Links

Hi Everyone,

So I just wanted to bring to your attention a couple of great links that need to be shared with you. Firstly, we are pumped to announce that Human Motion now has a Human Motion Channel on YouTube. On there you will find a database of exercise videos complete with voice-over describing correct technique and coaching cues. There are also some training videos for fat loss, strength, fitness, etc.

Check it out here! http://www.youtube.com/user/carmenbott#p/u

Secondly, I'd like to direct you to an audio interview where Nick Grantham (nickgrantham.com) quizzed Human Motion's Carmen Bott on her journey to becoming one of the world's top strength coaches, her philosophies on training the endurance athlete, and her insight on regeneration between training sessions.

You can hear the audiocast here: http://nickgrantham.com/wp-content/uploads/2009/10/Carmen-Bott-QA.mp3

Lastly, I thought I'd bring your attention to something that I have become very passionate about over the last year. More and more, we are starting to finally see some change to the way we view our health, lifestyle, and happiness. Specifically, support has started to become more mainstream for more holistic approaches to the way we tackle the above topics. Whether we are talking about our nutrition, our workplace, our training, or our environment, we know that these issues are very complex and thus must require a well-rounded integrated approach. My colleague and good friend Cliff Harvey is the owner of a company called Katoa Health. Specific to nutrition and natural therapies, Katoa Health provides nutritional advise, lifestyle coaching, and body work to everyone from the elite athlete to the middle-aged individual with a digestive illness. I think the pillars of Katoa Health symbolize the necessary approach needed to help an individual: We need to treat the individual as a whole-unit.

Check out Katoa Health here: http://www.katoahealth.com/

New Can-Fit-Pro Article!

Hi Everyone,

I just wanted to let you know that I have a new article that has been featured in the latest Can-Fit-Pro magazine. If you don't subscribe to the magazine, I've copied it below for you to take a look at.

Thanks!

Skating Strong : A New Approach to Groin Injury Prevention

Well, it’s that time of year again – the physiotherapists start to lick their chops in anticipation of the start of fall and winter sporting events. The excitement is obvious as the rather laid back summer activities get traded in for skates, skies, and of course – injuries. More specifically, skating sports such as hockey, speed skating, and cross-country skate skiing, see a very high incidence in groin injuries (Quinn et al., 2003; Tyler et al., 2001). Although there are many injuries that occur at the origin point of the groin muscles (stress fractures, avulsion fractures, osteitis pubis, sports hernia, etc.), adductor strains are the most common (Maffey & Emery, 2007). The groin muscles include the adductor brevis, longus, and magnus, the gracilis, and the pectineus which together flex, adduct, and medially rotate the thigh. The vast majority of these groin injuries are caused by the adductor muscles being put under a high eccentric load before having to decelerate (or accelerate in the opposite direction) and quickly shorten in an explosive concentric manner (Lynch & Renstrom, 1999). This can be seen when watching Cindy Classen drive her skate into the ice (abduction/extension) before quickly pulling (adduction/flexion) the femur back and ready for the next stride. Similarly, every time Roberto Luongo recovers from a butterfly, he has to drive his outside skate into the ice so that he can push across his crease in time for the next shot.

Some of these injuries are bad luck – the result of pushing off with the skate or ski, only to have it slip and not dig in. Because of the speed of the movement, the brain “thinks” or “assumes” that the skate will dig in, creating a nice surface to drive off of. However, when the slip occurs, the abductor group continues accelerating while the smaller adductor muscles go through a very powerful eccentric force, sometimes too large for this group to handle. Quite often however, groin injuries can be chronic injuries that seem to resurface time and time again during a competitive career.

Risk Factors

There are many risk factors that have been identified in the research that increase the likelihood of sustaining a groin strain in skating sports. These include previous injury, increased age (or number of years played), strength imbalances in both legs, increased abductor to adductor strength ratio, poor core stabilization, lack of sport-specific adaptation training, and poor adductor eccentric strength (Maffey & Emery 2007). Notice that adductor length has not been included in the list of risk factors. There has been some support for opposing muscle (hip abductors and quadriceps) length as a risk factor (Gabbe et al, 2005), indicating that hip flexibility should focus more on these muscles groups rather than the hip adductors.

As a strength coach, you need to address these risk factors, each weighted based on importance. Previous injury is usually something you have no control over. However, you can still learn from this information, and target the individual as “at risk” for future lower extremity injuries. Age or sport experience is again something out of your control but note that the older the athlete gets, the more detail and effort must go into implementing their training program.

Strength imbalances between legs should be recognized in the initial assessment of the athlete and addressed immediately in training. Unilateral strength training involving slow, controlled lifts will help to equalize the two limbs and improve movement economy. Similarly, although the need for abductor hip strength/power is crucial for success in skating sports, the opposing adductor group must not be far behind in order to reduce the risk of injury (Tyler et al 2001; Tyler et al, 2002).

Core stability, eccentric training, and dexterity training are three methods to help decrease some of the more controllable risk factors such as non-sport-specific adaptations, a large abductor:adductor ratio, and poor core stabilization.

Core Stability

Every athlete can benefit from proper core stabilization training. Most of the research that has been done on core stabilization and groin injuries has focused on implementing programs based on unstable surface training (BOSU, stability balls, balance boards, etc.). Although research has shown an increase in core muscle activation in a relatively static state, this does not cross-over to dynamic stabilization of movement (Cressey et al., 2007). Moreover, for the most part, skating sports occur on flat surfaces with the ankle joint fairly fixed in a boot; with unstable surface training, the foot is often placed in an awkward position, leading to an increased risk of injury.

Core stability has been shown to decrease injury in most sports, but specific to skating, it is proposed that a fair amount of groin pain results from the inability to transfer load properly from legs/torso to the hips (Ekberg et al., 1988; Meyers et al., 2000; Williams et al., 2000). As a strength coach you need to integrate core stabilization into primal movements and patterns specific to skating. It is one thing for a speed skater to be able to hold a front or side plank for 3 minutes, but it is another to decelerate quickly into a lateral lunge and power back while fatigued. The athlete must be able to brace under load to produce safe, powerful movements or else all that mat-based core work will go to waste.

Eccentric Strength

Eccentric strength training addresses a number of different risk factors: strength imbalances between legs, increased abductor to adductor strength ratio, lack of sport-specific adaptation training, and poor adductor eccentric strength. Previous research in hamstring injuries has indicated the importance in eccentric hamstring strength for avoiding hamstring strains and ACL injuries (Proske et al, 2004). This increase in hamstring eccentric strength increases their optimal length (force vs. length curve) resulting in the muscle group generating a greater force at a greater length – which means less incidence of hamstring strain.

So, why can’t we do this for hip adductors as well?

There hasn’t been a lot of attention given to eccentric training of hip adductors when it comes to addressing strength in the groin. Most of the protocols that have come from research have focussed on concentric strength. Plyometrics is one of the most effective training protocols in developing specific eccentric strength and rate of force development. In addition to weighted eccentric work, plyometric training allows the muscle (group) to undergo a very rapid stretch (eccentric), before transitioning (regaining potential energy) to a very explosive shortening (concentric) of the muscle. Lateral bounds, zig zags, angled lateral jumps, and cutting drills are great examples of plyometric exercises for the hip. Focus must be on making each jump as powerful as possible.

Weighted eccentric exercises are a little more complicated when it comes to the groin. Bands are often used as a training tool for eccentric training, however, as the groin is stretched (eccentric portion), the band gets shorter and thus provides less and less resistance (Emery, 2008). With eccentric training, the load needs to be significant and consistent to have the desired effect. One way to attempt this is using the cable pulley system. Attach the cable to the inside ankle and walk away (so the side of you faces the stack). Have a qualified strength coach holding your leg in neutral. As the coach lets go of your leg, your goal is to slow it down as it is being pulled back to the stack. To have a true eccentric effect, the weight should be heavy enough so that you cannot concentrically pull the leg back to the middle (coach returns the leg).

Sumo squats and deadlifts are a nice adjunct to plyometrics as they provide a wider stance in order to put the adductors on stretch. In addition, you are still getting the benefit of posterior chain strength – a necessity in skating sports. Weighted lateral lunges are also great for deceleration training, however, they focus more on the abductors; make sure you balance out the adductor strength with the above lifts to improve that abductor:adductor ratio.

Dexterity training

Now before you start doing finger push-ups, think again. Dexterity training as it applies to strength & conditioning is developing “a motor solution to a motor problem” (Bernstein, 1996). Because motor problems within sport are usually quite unpredictable as in hockey, we as strength coaches need to develop techniques and pre-habilitation programs that attend to as many contexts as possible (Moreno, 2008).

Oh great, so let’s get out the agility ladders right? Well, not exactly. Traditional coordination and agility training involves predetermined conditions to be performed as quickly as possible. With dexterity training, you want to create an unpredictable or chaotic environment. This can be done in conjunction with your plyometric training. For example, while your athlete is in mid-air during a vertical jump, point to a spot in which they must cut to upon landing. The objective is for the athlete to land, plant, and cut as quickly as possible while not having the luxury of a pre-planned movement pattern. This can also be done during on-ice sessions for goaltenders in hockey. Have the goalie perform continuous lateral pushes from a butterfly position. Tap your stick once to change direction, and twice to pop up into a stance. Although this will not eliminate situations such as losing an edge, it will better prepare your nervous system for the sporting environment.

So, whether you’re training a hockey player, skier, speed skater or other type of skater, keep in mind the importance of keeping healthy groin musculature.

References

Bernstein, N.A. (1996). On dexterity and its development. In Latash, M.L. and Turvey, M.T. (Eds), Dexterity and its Development. New Jersey, Lawrence Eribaum Associates.

Cressey, E. M., West, C. A., Tiberio, D. P., Kraemer, W. J., & Maresh, C. M. (2007). The effects of ten weeks of lower-body unstable surface training on markers of athletic performance. Journal of Strength & Conditioning Research, 21(2), 561-567.

Ekberg, O., Persson, H. H., Abrahamsson, P. A., Westlin, N. E., & Lilja, B. (1988). Longstanding groin pain in athletes. A multidisciplinary approach. / douleur persistante a l ' aine chez des athletes: Approche multidisciplinaire. Sports Medicine, 6(1), 56-61.

Emery, J. (2008). Groin pulls in hockey: An intervention to lower the risk. Human Motion: The Performance Advocate. Retrieved from www.humanmotion.ca

Gabbe, B. J., Finch, C. F., Bennell, K. L., Wajswelner, H., & Orchard, J. W. (2005). RISK FACTORS FOR HAMSTRING INJURIES IN AUSTRALIAN FOOTBALL. (abstract). British Journal of Sports Medicine, 39(6), 385-385.

Lynch, S. A., & Renström, P. A. F. H. (1999). Groin injuries in sport: Treatment strategies. Sports Medicine, 28(2), 137-144.

Maffey, L., & Emery, C. (2007). What are the risk factors for groin strain injury in sport? Sports Medicine, 37(10), 881-894.

Meyers, W. C., Foley, D. P., Garrett, W. E., Lohnes, J. H., & Mandlebaum, B. R. (2000). Management of severe lower abdominal or inguinal pain in high-performance athletes. / diagnostic et traitement d'une douleur severe dans le bas du ventre ou inguinale chez des athletes de haut niveau. American Journal of Sports Medicine, 28(1), 2-8.

Proske, U., Morgan, D., Brockett, C., & Percival, P. (2004). Identifying athletes at risk of hamstring strains and how to protect them. Clinical & Experimental Pharmacology & Physiology, 31(8), 546-550.

Quinn, A., Lun, V., McCall, J., & Overend, T. (2003). Injuries in short track speed skating. American Journal of Sports Medicine, 31(4), 507-510.

Tyler, T. F., Nicholas, S. J., Campbell, R. J., Donellan, S., & McHugh, M. P. (2002). The effectiveness of a preseason exercise program to prevent adductor muscle strains in professional ice hockey players. / fiabilite d ' un programme d ' exercices de pre-saison pour prevenir les lesions musculaires aux adducteurs chez des joueurs de hockey sur glace professionnels. American Journal of Sports Medicine, 30(5), 680-683.

Tyler, T. F., Nicholas, S. J., Campbell, R. J., & McHugh, M. P. (2001). The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players. / L'association de la force et de la flexibilite de la hanche joue-t-elle un role dans l'incidence d'une elongation du muscle adducteur chez des joueurs professionnels de hockey sur glace? American Journal of Sports Medicine, 29(2), 124-128.

Williams, P. R., Thomas, D. P., & Downes, E. M. (2000). Osteitis pubis and instability of the pubic symphysis: When nonoperative measures fail. / osteite du pubis et instabilite de la symphyse pubienne: Lorsque les mesures non-operatoires ne fonctionnent pas. American Journal of Sports Medicine, 28(3), 350-355.

Controversy - Is it always worth it? A response to Time Magazine's Weight Loss Article

You may or may not have read Time Magazine's article Why Exercise Won't Make You Thin. For those of you who haven't read it, here's the link: http://www.time.com/time/health/article/0,8599,1914857,00.html.

Again, I apologize for directing traffic to Time's website, but I feel it is warranted in this case.

This article has seen a lot of retaliation - my colleague Cliff Harvey wrote a great piece on the Human Motion Facebook Page: http://www.facebook.com/topic.php?topic=9882&post=39794&uid=8244761855#post39794.

So without further adieu, here is my response:

Well put Cliff. Obviously, there is some emotion in that post...and rightfully so. I can just see Cliff sitting down and typing that out...in 4 minutes. I don't know that I've read something that has had such a huge response in the online community. Controversy is what some writers go after; it gets attention and thus, gets more people reading and talking about it. So, well done John Cloud, you've probably earned yourself a lofty Christmas bonus from Time Magazine's head honcho.

Now John, I'm not sure if you are aware but we are currently in an obesity EPIDEMIC. Your very own Surgeon General claims that the “most pressing issue” before him and America today is not terrorism, but obesity. The only comparison that I can fittingly come up with would be an Alcoholics Anonymous mentor walking into their meeting and announcing, "Well everyone, we've been going about it all wrong. Booze is the answer to all our problems". I am really getting sick of reading and watching media coverage of what our society really wants to hear – the 1 in 50 studies that show McDonalds actually decreases strokes, or watching more TV gets kids to think critically. This may seem humorous to you but this is what gets published in mainstream newspapers and broad-casted on newscasts. And, sadly, this is exactly what Time Magazine – a magazine that millions upon millions of overweight or obese individuals read – has done.

I could fall back to my strength and conditioning background to criticise the author about how he “exercises”. I could ask him what the hell a “body wedge” class is. I could ask him why his training doesn’t involve anything that resembles high intensity. I could ask him if he even knows what a weight is. I could ask him if he is surprised that yoga and pilates doesn’t get rid of his “gut”. But I won’t ask him about these key ingredients of exercise for weight loss. Instead, I’ll retreat back to my previous point: What the hell kind of message are we trying to send? Sure, people need to be their own judge on issues they face. And sure, it’s not your (Mr. Cloud’s) fault that people would actually believe that “fiery spurts of vigorous exercise could lead to weight gain”. But for the love of anything that is willing to listen, that doesn’t mean you use that as an excuse to publish a message that attacks the notion that exercise is beneficial for weight loss or health.

The funny thing is this article actually has a paradoxical message that I can’t entirely disagree with: While knocking out exercise in the first round in the Battle Royal of weight loss, the article actually brings nutrition to the fore-front as the major determinant of weight loss. Now, the notion that exercise on its own does not help with weight loss is no hidden secret. Fitness professionals would be lying if they claimed that their program was all a person needed to lose weight. However, like Dr. John Berardi pointed out in his response to this article, there has been huge success - both research and anecdotal evidence - when combining sound nutrition and a proper high-intensity exercise program for weight loss. There is no doubt that nutrition is the major player here. However, like Cliff Harvey said, it’s not necessarily the amount of food, but the quality of food that is the concern. This combined with exercise programs that involve low intensity steady-state cardio and no weight training, is a huge reason why the “research” that Cloud pointed out did not yield any weight loss success. Not to mention that body composition was rarely taken into account during these studies.

Cloud is right, we see this all the time at the gym we train out of: People drive to the gym, jump on the elliptical for 45 minutes at the same low speed while talking to their friend, and then head on down to Tim Horton’s for a “well-deserved” iced-cap and doughnut.

The message that I take the most issue with, however, is informing people that exercise is a negative thing:

“Yes, it's entirely possible that those of us who regularly go to the gym would weigh even more if we exercised less.”

“In general, for weight loss, exercise is pretty useless”

“Exercise, in other words, isn't necessarily helping us lose weight. It may even be making it harder.”

“Could pushing people to exercise more actually be contributing to our obesity problem? In some respects, yes.”

“You should exercise to improve your health, but be warned: fiery spurts of vigorous exercise could lead to weight gain. I love how exercise makes me feel, but tomorrow I might skip the VersaClimber — and skip the blueberry bar that is my usual post-exercise reward.”

The author mentions a couple health benefits of exercise (which, I might add should take up this entire page), but it is in a matter-of-fact kind of way. It is as if weight loss is more important than overall health. It just absolutely pains me to read something like this when, as a 26 year old, I am hearing about a family member or friend’s parent passing away prematurely, due to a heart attack, stroke or some other disease related to physical inactivity and nutrition.

I realize that I can be quite harsh sometimes; I often criticize people for not making changes to their lifestyle that we KNOW will instantly improve their health and well-being. But, after reading articles like this, I can’t entirely blame people.

Cloud points out that we should re-define “exercise” and suggests that we shouldn’t be pushing ourselves so hard because it drains our energy, encourages us to eat more, and forces us to do less low-level activities. First off, you can still train relatively hard 2-3 days/week and see big increases in fitness level and health, while allowing your body to regenerate in between sessions. Similarly, walking more or just being outside can still be done with this style of training without feeling as though you have no energy. And, of course we are going to get hungry after exercising but that doesn’t mean we get an extra “stupid” button to press so that we continually force crap food into our bodies.

Lastly, I think this last quote sums up the author’s background and health knowledge:

“Some research has found that the obese already "exercise" more than most of the rest of us. In May, Dr. Arn Eliasson of the Walter Reed Army Medical Center reported the results of a small study that found that overweight people actually expend significantly more calories every day than people of normal weight — 3,064 vs. 2,080.”

That’s odd, I would have thought that an overweight or obese individual would be very efficient at moving and wouldn’t take that much energy in calories to move from A to B. Cripes. While it is true that muscle requires more energy than fat to function, overweight individuals are going to have larger bodies – which include larger muscles and organs – than “normal” weight individuals. So, to cite this reference as a “proof” that we should be exercising less is both unjustified and morally irresponsible.

TIME, you should be ashamed to have fallen victim to the appealing nature of controversy at the expense of people’s health. This is one topic that can’t afford to encourage inactivity, not at the rate we’re going.