The inclusion of wireless surface EMG and motion capture is growing in popularity with Functional Movement Screen providers. Those using a combined option of surface EMG and movement screening, both basic and individualized, are getting direction from the data beyond what was thought possible. Both conditioning coaches and sports medicine professionals can see reports that identify specific muscle function and add more quantified analysis to testing. Leveraging the speed and simplicity of the Functional Movement Screen, as well as feedback benefits and easy adoption, athletes can get the right interventions with confidence.
Getting More Out of the Hurdle Step
Using the existing criteria provided by Gray Cook, specific movement impairments and muscle function can be scored with surface EMG by placing just a few electrodes to key muscle groups and using motion capture. Within minutes a professional can perform the FMS, score the screen conventionally, and report the details instantly. Using surface EMG, the athlete, the team, or entire facility and collaborators can quantify things like:
(1) Lateral bending of the spine from improper torso recruitment
(2) Lack of dissociation ability during hip flexion with compensation
(3) Hip hiking with low gluteal activity during stance
The above three examples are just the tip of the iceberg, and baseline testing can grade the effectiveness of corrective exercise strategies and show a clear cause and effect with training interventions. Recently national level athletes were screened using the FMS and a combined motion capture and surface EMG solution.
After scoring the FMS with surface EMG, actionable interventions in training and sports medicine can be directed more effectively. For example, an increase of single leg exercises and target muscle strengthening can augment hip abductor recruitment and strength can reduce hip hiking. Marching exercises placed in the movement preparation section of a training session to help learn to “create silence” to flexors of the spine for better dissociation during hip flexion. Finally, stability and relaxation can be improved by incorporating multi planar chops in both kneeling and split positions.
Without immediate, accurate, and motivating biofeedback, corrective strategies are not be as effective and athletes may be slower to show improvement. The live streaming option can accelerate learning, allowing athletes to get visual guidance and assist professionals in pinpointing the root cause of poor movement patterns. The combination approach of using the FMS and surface EMG with motion capture is a rapid and effective methodology for those looking to increase accountability, improve athlete performance, and even prevent recurring injury. Scoring movement and coordination using surface EMG is no longer just for research, it’s a clinical and performance option that is growing in the industry.
Learn more at: http://noraxon.com/
Registration for the 2014 BSMPG Summer Seminar opens on Jan 1, 2014!
Symmetry and asymmetry are natural occurrences in sport, but the real insight to what is acceptable and what is an injury risk is unknown in the research on clinical ranges of motion, Electromyography, strength and power evaluation, and video analysis. One of the primary reasons Electromyography (EMG) is revealing is the specific details of why asymmetry may be present when visually the athlete appears to be symmetrical. What we do know is that asymmetry with injury is a valid etiology to muscle groups and joints of the lower extremity. Electromyography can easily add value to any existent movement screen or evaluation method or assist in designing new assessments if needed.
Etiology of Injury and Return to Play Strategies
Athletes may not be prone to injury just because of one imbalance or asymmetry, but as more factors elicit an symmetry, the probability increases. It is widely accepted that when an athlete is injured he or she will need the injured limb to exhibit less than a 10% deficit (1,2) between the uninjured limb, especially on strength. Maintaining symmetry is not just ensuring the strength is equal between limbs or sides, it's also important that range of motion and coordination is following the same guidelines. Removing symmetries is about reduction versus prevention, since most athletes will have anatomical and other technique styles that may encourage internal asymmetry. Performance and and medical specialists are to manage areas that may not be high risk and find areas that are likely culprits to the problems of non-contact injury, such as joint overuse syndromes and muscle strains. Following the 10% rule is a bit arbitrary as athletes in movement are not relying on just one muscle or system to create motion, but creating symmetry by revealing incomplete rehabilitation or unwanted training responses is necessary. While 10% may not be a true threshold, the act of measurement may reveal even higher deficits in functional movement such as jump tests, screening activities, and full sport movements. The goal of comparing limbs, especially the lower extremities, is to decrease the rate of injury by finding clear flags for further investigation. Injuries are common, but the they are often avoidable, especially in non-contact form.
Adding Surface Electromyography to Screening and Sport Movement
Visual compensations may not be present when significant neuromuscular dysfunction is present, due to the fact that most movements are a composite of multiple muscles systems. Flexibility, isolated strength, jump or movement tests, are all highly visible and most qualitative and quantitative information is limited by what the clinicians see. Other important insight is not visible, and kinetic data or EMG is a way to see what is below that surface. Coordination is hard to see, just the end result of motion, not the individual messages from the brain. Information from EMG shows activity of muscle groups or the lack of recruitment in joint activities, even when the resultant movements look normal. By looking below the surface a practitioner can see the root issues as symmetry visibly may be misleading when a specific firing pattern could be causing pain or malperformance. Noraxon <insert product> provides support to the the following options.
(1) Movement Screening- Any screen can be enhanced with EMG when used in combination, since movements are the result of the functional state of the neuromuscular system. Symmetry visually can be audited by the added data of EMG and determine if the movement screen is providing false negatives, common with athletes that are doing low force mobility screens. Movement screens can enhanced with incrementally higher speeds and forces to find what specific thresholds that can be problematic for that specific athlete, and improvements in training and therapy will raise the scorers over time if done properly.
(2) Power Tests- Simple lower, upper, or total body power tests are excellent ways to see if a functional imbalance is present with athletes. Power tests are normal part of training and athletes are comfortable doing them without any specific preparation or instruction. With absolute power tests coaches can combine risk factors with performance measures to get more information with the same tests, something especially necessary with limited time.
(3) Rehabilitation Exercises- Exercises in sports medicine studies are frequently validated with the use of EMG. Unfortunately many of the studies use exercises or movements that are not the options medical and performance staff need, and a gap exists to what is happening precisely besides estimated visuals. Sports therapists can create their own libraries of exercises and their variances internally when EMG is added to the movements.
(4) Sporting Actions- The most straightforward approach to evaluating possible dysfunctional movement or injury risk to look at the sporting movements the athlete is doing in practice or game simulation to see if something is compromised. Sporting actions are familiar with nearly everyone, so glaring problems can be clearly identified and knowledgable sport coaches can be part of the collaborative process.
In conclusion, the use of surface EMG is a gold standard in both performance and in modern rehabilitation. EMG explores and reveals what is beneath the surface visually and presents meaningful data when making comparisons in symmetry that could be troublesome if beyond the ability of the athlete.
- 1. Augustsson J, Thomee R, Karlsson S. Ability of a new hop test to determine functional deficits after anterior cruciate ligament recon- struction. Knee Surg Sports Traumatol Arthrosc. 2004;12:350-356.
Orchard J, Best TM, Verrall GM. Return to play following muscle strains. Clin J Sport Med. 2005;15:436-441.
1. Long Jump Run-Up Velocity
Freelap USA – A lot of the long jump performances have been stagnant or regressed over the last few years, and many point to the run up velocity as being part of the cause. You have several testing parameters that address max speed and acceleration, but include 150 m test. Can you share how they interact with both the Triple and the long Jump?
Boo Schexnayder – You have a limited time frame over which you can maintain high levels of fine motor control, so the ability to accelerate powerfully is prerequisite to high performance. This explains which some fast people can’t convert on the runway, because too much energy is expended to get to optimal velocities. Maximal velocity correlates with performance more than any other parameter for obvious reasons. The 150 is important to me because it is a good indicator of the ability to maintain motor control under duress and at high levels of power output. The ability to move freely through takeoff without guarding, tentativeness, or deceleration is directly related to 150 m performance for this reason.
2. Injury Prevention in Long Jump Traning
Freelap USA – When designing the actual jump training coaches have a huge set of options but must individualize the application of plyometrics or athletes may get injured from the wrong sequence and loading pattern. What are good general precautions that could guide us beyond contact totals and rest periods? Progressions are talked about but is there something deeper?
Boo Schexnayder – I really don’t think there is much dark and deep there, I think the problems arise from moving the coaching eye off the target. It’s very simple, over the course of time you must increase the impact values and levels of tension applied to the tissue, and employ some variety to give yourself some room for error and reduce injury risk. All decisions on exercise choice need to be on target in that regard. I think most injuries result from (1) fear of regression during rest phases, therefore loading values don’t fluctuate enough, (2) poor evaluation of the intensity associated with each individual exercise used, and perhaps, the most common of all, is (3) failure to progress. Each type of plyometric exercise serves a specific purpose in the progression and once that purpose is accomplished, it should go away. Many coaches fear losing something, and continue it in spite of its expired usefulness, and it becomes a new boulder in the bag of training baggage rather than a contributor.
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“In music it isn’t the notes themselves that create the music for there are similar groupings of notes in many pieces. It is the space between the notes or the silence between the notes that creates the differences between musical pieces.”
- Randy Huntington, 2013 BSMPG Summer Seminar Speaker on Training and Recovery
Save the Date: May 16-18, 2014
BSMPG: Where Leaders Learn
Registration Opens January 1, 2014
Performance coaches and medical specialists are looking for the best approaches during screening to reduce injuries. With time being a precious and almost endangered resource, coaches and therapists are wanting to gain as much information and data as possible during testing and evaluations. Professionals at all levels, be they in the clinic or in the field, are looking for the right data, not just more. One of the best ways to improve outcomes in screening is to add surface electromyography (SEMG) to the common tests used for assessment to get deeper and more defined information that goes beyond simple video capture. Most movement screens are scored based on visible criteria and knowledge of biomechanical compensation and neuromuscular recruitment patterns is difficult to discern solely through ocular observation.
Integrating SEMG is easy, provided one knows what to look for. Noraxon’s Clinical DTS SEMG system can capture the direct activity of the body's muscles in action, be it during a movement screen, sporting action, or an actual exercise in the weight room. SEMG helps practitioners evaluate what is going on at rapid speeds or can help validate interventions based on initial screenings. Currently there are five main principles clinics and organizations are finding to be the best practices in regards to complex injuries or effective screening programs. They are:
- Symmetry Threshold - An athlete's body is not perfectly symmetrical, and some sports are obviously not going to have symmetry such as baseball. While some asymmetry will exist between limbs from adaptation, the lower extremity especially is more predisposed to injury when dissimilarities become pronounced to the point of injury. No true percentage exists, but when the discrepancy becomes consistently greater than 10% risk will increase as the differentiation widens.
- Coordination Scoring - EMG looks at how efficient an athlete’s muscle recruitment is based on quiet periods, or times that muscles react and show little activation. The ability to efficiently move without various muscle groups being "on" is a cardinal sign of both coordinated movement and reduced risk of injury from proper timing. Coaches and medical professionals can create unique and individual scoring of efficient movement when surface EMG is used, ranging from gross primitive movements to the most fine motor abilities such as sporting actions.
- Optimized Sequence - Proper summation of forces will result in a more powerful movement, requiring a precise sequence of firing patterns through the kinetic chain. An error in timing, such as a muscle group in a joint action being too early or too late will increase the risk of injury through overload or reduce the performance of the action. EMG records the muscle firing pattern in milliseconds, meaning a very ballistic action such as throwing, kicking, jumping, and sprinting can be analyzed at speeds the naked eye can't see.
- Peak Activity – By using EMG to measure maximum muscle recruitment and look at patterns of firing and amplitude changes, training programs can more effectively prepare the body and ensure it is properly rehabilitated, with the appropriate work rest dosages. Higher levels of activity can be signs of successful intervention or improved motor control. Wireless EMG can capture an array of muscle groups to ensure maximum output is reached.
- Evidence Based Norms - Ideal models tend to be averages of a larger population with research. Deviations from the norm contribute to increased risk of injury or a decrease in performance if not carefully managed. At times outliers will create a need for unique analysis to properly assess individual differences, requiring medical and performance specialists to collaborate and support athletes with unique mechanics or styles.
In the next article we will investigate the above five principles of SEMG with case studies and show how without the measurements evaluations in movement screening would be deceiving. Surface EMG reveals what is going on below the surface; information that visually can't be seen must be revealed in order to make more accurate evaluations of athletes in motion.
Save the Date for the 2014 BSMPG Summer Seminar
May 16-18th, 2014
Click below to see highlights from our 2013 BSMPG Summer Seminar featuring Joel Jamieson.
More highlights are set to come in the next few weeks so stay tuned!
A special thanks again to our SPONSORS!
Remember to save the date for our 2014 Summer Seminar! May 16-18th.
Book your Hotel NOW! (you can always cancel, but you can't always find a hotel room in May!)
Save the Date: May 16-18, 2014
BSMPG: Where Leaders Learn
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"If a practitioner cannot define what they are feeling for in any realistic, scientific manner, then what is the outcome measures guiding their treatment? By this I don’t mean the outcome measure used to define success in the eyes of patients such as pain or range of motion. I mean what is the tactile finding that, on a moment-by-moment basis, guidance the practitioners treatment? How does one know when soft tissue ‘release’ procedures are appropriate vs. passive modalities? How does one know the needed amplitude and direction of force to apply? How does one know when the treatment is over? These and many other questions require that the practitioner is able to palpably distinguish between normal and abnormal anatomic structure, and further that they have a working definition/understanding of what they are looking for."
- Andreo Spina
Interview by Patrick Ward, http://optimumsportsperformance.com
1) Thanks for taking the time out of your busy clinical and teaching schedule to do this interview, Dr. Spina. Can you please give the readers a short overview of your background??
I studied Kinesiology at McMaster University in Hamilton, Ontario, Canada. I later graduated with summa cum laude and clinic honors from the Canadian Memorial Chiropractic College as a Doctor of Chiropractic and subsequently completed the two-year post-graduate fellowship in sports sciences. During my time studying Chiropractic, I became the first pre-graduate student to tutor in the cadaver laboratory in the department of Human Anatomy, a position that continued throughout my post-graduate fellowship program.
Stemming from my passion of studying and teaching anatomy, in 2006 I created Functional Anatomic Palpation Systems (F.A.P.)™ which is a systematic approach to soft tissue assessment and palpation. Following the success of F.A.P. seminars, I later created a follow up system of soft tissue release and rehabilitation called Functional Range Release (F.R.)® technique which is now being utilized by manual practitioners around the world including the medical staffs of various professional sports organizations. I then combined the scientific knowledge gained during my studies with my 29 years of martial arts training in various disciplines to create the third installment of my curriculum, Functional Range Conditioning (FRC)™, which is a system of mobility conditioning and joint strengthening.
Aside from my work teaching seminars, I also own a sports centre in Toronto, Ontario where I practice and train clients. I am a published researcher, and I have authored chapters in various sports medicine textbooks.
2) You approach to soft tissue therapy is extremely comprehensive and, after having attending one of your courses before, it is obvious that you have spent a lot of time reading research in order to develop your thought processes and theories about what may be taking place when we apply contact to another person’s body. The fascial system is a big part of your approach and the concept of the fascial system and how the body is connected has gained a lot of popularity in recent years. Can you please explain your approach and this concept you refer to as “Bioflow Anatomy”?
To say that the Functional Range Release system has a sole focus on fascia is not entirely accurate actually, although it might have been in the not so distant past. Further examination of literature has led/forced me to be more inclusive of other tissues, which together constitute the most abundant type of tissue in the human body, namely Connective Tissue (CT). Examples of other tissues inclusive in CT other than fascia include bone, cartilage, tendons, ligaments, blood vessels, lymphatic tissues…and even 80% of nerve structure. When contemplating the effects of manual therapy ‘inputs,’ or even training inputs for that matter, we must be inclusive of all of these tissue types as each of them will equally adapt to applied inputs. To say that with a particular soft tissue technique application I am affecting one tissue vs. another is as inaccurate as claiming that any particular exercise targets a single tissue, which is in fact impossible. This line of thought stems from literature examining the effects of load inputs on cellular/subcellular processes…a topic that we dive into deeply in the FR Release curriculum.
Continue to read the rest of this article by clicking HERE
Thanks to Patrick Ward for this interview!
"The snake which cannot cast its skin has to die. As well the minds which are prevented from changing their opinions; they cease to be mind."
- Friedrich Nietzsche
Join the Leaders in Sports Medicine and Performance May 16-18th at the 2014 BSMPG Summer Seminar
Is it stress or the way you handle it that will kill you?
Save The Date: May 16-18, 2014
BSMPG Summer Seminar
BSMPG is proud to announce Gerry Ramogida as a speaker at the 2014 BSMPG Summer Seminar - May 16-18th, 2014. Last year was a sell out and the only difference this year will be us announcing a sell out a month in advance! This will be one of the greatest performance and therapy seminars of all time!
Seriously, this will sell out - Registration will open January 1st, 2014. Members of the BSMPG family will receive an opportunity to reserve their seat in advance - stay tuned for details. With speakers and attendees traveling from around the world, this seminar will close in record time.
Be sure to save the date and reserve your hotel room well in advance.
See you in Boston next May!!!
Topic: Mechanics and Manual Therapy, Influences on Performance
Workshop: Micro-movement dictates Macro-movements
Dr. Gerry Ramogida is an internationally recognized chiropractor and performance therapist. He has served on many Canadian national teams and across a wide range of sports from football, soccer, ice hockey and athletics. Dr. Ramogida has been a chiropractic consultant with the Seattle Seahawks of the NFL since 2002. He was also brought on by the UK Athletics team as “their Lead” Performance Therapist for the 2012 London Olympics where they won six medals including four gold medals. He has been a practicing chiropractor since 1997 and has worked with dozens of high-profile professional and Olympic athletes. His research interests include how manual therapy influences performance and motor learning, particularly as it relates to the teaching and acquisition of sprint technique and speed development.