Jon cree

HIP$INJURY$PREVENTION$STRATEGIES:$$ FROM$THE$WEIGHT$ROOM$TO$THE$PITCH JON$CREE$MSC$GSR$ASCC$CSCS$ FMA$ANNUAL$CONFERENCE$

APPROACH$TO$THE$PROBLEM$

▪ As$an$S&C$coach….$ ▪ How$many$are$there?$ ▪ What$types?$

INJURY$STATS$(PREM$15/16$SEASON)$ $

Ref:$

INJURY$RATES$(PREM$15/16$SEASON) Hip$

Groin/Pelvis$

Hamstring$

Knee$

3$

3$

12$

22$

ASSESSMENT$OF$MOVEMENT$MECHANICS…$

BE$GOOD$AT$COACHING! ▪ Be$criIcal$of$athlete’s$technique$

▪ Hips$should$break$first$

▪ Drive$through$the$heels$

▪ Keep$the$chest$up$ $

QUAD:HAM$RATIO$ ▪ Concentric$quadriceps$and$eccentric$hamstring$strength$ ▪ ACL$injury$is$possible$due$to$the$anterior$translaIon$that$cannot$be$controlled$by$ the$weaker$hamstring$muscle$group$ ▪ AcceleraIons,$small$sided$games,$CODs$

CASE$STUDY$EXAMPLE$OF$COMMON$ISSUES$

OHS ▪ FuncIonal$movement$paXern$ ▪ Aims$to$idenIfy$restricIons$within$joints$ ▪ Provides$a$framework$from$which$to$work$

COMMON$DYSFUNCTIONS$SEEN$WITH$OHS$

CORRECT$OHS$TECHNIQUE

▪ Slow$movement$test,$but$can$be$modified$to$use$load$and$velocity$

FUNCTIONAL$ANATOMY$&$DYSFUNCTION$

MECHANICAL/$STRUCTURAL$TIGHTNESS ▪ Length$changes$such$as$shortening$can$cause$structural$changes$within$the$muscle$$

▪ Loss$of$Serial$Sarcomere$Number$(SSN)$and$increase$in$collagen$=$↓$extensibility$(Goldspink)$

▪ Leading$to$mechanical$Ightness$as$a$result$of$structural$changes$

NEUROLOGICAL$TIGHTNESS$

▪ Athlete$feels$Ight$as$muscles$cannot$be$passively$stretched$ in$rapid$fashion$through$full$ROM$(Sahrmann,$2002)$ ▪ Tight:$is$for$structurally$shortened$muscle$ ▪ “taut”$maybe$used$for$long$or$muscles$which$maybe$under$ stretch.$(Kendall,$2005)$ $

▪ May$be$a$protecIve$mechanism?$

ANTERIOR$PELVIC$TILT$

▪ RelaIve$flexibility$is$the$process$by$which$the$ body$finds$the$path$of$least$resistance$to$ moIon$(Sahrmann,$1994)$

▪ Twofjoint$muscles$which$lack$extensibility$lead$ to$excessive$ROM$else$where$in$the$kineIc$ chain$

▪ Onefjoint$muscles$that$develop$weakness$will$ allow$excessive$moIon$

ADAPTATIONS ▪ Autogenic$inhibiIon$is$the$reflex$inhibiIon$of$the$ muscles$around$a$joint$due$to$distension,$damage$or$ faulty$posiIon.$(Shakespeare$et$al$1985)$

▪ Tightness$or$lengthening$in$a$muscle$alters$segmental$ alignment$

▪ Stress$onto$a$smaller$surface$area$of$the$joint$and$ increase$the$pressure$per$unit$area$=$long$term$ degeneraIve$changes$ (Hopkins, 2000)

WEAKNESS$F$TIGHTNESS ▪ Weak$=$inhibitated$or$delayed$acIvaIon$of$a$ muscle.$ ▪ Associated$with$one$joint$muscles$–%“stretch% weakness”%(Richardson,%Jull,%Hodges%and%Hides,%1991)%$ ▪ Both$long$and$short$muscle$can$develop$ weakness$(Janda)%

▪ Structurally$short$muscle(Ight)$can$cause$ reciprocal$inhibiIon$of$the$opposing$muscle$ (weakness)$ ▪ Weakness$can$lead$to$neurological$Ightness$as$a$ possible$protecIon$mechanism$

CHRONIC$LENGTHENED$AND$SHORTENING$OF$MUSCLE$

SHORTENED ▪ SSN$is$reduced$by$up$to$20%$(Williams,$1990)$(Tabary$et$ al,1972;$Williams$&$Goldspink,$1973)$

▪ ImmobilisaIon$of$limbs$results$in$muscles$failing$to$ achieve$their$normal$lengths$Crawford$(1961)$/$Williams$ &$Goldspink$(1971)$$

▪ Weakness$due$physiological$disadvantage$

▪ Collagen$increase$

LENGTHENED

▪ SSN$increased$by$20%$(Grossman$2010)$

Normally Distributed

Loss of Sacromeres in Series

Addition of Sacromere in Series

LENGTH$TENSION$RELATIONSHIP

29$

LENGTH$TENSION$RELATIONSHIP Tension$

Length

Tightness$

Muscle$ Imbalance$ Motor$ paXern$

Weakness$

ONCE$IDENTIFIED$A/P$TILT,$WHAT$CAN$WE$DO? ▪ Programme$to$correct$alignment$ ▪ Programme$to$increase$posterior$chain$control$ ▪ At$speed/unilaterally/eccentrically$

FOAM$ROLLING$

▪ Down$regulate$overacIve$muscle$Issue??$ ▪ Reduces$fascial$adhesions$to$increase$ROM$

MOBILITY$THROUGH$STATIC$STRETCHING$

▪ IniIally!$

▪ Remember$sarcomere$length$

▪ Mobility$drills$ ▪ Hurdles$etc…$ ▪ AlternaIng$spiderman$stretch$

INTEGRATION$

▪ Unilateral$stability:$Hop$&$hold,$drop$lands,$star$excursion$drills$etc…$ ▪ Unilateral$strength:$SLBSS,$keXlebell$work,$OH$lunges$ ▪ RotaIonal$control$ ▪ CondiIoning$drills:$arching$runs$ ▪ High$impulse$loading:$Oly$lips$or$derivaIves,$Kfbox$work$ ▪ Lip$with$intent$ ▪ Provide$Imely$feedback$

THANK$YOU $ j.cree@mdx.ac.uk$ $ @J_cree$