Boston Sports Medicine and Performance Group, LLC Blog

There are certain things you just have to do each day – brushing your teeth is one of them.

I first heard the analogy from an old friend of mine when discussing implementing an ACL prevention program with our soccer team and the struggles to keep the coaches on it once the season started,

“You wouldn’t brush your teeth everyday for six months and then stop for six months would you?”

Dentistry has is right.

Not just the brushing every day part, (although clearly important) but their whole approach.

You probably don’t even remember your first visit to the dentist do you?  That’s my point.  Dentists get you right from the get-go. You’re evaluated, x-rayed for a baseline to compare future visits to, you get picked at, poked and prodded and then they finish your visit with a cleaning, rinse and some fresh minty breath.

If you have good insurance you get to go back twice a year – Shoot, sometimes you go in and you don’t have any tooth pain at all. But isn’t this the point?

If the dentist finds tarter build up – BAM that little hook comes in and blasts that gunk right out of there.  No use in letting that sit until it causes a cavity – your dentist wouldn’t be doing their job if they did. 

Yet, many times (I really mean all the time) in sports medicine we see athletes and patients with poor movement patterns, dysfunctional squats, steps and lunges and we do nothing.

We wait.

Their knee doesn’t hurt yet.

No need to take a look.  No baseline assessment. No poking. No prodding.

Once in a while an athlete or patient comes in on the advice from a friend – they have back pain.

“No problem. I’ll help – let’s just get some ice and e-stim on that, there, that should do the trick.  See you tomorrow.”

If you went to a dentist and you had a tooth ache and they rubbed some Novocain on your gum and told you to come back the next day to do it again you’d soon find another dentist to go to. One that addressed the problem and not just the symptom, and one then that gave you some advice on how to avoid future problems.

Dentists do it right – Baseline Evaluation, Regular On-Going Assessment, Treatment/Maintenance  and Education.

I remember when I was a child brushing my teeth three times a day and then if on the rare occasion I was allowed to have some ice cream or candy my mother would make me do it again!

33 years later not a single cavity.

I wish I could say the same for my back pain.

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.

BSMPG is proud to announce that Brandon Ziegler of Oregon State will be part of the Basketball Specific Conference speaker set featuring Dr. Shirley Sahrmann as a keynote speaker next June 3rd and 4th, 2011.

Brendon Ziegler is in his fifth season at Oregon State where he serves as the strength and conditioning coach for the men’s basketball team. In his duties, Ziegler handles all strength and conditioning duties for the men’s basketball squad, including lifting and strength work, core training, speed and agility drills, flexibility drills as well as conditioning. He also coordinates all off-season conditioning programs. Prior to Oregon State, Ziegler served in similar positions with Hawai’i, Wisconsin and the Chicago Bulls of the NBA.

Ziegler is certified through NSCA-CSCS and USA Weightlifting. A native of Edgerton, Wisc., Ziegler was a four-year starter in football at Hamline University and is also a competitive weightlifter.

Need a doctor, hire a doctor.
Need a lawyer, hire a lawyer.
Need a real estate agent, hire a real estate agent.
Need a dentist, hire a dentist.
Need a computer analyst, hire a computer analyst.
Need a strength coach, hire an assistant football coach, or assistant basketball coach, or an athletic trainer, or a PT, or a the director of operations, or your high school buddy..

Is there something wrong here???

Ray Eady is the Strength and Conditioning Coach at the University of Wisconsin and can be reached at RDE@athletics.wisc.edu

It’s been 6 weeks since the date of injury and the athlete you’ve been working with is nowhere near ready to return to play. The coaching staff is breathing down your neck demanding answers and the rest of your staff is raising their eyebrows wondering what could have gone wrong.

Panic sets in….

Instead of panicking after it’s too late, try allowing panic to set in early.

Have a work-study student do a lit-review on the injury as soon as it happens, research the probable causes, latest rehabilitation techniques, running progressions, alternative therapies, and similar cases.

Better yet, let panic set in real early.

Prior to the date of injury, research and implement prevention strategies alongside your performance staff prior at the beginning of the season. Perform a meaningful orthopedic and movement screen with your athletes on the same day as your traditional pre-participation screenings to identify asymmetries and dysfunctional movement patterns with prescribed intervention to address these problems.

Let panic set in before there is anything to panic about.

Panic just like a duck. Calm above the water, and paddling like mad underneath.

Panic is good.

Panic keeps you a float and moving forward.

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.

I had a manager from another company give me a call recently for a reference on a employee that worked for me several years ago.  He explained a little about the position and then I in turn told him a little about the employee's responsibilities here and how this particular person fit in with the group.  When I was done, he asked me how this employee stood out from the rest.  Great question.  My answer was immediate and without hesitation; they were one of my top students because they took ownership of their position. 

What is ownership exactly?  It's the difference between someone who does the minimum of what is expected of them and someone that takes a legitimate interest in improving their workplace.  Let's take the Ownership Quiz . . .

* During staff meetings, are you the person who volunteers for new tasks/projects or are you the person who lowers their eyes hoping someone else raises their hand?
* Do you take pride in the work you do on a day to day basis or do you simply do what is asked of you and be glad it's done?
* Do you take the initiative, bringing ideas for positive change to your office or are you the person that simply complains about how things could be better?
* If there is an issue outside of business hours, do your coworkers know it's alright to contact you or are they under the impression that would be a cardinal sin?
* Do you subscribe more to the idea of getting your job done rather than the phrase "business hours" or are you punching a clock at 9a and 5p every single day?

What if your well-being was tied directly into the performance of your whole office?  Well, I've got news for you.  It is.  Ownership is about treating your position as if you owned your own business.  It is about being a catalyst for positive growth in your environment regardless of whether you are the VP or an entry-level employee.  When you own your position, you are telling your supervisors, your co-workers, and the employees under you that you care.  You are providing a positive example for all and working towards bettering your environment regardless of the situation.  The highest compliment that I can give to any of my employees is that they took ownership of their position.  These are the ones that stood and continue to stand out from the crowd, even years later. 

Are you taking ownership of your workplace or just getting in the way of those that do?

Shaun Bossio is the Assistant Business Manager and ProShop Manager at Boston University FitRec.
He can be reached at sbossio@bu.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.

One of the most important points in the development of any young professional is when they’ve found a teacher and mentor that challenges them to not only develop their skills but develop the thought process needed for long term development and independent problem solving.  Steve Myrland, aka the “Strength Zen Master” challenges the “gurus” in this must read post.


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.

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Whether it is a 2 hour practice or 45 minute weight training session, proper movement prep (MP) is an essential part of our basketball routine.  This short session of stretches can have a big impact on your team’s physical and mental well-being.  There are many factors that need to go into devising your MP.  I will explain 4 Elements of MP along with other factors to take into consideration when designing your MP plan.  In my case I have to specifically come up with a plan for basketball.  Now the needs for my basketball team and are very different from what another team or sport may need.  Therefore, it’s vital to identify what my needs are.

When I design a MP, the first thing I ask myself is, what are we doing it for?  Well that’s easy, basketball, duh!  True, but I need to get more in depth than that.  Some days we will practice for 2 or more hours and it will be at a high intensity.  Another day may be getting shots up for an hour.  We may do individual work in a ¼ court setting with moderate intensity.  The MP may be after we got off a plane or bus!

Now that I know what I’m using the MP for I can ask myself a few more questions.  How long do I have for MP?  Coach usually gives me a timeframe to work with, it’s important to know.  If I have 5 minutes, I have to use exercises that give me the most bang for my buck.  If I have longer, I better know what to do with my time.  I can’t exhaust the team with my 10-15 minutes.

Where are the players at mentally?  If I have great exercises but mentally the players have cashed out on me, it’s something I need to take into consideration.  The great MP I designed won’t do its job, unless I get them doing it with some level of alertness and focus.  Over the course of a basketball season the mental part is huge!  After talking with a colleague this year, he calculated all of the movement preps over the course of a year at over 300!  Your players may lose some interest; the question to yourself is what can I do to get them ready today?

How many players will I be warming up?  If I have the entire team, how specific and difficult can I get with exercise?  It’s difficult to view 15 players trying to do a split stance lunge with 3-way uni-lateral upper body drivers with 3 angulations.   At another time I may have a 4 man group, who moves well and understands exactly what I want.  Timing is important for whatever you’re flowing into.

Will I have any implements?  It can be a very specific piece of equipment such as a tri-stretch or something much more basic as a box.  You can get very creative and expand your toolbox of exercises with implements.  Something else to consider are your resources when you travel.  It may be wise to travel with some equipment but size is an issue.  I’ve also found bleachers and railings are hidden gems when looking for implements on the road.

After you’ve answered those it’s time to get into the actual MP.  With each MP I believe you need to incorporate 4 Elements into its design.  I did not create these 4 categories but I was fortunate to study under, Matt Herring at the University of Florida for nearly 3 years and take away these organized ideas about MP from him.

1.        Increase muscle temperature (Warm-Up)

·         Dynamic flexibility
·         Multiple joints & muscles
·         3-planes

2.       Clear dysfunctions and improve mobility

·         Identify dysfunctions & issues
·         Mobility vs Stability – what needs what
·         3-planes
·         The big 3 – Ankle, Hip, T-Spine

3.       Turning on the CNS

·         3-planes
·         Ground based
·         Gravity
·         Proprioception

4.        Movement

·         Basic movement patterns
·         Basketball movement patterns

There is a 5th category I have as well but I don’t include it with the previous 4 elements.  The last one is a needs category.  This category is unique from the others.  Most often it turns out to be an energy and enthusiasm category.   I don’t always use it but if I can see we need it, I’ll include it.  These exercises are sometimes very specific to basketball but not always.  I may view the need for communication and incorporate that into a drill.  There have been days where the staff has gotten involved with category 5.  This category is always last; so it is right before the guys are handed over to coach.

Below is an example of a pre-practice warm-up that will last for 2+ hours at a high intensity.  It is done in the pre-season so the guys are fresh mentally.    The entire team will be involved and I’ll have all of my normal implements.  Coach has given me 10-12 minutes.

Muscle Temperature - 4 Dynamic Flexibility
    Knee Hug
    Heel to Butt
    Straight Leg March
    Sumo Squats

Dysfunction/Mobility- The Big 3
     Ankle – Tri-Stretch
     Hip – Hip Rockers w/ 3 stances
     T-Spine – T-Hugs/T-Swings

CNS
     Jump Matrix or Pivot Matrix w/ Arm Drivers

Movement
     High Knees/Butt Kicks – Forward/Retro
     Skip Matrix – Forward/Retro
     S-Pattern Runs/Shuffles

Category 5         
     Star Passing

Here are a few other things to consider:

·         Recording and dating each session
·         Creating an encyclopedia of exercises
·         Grading the MP, ex. too long, confusing, lost focus
·         Reuse a MP, probably not every day but maybe once every few weeks
·         When Coach says, “We won’t go hard today, do we need to stretch?”  Say yes, 5 minutes won’t hurt!
·         In-Season this is the only thing you may get to do with them for a week or 2 stretch (hopefully not)
·         It’s ok to ask the players what they need, they’ll often tell you.  Doesn’t mean you have to conform!  They’re mental needs of, “I Feel It,” are important
·         If you can get a copy of the practice plan, it can help with design.  It helps to know if practice will start with a 5 on 5 full court or defensive skill work

Andy Weigel is the Strength and Conditioning Coach for the Men’s Basketball team at the University of Alabama and can be reached at aweigel@ia.ua.edu.

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I remember coming home after failing a fifth grade geography test and showing my parents the results of my effort.  To avoid a long detailed explanation of what happened next let’s just say I wasn’t able to sit down for the rest of the day.  So failure’s bad right? But what about failure in the weight room? Is pushing yourself or your athletes past the discomfort associated with the last few reps a good thing?

I asked Northeastern University’s legendary throwing coach for his insight and the below is a summary of our interaction.

So Joe, is failing good?

Well this depends on several factors such as, how often the event takes place within a general workout or particular exercise.  
If it is a regular occurrence then:
•    it might be symptomatic of a load that is too heavy for the reps,
•    poor technique,
•    poor fitness.
•    It also can be a sign of over training or
•    It can also be a sign of oncoming poor health.

For a particular exercise, failure might be just a random event. (which is why many top lifters use a daily note log) Technique breaks down when the load becomes too heavy for the current capacity of the athlete.

If you constantly push to failure the system adapts to failure as a goal and feeds back into the athlete with more failure.  The technique of the exercise begins to disintegrate. It is a system of negative follow through where the last motor event in the sequence is the goal. Olympic shooters, for instance, are taught to site-hold on the target after the shot is gone ensuring that the pathway stays on target. What you practice is what you will get and I deal with this all the time in throwing. In baseball Ted Williams used to emphasize 'follow through'. Failure done regularly is a form of 'follow through'.

Can you have a micro-cycle where push to failure is OK?

 Yes you can, but the exercises should be ambiguous in nature and not closely related to the sport movement. In that way the technique can be undisturbed but the work effort to push CNS and increased body load capacity is affected.  Sometimes you need to 'blast' the system to make it more alert to change. It's the motor systems equivalent of a loud yell!

'Push to failure' in weight training must not impede other sport preparation. Sufficient recovery is necessary. Each athlete is different in this and recovery rates vary. This is why 'One workout for All' does not work for 'all'. You start with a general workout then customize based on developmental ability.

On the flip side, should athletes always experience "success" on each set or rep?

If they are, then they are not pushing hard enough. There is a time for high intensity and a time for general development and maintenance. High intensity in the sport event usually requires a reduced load in the wt room but there are anomalies. Some athletes get a psychological boost when training hard and a significant reduction of load or intensity raises their anxiety. What you believe is as important as what really works which is why education in the latter is so important.

When the failure occurs you can;
1. Do nothing and move on to the next set
2. Adjust the rest of the sets (ie: poundage down)
3. Adjust the reps
4. Adjust reps and poundage
5. Correct the technique

In conclusion, I would say push to fail is OK if done when needed, the cycle is short and does not interfere with the sport skill.  It is not the poundage in the weight room that decides whether a workout plan is effective. It is the sport skill result that is the final arbiter. The knowledge we gain is scientific but the application is still art.

Sometimes a good loud yell is what we all need but not in an airport security line!


*Thanks to Joe Donahue (Northeastern University Legendary Throwing Coach) for his thoughts and contribution.

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.

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