Sports Are Healthy Right? by Tadashi Updegrove

Continuing from my last post about the do’s and don’ts of an intern, SAPT received someone who exemplified pretty much exactly what I felt a good intern should be.  For the past semester Tadashi has made an impact on SAPT through his knowledge, coaching, and ability to learn and apply.  In his brief time here he became a colleague and a good friend. Unfortunately, his time at SAPT has come to an end and he has decided to take his talents to South Beach and by South Beach I mean College Park, Maryland to pursue an internship with the S & C department.  With that said, here is Tadashi’s final task for completing his time at SAPT.... As a Kinesiology major, I was required to enroll in a “Senior Seminar” class this past semester, where we basically got in a big group and discussed health.  Most discussions were centered around the importance of health, how we can inspire others to be healthy, and the future of health in the United States and the world.  As many of my fellow classmates declared their own personal mission statements to become soldiers in the war against obesity, or how to combat the big tobacco companies, I sat quietly in the corner, hoping I didn’t get called on.  Then I got called on:

“Tadashi, why are you so interested in health?”

After stumbling over my words I finally managed to utter something like “err… I, um... I’m not.”  I went on to explain that health was not my primary interest.  What I was interested in was sports and sports performance.  I wanted to understand how the human body adapts so I could understand how to manipulate the applied stimuli to make someone stronger, jump higher, hit harder, and pick up heavier things.

Then I was approached with a follow up question:

“Well, sports are healthy right?”

I don’t know how I feel about that one.  Sure being physically active and exercising is healthy, but after looking through countless research articles it’s hard to ignore the high percentages of participant injury in sports.  Competitive lifting, both powerlifting and weightlifting, ranks at the low end of participant injury with something between 40%-50% (Yup, ½ of participants getting injured apparently is low compared to other sports).  The NFL is under scrutiny right now because of the concussion rates and the violent nature of the game.  I know the NFL is easy to hate on when discussing health and safety because… well it’s football, and the game involves Hulk-Smashing people against their will.

But football players aren’t the only ones getting hurt.  Even the concussion rates in girls’ lacrosse are high enough to raise concerns about helmet requirements.  Take a look at ACL injuries and you’ll find that the overwhelming majority of ACL tears occur because of non-contact situations.  ACLs tend to rupture during a sprint, a jump landing, decelerating, or change-of-direction task.  Athletes in sports that demand a high volume of these tasks are placed at a higher risk of injury.  Think soccer, volleyball, basketball, etc.

During my experience working with the SAPT coaches and athletes, I began to realize more and more that training for performance is training for health. Learning to squat with the knees out and the hips back makes you more of a beast because you get more recruitment of the glutes and your legs are placed in a structurally ideal position to produce force into the ground.  This also happens to be the healthiest position for your knee joint by reducing the load to the medial compartment.  Bracing the midsection during a lift will increase performance because of an improved transfer of force between the upper and lower body.  This ability to create a rigid torso also happens to be the best way to keep your spine from folding in half under load.  Similar performance and health benefits can be said about keeping the scapulae retracted during rows or tucking the elbows during a pushup.

I played lacrosse and ran track in high school, and now compete in Brazilian Jiu Jitsu/submission grappling, and like many athletes in other sports, have come to understand that injuries are just part of the game.  Most athletes can expect to get banged up here and there.  Sometimes, unfortunately, they’ll get hit with a more serious injury that takes them out for a length of time that really puts their patience (and sanity) to the test.  For me it was a back injury that occurred during a grappling session which required surgery last September.  Looking back it’s easy to say I should have done more soft tissue work, anterior core exercises, mobility drills, and gotten more rest but… hindsight’s always 20/20.  What is it going to take for me to get healthy?  Strengthening the right muscles, mobilizing the right joints, and training the neuromuscular system appropriately.  Sounds eerily like training for performance...

I realize now that I am interested in health (specifically musculoskeletal health), because it goes hand in hand in optimizing athletic performance, but I still have to disagree with a blanket statement like “sports are healthy.”

Even a sport like distance running boasts a participant injury rate upwards of 70%!  The next time you watch a baseball or softball game watch the pitcher’s shoulder as he/she pitches.  Try and convince me that they throw this way to improve their health.

However, despite the risk of injury there are many reasons why I believe sports are awesome, and most of these reasons are not necessarily health related.  Growing up my Dad always told me that I would learn more from playing sports than I would learn in the classroom, and I’m pretty sure he was right (but I went to class too…).  I learned what it meant to work hard towards a goal, work with others, and make sacrifices for the benefit of the team.  Not to mention it’s FUN, and I’ve had some of my most memorable moments on a lacrosse field or a grappling mat.

Research Supports ACL Tear Prevention Programs Beginning at Age 11 for Girls

ACLTear

A recent study: Anterior cruciate ligament laxity and strength of quadriceps, hamstrings, and hip abductors in young pre-pubescent female soccer players over time: a three-year prospective longitudinal pilot study.

…whoo, long title… as I was saying, a recent study was published in Orthopedic Physical Therapy Practice that clearly demonstrates the timeframe and magnitude to which the strength balance of young females’ bodies begins to become unbalanced.

Here’s the abstract:

Purpose: This was a longitudinal study to determine the effects of maturation on anterior cruciate ligament (ACL) laxity and muscle strength in pre-pubescent female soccer players. Methods: ACL laxity and quadriceps, hamstrings, and abductors strength were measured annually from 2006 through 2008 in 22 pre-pubescent female soccer players, ages 7-12yrs. Results: ACL laxity increased 2.2 mm (p < 0.0002) in 2007 and 1.7 mm (p < 0.005) in 2008. Quadriceps strength increased 1.9 kg (p < 0.01) in 2007 and 2.1 kg (p < 0.009) in 2008. No significant change was noted in the hamstrings. Abductor strength decreased 3.0 kg (p < 0.0001) in 2007 and 2.3 kg (p < 0.0001) in 2008. Quadriceps to hamstring (Q/H) ratio decreased 0.4 kg (p < 0.02) in 2008. Conclusion: ACL laxity increased with age in pre-pubescent girls. The high Q/H ratio, and decreased abductor muscle strength, indicates an increased risk of ACL injury. Significant changes at age 11.5 occur both in ACL laxity and muscle strength, just one year prior to average age of menses. Girls may be approaching puberty with preexisting muscle weakness and imbalance that may expose them to ACL injury.

The critical pieces to pull from the abstract refer to the combined effects of a high strength ratio between the quadriceps and hamstrings (ideally, you want them to be well balanced and fairly even), the decreasing strength of the abductors (they keep the knee from "caving"), and ever increasing strength of the quadriceps.

It’s worth noting that this study was conducted on girls who are athletes, female soccer players to be exact. So, the increase in ACL laxity was not due to inactivity.

I think it is fantastic that the exact age – 11.5 years – has been pinpointed as the most significant time when this shift towards imbalance is occurring.

What should you do? Well, if you have a daughter, I’d suggest getting her started in a program that has a strong (and highly successful) ACL tear prevention protocol. Training to prevent ACL tears is serious business and, in the long run, it will cost a lot less to PREVENT a tear that to surgically repair and rehab a tear.

Get Started Today!

ACL Form

Mid-Point Goals

I want to give a few personal updates on my training these days. I am just over the half-way point with this pregnancy (21 weeks) and last week we found out we're having a boy (yay!). Since I've already been through this process once before I know that the next 20 or so weeks can become quite physically trying. So, I've reassessed my progress to this point and have created some new goals.

First 20-weeks goals:

1. Build a solid aerobic base ahead of time - ACCOMPLISHED. With Arabella I had NO IDEA how important aerobic exercise would be for my day-to-day tasks. I ended up having to play "catch-up." You'd think this would happen late in the pregnancy when you've gained a bunch of weight... surprise! It doesn't! It happens very quickly as the result of increased blood volume. The aerobic training helps your body adapt more quickly. For Baby #2 I began a conditioning program (geared towards 800m runners) about 1 month before we started trying to "get pregnant" - it has worked wonders. Weight gain has been slower and I've felt much better.
2. Address my body's areas of breakdown ahead of time - ACCOMPLISHED. I've learned that, while pregnant, I need to take special care of my lower back via simple strength movements like the bird-dog, address calf weakness and overall foot health, and can train with more vigor than I did with Arabella (again, I realized this about half-way through with her). The result is that while my back flares up from time-to-time, it is under control and overall I feel much more like myself in terms of strength and health. Regarding foot health, I won't know if I've been successful until after the baby is born.

Second 20-week Goals:

1. Continue to prioritize low- to moderate-level conditioning but without laying the foundation for wicked plantar fasciitis. I'm shifting towards Prowler sled pushes 2x/week, stepper or bike or smililar low impact activity 2x/week, and 1 or 2x/week of actual running. Believe it or not, with Arabella I ran 3-4x/week (with low impact on off days) up until I was 38 weeks pregnant. For my Prowler pushes I will do a "trip" for every week pregnant I am - today I did 21. Took about 30 min.
2. Keep up with lower leg pre-hab to keep my feet and calves strong enough to safely continue to propel my heavy(er) body when I'm running.
3. Maintain pullups and chinups in my training regime. Sadly, these will not be body weight. BUT, on the upside, they can be called "Banded + 25lbs Pullups" by the due date - I'm sure somewhere in there things even out. With Arabella the stretch placed on my torso from the hang position was too uncomfortable/borderline painful to keep in (even banded). So, I'm hoping to keep them in throughout, if possible. Same approach as the Prowler: 1 rep for every week pregnant.
4. Lastly - and, okay, I recognize this borders on the ridiculous - but, if everything goes smoothly and all the variables line up in the best possible way. Then my goal is to beat my time in "active" labor. Arabella took 55 minutes. I'm after a PR with this little guy.

One final note is that I'm not entirely a crazy person, I do certainly understand the limits of my body and the safety of the baby comes first. So, as with #1, I know when to dial things down if my body isn't feeling quite right. And, the above is by NO MEANS my recommendation to pregnant women looking to stay active throughout their pregnancies. Rather, this is the by-product of a body (mine) which has been trained consistently at a very high level for about a decade.

I categorized this post under "Awesome" and "Chest Thumping" because, well, staying active throughout a pregnancy is really, really tough. So, anyone who manages that feat should feel it is both awesome and a serious point of pride!