Youth Sports: Where Did the Fun Go?

What happened to the days of youth sports being fun? What happened to teaching sportsmanship and other life lessons with youth sports? It seems like monthly I see a story of kids between the ages of 8-12 participating in high level athletics, playing on “elite” teams and practicing multiple times a week. What happened to playing for the love of the sport and not for some scholarship 10 years down the road? What happened to an offseason for youth sports? Now when I say offseason, I don’t necessarily mean doing nothing. I am a big proponent of multi-sport/activity kids, but playing the same sport all year round is where I have the issue. I hear horror stories of kids playing upwards of 80-100 games per year, which is the epitome of overuse. This is borderline child abuse and I put much of the blame on the coaches but parents have just as much responsibility in this. A parent at some point has to look at what is best for the health of their child. Some of these club coaches, and school coaches aren’t exempt, will ride a “stud” to a championship. Guess what? Eventually that stud, whose body hasn’t matured enough yet to handle these stresses, will break down. It makes me cringe because I have seen the damage this causes. I have seen kids whose arms or knees are shot by the time they do make it to that “glorious” scholarship. News flash, if the kid can’t perform they won’t have that scholarship for long. 
We need to get back to the days where sport was apart of the community. Where it brought people closer together and taught our children life lessons. We need to stop putting so much pressure on young kids to be the next Lebron James. Let them develop at their own pace and on their own terms. 

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Athletic Trainer’s Nightmare

  

Yesterday a 14 year-old boy from Valdosta, GA passed away after being struck in the head during a baseball game. An athletic trainer was on-site but from the sound of the reports the young man’s chances of survival were slim.  This is an absolute nightmare for an athletic trainer.  We prepare for situations such as this in hopes of giving the person another chance. In our training we learn immediate care of emergency injuries such as CPR, AED administration, and spineboarding techniques. But sometimes a perfect storm brews and an injury occurs where the chances of survival are bleak. At that point, our goal as athletic trainers is to hopefully increase their chance of survival with immediate care.  This young man left Moultrie, GA in a helicopter headed to Tallahassee with a great chance of survival than had this occurred at home because an athletic trainer was there. This is another example of why every parent should be screaming at the top of their lungs to have an athletic trainer at their school. Through our training and expertise, we increase the chance of a good outcome in the midst of a terrible occurrence. 
I thank God that I have never had to deal with a situation such as the one in Moultrie but I have experienced the anxiety of dealing with an emergency. Afterwards is when the anxiety can be difficult to deal with. I pray for the family of the young man, the Valdosta Community and the athletic trainer who responded to this tragedy.

The Comfort Zone: Where Progress Goes to Die

  

We all strive to eventually reach a certain level of comfort in our life (bigger house, better job, nicer car, etc.) but to achieve success in life, we must get out of our comfort zone. Frederick Douglas said, “If there is no struggle, there is no progress.” Meaning if something is easy, it isn’t making you or those around you better. “If it doesn’t kill you, it only makes you stronger” has always been one of my favorite quotes. Successful people don’t look for the easy road, they hit the uphill trail with great determination and will.  
To be better in business/career it may mean stepping into a position that may not be “your cup of tea”. In fitness, it means working on your weakness. I have seen greater progress since evaluating my weaknesses and attacking them with a greater intensity. Stepping out of our comfort zone can be beneficial in all walks of life. I used to look to stay within my comfort zone, and wondered why the wheels were just kind of spinning.  
I am writing this more as a challenge to myself than to you but I know there may be someone out there with similar experience. There are goals that I have wanted to eventually achieve, but have I been stepping out of my comfort zone to reach those goals or just hoping they fall in my lap??  Probably not. Have you been sitting in your comfort zone?? Are you willing to get a little uncomfortable to achieve great things?  I know i have used a lot of quotes but here is another one to ponder, “Life begins at the end of your comfort zone.”

2015 So Far!

As we get close to reaching the end of the first quarter of 2015, I think it is time to revisit the goals that I mentioned in my post Goodbye 2014, Hello 2015!. Well for starters, my wife and I did not take long in purchasing our family’s first home.  I say first, but I hope it is our last….that process was trying. The negotiations and waiting probably aged my wife and I by 10 years. We also learned to have patience as we began to get caught up in the excitement of touring houses. Thankfully we had some outside eyes to help keep us grounded and to keep us from making a mistake we may have regretted. On February 5th, we finally closed on this house!


I don’t know that we could have found a better house for our family. Plenty of space, an office for my wife who works from home, a closer ride to work for me, and an area that is still not too crowded. This house did take a lot of work though, we had to put a lot of hours in painting. Every room in this house has been painted except for 2. It is finally beginning to feel like OUR space and OUR home.  
I am learning as a new homeowner that there is always something to do or some sort of project you want to do. As we began searching for homes, I made it known that I would like a space to create my own weight room. In this house, it looks like it will have to be my side of the garage. If I can clear it with the wife (all you married men know what I am talking about), I’d love to turn one side of the garage into a Palace of Pain.  I’m talking about an area for clanging and banging of iron. This may not be possible right now but a man can dream right??
I also set a goal for myself to reach a 400 lb squat and a 450-475 deadlift.  As of the end of March I had completed a 16 week program following the Juggernaut Method.  I usually do my own programming but sometimes I like to take the thinking out of it and try something someone else has found effective. I gained around 30-40 lbs on my squat and deadlift. I found some weakness that are holding me back, especially in my deadlift. My grip became a factor as I was working with higher loads and plan to make that more of a focus in my training. Currently I am working at a high rep and lower weight to help with some hypertrophy and will begin back to lifting heavy soon.  
As for my posting goals, I have stuck with my once a month goal and this will actually be my second for March. It is just hard to find the time and the ideas to write about.  I am trying to make a concerted effort of writing down ideas as they come up.  
So far I can’t complain about 2015, the weather could be better but I know there will be sunny days ahead!  

We Prepare, You Perform

The NATA for National Athletic Training Month has selected “We Prepare, You Perform” as the slogan for the month. This slogan shows what sets us as athletic trainers apart from other medical professions. Athletic trainers prepare for any situation that may arise so that athletes may participate as safely as possible.  I tell my kids often to play your heart out, and we’ll be here to fix you. Athletic trainers are working hours before practice and games to ensure that athletes are able to perform at the safest and highest level possible. From taping to setting up hydration states at practice or games, they are working tirelessly to prevent emergency situations.  
Athletic trainers help athletes prepare for their sport through preventative strengthening and flexibility programs. Athletic trainers work closely with strength coaches and other coaches to create these programs in order to make the athlete more resilient and move more fluently.  
Injured athletes also need athletic trainers to help them prepare to return to the highest level possible after injury. Whether it is your run of the mill ankle sprain or an ACL reconstruction, athletic trainers work daily with athletes.  They develop rehabilitation programs to help restore range of motion and strength.  Athletic trainers also implement strength and reconditioning programs to help that athlete return back to their previous level and maybe even better, with the ultimate goal being to prevent re-injury. 
Not all situations are avoidable, so athletic trainers also prepare to react to emergency situations. Long before a practice or game occurs, athletic trainers are creating and implementing, and rehearsing their emergency action plans. Through thorough planning and execution of these plans, the evaluation and care of all injuries runs smoothly.  Well thought out emergency action plans help coordinate care and make sure that everybody knows their role in the case that an emergency does occur.  
Much of an athletic trainers work is done before the craziness of sports has even begun, but it never stops as we are always preparing ourselves to be ready for any situation.  We are continually educating ourselves on the newest research, mentally going over situations that COULD occur, and working to maintain the safest possible environment for athletes to participate in.  

The Swing



The swing, whether with a kettlebell or with a dumbbell, has become one of my favorite strength and conditioning tools. I was not introduced to the exercise until a couple years ago and had not really used it consistently in my programming until recently. I prefer the kettlebell over a dumbbell as the ends of the dumbbell can be difficult to hold on to. The kettlebell puts the mass of the implement further away from the body making the swing more effective.  

The swing is not an exercise that many of us were taught during our physical education days of high school but the hip “hinge” is one of the most fundamental movements we as humans do. It is what separates the deadlift from the squat. To break it down simply, the hinge is the flexion and extension of the hip with a posterior weight shift. People may get the “hip hinge” and the squat confused because of the hip motion required for both. Here is a simple way to differentiate the two movements:
Hinge: Maximal hip bend, minimal knee bend




Squat: Maximal hip bend, maximal knee bend




The difference comes in the involvement of the knee. This is one of my biggest pet peeve with personal trainers when they try to implement the swing. It becomes a squat with a swing. This takes a lot of the power from the hips out of the equation and requires you to muscle the weight to the top position. The weight should be getting to the top position through the momentum of the hip snap, which is forcefully pushing the hips into extension after pushing your hips back. The arms should just be guiding the weight through an arc and the weight should basically be an extension of your arms and not flopping around.  The weight should return back between your legs and repeat the process. The weight should never be down around your ankles. I have seen others describe it as attacking the zipper or your forearms should be in the groin area. Also, be aware of spinal position. Below is a picture of Jillian Michaels showing off her impeccable KB Swing form….

If you look in the back of the picture you can see her vertebral discs after the shot out her back.  In all seriousness, you should have a solid spine with little flexion or extension occurring. A rock solid core should be engaged to help stabilize and control the weight.  
That was all the technical stuff….now onto why I use the swing. The swing is excellent at training and developing the posterior chain. Since implementing them into my workouts I have seen greater flexibility in my hamstrings. The stretch that is placed on them during the loading phase of the KB swing places a nice stretch on the hamstrings. Swings can also be a great accessory move for your bigger lifts like the squat or deadlift.  At the end range of hip extension the glutes, or your butt muscles are firing at their greatest. Glute development is especially important in protecting your back both in the weight room and in everyday activities.  Weak glutes means the responsibility to move the weight falls on the weaker back extensors usually leading to a muscle strain or even worse a vertebral disc injury.  
The swing is also a great conditioning exercise. If you are like me, I hate running or steady state cardio. Due to the high amount of muscle mass working at a high level, it can be quite taxing on the body. If done at a high enough intensity(weight, speed, etc), swings can get the heart rate up quite significantly. I like to use them in tabata format(20 sec on, 10 sec rest for 8 sets), in 6-8 sets of 25-50 reps with a minute to 30 seconds rest, and in Every Minute On the Minute type templates. Due to the primarily concentric nature of the exercise, there is also limited soreness associated with the swing. Much of the soreness created from exercise is due to the eccentric or slow lowering phase of your traditional exercises. Since gravity is doing much of the lowering during the swing, the muscle action during this time is relatively low. Swings have also been shown to increase testosterone and growth hormone after a bout of exercise involving swings, meaning they can be a great addition to an off/recovery day. These hormones are important in protein synthesis and muscle building. Swings can help increase our goals of strength and hypertrophy through the interaction the increased hormones in the body.  
The swing is a relatively new exercise in the mainstream fitness world but has been used in sports performance, especially the MMA’s for years. They help create powerful hips, strong low backs, and can increase cardiovascular capability.  These are important aspects to success in the athletic field and staying injury free.  

Why Do I Train?

Mike Robertson, a strength coach out of Indianapolis, posed this question in his recent blog post. It made me think about why I train and why I continue to make it a priority. Sure, most people say they workout or train for something or to look good/make their clothes fit better. As I have gotten wiser in my “old age”, my mindset for training has shifted. I now train to become stronger and move better. Looking better will usually follow suit.

My ultimate goal isn’t to lift a car, although that would make me one bad dude. I train to be stronger. To me, strength also produces resiliency. In college, I battled with low back issues primarily due to poor strength in my hips. Now, I have less back pain that is the result of injury. Sure, my back may feel toasted after a heavy deadlift session, but after proper recovery I am stronger. Strong muscles can help protect the weaker parts of the body such as ligaments or vertebral discs. Strong muscles can help maintain safe and proper positioning, and can make everyday activities easier. For instance, my wife and I will be moving from our apartment into our first house soon. Where I may have previously struggled with a large cumbersome piece of furniture, now I anticipate being better prepared and able to handle these awkward loads much easier. I may only feel like a truck hit me afterward, as opposed to a train.

I train to move better. Admittedly, I have never been and still am not the most limber human being in the world. I was never very good at the sit and reach test they made us do during P.E. in school. During the butterfly stretch, my knees were up by my ears. To say the least, my mobility was terrible. My current training, through my full range of motion, has made me much more pliable. I am now able to touch my toes with relative ease, and can get down into a full deep squat without any problems. I am able to “lift with my legs, instead of my back” when lifting up heavy objects. Better movement quality and efficiency means less injury.

Lastly, I train to scare that boy showing up at my front door 16 years from now to take my little girl out on a date. My father-in-law graciously once told me (as he gripped my hand), “You may be bigger than me, but I can still kick you’re a$$”. I now echo his sentiments.

Sure everybody works out to look better, but maybe we should re-evaluate why we workout. Really think about why you train. What does your training reflect? Let me know why you train!

Goodbye 2014, Hello 2015!

Goodbye 2014! You have been great to me and my family. This year, we had a wonderful addition to our family. Ella Marie has been my crowning moment so far in this life. She has changed our lives in an immense but unbelievable way. She lights up my world when I am having a rough day. Hearing her and my wife get into giggle fits is awesome.

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As great as 2014 has been, I look forward to an even greater 2015. It is customary for many people to set resolutions for the upcoming year. That is the goal of this post today, but I am going to take a different thought process into it. Many people set resolutions as “I will try”. I think this leaves a lot of room for failure. I am going into this year with the mindset of “I WILL”. It means that you are going to find a way to make things happen.

The first “I WILL” is more of a “We WILL”. A family goal of mine and Christa’s is to get us into our first house. We have begun the process of looking and I am excited about beginning this process. We have definitely grown out of living the apartment life….especially when your upstairs neighbors love to vacuum and drop things right when you are attempting to put down a little girl. Also, adding a little one to your family requires a lot of space, which an apartment does not allow for.

In 2015, I will also average at least 1 blog post a month. Looking at the review of how this blog did this year, I was strong at the beginning of the year. Around the time that little girl came around, things got crazy and the blogging got pushed to the back. I think an average of 1 post a month is achievable. I see this blog as a way to teach the everyday person how to take care of themselves or prevent injuries. Now to start thinking about topics!

In 2015, I will squat 400 lbs and deadlift between 450 and 475. For a tall human being like myself, these numbers are pretty substantial. A 400 lb squat would put me at 1.5 times my body weight.

There are other goals that I have throughout the year but in looking at what are the things that I enjoy or value the most, these were goals that would affect them the most.

What are your goals for 2015? Are you thinking I will try or I WILL? I wish you all a happy and fruitful 2015.

How to survive multiple games in one day?

An article I wrote for jucoreport.com
This Sunday I will be covering the JucoReport.com Battle of the South Jamboree, where these guys will be playing 3 games in one day. When I have covered these types of events in the past I see one major trend, the athletes’ performance suffering toward the end of the day. The athlete has done all the right things; getting their shots up, lifting weights, and working on their conditioning but their nutrition before and during is lacking.

What to Eat the Night Before
A coach who I played for had it right, “What you eat tonight, is what you will play on tomorrow.” This is especially true when the games begin early in the morning. The night before will set you up for success as it will allow you to wake up in the morning with a full tank. With my athletes, I usually recommend a large meal high in good carbs with a moderate amount of protein. A bad carb would be considered any carb that is quickly broken down and provide a quick short burst of energy. Any item containing a high sugar content would be a bad carb. A good carb, such as a whole wheat spaghetti, will breakdown slower therefore providing energy over a much longer period of time. The protein is recommended as it helps repair the broken down muscle tissue that occurs during heavy bouts of exercise. This protein source could come from chicken, fish, or lean meat. This protein will also help your body recover the next day, allowing you to have the strength in your third and fourth game. Eating right the day before will help set your body up with the fuel it needs to perform at a high level the next day.

Is Breakfast Important?
“Breakfast is the most important meal of the day.” We have all heard this saying before but I still see athletes who don’t eat breakfast before competing. These athletes are setting themselves up for disaster as they are waking up in a fasted state. This is a formula for disaster because your blood glucose levels are low which lead to low performance and ability to concentrate. Evensomething as small as a piece of fruit and some yogurt will help maintain your performance. I get the excuse that I didn’t have time….well failure to prepare is preparing to fail. Pack a simple snack for breakfast such as a breakfast bar or a banana and some peanut butter. A sports drink like powerade or gatorade will also be helpful. Again, the meal doesn’t have to be large before playing because it can cause some stomach distress if you eat too much before exercise but it is imperative to fuel your body after being in a fasted state for 8-10 hours.

How to Prep in between games
Now you have completed your first game and you have a game in an hour, what now? It is important to replenish what you lost during that time. One of my favorite “snacks” during this time is chocolate milk. Chocolate milk has the optimal mixture of protein and carbohydrate to help with recovery. Chocolate milk has been shown to be more effective in recovery than sports drinks like gatorade or powerade because of the its protein content. Again, as stated earlier, protein helps in rebuilding muscle tissue and help them recover back to their pre-exercise state quicker. Milk also contains some water as well as sodium and calcium which will help in rehydration as well as electrolyte replacement. Also a bar and a sports drink would be helpful in your recovery if you do not have chocolate milk. At some point during the day, lunchtime will sneak up on you. Stay away from greasy, high fat foods as they can cause stomach distress. A safe bet for many athletes would be a peanut butter and jelly sandwich or a sub sandwich with pretzels or a piece of fruit.

Don’t Forget to Hydrate
I would be re-missed if I did not touch on hydration tips. When an athlete has lost more than 2% of their body weight due to fluid loss, the athlete will see a drop in their performance. To regain that weight, it is recommended to drink between 16-24 ounces of water or sports drink to replace the fluids. I often get the question which is better, water or sports drinks. It is a mixture of bother personally. The sports drinks are going to help replace the electrolytes lost during exercise and due to the flavor encourage some athletes to drink more. I have also had athletes that report it is too sweet at times and prefer water. For these athletes a 50/50 mix may encourage more fluid replacement.

Especially for the young guys playing this weekend trying to find that scholarship from a 4-year school, performance is important. During the days where multiple games are played, it is imperative to fuel your body properly to perform at your highest level. You may be busy, but as I said earlier, failing to prepare is preparing to fail!

Gluteus Medius: the Root of Chronic Leg Pain?

Dealing with knee pain while running? Or even shin splints? What about a history of lateral ankle sprains? These may all be a symptom of a weakness at the hip, specifically weakness of the Gluteus Medius. We have all heard of the Gluteal Muscles but may not have heard of the Medius. The Gluteus Maximus gets all the glory for making a nice back side but the Medius may have greater implications in the the health of the lower extremity.

Anatomy and Function

The GMedius originates on the posterior aspect of the Ilium or the top part of the pelvis. The tendon inserts into the lateral surface of the greater trochanter of the femur, or the bony part of the hip on the side of the hip.

The Gmedius’ primary function is abduction of the hip or moving the leg away from the midline of the body. It also contributes to most of the actions of the hip but for the sake of this topic we will focus primarily on abduction. The Gmedius is also responsible for preventing the opposite side of the pelvis from dipping down while in the stance phase on that side. This helps prevent the Trendelenburg Gait which is pictured below.

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By creating stability in the frontal plane at the hip, it also creates stability in the same plane for the knee and even down into the foot. By limiting the amount of valgus moments at the knee during functional movement, pronation of the foot is also limited. Some individual difference can occur as we are all shaped different but we can hopefully prevent overpronation of the foot by controlling the knee through the hip. Below is a picture to visually explain what occurs when a valgus moment occurs in the knee.

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Pathologies
IT Band Syndrome
The primary cause of IT Bandy Syndrome is due to decreased abduction of the thigh and external rotational of the thigh while running. This creates and increased tension of the IT Band which runs along the lateral side of the thigh. This increased tension will create areas of friction either at the greater trochanter or the lateral femoral condyle of the knee. With soft tissue work of the IT Band (foam rolling or massage), and strengthening of the hip, there should be a decrease in pain with the IT Band
Patellofemoral Pain Sydrome
Patellofemoral pain syndrome is used to describe injuries such as patellar tendinitis and patellar chondromalacia (wearing away of the cartilage under the knee cap). Much like the IT band, these chronic injuries are caused by the decreased thigh abduction and external rotation. The lack of frontal plane stability at the knee caused by a weak GMedius can lead to poor patellar tracking mechanics through the femoral groove. The increased valgus angle at the knee also does not allow the quadriceps to work at efficiently as possible. This poor angle places more stress on the patellar tendon with high loads. This, if not corrected will lead to patellar tendinitis.
ACL Sprains
Probably the most known athletic injury is the ACL injury. It can lead to surgery and 6-9 months of intensive rehabilitation. The noncontact ACL injury can be prevented with a strong Gmedius. One of the mechanisms of tearing an ACL is rotation at the knee. The control of adduction and internal rotation of the knee through the GMedius can help protect the ACL in activities such as cuting and landing. Proper cutting and landing is important but a strong Gmedius will allow the body to absorb higher loads without a collapse of proper mechanics.

Assessment

For a quick and functional assessment my go-to test is the single-leg squat. This test places us in a position where we must have great control of the pelvis and knee to complete correctly. I first allow the patient to do it without any instruction other than visually how to do the exercise. The keys to visually assess are the amount of valgus angle at the knee. I also am looking at the hip and foot. If the arch collapses immediately or the knee angle gets better with some sort of support at the arch, then the issue may be more at the foot and ankle. But if the arch is compensating due to the lack of control at the knee then the hip will be the issue. I like to video my athletes while doing this so they can see the dysfunctions that are occurring. After I have seen how they are moving without any cues, I like to teach them a few cues so they can feel how to move correctly. My main cue is to keep the patella over the second toe. This cue seems to be the biggest help.

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Strengthening

I have a couple go-to exercises that I use for strengthening of the GMedius. While the patient or athlete is still symptomatic or non-weight bearing the clam exercise and the sidelying hip abduction exercise have been an essential part of my rehabilitation. These can be advanced through bands or weights. An important note with my sidelying hip abduction exercise is I had a bit of hip extension. This has lead to a greater focus on the GMedius and a greater burn when my athletes are doing it. It is also important to maintain a neutral spine while doing these exercises as it can lead to compensations.

As the athlete becomes more functional I like to progress to exercises that put them on their feet. The miniband side shuffle is one I rely on often and have found great results with. The Stepdown exercise is also a staple with the emphasis being on the eccentric phase of the exercise. I also like to implement the miniband around the knees with exercises like hip bridges and squats as it puts a load on the hip abductors while performing other functional exercises.

Clinicians, what other assessments are you using for general glute weakness or Gluteus Medius specifically? What exercises are you using to strengthen the Glute Med?