As a strength and conditioning coach who works entirely only with athletes, I’ll often see a case of an athlete being recruited or transferring in with a pre-existing shoulder injury. In the event that they opt for surgical treatment of their injury, I’ll often will receive calls from coaching discussing “how soon” can they return to training. Fortunately, we have a brilliant athletic medicine department here at Wichita State that does a tremendous job through an athlete’s rehabilitation.

Often times, I will work in conjunction with Athletic Medicine in devising an optimal plan for approaching the training of an athlete with a particular injury. In today’s blog, I’ll be discussing a case-study of an athlete 10 weeks out of a reconstructive surgical labrum procedure.

When I program for athletes, I tend to get away from the ideology of training individual parts. I’m more concerned with grooving and training movement patterns; be it a more functional approach to training modern day’s athletes. One could argue that it is all semantics, but I’d be digressing. Nonetheless, I look for developing the following patterns; bilateral knee dominant movements; unilateral dominant movements; bent knee hip dominant movements; straight leg dominant movements; vertical pressing movements; vertical pulling movements; horizontal pressing movements; horizontal pulling movements; anti-rotational core demands; anti-lateral flexion core demands; and anti-extension core demands.

My goodness, what a list. Let’s break it down a bit to see what I’m talking about.

Bilateral knee dominant movements
Cable Bilateral Belt Squat

Unilateral knee dominant movements
Low Pulley Cable Front/Backward Lunges

Bent knee hip dominant movements
Swissball Leg Curls

Straight leg dominant movements
Single-Arm Dumbell Romanian Deadlift

Vertical pressing movements
Tall-Kneeling Single Arm Dumbell Press

Vertical pulling movements
Tall-Kneeling Single Arm High Pulley Cable Pulldown

Horizontal pressing movements
Single Arm Dumbell Press

Horizontal pulling movements
Bilateral Stance Single Arm Cable Row

Anti-rotational core demands
Single Arm Pallof Press

Anti-lateral flexion core demands
Single Arm Waiter/Suitcase Carries

Anti-extension core demands
Deadbugs

These are just a few of the exercises that we’ve been using in this individual case. There is many other flexibility and mobility exercises that we also have this individual do to further enhance their functional and structural being. In this particular case, our Athletic Medicine staff does a tremendous job making sure that this individual is still progressing through strength and ROM in the injured shoulder. As a strength and conditioning coach, my number one responsibility is to ensure that no athlete ever gets injured or further injures themselves while under my supervision. It has taken this athlete a number of progressions to get to where they are currently at. I wouldn’t necessarily advise others to jump right into doing this without proper care of a trained medical athletic trainer supervising and signing off on an athlete’s clearance to do so.

If you have any questions or comments regarding any of this blog post, please don’t hesitate to e-mail or leave a comment below.

Until text time, Train Hard!

Clarifying the Five Levels of Leadership and how I apply it in a Strength & Conditioning Setting at Wichita State University.

Missouri Valley Conference

Being in the position I am at Wichita State University, I get to witness and work with some of the most tremendous athletes in our conference and the NCAA.  Being the associate strength and conditioning coach, I get to witness the full development of incoming freshman and help them mature and evolve to their peak athletic potential as they enter into the senior year of eligibility.  It’s a tremendous journey and a marvelous transformation to witness and be a part of.

The science of strength and conditioning is also experiencing maturation similar to an incoming recruit.  And again, I find myself involved with the transformation of the strength and conditioning field, in respect to the teachings and coaching of our Wichita State University Shocker Athletes.

The days of creating monstrously strong athletes with no regard of asymmetries, compensatory movement patterning, tissue extensibility, and joint mobility is over.  Strength and conditioning coaches need to focus on creating efficient athletes who possess all aspects of athleticism.

Grooving Movement Patterns over Muscles

Movement Based Approach to Preparing Athletes

It’s my belief that we need to focus on creating efficient and strong movement patterns over simply training isolated muscles.  We can argue semantics until we are both blue in the face but the principles I coach by is of those that create the most efficient athlete.  Can our Wichita State athletes perform a functional bodyweight squat, in-line lunge, or push-up variation? Absolutely.

Perhaps my philosophy has evolved to a more movement based approach over the course of utilizing the functional movement screen into our team testing.  We cannot rationally believe that training limbs in isolation will create an equally strong sum of the effects.  The human body does not work that way and we need to properly train the body as a whole.  This statement doesn’t mean that we don’t do some isolation; we do some isolated movement patterns adopted from physical therapy and preventive prehabilitation exercises for a number of our athletes.

With creating the most efficient athlete, we utilize a movement based approach that focuses on movement patterns that fall within a number of classifications.  We utilize vertical pressing movements, vertical pulling movements, horizontal pressing movements, horizontal pulling movements, hip dominant movements and knee dominant movements.  We focus on anti-rotational core exercises an arsenal of s stabilization focused bridging/plank core exercises.

We try to focus on developing the total package when we develop our athletes.  We train specifically to draw out the emphasis that each athlete needs individually, determined from their FMS, and needs assessments.  We train whole body movements so that we can focus on utilizing functional core strengthening through dynamic multi-joint, multi-planar and multi-mode exercises.  We spend a tremendous amount of time fixing asymmetries whether tissue extensibility or strength.

Programming Recovery

Adding Fuel to the Machine. Proper Nutrition Is Vitally Important for our Wichita State Athletes

Nutrition

One of the advantages at working at a larger university is the tremendous support we receive from boosters, administrators and people of the community.  I am truly blessed to be surrounded by great people who are looking to advance our athletic program.  One area that has a tendency to get neglected by a strength and conditioning department is the emphasis of nutritional strategies in relation to athletic recovery.

I pride our program on doing everything we can to educate our student-athletes about proper nutritional choices; be it before, during, or after practice, competition, and weight/conditioning sessions.  We take it upon ourselves to physically go out into the community with student-athletes and conduct grocery store tours in attempts to educate student-athletes about what foods are “performance foods” and which to avoid.  We do the same thing for our on-campus athletes by visiting dorm cafeterias and educating about nutritional choices and healthy food options.  We have athletes who request nutritional guidance to undergo a 3-day or weekly food log so we can help identify problematic trends and help offer recommendations to better fit their performance goals.

The reason I do this is simple, I believe nutrition absolutely plays a larger role in recovery than what most athletes think.  I also know that athletes retain healthier eating patterns and educational information when they “learn by doing” rather than a piece of paper with healthy information printed on it.  Proper nutrition provided the fuel for these incredible athletes and I need to make sure the fuel their using is of the best and highest grade.

Even today I found myself using the following analogy with one of my student-athletes.

“Picture the athlete as a shiny new 2011 amazing Ferrari (the Human Body); with the capability of reaching speeds of 150 MPH at a drop of a hat.  Simply put, this piece of metal and steal is an incredible machine with marvelous performance potential.  The Engine (the Human Mind) is even more pristine with the pistons and gears turning at all the right times to generate the power for this body to move.  The engine determines how much effort, and much muscle can be generated by the body of the car. If you swapped the Ferrari’s engine with that of a Ford Taurus, you would not expect the vehicle to performance at the same potential as a stock Ferrari.  The mind controls the body as the engine controls the car.  The Fuel (the Human Nutrition) provides the energy for the Engine & Car to use.  You would not expect a highly sophisticated piece of beauty like a Ferrari to run off of crude engine oil?  Why would we expect the same out of our athletes?  We don’t – so I take it upon myself to do everything in my power to educate our athletes about proper nutritional choices.

Foam Rolling

Soft Tissue Work is Programmed Into Every Workout

Another area we spend a lot of time focusing on is improving tissue quality by using foam rollers and soft tissue work.  Before our team lifts we have our teams roll out on a number of different foam rollers trying to improve tissue quality in areas like the their glutes, hamstrings, TFL, adductors, calves, upper back, lats, and pectorals.

I’m a firm believer that rolling should precede strengthening or stretching.  It also serves as a 5-minute window for our athletes to ‘prepare mentally’ for the challenges (the lifting session) that is ahead of them.  It is a great time to allow our men and women to bond as a team and also serves as a way for me to casually draw athletes into conversations.  I have found the more I listen to the athlete share details of practice, their day, and their stories that in return the athletes gives me more of their attention when I discuss details of the lift and directions.

Stretching

While at Wichita State University, I program a lot of stretching into post practice routines and lift sessions in order to regain loss length in otherwise tight muscles.  At the start of each semester, we utilize a functional movement screen with all of our teams to determine which areas or movement patterns we need to focus on strengthening, lengthening or both.

We try to target some problematic areas for a majority of our athletes.  We find that a large percentage of athletes have general hip-flexor tighteness that results in an anterior pelvic tilt.  This is problematic for our strength and conditioning department because this APT inhibits the glutes from properly firing.  Obviously, maximizing our gluteus functioning and firing is important during training and athletics, so we do everything we can from stretching, foam rolling, and hip mobility work in order for the glutes to function properly.  A large part of this is lower body stretching the target areas like the hip-flexors; hamstrings; long/short lever adductors; high hamstring/groin; IT-band; and glutes.

Conclusion

We try to do everything we can for our athletes to provide a scientific-based approach to training the human body for maximal athletic performance.  We’re not trying to create monsters that cannot move nor individuals who cannot push and move opponents around the court.  The Missouri Valley Conference is competitive and the athletes of the MVC will push and shove and it’s our job to prepare our athletes for the brutality of this conference.  We’re going to use everything in the current field of research from movement screening, movement based strengthening, muscle activation,  prehabilitation, soft tissue work, flexibility and mobility work to improve our athletes.  We will not be out worked nor out researched.

As strength coaches our number one priority should be preventing injury. No matter how strong or fast we can make our athletes, it is useless if they’re sitting on the bench due to an injury. I know there are many facets that we cannot control once the athlete is in the game. However, there are a number of things we can do in our training environment to “better the chances” that our athlete won’t get injured during their competition. Even more, each year one out of 100 high school female athletes and one of 10 college female athletes experiences an ACL injury. This is crazy, isn’t it? At our training facility we have a majority of the female teams and to personally think that one out of every ten women who walk through our door will have an ACL injury – outrageous.

Based on the data provided by the NCAA, we know that approximately 2,000 female athletes are expected to tear their ACL. What the means is that generally females have 8x the chance of ACL injuries compared to men. You might be asking, how the hell is this happening? Beside all the physiological differences between men & women, one of the biggest components may be the lack of hamstring strength. The NCAA also cited that an ACL surgery costs the university approximately $25,000 to repair. Can you imagine that? Not only does the athlete lose their playing season, a possible scholarship, but in a matter of a second we could cost a university $25,000. (1,2) Damn.

So we got to ask ourselves; what are we doing to stop this (or at least lower the rate of occurrences)? I can tell you a number of things what we’re doing, but if you’re up on your literature, it should come as no surprise.

Deep Front Squat.

Let’s first take a look at what usually happens when a female athlete first steps through our doors. Most will come in being extremely quad dominant. This is no surprise as the majority of their athlete careers they were probably running & jumping, kicking and all other sorts of knee dominant movements. This is great that they’re extremely strong through their quads, but whenever we tested their hamstring strength in relation to their quad strength, they’re hamstring was extremely significantly weaker.

As we know through research, the balance of power and recruitment between the quads and hamstrings is one of the most important factors of knee stability in sport. As I already stated the ratio of Q/H (Quad to Hamstring) in female athletes tend to favor more quadriceps strength than hamstrings. The difference between men & women is that women tend to be more quad dominant meaning on knee dominant exercises, females tend to engage the hamstrings first which increases stress on the ACL (1,2,3,4,5).

So the article is named, “Let’s Get Our Female Athletes Squatting Again”. With that said, now is time to start discussing what we’re doing to try to increase hamstring strength and improve that Q/H ratio. With our athletes it’s important to ensure that we’re doing everything we can to get better hamstring and glute activation and work. Whether it is the glute/ham, bodyweight hamstring negatives, leg curls, Romanian deadlifts, glute bridges, swiss-ball hamstring curls, mini-band adduction/abduction walks, etc. We make sure to use them ALL.

However, when we approach “selling” the squat to female athletes, there always seems to be some hesitation. “I don’t want my butt to get bigger”, “I don’t want to look like those women bodybuilders”,
“I only want to look toned”. Whatever the excuse may be, it’s our job to sell the squat like its the million dollar cure that is going to change their world. How can we do that? Proper queuing, coaching, psychology.

Deep Back Squat

Now at this point you might be following me and the article but is wondering about “Why Squats”. I know there are 100 ways to skin a cat and certainly a squat is merely “one tool in our toolbox”, but based on the photos provided, look at how much total muscle activation/work the squat accomplishes. The way we instruct squats is a wide stance (as research has shown to get better glute work) with intense verbal queuing to sit back, sit back, sit back (to engage more hamstring). If we’re looking for even more glute work we’ll throw a mini-band around the knees to get more RNT (Reactive Neuromuscular Training) which will slightly adduct the knees into a valgus position “queuing” the the glute med to “turn on” to abduct those knees into neutral alignment, essentially flipping the switch that allows for more glute med work.

So that is it folks. I will by no mean say that I’m an expert at this. I have probably bastardized so many concepts that it isn’t funny. However, I will say I know simply enough to be dangerous. All joking aside, whether my research, writing skills, or communication capability lacks a bit, I can say that since we focused heavily on improving the posterior chain in our female athletes, our ACL injury rate has decreased dramatically. Like I said in the beginning, it’s our job to make sure we’re doing everything we can to prevent injury in our athletes. Whether you want to include squats in your program is ultimately up to you, but you cannot neglect adding posterior chain exercises in your programming to prevent ACL injuries.

1. Adams, Erik, M.D., Ph.D., An Increased Risk of ACL Rupture in Female Athletes. Midwest Institute of Sports Medicine, Epidemiology, 2002.

2. Griffen, Letha Y., M.D., Better Understanding of ACL Injury Prevention. The NCAA News, October 2000.

3. Boden, Barry, M.D., Letha Griffin, M.D., Ph.D. and William Garrett Jr., M.D., Ph.D., Etiology and Prevention of Non-contact ACL Injury. The Physician and Sportsmedicine, v28, 4, April 2000.

4. Courdes, Laura, For Women, ACL Tears All Too Common. The DePauw.com, December 1999.

5. Mannie, Ken and Tim Wakeham, Strength Training for Female Athletes. Coach and Athletic Director, v70, 5, December 2000.

As strength coaches our number one priority should be preventing injury. No matter how strong or fast we can make our athletes, it is useless if they’re sitting on the bench due to an injury. I know there are many facets that we cannot control once the athlete is in the game. However, there are a number of things we can do in our training environment to “better the chances” that our athlete won’t get injured during their competition. Even more, each year one out of 100 high school female athletes and one of 10 college female athletes experiences an ACL injury. This is crazy, isn’t it? At our training facility we have a majority of the female teams and to personally think that one out of every ten women who walk through our door will have an ACL injury – outrageous.

Based on the data provided by the NCAA, we know that approximately 2,000 female athletes are expected to tear their ACL. What the means is that generally females have 8x the chance of ACL injuries compared to men. You might be asking, how the hell is this happening? Beside all the physiological differences between men & women, one of the biggest components may be the lack of hamstring strength. The NCAA also cited that an ACL surgery costs the university approximately $25,000 to repair. Can you imagine that? Not only does the athlete lose their playing season, a possible scholarship, but in a matter of a second we could cost a university $25,000. (1,2) Damn.

So we got to ask ourselves; what are we doing to stop this (or at least lower the rate of occurrences)? I can tell you a number of things what we’re doing, but if you’re up on your literature, it should come as no surprise.

Deep Front Squat.

Let’s first take a look at what usually happens when a female athlete first steps through our doors. Most will come in being extremely quad dominant. This is no surprise as the majority of their athlete careers they were probably running & jumping, kicking and all other sorts of knee dominant movements. This is great that they’re extremely strong through their quads, but whenever we tested their hamstring strength in relation to their quad strength, they’re hamstring was extremely significantly weaker.

As we know through research, the balance of power and recruitment between the quads and hamstrings is one of the most important factors of knee stability in sport. As I already stated the ratio of Q/H (Quad to Hamstring) in female athletes tend to favor more quadriceps strength than hamstrings. The difference between men & women is that women tend to be more quad dominant meaning on knee dominant exercises, females tend to engage the hamstrings first which increases stress on the ACL (1,2,3,4,5).

So the article is named, “Let’s Get Our Female Athletes Squatting Again”. With that said, now is time to start discussing what we’re doing to try to increase hamstring strength and improve that Q/H ratio. With our athletes it’s important to ensure that we’re doing everything we can to get better hamstring and glute activation and work. Whether it is the glute/ham, bodyweight hamstring negatives, leg curls, Romanian deadlifts, glute bridges, swiss-ball hamstring curls, mini-band adduction/abduction walks, etc. We make sure to use them ALL.

However, when we approach “selling” the squat to female athletes, there always seems to be some hesitation. “I don’t want my butt to get bigger”, “I don’t want to look like those women bodybuilders”,
“I only want to look toned”. Whatever the excuse may be, it’s our job to sell the squat like its the million dollar cure that is going to change their world. How can we do that? Proper queuing, coaching, psychology.

Deep Back Squat

Now at this point you might be following me and the article but is wondering about “Why Squats”. I know there are 100 ways to skin a cat and certainly a squat is merely “one tool in our toolbox”, but based on the photos provided, look at how much total muscle activation/work the squat accomplishes. The way we instruct squats is a wide stance (as research has shown to get better glute work) with intense verbal queuing to sit back, sit back, sit back (to engage more hamstring). If we’re looking for even more glute work we’ll throw a mini-band around the knees to get more RNT (Reactive Neuromuscular Training) which will slightly adduct the knees into a valgus position “queuing” the the glute med to “turn on” to abduct those knees into neutral alignment, essentially flipping the switch that allows for more glute med work.

So that is it folks. I will by no mean say that I’m an expert at this. I have probably bastardized so many concepts that it isn’t funny. However, I will say I know simply enough to be dangerous. All joking aside, whether my research, writing skills, or communication capability lacks a bit, I can say that since we focused heavily on improving the posterior chain in our female athletes, our ACL injury rate has decreased dramatically. Like I said in the beginning, it’s our job to make sure we’re doing everything we can to prevent injury in our athletes. Whether you want to include squats in your program is ultimately up to you, but you cannot neglect adding posterior chain exercises in your programming to prevent ACL injuries.

1. Adams, Erik, M.D., Ph.D., An Increased Risk of ACL Rupture in Female Athletes. Midwest Institute of Sports Medicine, Epidemiology, 2002.

2. Griffen, Letha Y., M.D., Better Understanding of ACL Injury Prevention. The NCAA News, October 2000.

3. Boden, Barry, M.D., Letha Griffin, M.D., Ph.D. and William Garrett Jr., M.D., Ph.D., Etiology and Prevention of Non-contact ACL Injury. The Physician and Sportsmedicine, v28, 4, April 2000.

4. Courdes, Laura, For Women, ACL Tears All Too Common. The DePauw.com, December 1999.

5. Mannie, Ken and Tim Wakeham, Strength Training for Female Athletes. Coach and Athletic Director, v70, 5, December 2000.