Boston Sports Medicine and Performance Group, LLC Blog

by Adam Naylor, EdD, CC-AASP

The United States armed forces do a tremendous job teaching men and women a variety of performance and life skills. I had the opportunity to sit down with university Marine ROTC commanders and cadets to discuss the development of high performance programming. The meeting struck me with a tremendous lesson in leadership for sports coaches.

You may have seen many tough as nails, drill sargents glamorized in the movies… have all kinds of wild images about hell week at Quantico dancing in your head… but do you have a good sense of coaching done Marine-style? I sat at a conference table with two commanders and three cadets. There was definitely a rank and order to the room, but strength and leadership emanated from all corners. The commanders had some ideas, checked to see if their ideas meet the cadet realities, asked the cadets for their ideas, made decisions together, and made it clear that the cadets will lead battalion actions and performance.

Marines are tough and are built to battle. They are not abusive in their coaching style, but rather collaborative and empowering. There’s nothing soft about a leader that recruits strength and leadership from within the team… one can argue it’s the coaching style that creates the bravest competitors to walk the planet.

Meet Adam Naylor and other leaders in Sports Medicine and Performance Training at the 2013 BSMPG Summer Seminar - the only seminar where our attendees are speakers at other conferences!

Previous posted Feb 10, 2012 at the Professional Sport Psychology Symposium blog – http://prosportpsychsym.wordpress.com

“Do you know what all those names on that bucket mean?”

“Um, no I’m not sure. What?”

“Each name is a kid that puked during one of our training sessions. Isn’t that awesome?  See the one that has the number four scratched off and a five put beside it? He really blew some chunks!  I let them sign it after they puke.”

(The above is an actual conversation from a “performance coach” at a “sports performance” center just outside Boston )

Now accepting your child for only $600 for an eight week session!

When did squat, clean and puking become the standard for which we measure success?

What’s next, bicep and hernias?

The challenge for sports performance centers is not necessarily developing a bigger bench, squat and clean, but developing performance measures that correlate directly to success in their client's individual sporting events and filling the gaps in their training and performance profile.

Either way, puking isn’t an indicator of success in any sport.

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.

Nothing says recovery after a conference road win like a stop at the neighborhood Friendly’s.  I mean, there are some good choices there right?

Double Thick Milkshake – Vanilla 770 cal, 32 grams of fat
“What? It’s made from milk?”

Honey BBQ Chicken Strips, 6 strips 1670 cal, 81 grams of fat
“Look, no bun! I’m watching my carb intake”

Chicken Caesar Salad   1030 cal, 84 grams of fat
“Watching your weight? A light salad is perfect”

Happy Ending Hot Fudge Sundae 330 cal, 17 grams of fat
“Hey, we won. Coach says when we win we can order dessert!”

TOTAL     3800 CAL, 214 grams of fat

I’m utterly baffled when I hear stories of sports teams and sport coaches that commit their very souls to winning, the ones that basically sleep at the gym drawing up the winning inbounds play into the wee hours of the night, yet overlook the most controllable factor in all of their training program – Nutrition.  It’s hard to control a referee’s call, a delayed flight, or even whether or not your luggage arrives when you do, but the choice you make for your team regarding where and when to eat is totally within your control.   So when your team is running out of gas in the fourth quarter and they can’t seem to find the energy to break the press, think about the all-you-can-eat Waffle House you went to for pre-game.

But whatever you do, don’t blame Friendly’s… that’s for post game!

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.

Whether you're in favor of it or not, the Second Amendment of the United States Constitution allows you the right to bear arms. That is unless you're visiting the Magic Kingdom. Apparently, Mickey Mouse doesn't think it's a good idea to bring hand guns into theme parks - pistols and peppermint patties just don't mix. 

So if Walt Disney can say no to this absolute silliness (believe it or not people are actually fighting Walt on this one) we can also say no to some of the silliness that goes on in our weight rooms as well.

I know, the Second amendment allows you to bear arms.  And I know a Strength and Conditioning degree allows you to program Bench Press every Monday, and allows you to put a bar on someone's back and load it up because you have to get those numbers. But just because you can, doesn't mean you should.

Thanks for the lesson in common sense Walt.

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.

An alien visits your athletic training room during your fall pre-participation physicals where you are performing your standard evaluations consisting of height, weight, blood pressure and pulse.

"I see you measuring everyone's height?" The alien asks. "You must have a terrible shrinking problem that you want to keep track of and monitor closely?"

"Well no, we just measure their height, record it in their chart and it's never looked at again."

The alien scratches his tentacles inquisitively, "Well surely then you must be tracking closely their body weight and have a terrible case of weight gain here which you then correlate to health and performance parameters later on?"

"Um, not exactly, once in a while the football coach wants to know how much weight a kid gained, or we use it maybe once a year to track a sudden loss in weight for athletes with eating disorders, but other than that it's usually recorded and forgotten about."

The alien stands puzzled even further.  An awkward silence sets in until the alien proudly bursts out, "I see you taking blood pressure and pulse?" His pride obvious now, "surely this population you work with has a high rate of cardiovascular disease in which you must observe, monitor, treat and watch closely yes?"

"Well actually, the athletes we see are 18-22 years old and rarely suffer from cardiovascular disease although we do manage to find some outliers that escape their home physician and we are able to help them, but this number is very small."

"Tell me then, what evaluation is taking place on those tables across the room?" the alien asks, pointing at the row of treatment tables filled with athletes covered in ice bags.

"That's not an evaluation, that's treatment for injuries the athletes have sustained from running, jumping and throwing too much."

"Do those injuries happen often?" the alien asks.

"Yes, all the time! You should see the athletic training room in the afternoons," beamed the young athletic trainer. "Some days you can hardly get enough ice bags or e-stim machines available for everyone."

"And you say this happens all the time?"

"Yes, yes - every year! It basically takes up our entire day. Some days I have to stay a couple of hours late after work just to get enough ice and e-stim on everyone"

The alien obviously troubled asks, "So what evaluations do you do for those athletes prior to becoming injured? For the athletes with the ice bags on their backs, ankles and knees?"

"We don't do any evaluations for those things," the athletic trainer responds.

The alien reaches into his solar-pack, grabs his intra-planet communication device and radios back to base, "requesting immediate pick-up! No intelligent life here."

Now, I can poke fun and joke about this "processing of data" or should I say, lack thereof because I'm an athletic trainer and have caught myself doing this.  I'm not trying to minimize the importance of cardiovascular screening in the least. I do however think that we might be missing a golden opportunity to screen and address for other problems that take up the majority of our days along with the usual screening tools?

How many kids with high blood pressure do you refer and care for compared to the number of kids you evaluate and treat with anterior knee pain?  Did you wait until the kid's heart hurt to measure his blood pressure?  Then why wait until the kid's knee is swollen to evaluate his hip strength? ROM or ankle mobility?

Let's prove the alien wrong this fall.

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.

A special thanks to Matt Nichol who presented at the Second Annual Boston Hockey Summit and Basketball Symposium who challenged each attendee to look at the way we currently do business with a fresh set of eyes.

I've heard from a number of people in the past that in ancient China, the model doctor was the one who was able to teach a healthy lifestyle in order to prevent diseases, disability, injury and illness. Doctors got paid when they were successful (in keeping their patrons healthy) - not when the patients fell ill (which was considered a sign of failure!)

I don't know if this is actually true or not, but the concept is right up my alley.

Imagine if you were only paid when your patients/athletes were healthy?

How would this change your yearly training plans? Rehabilitation protocols? Strength programs? Pre-participation screenings and exercise prescriptions?

Would you be forced to take on a night shift at McDonalds to pay the bills?

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.

Question: A strength coach, an athletic trainer and a physician are in a car driving through the Arizona desert.  They get a flat tire.  Whose fault is it?

Answer: It doesn’t matter. They are all going nowhere together.
You can argue that the flat tire can be blamed on the strength coach for not ensuring the tires were made to withstand the rigors of the desert, or the athletic trainer for not checking the air pressure prior to the trip, or even the physician for giving the nod to drive over the speed limit even though the engine was never tested to perform at that speed.  The fact remains that each professional is stuck together going nowhere.  

Sound familiar?

When we work with our athletes who are unable to play for whatever reason we often end up blaming the flat tire on someone else when in fact we are all now stuck in the same car going nowhere. Prior to your next road trip, let’s make sure we all meet in the garage together and develop a plan for our athletes before taking “the car” out for a zip around town.

Remember, if you’re looking to go nowhere, any road will take you there.

Art Horne 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.

It is very rare that one can get sound training in any of the sport sciences without having to take at least one research methods class.  Perhaps it is human nature or some sort of cultural creation, but too often such a class is seen as a requirement to pass rather than a true asset to someone that will work in the “real world” of sports.  Unwittingly, this limits the sport-scientist/coach from truly reaching excellence.  It leads to a poor consumer of science and one that is poor in execution of focused player development plans.  With this in mind, there are 5 basic research ideas that I have found important to quality sport science practice:

1.  Research is not about proving yourself right.  

Too often young researchers decided that study findings that contradict a study’s hypothesis are a bad thing.  This is absolutely wrong.  If the study was well designed and well thought out, these findings are valuable.  Open mindedness and healthy skepticism is required when looking at all data.  There are risks to viewing one’s self as “right” too quickly (i.e. imagine implementing a training plan that seems to make sense, but in reality only leads to injured athletes).  Similarly, there are risks to dismissing findings that are not in support of a hypothesis without sufficient thought (i.e. the nuances to the solutions to many of life’s complex questions can lie in the contradictions).

Understanding these concepts extends beyond naïve graduate students, but to the public as a whole.  It was surprising to stumble upon the following quote from Bill James, the Red Sox’s famed sabermatrician, “Random data proves nothing and that it cannot be used as proof of nothingness.  Why?  Because whenever you do a study, if your study completely fails you will get random data.  Therefore, when you get random data, all you may conclude is that your study failed.”  He is getting at something with this quote, but the willingness to suggest a failed study because of unclear data is shortsighted.

Research is about keeping an open mind and gaining information through well regulated examination.

2.  Manipulate only one variable at a time if you want precise understanding of the impacts of coaching interventions.  

Coaching approaches and philosophies can change quickly.  There is nothing wrong with this, however if performances dramatically decrease or increase it will be tough to determine what the cause of these costs or benefits were.  Single-subject research design tells that during research only add a single new variable at a time and then watch things for a while.  If the outcome being examined changes in any significant manner, you can say it was most likely due to the variable that you recently added.  Differently if you add two or more variables at a time you are left confused as to what actually led to change in behavior.

This concept can be clearly seen in the coaching of Michael Boyle.  While he might have a bit of a “shock and awe” style to his writing and presentations, his coaching is quite disciplined.  It is always impressive to hear him in his talks about refining the strength and conditioning programs of athletes and how he religiously adheres to the “manipulate one variable at a time” principle.  A sports medicine colleague commented to me the other day, “Heck, if Mike added bananas into an athlete’s diet, he wouldn’t mess with anything else for a few weeks until he determined if the banana eating had any significant impact.”  The question for those working in athletics is, “Can you stay this disciplined when refining your player development programs?”

3.  Establish your “baseline” before you change the game plan. 

This concept is closely related to #2.  Human beings (at least Westerners) tend to be an impatient population.  When something does not appear to be going right we push for changing something… anything.  Back to considering single subject research, prior to initiating any interventions have a substantial baseline period.  Highs and lows of behavior may just be artifact early on rather than the “truth.”  Giving actions and performances a fair test of time truly allows someone to see “what is what.”
A good example of this is the baseball player calculating his batting average after the first two games of the season.  It is likely that the average is quite high or quite low at this time – and likely a false measure of the player’s goodness.  After 20 games or so, it would appear that things begin to come into focus.  The batter that begins to make swing changes and panics after the second game certainly lacks 20/20 vision for his current status as a batter.  It takes a bit of time to establish a baseline, but it’s worth it because it creates a true foundation off of which one can be coached and learn.

4.  Appreciate the normal curve.  

“Outliers” has become a hot term with the publication of Malcolm Gladwell’s most recent book.  This being said, focusing on them can sometimes get us into a bit of trouble.  Perhaps one of the biggest lessons I learned early on in my career was from Bob Dallis, currently the Dartmouth College women’s tennis coach.  After I concluded a workshop that went o.k. but seemed to miss a few of the players, Bob pulled me aside and said, “Think about the normal curve when considering how and if you reached a team.”  What he meant by this was that there are likely to be outliers.  A small section of every group will love what you say regardless of what you say.  Conversely there is likely to be a small section of the group that will not appreciate your efforts regardless of how good they are.  The job of a good educator is to make sure to get the middle to attend, learn, and embrace the ideas being shared.  Trying too hard to sway the negative outliers leads to a failure to attend sufficiently to others.  Also, basking in the glow of the positive outliers only build the teacher’s ego and does little for the students.  In a lot of ways, you can measure the quality of your work by the growth of the “normal” athletes in front of you.

5.  Embrace evidence-based practice.  

“Evidence-based” is a hot term these days… yet it is an old idea.  If one considers it closely, it simply means being an effective and ethical practitioner of your craft.  Part of such quality practice is having the stomach and patience to read primary research and quality reviews of up to date study in the sport sciences.  Appreciating recent publications in referred journals can help one refine his craft.  The common criticism of this concept is that such sources are too slow to publish about the current trends in sport science, knowledge moves too fast for them to keep up.  This is a cop out and at times can lead to reckless practice (not to mention a waste of an athlete’s valuable training time).

It is true that sometimes coaches and practitioners “in the trenches” are ahead of the scientists.  This does not mean one should abandon evidence-based practice.  In actuality, the wise practitioner realizes that this is an opportunity to create evidence by being thoughtful, focused, and organized in coaching practices.  Evidence-based is about both learning from quality practice that has preceded and objectively creating evidence off of which to make educated coaching decisions when relevant studies do not seem to exist.  This being said, I have found that too few people give a fair crack at the first step of quality practice:  taking a good look at the literature and understanding the nuances of everything read leads to great practices on and around the playing field.  If you want to be able to build great athletes lay a solid foundation by using scientific evidence.

Did you pay attention in your research methods class?  In many regards it was about making good professional decisions and making athletes great…

Dr. Adam Naylor, AASP-CC. is the Director of the Boston University Athletic Enhancement Center (www.bu.edu/aec).  He has serves as a mental conditioning and player development resource for players at all stages of their sports career.  More reflections on player development and sport psychology can be found at http://prosportpsychsym.wordpress.com and Dr. Naylor can be reached at ahnaylor@bu.edu and followed on Twitter @ahnaylor.

When did hard work go out of style?
When did squatting, pull-ups, and heavy sled pushes become bad for you?
Athletes now more than ever are always looking for a secret answer from above. Something to swoop down and give them the advantage that they need to become bigger, faster and stronger (as long as it doesn’t require actual work mind you).  Even in the athletic training room you’ll find it. Athletes would rather wear organic blueberry filled “pain patches” on their patellar tendons rather than complete an uncomfortable eccentric single leg squat program for their knee pain.
“I saw such and such pro-athlete use these/do this, it will help me too.”
Deus ex machina!

Even some strength coaches and athletic trainers have gotten into the mix. You’ll always know if your colleagues have gone to a course taught by a “guru” over the weekend.  Suddenly on Monday morning, every athlete needs this or can be treated with that.
Deus ex machina!

Literally translated, Deus ex machina means “God from the machine” and is used to describe the sudden and miraculous appearance of an unexpected way out of a very difficult situation.  In Roman and Greek plays, a “god” was lowered onto the stage via mechanical device to resolve a complicated situation in the plot. A divine intervention if you will.  A God sent from above to rescue you from your very poor predicament! Too good to be true, right?  But in modern Hollywood films and movies, this is frowned upon because it undermines the story’s internal logic… unless you are directing a silly comedy like Dumb and Dumber or Tommy Boy which requires a lack of logic and the more dues ex machina, the funnier it gets.

So this summer, as you prepare your off-season training programs, don’t let a guru who yells the loudest, or your athletes who just logged off youtube undermine your logic.  Let’s all agree to leave deus ex machina to those that that need it most, and get back to programming rehab and strength programs based off of sound evidence.  If a place as crazy as Hollywood understands this simply concept, we should too.

 

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.

As strength and conditioning coaches, it is imperative that we have a good understanding of what fatigue really is. A dictionary definition might be a decrease in energy, but most of us would say that fatigue is a decrease in force production. That might be acceptable to tell your athletes, but do you really understand what is going on? Let’s take a close look into what fatigue really is and it’s untapped potential.

There are two classes of fatigue: “peripheral” and “central”. The more commonly known and understood is peripheral fatigue. Peripheral fatigue is what is happening in the extremities, more specifically the muscles. This is usually due to action potential failure or impairment in the cross-bridge cycle. Studies have shown that there is an increase in lactic acid concentration and a decrease in pH, ATP, and creatine phosphate. Also, there is a decrease in muscle or liver glycogen stores during sub maximal exercise which is all believed to cause fatigue. These metabolic processes add up together to prevent the muscle from a forceful contraction. Essentially, you can look at peripheral fatigue as the muscle no longer capable of producing the force that it is being asked to produce. An example would be doing 1,000 bicep curls and getting the “BURN”.

Less commonly known is central fatigue. Central fatigue is a decrease in neural drive or a disruption in the efferent fibers. In more simple terms, central fatigue originates in the brain. There is limited research on this phenomenon, but studies show that during exercise there is a change in neurotransmitters, such as increase in serotonin, which can regulate muscle contraction among other things, and a decrease in dopamine and acetylcholine which play a role in voluntary movement, motivation, attention, working memory, and learning; and then opens ligand-gated sodium channels in skeletal muscle to produce muscle activation, respectively. Now, I know neurology wasn’t my favorite class either so to develop the big picture, let's just say when there is increase in neural drive, there is an increase in neurotransmitter activity which results in a decrease in brain capacity to recruit motor neurons. This is that feeling of your body just not doing what you ask it to do although your muscles aren’t on fire, that “I just don’t have it today” feeling.

The debate on central fatigue is that I mentioned it being a disruption in efferent fibers. Proponents of peripheral fatigue will argue that it is just the opposite, and that it is the afferent fibers that cause a change in the neurotransmitters. Meaning that muscles, by way of the mentioned metabolic processes, are sending sensory information to the brain that then activate the change in the neurotransmitters to stop exercise. But then studies have shown that fatigue doesn’t start in the motor cortex but even further up in cortical regions, as in the prefrontal and cingulate cortex. So what comes first, the chicken or the egg?
No studies have shown a physiological change with no change on perceived fatigue. Actually, just the opposite has been shown.   Perceived fatigue has been expressed with no physiological change. Chronic fatigue syndrome is just that; patients express fatigue at rest when there is no impairment of the metabolic processes that we discussed. . Consider the fact you can produce more force during an eccentric lift than a concentric lift, which would suggest different neural drives. Studies show that at most during maximal voluntary contraction (MVC) one can only recruit 70% of motor units and some suggest that 100% recruitment would tear tendons right off the bone. On the other side perhaps central fatigue takes place as a protective mechanism. By changing neurotransmitter activity your brain will not allow 100% MVC. So what are your muscles actually capable of and what can you do about it?

Whether you believe it is the chicken or the egg that comes first, you can’t argue that they both have a role in fatigue. Metabolic processes do take place and your brain does prevent 100% MVC. So how do decrease the protective threshold? For the sake of this article, we will save the idea of over training for another time and just focus on a single training session. In order to get more out of our athletes, we need to engage their brain. Increase dopamine and acetylcholine. Studies have shown that verbal encouragement during activity will increase the duration of the contraction. Others have shown that yelling during a lift actually can increase force production. Another study showed that when subjects were asked to give maximal effort during a cycling sprint their power output decreased over the reps except it increased on their last rep, indicating a “reserve tank”. Perhaps the brain protects less knowing that it is your last rep. Perhaps this developed during the pre-historic era when our ancestors had to hunt for their food, but maintain a reserve tank of energy in case they became the hunted. Either way, we need to tap into that reserve tank. One way to achieve this is by including open looped activities. Doing 10 reps or sprinting for 1 minute is a closed loop activity because you know when it will stop allowing you to pace yourself. So including an open loop activity is one way to do short maximal effort without pacing yourself, such as having your athlete sprint for an unknown time stopping when you decide to blow the whistle. Challenge yourself to develop ways for the conscious brain to control the unconscious brain. Don’t allow your athletes to pace themselves. Training is not about surviving, it is about DESTROYING.

If a mother is able to lift a car to save her child, find a way for your athlete to lift a bus, because they can.


Keke Lyles is a DPT student at Northeastern University and has worked directly with both the Men’s and Women’s Basketball teams.

____________________________________________________

Register for the May 2010 conference. Spots are filling up!