“The Australia-based Catapult uses wearable technology to track athlete movement on the playing court, and it currently calls 13 NBA teams clients…Oklahoma City is not one of those 13 teams, but the Thunder aren't dinosaurs when it comes to injury prevention.”

By Tom Haberstroh ESPN Insider

Recently Kevin Durant sustained a fracture of the fifth metatarsal bone, creating a ripple effect in the NBA and college basketball. Seeing the MVP in the league out of at least 6-8 weeks is frightening, and some programs are already asking hard questions with sports medicine. Teams wanting to appear as progressive are apparently monitoring everything imaginable to look like they are covering the bases. Some teams are analyzing brain waves, performing blood analysis, and now tapping into DNA of players. The question is not necessarily does monitoring work, but the real question is are teams really doing all of this at a high level or is just smoke and mirrors? In the earlier article Anti-Fragile Algorithms, the specific injury mentioned as a working model, fifth metatarsal injuries tin basketball was showcased as a dire warning to emerging problems in the NBA. The article was popular based on retweets on social media, but is anyone actually taking the advice? Unfortunately many of those sharing the article on twitter didn’t do the recommendations in the guest post, otherwise we would not see as many factures in sport.

Every time I get a request to talk about technology in sport with coaches I suggest reading the book Jurassic Park as a dire warning to reliance on computers. Without having solid education behind the keyboard, technology can backfire big time. Since the book is a classic and a movie, most readers appreciate the motif of the story foreshadowing a Frankenstein allusion to DNA and misdirected science without wisdom. Now that DNA analysis is widely available commercially, we would hope to believe that science, specifically sport science, is making a change in injuries and performance. Based on injury data, very little, if any in fact, improvements are shown in the medical logs with injury reduction.

The rise of the Athlete Management Systems (AMS) we see from the UK, and other software providers, are frankly not helping much at all. The reason?  Visualizing data without interpretation skills and the power to apply an intervention is just putting lipstick on a pig. I am in strong support of data display because it commits to addressing known problems, but if you don’t have the ability to do an intervention, it’s just job security paper trails. Most systems available are nothing more than overpriced dashboards without any analytic engine to create value besides seeing crude data with a team logo. Coaches and teams pressured to be data driven succumb to buying more technology and the results have been the same, but with cool wearable devices wirelessly displaying meaningless metrics on the nearby oversized flat screen. What we see is the same as what the Michael Crichton story depicted, the inmates are running the asylum and the only differences are the freaks of nature are smaller and from this era.

Are We Tracking the Tracks?

The most glairing issue I have with any foot injury is the lack of appreciation of foot strike and how to manage forces properly. SportVu and Catapult are measuring displacement of athletes, sort of like surveillance if you will. Player tracker doesn’t drill down to the actual ground contact needed to fully reduce the chances of a fifth metatarsal injury beyond crude accelerometer values. The use of pressure mapping is essential to actually evaluating how much strain we are placing specific parts of the foot, not just counting steps or player distance. While the minutes on Kevin Durant’s body were enormous, minutes are always going to be high when players are competing so many times a month, and crafty teams like San Antonio are strategically resting players with continued controversy from the league. So to increase the risk margin and reduce injuries, real screening is needed to the areas at risk. Basketball specific screening can be done with simple mat and in-shoe pressure systems available on the market.  Combined with a solid foot evaluation performed by a sports medicine professional using manual techniques, a proper risk profile can be created. No longer do we need to depend on minutes played only to find risk, but movement patterns and foot structure can move the needle to seeing potential problems. Injuries are obviously multifactorial, but specific risk factors are identified in the current literature and are open to medical professionals now.  Presently, the most precise targeting approach to risk of basketball injuries I know is with the Mercury XML, a foot testing system and algorithm that can zero into the exact problem and provide needed interventions and guidance. As of this time only, I don’t know too many teams doing more than just standard podiatric evaluation if at all.

My suggestion for teams, not just basketball, is to commit to a comprehensive evaluation of foot function every year to track changes and make refined interventions. Every player should have all foot attire evaluated and properly scored. We buy smartphones and food with tech specs and labels, yet all we have is the size of the shoes, not a standardized breakdown of key functional indicators. Imagine going to buy medications by “trying them on” instead of using a proper channel? Our most valuable wearable is not a fitbit or the new trendy “smart fabric” but the shoes one selects for training and competition. Selecting footwear is highly individual and should be done with great care.  We need to prescribe footwear with the same respect as medications, and watch for side effects with Elastography and Myoton readings. In addition to shoes, make sure each athlete is pressure mapped barefoot as well as in-shoe, to see how orthotics and shoe design is mixing in the foot strike composite. I have done this for years with soccer athletes and it does take time, but the sleep I get is much better now and have the charts to even show it!

Are we Tracking the Inside?

The ESPN article by the same author Tom Haberstroh hinted that teams are doing blood testing to get more data on their players, but based on information from the players, it doesn’t seem to match the necessary frequency to create solid connections. Biomarker testing with blood is a rich source of information, but like any data the shelf life isn’t long and retesting is needed. My own experience using blood testing every month really shows what is going on during a long season, and not a moment in time.  Haberstroh writes:

When asked by ESPN to elaborate on blood analysis, Cuban declined further comment. But interviews with several Dallas players indicate that the team's expanded testing policy is neither obvious nor rosterwide. Guard Devin Harris recalls giving blood only in the preseason as part of the standard team physical; perhaps by design, other plasma-related details remain vague. "I don't know what they do with it once they have it, but they definitely take it," Harris says. "And I know they talked about taking blood throughout the season for certain stuff."

Sport Scientist Xavi Schelling, now with San Antonio researched the trends and patterns with hormones with professional basketball for years in his insightful study recently with the Journal of Strength and Conditioning. The summary in the paper clearly illustrated the differences beyond just minutes played. As someone who helped edit the manuscript, I read that study over a dozen times and saw an alarming problem, Europeans play less than the NBA and are struggling to recover, imagine playing multiple times a week including back to back games? Mark Cuban is going to need a think tank rather than a shark tank to help his team adjust if they are not testing everyone a few times a season. All players in professional basketball, regardless of minutes played should be tested multiple times to see trends. When doing a baseline test it is very important to factor in several additional metrics, such as muscle fiber estimation and performance testing.  Baselines without profiling and adjusting should be left for the court, not for the athletic lab. Again who really knows what is going on with teams since all of this is all speculation, and Mark is a bright guy and didn’t become a billionaire because he shared his secret sauce with his competition.

A simple solution to blood testing is use the data everyone is getting in the pre-season and make that the primary focus on team leaderboards to drive change. I love HRV (Heart Rate Variability) and using daily neuromuscular fatigue measurement, but every day most athletes have three meals to make an impact in what they are doing, and see a cause and effect with training and sleep with biomarkers outside vitamins and minerals. Not seeing the data is like expecting a police officer to use a radar gun and then seeing you after a crash, so sometimes a little discussion can go a long way.

Sleep Tracking with the NBA Schedule

A popular request with teams is finding the competitive edge with sleep quality and quantity. It’s not rocket science that sleep matters and no matter how many research studies athletes are shown in cartoony infographics they will be seduced by the other “theme parks” that sometimes will include adult themes and adult beverages.  Even the good father who loves playing dad will become a zombie after a few weeks of a baby crying all night or dealing with a spouse snoring.  No matter what magic calculation of time zone adjustment is made during travel planning, evening games with last minute heroics will pump enough adrenaline to render players disrupted biologically during sleep. Elite athletes are human and will be under stress, so all of the protocols for setting up sleep are nice on paper and certainly sound good, why are we still seeing CNS fatigue and poor autonomic status?

The reason the NBA struggles to apply sleep monitoring is because without the iron and sweat of training properly, sleep tracking is futile.  Everyone knows that modern athletes underprepare and simply compete too much with entertainment-over-health schedules, but the key break is to remember to do the basics.  Tracking sleep and working on sleep hygiene is a great start, but the trend needs to but the meat and potatoes back to strength coaches. I am not surprised that teams are using wearable devices but some caveats exist with the limitations of accelerometer technologies with sleep tracking.

Three years ago I was using several sleep tools to get sleep data on my sprinters and a few athletes for a colleague. What I realized quickly that team sport athletes were the Velociraptors of the Jurassic Park and were very clever. Here is just the tip of the iceberg with sleep data. Here are three real world challenges coaches are facing now:

Context Errors - If a pro athlete appear like they are getting a solid 8.5 hours after a game but may be passed out from drinking all night. No algorithm can detect every sleep to detect large amounts of ethanol (booze) from “Club Jaguar”.

Data Integrity- Sometimes a pro athlete will have great sleep data, but is that his data or the groupie? Is it one of his friends in the entourage? Is the sensor on his Cat “Pepe”, who sleeps great during home games and has a key ring for the band? I don’t know too many coaches who tuck their athletes into bed, so after a short experiment athletes don’t like getting monitored by big brother.

Interpretation Errors- A high quantity of sleep may be a sign of actually overtraining. When an athlete is sleeping more they could have an illness such as mononucleosis or be fighting exhaustion.

So much of sleeping well is ensuring athletes are not tired from overtraining syndromes more than just teaching or educating about “Bed time”. Even compliant athletes will find sleeping difficult, especially in the NBA when beds are not exactly designed for the bigger “dinosaurs”. When athletes are not prepared fitness wise, have poor biomarkers, and are not strong in the lower body, sleep is poisoned by outside variables. The big picture is to make athletes focused on doing the training, not just the spa recovery needs. In the future the athletes will have to decide themselves what they are willing to do to get better, and that starts with the weight room, not just the bedroom.

I will not point fingers and do the blame game, that is for the experts and pundits, but I will point to other factors than what we see online or in print. I don’t know if Oklahoma City is doing blood analysis, advanced sleep tracking, and cutting edge foot diagnostics with pressure mapping, but even if they did a limit exists to the body and I am not sure if we passed that point of no return or not with the NBA. What I do know is that the reliance on technology is dangerous without a good plan and good people, and teams with a great staff and talented athletes will win at the end.

Article contribution by Carl Valle

BSMPG is proud to announce ERIC OETTER as a speaker at the 2015 BSMPG Summer Seminar - May 15-16th, 2015.  Last year was a sell out and the only difference this year will be us announcing a sell out well in advance! This will be one of the greatest performance and therapy seminars of all time!  If you were in Eric's session last year you know he absolutely killed it and our boy from Georgia is back to drop the #boom again this year!

Be sure to save the date and reserve your hotel room well in advance.

See you in Boston in May!!!  

ERIC OETTER

SPONSORED BY:

Eric is an author, speaker, coach, and student, currently pursuing his DPT from the Emory University School of Medicine.

Following an injury-shortened athletic career at Georgia Tech, Eric has coached a diverse clientele at two of the top gyms in the country, Indianapolis Fitness and Sports Training and Cressey Performance. He has since consulted with coaches in the Big Ten and was recently named one of the Top 25 Fitness Industry Rising Stars by FitnessBusinessInterviews.com.

Eric champions the principles of the Postural Restoration Institute and has been formally trained in the methodologies of DNS, FMS/SFMA, and PRRT, among others.

His articles can be found on EricCressey.com, 8weeksout.com, and in Fighting Fit magazine.

Registration Opens Jan 1, 2015

Additional speakers to be announced shortly - Trust us when we tell you that this year will blow your socks off!

We asked the leaders in Sports Medicine and Performance Training what they are either currently reading or have read and here is what they said!

See complete (and ever growing) list of suggested reading at the BSMPG LIBRARY. 

NEIL RAMPE

Arizona Diamondbacks

We asked the leaders in Sports Medicine and Performance Training what they are either currently reading or have read and here is what they said!

See complete (and ever growing) list of suggested reading at the BSMPG LIBRARY. 

BOO SCHEXNAYDER

We asked the leaders in Sports Medicine and Performance Training what they are either currently reading or have read and here is what they said!

See complete (and ever growing) list of suggested reading at the BSMPG LIBRARY. 

BRANDON BOVEE

"Here we report that, in patients with chronic hand pain, magnifying their view of their own limb during movement significantly increases the pain and swelling evoked by movement. By contrast, minifying their view of the limb significantly decreases the pain and swelling evoked by movement. These results show a top-down effect of body image on body tissues, thus demonstrating that the link between body image and the tissues is bi-directional.

Ten right-handed patients with chronic pain and dysfunction of one arm participated in our study (see Table S1 in the Supplemental data available on-line). Patients watched their own arm while they performed a standardized repertoire of ten hand movements, at a set speed and amplitude, and in randomised and counterbalanced order. Four randomised conditions involved different ways of looking at the arm: Control (looking without any visual manipulation); Clear (looking through binoculars with no magnification); Magnified (binoculars with 2x magnification); and Minified (inverted binoculars). The patients’ pain (on a 100 mm visual analogue scale) was worse after movements than it was before,but the extent to which it was worse depended on the type of visual input. That is, the increase in pain was greatest when participants viewed the magnified image of their arm during the movements (mean ± SD increase = 41 mm ± 15 mm) and least when they viewed the minified image of their arm during the movements (19 mm ± 18 mm; Figure 1). Swelling — the circumference of the fingers, relative to the unaffected hand — also increased less when participants watched a minified image of their arm during movements than when they watched a magnified image (p < 0.01), or when they viewed their limb as it normally appears (p < 0.02). Recovery to pre-task pain was slowest when the visual input during movements had been magnified but quickest when it had been minified (Figure 1B; see Supplemental data for statistics). Two patients terminated movements in every condition because of intolerable pain and two other patients terminated movements because of intolerable pain in the magnified condition only (Figure S3 in the Supplemental data). These results support the hypothesis that making a limb look bigger increases the pain and swelling evoked by movement. Remarkably, they also demonstrate that making a limb look smaller decreases the pain and swelling evoked by movement."

These results support the hypothesis that making a limb look bigger increases the pain and swelling evoked by movement. Remarkably, they also demonstrate that making a limb look smaller decreases the pain and swelling evoked by movement.

"The obvious clinical implication is that if manipulation of visual input can reduce the pain and swelling evoked by movement, it may assist in the rehabilitation of acute and chronic physical, neurological and psychiatric  disorders associated with certain body image disturbances. Regardless of the mechanism(s) underpinning the effect, modulation of pain and swelling via distortion of vision establishes that the link between pain and tissue condition on the one hand, and distorted body image on the other, is a bi-directional one. The result also suggests that the manipulation of visual input might lead to novel clinical applications, should the reduction in swelling and pain following the viewing of the affected limb through a minifying lens demonstrated here be shown to lead to longer-term beneficial effects in future research.

Join us at the 2014 BSMPG Summer Seminar and travel down the rabbit hole of Elite Sports Medicine and Performance Training - your patients, athletes, and clients will thank you!

Question 1:  The fine line between tapering and of course detraining is getting smaller as seasons are getting longer. With some metrics of fitness and power varying, how does one know if they are reaching a point of lost fitness in team sports? Some teams are monitoring fatigue but not managing training outside practice. What are ways to make non-specific training outside of practice a combination of both adaptation and monitoring physical abilities? Any good workouts for soccer that can help monitor power or conditioning that would be good for college and or professionals?

Iñigo Mujika:  In my view, the key metric to assess where an athlete is at each point in time is performance in training and in competition. If an athlete is not performing at his or her expected level, we need to make some kind of performance-fatigue assessment. If performance is indeed declining, we should assess why this is the case, starting with exclusion criteria such as confounding illnesses. We should also assess whether there are clear errors in the athlete’s training program: insufficient training volume, intensity or frequency; excess or insufficient competition; nutritional errors; and other confounding factors such as psychological problems, social issues, travel fatigue, etc. We can of course make use of biological markers such as resting cortisol levels or maximal lactate production, but I have always believed that communication with the athlete is the most important way to assess what is going on.

Not assessing training or physical activities outside of formal team practice is equivalent to trying to make a nutritional assessment including only the foods ingested by an athlete at team meals, but ignoring what they eat once they are on their own. We need to know what the athlete does outside of formal practice, as this may have a huge impact on the way they adapt to training. All physical training should be included in the quantification of an athlete’s activity profile, and this can be done with the use of physical activity questionnaires, or by means of technological tools such as heart rate monitors or accelerometers.

In terms of tests or workouts that may help monitor power or conditioning, I am sure that every fitness coach has his or her own method, which could be a reference training set, a countermovement jump, a repeated effort test, a maximal or submaximal Yo-Yo Intermittent Recovery Test, etc. The most important thing is that these reference workouts or tests should be carried out in standardized conditions, be relevant to the sport, valid, reliable and sensitive to changes in an athlete’s fitness level.

Question 2:  Small Sided Games are popular ways to work on tactical and technical areas, but you mentioned years ago that longer sprints may be important to prepare for injury reduction. Linear sprints being the most common way of scoring as well as the most common cause of hamstring pulls, what can sport science do to help the medical and team coach with practices during the season by integrating a balance between skill and general training?

Iñigo Mujika:  Small sided games can be very effective training exercises. As you say, they allow to work on tactical and technical aspects of the game, and they can also be effective at improving players’ fitness. Nevertheless, I consider that basing fitness training exclusively on small sided games is an error that is often justified by the wrong assumption that training should always be as similar as possible to the game itself. If that were the case, the best practice would simply be to play the game all the time. My philosophy is that we need to identify the factors that determine physical performance in the sport, then try to find the right training mix that includes proven methods to improve each and everyone of those factors. A soccer player, for example, requires high levels of endurance, speed, power, strength, agility, repeated sprint ability… We as coaches need to make use of the best training methods to improve each one of these qualities, and simply playing small sided games is certainly not the best possible way to achieve this. Of course we also need to be aware that the technical and tactical areas are also key to performance, and after assessing our team’s strengths and weaknesses, we need to determine the training time that will be specifically allocated to each of these areas, and the time needed to optimally integrate them to maximize each player’s contribution to the team’s overall performance. Within this framework, injury prevention is also a key aspect of daily training. In a sport like soccer, the physical qualities required from the players should be trained in conjunction with injury prevention (e.g. core training, proprioception, use of eccentric overload training of thigh muscles, dynamic stabilization through vibrations, uneven and unstable surfaces, etc.). In this respect, I believe that it is better to have your best players at 90% of their physical capacities on the pitch, than having them sidelined due to injury.

Click HERE to continue reading this interview from speedendurance.com  

BSMPG 2014 Summer Seminar - Keynote Speaker Iñigo Mujika 

SPONSORED BY:  

Keynote Session: Tapering and Peaking for Optimal Performance

Breakout Session: Detraining following Injury

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.

Registration for the 2014 BSMPG Summer Seminar ends at 7pm on Monday May 12th.

@BSMPG_1

We always hate losing great speakers to unexpected life events, but when a world authority in performance training is able to step in last minute, well, it sort of takes the sting out of it.

BSMPG is proud to bring Dr. John Sullivan to Boston for the 2014 BSMPG summer seminar! We are officially one week away and are ready for the largest seminar to date!

Registration will be open until Monday May 12th - but then its CLOSED!

Sign up today!

See you in a week!

DR. JOHN SULLIVAN

Topic: Readiness – Science and Application

SPONSORED BY:

THE 2014 CATAPULT PERFORMANCE DIRECTORS MEETING

Mission of the BSMPG Performance Director Forum: To provide the leaders in performance training and medical oversight an opportunity to engage with leaders of similar attitude, vision, and entrepreneurial spirit, while pursuing innovative strategies in performance methodology. 

WHEN: Sunday May 18th

WHERE: Somewhere awesome in Boston (you'll find out when you get your registration confirmation)

WHY: Because you want to be #BESTINTHEHISTORYOFEVER

SPEAKERS: See below

SPOTS AVAILABLE: A few spots remain - send notice of interest to bostonsmpg@gmail.com for official invite

DRESS: Business casual

COMPLETE DETAILS: Click HERE for complete details including a full speaker and attendee list.

DAVID TENNEY was named the Sounders FC fitness coach on January 9, 2009. He is one of Major League Soccer’s most respected and highly-regarded fitness coaches following two years in Kansas City. On January 1, 2014, Tenney was named Sports Science & Performance Manager for the Sounders. Tenney’s Sports Science & Performance department is the first of its kind in MLS — and is tasked with collecting and analyzing the physiological, physical, and tactical data related to performance, fatigue, and injury prediction. Prior to the Seattle Sounders, Tenney held similar positions with the Kansas City Wizards (now Sporting KC), the George Mason’s Men’s & Women’s teams, and the Washington Freedom (women’s professional soccer).

DR. PHILIP SKIBA is the Program Director for Sports Medicine at Lutheran General Hospital, in Chicagoland. He also serves as acting Program Director for Sport and Exercise Medicine at The University of Exeter, UK. His research studies focus on the determinants of athletic performance in both power / speed and endurance sports. His work has been used by athletes in amateur and elite sport on a regular basis, including the 2012 London Olympic Games. He is the CEO of PhysFarm Training Systems LLC, and has coached a number of world-class athletes, most notably U.S. Olympian, Half-Ironman World Champion and World Record Holder Joanna Zeiger, and 4-Time World Champion Catriona Morrison of Scotland.

DEREK HANSEN is a sports performance consultant based out of Vancouver, B.C., Canada.  He currently works as the Director of Athletic Performance at Simon Fraser University.  He has worked extensively with coaches and athletes from all levels of high performance including the NBA, NFL, NHL, MLB, CFL and the NCAA.  His involvement with Olympic athletes, coaches and teams includes sports such as Track and Field, Speed Skating, Softball, Bobsleigh and Field Hockey, with many of these athletes having won Olympic medals and achieved world record performances.

Derek’s specific areas of expertise include speed development, electrical muscle stimulation for performance, tapering and recovery, and hamstring rehabilitation.  Two significant influences in the development of his approach have been Charlie Francis and Al Vermeil.  Derek worked closely with Coach Francis from 2001 to 2010, providing coaching to elite athletes and developing Charlie’s educational materials for on-line presentation and seminar delivery.  Coach Vermeil has also been a steady source of mentorship to Derek from 2002 to the present day, providing insight into all areas of athlete performance.

When not coaching, Derek is a course conductor with the Canadian National Coaching Certification Program in the areas of Physical Preparation, Recovery & Regeneration and Sport Biomechanics.  He has developed a broad series of electrical muscle stimulation protocols for Globus Sport and Health Technologies, known as the SpeedCoach, that integrates EMS programming with conventional training to enhance speed performance.  Derek also runs a highly successful Strength and Conditioning apprenticeship program that places young coaches in jobs all over the world.

BSMPG: WHERE LEADERS LEARN