Boston Sports Medicine and Performance Group, LLC Blog

BSMPG is Boston Strong

Posted by Boston Sports Medicine and Performance Group on Mon, Apr 21, 2014 @ 07:04 AM


BSMPG would like to wish the over 27,000 runners of the 2014 Boston Marathon the best of luck!


athletic training


Find out how the great endurance athletes from across the world continue to dominante their field from the guy that wrote the book on endurance training at the 2014 BSMPG Summer Seminar - May 16&17th (no we're serious, he literally wrote the book on endurance training, tapering, and peaking for optimal performance).


See the world authority in endurance training, Iñigo Mujika at the 2014 BSMPG Summer Seminar - May 16&17th here in Boston.

There is only one Boston Marathon and there is only one seminar which brings the world's authorities in Sports Medicine and Performance training together for two awesome days of learning.




Inigo Mujikatmg

Iñigo Mujika 

Keynote Session: Tapering and Peaking for Optimal Performance

Breakout Session: Detraining in Elite Athletes


Iñigo Mujika earned Ph.D.s in Biology of Muscular Exercise (University of Saint-Etienne, France) and Physical Activity and Sport Sciences (University of The Basque Country). He is also a Level III Swimming and Triathlon Coach and coaches World Class triathletes. His main research interests in the field of applied sport science include training methods and recovery from exercise, tapering, detraining and overtraining. He has also performed extensive research on the physiological aspects associated with sports performance in professional cycling, swimming, running, rowing, tennis, football and water polo. He received research fellowships in Australia, France and South Africa, published over 90 articles in peer reviewed journals, four books and 30 book chapters, and has given 210 lectures and communications in international conferences and meetings. Iñigo was Senior Physiologist at the Australian Institute of Sport in 2003 and 2004. In 2005 he was the physiologist and trainer for the Euskaltel Euskadi professional cycling team, and between 2006 and 2008 he was Head of Research and Development at Athletic Club Bilbao professional football club. He was Physiology consultant of the Spanish Swimming Federation in the lead-up to London 2012. He is now the Head of Physiology and Training at Euskaltel Euskadi World Tour Cycling Team, Associate Editor for the International Journal of Sports Physiology and Performance, and Associate Professor at the University of the Basque Country.


endurance training 


Join the Leaders in Sports Medicine and Performance at the 2014 BSMPG Summer Seminar - May 16 & 17, 2014.

Registration is now OPEN.

Topics: BSMPG Summer Seminar, barefoot running

Heel Strikes, Sudden Impacts and Running Injuries

Posted by Boston Sports Medicine and Performance Group on Tue, Apr 17, 2012 @ 06:04 AM


If you haven't been living under a rock you know that the annual Boston Marathon took place this past Monday, April 16th.  With it came over 25 000 registered runners and thousands more non-registered runners tackling heartbreak hill and the 26.2 mile Boston course.  Although many of the leaders looked strong heading into the final mile, thousands more never experienced the thrill of victory but instead suffered the agony that so many runners face on a daily basis - a running injury that either limits or completely stops their running.

So what caused this running injury?  The answer might surprise you - it's the way you hit the ground!

Learn more about why you continue to ice your knees and shins and how you may be able to avoid these pains in the future with only a simple change in your stride.


Below is a summary of Professor Davis' article:


Do Impacts Cause Running Injuries? A Prospective Investigation

By Irene Davis, Bradley Bowser and David Mullineaux


“Up to 79% of runners sustain an injury in a given year. Approximately 80% of shod runners are rearfoot strikers. It is plausible that rearfoot strikers with increased impact loads, may be at greater risk for the development of an injury that those with lower loads. In summary, previous studies have documented higher impact loading in runner with a history of injury. However, these studies were retrospective in nature and cannot establish causative relationships. Therefore, the purpose of this prospective study was to compare the impact loads of rearfoot strike runners who go on to develop a running injury to those who have never been injured. It was hypothesized that runner who went on to develop a running- related injury would have higher vertical impact peaks, vertical average loadrates, vertical instantaneous loadrates and peak tibial shock.”

Davis and her group went on to recruit 240 female rearfoot strike runners aged 18-40 who ran a minimum of 20 miles per week.  Data was collected including ground reaction forces, vertical average loadrate, peak vertical force, etc.  Running mileage and injuries were reported monthly for 2 years.


“Our injury findings were consistent with previous literature. It has been reported that between 20-80% of runners get injured in a given year, and 57% of our runners sustained a prospective injury. In terms of injury distribution, iliotibial band syndrome, anterior knee pain, tibial stress syndrome, and plantar fasciitis were also among the top five injuries in much larger study of 2002 runners.

As hypothesized, all impact loading was greater in the injured runners compared with the never- injured group. All impact variables were significantly higher, except for VILR. Interestingly, FZ, the peak value of the vertical force, was identical between groups. This further underscores the importance of impact loads in the development of these injuries."


Barefoot in Boston

Sudden impacts are BAD! Notice the sudden spike with the RFS?

(RFS=Rearfoot Strike, FFS = Forefoot Strike, MFS = Midfoot Strike)


"The fact that all running injuries were included increases the significance of these results. While it is recognized that the etiology of running injuries is multi-factorial, this suggests that impact loading may be global indicator for the development of an injury. Based upon the odds ratio for VALR, reducing impacts is likely to result in an overall reduction of injury risk. Based on previous sports, adopting a midfoot or forefoot strike pattern will reduce these impacts. However future studies of injury patterns in midfoot and forefoot strike runners are needed.”


Want to avoid these sudden impacts associated with injury? Better think about adopting not only a different gait, but also a different pair of shoes.  Many modern running shoes have heels that are simply so thick that they prevent you from making contact with the ground in any other way than with the heel - and thus the dreaded impact forces!

Learn more about transitioning back to mother earth by reading BAREFOOT IN BOSTON: A Practical Guide to Achieving Injury Resolution and Enhancing Performance


Topics: barefoot strength training, Barefoot in Boston, barefoot running, barefoot training

Good Luck Runners! - 2012 Boston Marathon

Posted by Boston Sports Medicine and Performance Group on Mon, Apr 16, 2012 @ 07:04 AM


BSMPG wishes the over 30,000 runners in the 2012 Boston Marathon the best of luck!


Run Strong!


Boston Marathon



Topics: BSMPG, barefoot strength training, Barefoot in Boston, barefoot running, barefoot training

Christopher McDougall talks Running Barefoot and if we were BORN TO RUN

Posted by Boston Sports Medicine and Performance Group on Sun, Apr 15, 2012 @ 07:04 AM

Christopher McDougall Talks Barefoot and Why Humans Were Born to Run

Are you wondering why your running shoes resemble high heels? Ever think about why your big toe overlaps your second and why your arch really isn’t an arch anymore and resembles more of a pancake? Thinking about baring your sole? Barefoot training has recently become popularized as a potential benefit in injury prevention and rehabilitation programs. It is also purported to serve as an additional means to enhance athletic performance and running economy. However, limited clinical research is currently available to justify this practice and even less information is available describing how one may go about safely implementing a barefoot training program. This book explores the scientific and theoretical benefits concerning the merits of forgoing the modern running shoe for a simpler approach and offers real life solutions to all the obstacles standing between your feet and mother earth. Although it’s true that Americans love their shoes, what you learn about the merits of stuffing your feet and toes into these modern day casts might just have you singing a different tune – a tune your feet will certainly be much happier moving to. Welcome to Barefoot in Boston!
Enjoy Born to Run author, Christopher McDougall's TED presentation below!


Learn how you too can enjoy the benefits of being barefoot by reading BAREFOOT IN BOSTON, available now in both paperwork and kindle.

barefoot in boston

Topics: athletic training conference, athletic training, Irene Davis, Christopher McDougall, athletic training books, barefoot strength training, achilles pain, barefoot running, barefoot training

Interview with Mark Toomey and Dr. John DiMuro - 2012 BSMPG Summer Seminar Presenters

Posted by Boston Sports Medicine and Performance Group on Wed, Mar 28, 2012 @ 07:03 AM

Co-Presenters at the 2011 BSMPG Summer Seminar, Dr. John DiMuro and Mark Toomey return to Boston in May for the 2012 BSMPG Summer Seminar for a series of lectures that are sure to provide attendees with a number of monumental "ah-ha" moments as they show with fluoroscopy EXACTLY what is happening during exercises in both your rehabilitation and performance training programs.  

The difference between what you thought was happening during simple exercises and what is actually occuring at each joint will have you thinking twice before you prescribe your next exercise program or therapeutic intervention.


Click HERE to listen to a recent interview with Dr. DiMuro and Mark Toomey on



Mark Toomey


Dr John DiMuro DO, MBA

Dr. DiMuro is a Board Certified Anesthesiologist and Pain Medicine expert who specializes in advanced interventional pain treatments for all types of pain conditions. He grew up in central New Jersey prior to attending medical and business school in Philadelphia . He has an M.B.A. in health care management from St. Joseph 's University and completed his internship at the Tampa Bay Heart Institute. He was chief resident during his Anesthesiology residency at Georgetown University in Washington , D.C. prior to completing a pain medicine fellowship at the world-renowned Memorial Sloan-Kettering Cancer Center in New York City . He currently serves on the Carson Tahoe Hospital Cancer Committee. He continues to work in private practice and lectures nationally for the Kimberly Clark Company and Boston Scientific.

Mark Toomey, Sr RKC, CSCS

Mark Toomey is a fitness instructor from Reno , Nevada . He serves as a Subject Matter Expert (SME) in fitness and conditioning for the United States Navy and the United States Marine Corps. He is the Director of Operations for Dragon Door Publications, a producer of cutting edge material on strength and conditioning and acts as a Senior Instructor for the RKC, the first and largest entity specializing in kettlebell and body weight exercise instruction. Mark is an NSCA Certified Strength and Conditioning Specialist and a certified CK-FMS practitioner.


Be sure to register for the 2012 BSMPG Summer Seminar today before they sell out!

Click me


Topics: basketball conference, athletic training conference, boston hockey summit, Craig Liebenson, boston hockey conference, Bruce Williams, Cal Dietz, Bill Knowles, Dan Boothby, barefoot running

Gray Cook Talks Barefoot

Posted by Boston Sports Medicine and Performance Group on Mon, Mar 5, 2012 @ 07:03 AM


In Gray Cook's most recent podcast, he discusses the importance of going without shoes and the benefits that come along with going with less on your feet.


Click HERE to listen to Gray Cook.


For more information on going barefoot and how to implement a barefoot program safely click HERE to visit our web page dedicated to going with less on your feet or purchase BAREFOOT IN BOSTON today - your feet will thank you!


Barefoot in Boston

Topics: Art Horne, barefoot strength training, Barefoot in Boston, barefoot running, Gray Cook

Obesity on the Rise in America by Daniel Lieberman

Posted by Boston Sports Medicine and Performance Group on Fri, Mar 2, 2012 @ 07:03 AM


Barefoot expert and Harvard Professor Daniel Lieberman talks about the obesity problem in America.  This 13 minute presentation examines our evolutionary path to obesity and concludes with a radical idea to fight this growing problem.



Topics: BSMPG, athletic training conference, Daniel Lieberman, barefoot strength training, barefoot running, barefoot training

Barefoot in Boston reviews - What the Pro's are saying

Posted by Boston Sports Medicine and Performance Group on Thu, Dec 29, 2011 @ 07:12 AM

See what professional strength coaches are saying about Barefoot in Boston.


"When the foot hits the ground everything changes!  Training your feet without the use of shoes and preparing them, and your entire lower extremity for the rigors demanded in elite sporting events not only makes sense, but is a must for decreasing injury rates while enhancing foot function and performance."


Keke Lyles, Strength & Conditioning Coach

Minnesota Timberwolves, NBA


"Arthur Horne writes a wonderful book to enlighten and enhance athletes & non athletes on the intrinsic nature of how we are and can be through barefoot training. In a short time I was on the last page with more clarity on this subject than before. A quick read that focuses on "what's the next step" to help the reader learn and apply the lessons of this author and researchers that have studied this training method before. Great book to learn and train more toward barefoot in whatever way may be suitable."


Joe Hogarty, Strength & Conditioning Coach

Baltimore Orioles, MLB 


Purchase Barefoot in Boston on Amazon Today. Available in book and kindle editions!




Topics: Art Horne, Barefoot in Boston, barefoot running, barefoot training

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

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

by Art Horne


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

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


sports medicine resources


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

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

Case Presentation:

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

Here’s the story:

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

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


sports medicine

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


movement screen


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

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

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

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

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

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

sports medicine


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

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

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

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

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

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

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

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

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

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

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



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





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

Art Horne Interviews with Joe Heiler on

Posted by Boston Sports Medicine and Performance Group on Wed, Sep 7, 2011 @ 07:09 AM




Click HERE to listen to this interview.

In this interview, Art discusses his new book, "Barefoot in Boston: A Practical Guide to Achieving Injury Resolution and Enhancing Performance", as well as discussing some research on barefoot walking and training versus wearing shoes, what to look for in minimalist shoes, how he has incorporated barefoot training with his basketball team, and much more..(including how to take a hack saw to a basketball shoe!)

Topics: Basketball Related, Art Horne, BSMPG, functional movement screen, boston marathon, foot pain, foot fracture, barefoot strength training, Barefoot in Boston, achilles pain, barefoot running, barefoot training