Boston Sports Medicine and Performance Group, LLC Blog

Readings from last week

Posted by Boston Sports Medicine and Performance Group on Mon, Mar 26, 2012 @ 07:03 AM

Readings from last week.

Enjoy!

 

Cold-Water Immersion for Preventing and Treating Muscle Soreness After Exercise  

 

Predictive Factors for Ankle Sprain  

 

Assessing the SI Joint   

 

Don't forget to sign up for the 2012 BSMPG Summer Seminar featuring Dr. Craig Liebenson along with 14 other leaders from the worlds of sports medicine, performance and hockey/basketball specific training!

 

Click me

 

 

 

Topics: Art Horne, basketball resources, BSMPG, athletic training conference, boston hockey summit, basketball videos, hockey conference, Bruce Williams, Cal Dietz, Bill Knowles, Alan Grodin, Dan Boothby

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

Isometrics To Improve Strength And Speed Performance In Female Basketball Athletes

Posted by Boston Sports Medicine and Performance Group on Thu, Jun 2, 2011 @ 11:06 AM

 

Ray EadyIf

 

If you have never heard of Ray Eady, Strength and Conditioning Coach at the University of Wisconsin before, you will after this weekend.  Ray's one of the brightest basketball strength coaches in the business and his business is getting basketball athletes STRONG!  I was blessed to work with Ray earlier in his career and to say that Ray "gets it" as a strength coach is an understatement. 

His balance of assessment, movement development, injury prevention and of course serious strength development has made him one of the most sought after basketball strength coaches around.

Take a sneak peek at what Ray will be discussing as he joins the top basketball coaches from across the country including, Brendon Ziegler - Oregon State, Jonas Sahratian - UNC-Chapel Hill, George Mumford and Brian McCormick this weekend in Boston.

Click HERE to view Ray Eady's lecture at the 2011 BSMPG, "Standing On The Shoulders Of Giants" Seminar

Topics: Ray Eady, Art Horne, basketball resources, basketball conference, basketball training programs, basketball videos

Your Engine Light Is On

Posted by Boston Sports Medicine and Performance Group on Tue, Jan 18, 2011 @ 07:01 AM

athletic training resources

I’m always amazed during fall pre-participation screenings how accepting we’ve become to athletes reporting pain.

“Ya, it hurts, but it never keeps me from playing.”

That line is often followed by:

“Ok, let me know when it really bothers you” (which is usually too late) or, “just make sure you ice after practice each day (like that was some magic bullet which was going to keep them from missing practice or playing time during the year).

One of the most important reasons to screen your athletes prior to participating in athletics is to “filter” out those that experience pain during simple motions and motor patterns. If an athlete reports pain during a deep squat or a simple McKenzie press up, how do we expect them to get through fall camp?

Reporting pain is not a bad thing.  It’s simply an opportunity for us to address dysfunction before that pain becomes a problem.

 

“Pain is a warning sign. Long before pain represents a chronic problem, it can alert us to poor alignment, overuse, imbalance and inflammation.  We embrace all the other warning signs in our lives – computer virus alerts or the oil light on the dashboard – but when it comes to the body, we act as if the warning sign of pain is an inconvenience.  We cover it up so we can keep moving. If we ignore pain’s natural self-limiting nature, we are ignorant to the lessons its ancient design provides.”
p. 50. Movement by Gray Cook.

 

 

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


 

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

If You Don't Know Where You're Going, Any Road Will Take You There

Posted by Boston Sports Medicine and Performance Group on Thu, Jan 6, 2011 @ 08:01 AM

basketball conference


I ran into an old friend a few weeks ago and asked him what he did for screening at the end of his soccer season as I was looking to improve on our year end procedure.

“What do you mean?” he asked, “once the fall season is done I don’t really think about them until next fall again – maybe a few post-season surgery follow ups but that’s it.”

Puzzled, I asked,

-    How do you know what specific weaknesses each athlete should work on individually during the spring and summer to avoid injury next fall?
-    How do you know if your rehabilitation programming was successful? Did the athlete with the ankle sprain ever regain their single leg hop test distance (oh, I guess you have to measure that to be able to compare)
-    How do you know if your strength program lowered the team’s injury rate from previous years? Did it maintain lower extremity strength and power over the course of the season?

How do you know where you’re going if you don’t know where you are to begin with?

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

Topics: Basketball Related, Art Horne, basketball resources, boston hockey summit, boston hockey conference, basketball videos

The Best Blogs Of 2010

Posted by Boston Sports Medicine and Performance Group on Wed, Dec 29, 2010 @ 07:12 AM

As 2010 comes to an end, I thought I'd use this last week to direct you to 5 of the most popular blog articles from this past year.

Happy New Year and all the best this coming year!

Enjoy

 

Seeing The World Through The Hole In A 45 Pound Plate

I'm Not A Businessman, I'm A BUSINESS Man

SHIPPERS WANTED

Barbershop Talk

Are You Filling The Right Gaps?

 

 

Topics: basketball performance, basketball conference, basketball training programs, boston hockey summit, basketball videos

One Week Remaining - DVD's At Discounted Rate

Posted by Boston Sports Medicine and Performance Group on Mon, Dec 27, 2010 @ 07:12 AM

Purchase the 2010 Basketball and Hockey Specific Training DVD's before the new year and save.  These DVD sets will only be on sale for one more week until they return to their original price.

Watch the country's best strength and conditioning coaches and therapists discuss how to take your team's training to the next level.

Click HERE to purchase one or both of these DVD sets.

 

hockey conference This conference was held in Boston, MA on May 22nd and 23rd, 2010 

Included: 4 DVDs with almost 6 total hours of Hockey Training information

Presentations by: Sean Skahan - Anaheim Ducks, In-season Training in the NHL, Jack Blatherwick - Washington Capitals, Sources of Information: Separating Fact from Fiction, Frank Burgraff - Burgraff Skaing, Protecting the Stride, Larry Cahalin - Northeastern University, Inspiratory Muscle Training: Improving Lung Function and Recovery, Alan Degennaro - formally of the Cleveland Browns, Injury Prevention and Sport, and Keynote Presentation by Bill Hartman, Corrective Exercise Techniques.

Cost: $89.00  NOW ON SALE!  $75

 

 

everything basketballThis conference was held in Boston, MA on May 22nd and 23rd, 2010

 Included: 5 DVDs with over 7.5 hours of Basketball Information

Presentations by: Keith D'Amelio - Stanford University, Assessing the Basketball Athlete, Charlie Weingroff - formally of the Philadelphia 76ers, Lower Extremity Performance and WBV Training Methods, Mike Curtis - University of Virginia, A Systematic Approach to Movement Training for Basketball, Tim Beltz - University of Pittsburgh, Establishing a Training Base for the Basketball Athlete, Amanda Kimball - University of Connecticut, Building a National Champion, Alan DeGennaro - formally of the Cleveland Browns, Injury Prevention and Sport and Keynote Presentation by Bill Hartman, Corrective Exercise Techniques.

Cost: $119.00 NOW ON SALE! $99

Topics: basketball resources, basketball conference, basketball training programs, boston hockey summit, boston hockey conference, basketball videos

Happy Holidays From BSMPG!

Posted by Boston Sports Medicine and Performance Group on Fri, Dec 24, 2010 @ 08:12 AM

BSMPG wishes all of our friends and family the very best this Holiday Season.

basketball resources

Topics: basketball performance, basketball resources, basketball training programs, athletic training conference, basketball videos

Charlie Weingroff releases DVD

Posted by Boston Sports Medicine and Performance Group on Mon, Dec 20, 2010 @ 07:12 AM

Training = Rehab - Rehab = Training DVD set now available by Charlie Weingroff.

 

Training=Rehab, Rehab=Training is a 12+ hour, 6-disc set shot on-location over a weekend at an Equinox Fitness Club in New York City.  It documents Dr. Weingroff’s continuing efforts to reinvent and redefine the language between the rehabilitation and performance enhancement training landscapes.  And while there are plenty of examples for those who just want the exercises, these DVDs are more about designing your own blueprints based on common rules that medical professionals and personal trainers should honor.

If you weren’t there, this puts you in the room for the entirety of an extraordinary voyage with one of the most influential and outspoken voices in the industry.  Training=Rehab, Rehab=Training will surely be an educational milestone and a must-have in the collection for every physical therapist, strength coach and personal trainer.

 

Catch Charlie in Boston this coming June 3rd/4th at the BSMPG Basketball Specific Training Symposium along with Shirley Sahrmann, Tom Myers and Clare Frank.

 

basketball resources

Topics: basketball performance, basketball resources, basketball conference, basketball training programs, Charlie Weingroff, basketball videos

The Juice Is Worth The Squeeze

Posted by Boston Sports Medicine and Performance Group on Tue, Dec 14, 2010 @ 07:12 AM

basketball resources

 

Some things are just worth the little bit of extra effort.

Yes, squeezing takes a little more planning, a little more time, and a little more work.  But like freshly squeezed OJ, your extra effort certainly tastes better than the frozen from concentrate your competitors are serving.

Yes, the juice is certainly worth the squeeze.

 

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.

 

Talk about effort is worth the result….


 

Topics: Art Horne, basketball performance, basketball training programs, athletic training conference, boston hockey summit, boston hockey conference, basketball videos