Month: August 2013

Optimizing Movement Q&A

With the official release of Optimizing Movement, I want to address several questions I’ve gotten both over the last week and over the last few years pertaining to the importance of maximizing movement quality and capacity. If you have a question not covered here, please post it in the comments section below!

Click here for more information and to watch the trailer! >> Optimizing Movement

What does “optimal movement” really mean?

Over the last several years I’ve referenced a growing body of research studies on a wide variety of populations that indicate that both athletic and non-athletic populations alike have an array of structural deviations and sub-clinical pathologies. Some are in pain; some are not. In other words, some may have issues that come to you as a red flag; others may not be aware of it at all (yet). Likewise, the Postural Restoration Institute has done an outstanding job of highlighting some of the structural and functional asymmetries that are present in all humans and how these may predispose different populations to specific injuries. Naturally, people also adapt to the stresses they DO or DON’T place upon themselves. These are small examples, but the big picture is that people are born with different structures and their structures adapt/change differently over time. Optimal movement starts by understanding the individual’s structural capacity. From here, the goal is to discover if the individual has limitations or imbalances WITHIN their maximum capacity, and then further prioritize which order to address these limitations depending on what the demands of the individual’s sport/activity are. Simply, the word “optimal” means allowing an individual to express their full movement capacity based on their structure.

How does optimal movement affect sports performance?

This is a bit of a loaded question and one that could be the subject of a book series. In short, there are three major buckets in which movement capacity can influence sports performance:

Economy
Skill Performance
Injury Risk

When a joint doesn’t possess sufficient range of motion or isn’t positioned optimally at any given time, another joint (frequently an adjacent one) will need to pick up the slack in terms of both providing the necessary motion to allow a certain movement, and in helping to produce or reduce/absorb the force that the other joint could not. As you can imagine, while this system allows the execution of some version of the intended movement, it certainly isn’t a very efficient system. Movement efficiency can influence both local (at a specific muscle or structure) and global (the entire system) conditioning/endurance, and may therefore impact how an athlete performs both at the end of a competition, AND at the end of the season.

Movement capacity can heavily influence skill performance. As a simple example, when a hockey player takes a slapshot, the movement necessitates internal rotation on the front hip, in this case the left. If the player doesn’t have sufficient left hip internal rotation (EXTREMELY COMMON!), they won’t have as large of an arc to produce force, they’ll lose some of their ability to use their glute to decelerate the movement, and they’ll need to compensate by both moving excessively at a neighboring joint (in this case probably more of a lateral bend and rotation of the spine/rib cage), and by excessively loading additional musculature to decelerate the movement. Tying this in to the third point, this environment can lead to breakdowns in a number of fairly predictable places: lumbar disc or spinal fractures, oblique strains and lower abdominal tears (e.g. sports hernias), anterior superior hip labral tears (the lack of IR on the lead leg will cause compensatory movement within the joint). This is a hockey example, but this can be paralleled to any high velocity rotational sport, such as baseball and golf, among others.

I just assume this went bar down?

While I presented these as three distinct issues, I don’t feel they can really be separated. I can’t imagine a situation where an athlete has a mobility limitation that impairs their skill expression and increases their injury risk, but improves their economy/conditioning. To me, it always comes back to the Athletic Performance Pyramid idea; the larger the foundation, the higher the peak.

Optimizing Movement is all about building a larger foundation, so the athlete can fulfill his/her TRUE athletic potential.

What if I don’t have time for assessments?

If you don’t have time, I’d suggest making time. Always think “how”, and not “if”. That said, I understand that some folks are in really tough situations and don’t have the flexibility to even determine where their time is spent with a team or client. In this case, I’d suggest looking for a new job! But in all seriousness, I get it. If you are an astute observer of movement, you can pick up on a lot just by watching your athletes/clients move. As I discuss in the DVD, a corrective approach isn’t just about corrective exercise. When you learn what to look for and have a system set up to address limitations when you see them, you can take a huge step in the right direction without including formal assessments. This is a major topic of Optimizing Movement and one that I think will resonate with just about everyone in the training and rehabilitation professions.

Is Optimizing Movement an ACTUAL DVD or just streamed online?

Optimizing Movement is a 2-DVD set. After you order, the DVDs will be shipped directly to the address you specify. In addition to the U.S. and Canada, the DVDs can be shipped to Australia, Asia, Europe, the United Kingdom, and Ireland. If you’re in an area where shipping isn’t currently available and would like to buy the DVDs, just drop me a note below and we’ll work it out. If you’re in a sunny area, I may even deliver them myself.

What if I don’t like it?

I can’t imagine that will happen. I sent an advance copy to a D1 Hockey S&C Coach, and he emailed me back with “Just finished the first DVD. Hands down the best DVD I’ve ever watched.” The information has been very well received and I know you’ll love it too! That said, I understand there may be a person or two out there that are offended I’m wearing a Flyers hat the whole DVD and will want to return it. The DVDs are backed by a 60-day 100% no risk, no questions asked money back guarantee. Simply return the DVDs and you’ll be issued a full refund.

Click here for more information >> Optimizing Movement

That’s a wrap! As I mentioned above, if you have a question that wasn’t addressed above, please post it in the comments section below!

To your success,

Kevin Neeld
OptimizingMovement.com
UltimateHockeyTraining.com

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Optimizing Movement is Here!

In February, I had an opportunity to do a one-day presentation with Joel Jamieson at Dynamic Strength and Conditioning in Nashua, NH. Shortly after announcing I would be there, I got an influx of emails from people that wouldn’t be able to make it (weird that people wouldn’t want to travel to New Hampshire in the middle of Winter?), but were hoping my presentations would be recorded. I’m excited to announce that the 2-DVD set of the three presentations I gave are FINALLY here!

Click here for more information and to watch the trailer! >> Optimizing Movement

As I alluded to in my article “Groundbreaking Research on Hockey Hip Injuries” from a couple days ago (which also discusses how prevalent these issues are in other sports and populations), the athletic population that is entering our facilities these days are increasingly “sub-clinical”, presenting with a number of structural and functional limitations that will heavily influence their movement, athletic capacities, and ultimately their performance in sport. The assumptions that exercise technique standards should be the same for all athletes and that athletes are symmetrical in their joint structure and range of motion aren’t just misguided, they’re potentially very dangerous. As a result of these things, the sports performance coach or clinician that has a toolbox of specific assessments, a system of effective corrective approaches, and a keen eye for how specific limitations influence movement expression/exercise technique, will be able to design more individual-specific training programs and use more individual-specific coaching/teaching cues. Simply, this approach leads to better results, and helps develop high performing, extremely durable athletes, which is always the goal.

This is exactly why I put this presentation together, to outline my philosophy, assessment system, and corrective approach to training athletes. The DVDs are divided into three sections:

Optimizing Movement: Creating a Foundational Platform for Peak Performance
Integrating Assessments into Sports Performance Programs
Managing Movement: Corrective Exercise and Program Adaptations

Optimizing Movement systematically addresses the whys and hows of assessing individual athlete needs and designing programs accordingly. The feedback from personal trainers, strength and conditioning coaches, and rehabilitation professionals alike has been outstanding so far. Click the link below for more information and to grab your copy today!

Click here for more information >> Optimizing Movement

To your success,

Kevin Neeld
OptimizingMovement.com
UltimateHockeyTraining.com

P.S. No time for assessments? Optimizing Movement presents alternative approaches on how to individualize programs that can be used in ANY training situation! Click here to learn how >> Optimizing Movement

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Groundbreaking Research on Hockey Hip Injuries

In an effort to better understand the mechanisms that contribute to injury and to design better programs to make our players more durable on the ice, I’ve read a ton of research on hip injuries, such as hip flexor/adductor tears, sports hernias, osteitis pubis, femoroacetabular impingement (FAI), and labral tears over the last several years. While I recognize that every injury is multi-factorial, I always frame injuries within the context of “what can we do to minimize risk, if not prevent them?”

It’s become clear along this journey that hip injuries tend to coincide with one another and the issue is almost always much more complex than simply “overuse” or “we found a labral tear, which needs to be repaired.” This latter point was highlighted by a 2011 study from Silvis et al. that demonstrated that 77% of the 39 NCAA D1 and pro hockey players had abnormal hip/groin MRI findings that were indicative of pathology, despite being entirely asymptomatic (Read the abstract here: High prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players). This is a hockey-specific example, but there are others looking at different joints and in different populations that support the idea that something appearing broken may not always lead to pain and may not always need to be repaired.

When I first started to read about how FAI (a bony overgrowth of either the femoral head/neck offset and/or the acetabular hood; image below) limited hip flexion ROM, I began including some assessments in our intake to help screen for those limitations and, over time, developed a better eye for seeing suspicious compensations throughout various exercises. Despite there not being clear research evidence in support of FAI being developmental (there was a thought that it was congenital and/or developed from a slipped capital epiphysis, both of which are explanations I believe hold merit in a minority of cases), I never really had any doubt that the majority of these cases are progressive, likely resulting from poor femoral head tracking and too much time or volume spent at or near end-range hip flexion. This is important, because if things are progressive there is an opportunity to intervene. Given that this bony overgrowth is associated with increased anterior-superior labral wear/tearing and eventual osteoarthritis (see Streit et al, 2013, among others), the need be proactive in minimizing risk is important from both a short- and long-term perspective.

A demonstration of the bony overgrowth illustrative of FAI

In the last few months, several interesting articles have been published that continue to shed light on this issue. First, Larson et al. (2013) published data on NFL prospects in college and found that 90% of the 125 athletes they looked at and 87% of the hips (an alarming statistic!) had findings consistent with FAI. Of these players, those with symptoms tended to have a greater prevalence of CAM or Mixed FAI and osteitis pubis, but the only independent predictor of groin pain was how progressive the bony overgrowth was (the “alpha angle”). This is interesting for a few different reasons. As I mentioned in the past (See: An Updated Look at Femoroacetabular Impingement), hockey players aren’t the only population affected by this hip “abnormality”. This is the first study I’ve seen (admittedly, I’m not looking for other sports) that has used an athletic population not typically put in the most “at risk for hip injury” bucket. As a backdrop, it suggests that as the bony overgrowth gets worse, the athlete is more likely to be symptomatic.

This latter fact is not surprising given a 2012 study from Birmingham et al. that concluded:

“Dynamic femoroacetabular impingement as caused by the presence of a cam lesion causes internal rotation motion at the pubic symphysis. Repetitive loading of the symphysis by cam impingement is thought to lead to increased symphyseal motion, which is one possible precursor to athletic pubalgia.”

As a follow up, increased motion at the pubic symphysis is also a risk factor for osteitis pubis (inflammation in the area), which is another cause of groin pain.

So what does this have to do with hockey players? I’ll get there!

A study published last month from Philippon et al. provided solid evidence that FAI is in fact developmental/progressive, at least in the hockey population. In short, they imaged the hips of 61 youth hockey players from 10-18 years old, and found that:

In PeeWees (10-12 y/o), 37% had FAI and 48% had labral tears
In Bantams (13-15 y/o), 63% had FAI and 63% had labral tears
In Midgets (16-19 y/o), 93% had FAI and 93% had labral tears

While there will inevitably need to be follow up studies done, this provides some interesting information as to how these structures develop, and really highlights how important it is for hockey coaches, strength and conditioning coaches, and sports medicine professionals to be aware of their existence. In short, a player may not be skating lower because he/she physically does not possess the structure to achieve a deeper stance (remember this is a BONY block; it can’t be stretched), and he/she may not be able to squat/lunge/deadlift like textbooks suggest they should be able to for the same reason.

While slightly tangential to the previous conversation, a 2013 study from Jakoi et al. found that NHL players were less productive in the 2 years following sports hernia surgery than they were prior to the surgery. This was especially true for the “veteran” group (7 or more years in the league) as they played significantly less games per season (from 70.5 to 49.0), scored less goals per season (17.1 to 7.8), had less assists (25.4 to 13.1), and weren’t able to play as much time per game (from 18.6 to 15.2 minutes). While the declines in games played, goals and assists weren’t significant for the younger group (6 or less years in the league) there was still a decline despite playing more minutes per game (from 16.4 up to 18.4). When you factor in the total minutes played per season (games played x minutes per night), the younger group had almost equivalent minutes pre- and post- surgery (1077.48 vs. 1074.56), but still averaged less goals and assists following the surgery. This certainly isn’t to dismiss the potential benefits, and in some cases the necessity of the surgery, but instead should be taken as another argument for the importance of recognizing risk factors and intervening early.

There is a theme to this discussion. While it may not be possible to PREVENT 100% of injuries, it is important to do whatever is possible to screen/assess for risk factors, provide corrective strategies when appropriate, and coach around limitations that do exist so as to not exacerbate the problem. Given the data on how prevalent structural abnormalities are in athletes in a variety of sports, as well as the short- AND long-term implications of these injuries, taking the appropriate steps to improve an athlete’s durability may not just change your season (the two goal decrease in production could be the difference between making the playoffs or not, winning the championship or not), it may change his/her life.

Over the last several years, I’ve gotten a lot of questions about how I assess our players, what I’m finding, and how this influences my programming. In my new DVD Optimizing Movement, I cover these very topics in detail. For the first time ever, I discuss the exact assessment protocol I use (including videos of the assessments), how we integrate corrective strategies into group settings (and how you can too), how we alter exercise selection based on assessment findings, and the 4 things that underlie correctly performing almost every exercise. The DVD has gotten outstanding feedback from everyone ranging from personal trainers, to sports med professions in professional sports, to collegiate strength and conditioning coaches, to private physical therapists. Check it out at the link below!

Click here for more information and to watch the trailer! >> Optimizing Movement

To your success,

Kevin Neeld
UltimateHockeyTraining.com

References:

Silvis, et al. (2011). High Prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players. American Journal of Sports Medicine, 39(4), 715-721.
Streit, et al. (2013). The shape of the proximal femur influences acetabular wear patterns over time. Clinical Orthopaedics and Related Research, 471(2), 478-485.
Larson, et al. (2013). Increasing alpha angle is predictive of athletic-related “hip” and “groin” pain in collegiate national football league prospects. Arthroscopy, 29(3), 405-410.
Birmingham, et al. (2012). The effect of dynamic femoroacetabular impingement on pubic symphysis motion: a cadaveric study. American Journal of Sports Medicine, 40(5), 1113-1118.
Philippon, et al. (2013). Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players. American Journal of Sports Medicine, 41(6), 1357-1362.
Jakoi, et al. (2013). Sports hernia in National Hockey League players: does surgery affect performance? American Journal of Sports Medicine, 41(1), 107-110.

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