"The plantar fascia, essentially a continuation of the Achilles tendon, attaches from the base of the calcaneus, covers the bottom of the foot, and inserts into all five digits of the foot. This band acts as both a support of the underlying muscles, thereby assisting stabilization of the foot, and a shock absorber for the body.  It has been referred to as a prime stabilizer in that it helps prevent collapsing of the mid-foot during the midstance phase of gait as the person's body weight passes over the supporting structure of the foot. Through its connections to the Achilles tendon, gastrocnemius, hamstring complex, sacrotuberous ligaments, erector spinea, and epicranial fascia, the plantar fascia has essentially direct communication with the entire body.  Inhibition of the intrinsic foot musculature can often lead to losses of structural integrity within the plantar fascia, which contributes to increased pronatroy stresses at the hip, knee, and ankle/foot complexes, and resultant stabilization issues of the lumbopelvic region. Likewise, poor proximal control of the Thoracopelvic Canister and/or lower extremity pronation tends to overload the plantar fascia, creating many of the common lower extremity compartment and overuse syndromes."

pg. 43

Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction by Evan Osar

Give the gift of health and wellness from BSMPG this holiday season - Choose stocking stuffers such as a previous conference DVD or Barefoot in Boston, the book that has people thinking twice about todays modern shoes!  

Looking for a larger present to give? Try giving the gift of registration to the 2013 BSMPG Summer Seminar featuring the world's top Sports Medicine and Performance Training professionals including Dr. Stuart McGill.  Discounted rates appy until December 31st!

2012 BSMPG Summer Seminar Attendee Social

BSMPG 2013 Attendee Social Details

Date: May 17th 

Time: At the conclusion of the last lecture of the day

Location: It's a secret - once you register you'll obtain additional location details (Just kidding, we're still looking for a spot big enough to hold our largest attendee event to date!)

Who: All Attendees, Sponsors, Speakers and generally the smartest people on the planet will be there.

Why You Should Attend:  It's no secret that deals get done over dinner and drinks. Whether you're looking for your next job at the professional or collegiate level, looking for additional insight from one of our world class speakers, or simply trying to make a deal with one of our sponsors, the attendee social is the place to be!

BSMPG 2013 Attendee Social Sponsored by:

Only three more weeks remain for our EARLY EARLY BIRD SPECIAL!  Sign up today and enjoy the holiday discount.

Seats for DNS Course B - Boston are rapidly filling!

If you are interested in attending but are waiting until the new year to register, contact us at bostonsmpg@gmail.com to reserve your spot in our class.  This course is limited to 30 people and we have just passed the 1/3 mark.  

Don't be disappointed! Contact us now to reserve a spot or register today!

This course will sell out!

View a presentation on Developmental Kinesiology and Postural Ontogenesis by the Prague School of Rehabilitation by clicking HERE.

Course Details

Date: April 27, April 28, April 29, & April 30th 2013

Location: Boston MA, Campus of Northeastern University. Building TBA

DNS Course Requires Advanced Certification and skills and therefore is only available to the following Occupations: PT, MD, DO, DC, OT and ATC.  

Interested attendees must scan and email or mail proof of their advanced certification to bostonsmpg@gmail.com send directly to: 200 Freeman Street, #2, Brookline MA 02446.  After review you will be sent a link to register or you may choose to register by mail and send proof of certification with your registeration.  

Click HERE to download registration form for the 2013 DNS Course "B" hosted by BSMPG   

Course Instructors

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”

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

by Dr. Adam Naylor, CC-AASP

Self-control on the playing field is over-rated… or at least active efforts towards it.  There is no doubt that unchecked anger and drifting attention are detriments to performance.  Yet, how to achieve positive emotions and a resilient focus needs to be considered.  In many regards keeping one’s cool when referees make undesirable calls and maintaining concentration in the face of particularly pesky opponents happens well before the ball is officially put in play.

In essence the most impressive displays of mental toughness occur rather effortlessly… or to be more precise, they are displays of automatic self-control.  This is not to say that in-game cue words, mental imagery, or diaphragmatic breathing are not helpful, but they simply too often lack the robust benefits that effortless self-control mechanisms deliver.  Active efforts to control one’s self reduce the ability to successfully control one’s self in the future.  Plainly put, each time a conscious effort is made to regulate emotions there is a cost to future cognitive abilities… attention is a bit more likely to wander… frustration creeps in more easily…. decision making becomes a bit less precise.  Just like physical muscles, mental muscles fatigue.

This is not an invitation towards wanton disregard for self-control, but rather a consideration of the benefits of priming performances in advance.  It ought to come of little surprise that the environments in which one trains and competes have incredibly formative roles in an athlete’s development.  It is clear how technical proficiency improves under the tutelage of a coach’s keen eye.  It is also apparent how shared goals and aspirations of teammates can unify and rally a team.  Now becoming more clear is how social environments can lead to successful management of emotions and attitudes.

Subtle cues and modeled behaviors can develop emotionally resilient competitors.  Without words, social norms quietly teach individuals how to regulate feelings such as anger.  Consider this on and around the playing field.  Coaches that model a stiff upper lip when disappointed will find players who follow this focused lead.  Conversely, sports parents that are quick to blame coaches for their child’s modest playing time are likely to develop athletes that are quick to play victim in the face of challenge.  Sports culture of coaches and teammates that gravitate towards calm in the face of challenge reinforces these behaviors.  The mental game is contagious… sport communities can spread strength or instability.

Recent research has gone as far as to highlight that the specific words that are heard and read literally are able to prime emotional performances.  Kevin Rounding and his colleagues found that when sacred words (“Bible, “divine,” etc.) were subtly layered into sentence unscrambling tasks research participants had deep wells of self-control following their reading.  Religion aside, Iris Mauss and her colleagues found that people’s anger could be automatically controlled when primed with words such as “cool,” “restrains,” and “disciplined.”  In a somewhat cunning manner, such studies suggest that thoughtful and consistent use of particular language by coaches and sports organizations can reap great mental toughness benefits.  This is far different than a passionate lecture about the importance of controlling one’s emotions.  Quite literally the coach that embeds specific words of self-control into pre-game speeches could potentially see fewer penalties and greater resilience from his team on the field.

The sporting landscape is filled with examples of poor emotional regulation – from Bobby Knight’s chair throwing incident to parent misbehavior at youth baseball games to hockey violence committed out of frustration.  Close inspection also reveals that too often the words of competition can be filled with themes of unrestrained aggression  – one can only imagine the language, layered throughout the locker rooms involved in NFL bounty-gate.  Aggressive play is important, but competing with unrestrained emotion leads to more failures than successes.  I am a strong advocate of priming performance, sporting environments that give themselves regular doses of emotional regulating cues find focus and well directed energy on the field.

Originally published at Psychology Today’s The Sporting Life November 2012.

Register for the 2013 BSMPG Summer Seminar May 17 & 18th, 2013 in Boston MA

Over the next month we will be previewing the 2013 BSMPG Summer Seminar speakers, their thoughts on the current state of Sports Medicine & Performance Training, how technology is influencing our profession (for better or worse) and preview their lectures.

Enjoy.

BOBBY ALEJO

North Carolina State Wolfpack

Assistant Athletics Director for Strength and Conditioning Bob Alejo oversees all of the strength and conditioning efforts of the department, and coordinates the day-to-day efforts of the men's basketball team.

Prior to joining the Wolfpack staff in April, Alejo served as the Director of Strength and Conditioning for the Oakland A's, a position he also held from 1993-2001. In that role, he was responsible for all aspects of the organization's year-round physical preparation at both the major league and minor league levels. 

1. How has the field of sports medicine/performance changed in the last five years? Where do you see the field headed in the next five years

1. A little more science in the field that is being used. Science has been and always will be the basis for S&C however not everyone subscribed to or  understood it. The FMS test is another big influence, at least in my instance, that has happened recently. My hope is that there is a better realization that the basics work every time all the time. There is a lot of new methods most of which aren't the most effective choices; the methods are new but the science is not.

2. Athlete monitoring and sports analytics has emerged as leading topics within Sports Medicine and Performance Training, how has this field influenced your practice?

Well, some of these analytics have been around for longer than people think. I remember in the 80's a soccer athlete of mine was coming back from Europe where they were testing for lactate. But, if looking at your data (testing scores and literature) and designing programs from the information makes you a slave then I have been guilty for 30 years. That's what your supposed to do!!!! Intuition of what might happen in the future is one thing but ignoring the numbers is a mistake.

3. What can attendees expect to hear from you at the 2013 BSMPG Summer Seminar? How may your lecture impact their practice on Monday morning?

Expect to hear what 30 years of experience has revealed. Not what I thought might have happened or what should have happened but rather "this is what I did and this is what happened". Don't tell me for example, that the Olympic lifts are dangerous after I tell you that I have not had one injury related to the Olympic lifts in 30 years. Or that overhead pressing is bad for the shoulder without giving one shred of evidence confirming the notion. In other words, what I do might not fit in your program or your philosophy but don't come to the conclusion that what someone has done cannot be done.

Over the next month we will be previewing the 2013 BSMPG Summer Seminar speakers, their thoughts on the current state of Sports Medicine & Performance Training, how technology is influencing our profession (for better or worse) and preview their lectures.

Enjoy.

Director of Athletic Development & Athletic Development Coach

Kevin Neeld is the President, COO, and Director of Athletic Development at Endeavor

1. How has the field of sports medicine/performance changed in the last five years? Where do you see the field headed in the next five years?

Sports performance is a constantly evolving field, but over the last few years it seems like people are paying more attention to the importance of grooving fundamental movement patterns, addressing common mobility restrictions, and redefining “core” work to include more “anti-movement” exercises and exercise that address the pelvis, thorax, and neck. These changes, in large part, are a result of the seminars and lectures that guys like Gray Cook, Michael Boyle, Charlie Weingroff, and Eric Cressey (among others) have put on.

In the same vein, the fields of performance training and rehabilitation continue to merge such that professionals on both ends of the continuum are learning from one another, sharing information, and ultimately gaining a better appreciation for where their clients fall along that progression and what skills they can utilize (or develop) to help move them in the right direction. From a training perspective, this has become increasingly important given the adaptations that result from living a dichotomous life of sedentary behavior and high-level athletics, which seems to be the societal trend, at least in our country. More athletes are presenting with structural abnormalities such femoroacetabular impingement or acquired postural dysfunction that significantly affects their ability to breathe, move, and ultimately to adapt favorably. Understanding the signs and implications of these dysfunctions puts the training professional in a much better position to help the athlete fulfill his or her potential. A platform of quality static posture and dynamic movement must be established in order to develop durable elite-level physical capacities.

As for the future, I think we’ll continue to see:

An increased recognition of the benefits of manual therapy

While it’s possible to over-utilize or become over-reliant on manual therapy, different manual modalities are extremely effective at troubleshooting soft-tissue dysfunction, which can provide for a faster “reset” in function and movement quality, and remove pain, which allows for the development of a cleaner motor pattern (and happier athlete). Manual work can also be used to stimulate a parasympathetic shift in athletes, which has a number of physiological consequences, but ultimately allows the athlete to recover faster.

An increased focus on recovery and management of training, dietary, environmental, and lifestyle stressors

As technology and our understanding of the human organism continue to develop, monitoring and manipulating specific and non-specific stress responses will become more feasible. As a few examples that are already gaining traction, heart rate variability and sleep quality can be easily and inexpensively assessed using BioForce HRV and Zeo Sleep Manager, respectively, nutrient and hormone levels can be self-assessed at home using tests from Bioletics, and recovery or “restoration” can be altered while you sit at a desk or sleep using Earthing products. All of these tools are likely to be refined over time to provide more information, a greater benefit, be more user-friendly, or simply more accessible (e.g. cheaper).

A shift toward greater individualization in program design

In the last few years, this shift has taken place with regard to identifying movement limitations and taking an individualized approach toward restoring fundamental movement patterns through the use of different corrective exercises and changes to exercise selection within the program. I think the next step, one that many are already starting to make, is to take the same approach toward identifying strengths/weaknesses in the individual’s various physical capacities and programming energy system work (which is really the entire program) based on the individual’s profile. This is an area I’ve learned a lot about from guys like Patrick Ward, Joel Jamieson and Dave Tenney. This form of programming is as much an art as it is a science, but you need to know the science to perfect the art!

2. Athlete monitoring and sports analytics has emerged as leading topics within Sports Medicine and Performance Training, how has this field influenced your practice? Has the field in your opinion gone too far with some professionals becoming slaves to data sets instead of providing solid clinical practice and coaching? Is there room for more monitoring? What "data sets" are you seeing as most impactful when is comes to providing athlete care and training?

I think it’s inherently good when you have a means of monitoring the effectiveness of your program. Technological advancements have provided an additional means of doing so, which will ultimately allow us to be more specific in the application of stressors. Tracking heart rate and kinematic data (e.g. GPS-drive data) over the course of training, practices, and competitions can provide extremely valuable information to coaches about the amount of absolute and relative stress applied to an individual that day. I think this data will continue to show significant differences even between two players at the same position that went through the same practice. Likewise, tracking HRV throughout the year provides evidence as to how the individual is responding to and recovering from these stressors. Taking a step back, all of this information, in conjunction with movement assessments/screens like the FMS and more traditional “performance” data (e.g. 40-yard dash time, vertical jump height, 1-RM resistance training numbers, conditioning test performance, etc.) provides the coach with an audit as to how effective their program is for that individual.

All that said, I think some of this data in certain circumstances will undermine the psychological strength of certain athletes. The reality is that the majority of team sport athletes experience some degree of fatigue accumulation, but they still perform. If an athlete’s HRV is less than optimal on a game day, it’s possible they may be at a greater risk of injury or getting sick, but it’s also possible they won’t. While this is a bit of a roulette game, I think the important thing is to collect, analyze, and track the information, but don’t become imprisoned by it.

3. What can attendees expect to hear from you at the 2013 BSMPG Summer Seminar?  How may your lecture impact their practice on Monday morning?

The purpose of my talk will be to describe common structural and functional deviations that affect the hockey athlete, their implications, and consequent programming strategies. This discussion will address topics like the consequences of FAI on exercise performance, exercise selection, and skating technique, and how diaphragm position and function impacts core stability, shoulder health, and the athlete’s ability to recover. This talk should provide the attendee with a deeper appreciation for the postures and patterns they see on an everyday basis, as well as simple cues, exercises, and programming strategies to best serve the athlete. 

Super Discounted Rates End December 31st, 2012!

Sign Up Today

Over the next month we will be previewing the 2013 BSMPG Summer Seminar speakers, their thoughts on the current state of Sports Medicine & Performance Training, how technology is influencing our profession (for better or worse) and preview their lectures.

Enjoy.

1. How has the field of sports medicine/performance changed in the last five years? Where do you see the field headed in the next five years

We have now more tools to measure and understand what constitutes performance and how athletes are progressing so training and nutritional prescriptions are becoming more accurate and many activities can be tailored to individual athletes to maximise their development and increase the chances of performing well. The field is moving quickly and with miniaturisation of technology it will be possible to know more about athletic performance and have better evidence to apply interventions. However training equipment does not seem to be evolving at a faster rate for various reasons. Food technology is also quickly accelerating so soon it will be possible to access functional foods tailored to individuals. More needs to be done to accelerate recovery from injury so I can see new compounds capable of accelerating muscle and tendon repair.

2. Athlete monitoring and sports analytics has emerged as leading topics within Sports Medicine and Performance Training, how has this field influenced your practice?

I think there has been a good evolution, still too many people collect too many data which do not affect performance. However data are good to provide an evidence-based approach to sports science and medicine and improve coaching decisions.

Has the field in your opinion gone too far with some professionals becoming slaves to data sets instead of providing solid clinical practice and coaching? Is there room for more monitoring? What "data sets" are you seeing as most impactful when is comes to providing athlete care and training?

Well, many people talk about data, few understand what makes good data. Clinical practice and coaching requires experience driven by knowledge and the real impact happens when knowledge combined with clinical practice make a (measurable) difference. So in some cases there has been an improvement, however in many cases people want/try to collect complex datasets but forget the collect simple ones so it is impossible to make informed decisions despite the fact that some “sexy”data sets are collected. For example, some people want to measure or measure salivary hormones but then do not have good training diaries (prescribed vs. executed) so they cannot manipulate training even if the hormone data seem to show some aspects of change.

3. What can attendees expect to hear from you at the 2013 BSMPG Summer Seminar? How may your lecture impact their practice on Monday morning?

I will address the issues presented before showing some examples of case studies as well as discussing current activities and highlighting some points being missed. I will also talk about practicality of interventions and will discuss the following concepts/approaches:

Signal-Noise

Dose-Response

Cost-Effectiveness

I am looking forward to attend the conference to share my experiences and view but most of all to meet colleagues and understand more about the state of US sport.

If you were the average student in the average anatomy class, you were taught that the psoas major was responsible for hip flexion and external rotation of the femur.  If you were lucky, you may have had a minor discussion regarding its role in lumbar stability.  

But did your anatomy teacher discuss the psoas as it relates to the diaphram and breathing? What about the psoas and the pelvic floor?

No?

I didn't think so.

Let's take a quick look at what you may have been missing...

"The fascial relations of the psoas major to the surrounding tissues warrant special attention as these links influence the biomechanics of these interlaced structures. The medial arcuate ligament is a continuation of the superior psoas fascia that continues superiorly to the diaphragm. The right and left crus constitute the spinal attachment of the diaphragm. They attach to the anterolateral component of the upper three lumbar vertebral bodies. The crus and their fascia overlap the psoas major and appear to be continuous with this muscle until they come more anterior and blend with the anterior longitudinal ligament. (8) As the psoas descends, its inferomedial fascia becomes thick at its inferior portion and is continuous with the pelvic floor fascia. (9) This forms a link with the conjoint tendon, transverse abdominus, and the internal oblique. (10) As the psoas major courses over the pelvic brim, the fascia of the posterior fascicles attach firmly to the pelvic brim."

Psoas major: a case report and review of its anatomy, biomechanics, and clinical implications by Sajko, Sandy & Stuber, Kent. Journal of the Canadian Chiropractic Association, 2009.

Discover what you've been missing and what the leaders in Sports Medicine and Performance already know at the 2013 BSMPG Summer Seminar - May 17 & 18, 2013 in Boston.

Solving the Mystery of the Pelvic Rotator Cuff

By Janet A. Hulme, M.A., P.T

Think the diaphragm is just for breathing? Think again.

At just over 140 pages, this day read will have your entire rehabilitation and strength programming going from good to GREAT!

Enjoy -

“The breathing diaphragm, abdominals (particularly transverse abdominus), latisimus dorsi, gluteals, and multifidus are integral in optimal PRC function. They are not directly part of the PRC but function in an integrated system of support and to facilitate bladder and bowel function, lumbosacral stability, balance and ambulation.

The breathing diaphragm rests in a dome shape at the top of the abdomen attached to the lower ribs, sternum and lumbar spine. In diaphragmatic breathing, the diaphragm descends and returns to the rest position 12-14 times per minute each minute of each day. This action helps maintain the optimal pH of all body fluids and optimal oxygen-carbon dioxide balance.  It gently mobilizes the thoracic and lumbar spine,12-14 times per minute. In addition to these important benefits, the breathing diaphragm movement massages the sympathetic nerve roots as they exit the thoracic and upper lumbar vertebrae. It functions as a pump for blood and lymph circulation with the pelvic organs and related structures.  The major organs of the trunk are suspended from the breathing diaphragm either directly or indirectly so the rhythmical movement of the diaphragm helps maintain normal mobility of these organs, and lifts the bladder 2-3 centimeter during the exhalation phase of breathing. There is evidence that they breathing diaphragm in conjunction with the transverse abdominus assists in spinal stabilization by increasing the intra-abdominal pressure during limb movement according to Richardson et al (1999). There is evidence of synergistic contraction of the breathing diaphragm, transverse abdominus, and pelvic diaphragm muscles, as described by Hodges and Richardson (1996). Diaphragmatic breathing is essential  for spinal health, bladder and bowel health, and standing balance.  Diaphragmatic breathing is the first exercise to implement in order to achieve spinal and bowel/bladder health.”

Pg.29-30

Next Stop on the Information Highway - BSMPG Summer Seminar May 17&18, 2013

Register before December 31st for discounted rates.