Monday, June 30, 2008

Product Review: James Waslaski’s 6 DVD set- Sports and Orthopedic Massage

James Waslaski is a sports and orthopedic massage therapist who has helped to treat injuries and chronic pain with everyone from the general population to elite, Olympic and professional athletes.

I heard about James Waslaski from a great Scottsdale based massage therapist, Don Miller. Don is a really smart guy and when he talks I listen. So per his recommendation I went to Mr. Waslawski’s website, read the published articles (which were informative and interesting) and decided to make a purchase. I know I could have bought just one of the DVDs and checked it out first; but, when it comes to my continuing education I don’t believe in doing things on small scale. So I purchased the entire 6 DVD set. I want all the knowledge, not just 1/6th of it!!

Honestly, if you are a massage therapist, physical therapist, athletic trainer, chiropractor, orthopedic surgeon or anyone working in the sports medicine field, these DVDs are a must have! The best part about these DVDs, which sets them apart from other DVDs of its kind, is that Mr. Waslaski doesn’t just give you some protocol to follow. He gives you his thought process! This is huge in this field because when treating people, it is important to remember that no two people are alike. Individual differences are going to create changes in your treatment protocol, and those that watch and follow a protocol based DVD are not going to be able to pick up on these difference, ultimately leaving them with a half-hearted treatment.

I feel that the review of this product is fitting given that my last blog entry was a research review centered on functional assessment and some of my feelings on proper assessment in the field of strength and conditioning. As everyone who reads this blog knows, I am an assessment junkie. It was refreshing to see that Mr. Waslaski is the same way! Most massage therapists don’t do a proper assessment and just go and “dig right in.” It was great to see Mr. Waslaski go over his process of assessment and treatment. Really focusing on assessing posture, active ROM, passive ROM and muscle strength testing. This really helps to make the treatment specific to the client’s needs, and again, a feature that those who view more protocol based DVDs are going to miss out on.

I enjoyed how Mr. Waslaski went through his treatment process and talked about various techniques of soft tissue therapy and how and when to use which ones depending on the feedback from the client and how the tissue feels (palpation assessment). This is critical as I feel that a lot of people get so wrapped up into one thing. For example they only do Neuromuscular Techniques or the only do Myofascial Release or they only do Active Release Techniques. All of these techniques are great, but they all have different places in a treatment program, and it is really up to the therapist to determine which one is the proper technique to use and when to use it. Again, it is essential to get away from protocol based work and more into interpreting what the clients’ needs are.

It was also excellent to see a massage therapist stress the importance of stretching (especially contract-relax-contract antagonist) following soft tissue work. This is really a missing link in a lot of massage therapists’ treatments of soft tissue injuries. Restoring proper length and helping to re-align collagen fibers is essential in facilitating a healing environment. While stretching is an integral part of most treatments in physical therapy, athletic training and strength and conditioning, massage therapists seem to overlook this modality. The other great thing that was stressed in these DVDs was to only stretch what needs to be stretch! To often people try and go in and stretch everything, using what I call the “shotgun approach.” IE, if you just stretch everything, one of them will work. This really comes back to having a good assessment and then being specific with the treatment. The more specific you can get, the better your treatment will be (just as in Strength and Conditioning, the more specific we can get with our assessment and program design, the more efficient we will be in helping athletes’ correct their weak links and movement impairments).

I really can’t say enough good things about this product. If you are in this field, you really need to have this product in your collection!

I’ll be back later this week with more research and training info! As always, if you have a question (or comment) for the Q&A segment, please use the ‘comment’ feature at the bottom of each blog entry.


Wednesday, June 25, 2008

Assessing your Clients

Core strength: a new model for injury prediction and prevention.

Peate WF, Bates G, Lunda K, Francis S, Bellamy K. J Occup Med Toxicol. 2007 Apr 11;2:3.

OBJECTIVE: Many work in injury prone awkward positions that require adequate flexibility and strength in trunk stabilizer muscle groups. Performance on a functional movement screen (FMS) that assessed those factors was conducted and an intervention was designed.

METHODS: A battery of FMS tests were performed on 433 firefighters. We analyzed the correlation between FMS performance and injuries and other selected parameters. An intervention to improve flexibility and strength in trunk stabilizer or core muscle groups through a training program was evaluated.

RESULTS: The intervention reduced lost time due to injuries by 62% and the number of injuries by 42% over a twelve month period as compared to a historical control group.

CONCLUSION: These findings suggest that core strength and functional movement enhancement programs to prevent injuries in workers whose work involves awkward positions is warranted.

Some of my own thoughts: If you read this blog regularly, you will know that I am big on assessments, especially assessments which look at how the athlete or client moves. Gaining information about the way in which your athlete/client movements (or how the DON’T move) is extremely valuable because it allows you to determine where things are breaking down, were possible energy “leaks” are in their movement, the quality with which they move and areas that injury may potentially occur.

I use several different tests when I perform an assessment and the things that I have used over the years have sort of evolved as I have learned more or learned better ways to assess things I am looking for. Part of my assessment consists of the 7-test functional movement screen (FMS) as developed by Gray Cook. If you are a strength coach, personal trainer, physical therapist, or anyone that works in the field of sports medicine, I highly recommend Gray Cook’s book Athletic Bodies In Balance. It is just about the best $15 you can spend. The book was written for the general public (coaches, trainers and athletes’ alike) so it doesn’t get to “heady” or overly complicated. The book was written with the athlete in mind, so that the athlete could perform the tests on themselves (which can be tough, as assessing yourself is not always the best way to go), so only 5 of the 7 tests are detailed in the book. Regardless, the book is an excellent resource and will help you really understand movement.

This particular study was of interest to me because it utilized the functional movement screen (and I like to be as evidenced based as possible in my work) to assess firefighters. Because there was a decrease in lost time due to injuries, the authors concluded that a core strengthening program and functional movement training were beneficial to firefighters. The functional movement screen was used in this study to evaluate the firefighters and then they were enrolled into a training program designed by a sports medicine team. The program was designed to emphasize movements list bending, lifting and squatting that the firefighters may encounter in a work situation. The firefighters were taught “exercises which help to increase core strength and decrease mechanical load on the affected parts of their musculoskeletal system during ergonomically challenging job tasks”.

Aside from injury rates being lowered, the movement screen was also helpful in recognizing movement impairments of firefighters who had suffered injuries. A history of a past musculoskeletal injury lowered a firefighters score by 3.44 points (there is a total of 21 points available on the functional movement screen test). As well, the odds of failing a functional movement screen were 1.68 times greater for firefighters with a history of any injury.

This study gives us an idea of just how powerful a movement screen can be. Often times we get so caught up in performance based tests. What do you bench? What do you squat? What is your 40-time?

A more important question to ask would be “Why is that your bench/squat/40-time and what can we do to make it better? What are your limiting factors?”

Another thing that you can take away from this study as a strength coach or personal trainer is that, those who have been injured do not move properly! Remember, the body is all connected. Injury in one area can cause problems in another. Increased or decreased movement at one joint; will lead to increased or decreased movement at another joint. As we can infer from this study, those that have had an injury (be it sports injury or work injury) are going to need special attention when it comes to designing their program, as care must be taken to ensure that proper movements are re-learned and understood before progressing to more advanced training.


Monday, June 23, 2008

Coach's Q&A: Middle Distance Runners

Q: What is better for training, especially for middle distance - speed or miles?

A: Middle distance can be a real bear, because it is a little to long to be considered a sprint and a little to short to be considered a distance run. You really need to have the best of both worlds as far as energy system development goes. So, in this instance, there is no “better”. Rather, you need to be prepared to break your training up through out the week into more intensive days, where you are training shorter/more speed distances with full rest/recovery in between repetitions and extensive days, where you are doing longer runs and working on developing work capacity. I really like tempo runs for this as they help to develop work capacity, but allow you to get rest in between your sub-maximal runs so that you can focus on form and not allow high amounts of fatigue to destroy running technique.

Typically, because of the intensity of the speed work and the high amounts of neurological fatigue it can induce on the bodies system, you want to keep the volume of this work low through out the week. I feel that 2x’s a week of intense sprint work will be sufficient. The other days you can perform your tempo work and/or distance work (since I am unsure if you are a recreational runner that likes to just go out and run sometimes with the running groups in town. Not everyone is training to be a high performance athlete, and that is fine). So, at a weeks glance, your running program may looks something like this:

Monday- Speed work
Tuesday- tempo runs
Wednesday- off
Thursday- Speed work
Friday- tempo runs
Sat- easy run (or long distance if you typically run with a running group on a Saturday, as most do)
Sun- off

That would be a generic little program to follow. Another thing that you may want to keep in mind is that depending on where you are in the season, the amount of speed work and tempo runs or longer distance work may shift, as you can not and should not, train maximal speed year round. This is a great way to burn out and potentially get injured. The planning of your program should be set up by a qualified coach to ensure that the variables are set up properly.

Of course there are other things that you would want to consider. You may want to think about adding in some resistance training in order to help increase your strength and power and to fix any movement problems or technique flaws that you may have. This will not only increase your performance in the middle distance events (or in longer or short distance events), but also will help to prevent injuries.

A proper assessment is needed in order to understand what your limiting factors are in the race so that a solid training program can be set up. Again, just like with the running, strength, power and muscular endurance work are going to shift in volume through out the season in order to prevent over training and ensure that you are fresh and ready to run when it comes to race day. Also, when you add lifting into the schedule above, the schedule becomes very “busy”. It would be best for you to sit down with a qualified coach to determine the best way to set up your schedule for your goals and for the amount of time each week you are able to train.

The worst thing you can do is attempt to do too much and over-train yourself into a ditch. When it comes to speed training, the “less is more mantra” is always a great philosophy to follow. Always opt for low volume/low amounts of higher quality work rather than a high volume/high amount of low quality/poorly executed work. As they say, “Practice doesn’t make perfect. Perfect practice makes perfect!”

Good luck,


Tuesday, June 17, 2008

Coaches Q&A: Warming up

Q: I know it is important to warm up, but I am concerned about it affecting my performance in the race. Should I not warm up and just start out running in order to have fresh legs and try and set personal bests.

Warming up is extremely important. It prepares our bodies to move and helps facilitate an environment in which we can perform at our best. Going out and trying to exercise or compete (especially if you are trying to hit a PR in a run) is never advisable.

If a true concern of yours is that the warm up will detract from your performance time then, not trying to be mean here, you probably shouldn’t be running the race anyway. You probably need to develop your work capacity and general health and fitness.

The goal of the warm up is to get the body warm. You need to raise your core temperature and properly warm up the joints and muscles that are going to be stressed in your event. Exercise physiology textbooks will tell us that we need approximately 10 minutes to warm up our body and prepare it for training or competition. For runners, this can start by simply standing in place and loosening up the joints (ankle circles, hip circles, shoulder circles, planks, bridges, lunges, etc.) and then taking brief warm up jog to help prepare the body for running.

The main thing is that the warm up should not be extremely stressful! This is not a time to get out there and see how fast you can run 100 meters or do anything silly like that. It should however, be adequate enough to raise your temperature and make you break a little bit of a sweat. After the warm up, you should feel primed and ready to go.

No go warm up and set some PRs!


Sunday, June 15, 2008

Coaches Q&A: Why does my shoulder hurt when I run?

I was asked to participate in a coach’s panel today at a 5K race in phoenix. It was part of a series that Aztech Training is conducting to help runners get educational information with regard to their running, program, and nutrition. This will be taking place at several of the runs this summer and then during the weekend long runs in August in preparation for the Phoenix PF Chang Marathon. So, if you are planning on running any of these races, please stop by and say hi! Also, if you need a team to join for the PF Chang Marathon, AZtech really is the best in the city!

I have decided to take some of the questions and answer them here since some that are reading this blog may benefit from it. I will tackle a few of the questions each week and hopefully, they will spawn other questions from my readers (if you have any questions, just leave it in the ‘comments’ section at the bottom of each entry and I will try to get to it).

Q: Why does my shoulder hurt when I run, and what can I do about it?

A: This is a great question and one that I happen to get a lot. I will say that without being there to see you run or do a proper assessment, it is tough to pin it to just one thing. As well, I am not a doctor or physical therapist, so I do not (ever) diagnose anything. I do put people through assessments (both movement assessment and, now that I have been working on completing my massage licensure, more specific soft tissue assessments). From there, I try and get any idea of what may be causing the pain and determine whether or not I can help you with this problem. When I need to, I do refer out to the physical therapist for a specific diagnosis. So, to answer the second part of your question, what you can do about it is go to see a professional to determine what the problem is and get on some sort of treatment plan. This can be a trainer who has a solid assessment, a massage therapist (specifically someone who focuses on orthopedic massage and neuromuscular techniques) or a doctor or physical therapist (for a specific diagnosis).

As we say, never chase pain. All that means is that if you have some sort of pain, it may (or may not) be due to the specific structure that is giving you the problem. You really need to look at everything when you are analyzing why someone hurts. Symptoms are nothing more than presentations of a problem. They don’t tell us WHY you hurt, they just tell us that SOMETHING is wrong. It is up to the professional to figure out what that something is. When it comes to shoulder ‘pain’, there are a few things that I look at:

1) Breathing patterns- Is the person an upper chest breather? This tends to create lots of tension in the shoulders and chest and can cause postural problems or exacerbate already existing postural abnormalities (especially late in a race when you are more fatigued).
2) Thoracic spine mobility
3) Cervical spine mobility
4) Scapular movement and position
5) Soft tissue assessment
6) Shoulder mobility and flexibility
7) Scapular stabilizer strength
8) Core strength

9) Posture- Not just upper body posture or thoracic spine posture, but the entire body. Remember, if something is off in the foot, it will affect everything above it. Sometimes, the pelvis can be out of position, causing posture to change all the way up the chain. Total body posture is a big one and it is always the first thing I look at when assessing someone (even though I didn’t list it first here).

As I stated earlier, it is also important to look at how you run late into the race, in a fatigue situation. Runner’s, especially distance runners, don’t always like to do strength training as they feel that it will hinder their performance. I do feel that some of the problems they have can be alleviated with proper strength work. Again, seeing a professional to help determine areas of weakness is really critical to ensuring that you are on the right program at the right time in your training season.

In other news…Tiger Woods Ya’all! Tiger Woods! What an incredible US Open it has been so far. I can’t wait for the playoff round tomorrow. It is almost unfair that I have to work. I feel like it should be some sort of holiday!


Monday, June 2, 2008

Plyometric Training Frequency

Low and Moderate Plyometric Training Frequency Produces Greater Jumping and Sprinting Gains Compared With High Frequency.

de Villarreal ES, González-Badillo JJ, Izquierdo M. J Strength Cond Res. 2008 Mar 22(3):715-25.

Purpose: The purpose of this study was to examine the effect of 3 different plyometric training frequencies (e.g., 1 day per week, 2 days per week, 4 days per week) associated with 3 different plyometric training volumes on maximal strength, vertical jump performance, and sprinting ability.

Methods: Forty-two students were randomly assigned to 1 of 4 groups: control (n = 10, 7 sessions of drop jump (DJ) training, 1 day per week, 420 DJs), 14 sessions of DJ training (n = 12, 2 days per week, 840 DJs), and 28 sessions of DJ training (n = 9, 4 days per week, 1680 DJs). The training protocols included DJ from 3 different heights 20, 40, and 60 cm. Maximal strength (1 repetition maximum [1RM] and maximal isometric strength), vertical height in countermovement jumps and DJs, and 20-m sprint time tests were carried out before and after 7 weeks of plyometric training.

Results: No significant differences were observed among the groups in pre-training in any of the variables tested. No significant changes were observed in the control group in any of the variables tested at any point. Short-term plyometric training using moderate training frequency and volume of jumps (2 days per week, 840 jumps) produces similar enhancements in jumping performance, but greater training efficiency ( approximately 12% and 0.014% per jump) compared with high jumping (4 days per week, 1680 jumps) training frequency ( approximately 18% and 0.011% per jump). In addition, similar enhancements in 20-m-sprint time, jumping contact times and maximal strength were observed in both a moderate and low number of training sessions per week compared with high training frequencies, despite the fact that the average number of jumps accomplished in 7S (420 jumps) and 14S (840 jumps) was 25 and 50% of that performed in 28S (1680 jumps).

Conclusion: These observations may have considerable practical relevance for the optimal design of plyometric training programs for athletes, given that a moderate volume is more efficient than a higher plyometric training volume.

Some thoughts: A lot of times, coaches load up their athletes with plyometric work, especially if they are in jumping sports (IE, basketball, volleyball, etc.). The more is better philosophy still holds true today.

This study set out to evaluate whether or not you can get the same benefits from plyometric work with lower amounts of training volume.

The researchers concluded that the moderate amount of plyometric frequency/volume (2 days per week) group had better results that the high frequency/volume plyometric group. This study may be helpful to coaches who are planning their training programs that include plyometric exercises, specifically if the athletes are preparing for sports which require high amounts of jumping already.

One of the times when coaches run into problem is during inseason workouts. Usually, they continue on with the same training program that the athletes’ were performing in the pre-season phase of training. The problem with this is that not only are the athletes’ still doing the same workout, they have just increased their activity by including practices (usually 5 days a week) and games! This leads to a great amount of overload. This is especially true for those who play in a jumping sport and are trying to balance practice and a high frequency/volume plyometric program.

The main thing I tell coaches in these situations is that they need to drop the plyoemtric training volume so that the athletes’ are fresh and ready to perform properly in practice. This study should give those coaches some insight into how their program can be set up to accommodate the training stress of practice and competition.

Additionally, this program was conducted on physical education students (42 subjects in all) and not elite athletes. At the elite level, the athletes may require high a frequency/volume of training in order to get the same neural benefits that plyometrics provide. The determination of training volume/frequency/load should be established by the strength and conditioning specialist and the athlete should adequately be prepared to handle this level of work by completing prior phases of strength and conditioning to help enhance their training base.

Happy jumping,