January 2015

All posts from January 2015

Assessing Functional Asymmetry in the ACL Injured Athlete

by Matt Jordan on January 16, 2015 , No comments

Article Overview: 757 words on assessing functional asymmetries using dual force plate methodology.

About 3 weeks ago I gave an hour presentation at a local ski shop to discuss my PhD research, which focused on functional neuromuscular assessments throughout the late phase rehabilitation to improve outcome for ACL injured elite ski racers.

Like most applied strength and conditioning research projects, this one evolved out of ongoing efforts to track and monitor my athletes.  In addition to tracking training loads and athlete readiness using subjective questionnaires, I was using a dual force plate system to assess explosive strength, mechanical muscle power and jumping ability in my athletes.

As time went on, I started to see that the lower limb force asymmetry obtained during vertical jumping was sensitive to MSK functional status throughout the return to sport phase after an ACL injury.

This is not a new finding but I took a unique perspective as a strength coach and began looking at specific movement phases that we often address in our programming.  Specifically, I broke the asymmetry in the countermovement jump down into the eccentric deceleration phase and the concentric phase, and looked at the early phase asymmetry in an unloaded and loaded squat jump along with the late phase asymmetry.  More recently, I began evaluating the landing asymmetry as well.  I coined the term kinetic impulse asymmetry index (KIAI) and published a paper on how I go about doing this in case you’re interested (Jordan et al., 2015. SJMSS).

The functional asymmetry assessment along with a few other specific neuromuscular diagnostic tests have now become integral to my approach for evaluating uninjured and ACL-reconstructed athletes alike.  In fact, as a part of our monitoring system, we began evaluating functional asymmetry in many of our uninjured athletes and we are now finding the kinetic impulse asymmetry index in the eccentric deceleration phase to be predictive of lower body injury in previously uninjured athletes.

In terms of assessment time, the two tests take about 10 minutes to perform and are easily administered in a high performance weight room.  You can also obtain a dual force plate system for around $2500-$3000.  This is still expensive but it is far cheaper than the typical price tag of $15,000 / force plate. I’ll tell you, this is the best money I’ve spent in a long time but you’re talking to a strength coach that sticks to the basics.

I often get asked by strength coaches if it is adequate to simply look at vertical jump height or jump distance.  The short answer is that it does provide some insight into functional asymmetry.  However, using a dual force plate system and looking at the kinetic impulse asymmetry index allows me to obtain a much better picture of where the deficits lie and how I will program to fix them.  Remember, that athletes can often shift their jumping strategy so that jump performance remains the same but in the case of the ACL-reconstructed athlete, deficits may still remain.

Your uninjured athletes will also find crafty ways of maintaining performance in the presence of an impending injury or fatigue.  This is why how an athlete performs the movement is more important than the performance in the context of identifying athletes who may be around the corner from a injury.

 

Using this approach along with the information I obtain from my MSK assessment, I’m able to zero in on deficits and barriers that are limiting an athlete’s return to sport after an ACL injury.

I’m also able to evaluate when my programming is out of whack and when it has led an athlete into a state of maladaptation.

Together, having these metrics have really shaped how I program for the ACL-reconstructed athlete.

On that note, you can click the link below to get a PDF of the presentation I gave a few weeks ago.  There is some background information on ACL injuries and I also provided some thoughts on how I program for ACL injury prevention.

By no means is this exhaustive but it gives an idea of the approach I take.  I also recognize there is some amazing expertise out there so I would encourage you to read up from others if you are interested in how to manage this extremely challenging and multi-factorial injury.

I think the important take home message is that you never know where simple monitoring will get you as a strength coach. The key is to start evaluating what you think is important and then keeping an open mind to the possibilities.

As always, I look forward to comments and feedback so send them along.

ACL INJURY PREVENTION_JORDAN

 

 

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Matt JordanAssessing Functional Asymmetry in the ACL Injured Athlete

The Most Convenient Training Environment Doesn’t Equal the Optimal Environment

by Matt Jordan on January 11, 2015 , No comments

Article Overview: 866 words on the importance of creating discomfort (discomfort quotient) in training.

My Sunday mornings are typically reserved for a catch up day on the lay blogs, articles and happenings in the world of sport science.  During the week I tend to focus more on generating new knowledge through my own research and staying current with the scientific literature.

One of the articles I stumbled across this morning entitled: Caloric Restriction, Hormesis, and what they teach us about Evolution by Josh Mitteldorf provided an easily digestible read (no pun intended) on the counterintuitive process of hormesis that suggests an absence of stress tends to decrease the vitality of living organisms whereas life tends to fair better in the presence of stress.

In the context of caloric restriction, there are plenty of examples where depriving a living creature of food can actually extend the lifespan.

Personally, I find this observation to extend to my own life including personal and professional matters.  When I reflect, it’s interesting to note that my highest levels of productivity and satisfaction occurred when my personal and professional life were the least comfortable.  I thrived in this environment even though I often went to sleep tossing and turning because I felt stressed.  Comparatively, some of my most dissatisfying periods occurred when things were relatively easy.

I think the concept of hormesis also extends to the training environments we create for our athletes.  The tendency for many teams or sport systems is to identify ways to remove stressors for the athlete.  We design state of the art facilities with all the comforts of home, implement meal plans, develop convenient schedules so the athlete can devote more energy into training and often evaluations are done to obtain subjective feedback to ensure we are giving the athletes what they want.

Think about the fast emerging discipline of Recovery Science – it’s curious to note that blunting the stress response actually diminishes the training response in many studies.  I also have yet to find a single newly constructed training facility that doesn’t have a sizeable regeneration area that is regularly filled with athletes.

While there are exceptions, most training facilities I visit are are now in general terms far more convenient and stress-free compared to the ones I visited throughout the late 80’s and 90’s.

However, the question is: has the trend towards seeking to remove stressors from an athlete’s life and training environment equated with a stronger, faster and more resilient athlete?

I can think of specific examples where the answer to this is might be ‘yes’ but these were mature athletes who had been through the struggles of elite sport and understood the aim wasn’t to make things comfortable.  Instead, by removing some of the stressors from their training environment, these athletes were actually able to endure more discomfort.  Somehow they knew that intuitively it wasn’t about making things easier.

On the other hand athletes who didn’t understand what it took to be the best seemed to lose the edge when training in this ‘optimal’ environment.

I can think of several high level athletes who’s performances really seemed to suffer as their environment got progressively easier.

I can also think of young athletes who grew up in the new emerging world of stress-free training environments who just never seemed to develop the resilience that their predecessors displayed.

Another very interesting point of reflection are those athletes who, for whatever reason, lost the chance to train in this ‘optimal’ training environment.  I was always amazed that contrary to expectations (i.e. the athlete loses the opportunity to train in the “best environment” and performance plummets) the athletes actually delivered the exact opposite result – they got better!

It’s almost as if challenging their comfort levels and making things harder were necessary elements for performance to improve.

How is it possible that an athlete who is deprived of the “world’s greatest training environment” and enters into an environment of stress and uncertainty actually realizes their potential?

Think about the concept of hormesis and ask yourself: how do I program to increase my athlete’s Discomfort Quotient (DQ) ?

In academics there is the intelligence quotient (IQ) and in social sciences there is the emotional quotient (EQ).

Both are considered to be key success factors or performance indicators.  I would argue that the Discomfort Quotient is a key performance indicator for elite athletes, coaches and teams.

While our intuition and the natural trend towards seeking efficiencies, making life easier and enhancing comfort is commonplace in our society, might we be doing a disservice to athlete performance by applying the same logic?

If the aim is to create a robust and self-reliant athlete who to the core is truly comfortable with being uncomfortable how do we support this aim by continually looking to make things easier?

Similar to the potential benefits of stress such as caloric restriction for extending the lifespan, I think there may be important benefits obtained by keeping non-training stressors in the training environment.

I think this boils down to the core philosophy of a program.

The bottom line is we shouldn’t be afraid of exposing athletes to stressors.

Further, we should be mindful that we fight our intuition and actually work to keep reasonable non-training stressors in our training environments.

 

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Matt JordanThe Most Convenient Training Environment Doesn’t Equal the Optimal Environment