Boston Sports Medicine and Performance Group, LLC Blog

Standing On The Shoulders Of Giants DVD's Available

Posted by Boston Sports Medicine and Performance Group on Thu, Sep 29, 2011 @ 08:09 AM

Missed this summer's BSMPG summer seminar?

Wished you could have seen the authors of these books and video speak while they were in Boston?

 

Tom Myers  Charlie Weingroff  Clare Frank

Well now you can - We captured three groundbreaking presentations from this once in a lifetime seminar.  Catch three of these Giants in action as they presented at the 2011 "Standing On The Shoulders Of Giants" Summer Seminar.

This conference was held in Boston, MA on June 3rd and 4th, 2011

Included: 3 DVDs with over 4.5 hours of Sports Medicine and Rehabilitation Information

Presentations by: Clare Frank - Muscle Balance and Stability, Tom Myers - Anatomy Trains and Myofascial Fitness and Charlie Weingroff - Trying to Define the Core.

clare frank Tom Myers Charlie Weingroff

Click HERE for complete details.

Topics: Art Horne, basketball resources, basketball conference, BSMPG, boston hockey summit, athletic training, Charlie Weingroff, boston hockey conference, Tom Myers, athletic training books, barefoot strength training, Clare Frank

BSMPG Summer Seminar DVD's Now Available!

Posted by Boston Sports Medicine and Performance Group on Thu, Sep 15, 2011 @ 07:09 AM

Missed this summer's BSMPG summer seminar?

No Problem - We captured three groundbreaking presentations from this once in a lifetime seminar.  Catch three of these Giants in action as they presented at the 2011 "Standing On The Shoulders Of Giants" Summer Seminar.

This conference was held in Boston, MA on June 3rd and 4th, 2011

Included: 3 DVDs with over 4.5 hours of Sports Medicine and Rehabilitation Information

Presentations by: Clare Frank - Muscle Balance and Stability, Tom Myers - Anatomy Trains and Myofascial Fitness and Charlie Weingroff - Trying to Define the Core.

clare frank Tom Myers Charlie Weingroff

Click HERE for complete details.

Topics: basketball resources, athletic training conference, boston hockey summit, athletic training, Charlie Weingroff, boston hockey conference, Tom Myers, athletic training books, Clare Frank

Integrated Care - Part IV : Addressing & Correcting Hip Extension Problems

Posted by Boston Sports Medicine and Performance Group on Mon, Sep 12, 2011 @ 07:09 AM

by Art Horne

 

As we mentioned last week, our society has clearly become hip flexion dominant. 

This is really no surprised as Janda identified this “epidemic” long ago and termed it, the Lower Crossed Syndrome.  Clearly ahead of his time, and well before Blackberrys and IPhones caused us to hunch over and run into people on the sidewalk, Janda also described and discussed the upper crossed syndrome which is more prevalent today than ever as well.  With that said, so many of the young “healthy” athletes that sign up to play collegiate level athletics no longer are able to express the fundamental movement patterns that we so often take for granted.  This of course is not always a mobility problem, as many athletes are not able to reach end range of these patterns simply out of a reflexive protective mechanism.

 

sports medicine resources

 

Your body will simply not allow you to go where you have no business going.  (Ever wonder why LBP patients can’t touch their toes? Hint: it has nothing to do with hamstring length and everything with your brain not letting you get to end range flexion, you know, the place you have no business going)
In other cases, mobility is the main culprit and can usually be addressed with a simple movement exam along with some corrective therapy and exercises. 


Let’s take a look at an example to see what I mean.

Case Presentation:

This athlete presented to me many years ago, and unfortunately the overall theme continues year after year despite our best efforts to educate our athletes and their high school and youth coaches.

Here’s the story:

On evaluation athlete complains of having a persistent anterior hip pain from day one of pre-season practice.  She states that she had a “significant” hip injury at age 13 which lasted about one year and limited her from all sporting activities including gymnastics where she originally hurt herself during a coach “assisted” stretch.  At the time of the stretch, the athlete’s injured leg was down and extended behind her pelvis, with knee at 90 degrees and the opposite limb forced into extreme flexion.  At that time she felt intense pain and was not able to return to any physical activities for about one year. 

She went on to a successful high school career and eventually earned a college scholarship for her efforts.

 

sports medicine

(not the same stretch - but close. OUCH!) 

 

movement screen

 


On movement evaluation utilizing the SFMA, cervical and shoulder motions were FN (functional and non-painful), multi-segmental flexion FN, multi-segmental extension FP (functional but painful), multi-segmental rotation DN (dysfunction and non-painful) away from the injured side, single leg stance was DP on injured side, FN on uninjured side (NOTE: during this test athlete complained of pain with standing hip flexion.  She was however able to get her knee/femur past 90 degrees of hip flexion but had to first abduct her leg then lift it in front – so to basically avoid iliacus involvement and use only psoas with some help from TFL and Sartorius). Lastly,  deep squat was DN. 


(Now, according to the SFMA I should have “broke out” her multi-segmental rotation pattern and addressed her subsequent restriction but given her prior history and description of pain I decided to go directly to the prone hip extension test to confirm my suspicion that she had originally injured her iliacus some 5 years ago.)

On prone hip extension, athlete was unable to extend her injured leg to a minimum of 10 degrees.

Treatment Plan: evaluate and address tissue density changes and restrictions within the hip flexion musculature including both psoas and iliacus specifically.


If you aren’t familiar with manual therapy techniques to address soft tissue restriction within the iliacus consult a co-worker or expert in your area for help or training (If you’re in the Boston area one of the most talent manual therapist I’ve ever had the pleasure working with is Dr. Pete Viteritti.


Below are a few key technical points regarding treatment of the Iliacus utilizing a manual therapy release technique.  Remember: the iliacus is to hip dysfunction as the psoas is to lumbar dysfunction.

sports medicine

 

1. Begin with the patient lying on their side, hip and knee flexed and relaxed.

2. With the contact fingers extended, work the soft contact from the anterior superior iliac spine (above the inguinal ligament) medically onto the iliacus treating from proximal all the way distal to the lesser trochanter.  The adhesion can be anywhere in the muscle.  Also, be sure to move your hand contact treating medially until you bump into the psoas.  The junction of the iliacus and psoas is very important, be sure they are not adhering to one another. (adhesion's between muscles which cause them to adhere to one another is much more of a problem than an adhesion in a muscle itself).

3.The inguinal ligament should also be checked to be sure you can bow it both distal and proximal, as it can adhere to the iliacus underneath it.  Find the inguinal ligament at the ASIS and trace it as it moves medially and deep.  It is only the lateral aspect of it that comes in contact with the iliacus and can become entrapped.

4. As you begin, be sure to move the mesentary medially and not treat through it.  Use care to avoid putting tension on the mesentary as this will not only cause discomfort to the patient, but will significantly limit treatment effectiveness.

5. Once on the tissue, begin to put tension on the tissue superiorly with your inferior hand while the superior hand backs it up.

6. Have the patient extend the hip and knee straight and then extend the hip as far as possible.

Post treatment: Athlete was able to regain full prone hip extension, pain resolved with both single leg stance (athlete was able to lift knee/leg straight up in sagittal plane) and multi-segmental extension pattern.  Deep squat pattern improved significantly but was not yet perfect.  And most impressive post treatment was the look of shock and excitement on her face.

Whether you’re dealing with a shortened iliacus, a tight psoas major or a restricted rectus femoris (or perhaps even a shortened rectus abdominis thanks to the 2 million crunches you’d done), identifying the global limitation first (an extension pattern in this case), and then referring to an expert or addressing the underlying tissue restricting this pattern yourself before high levels of organized activity begins can mean the difference between weeks of treatment post injury or a few moments of your time prior, during your screening process.  Of course identifying the exact limiting factor/tissue/pain generator is the ultimate factor when it comes to whether your treatment will be a success or not.

“So what does this have to do with integrated care?  This sounds like a pure sports medicine problem and treatment approach to me.”

Perhaps – but all strength coaches can look at global movement patterns including extension and make the appropriate referrals.  Whether it’s during your pre-participation examination or during a simple recheck in the weight room – having all coaches, athletic trainers and therapists understanding the normal parameters of human movement and speaking the same language eliminates the language barrier and allows all parties involved in the care and performance of the student-athlete to be provide a unified care approach to the identified problem.  Although many strength coaches won’t be able to apply a manual therapy technique for this identified problem, appropriate strategies within the weight room can certainly maintain this new tissue quality and “cement” this new found range of motion with strength exercises appropriate for the athlete and previous injury.

Although the skill set or specific treatment modality between the two professional groups my vary slightly, the underlying philosophy should not and in this case addressing this extension limitation with whatever tools you are allowed to use will certainly pay dividends at the end of the day.

 

 

Next Week: When Not Being Able To Touch Your Toes Is Not A Hamstring Issue

 

 

 

 

Topics: Art Horne, basketball training programs, athletic training conference, basketball videos, Pete Viteritti, athletic training books, barefoot strength training, barefoot running

When Reading Is NOT Good

Posted by Boston Sports Medicine and Performance Group on Fri, Aug 5, 2011 @ 07:08 AM


by Keke Lyles, DPT, CSCS

I had a conversation with someone the other day who was telling me about how he has started to train with a guy who is currently in school with aspirations to become a strength coach. He was telling me about all the different books, websites, and articles that his guy has been reading. It is always refreshing to hear about any professional who is trying to do all they can to better themselves. He continued on to tell me how his guy started to use Graston tools on him to help with his soft tissue issues, and then shared with  me how he got all “jacked up” from the Graston. He had to seek medical help to deal with the consequences.


My question to all professionals is at what point is it okay to read about different techniques or skills and then decide you are capable of performing such skill? I don’t want to sound like a bitter physical therapist who doesn’t like the idea of strength coaches trying to expand their knowledge, but as a strength coach myself, we MUST operate within our scope of practice. Even as a physical therapist, I would not recommend anyone just picking up Graston tools or any other such tool without proper training and education beforehand. Yes, it is true that given impairments would greatly benefit from such techniques, but our job as strength coaches, physical therapist, or athletic trainers is sometimes to swallow our pride and refer our clients/athletes to the people who are experts and trained properly to use specialized techniques.

Many techniques are certainly beneficial but at the same time can be very destructive to the tissues that we think we are correcting. As a result, serious consequences may arise from practitioners who are trying to do the right thing, but without the proper skill set. I urge us all to continue to read and learn about the advancements we are making both in the strength world as well as in the rehab world. However, just because I read about how great some patients responded to PRP injection in their patella tendon, doesn’t mean I am going to try to perform injections myself to everyone that comes to me complaining of patella tendon pain.  That is not my decision to make and certainly not the person to perform it.

Be responsible with your actions and continue to read to learn about the current evidence-based practices so that when you come across someone who may benefit from such technique, you can do you part of informing them of the options and then refer them to the right person who is suitable to perform such technique.

 

Topics: basketball training programs, athletic training conference, boston hockey summit, boston hockey conference, athletic training books, everything basketball

What the GIANTS are Reading - Brijesh Patel

Posted by Boston Sports Medicine and Performance Group on Mon, Jul 11, 2011 @ 07:07 AM

We asked what the Giants in Sports Medicine & Rehabilitation, Basketball and Hockey performance training have read or are currently reading and we brought their list to you.  

Click HERE to view our recommended library with an ongoing list from these speakers who presented at the BSMPG "Standing On The Shoulders Of Giants" 2011 summer seminar.

Brijesh Patel

Brijesh Patel

 

 

Topics: Basketball Related, basketball performance, basketball resources, athletic training conference, Brijesh Patel, athletic training books

What the GIANTS are Reading - Shirley Sahrmann

Posted by Boston Sports Medicine and Performance Group on Fri, Jul 8, 2011 @ 07:07 AM

We asked what the Giants in Sports Medicine & Rehabilitation, Basketball and Hockey performance training have read or are currently reading and we brought their list to you.  

Click HERE to view our recommended library with an ongoing list from these speakers who presented at the BSMPG "Standing On The Shoulders Of Giants" 2011 summer seminar.

 

Shirley Sahrmann

Keynote Speakers Pete Viteritti and Shirley Sahrmann

 

Topics: Basketball Related, basketball conference, basketball training programs, athletic training conference, boston hockey conference, Shirley Sahrmann, Pete Viteritti, athletic training books

Worry About What You CAN Control

Posted by Boston Sports Medicine and Performance Group on Wed, Jun 22, 2011 @ 07:06 AM


by Shaun Bossio

 

I had a colleague recently come to me out of frustration. Their position grade was below that of several other people in their department that they felt were not as valuable. In addition, they felt as though both title-wise and salary-wise they should be receiving more consideration than these folks that they felt had received some undue advancement. After about three years in their position, they felt as though they deserved more than the token merit increases that they had seen over that time.

In actuality, there are two different problems here. The first is that they felt as though they were not receiving the proper recognition. The second and most important though is that they were measuring themselves against the performance of others within their department. Therein is where the problem lies for you. Unless these staff members are reporting to you, there is not a whole heck of a lot you can do about their perceived performance vs. yours. Equating yourself to other comparable employees within your organization is a lot like playing golf. You cannot control what your opponents are shooting, so your best option is just to concentrate on shooting the best score that YOU can. Focusing on comparisons between your coworkers and yourself is a trap that many people fall into and really it is energy that could be better spent making yourself an even better employee.

Many of us at one time or another have felt as though we were not receiving the proper amount of credit (compensation, title, accolades, etc). It is important to remember that while this may be the case, it is a matter to be handled between your employer and yourself and has nothing to do with your coworkers. If you are truly underappreciated in your organization, then it is time to approach your supervisor and let them know why and remind them of the value that you provide to them. In some cases it may be as simple as making a solid case for your yourself and in others the possibility exists of setting goals that, if met, will yield increased benefits to you. Sometimes however, your opportunity lies elsewhere. In many organizations (universities in particular come to mind), unfortunately your best chance is in taking a promotion with another company. In these cases, if you revere your organization, the chances of returning at a higher salary/title have already increased.

Regardless of how you perceive your future, know that the best thing for you is to simply focus on yourself and to do the best job that you can do. If you get to a point where you feel as though you are not being properly appreciated, take some time to remind your employer what they have and why they need you around. The folks that are busy comparing themselves to each other are the ones that are only concerned with doing their job as well or slightly better than their coworkers. In the meantime, you can be the one excelling and getting people to notice.

 

Shaun Bossio is the Assistant Business Manager at the Boston University FitRec.

Topics: basketball performance, basketball conference, basketball training programs, athletic training conference, boston hockey summit, boston hockey conference, Shaun Bossio, athletic training books

What the Giants are reading - Charlie Weingroff

Posted by Boston Sports Medicine and Performance Group on Wed, Jun 8, 2011 @ 06:06 AM

We asked what the Giants in Sports Medicine & Rehabilitation, Basketball and Hockey performance training have read or are currently reading and we brought their list to you.  

Click HERE to view our recommended library with an ongoing list from these speakers who presented at the BSMPG "Standing On The Shoulders Of Giants" 2011 summer seminar.

 

Charlie Weingroff

Charlie Weingroff:

Topics: basketball conference, BSMPG, athletic training conference, Charlie Weingroff, recommended reading, athletic training books

Do The Opposite

Posted by Boston Sports Medicine and Performance Group on Mon, Feb 14, 2011 @ 07:02 AM

I once heard Mike Boyle say if you ever want to get fit, simply go to your nearest commercial gym and do the exact opposite of what everyone is doing.  I decided to put his theory to the test at our general student fitness facility this past week. 

 

1. Commercial Gym Choice: Laying down and lumbar flexion

athletic training conference


I think this exercise choice can be summed up best when I heard one kid ask another,”Are you sure this is suppose to hurt like this?”


Opposite Choice: anything not involving lumbar flexion including front bridges and McGill’s Big Three.

 

basketball conference

(ahhh, sweet back relief)

2. Commercial Gym Choice: Slow Paced Jog

 

boston hockey summit


What’s the definition of crazy? Doing the same thing over and over again and expecting a different result.  I’ve never understood why people continue to jog at a slow pace for hours on end and then act surprised when they haven’t lost any weight or end up injured.


Opposite Choice: it was a nasty Boston day with snow and sleet so elected to stay inside and join the herd of runners on the treadmills except choosing to ramp both speed and incline upwards while jumping on and off in 30:30 second sprint intervals. 

athletic training resources


 
3. Commercial Gym Choice: Partial Body Weight Movement

During the aforementioned sprint rest intervals I couldn’t help but notice on the woman on the treadmill beside me. Her treadmill was set to the highest incline possible with both hands on the front rail holding on for dear life!  I’ve never seen anything like it before – it was as if she was in a hurricane and the rail at the front was her lifeline! Not to be outdone, the guy on the stair climber just down from her had the reverse-extended-elbow lock on each hand rail suspending his body weight overtop of the moving stairs below.  If you choose to utilize any type of “cardiovascular” equipment be sure to move your own body weight and not have the machine help you out.

 

athletic training resources

(ok, so she's not hanging on for dear life, but why is she hanging on at all? Is it that hard to walk?)


Opposite: I was still sprinting without holding on so I figured this one was covered.

 

More tomorrow....

Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at a.horne@neu.edu.

Topics: Art Horne, basketball resources, basketball conference, basketball training programs, athletic training conference, boston hockey summit, athletic training books

My boss won't let me

Posted by Boston Sports Medicine and Performance Group on Wed, Sep 15, 2010 @ 06:09 AM

everything basketball

 

Is just an excuse for not wanting to do the work required to get a project shipped.

If your boss truly won’t let you, it’s probably because you are asking the wrong questions.

If you want your boss to support you during a project which will ultimately reward you if it works, but punishes the boss if fails then of course you’re asking the wrong questions.

What exactly won’t your boss let you do?

Did you investigate it? Research it? Find a gap in your current operating procedures that is worth filling? Does it fit into your core principles? Values?

If the answer is yes, and your boss really won’t let you, then you might want to find another job where your boss supports the extraordinary work that you’re doing.

Unless of course, your happy with ordinary?

(rant inspired by Seth Godin and his most recent book, Linchpin)

Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at a.horne@neu.edu.

Topics: basketball conference, Strength & Conditioning, Ownership, discipline, athletic training books, customer service, development, Seth Godin