Month: December 2011

Concussions in the NHL

Concussions have been a hot topic over the last two years in the NHL. Not in small part to Sidney Crosby’s concussion, more attention is now being paid awareness, prevention, and more conservative return-to-play guidelines.

Long-term concussion symptoms are becoming a more prevalent problem

Concussions are far from a simple injury. It’s the underlying complexities in injury mechanism AND predisposition that makes concussions so hard to treat. As I’ve mentioned in the past (see Sidney Crosby’s Concussion), a large component of preventing things from getting worse than they need to is following a complete return-to-play sequence. Given the alarming statistic that 92% of repeat-concussions occur within 10-days of the original incident, it would seem logical that a bare minimum precaution should be to keep players out for 2 weeks following ANY concussion suspicion. I can see the hesitation in adopting this practice as a norm, but the reality is that the amount of development and exposure that can occur within this time frame is negligible, especially when put in the light of the potential short- and long-term consequences of suffering a repeat head injury.

As my friend Maria Mountain recently wrote (see A Rant about Concussions in Hockey), it’s bizarre that the phrase “concussion-like symptoms” seems to frequent hockey media channels now. This is a suspicious description given both the diverse nature of concussion symptoms (which can range from those comparable to tension headaches to those resembling vertigo), and the lack of clarity in diagnosis in general. How does someone suffering concussion-like symptoms differ from someone with a concussion? Is concussion-like symptoms simply being used as an umbrella diagnosis to put a name on something not medically understood? If concussion-like symptoms are being used as a diagnosis for those exhibiting symptoms that don’t present with observable brain trauma and/or have relatively normal ImPACT scores, then it’s important to look at some of the underlying mechanisms that dispose athletes to these symptoms.  There are certainly a lot of questions that remain to be answered regarding concussions, but with the increased attention being paid to the associated consequences of impact and adaptations to the brain itself, I thought it would be beneficial to discuss some of the lesser known underlying causes of “concussion-like symptoms” that may be related to or exacerbated by impact, but aren’t necessarily a brain injury.

Mechanisms of Concussion-Like Symptoms
Below are three mechanisms that can cause concussion-like symptoms, that are not associated with a brain injury:

  1. Poor Visual Tracking
  2. Sub-occipital nerve impingement
  3. Altered sensory input secondary to a loss of neutrality

Poor Visual Tracking
I was first introduced to this idea by Dr. Josh Bloom at Pete Friesen’s Physio-Fitness Summit a couple years ago. Dr. Bloom pointed out that in players with ongoing symptoms, or those that do not seem to be making progress, it is often the case that they have an eye that is not tracking properly. In a sort of ocular constraint-induced movement therapy, the employed strategy involved covering the properly functioning eye and training the eye that did not track optimally. He noted that in some cases, symptoms resolved almost immediately (within a single session) and had no recurrence. Whether ever player has this experience or not, it’s certainly worth looking into. The idea that a player may have ongoing symptoms that they think are related to a concussion may cause inappropriate limitations in their training and practice and a delayed return to play.

Sub-Occipital Nerve Impingement
Over the Summer, my friend Ned Lenny (physical therapist based in Cherry Hill, NJ if you’re local) and I were talking about postural adaptations that we see in both the hockey and general populations, and about how the hockey adaptations were typically in-line with a more extreme version of what we saw in the general population. In other words, the postural changes we see in most people that result from sitting too much and moving too little are significantly worse in hockey players. In general, these adaptations can be described by Janda’s upper and lower crossed syndromes.

Most relevant to the concussion discussion, the adaptation that most directly influences these symptoms is a forward head posture, or more directly, a posterior rotation of the occiput on the atlas.

Ned pointed out that hockey players spend a substantial amount of time sitting on the bench, in cars/buses/airplanes, playing video games at home, and after many practices and games, they hop on a stationary bike. Going for a post-skating bike ride isn’t inherently harmful; in fact there is some value in restoring a more optimal autonomic nervous system balance. The kicker is that players hop on the bike and immediately look for the TV, which is usually posted above their heads somewhere, forcing them to rotate their head further back. Living in this position of posterior cranial rotation predisposes them to suffering symptoms related to impingement of the local nerves when forced further into posterior rotation, which can result from contact of varying severity. This might be why you see some players with prolonged symptoms after taking what looked like a relatively innocent hit.

The key to minimizing this predisposition is to improve the player’s posture and awareness of cervical position. We spent a lot of time last off-season emphasizing a “packed neck” position with all our hockey players at Endeavor and continue to emphasize this position now with our in-season groups. In reality, this isn’t an injury prevention strategy as much as it’s just the right way to train, but it can feel a bit unnatural for players at first.

Chicks dig guys with a good neck pack

Altered Sensory Input Secondary to a Loss of Neutrality
This is a very complex way of saying that humans are inherently asymmetrical and have tendencies to drift toward predictable positions of non-neutrality. This concept stems from my ongoing apprenticeship of the Postural Restoration Institute information, and has profound implications for athletes and non-athletes alike. Over the last week at Endeavor, I’ve assessed a dozen people that all had NO adduction on their left side, but had full adduction on their right side. For hockey players, this pattern will compromise their stability and skating power, and it’s likely that a player will feel more comfortable crossing over one way (usually to the right) than the other. Failing to address this pattern can lead to a number of compensations of varying severity. Luckily, neutrality can be restored pretty easily using a number of specific breathing techniques.

Importantly, these human tendencies aren’t limited to the hips, but affect everything from the position of the foot to the position of the temporal bones. Specific to the cranial region, it’s worth noting that the common adaptations in the spine lead to a non-neutral head orientation. Because the body naturally seeks a position where the eyes are horizontal, there are compensations that occur through the spine, bones of the head, and the ocular system, all of which will alter the related sensory input, and can lead to feelings of dizziness or general feelings of spatial instability. I realize this is an abstract concept, but it’s not one to be overlooked. At PRI’s Advanced Integration course a couple weeks back, Ron Hruska discussed what he referred to as “ocular scoliosis” and noted that restoring neutrality can actually change a person’s eye prescription. The eyes are among the body’s most powerful sensory organs. Restoring a more neutral position can lead changes in sensory “symptoms” stemming from multiple sources.

Take Home
The major take home from this discussion is that it’s possible to have symptoms resulting from contact that resemble those of a concussion that have an underlying cause not related to brain impact. Because all of the above mechanisms have relatively quick fixes, they’re certainly worth exploring if you have ongoing symptoms AND should be attended to regularly in the interest of minimizing concussion risk in the first place. With the medical team that Sidney Crosby has put together, you would hope that these, and all other underlying factors, are also being addressed.

That’s a wrap for today. Pass this along to other players, parents, and coaches, or anyone else you think may benefit from learning more about concussion prevention!

To your success,

Kevin Neeld

Please enter your first name and email below to sign up for my FREE Athletic Development and Hockey Training Newsletter!

Is Repeat Sprinting an Aerobic Activity?

It’s great to be back in the gym after a relaxing weekend. My mom came to visit Emily and I from Raleigh, NC so it was nice to have some down time to hang out with her. As you can imagine, my schedule keeps my pretty busy, so I don’t get to spend as much time with friends and family as I’d like!

As I mentioned last week, I’ve been reading quite a bit of research on energy systems recently. Understanding where energy for certain activities comes from will help make training more specific and appropriate to the demands of the sport (and the position in some cases). In general, it is traditionally thought that:

  1. The ATP-PCr System contributes to high intensity activities ranging from 0-12 seconds.
  2. The Anaerobic Glycolytic System contributes to moderate-high intensity activities ranging from ~13s-~30-45s
  3. The Aerobic Glycolytic System contributes to moderate intensity activities ranging from ~30s-3 minutes
  4. The Aerobic Beta-Oxidation System contributes to low-moderate intensity activities from 3-minutes on

Naturally, this is a grossly oversimplified view of energy systems training, which is the major reason for this discussion. It’s important to realize that the intensity of movement is equally, if not more important in determining energy system contribution than the duration of the activity. In other words, if you walk for 12 seconds, you won’t be relying on the ATP-PCr System as your primary energy source; it’s a low intensity activity that doesn’t require a huge surge of energy production. As your body performs work, it breaks down ATP. Replenishment of ATP is needed to continue to do work. Naturally, the higher the intensity of the activity, the faster the breakdown of ATP and therefore, the faster the replenishment source needs to be. This is why high intensity activities rely on the ATP-PCr system; it’s the fastest replenishment source. Unfortunately, this supply is limited, so as stores become depleted, the body must rely on other energy systems for the replenishment of ATP. Because these other systems cannot replenish ATP as rapidly, performance decreases. This is an underlying reason why someone can run a 4.3s 40-yard dash (120 feet at 27.9 ft/second), but not a 3:09 mile (5,280 feet at 27.9 ft/second). Simply, the rate at which energy can be resupplied is a limiting factor in maintaining high level performance.

After reading the above paragraph, it’s reasonable to think that the systems are activated in the presented sequence; the next being activated when the former is depleted. In other words, Anaerobic Glycolysis System becomes active when the ATP-PCr System depletes, the Aerobic Glycolysis System becomes active when the Anaerobic Glycolysis System depletes, and so on. In fact, this isn’t too far off of how this is typically presented in undergraduate academic programs. In reality, almost ALL systems are always active to some degree during every activity and preceding activity will play a role in which system predominates.

One illustration of this comes from a 1999 study from Parolin et al. titled “Regulation of skeletal muscle glycogen phosphorylase and PDH during maximal intermittent exercise.” As an aside, I find that I’m a little embarrassed when research of this magnitude is over 10 years old before I come across it!

The study looked at the contribution of ATP regeneration from PCr, glycolysis, and oxidative (aerobic) systems during a repeat high intensity sprint task. More specifically, the subjects were asked to perform 3 30-second maximum effort cycling sprints at 100 RPMs, separated by 4 minutes of rest. The authors compared the first and third cycling effort using the following time periods:

  1. “Rest”: Immediately before the 1st and 3rd trials
  2. 0-6 second time block of the 1st and 3rd trials
  3. 6-15 second time block of the 1st and 3rd trials
  4. 15-30 second time block of the 1st and 3rd trials

What they found was fascinating.

Results:

  1. Total power decreased from 622+/-27 W to 459+/-32W from the 1st to 3rd work bouts respectively.
  2. Total PCr hydrolysis was greater in the 1st trial compared to the 3rd (80.7 vs. 59.9 mmol/kg/dry wt). Before the 3rd trial, PCr availability was 79% of what it was before the 1st trial, indicating incomplete replenishment.
  3. Muscle glycogen utilization was 89.2+/-31.3 mmol/kg dry wt during the 1st trial, but reduced to a negligible 4.2+/-28.5 mmol/kg dry wt during the 3rd trial.
  4. The rate of pyruvate production was highest in the first 15s of the 1st trial, but dropped to <1/3-1/6 in the last 15s of the 1st trial and through throughout the 3rd trial. However, pyruvate oxidation increased for than 3x during the last 15s of the first bout.
  5. During the 1st trial, concentrations of lactate, pyruvate, and H+ increased progressively during the first 15s, and then leveled off across the final 15s. Levels of these metabolic byproducts remained high during the 3rd bout, but DID NOT increase further.
  6. However, the concentration of ATP was UNCHANGED during exercise AND between bouts.

This is just a snapshot of a myriad of results from the authors’ analyses, but taken together this study demonstrates:

  1. After 15s of a single 30s bout, oxidative phosphorylation becomes the primary contributor of ATP replenishment.
  2. Oxidative energy systems provide an increasing proportion of total ATP replenishment with repeated high intensity efforts.

In other words:

  1. The oxidative system provides a significant amount of energy almost immediately, even during high intensity efforts.
  2. Oxidative systems become increasingly important with repeated efforts (think multiple shifts).

Again, there is much more discussion to be had on the methods and results of this study, but it provides reasonable evidence for the importance of developing aerobic systems even in sports that are seemingly anaerobic dominant, such as ice hockey. As I’ve alluded to in the past, there are appropriate times of year and methods to develop this system, but the idea that hockey players ONLY need to do high intensity intervals from 30-45s is just as misguided as the idea that they only need to go for long jogs or bike rides to develop their conditioning.

To your success,

Kevin Neeld

P.S. Special thanks to Joel Jamieson for directing me to this study.

P.S.2. If you want a structured off-ice hockey conditioning system, check this out: Ultimate Hockey Training!

Reference:
Parolin, M., Cheseley, A., Matsos, M., et al. (1999). Regulation of skeletal muscle glycogen phosphorylase and PDH during maximal intermittent exercise. American Journal of Physiology, 277: E890-900

Please enter your first name and email below to sign up for my FREE Athletic Development and Hockey Training Newsletter!

This Week in Hockey Strength and Conditioning

Back on track with another update on what’s been going on in the world of hockey strength and conditioning. Since my last update, I’ve added 6 articles to my site. If you missed them, you can check them out at the links below:

  1. Hockey’s Original Recovery Drink
  2. Hip Stabilization Exercises
  3. Current Ice Hockey Research
  4. An Updated Look at Femoral Acetabular Impingement (FAI)
  5. The Most Valuable Lesson I’ve Ever Learned
  6. Energy Systems Training for Hockey

There have also been a lot of great content additions to HockeyStrengthandConditioning.com over the last few weeks. Check out what you’ve been missing!

Hockey Training Articles

  1. Off-Ice Skating Strength Exercises from Mike Potenza
  2. Rotary Power Demands for Hockey Players from Anthony Donskov
  3. My Favorite Set and Repetition Schemes from Darryl Nelson

Hockey Training Programs

  1. 2011 Off-Season Phase 3 Strength Training from Sean Skahan
  2. Christmas Break Training from Darryl Nelson
  3. Clarkson In-Season Phases from Jaime Rodriguez

Training Videos

  1. Skater Crossover Step Lunge from Mike Potenza
  2. Athlete with Bilateral CAM Impingement from me

As you can see, we’ve had a diverse mix of quality content over the last few weeks. Potenza’s videos demonstrate “hockey-specific” exercises that are valuable options for youth programs looking to improve body awareness and skating technique OFF the ice and without equipment. I’m glad Darryl added their holiday break program, as I think it’s timely AND illustrates that the development process is ongoing! This isn’t the time for me to get on my soap box, but we’ve all seen players that work their ass off in the off-season and then pack it in and don’t train at all during the year. In this case, most holiday breaks verge on a month, which is long enough to have a substantial detraining effect if not handled correctly. Darryl’s program also demonstrates the need to make things simple for players when they’re out training on their own, a lesson that also applies to coaches working with an unfavorable coach-to-athlete ratio.

If you haven’t seen the video I posted of the athlete I’ve been working with that has bilateral CAM impingement, I suggest you take the time to do so. Recognizing that EVERY athlete will have a varying degree of hip mobility that is 100% structural and will never be improved through stretching, soft-tissue work, or joint mobilizations, will help prevent a lot of unnecessary damage resulting from trying to force athletes through these ranges of motion. As a profession, we need to appreciate that everyone is built differently, and movement standards need to be adjusted accordingly.

It’s always good to have contributions from guys like Jaime Rodriguez, who recently took over as the Head Strength and Conditioning Coach at Clarkson University (he’ll be getting a few Endeavor players over the next couple of years), and Anthony Donskov, who runs a private facility out in Columbus, OH. These are both guys that I look to for new information and better coaching techniques.

Lastly, check out these threads on the forum:

  1. Youth Hockey Practice Times
  2. Boogaard Article
  3. Nike Vapor Strobes
  4. Grit
  5. Set and Rep Schemes

That’s a wrap for today. As always, if you aren’t a member yet, I encourage you to try out Hockey Strength and Conditioning for a week. It’ll only cost $1, and if it’s not the best buck you’ve ever spent, I’ll personally refund you! Plus, getting a glimpse of Potenza’s mustache in the Skater Crossover Step Lunge video is MORE than worth the price of admission!

To your success,

Kevin Neeld

Please enter your first name and email below to sign up for my FREE Athletic Development and Hockey Training Newsletter!

Energy Systems Training for Hockey

I mentioned yesterday that I’ve spent a substantial amount of time reading through research pertaining to energy system development, GPS tracking, and heart rate variability. In reality, these topics are more interrelated than separate, as they all pertain to what energy systems athletes are relying on, and how much recovery time may be warranted following any give stress load (or work bout).

As you likely know, I’ve been a huge supporter of interval training for hockey players. In general, mantras such as “train fast to be fast” are applicable to hockey. This message is especially important for the players that ONLY condition by going on long jogs or bike rides. However, I think what might get lost in the “pro interval training” message is the need to use this strategy to train different energy systems, or phrased another way, different fuel replenishment systems. In other words, not EVERY interval of EVERY training session is going to be 20-30s of all out effort. Some will be shorter; some will be longer; some will be all out; some will be lower intensity. The desire to over simplify often leads us astray.

Over the last week I’ve been going back through a few hockey training and periodization resources that I haven’t read in several years. It’s interesting to re-read these things. Naturally, as one’s knowledge evolves, so to will their interpretation of any information.

Relevant to energy systems training for hockey, it’s important to recognize that, although hockey is a highly interval-based sport, the contributions of the aerobic system are still quite significant. In fact, in “Periodization Training for Sports” by Tudor Bompa and Michael Carrera, they point out that:

“Acceleration and quick changes of direction are important elements of ice hockey. Training should focus on refining skills and developing power and aerobic and anaerobic endurance.”

They also estimate that energy supply for hockey performance is:

  1. 10% Alactic
  2. 40% Lactic
  3. 50% Aerobic

Periodization Training for Sports

And, as I’ll mention shortly, while I think it’s important to recognize how the game has evolved over the last decade, I still think this information holds a lot of merit. The “aerobic base” that is often cited in periodization literature doesn’t mean that hockey players need to train like marathon runners, but building a strong aerobic system STRATEGICALLY during portions of the early off-season will improve the player’s ability to recover quickly from high intensity bouts AND improve their overall stress capacity.

In order to truly understand the energy contributions of the game, it’s helpful to have an illustration of the intensity and duration dynamics of a typical period and a typical game. One study (from Green et al., 1976) provides information on shift durations and distances covered during a college hockey game and differences in these measures between positions. They found:

  1. Total playing time averaged ~24.5 minutes
  2. ~5,553 meters were covered in the span of the game
  3. An average shift consisted of 39.7 seconds of uninterrupted playing, followed by 27.1 seconds of stoppage, repeated 2.3 times.
  4. Across the three periods, playing time (+17.4%), playing time per shift (+18.7%), playing time between stoppages (+13.3%), and the time taken to resume play after a stoppage (+22.0%) all increased.
  5. The average velocity remained constant over the first two periods and then dropped 5.2% in the 3rd period
  6. The average heart rate was found to be 87-92% of the max value achieved during a VO2 test
  7. Compared to forwards defensemen had more shifts (+26.1%), shorter recovery periods (-37.1%), and played longer (+21.2%).
  8. However, the average defensemen shift was shorter (-7.4%), had less continuous playing time (-10.1%), and took longer to resume play following a stoppage (+12.9%) compared to forwards.
  9. Lastly, on average, defensemens’ heart rates were 10-15 beats/min lower than forwards
  10. Interestingly, the authors also noted that blood lactate increased 457.1% after the first period, but gradually declined over the next two periods!
  11. Goalies showed relatively insignificant changes in blood lactate

Given that this research is now 35 years old, the results should be interpreted with a degree of caution and awareness of the changes in today’s game. That said, research like this is incredibly valuable in understanding the true demands placed on players throughout practices and games. Information in distance traveled and time at specific velocities can be achieved in outdoor sports using GPS systems. Unfortunately, GPS systems aren’t of much use to ice hockey, and other indoor sport. Although, a company called Catapult Sports is pioneering the integration of indoor monitoring systems, and will likely lead the way in providing a technology that governs the future of load and sport-related stress management in hockey. This information is doubly valuable with the addition of monitoring heart rate variability, as this provides information on both the training load AND the individual’s physiological response. If you’re not familiar with heart rate variability, I highly recommend you read David Lasnier’s post Managing Fatigue and Recovery and Joel Jamieson’s free report The End of Group Training.

Joel referenced an interesting study in his energy systems presentation that I had an opportunity to read on my flight back from Lincoln regarding how energy system contribution changes with repeat high intensity interval performance, which I’ll discuss more about next week. The big take home from this discussion is that ALL energy systems contribute to hockey performance and all need to be trained. The balance, progression and periodization of each system is where the magic lies.

To your success,

Kevin Neeld

P.S. Don’t forget, less than 48 hours left to take advantage of the $1 trial and $100 discount on what I consider the best fitness business product out there! Click here for more information: Fitness Business Blueprint!

Please enter your first name and email below to sign up for my FREE Athletic Development and Hockey Training Newsletter!

The Most Valuable Lesson I’ve Ever Learned

It’s good to be home and settled again. I got back to Philadelphia from my trip out to Postural Restoration Institute‘s Advanced Integration course in Lincoln on Sunday at midnight. Lincoln’s airport was an interesting experience. It was one of those places where they had one cab driver on call for the entire city…who also doubled as airport security, flight attendant and pilot.

“And now the moment you’ve all been waiting for. At six foot five a solid meaty 215 pounds… your pregame announcer, your owner, your coach… your pop-singing sensation, but most importantly… your power forward… yours truly, Jackie Moon!”

The course itself was a great experience, and one that I’ll inevitably be referencing frequently in the near future. Not only was the information powerful, but as the only strength coach in a room of 55, speaking with the other attendees was equally as insightful as the course itself. It’s these educational and networking experiences that I rely on for continuing to improve as a professional in the field. Regarding PRI specifically, information from their courses provides the explanation for the staggering proportion of the general population that suffers from femoroacetabular impingement (see: An Updated Look at FAI), and is a major reason why I’m able to successfully work with current and former athletes that suffer from a myriad of hip injuries successfully.

As highly as I speak of PRI (and deservedly so), they are certainly not the only educational resource that I rely on. Since June, I’ve attended/completed 10 different seminars/courses to help broaden and deepen my understanding of material from Functional Movement Systems, USA Weightlifting, USA Hockey, and people like Joe Dowdell and Mike Roussell (among others). I also have a formidable stack of research on energy systems, heart rate variability, and GPS tracking that I’ve worked my way through in the last month. I say all that, not to boast, but simply to put things in perspective. If you want to be good at anything, it’s going to take two things:

  1. Focused, consistent work/practice
  2. Time

I consider myself very fortunate to have learned these lessons early from people like Mike Boyle and Eric Cressey. In my experience, the people that struggle in the fitness profession are those that, at some point, assume their educational journey is over and shut it down. This same thing can be said of almost every profession AND can be applied to athletes. There is always something or someone out there that can help you, and it’s wise to proactively seek these resources out.

Unfortunately, I’m not much of a business man. I’m not passionate about business; I’m passionate about athletic development and hockey training. That said, educating myself on contemporary marketing strategies is a “necessary evil” so to speak, as it doesn’t matter how much I, or the rest of the Endeavor staff, knows about training if no one knows we exist. With that in mind, I’m conscious of spending some (as little as possible) of my continuing education time on business-related materials. Over the last several years, the single best business resource I’ve come across is the Fitness Business Blueprint from Pat Rigsby, Eric Cressey and Mike Robertson.

I continue to refer back to my notes from their videos, and have used their information to reshape all of the internal and external business systems within Endeavor. Unlike many business resources, it’s not based on theory, it’s based on implementable steps and action plans, which makes things easier for the not-so-business savvy people like me. The GOOD thing about business resources is that if you apply the information correctly, the investment pays itself off many times over. The GREAT thing about this particular resource, which usually runs for $299, is that they’re offering a $1 30-day trial, at which point you’ll still receive a $100 discount off the package price and can divide the payments up across two months. Simply, you save $100 AND you get to try it for 30 days for a $1 before you make any commitment. If you’re an action taker, you’ll have made enough money to pay for the package by the end of your 30-day trial! Click here for more information: Fitness Business Blueprint

Remember that the path towards excellence in any area is an ongoing journey. Too many people quit right before their big break. Keep moving forward; it will be worth it in the end!

To your success,

Kevin Neeld

P.S. As with many great opportunities, the $1 trial for Fitness Business Blueprint will only be available for the next 72 hours so take action now and click here for more information on how you can get your hands on the best fitness business resource out there: Fitness Business Blueprint!

Please enter your first name and email below to sign up for my FREE Athletic Development and Hockey Training Newsletter!