Month: June 2010

Sub-Clinical Hockey Injuries?

Last week, Eric Cressey put up a few great posts on an issue that I think everyone working in the human performance arena should be aware of. You can check them out here:

Preventing Lower Back Pain: Assuming is Okay

Healthy Shoulders with Terrible MRIs?

Who Kneeds Normal Knees?

Despite the last title, these three posts contain a lot of great information. The big take home message from all these posts is that many people (athletes and non-athletes alike) have positive MRI findings (positive MRIs means something is wrong), despite not having ANY symptoms. This is most profound in the lower back area, where one study found that 82% of the 98 MRIs taken of asymptomatic individuals came back showing a spinal disc abnormality (Jensen et al, 1994). Eric points on in these posts that similar (although not QUITE as profound) findings have been found in the knees and shoulders of various athletic and non-athletic populations.

More specific to ice hockey players, recall from my post Off-Season Hockey Leads You to Surgery? that similar findings have been found in the hips of elite level hockey players. To refresh your memory, the article found that MRIs of 39 NHL and NCAA Division 1 players, twenty-one (54%) had labral tears, twelve (31%) had muscle strains, and 2 (5%) had tendinosis (degeneration of the tendon). Overall, 70% of these hockey players, who otherwise present as “healthy”, had irregular findings on their MRIs.

We could have a very lengthy discussion about how to interpret all this information, but one major question arises: “If they’re asymptomatic, do the positive MRI findings matter?”

The answer is yes. While positive MRI findings shouldn’t be taken as an instant justification for surgery, they still shouldn’t be overlooked. It’s likely that many of these individuals are just “sub-clinical”, meaning they have a pathology that isn’t normal, but hasn’t yet advanced to the point of pain or disability…yet.

A major take home from these studies is that many hockey players that appear fine probably have some pretty serious injury predispositions. Any injury (even subclinical) can cause neural alterations to the timing and strength of signals sent to various muscles, and therefore have a profound impact on movement.

This latter point was the main message in Proprioception and Neuromuscular Control in Joint Stability, the awesome text book I’ve spent the last 9 months reading.

When I read stuff like this it just reinforces how important it is to teach and emphasize proper movement patterns. It makes me wonder if my half dozen left shoulder injuries, bilateral hamstring tears, 5+ year groin pain, and double hernia surgery could have been prevented had I worked with a quality Strength and Conditioning Coach when I was younger. It also makes me nervous for the countless young players out there that think they can “do it on their own”.

Exercise isn’t as simple as people think it is. Injuries don’t happen by accident. Coaching isn’t a commodity; it’s a necessity. Hopefully hockey players will hear this message from a decent strength coach before they hear it from a physician.

To your uninjured success,

Kevin Neeld

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The Truth About Stretching

I recently came across an excellent video that I want to share with you. Doug Richards from the Physical Education & Health department at University of Toronto St. George gives a lecture entitled, “Stretching: The Truth”. In his presentation, he discusses all the myths of stretching and outlines the foundational scientific knowledge that everyone should be familiar with before implementing a stretching program.

A lot of this information (notably understanding the mechanical properties of various soft tissues like muscles, ligaments, tendons, and fascia) is similar to what Bill Hartman recently discussed during the Coaching Call he did for my Hockey Development Coaching Program. After hearing Bill talk about the various stretching techniques he uses (and why) and no hearing Doug Richards detail the science behind it, I’ve really changed my outlook on the whole stretching process and how to go about recommending stretches to my hockey players.

Check out the video; I bet you start to reconsider some of the stuff in your programs too!

Enjoy.

To your success,

Kevin Neeld

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Groin Soft Tissue Work for Hockey Players

As you know, the adductors “groin” present a lot of problems for hockey players. Some are tight; some are weak, some are injured. The more time players spend on the ice, the more of an issue this becomes.

One area that hockey players are frequently locked up is in the area of the posterior adductor magnus and medial hamstrings. Adhesions can form in this area and almost “glue” these muscles together.

Restrictions in this area can affect both hip and knee joint motion. More specifically, hockey players with restrictions in this area will have a difficult time achieving full hip flexion, which will affect their ability to do exercises like reverse lunges and back leg raised split squats correctly.

A great manual therapist can help alleviate this problem by re-creating separation and smooth movement of these muscles. With that said, we don’t all have a great manual therapist waiting to help our players address these problems. My colleague David Lasnier recently posted a great video on an adductor soft tissue technique that we use at Endeavor. Check out the video here: Soft Tissue Work For Groin Pain

To your continued success,

Kevin Neeld

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Rate of Force Development and Explosive Lifts

The other day I got an email with a quesiton from someone that had just read an article I had written a while back for EliteFTS: Rapid Rate of  Force Development

He asked:

“Based on the information in the article, and relating this to a power clean/hang clean, would this then explain that a power clean requires more ROFD than a hang clean, or in laymen terms, a power clean is a much more explosive lift?”

It’s a good question. My assumption is that he was thinking that the power clean starts off the floor with minimal muscle activity, so it’d require a greater rate of force development to get the bar moving. To an extent, that may be true, but this is based on a couple important assumptions:

  1. The muscle activity in the start position is greater in the hang clean than power clean (reasonable)
  2. The same muscles must reach the same amount of muscle activity to perform the exercise (probably unreasonable)

Both lifts involve some sort of muscular pre-tension (holding the bar in a hang clean will pretension the muscles; gripping bar and pulling yourself into the right position will pre-tension the muscles in the power clean). In other words, you aren’t starting from complete muscular inactivity in a power clean. You still need to perform an isometric contraction against the bar to get into the correct starting position, but it’s reasonable to assume there would be more activity in the glutes, traps, and back extensors during a hang clean.

To expand on the latter, the exercises are simply different. Even with the same load, the momentum and stretch-reflex characteristics of the two exercises are likely to be different. I don’t think a power clean is necessarily a more explosive lift. You definitely do more work (by definition work is calculated by the distance a weight travels) during a power clean than hang clean, but I think saying it’s more powerful may be giving the wrong impression.

Regarding athletics, I think the hang is a better option because you get to reinforce the proper athletic position and you avoid the problems most athletes have with off-the-floor exercises associated with limited range of motion.

To your success,

Kevin Neeld

 

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Joint vs. Muscular Restriction

Over the past couple weeks at Endeavor, we’ve had a bunch of new and prospective athletes come through our doors. When I teach new people our warm-up, the words “mobility” or “mobilization” come up repeatedly.

Mobility is a term frequently used to describe one of two things:

  1. The ability for a bone to move (e.g. roll, glide, spin, slide, etc.) within a joint
  2. Global range of motion around that joint

It’s important to understand that mobility around a joint is dependent upon several factors:

  • The anatomy of the joint itself (e.g. bone shape/contact, cartilage support, etc.)
  • Supporting ligaments (size, strength, direction of pull, integrity, etc.)
  • The extensibility of the muscles surrounding the joint

Of these, most people think of improving range of motion around a joint as simply improving the extensibility of the muscles around it. Many times, this can be an effective strategy, but sometimes it’s not that straight forward. Mike Boyle first introduced this concept to me within the context of ankle mobility.

He correctly pointed out that if someone lacks dorsiflexion range of motion (knee going forward over the toes) it may have nothing to do with tight calves. Instead, it may be that your talocrural joint (tibia and fibula on top, talus below) isn’t gliding the way it should be. As a result, your dorsiflexion ROM will be limited and you may even feel sensations of impingement in the front of your ankle. Bill Hartman does a great job of discussing this issue specifically in these two videos:

Self-Ankle Mobilization 1

Self-Ankle Mobilization 2

Improving range of motion isn’t always a simple fix. Like all things in performance, you need to get down to the cause of the limitation, not just guess your way around the symptoms.

To your success,

Kevin Neeld

 

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