Boston Sports Medicine and Performance Group, LLC Blog

Predicting Performance and Injury Resilience in Collegiate Basketball Athletes

Posted by Boston Sports Medicine and Performance Group on Wed, Aug 1, 2012 @ 06:08 AM


by Art Horne



basketball performance resized 600


Just recently Dr. Stuart McGill, Jordan Andersen and myself published an article in the Journal of Strength and Conditioning Research examining the link between traditional pre-season strength, fitness, and sports medicine testing to overall on-court basketball performance and injury resilience throughout the course of two collegiate basketball seasons.  Although I would be the first to admit that there are some clear limitations to this study (number of participants for example), key performance predictors (points scored, ability to rebound, block shots, etc) were NOT associated with traditional strength or performance measures so often pursued in collegiate basketball strength programs.

Over the course of the next few weeks I will review this article in detail and provide insight into how actual on-court basketball performance may be improved upon beyond simply finding better parents or recruiting.  


Predicting Performance and Injury Resilience From Movement Quality and Fitness Scores in a Basketball Team Over 2 Years

McGill, Stuart M.1; Andersen, Jordan T.1; Horne, Arthur D.2

Journal of Strength and Conditioning Research

July 2012



The ability to successfully predict injury resilience and competition performance from preseason testing is a very wishful goal; however, questions remain regarding this objective: Do tests of fitness have a predictive ability for injury and are there other factors that can be assessed that may predict injury? Are there specific indicators that predict performance? This study was motivated by these questions.

Attempts to understand injury mechanisms and performance sometimes consider links to fitness. Traditionally, fitness testing, at least in occupational settings, has included the assessment of strength (13), joint range of motion (ROM) (23), and physiological variables such as heart rate, blood pressure, and oxygen uptake (2), but the performance scores in the occupational context are difficult to quantify. In contrast, there have been some studies relating fitness to sporting performance that are more tangible. In studies of ice hockey players (6,24), success could be more tangibly quantified from on-ice measures such as total minutes played and scoring chances. Green at al. stated that “goals scored” was not the best measure of hockey skill. Studies of football players suggest that those who score higher on movement quality tests have few injuries (11,12); however, preseason football combine testing is dominated by tests of strength and running speed. Recognizing that movement asymmetry and compromises to neuromuscular control have been linked to both future injury (11,12) and with having a history of back injury (17), movement assessments have been developed (3,4) and have been suggested to predict injury rates. Further, several fitness and movement tests have been implicitly assumed to predict “playing” performance by their inclusion into standard preseason tests. These include tests of endurance, strength, joint ROM, agility, and speed. The question remains as to the validity of these factors when attempting to predict injury resilience and performance.

Although links between moving well and injury resilience and performance seem intuitive, this notion remains controversial. Interestingly, some evidence suggests that fitness training alone may not ensure peak performance or injury resilience (8,20). In addition, movement quality has been suggested to predict future injury (12). A possible mechanism may be that injury changes the way a person moves as an accommodation to pain (consider, e.g., the changes in mechanics throughout the anatomical linkage when limping from foot pain). Having a history of injury, in particular back injury, appears to change movement patterns (17). Movement patterns determine important injury criteria, such as joint and tissue load, together with influencing the length of time and repetitions an individual is able to perform a task with uncompromised form. Compromised form exposes the tissues to inordinate load elevating the risk of injury. Several examples of this link are available, for example, not maintaining a neutral curve in the lumbar spine while bending and lifting decreases the tolerable load at injury (in this case tissue failure [18]); having restricted hip motion is linked to having more spine motion when bending (17). Movement competency has also been linked with anterior cruciate ligament (ACL) injury rates, for example, having larger knee abduction moments and angles when landing from a jump predicted higher ACL injury rates (9). Given the variety of considerations for interpreting the links between movement, fitness, performance, and potential injury, the goal of this study was to first evaluate some traditional fitness test scores in a controlled athletic group that has a variety of challenging movement demands and also perform an assessment of the quality of movement. It was hoped that following a test group for a period of time would reveal links between specific fitness scores and movement quality with variables to predict injury resilience and performance. If such links exist, they could form a rationale for specific tests to be included in preseason testing.

The purpose of this study was to see if specific tests of fitness, and movement quality, could predict injury resilience and performance in a team of basketball players over 2 years (playing seasons).

It was hypothesized that in a university basketball population, (a) Preseason movement quality and fitness scores would predict in-season performance scores. (b). Preseason movement quality and fitness scores would predict in-season injury resilience.



See Dr. Stuart McGill and other world authority in Sports Medicine, Science and Performance at the 2013 BSMPG Summer Seminar - May 17 & 18 in Boston MA

Topics: Art Horne, Brian McCormick, basketball performance, basketball conference, basketball training programs, athletic training conference, Craig Liebenson, Shawn Windle, Basketball Training, Stuart McGill, Keith D'Amelio

Up the Chain It Goes... (Part II)

Posted by Boston Sports Medicine and Performance Group on Fri, May 4, 2012 @ 07:05 AM

By Art Horne


turf toe derrick rose toe injury



In a follow up from a previous post (Up The Chain It Goes), additional evidence supporting the relationship within the kinetic chain has emerged from south of the equator.  In a study out of South Africa examining the link between available dorsiflexion and mechanical low back pain researchers found a statistically significant decrease in ankle dorsiflexion ROM and associated reporting of low back pain (Brantingham, 2006).   With the vast majority of adults suffering from low back pain at some time in their life, (some reports are up to 85%) and 80% of people reporting foot problems during their lifespan, it’s not a surprise to see that these two conditions may very well be related.

Let’s take a closer look:

Methods: “ The study was a blinded, 2-arm, non-randomized clinical study involving 100 subjects with chronic or recurrent mechanical low back pain (intervention group) and 104 subjects without chronic mechanical low back pain (control group) between the ages of 18 and 45.  A blind assessor performed weight-bearing goniometry of the ankle and big toe and the navicular drop test on all subjects in both groups.”

Results: “An independent t-test (inter-group) revealed a statistically significant decrease in ankle dorsiflexion range of motion in individuals with chronic mechanical low back pain.”

Conclusions: “This study’s data found that a statistically significant decrease in ankle dorsiflexion ROM, but not flatter feet, was associated with subject report of chronic mechanical low back pain disorders.”

Discussion: “The findings of this blinded study support previous reports suggesting that decreased ankle dorsiflexion may be a factor in chronic mechanical low-back pain.  There was no clear association found between decreased hallux ROM and mechanical low back pain in this study.  If these findings are confirmed through additional studies, exercise and manipulation therapy to increase ankle range of motion could become an important consideration in the treatment of some patients with mechanical low back pain disorders.”

Hmmm, if only we had some additional studies….

Perhaps this will help.

During a routine exit physical, 60 division one athletes were assessed for available weight bearing dorsiflexion bilaterally as described by Bennell et al in 1998 (inclinometer was replace by Clinometer app for ITouch) to examine limitations in this movement.   Ten athletes with limited weight bearing dorsiflexion (less than 4 inches from knee to wall) volunteered for follow up evaluation and manual treatment. Out of the initial 120 measured ankles, 47 ankles (21 right, 26 left) demonstrated limited weight bearing dorsiflexion range of motion.

Athletes were then asked to walk normally in their athletic shoes while wearing an in-shoe pressure sensor (Tekscan) and through an optical measurement system (Optojump).  Each athlete then underwent a general manual therapy intervention aimed to improve ankle dorsiflexion, followed again by the same gait analysis and pressure mapping data capture.


Gait Evaluation



Gait Cliff Notes: optimal gait should have two mountains with a trough between them. The first mountain represents heel strike to midstance, the trough representing the mid-stance phase, and the second mountain being propulsion from full foot contact to toe-off.

Easy right? Good. 

Note: The second mountain should almost always be higher than the first.


Case Study 1:

Tekscan report


Pre-treatment (RED):

Notice how the first mountain is slightly higher than the second – this is BAD!

Remember from our cliff notes: the second mountain should be higher.

Post-treatment (GREEN):

Notice change in toe off from pre- to post-treatment which specifically targeted patient's limited dorsiflexion?  The second mountain is now higher than the first. That’s a GOOD thing!

Awesome right?

Better yet – athlete was measured 3 days post treatment and improvement in Dorsiflexion range of motion stuck!  Try doing that with a slant board stretch.


See Art Horne and Dr. Pete Viteritti discuss these and other changes at the foot and ankle, and how to assess and address soft tissue and bony restrictions in their presentation at the 2012 BSMPG Summer Seminar May 19-20th in Boston.


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Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH and Hall AJ. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Australian Journal of Physiotherapy. 44;175-180.

Brantingham JW, Gilbert JL, Shaik J, Globe G. Sagittal plane blockage of the foot, ankle and hallux and foot alignment-prevalence and association with low back pain. J of Chiropractic Medicine. 2006; 4(5); 123-127.




Topics: Art Horne, basketball performance, basketball training programs, boston hockey conference, barefoot strength training, Bruce Williams, Cal Dietz, Bill Knowles, Barefoot in Boston, Chris Powers, Dorsiflexion

Up the Chain it Goes...

Posted by Boston Sports Medicine and Performance Group on Sun, Apr 29, 2012 @ 15:04 PM

By Art Horne



derrick rose torn acl



With recent season ending ACL injuries to New York Knicks Iman Shumpert, and Chicago Bull’s point guard Derrick Rose coming on the same day, (not to mention Eric Maynor from the Thunder and Spanish Star Ricky Rubio earlier this season) discussion has arisen as to how these terrible injuries could have been avoided.  Although the possible contributing factors are endless, ranging from previous injury to simply fatigue, one area worth shedding more light on, especially in the case of young Rose, is the implication of the kinetic chain as a whole.

Let’s start at the ground and work our way up.

I think we’d all agree that the big toe is a big deal.   But how closely are we looking at this “pivotal” body-ground juncture?

In a study by Munuera et al, researchers found that “Hallux interphalangeal joint dorsiflexion was greater in feet with hallux limitus than in normal feet.  There was a strong inverse correlation between first metatarsophalangeal joint dorsiflexion and hallux interphalangeal joint dorsiflexion.” (Munuera et al, 2012). 

TRANSLATION: People with abnormally stiff or limited motion at the great toe had excessive motion at the joint just distal.

If you don’t have mobility where you need it, you’ll surely get it somewhere else.

Let’s move up the chain shall we?

In a study by Van Gheluwe and his group,  researchers looked at how a stiff or limited great toe joint changes the way we walk.  In their study, “two populations of 19 subjects each, one with hallux limitus and the other free of functional abnormalities, were asked to walk at their preferred speed while plantar foot pressures were recorded along with three-dimensional foot kinematics.  The presence of hallux limitus, structural or functional, caused peak plantar pressure under the hallux to build up significantly more and at a faster rate than under the first metatarsal head.  Additional discriminators for hallux limitus were peak dorsiflexion of the first metatarsophalangeal joint, time to this peak value, peak pressure ratios of the first metatarsal head and the more lateral metatarsal heads, and time to maximal pressure under the fourth and fifth metatarsal heads.  Finally, in approximately 20% of the subjects, with and without hallux limitus, midtarsal pronation occurred after heel lift, validating the claim that retrograde midtarsal pronation does occur.”

TRANSLATION: if you have a limited motion in your great toe, pressure changes will occur – increase pressure changes will cause pain over time (think blister on your foot).

And pain changes the way we move – period.

Let’s take a look at the ankle.

In an article  by Denegar et al, the authors outline the importance of regaining normal talocrural joint arthrokinematics following an ankle injury.   The authors note,

 “All of the athletes we studied had completed a rehabilitation program as directed by their physician under the supervision of a certified athletic trainer, and had returned to sports participation.  Furthermore, all had performed some form of heel-cord stretching. None, however, had received joint mobilization of the talocrural complex.  Despite the return to sports and evidence of restoration in dorsiflexion range of motion, there was restriction of posterior talar mobility in most of the injured ankles.  Posterior talar mobilization shortens the time required to restore dorsiflexion range and a normal gait.  Without proper talar mobilization, dorsiflexion range of motion may be restored through excessive stretching of the plantar flexors, excessive motion at surrounding joints, or forced to occur through an abnormal axis of rotation at the talocrural joint.” (pg. 172)

TRANSLATION: I repeat, Without proper talar mobilization, dorsiflexion range of motion may be restored through excessive stretching of the plantar flexors, excessive motion at surrounding joints, or forced to occur through an abnormal axis of rotation at the talocrural joint.” (pg. 172)

If you don’t have normal ankle motion, and specifically at the talus, your ankle motion (although appearing normal) is probably coming from other joints and/or in a combination with foot pronation.


Foot Pronation = Tibial Internal Rotation

Tibial Internal Rotation = Femoral Internal Rotation

Tibia and Femur Internal Rotation  =  Knee Valgus (or knee collapse)

Knee Valgus = BAD


But just because you have some extra motion doesn’t mean you’re doomed right?


But, excessive motion without the ability to control that motion certainly does.  So where does knee control come from? The Hip!

But hip strength, control, and neuromuscular timing is seldom appreciated, and in the case of the basketball athlete it is certainly poorly measured, especially after ankle injury.

In a study by Bullock-Saxton, researchers investigated muscle activation during hip extension after ankle sprain and showed a changes in timing of muscle activation in the ankle sprain grouped compared to the non-injured group.

 “the results highlight the importance of the clinician’s paying attention to function of muscles around the joints separated from the site of injury.  Significant delay of entry of the gluteus maximus muscle into the hip extension pattern is of special concern, as it has been proposed by Janda that the early activation of this muscle provides appropriate stability to the pelvis in such functional activities as gait.” (pg. 333)


In another study examining ipsilateral hip strength/weakness after the classic ankle sprain, researchers demonstrated that subjects with unilateral chronic ankle sprains had weaker hip abduction strength and less plantar flexion range of motion on the involved sides (Friel et al., 2006)

“Our findings of weaker hip abductors in the involved limb of people with chronic ankle sprains supports this view of a potential chronic loss of stability throughout the kinetic chain or compensations by the involved limb, thus contributing to repeat injury at the ankle.” (pg. 76)

“If the firing, recruitment, and strength of the hip abductor muscles in people with ankle sprains have been altered because of the distal injury, the frontal-plane stability normally supplied by this muscle is lacking, and the risk for repeat injury increases.  Weak hip abductors are unable to counteract the lateral sway, and an injury to the ankle may ensue.”

TRANSLATION: Ankle sprains cause neuromuscular changes up the chain and specifically in the hip.  If this weakness is not addressed after an ankle injury,” frontal-plane stability normally supplied by this muscle is lacking.” 


Lack of frontal-plane stability + Knee Valgus = Injury


Of course suggesting that the above points are exactly the reason for which Rose suffered his injury is certainly a stretch and not the intention of this post, nor is it to question the treatment that he or any other NBA player received prior to their devastating injury (for the record, the Chicago Bulls Sports Medicine and Strength Staff are regarded as one of the very best in the league).  What I am suggesting however is that examining athletes and patients with the use of advanced technology to determine a state of readiness to participate, and/or examine more closely changes in gait and neuromuscular firing is certainly worth pursuing, especially in light of the ever-rising salaries within professional sports.  A quick look is certainly worth the small investment.

One thing is for sure, ACL injury is not limited to teenage females or only seen on the soccer pitch.


Previous Posts:

The NBA Should Have Learned From The NFL - Injuries On The Rise

Did The NBA Lock-out Ultimately End Chauncey Billups' Career?


See lectures directly related to gait, injury prevention, and performance at the 2012 BSMPG Summer Seminar:

1. Dr. Bruce Williams: Hit the ground running: Appreciating the importance of foot strike in NBA injuries

2. Dr. Bruce Williams: Breakout Session: Restoring Gait with evidence based medicine

3. Art Horne and Dr. Pete Viteritti: Improving Health & Performance - Restoring ankle dorsiflexion utilizing a manual therapy approach

4. Dr. Tim Morgan: Biomechanics and Theories of Human Gait: Therpeutic and Training Considerations

5. Jose Fernandez: Advanced Player Monitoring for Injury Reduction



See the most advanced player monitoring equipment currently available at the 2012 BSMPG Summer Seminar:


 zeo affectiva  ithlete

BioSensics  Zflo insideTracker


Dartfish  freelap timing   Tekscanoptosource

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Munuera PV, Trujillo P, Guiza L, Guiza I. Hallux Interphalangeal Joint Range of Motion in Feet with and Without Limited First Metatarsophalangeal Joint Dorsiflexion. J Am Podiatr Med Assoc. 102(1): 47-53, 2012.

Denegar, C., Hertel, J., Fonesca, J.  The Effect of Lateral Ankle Sprain on Dorsiflexion Range of Motion, Posterior Talar Glide, and Joint Laxity.  J Orthop Sports Phys Ther. 2002; 32(4):166-173.


Van Gheluwe B, Dananberg HJ, Hagman F, Vanstaen K. Effects of Hallux Limitus on Plantar Foot Pressure and Foot Kinematics During Walking. J Am Podiatr Med Assoc. 96(5): 428-436, 2006.

Bullock-Saxton, J. E., Janda, V., & Bullock, M. I. (1994) The Influence of Ankle Sprain Injury on Muscle
Activation during Hip Extension. Int. J. Sports Med. Vol. 15 No. 6, 330-334.

Friel, K., McLean, N., Myers, C., & Caceres, M. (2006). Ipsilateral Hip Abductor Weakness After Inversion
Ankle Sprain. Journal of Athletic Training. Vol. 41 No.1, 74-78

Smith RW, Reischl SF. Treatment of ankle sprains in young athletes. Am J Sports Med. 1986;14:465-471.

Topics: Art Horne, basketball performance, basketball training programs, BSMPG, athletic training conference, Charlie Weingroff, boston hockey conference, barefoot strength training, Andrea Hudy, Bruce Williams, Cal Dietz, Alan Grodin, Barefoot in Boston, Dr. DiMuro, Dan Boothby, Chris Powers, achilles pain, Dorsiflexion, ankle problems

BSMPG 2012 Summer Seminar Agenda Finalized!

Posted by Boston Sports Medicine and Performance Group on Fri, Mar 9, 2012 @ 07:03 AM

In 2011, BSMPG invited the titans of Sports Medicine and Performance to Boston for the largest conference of its kind, and many attendees left asking the question, "how could you ever top that speaker line-up?"

Well, we did.

BSMPG is proud to announce May 19-20, 2012 as the selected date for Sports Medicine and Strength professionals to desend upon Boston MA for another monster conference! So how could we ever top last year's speaker set? Let's just say that we asked last year's speakers who they wanted to hear and we got em! As we did last year, this seminar will be divided into three distinct educational tracks including a Hockey focus, a Basketball Focus, and a clear Sports Medicine/Rehabilitation Track with Keynote Speakers throughout the weekend bringing each track together for common lectures. Attendees may choose to stay within one track throughout the entire weekend or mix and match to meet their educational needs. Remember to save the date now - you won't want to miss another great summer seminar presented by BSMPG.


Date: May 19-20, 2012

Location: Boston MA. Campus of Northeastern University

Agenda: Click HERE to view

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Get to know Keynote Speaker at the 2012 BSMPG Summer Seminar, Craig Liebenson below in an interview by Everything Basketball:





dunk shot 

 Craig Liebenson 


How and why did you get into the field of Sports Medicine / chiropractic studies?

Mainly because I felt strongly an allopathic orientation to health & disease was too focused on the disease end of the spectrum and not enough on health & wellness.

Who in the field has influenced or helped you the most? Influenced your philosophy? What have you learned from them that you can you share?

Karel Lewit & Vladimiir Janda the great Czech neurologists have had by far the greatest influence on me. They have taught me that functional pathology of the motor system holds the key to reducing pain, preventing injury & enhancing performance. Their approach focuses in the broadest sense on all structures of the locomotor system (skin, fascia, muscle, tendon, ligament, and joint). What is most important are the faulty movement patterns that are "memorized" in the CNS and lead to tissue strain.

Name 3-5 books everyone helping basketball athletes should have in their library and why?

  • Stuart McGill - because it gives a ‘no-nonsene' approach to spinal biomechanics 101. Sadly a horribly misunderstood subject
  • Karel Lewit - Musculoskeletal Medicine - it gives the foundation for an integrated approach to manipulation & rehabilitation
  • Joanne Elphinston - Stability, Sport and Performance Movement - great illustrations of stable & unstable movements
  • Vern Gambetta - Any of his books - because he know how to coach better than anyone else

What is the last book you read and why?

Continue reading this interview by clicking HERE



Topics: basketball training programs, athletic training conference, Craig Liebenson, boston hockey conference, DNS course

Appreciating The Importance of Foot Strike in NBA Injuries

Posted by Boston Sports Medicine and Performance Group on Thu, Feb 9, 2012 @ 07:02 AM


Wondering why there seems to be so many injuries this NBA season?

Learn from Dr. Bruce Williams at the 2012 BSMPG Summer Seminar and understand how poor foot strike and foot function may predispose athletes to injuries.

Join the nations best sports medicine and performance professionals in Boston this May 19th and 20th at the Annual BSMPG summer seminar.


Bruce Williams



Topic: Hit the Ground Running: Appreciating the Importance of Foot Strike in NBA Injuries

There have been many published studies on the relationship between foot function and lower extremity injuries.  Specifically, a 2010 Study on NBA injuries showed that 62% of all injuries in professional basketball and 72% of all games missed were due to lower extremity injury.

There are many popular technologies on the market for quantifying data on gait and movement in sports.  GPS systems, accelerometers, jump plates, motion capture technology, and in-shoe pressure systems are owned by many professional athletic teams.  Though utilized, few of these systems have really made an impact toward injury reduction or prediction.

The general sports medicine system is flawed. Very few teams, let alone individual medical practitioners, fully quantify and record the structural and functional findings of the physical examination of an athlete. 

The association between foot strike and foot function will be discussed in relationship to the five most common injuries in the NBA:  Lateral ankle sprains, Patellofemoral inflammation, Lumbar sprain / strain , Hamstring strain, and Adductor strain.

Suggestions will be made on how to utilize the above technologies for validation of the structural and functional components of the foot strike for improvement in injury rates and injury risk assessment.

It is time for sports medicine to exit the dark ages and enter the age of analytical enlightenment.  Adapt, quantitate and validate, or die!


Dr. Bruce Williams graduated from Scholl College in 1991 and completed his Podiatric Surgical Residency at St. Mary’s Medical Center in Merrillville, Indiana in 1992.  He has been in private practice for the last 19 years in Merrillville Indiana.  Initially he was in practice with his Father, Dr. Robert M. Williams ( ICPM ’72) who is now deceased.

Dr. Williams is a Diplomate of the American Board of Podiatric Surgery and also a fellow and past president of the AAPSM (American Academy of Podiatric Sports Medicine.)  His practice focus is foot and lower extremity biomechanics, computerized gait analysis, and sports medicine.  Dr. Williams has numerous published articles in in-shoe pressure analysis and custom foot orthotics.  He wrote a chapter on Clinical Gait Evaluation of the Athlete in the book, “Athletic Footwear and Orthoses in Sports Medicine” Springer; editors M. Werd, E. Knight 2010.

Dr. Williams is also the teams podiatrist for Valparaiso University and Calumet College of St. Joseph’s.






Topics: basketball conference, basketball training programs, BSMPG, athletic training conference, boston hockey conference, Foot Strike

BSMPG Announces Dan Boothby as Speaker at 2012 BSMPG Summer Seminar

Posted by Boston Sports Medicine and Performance Group on Fri, Jan 20, 2012 @ 07:01 AM

BSMPG is proud to announce Dan Boothby as a speaker within the Hockey Specific Training Track for the 2012 BSMPG Summer Seminar, May 19-20, 2012 in Boston MA.


dan boothby


Northeastern University

Dan Boothby begins his sixth full season as strength & conditioning coach for the Northeastern University hockey team. Boothby oversees all strength, conditioning and nutrition for the team, and aides in team building and organization.

Boothby was promoted to Director of Strength & Conditioning at Northeastern in 2010.

Boothby has spent the last five years working with Northeastern athletes, having joined the staff as an Assistant Strength & Conditioning Coach in Nov. 2005. He has served as the Director of Player Development for the Northeastern men’s and women’s hockey teams since July 2006. In his first role, Boothby had the opportunity to design and implement strength and conditioning programs for various Husky athletic teams, including year-round nutrition, weight and injury-prevention programs. Working with the hockey teams, Boothby expanded his role to include budget management and biomechanical evaluations.

Boothby, a National Strength and Conditioning Association Certified Strength and Conditioning Specialist, also holds Dan Boothby Performance Training camps, which are tailored for sport-specific strength and conditioning for all levels, including high school, college, professional and Olympic-caliber athletes. Over the past year, he has been advising Northeastern alumna Zara Northover, who competed in the shot put at the Olympics in Beijing.

Before coming to Northeastern, Boothby served under the Head Strength & Conditioning coach at Central Connecticut State University as an undergraduate intern while playing on the offensive line of CCSU’s football team for four seasons.

The Kennebunk, Maine, native graduated from Central Connecticut State in 2005 with a bachelor’s degree in Exercise Science and now resides in Allston, Mass.



Famously uttered by Sir Isaac Newton,

“If I can see further than anyone else, it is only because I am standing on the shoulders of giants.”

In 2011 BSMPG invited the titans of Sports Medicine and Performance to Boston for the largest conference of its kind, and many attendees left asking the question, "how could you ever top that speaker line-up?" Well, we did. BSMPG is proud to announce May 19-20, 2012 as the selected date for Sports Medicine and Strength professionals to desend upon Boston MA for another monster conference!

So how could we ever top last year's speaker set?

Let's just say that we asked last year's speakers who they wanted to hear and we got em!

Stay tuned over the next few weeks as we reveal our entire 2012 speaker set. As we did last year, this seminar will be divided into three distinct educational tracks including a Hockey focus, a Basketball Focus and a clear Sports Medicine/Rehabilitation Track with Keynote Speakers throughout the weekend bringing each track together for common lectures. Attendees may choose to stay within one track throughout the entire weekend or mix and match to meet their educational needs. Remember to save the date now - you won't want to miss another great summer seminar presented by BSMPG.

May 19-20, 2012 - Boston MA. Complete details coming soon!


Remember to Save the Date for the BSMPG 2012 Summer Seminar - May 19-20th in Boston MA.


A limited number of seats still remain for our DNS "A" course. Sign up now before the last seat is gone!

Topics: basketball conference, basketball training programs, BSMPG, athletic training conference, boston hockey conference, Dan Boothby

DNS Course - Boston - Meet the Instructors

Posted by Boston Sports Medicine and Performance Group on Wed, Oct 19, 2011 @ 07:10 AM


Course Instructors - Boston 2012


Clare Frank

Clare C. Frank DPT, MS, OCS, FAAOMPT

Dr. Frank received her physical therapy degree from Northern Illinois University. She completed the Kaiser Permanente Orthopedic Residency program in 1993 while working on her Master of Science degree in Physical Therapy at University of Southern California. She received her post-professional doctorate degree from Western University of Health Sciences, Pomona, California 2004. She is a board certified specialist in Orthopedic Physical Therapy and a fellow in the American Academy of Orthopedic Manual Physical Therapy. Her clinical career has been greatly influenced by Shirley Sahrmann PT, PhD, and the Prague School of Manual Medicine faculty, namely, the late Vladimir Janda MD, Karel Lewit MD, and Pavel Kolar PT, PhD.

Dr. Frank practices at a private clinic in Los Angeles, California. She has been instrumental in setting up the Movement Science Fellowship at Kaiser Permanente, Los Angeles. She has served on the medical team for the 2009 World Figure Skating Championships in Los Angeles, as well as the injury prevention team for the Chinese Olympic Teams 2010/11. She currently teaches in the U.S. and internationally and has co-authored “Assessment and Treatment of Muscle Imbalances: The Janda Approach”



DNS course Boston

Marcela Safarova PT, PhD

Dr. Safarova received her physical therapy training and completed her doctoral studies from Charles University. She is the head physiotherapist at Motol Hospital, a large teaching hospital associated with Charles University in Prague, Czech Republic. Dr. Safarova specializes in the  rehabilitation of the locomotor system. She is also a certified Vojta therapist and has trained and works with both Professors Pavel Kolar and Karel Lewit. She also serves as an adjunct lecturer for both medical physiotherapy students at the university. She currently serves as an instructor for Professor Kolar’s courses both in Prague and internationally


Click HERE for complete details and additional course information

ATTENTION: This course is limited to 30 seats only! Once seats are filled registration will close.  Sign up before you miss this once in a lifetime learning opportunity.




Topics: basketball conference, basketball training programs, BSMPG, athletic training conference, Craig Liebenson, Charlie Weingroff, Barefoot in Boston, Clare Frank, DNS

Limited Anke Dorsiflexion? Find a Ninja

Posted by Boston Sports Medicine and Performance Group on Thu, Oct 6, 2011 @ 07:10 AM



By Art Horne


ankle dorsiflexion


So often ankle dorsiflexion or should I say a lack thereof, is pointed at as the underlying culprit for a variety of movement impairments … and rightfully so. A lack of true talocrural motion can cause havoc up the chain involving itself in a variety of impairments including anterior tibial pain, patellofemoral pain and general low back pain to only name a few.

However, the actual limiting factor causing this lack of osteokinematic motion may be multi-factorial and if clinicians are hoping to address this limitation over the long haul with permanent change the exact location and tissue responsible for this restriction must be clearly identified and addressed with a specific intervention to match the specific tissue.

With regards to soft tissue restrictions there are only 6 possible structures that can limit this motion, and these are:

1. Soleus
2. Posterior Tibialis
3. Flexor Hallucis Longus
4. Flexor Digitorum Longus
5. Posterior Talofibular ligament
6. Posterior Tibiotalar Ligament

The gastrocnemieus, although probably the very first structure that comes to mind, does not limit true dorsiflexion in function (that is unless you participate in ski jumping or speed walking, and then you need to include this in your assessment), since the knee is almost always flexed when the ankle is asked to express dorsiflexion in function, such as walking, running, squatting, lunging, stepping, jumping and landing.


racewalking skijumping
Now that’s some dorsiflexion!


Remember, in order for your tibia to pass over your talus, and your talus to move between the tibia and the calcaneus we need to think of what pathology or dysfunction is not allowing the above mentioned tissues to lengthen.  More often than not, fibrotic adhesions within the muscles or fascial restrictions are to blame, with the filet mignon of tissue treatment choice being an Active Release Technique.  Although lesser cuts of treatment choices allow tissues to mobilize at times, rarely can a foam roller or tennis ball address a specific adhesion like a skilled clinician and the appropriate manual release technique.  That’s not to say one is wasting their time or shouldn’t employ the soft tissue mobilization techniques that they are allowed to use given their credentialing or state laws, but understanding when to refer to a specialist with a very specific skill set is the difference between a butter knife a ninja – both may get the job done but we all know which one we’d rather have on our side.




So how does one differentiate between these tissues?

Because the Soleus and Posterior Tibialis are the two usual suspects and responsible for the majority of problems when it comes to ankle dorsiflexion limitations, these two will usually require the majority of your focus both in evaluation palpation and treatment.


posterior tibialis


However, both the Flexor Hallucis Longus and the Flexor Digitorum Longus can limit dorsiflexion and should be excluded to be sure that they are not involved.  To exclude these two structures from your list of possible dysfunctional contributors simply ask the patient to maximally dorsiflex their ankle while keeping their heel on the ground.

1. Gently pick up the great toe off the ground into extension. If there is slack and the patient does not indicate an increase in symptoms then the FHL is more than likely not involved.
2. Repeat tissue testing by selecting the toes and pulling them into extension.  If there is slack and the patient does not indicate and increase in symptoms then the FDL is more than likely not involved.


dorsiflexion  ankle motion


To identify the underlying tissue whether it be the soleus or posterior tibialis requires some discernable palpation skills.


Did I make a permanent change?

Charlie Weingroff calls it the “Audit Process”  while others such as good friend and colleague Pete Viteritti simply calls it, test-treat-retest.  If the correct treatment choice was matched to the correct tissue choice and location then a marked improvement in range, function and/or pain levels should occur. 

If minimal or no improvements were made than the following may have occurred:

1. You applied the correct treatment to the wrong tissue (tissue adhesion was within the posterior tibialis and you treated the soleus for example), or
2. You applied the incorrect treatment to the correct tissue (pressure was too light and thus was not sufficient to break up the underlying scar tissue), or
3. The limiting factor was not soft tissue but instead an osteokinematic “misalignment” or a position fault as described and made famous by Brian Mulligan (more Mulligan in a future post).

Summary: The most important step in any treatment approach starts with first identifying the correct pain generator or dysfunctional tissue involved.  Without a correct place to start, all treatment options will fail to make a lasting change.

Topics: Art Horne, basketball conference, basketball training programs, athletic training conference, athletic training, boston hockey conference, Barefoot in Boston, Dorsiflexion, ankle problems

Integrated Care - Part VII: Mastering the Hip Hinge

Posted by Boston Sports Medicine and Performance Group on Mon, Oct 3, 2011 @ 07:10 AM

by Art Horne


Last week we discussed the importance of bringing all professionals who care for and provide performance services to your student-athletes together to develop a consistent teaching methodology and progression to mastering the squat pattern.  This week we look at the Hip Hinge.


hip hinge


Deadlift – Hip Hinge

Hip Hinge: all athletes should be able to separate their hips from a back strategy both in 2-legs and single leg stance -whether its knee, hip or other LE injury pain, we should be able to look at this movement pattern and address some overall concerns IN ADDITION to their traditional rehab program.

The hip hinge can be easily taught and standardized with our stick series.

Teaching Stick Series:

1. Stick maintains contact with three points (head, back and butt crack) throughout entire movement.
2. Reach butt backwards; knees should have slight bend.
3. Start with two feet on ground and progress to single leg stance.
4. This is not a squat pattern – be sure to hinge at the hips.
5. Maintain a packed neck (c-spine in-line with sternum throughout movement).

Start one foot away from wall (maybe just less) and reach back towards the wall with butt

1. Maintain three points of contact with stick on head, back and butt crack
2. This is not a squat pattern – first motion should be back towards the wall and not downwards.
3. Inch outwards from the wall with each successful repetition and repeat until you have found your end range.
4. ALTERNATIVE: face wall and touch with hands, move away from wall and repeat until you have reached max distance from wall while maintaining perfect form


1. Two Leg Stick
2. SL Stick
3. 2-Leg – 2 hand Kettlebell Deadlift
4. SL 2-DB Deadlift
5. SL contralateral 1-DB Deadlift


When you finally get strength and sports medicine professionals together in the same room some amazing things begin to happen, especially when you start talking about hinging at the hips including:

1. Agreement to Pack the Neck: Packing the neck and maintaining a neutral cervical spine instead of admiring yourself in the mirror during a hip hinge stick series becomes a universal theme among both groups and taught and coached consistently – whether it’s pulling 300 pounds from the floor during a sumo squat or 4 weeks post ACL surgery during a simple stick series.  Knowing where an athlete is going and where they’ve come from is half the battle in my opinion.

2. Glute activation takes on a whole new meaning to athletic trainers when they see firsthand the work and technical coaching  that strength coaches employ with their athletes.  Sets of 3x10 for glute bridges and then discharge to full participation is no longer acceptable.

3. Bad Hip Hinge means Bad Back: In the same breath, strength coaches are able to discuss challenges with low back pain patients with sports medicine professionals and appreciate how important they are in the rehabilitation and care of those persons as well as how incredibly dangerous a poorly performed lift can be.


Read article on Hip Hinge by clicking HERE.

Topics: basketball resources, basketball training programs, athletic training conference, athletic training, athletic training books, barefoot strength training, Hip Hinge, deadlift Art Horne

Integrated Care - Part V: When NOT Touching Your Toes is NOT a Hamstring Problem

Posted by Boston Sports Medicine and Performance Group on Sun, Sep 18, 2011 @ 06:09 AM

by Art Horne


I remember being taught in school that people have low back pain because their hamstrings are tight.  Therego, stretch the hamstrings and resolve the low back pain.  It was a simple solution to a very complex and often misunderstood problem and yet as a student it was a clean and direct resolution to an often nagging dilemma.

Further testing and evaluation always “proved” the hamstrings as the culprit since so many of the low back pain patients were never able to touch their toes, and of course toe touching was a direct result of hamstring length.  Again, this bore out to make sense since after spending an exhausting amount of time stretching these patient’s hamstrings, and then retesting, some measurable change were noted (sometimes) with the patient inching closer to their toes.  The only problem in this clean and concise “hamstring-LBP” relationship was that these patients, no matter how long I stretched them or which stretching technique I employed ALWAYS ended up coming back the very next day for the same stretching routine and the same unresolved back pain.



Insanity: Doing the same thing over and over again and expecting different results.


Of course, many of these patients really never had “tight” hamstrings after all, but instead had hamstrings that were preventing them from a place they no had no business being in the first place. 

What do I mean?

Well, many of these patients, or at least the majority of them,  were flexion intolerant which means both flexing their spine and/or moving into flexion caused a reflexive “tightening” of the hamstrings to essentially keep them from FLEXING FORWARD and moving into a region which would exacerbate their current condition, or “a place they have no business being.”  In addition, many of these “tight hamstring” patients were never ever feeling a hamstring stretch, but instead were experiencing a neural stretch, which unfortunately after stretching only continued their “tight-stretch-pain-tight” cycle. 

Soo… Should I Stretch or Not?

1. First distinguish between hamstring tightness and neural tension.  Neural tension is always described differently than muscular tightness – that is if you’re listening.  I had a professor who told me that your patient will always tell exactly what is wrong with them if you listen long enough.  And if you listen just a little bit longer, they’ll also tell you exactly how to make them better.  This case is no different – of course, if you’re too busy catering water you’ll never have enough time to listen long enough.

2. Neural tension is often described as “pinching” or with other words that clearly denote nerve origin such as “zapping” or “burning.”  Muscle tension doesn’t zap or burn.

3. Confirm neural involvement with a slump test – then STOP stretching and begin a nerve flossing regiment if indicated.

4. Does the patient need more mobility (hamstring stretching) or do they simply lack the appropriate stability (or neuromuscular control) which ultimately is limiting them from moving into a place where they simply didn’t have the requisite control? I’m willing to bet that more often than not that stability/neuromuscular control is the limiting factor and not hamstring length – especially in low back pain patients.

So what does this have to do with integrated care?

1. On evaluation during pre-participation screenings a simply toe touch as a gross indicator of both ability and willingness to forward flex will “catch” those athletes who either have had previous back pain, current back pain or a complete lack of understanding relating to lumbar spine/pelvis position and an ability to disassociate them during normal daily living.

2. Those with pain or previous pain should be referred to sports medicine for further evaluation – yes, even those that don’t currently have pain.

3. Those that have trouble separating hip and lumbar motion should be placed into a “teaching” group while in the weight room until they can successfully “stiffen” their spine while gaining mobility and motion throughout the hips; both which are essential if any type of squat or deadlift pattern are prescribed in their program.  But really more importantly, these two patterns occur each and every day of their lives and must be grooved before major lumbar spine pathology presents itself.

Click HERE for a quick note on establishing a hip hinge.

Next week: A quick in-service to get both Sports Medicine and Strength Training hinging at the hips and teaching all athletes a great squat pattern. 

Topics: Art Horne, basketball performance, basketball resources, basketball conference, basketball training programs, athletic training conference, barefoot strength training, Barefoot in Boston, barefoot training