historical fantasy set in Dickensian London.
   17. The Dark Judges: Alan Grant & John Wagner. Graphic Novel as part of World Book Night.
   18. Cosmopolis: Don Delillo. Fictional treatise on modern day New York capitalism.
   19. Full Disclosure: Andrew Neil. Autobiographical account of his tenure at the Sunday Times and relationship with Rupert Murdoch.
   20. Let the right one in: John Ajvide Lindqvist. Swedish horror story.
   21. The Art of Thinking Clearly: Rolf Dobelli.
   22. The World Until Yesterday: Jared Diamond. Look at primitive societies and what we can learn.
   23. Bruce Lee: Words from a Master. Ed. John Little. Interviews and reflections with Bruce Lee.
   24. The Twilight Watch: Sergei Lukyanenko:.Russian crime/ horror novel.
   25. The Last Watch: Sergei Lukyanenko:. Final part of quadrology.
   26. Thinking Fast and slow: Daniel Lederman. Terrific analysis of how we think (or don’t). Must read.
   27. Teaching Gymnastics:Mauldon, E. Layson, J.Excellent older text on creative movement lessons and plans for school children.
   28. The Way Home: George Pelcanos. Crime/ drama novel set in Washington DC.
   29. Solar: Ian McKewan. Satire about flawed scientist.
   30. The Checklist Manifesto: Atul Gawande. Thoughtful look at getting simple things done well consistently based on flight checks.
   31. Republic: Plato. Classic treatise on morality and creating a perfect society.
   32. A Quiet Belief in Angels: R.J. Ellory. Crime coming of age novel set in Georgia, USA. Emminently readable; read it in a day.
   33. Encylopedia of physical education, fitness and sports. Cureton, t. Stull,G. Eds. 1980 compilation of reports, papers. Especially good on youth fitness.
   34. From here to infinity: Martin Rees. Based on his 4 reith lectures, an overview of science in the future and how it affects humanity.
   35. Total Recall: Arnold Schwarzenegger. Autobiography from youth to present day. Real page turner.
   36. Comic books 101; The History, Methods and Madness: Chris Ryall & Scott Tipton. Nice overview of modern day American comics.
   37. Just six numbers: Martin Rees. How our universe is shaped by 6 different numbers.
   38. The Art of War for Executives: Donald Krause. A reshaping of Sun Tzu’s text for business.
   39. The Ace of Skulls: Chris Wooding. Sci fi novel about the Ketty Jay.
   40. Practice Perfect: Doug Lemov. Great book about teaching/ coaching practice. Uses 42 lessons.
   41. Track and field omnibook: Ken Doherty. Classic coaching textbook.
   42. Carter beats the devil: Glen David Gold. Historical novel about US magician Charles Carter and President Harding’s death.
   43. Antifragile: Nassim Nicholas Taleb. Outstanding thought leader’s book about how to get stronger in life. Myth busting about the wealth / education relationship of nations. Really attacks academia and the banking system and how innovation and originality occur through other means.

   I think I might try the same next year. I liked the process of recording what I actually read.

   I need to make more use of the library for the general books. Unfortunately the text books are usually unavailable, so I tend to buy from Abe books.

   You might like to check out my author page on Amazon 

   What were your favourite books of 2013?

5. Advice to young coaches: break the mirrors

   4th October 2013 4:01 pm Leave a Comment

   “I was someone who literally spent his life in front of mirrors, practicing poses, working on the biceps or the triceps, always checking the mirror for progress.“

   Arnold Schwarzenegger in his autobiography “Total Recall” talks about being inspired by his Father-in Law Serge Shriver who gave this speech to Yale graduates in 1994.

   “I have one small word of advice because it is going to be tough:Break your mirrors!!! Yes indeed — shatter the glass. In our society that is so self-absorbed, begin to look less at yourself and more at each other.

   Learn more about the face of your neighbour and less about your own.

   I suggest this: When you get to be thirty, forty, fifty, or even seventy years old, you’ll get more happiness and contentment out of counting your friends than counting your dollars.

   You’ll get more satisfaction from having improved your neighborhood, your town, your state, your country, and your fellow human beings than you’ll ever get from your muscles, your figure,your automobile, your house, or your credit rating.

   You’ll get more from being a peacemaker than a warrior. I’ve been both, so I speak from experience. Break the mirrors!“

   19 years later and with Generation iY entering the workplace, narcissism seems to have overtaken altruism.

   Coaching is about helping other people out. Unfortunately young, keen people are often worried about “making a name for themselves” or “increasing my followers on twitter“, rather than coaching the person in front of them.

   Schwarzenegger was the ultimate narcissist, but life, experience and surrounding himself with good people changed him. His autobiography is a fascinating read and a real page turner.

   Good advice at the end too.

   5 tips on how to get started in strength and conditioning coaching 

6. Summer reading list for Coaches

   8th August 2011 2:48 pm Leave a Comment

   What books are you reading this summer?

   What are you reading this summer? Is it a book, a journal or just stuff on the internet?

   Ex Prime Minister Gordon Brown on his recent trip to Africa encouraged African countries to expand their internet coverage. This is similar to a laptop to every pupil schemes by US philanthropists.

   However, giving kids or families a computer and internet access without them having an educational bent has not improved learning ability in the Western World. Low income and low education families use the internet for: porn or games depending on their age group.

   Giving pupils access to cheap or free books over the summer vacation actually increases educational achievement the next academic year. It prevents them for having dips in learning which can’t be made up. Other recent research states that having 20 books in the house is the number that differentiates later academic learning from early school leavers.

   One theory is that teach someone how to read and then give them a book and they become a “reader”. This is a different class of person from someone who doesn’t read. Reading allows you to access the thoughts of minds and experiences greater than your own and encourages ambition and further learning. Having a computer and internet connection allows you access to entertainment and information- that is different from an ability to learn.

   It is not about money- why not join your local library this summer and see what you can find?

   It seems to be the time to read more books, not sure whether that is due to rubbish tv, more people on holiday, or less email traffic. Here are some of mine.

   “How to help Children find the Champion within themselves”. David Hemery

   This is a great little book, easy to read, but with valuable insights into coaching young people. A must read for the enthusiastic parent, or coach of yongsters.

   It is broken down into sections for the parent and for the coach- how to do things at home as well as on the field. The cartoons throughout aid the process. Useful tips on the communication process.

   Beyond Winning: The timeless wisdom of great philosopher coaches. Gary Walton

   A biographical book of 6 great  (mostly American) coaches: Woody Hayes, John Wooden, Vince Lombardi, James “Doc” Counsilman, Brutus Hamilton and Percy Cerutty.

   The premise here is that these coaches added something more than just tactical and technical nouse to the field of coaching.The book has a chapter on each and a summary chapter of the essence of philosopher coaching.

   A useful book for more experienced coaches on how they are developing their practice.

   This isn’t a textbook: A somewhat intemperate look at sport, teaching, Coaching and life. Kelvin Giles

   A collection of thoughts, blogs and experiences from the past 20 years or so from this very experienced coach. Another easy read, although I made the mistake of taking it on holiday and kept reflecting on my own practices rather than relaxing. (Not to self, only take fiction and hisory books again).

   It is interspersed with good motivational quotes, that break up the reading. The format may not suit a beginner, as there is no progression. I found it useful as I could relate to a lot of it. It does offer some training principles and reinforces the need for movement efficency before metabolic conditioning.

   “Don’t let the music die within you.” Wayne Bennett

   I read the updated version by this great rugby league coach. It has insights into how he deals with the media, young players, loyalty and leadership. The writing is quite simplistic (maybe aimed at rugby league players) and is pleasant enough, but not ground breaking.

   The chapter on “duty of care” is recently added and very relevant to today.

   One for the fans maybe, or perhaps I have just read a lot of these types of books.

    Have you got any favourites you could recommend?