Archive for the ‘Track/Cross Country’ Category
Ankle Flexibility is Key to Performance
Monday, May 2nd, 2011.jpg)
Research shows that all athletes need at least 20 degrees of dorsiflexion in their ankles to maximize speed and prevent injuries. Most of the time when I tell this to coaches or patients, I get a blank stare back and they ask what in the world “dorsiflexion” is. Simply put, dorsiflexion of the ankle is the motion where you pull your foot back towards your body — the opposite of pointing your toes. This motion is vital for running, cutting, jumping and even proper throwing/pitching mechanics.
Most Americans have very limited dorsiflexion in their ankles, regardless of their age or activity levels. We see just as many tight ankles in our youth athletes (even grade school age!) as we do in sedentary adults. The reason we all tend to have tight ankles is because most people tend to overuse our gastrocnemius (posterior calf) muscles and underuse our glute max muscles as we walk, run and jump.
For a while, we’re able to fool ourselves and maintain performance without using our glute max for power. We just use more calf power. But after a period of time, the gastrocnemius muscle starts to fatigue, develops scar tissue and loses it’s strength because it starts to tighten, reducing our ankle flexibility. Sometimes you’ll notice tenderness or a decrease in speed. At other times, you simply won’t continue to improve your performance – you will plateau or become sloppy and have no idea why.
Pro Stretch Device
For prevention, I always encourage all athletes to make sure they regularly stretch their posterior calf muscles by using a stretching strap, runner’s stretch or using the Pro-Stretch device. In addition, using “The Stick” or the foam roller on the area can also help keep the muscles lose and flexible by working out knots. But don’t stop at stretching…make sure you are actively working on strengthening your glute max muscles through squats, lunges or kick-back exercises. The stronger your glute max, the less you will overuse your gastrocnemius muscles and the looser your ankles will be.
If you try these stretches and exercises and don’t see improvements within a few weeks, it’s very possible that you have been tight so long that you need professional help to get your flexibility back. In our practice, we see good results using Graston Technique, Kinesiotaping and even manipulation of the ankle combined with glute strengthening. Often the patient is able to return to 100% or even reach new levels of performance once they acheive proper flexibility.
Easy test for hip strength can predict knee pain risk
Tuesday, April 5th, 2011Knee and thigh pain are some of the most common complaints that we see in our pediatric and adult athletic patients, whether they run track, play softball or compete in triathalons. Many times, patients will come in with a stack of CD’s containing MRIs, x-rays and other testing done on their leg to no avail — they’re still in pain. Since nailing down the exact cause of knee and thigh pain can be tricky (especially if there is nothing showing up on imaging), chiropractic sports physicians and other rehab specialists started testing various hypothesis on how muscle imbalances in the hips and legs might contribute to knee pain.
Proper positioning during the SLST
One of these hypothesis is that weakness in the muscles that abduct the hip (keep the thigh from tilting towards the midline) creates additional pressure on the thigh and knee, creating additional wear and tear along the backside of the patella. To test the strength of these hip muscles, we have the patient stand on one leg and perform a small squat or dip, keeping the torso perpendicular with the ground. If the hip, knee and ankle all stay in one line during the test, the patient’s hip strength is good. If the knee moves towards the midline during the test, the patient’s hip strength is poor. This test is called the Single Leg Squat Test (SLST).
Athough this hypothesis has been working well for doctors in a clinical setting, researchers at the
Failing position during the SLST
Melbourne School of Engineering in Australia wanted to test the reliablity of the SLST for measuring hip strength as well as predicting risk for knee pain. In the February issue of the American Journal of Sports Medicine, their study was published and it confirmed that the SLST was a reliable tool and also can identify those at risk for knee pain. What’s even better about the SLST is that it doesn’t cost anything to perform and can be done by the sports doctor in 60 seconds — much easier than spending thousands of dollars on MRIs and CT scans.
It’s important to see a doctor who is familiar with sports injuries and also is up to date on the latest diagnostic and treatment methods to get you back to your sport as quickly as possible. Although family practice and immediate care physicians are great at detecting fractures and life threatening conditions, they may not be up to date on functional strength tests such as the SLST and possibly miss the true cause of your knee pain.
If you have knee pain or think that you might not pass the SLST, feel free to email me at drerin@ducatchiropractic.com and I would be glad to answer your questions. Remember the longer you compete on an injured or weak area, the longer it will take to get back to 100%!
Which is more important? Flexibility or Strength?
Tuesday, March 1st, 2011In the field of sports medicine, there are generally two camps of thought: doctors who think a lack of flexibility is the cause of most injuries and doctors who think a lack of strength is the cause of most injuries. Those two groups of doctors influence athletic trainers, personal trainers, coaches and parents to either teach their athletes to be constantly stretching or constantly strengthening. Since these two camps have been entrenched in sports medicine several years, we are now able to see if an emphasis on stretching or strengthening helps prevent athletic injuries. Interestingly enough, athletes in both groups have just about the same number of injuries.
So does that mean that stretching and strengthening are both a waste of time? Although it’s easy to make that argument, new research is now showing that both flexibility and functional strength play a large role not only in injury prevention, but in athlete performance as well. The problem is that many of the measurements that we commonly use on athletes to guage their flexibility and strength are looking at the wrong parameters.
Take for instance the sit-and-reach test. This tool has been used to measure athlete flexibility in sports ranging from baseball to track to basketball. The test itself is flawed. Although we think that we are measuring pure hamstring flexibility (hip flexion), we are really measuring hamstring flexibility coupled with low back flexion. Just look at this picture. See how the low back is rounded? That biases the results and doesn’t tell you anything about your athlete’s true hamstring flexibility.
On the strengthening side, many times we monitor how much our athletes can chest press or squat in the weight training room. What do those movements have to do with your athlete’s pitching technique or running efficiency? Little to nothing. Those strengthening exercises train athletes for gross strength (big, powerful movements), not agility or core strength (small, fine movements that protect from injury and also increase performance).
In response to this new research, there is a new movement in sports medicine called functional strengthening. The keystone of this philosophy is that we need to measure athlete risk by taking them through functional tests that include both flexibility and agility/core strength parameters to determine areas that are tight, tender, weak or deconditioned. Examples of these tests include the squat test (pictured here), and wall angel tests.
If the athlete can pass these tests, their risk of injury is very low and can often continue with a basic strength/conditioning program. If the athlete cannot pass these tests and are pain-free, they can start an individualized training program to loosen restricted areas and increase strength in their weak spots. Often they are released from the individual program within 4-6 weeks and can then continue with a basic strength/conditioning program. If the athlete cannot pass these test and has signs of injury/pain, they need to start rehabilitation ASAP (even if the pain isn’t stopping them from competing) to reverse these tight/weak muscle patterns and prevent a career-ending injury.
We take every patient (athletic or not) through these functional tests so that we can not only help eliminate their pain, but prevent it from returning by treating it from its source. As part of our sports clinic outreach, we also conduct workshops for coaches and athletic trainers on the basic functional tests and how to triage injuries so that they can help their athletes improve performance and return to play. If you have further questions on functional strength testing or would like us to come conduct a workshop for your group, please email drerin@ducatchiropractic.com.
Improve Performance Through Hamstring Flexibility
Wednesday, February 2nd, 2011
In all track and cross country events, the flexibility of the hamstring muscle is crucial for speed, power and acceleration. Unfortunately, hamstrings are tight in almost all of the athletes that participate in these sports at every level even though coaches have been leading their teams through hamstring stretches for decades at almost every practice. Why can’t we seem to loosen up?
Whenever you stretch a muscle and it snaps back to its original tightened state by the next day, you know that you aren’t just dealing with a tight muscle, but a muscle imbalance. Muscle imbalances are formed by incorrect firing patterns being used over and over in a repetitive activity. For instance, you may have a track athlete who overuses his hamstrings to propel himself forward while jumping because his glute max is weak. Do this enough times and the bad muscle firing pattern is ingrained into his brain. You can stretch the hamstring, but if he jumps a few times afterwards, you will be right back where you were before you started stretching!
Because its so easy to “train” a muscle like the hamstring to be tight, it’s important to start stretching this muscle early in the athlete’s development. In addition to traditional stretching, try integrating foam roller mobilizations to the hip and thigh as well (see video). If you notice that they are consistently tight for more than 2 weeks or if the tightness in the hamstring is causing any other pain, refer them to your local chiropractic sports physician for evaluation.
Chiropractic physicians that are trained in sports medicine will be able to diagnose where the muscle imbalance is and also will be able to treat it with a variety of techniques such as Graston Technique, Kinesiotaping, manipulation and therapuetic exercise to reverse the bad firing pattern. The earlier this process is started, the faster your athlete recovers.
If you have further questions or would like more information on this topic, please email me at drerin@ducatchiropractic.com.
