Off-Season Training: Overhead Athletes
Last week, we laid out some general guidelines for athletes heading into their off-seasons. You should read it, if you haven't already. Today, we'll delve into some specifics for overhead athletes (i.e. baseball, softball, javelin, shot put, swimmers (though it seems as if they never have an off-season), etc.). Shoulders are rather complicated and annoyingly fickle joints that can develop irritation easily which is why proper attention MUST be paid to shoulder mechanics and care during the off-season. There is nothing "natural" about throwing a heavy object (or a light one really, really fast) and shoulders can get all kinds of whacky over a long, repetitive season. I'm going to keep it sweet and simple.
1. Restore lost mobility and improve stability
- Hips: they get locked up, especially on athletes that travel a lot during the season (helloooo long bus rides). Restoring mobility will go a long way in preventing hip impingements, angry knees, and allow for freer movements in general. Locked up hips will prevent safe, powerful throws and batting, thus, now is the time, Padawans, to regain what was lost!
- Lats: Usually tighten up on the throwing side and create a lovely posture that flares the rib cage and makes breathing not-so-efficient. Loosen up these bad boys!
- Breathing patterns: Those need to be re-trained (or trained for the first time), too. Breathing affects EVERYTHING. Learning proper breathing mechanics will do a lot to restore mobility (T-spine, shoulder, and hips), increase stability (lower back and abdominal cavity), and create a more efficient athlete (more oxygen with less energy expended to get it). I've written about it before HERE.
- Pecs and biceps: These guys are gunky and fibrotic and nasty. Self-myofacial release is good, finding a good manual therapist would be even better, to help knead that junk out! One caveat: make sure that as you release these two bad boys, you also add stability back into the shoulder. This means activating lower and mid-traps and the rotator cuff muscles to retrain them to work well again. Why? Most likely, the pecs and biceps are doing a LOT of stabilization of the shoulder (which they shouldn't be doing so much) so if you take that away through releasing them, one of two things will happen: 1) injury will occur since there's nothing holding stuff in place, 2) no injury, but the pec and/or bicep will tighten right back up again as your body's way of producing stability. So, mobilize then stabilize!
2. Improve scapula movement and stability
Along the lines of restoring mobility everywhere, the scapula need particular attention in overhead athletes as they are responsible for pain-free, overhead movements. Below is a handy-dandy chart for understanding scapula movements:
Now, over the course of the season, an overhead athlete will often get stuck in downward rotation therefore at in the early off-season (and throughout really) we want to focus on upward rotation of the scapula. Exercises like forearm wallslides are fantastic for this.
Eric Cressey notes that the scapula stabilizers often fatigue more quickly than the rotator cuff muscles. This means the scapula doesn't glide how it should on the rib cage, which leads to a mechanical disadvantage for the rotator cuff muscles, which leads to impingements/pain/unstable shoulders.
As we increase the upward rotation exercises, we want to limit exercises that will pull the athlete back into downward rotation, i.e. holding heavy dumbbells at their sides, farmer walks with the weight at sides, even deadlifts.(whoa now, I'm not saying don't deadlift, but limit the volume on the heavy pulls for a few weeks, and like I said in the last post, training speed work will limit the amount of load yanking down on those blades.) Instead, athletes can lunge or farmer carry in the goblet position (aka, one bell at their chest).
There is more to be said, but let us move on, shall we?
3. Limit med ball work
At SAPT, we back off on aggressive med ball throwing variations for the first couple weeks post season as the athletes have been aggressively rotating all season. Instead, we'll sub in some drills that challenge the vestibular such as single-leg overhead medicine ball taps to the wall. (I don't have a video, sorry.)
Or, stability drills such as this:
If we do give them some low-intensity throws, we'll have them perform one less set on their throwing side than on the non-throwing side.
4. Limit reactive work
We don't usually program a lot of sprint work or jumps the first few weeks. If we do program jumps, we'll mitigate the deceleration component by adding band resistance:
5. Keep intensity on the lower end
As mentioned in the last post, instead of piling on weight, we enjoy utilizing isometric holds, slow negatives, and varying tempos to reap the most benefit from the least amount of weight. We also maintain lower volumes over all with total program.
There you have it! Tips to maximize the off-season and lay a strong, stable foundation for the following season!
Early Sport Specialization: Why This Needs to Stop (with a capital "S")
Here in northern Virginia, and in other hub-bub places too, it's not uncommon for an athlete to play a sport during the high school season, and then transition straight into the club season (which lasts f-o-r-e-v-e-r), leaving the athlete with maybe 2-3 weeks rest before try-outs for the next year's high school season start. Does this sound familiar? Does this sound healthy? Today we're going to address a growing (alarmingly so) problem with youth athletics: early sport specialization. As a strength coach, I see some messed up kids when it comes to movements, joint integrity, and muscle tissue quality (all = poop) who play year-round sports at young ages (that is, under 16-17 years old). I see year-round volleyball players who can't do a simple medicine ball side throw. Why? Because they spend ALL YEAR moving in the saggital (forward/backward) plane with a little bit of the frontal plane (side to side shuffling, but even that is dominated by their inability to actually move sideways; they tend to fall forward and/or move as if they're running forward, just facing a little bit to the side.) They have limited movement landscape (remember this?) and therefore are limited athletes.
I see young baseball players with chronic elbow or shoulder pain. Why? Because they throw a ball the same way ALL YEAR ROUND. And they're not strong enough to produce the force needed to throw it properly, (because, heaven forbid, they take some time off to actually weight train and get stronger) so they rely on their passive restraints (ligaments, tendons, and joint capsules) to throw.
This topic gets me fired up because I see SO MANY injuries and painful joints in kids who shouldn't have injuries or painful joints. I see kids who can't move like a normal human being because they're locked up and, worse, don't even have the mind-body connection to create movements other than those directly related to their chosen sport.
There's this pervasive myth that if a kid doesn't play year round or get 10,000 hours of practice, then he/she will never be a good athlete. Parents get caught up in chasing scholarships and by golly, if Jonny doesn't play travel ball he'll fall behind, then he won't make varsity, then he won't get into a good college... and on and on. My friends, we need to take a step back and think about what's best for the athlete. Do the aforementioned afflictions sound good to you?
But enough of my opinion, let's look at some hard science to support the Stop-Early-Specialization-Theory.
Playing multiple sports and playing just for the sake of running around like a kid builds a rich, diverse motor landscape, especially during the years before late adolescence. Diversifying the motor landscape, or movement map, or the bag-o-skillz, or whatever you want to call it, is essential to human development and especially valuable to athletes. I'm going to sound like a broken record, but kids need a broad and varied map to:
1. Understand how to move their bodies through space
2. Create and learn new movements
3. Learn how to adapt to their environment
4. Develop better decision making and pattern recognition based on their circumstances (i.e. being able to find the "open" players in a basketball game helps in finding one on the soccer field. )
Matter fact, this really smart fellow, Dr. John DeFirio MD, who is the President of the American Medical Society for Sports Medicine, Chief of the Division of Sports Medicine and Non-Operative Orthopaedics at the David Geffen School of Medicine at UCLA and Team Physician for the UCLA Department of Intercollegiate Athletics (that's quite the title, eh?) says this:
"With the exception of select sports such as gymnastics in which the elite competitors are very young, the best data we have would suggest that the odds of achieving elite levels with this method [early sport specialization] are exceedingly poor. In fact, some studies indicate that early specialization is less likely to result in success than participating in several sports as a youth, and then specializing at older ages"
And, Dr. DiFiori encourages youth attempt to a variety of sports and activities. He says this allows children to discover sports that they enjoy participating in, and offers them the opportunity to develop a broader array of motor skills. In addition, this may have the added benefit of limiting overuse injury and burnout.
You can read his full article here. The article also notes two studies in which NCAA Division 1 athletes and Olympic athletes were surveyed regarding what they did as children. Guess what? 88% of the NCAA athletes played 2-3 sports as kids, and 70% of them didn't specialize until after age 12. The Olympians also all averaged 2 sports as kids Are you picking up what he's putting down? Specialization doesn't make great athletes, diversification does!
Side bar: Check out Abby McCollum, who played 4 sports for a Division 1 school. The article says that she was recruited last minute... probably because she was such a great all-around athlete that she could play any sport.
Next up: injuries rates.
Dr. Neeru Jayanthi, a sports medicine physician, in conjunction with Loyola University published a few studies using a sample set of 1,026 athletes between ages 8-18 who came into the Lurie Children’s Hospital of Chicago for either sports physicals or treatment for sports-related injuries. The study ran from 2010 to 2013. Dr. Jayanthi and her collegues recorded 859 injuries, of which 564 of them were overuse injuries (that's well over HALF). Of those 564 injuries, 139 of them were serious injuries concerning stress fractures in the back or limbs, elbow ligaments or injuries to the cartilage. All of these injuries are debilitating and can side line and athlete for 6 months or more. The broad study is reviewed here and a more specific cohort (back injuries, which carry into later in life) is here. I highly recommend reading both as the data are eye opening.
To sum up Dr. Jayahthi and co.'s recommendations on preventing overuse injuries (I took it directly from one of the articles in case you don't have time to read them both):
• If there's pain in a high-risk area such as the lower back, elbow or shoulder, the athlete should take one day off. If pain persists, take one week off. (though I think it should be more)
• If symptoms last longer than two weeks, the athlete should be evaluated by a sports medicine physician. (and go get some strength training! There's a reason that pain is occurring; something is overworking for something else that's NOT working.)
• In racket sports, athletes should evaluate their form and strokes to limit extending their backs regularly by more than a small amount (20 degrees). (this should also apply to any overhead sport like volleyball, baseball, softball, etc.)
• Enroll in a structured injury-prevention program taught by qualified professionals. (hey, like SAPT? Lack of strength is a common denominator among injured athletes.)
• Do not spend more hours per week than your age playing sports. (Younger children are developmentally immature and may be less able to tolerate physical stress.) (10 year-olds don't need 12 hours or soccer! Also check out Dr. Jayahthi's injury prediction formula.)
• Do not spend more than twice as much time playing organized sports as you spend in gym and unorganized play. (Kids, go play tag, get on the playground, play capture the flag, anything; JUST PLAY!)
• Do not specialize in one sport before late adolescence.
• Do not play sports competitively year round. Take a break from competition for one-to-three months each year (not necessarily consecutively).
• Take at least one day off per week from training in sports.
The highlights and comments are mine. Do you see the RISK involved in specializing in a sport early in life? Not only does the risk of injury skyrocket, and the ability to move fluidly and easily plummet, but there's a lot of external pressure on the athlete to perform. Stressed athletes don't perform well. I don't know how many times I've asked my year-round players what they're doing on the weekends, it's always "tournament" or "practice." They have NO LIFE outside of sports. To me, that seems unhealthy and frankly, a recipe for burn-out.
Parents, athletes, and coaches, in light of all this research, I urge you to strongly reconsider year-round playing time for kids under 16 or 17. I urge you to allow athletes time off, to play other sports besides they're favorite, and to just be a kid. I urge you to keep the long-term development of our athletes in mind; do you want to risk a permanent injury, hatred of sport (because of burn out), or development of weird compensations and movement patterns?
Let's build strong, robust athletes that can do well in the short- and long-term instead of pigeon-holing them into a particular sport and limiting their athletic potential.
Why Train In-Season?: Strength and Power Gains
Hopefully by now, you've read about the signs and reversal of overtraining. Now let's look at why and how to train intelligently in-season. A well-designed in-season program should a) prevent overtraining and b) improve strength and power (for younger/inexperienced athletes) or maintain strength and power (older/more experienced lifters).
First off, why even bother training during the season?
1. Athletes will be stronger at the end of the season (arguably the most important part) than they were at the beginning (and stronger than their non-training competition).
2. Off-season training gains will be much easier to acquire. The first 4 weeks or so of off-season training won't be "playing catch-up" from all the strength lost during a long season bereft of iron.
I know that most high school (at least in the uber-competitive Northern VA region) teams require in-season training for their athletes. Excellent! However, many coaches miss the mark with the goal of the in-season training program. (Remember that whole "over training" thing?) Coaches need to keep in mind the stress of practice, games, and conditioning sessions when designing their team's training in the weight room. 2x/week with 40-60 minute lifts should be about right for most sports. Coaches have to hit the "sweet spot" of just enough intensity to illicit strength gains, but not TOO much that it inhibits recovery and negatively affects performance.
The weight training portion of the in-season program should not take away from the technical practices and sport specific. Here are a couple of things to keep in mind about the program, it should:
1. Lower volume, higher intensity-- this looks like working up to 1-2 top sets of the big lifts (squat or deadlift or Olympic lift), while maintaining 3-4 sets of accessory work. The rep range for the big lifts should be between 3-5 reps, varied throughout the season. The total reps for accessory work will vary depending on the exercise, but staying within 18-25 total reps (for harder work) is a stellar range. Burn outs aren't necessary.
2. Focused on compound lifts and total body workouts-- Compound lifts offer more bang-for-your buck with limited time in the weight room. Total body workouts ensure that the big muscles are hit frequently enough to create an adaptive response, but spread out the stress enough to allow for recovery. Note: the volume for the compound lifts must be low seeing as they are the most neurally intensive. If an athlete can't recover neurally, that can lead to decreased performance at best, injuries at worst.
3. Minimize soreness/injury-- Negatives are cool, but they also cause a lot of soreness. If the players are expected to improve on the technical side of their sport (aka, in practice) being too sore to perform well defeats the purpose doesn't it? Another aspect is changing exercises or progressing too quickly throughout the program. The athletes should have time to learn and improve on exercises before changing them just for the sake of changing them. Usually new exercises leave behind the present of soreness too, so allowing for adaptation minimizes that.
4. Realizing the different demands and stresses based on position -- For example, quarterbacks and linemen have very different stresses/demands. Catchers and pitches, midfields and goalies, sprinters and throwers; each sport has specific metabolic and strength demands and within each sport, the various positions have their unique needs too. A coach must take into account both sides for each of their positional players.
5. Must be adaptable --- This is more for the experienced and older athletes who's strength "tank" is more full than the younger kids. The program must be adaptable for the days when the athlete(s) is just beat down and needs to recover. Taking down the weight or omitting an exercise or two is a good way to allow for recovery without missing a training session.
A lot to think about huh? As a coach, I encourage you to ask yourself if you're keeping these in mind as you take your players through their training. Athletes: I encourage you to examine what your coach is doing; does it seem safe, logical, and beneficial based on the criteria listed above? If not, talk to your coach about your concerns or (shameless plug here, sorry), come see us.
Overtraining Part 1: Symptoms
This month's theme is in-season training since the spring sports are starting up. All the practices, games, and tournaments start to add up to over time, not to mention any weight room sessions the coachs' require of their athletes. Lack of proper awareness and management of physical stressors can lead, very quickly in some cases, to overtraining... which leads to poor performance, lost games, increase risk of injury, and a rather unpleasant season.
The subject of overtraining is a vast one and we won't be able to cover all the aspects that contribute, but by the end of this two part series, you should have a decent grasp on what overtraining is and how to avoid it. Today's post will be about recognizing the symptoms of overtraining while next post will offer techniques and training advice to avoid the dreaded state of overtrained-ness. (Yes, I made that word up.) Li'l food for thought: quite often the strength and conditioning aspect of in-season training is the cornerstone of maintaing the health of the athlete. Too much, and the athlete breaks, but administered intelligently, a strength program can restore an athlete's body and enhance overall performance. Right, let's dive in!
Who doesn’t like a good work out? Who doesn’t like to train hard, pwn some weight (or mileage if you’re a distance person), and accomplish the physical goals you’ve set for yourself? Every work out leave you gasping, dead-tired, and wiped out, otherwise it doesn't count, right? (read the truth to that fallacy here)
We all want a to feel like you've conquered something, I know I do!
However, sadly, there can be too much of a good thing. We may be superheroes in our minds, but sometimes our bodies see it differently. Outside of the genetic freaks out there who can hit their training hard day after day (I’m a bit envious…), most of us will reach a point where we enter the realm of overtraining. I should note, that for many competitive athletes (college, elite, and professional levels) there is a constant state of overtraining, but it’s closely monitored. But, this post is designed for the rest of us.
Now, everyone is different and not everyone will experience every symptom or perhaps experience it in varying degrees depending on training age, other life factors, and type of training. These are merely general symptoms that both athletes and coaches should keep a sharp eye out for.
Symptoms:
1. Repeated failure to complete/recover in a normal workout- I’m not talking about a failed rep attempt or performing an exercise to failure. This is a routine training session that you’re dragging through and you either can’t finish it or your recovery time between sets is way longer than usual. For distance trainees, this may manifest as slower pace, your normal milage seems way harder than usual, or your heart rate is higher than usual during your workout. Coaches: are you players dragging, taking longer breaks, or just looking sluggish? Especially if this is unusual behavior, they're not being lazy; it might be they've reached stress levels that exceed their abilities to recover.
2. Lifters/power athletes (baseball, football, soccer, non-distance track, and nearly all field sports): inability to relax or sleep well at night- Overtraining in power athletes or lifters results in an overactive sympathetic nervous response (the “fight or flight” system). If you’re restless (when you’re supposed to be resting), unable to sleep well, have an elevated resting heart rate, or have an inability to focus (even during training or practice), those are signs that your sympathetic nervous system is on overdrive. It’s your body’s response to being in a constantly stressful situation, like training, that it just stays in the sympathetic state.
3. Endurance athletes (distance runners, swimmers, and bikers): fatigue, sluggish, and weak feeling- Endurance athletes experience parasympathetic overdrive (the “rest and digest” system). Symptoms include elevated cortisol (a stress hormone that isn’t bad, but shouldn’t be at chronically high levels), decreased testosterone levels (more noticeable in males), increase fat storage or inability to lose fat, or chronic fatigue (mental and physical).
4. Body composition shifts away from leanness- Despite training hard and eating well, you’re either not able to lose body fat, or worse, you start to gain what you previously lost. Overtrained individuals typically have elevated cortisol levels (for both kinds of athletes). Cortisol, among other things, increases insulin resistance which, when this is the chronic metabolic state, promotes fat storage and inhibits fat loss.
5. Sore/painful joints, bones, or limbs- Does the thought of walking up stairs make you groan with the anticipated creaky achy-ness you’re about to experience? If so, you’re probably over training. Whether it be with weights or endurance training, you’re body is taking a beating and if it doesn’t have adequate recovery time, that’s when tendiosis, tendoitis, bursitis, and all the other -itis-es start to set in. The joints, muscles, tendons, and ligaments are chronicallyinflamed and that equals pain. Maybe it’s not pain (yet) but your muscles feel heavy and achy. It might be a good time to rethink you’re training routine…
6. Getting sick more often- Maybe not the flu, but perhaps the sniffles, a sore throat, or a fever here and there; these are signs your immune system is depressed. This can be a sneaky one especially if you eat right (as in lots of kale), sleep enough, and drink plenty of water (I’m doing all the right things! Why am I sick??). Training is a stress on the system and any hard training session will depress the immune system for a bit afterwards. Not a big deal if you’re able to recover after each training session… but if you’re overtraining, the body never gets it's much-needed recovery time. Hence, a chronically depressed immune system… and that’s why you have a cold for the 8th time in two months.
7. You feel like garbage- You know the feeling: run down, sluggish, not excited to train… NOOOOO!!!!! Training regularly, along with eating well and sleeping enough, should make you feel great. However, if you feel like crap… something is wrong.
Those are some of the basic signs of overtraining. There are more, especially as an athlete drifts further and further down the path of fatigue, but these are the initial warning signs the body gives to tell you to stop what you’re doing or bad things will happen.
Next time, we’ll discuss ways to prevent and treat overtraining.
Tackling Technique: How to (Safely) Pummel Your Opponent
Today's special guest post comes one of our athletes, Dumont, who's played Rugby professionally and currently coaches for the Washington Rugby Club. Given his past history and present involvement in Rugby, and the fact that the dude is a monster, it stands to reason that he knows a thing or two about pummeling an opponent. He graciously offered his expertise on tackling to share with everyone here on SAPTstrength. Here he provides many practical tips on not only executing an EFFECTIVE tackle, but also how to do so in a safe and concerted manner. Hit it Dumont!
The NFL combine is just days away, and many aspiring athletes will be jumping, running, and lifting in an attempt to impress potential employers. One skill that not showcased at the NFL Combine is tackling. Some could argue the tackle is a lost art in today’s NFL game. Yes, we see plenty of big hits each week, and as a result of those big hits, the NFL is attempting to regulate the tackle zone in an effort to protect its players. However, with the increase in big hits, what we are actually seeing as is many defenders forgetting the fundamentals and failing to finish the tackle. The result is we see a lot of missed tackles on Sunday, and a lot of needless injuries. The art of the proper form tackle has been lost.
What is a proper form tackle? A form tackle requires the tackler to use their entire body. Eyes, arms, shoulders, core, and legs are all engaged in an effort to bring a ball carrier to the ground in an efficient and safe (well as safe as a tackle can be) manner. While it may not result in the big “jacked up” highlight hit we’ve become accustomed to seeing on television, a form tackle will bring a ball carrier to the ground, and stop them in their tracks every time.
Before we break down the parts to making a tackle let’s point out the first step, take away a ball carrier’s space. The closer a tackler can get to the ball carrier the less opportunity they have to shake and get out of the way. Close the space to within a yard, of the ball carrier and now the tackler is in the tackle zone. Closing the space also allows the tackler to use their body like a coiled up spring that can explode into contact at the right moment.
Let’s break down the tackle into parts and make it easier to digest. The first part is the eyes. Before one can make a tackle, a player needs to spot their target, and know what they are aiming for. The tackler must remember to keep your eyes open and spot their target. This will also help to keep their head up. Keeping their head up is key not just so they can see, but also for safety. It keeps the back in a straight line and helps to protect the neck.
Two keys a tackler should remember when using their eyes:
- Keep them open- sounds simple but you’d be surprised at how easily they close just before impact
- Focus on the ball carrier’s core- they can move their legs, arms, and heads, but where their core goes, the entire body goes. Focusing on the core will lead to the tackle point.
The second part of the tackle is the arms and shoulders. Many people have different ideas of what to do with their arms when making a tackle. Often times tacklers start with their arms out wide and it looks like they are trying to bear hug their opponents. While this is effective in making a tackler look big and fierce, it’s actually inefficient when it comes to making the tackle and dangerous as it exposes the weaker muscles in the arm. When a tackler’s arms are out wide it creates “weak arms,” we teach ball carriers to run towards those open arms because it’s much easier for them to break through. By keeping the arms in tight and the hands above your elbows the tackler engages the shoulders and the arms creating a strong base to enter the tackle zone.
Here are the keys for the arms when making a tackle.
- Imagine creating a TV screen with your hands, and the ball carriers core is the show you want to watch.
The next part to the tackle equations is the legs. First we’ll focus on the feet. The lead foot is most important. Step towards the ball carrier using the lead foot. This brings the tacklers body with them, and allows them to use their entire body and keeps the body compact and coiled like a spring.
Keys to good footwork
- Step towards the ball carrier taking away their space
- Do not cross your feet
- Take short controlled steps not to overextend yourself.
Once the feet are in position, we need to focus on getting the rest of the legs into proper tackling position. This is done by bending at the knees, and creating a powerful base. By bending at the knees a tackler engages their legs and they are coiled and ready to explode. This will also keep the tackler low and allow them to attack the ball carriers core and legs. We do not want to tackle ball carriers up around the chest and arms, it’s too easy for them to break through when we get that high. Bending at the knees also gives the tackler the agility to move left, or right should the ball carrier change direction. Remember to keep your head up and your eyes open during all this.
So far we’ve covered a lot of stuff, so let’s take a moment and give a quick rundown of everything to make sure every is on the same page.
- Eyes Open
- Arms in tight, hands up
- Lead foot forward
- Bend at the knees
- Heads up
This puts an athlete into the perfect tackling position. To make contact the tackler wants to pick a side of the ball carrier’s body and attack that with their shoulder. The head should be placed on the side of the ball carrier’s body, not across it. This protects the tackler from being kneed or elbowed in the head, and reduces the possibility of injury. Using your lead foot step in, make contact with the shoulder.
A good rule to remember is “cheek-to-cheek.”
The next part of the tackle is the arms. We already have our arms in tight and our hands are up. Once the tackler makes contact with the shoulder we want to punch with the arms. Bring the arms up keeping them close and wrapping them around the ball carriers body, pulling the ball carrier in tight.
The final part is engaging the legs and drive forward. Once the tackler made contact with the shoulder and wrapped up the ball carrier with their arms, start pumping the legs. Drive forward and force the ball carrier to the ground. Use the ball carriers body as a pillow to land on. This will bring the ball carrier to the ground.
Form tackles are effective. The main key is putting the body into the correct position. Take away the ball carrier’s space, head up, eyes open, arms in, hands up, knees bent, then explode into the contact point, wrap the arms and drive the legs.
Thanks Dumont! Hopefully you all learned a li'l sumthin' sumthin' about tackling (safely and effectively... as opposed to just mindlessly throwing your body at your opponent). Proper technique will go a long way to both helping prevent injuries and winning games. And just for fun, here's a video of football vs. Rugby:
And if you want to smile: *Note* I love our soccer players! I just thought the video was funny.
Femoroacetabular Impingement and Football Kickers. "That's Why My Hip Hurts!"
Femoroacetabular impingement (FAI) syndrome has become more widely recognized thanks to folks such as Kevin Neeld, Eric Cressey, Mike Reinold, and a plethora of other smart coaches. FAI is a common* syndrome/injury in athletics and football kickers are especially susceptible due to the nature of the violent hip flexion during the kick off/punt. At the end of the article I'll put some links for more information regarding testing for FAI, research regarding FAI, and other resources. The last two posts have been marathon length, so we'll keep today short and to the point. What is FAI?
FAI is essentially:
Femoroacetabular impingement or FAI is a condition of too much friction in the hip joint. Basically, the ball (femoral head) and socket (acetabulum) rub abnormally creating damage to the hip joint. The damage can occur to the articular cartilage (smooth white surface of the ball or socket) or the labral cartilage (soft tissue bumper of the socket).
from www.hipfai.com. Athletes that participate in activities that include repetitive hip flexion and internal rotation or folks who have super crappy mobility in their hips are at a higher risk of developing hip issues. Also, athletes who are constantly in a state of anterior pelvic tilt (aka: nearly every one of them) are also primed for some impingement.
Now, look at a football kick off. Check out the crazy hip flexion and internal rotation (when his leg crosses over the midline of his body around the :29-:31 mark).
Can you see how a kicker might develop a problem? Especially if they're not a physically STRONG kicker?
Just so you know, FAI comes in three flavors, none of which include chocolate or vanilla:
CAM- bony overgrowth on the femoral head (ball)
Pincer- body overgrown on the acetabulum (on the socket on the pelvic bone)
Mixed- a lovely combination of both.
How do I spot FAI?
IMPORTANT: Remember, unless you're a doctor, you CANNOT DIAGNOSE. The following are merely indicators that something is amiss. A visit to the doctor and possibly the Wonder Machine (MRI) will be the only sure way to diagnose any pathology.
Now, as a coach/player it's important to be aware of FAI and be on the look out for the symptoms. FAI will most likely manifest on the kicking leg simply because it is subject to that the crazy-hip-flexion. Bilateral FAI is found more often in sports with bilateral hip flexion such as hockey or powerlifting. However, this doesn't mean that both sides can't be affected, so be on the vigilant!
There are two simple tests that you can do yourself (though I STRONGLY recommend you see a professional..cough, cough.)
One is the Faber Test.
The other is a supine hip flexion with internal rotation of the femur.
If this lights you up, and you're also experiencing the symptoms below, you should probably high tail it to a person with the initials, "M.D." after there name.
A few other symptoms that as either a coach or a player you should be on the watch for (and probably perform the aforementioned tests):
1. Pain with squatting below 90 degrees. Speaking from experience, it feels "pinchy" in the front of the hip, just a smidge medial (inside) of the pelvic bone.
2. Pain with internal rotation and hip flexion. For example, getting into a car leading with the affected leg (one has to flex the hip to sit and internally rotate the hip to slide into the car).
3. Another potential, but not always present, is a history of repeated sports hernias or groin pulls.
4. As a coach, if you're watching a player squat, if one hip seems to drop more than the other. The hip that DOESN'T go as low, will be the affected hip. The player will also weight shift towards the affected side as they stand up from the bottom of the squat.
Don't be stupid and keep training through this pain (again, I speak from experience). Some of the associated symptoms/pathologies of FAI include: cartilage damage, labral tears, (the labrum helps keep the hip stabilized. It's really important.) early on-set osteoarthritis of the hip, sports hernias, and low back pain.
Speaking as someone who has bilateral FAI (and the labral tears), it sucks. Don't be a hero, go to the doc if you're experiencing these symptoms.
What are the Implications of FAI?
An athlete the has impingement of their hip will have limited hip flexion range of motion (ROM) on the affected side. What does this mean for a football kicker?
- No more squatting. Think about it: 1) hip flexion ROM is going to be limited on one side. 2) If you're bilaterally loaded, as in a squat, one hip will drop lower than the other, and if the hips can't move independently, as they could in a lunge, you're going to impose some wonky forces on the spine. 4) Wonky forces on the spine eventually lead to injuries and pain. Not the best game plan. (You could get away with squatting above 90 degrees, but no sense in playing with tigers if you don't have to.)
- There's a study found here that looked at hip flexor strength a group of people with diagnosed FAI. The study found that those with FAI had weaker hip flexors than the controls. (I can personally attest this is true.) Whether the people had FAI because their hip flexors were weak, or the hip flexors became weak with FAI onset, doesn't matter for this discussion. What does matter is that the HIP FLEXORS ARE WEAK! Now, in a football kicker, what's the main group of muscles used to kick? HIP FLEXORS! Do you see a problem? If a coach is oblivious to this, yelling at a kicker to kick harder isn't going to do much. Also, without proper training (perhaps some focused work for the hip flexors such as SL marches or hanging leg raises), other muscles are going to take over for the lack luster hip flexors and then you have a whole new set of problems.
- Hip dominant exercises (deadlifts, RDLs, glute bridges, and swings) and single leg work (split squats, step back lunge variations, step ups (as long as the hip stays >90 degrees), and single leg RDLs) must be the bulk of lower body work. All of these tend to keep the hip out of excessive hip flexion + internal rotation. They also hammer the glutes, which will help keep the femur from gliding forward in the socket and causing more ruckus in the pelvic region. Food for thought: I've personally found that walking lunges/forward lunges tend to make my hip ache as do back-and-feet elevate glute bridges.
- As far as corrective work goes, hammer hip stabilization and anterior core. Low level glute work such as double- and single leg glute bridges, monster walks, and bowler squats will challenge the smaller stabilizers of the hip. This in turn will keep the femoral head from gliding around and causing more damage. Anterior core is necessary to, hopefully, control anterior pelvic tilt (which most athletes sit in anyway) and even, possibly, pull the pelvis a little posteriorly. This will, again, keep those bony overgrowths from grinding on each other. Here's a great video by my better half on anterior core progressions.
Another note: I've found that single leg anterior core exercises (such as a single leg plank) bother my hips. Be mindful and if it hurts, don't do it.
Wow, so I broke my promise of writing a lengthy post. However, this is an EXTREMELY important issue that many kickers are faced with (we've had one walk through our doors, not to mention the other handful of other athletes from a range of sports).
*Just chew on this; a recent study of asymptomatic people found that of the 215 male hips (108 patients) analyzed, a total of 30 hips (13.95%) were defined as pathological, 32 (14.88%) as borderline and 153 (71.16%) as normal. That means potentially 1 in every 3-4 males have some sort of underling hip "thing" going on. (thanks Kevin Neeld!) That's a lot.
As promised here are some links for more information:
Post on Mike Reinold's site with more in-depth diagnoses.
Kevin Neeld has a bunch: 1, 2, and 3 (and the one linked above)
And Tony Gentilcore, who does a fantastic job communicating a complex topic to the lay population, while adding some humor to boot.
Whew!
