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“Merging COACHING with SPORT SCIENCE & MEDICINE”

HIGH PERFORMANCE

SIRCuit

Haut niveau

“La fusion d’entrainement avec les sciences du sport et la médecine du sport” Fall / automne 2011

Volume 2 (1)

JASEY-JAY ANDERSON Talks about his journey to gold. Nous parle de son voyage à la médaille d’or.

Sport Research Intelligence sportive

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SIRCuit Volume 2 (1) Fall / automne 2011


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If Issue Number 1 is any indication – WOW – this is first class. Dave Pym, Managing Director Canadian Snowsports Association

Great work on this. Congratulations. We look forward to continuing the partnership. Alex Baumann, Chief Executive Officer Own the Podium

Thanks very much for the High Performance SIRcuit….it is very well done!! Excellent information and delivery format. Vicki Harber, Faculty of Physical Education & Recreation University of Alberta HP SIRCuit is partially funded by

Editor Creative Director Design team Content Director

Debra Gassewitz David Roberts Kim Sparling Nancy Rebel

Contributing Editor Contributors Special Thanks

Dr. Jon Kolb, OTP Ryan Van Asten Dr. Ben Sporer Rob Gathercole Dr. Charles H. Samuels Dr. Jason Vescovi Scott Livingston Damien Moroney Allan Wrigley Leo Thornley Heather Hynes Judy Goss Bruce Craven Willem Meeuwisse Matt Jordan Cara Thibault, OTP Paul Dorotich, OTP

Sport Information Resource Centre (SIRC) is Canada’s national sport library, established over 35 years ago. Centre de documentation pour le sport (SIRC) est la bibliothèque nationale du sport au Canada fondée il y a plus de 35 ans. Mailing address: SIRC 180 rue Elgin Street, suite 1400 Ottawa, Ontario, Canada K2P 2K3 Tel: +1 (613) 231-7472 Fax: +1 (613) 231-3739 Disclaimer: Author’s opinions expressed in the articles are not necessarily those of SIRCuit, its publisher, the Editor, or the Editorial Board. SIRC makes no representations or warranties whatsoever as to the accuracy, completeness or suitability for any purpose of the content. Avis de non-responsabilité: les opinions exprimées dans ces articles n’engagent ni SIRCuit, ni l’éditeur, ni le distributeur, ni le comité de rédaction. Le SIRC ne donne aucune garantie ni ne fait aucune déclaration quant à la qualité, à l’exactitude ou au caractère exhaustif de son contenu. Copyright © 2011 SIRC. All rights reserved. No part of the publication may be reproduced, stored, transmitted, or disseminated, in any form, or by any means, without prior written permission from SIRC, to whom all requests to reproduce copyright material should be directed, in writing. © 2011 SIRC. Tous droits réservés. La reproduction, le remisage, la transmission ou la diffusion en tout ou en partie de cet article sous quelque format que ce soit est interdit sans avoir obtenu au préalable la permission écrite du SIRC. Les demandes de reproduction de tout document protégé par droit d’auteur doivent être adressées par écrit au SIRC.

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Editorial This latest issue of the HP SIRCuit is packed with cutting edge high performance knowledge for both coaches and the sport scientist. Be sure to review Dr Chuck Samuels, first in a three part series, on sleep-recovery and human performance. Long term planning is critical for successful research projects. Dr. Jason Vescovi, a physiologist with the Canadian Sport Centre Ontario, presents the innovative work he has developed utilizing GPS for training and competition in women’s soccer. The timing is now to plan for application of this technology for many team sports as we look beyond London to Rio in 2016. Coinciding with the flurry of national activity on talent identification and development, Nancy Rebel shares an extensive literature review on the topic. And be sure to view the interview with JaseyJay Anderson.......even more exciting now that he has come out of retirement! Many thanks for your continued support, and we look forward to your comments and suggestions as we work towards the merger of the art of coaching with the science of sport. Cheers Jon Kolb, PhD Director, Sport Science, Medicine and Innovation Directeur, Sciences du sport, Médecine et l’innovation Debra Gassewitz President & CEO SIRC

Contents

Performance Performance 4 8

Off-season Physical Preparation for the Elite Athlete Optimizing the Warm-Up

12 15 16

Sleep, Recovery, and Human Performance CAMP launches EMR at PanAm Games in Guadelajara Women’s Field Sports - Understanding Demands with GPS technology

22

Talent Identification and Development

Sport Innovation

Competitive Intelligence

Proactive & Preventative Medicine 26

Building More Efficient, Effective and Resilient Athletes

Departments 20 24 25 31 32

Athlete Focus - Jasey-Jay Anderson Stay Informed with SIRC Upcoming Events Recommended Readings from SIRC IST Journal Club 3

SIRCuit Volume 2 (1) Fall / automne 2011


Performance Off-season Physical Preparation for the Elite Athlete Ryan Van Asten

Abstract

The off-season is one of the most important periods of time when preparing an athlete to compete at the highest-level deep into the long competition schedule. This training lays the groundwork from which to build to have a successful, injury-free season and career. The topics covered in this article will include physical testing and when it should implemented, various methods of training periodization, the specific components of physical training and recovery, and athlete monitoring throughout the off-season. Although the main topic of discussion surrounds physical preparation for the elite athlete, many of the testing and training techniques described can also be applied to a broad range of skill level and are not specifically reserved for athletes at the highest level of competition.

Résumé

La période hors-saison est l’une des plus importantes périodes de l’année quand il s’agit de préparer un athlète à performer au plus haut niveau tout au long de son programme de compétitions. Cette période permet d’installer les assises d’une saison fructueuse et d’une carrière couronnée de succès, et ce, à l’abri des blessures. Dans cet article, on traite de l’évaluation physique et du moment propice à sa réalisation, des diverses méthodes de périodisation de l’entraînement, des composantes spécifiques de l’entraînement physique et de la récupération ainsi que du suivi de l’athlète tout au long de la période hors-saison. Même si le principal thème de cet article porte sur la préparation physique de l’athlète de haut niveau, la plupart des techniques d’évaluation et d’entraînement présentées sont exécutables par des athlètes de divers niveaux d’habiletés; les techniques ne sont pas seulement à l’intention des athlètes qui performent au plus haut niveau.

P

Physiological and Performance Testing

rior to commencing the off-season training plan each individual athlete should be assessed in areas of anthropometry (body composition), biomechanics and movement quality, general performance, and physiological variables relevant to the sport in question. These assessments are important for a number of reasons including: observation of the physical ‘starting’ point in which to build and guide the offseason training plan, identifying areas of weakness or concern, and tracking the athlete’s long term progress from month to month and year to year.

muscle mass, which is important in an elite setting. Measurement of muscle is more time consuming and often requires a skilled anthropometrist to conduct the measurements.

Biomechanics and Movement Quality Today, strength coaches are realizing the importance of movement quality and how it relates to injury prediction and possibly athletic performance. Assessing movement quality, however, can be difficult to objectively measure. The coach needs to identify the differences between the fundamental biomechanical principles of the movement (i.e. technique) and the athlete’s individual style of performing the movement. A Anthropometry Anthropometry is the science that deals with measurement simple screen, known as the Functional Movement Screen of size, weight, and proportions of the human body. There (FMS), can add an element of objectivity to assessing movement are several ways to determine the composition of the body, technique in certain fundamental patterns. This screen cannot which include: underwater weighing, dual-energy x-ray predict athletic performance, but can give the coach a good absorptiometry (DEXA), skinfold measurement of subcutaneous idea of where certain deficiencies and imbalances lie within the fat, bioelectrical impedance analysis, magnetic resonance individual athlete. To take the concept of the movement screen a imaging, and ultrasound technology. When athlete numbers step further, we as coaches need to identify where the individual are high the skinfold measurement method is the most practical athlete lies on a normal curve and assess their mobility, stability, and provides reliable data provided the tester is experienced. and motor control on a daily basis relative to their training There are a number of different methods in determining body fat load. If the athlete falls outside of their ‘normal’ they will be through skinfold measurement, all with pros and cons, but the at a greater risk of injury. This type of screen is referred to as Jackson and Pollock seven-site test (triceps, pectoral, midaxilla, the Quotidian Movement Screen (QMS) – See video by Matt subscapula, abdomen, suprailiac, and quadriceps) is very simple Jordan of the Canadian Sport Centre – Calgary on the QMS and and effective in determining adiposity of an individual 1. This how it is implemented. technique, however, does not provide a direct measurement of www.sirc.ca

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See video by Matt Jordan of the Canadian Sport Centre – Calgary on the QMS and how it is implemented.

Performance Testing The performance testing battery should be specific to the requirements necessary to demonstrate success at the given sport. The coach needs to evaluate these specific physiological and performance needs and design the testing battery to satisfy them. Specific performance variables include: muscular power, muscular strength and endurance, speed, energy systems, flexibility/mobility, and sport specific to name a few. A number of different methods or tests can be used to evaluate each variable and they can be tracked over time to ensure continued athletic progress and also be used as evaluation criteria.

Here is a general breakdown of the warm-up protocol: 1. Progressive intensity aerobic activity 2. Inhibition (i.e. self myofascial release) a. Maintenance of tissue quality and allow mobility work to be more effective. 3. Mobility/Flexibility a. Mobilizing or maintaining mobility joints that require a certain range of motion. b. Maintenance of optimal tissue length. 4. Muscle Activation a. ‘Turn’ the inhibited muscles back ‘on’ before higher intensity dynamic movements. b. Proper mechanics, movement patterns, and muscle sequencing reinforced. 5. Dynamic Movement a. Integration into whole body movement patterns. b. Progressive - starting with low intensity movements (i.e. body weight squatting and lunging) building up to higher intensity movements such as marching, skipping, jumping, sprinting, and rapid response activities (often called neural preparation). c. Opportunity to coach the athlete in terms of proper biomechanics and body posture.

Movement Training The main goals of the movement session are to develop movement efficiency, speed, and power in areas that mirror the demands of the sport and are tailored to the athlete’s individual needs. Typically the movement sessions have a linear or multidirectional focus and are broken down into movement skill training (i.e. technique) and movement application (i.e. Off-Season Training Off-season training can take on many forms and directions. force and power production). These are progressive in nature There is no ‘right way’ as there are numerous methods to to allow the athlete to master movement skills and techniques at low velocity and low technical demand achieve the same results. The key is that (i.e. programmed drills). As the sessions these results are achieved by designing progress throughout the off-season the a program that fits your philosophy and technical components become more your athletes’ needs. That being said, difficult, the velocity increases, and the training program should include the elements of randomness are incorporated following variables: warm-up, movement to prepare the athlete for their sport. Far training, power and strength training, too often coaches will implement speed, energy systems training, sport specific agility, quickness, and plyometric drills training, and regeneration and recovery. with high velocities and multiple changes in direction when the athlete is not able Warm-Up to perform these movements efficiently. The warm-up is essential for preparing This aspect of training is no different than the body to perform at the highest level any other and needs to progress gradually possible while minimizing risk of injury. with each drill and session building off It should be progressive in nature (i.e. low the previous and be appropriate for the intensity to higher intensity), be specific individual’s skill level. to the training to follow (i.e. for a linear movement training session the warm-up Strength and Power Training should prepare the athlete to move in a Development of appropriate strength and linear fashion), and also be a time where power qualities to support the individual’s corrective exercises can be done if any needs is a requirement of every successful deficiencies exist. www.sirc.ca

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SIRCuit Volume 2 (1) Fall / automne 2011


• • • •

of the movement. Often thought of as the most important quality in sport performance. Starting strength is the speed with which the neuromuscular system develops force from zero velocity. Explosive strength is the ability to continue to develop the already initiated force. Reactive or elastic strength is the ability to change from eccentric to concentric muscle action 3.

Strength/Power Endurance Facts: • Strength endurance is the capacity to resist fatigue during repeated contractions with loads greater than 30% of maximum concentric strength. • Power endurance is the ability to sustain high levels of power output.

Table 1. Various loading and programming parameters associated with the different strength and power qualities.

off-season program. Specific strength and power qualities include: muscle hypertrophy/muscle mass, maximal strength, power, and strength/power endurance. Muscle Hypertrophy Facts: • Muscle hypertrophy is characterized by an increase in the size of the muscle cells. • The cross-sectional area (CSA) of the muscle is directly related to the force generating capacity of the muscle. • Increase hypertrophy of all fibre types, but fast twitch muscle fibres have the greatest potential for growth. Maximal Strength Facts: • Maximal strength is the maximum force developed by a muscle or muscle group in a single voluntary contraction and is irrespective of time. • Increases in strength at the beginning of training not in proportion with increases in hypertrophy. • Improvements in intermuscular coordination (coordination between muscle groups) and intramuscular coordination (coordination within a muscle, i.e. rate of motor unit firing, number of motor units recruited, motor unit synchronization) account for much of the initial increases in maximal strength 2. Power Facts: • Power is the force produced multiplied by the velocity

Principles of Strength and Power Training One of the keys to strength and power training is mastery of the basic movement patterns (i.e. squat, deadlift, upper body push, and upper body pull) before progressing to more complicated movements. If the athlete masters these basic patterns the program will be successful. The main priority in the strength and power program should be compound movements involving multiple joints and large muscle groups and the assistant lifts should target areas of weakness or secondary physiological priorities. In general, the exercise order should go as follows: Fast to slow, hard to easy, and multi joint to single joint 4. Table 1 outlines the various loading and programming parameters associated with the different strength and power qualities. Energy Systems Training When it comes to energy systems most think of either the aerobic or anaerobic in a general sense. However, these global systems can be broken down further into aerobic capacity, aerobic power, lactate capacity, lactate production, and pure speed. Sport requirements need to be determined in order to prescribe the appropriate energy systems training to meet those needs. Table 2 gives a comprehensive outline of the specific qualities and recommendations for duration, repetitions, and rest and the primary outcomes of each type. Sport Specific Training Sport specific training is essential to mastery of the skills required to achieve elite status in the given sport. The type of specific

Table 2. Energy system training recommendations.

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training is normally guided by the expertise of the technical coach for the sport. For example, the Canadian National Luge team completes a number of one to two week blocks of sport specific training (i.e. flat ice start training, wheel sliding, start ramp training, and start training on a track with a wheeled sled) where the emphasis is on the technical and physiological components specific to the sport of Luge. During this period, minimal time is spent training in the general areas of strength and conditioning. Recovery and Regeneration The off-season training schedule for many elite athletes is extremely demanding both physically and mentally. Recovery and regeneration techniques between sessions and training days are essential in order to have the highest quality training possible. Factors Affecting Recovery Post-Training There are several factors that can affect recovery post training, below are some of the most common: 1. Metabolic Disturbances
- Increases in lactate and associated hydrogen ion (controversial evidence on effects)
- Oxidative stress (radical formation) 2. DOMS (Delayed Onset Muscle Soreness)
- Pain normally occurring 1-2 days post-exercise 3. Nervous system changes/disruptions 4. Nutrition (Pre, During, and Post Training)
Rehydration, protein and carbohydrate intake, other supplementation 5. Inflammation in Muscle
- May impair muscle repair and adaptation (mechanisms not completely known) 6. Imbalance between stress and recovery over time
Previous recovery may not have been enough relative to the amount of stress on the system. Although this area of research is relatively young, the list below outlines several modalities that have been shown to have benefit in various areas of recovery: 1. Massage/Self Myofascial Release 2. Active Recovery (i.e. light aerobic activity, dynamic movement patterns) 3. Cryotherapy (i.e. cold water immersion) 4. Contrast Temperature Water Immersion 5. Compression 6. NSAIDS (nonsteroidal anti-inflammatory drugs) 7. Stretching 8. Electromyostimulation (EMS) These recovery methods should be structured and periodized in a way that optimizes the outcome of the program. For example, during periods of high muscle adaptation (i.e. muscle hypertrophy training), the inflammatory response to the training is often beneficial to the adaptation itself and therefore eliminating this inflammation may attenuate the very muscle adaptation you were hoping for. www.sirc.ca

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Athlete Monitoring Monitoring is an essential piece of the off-season training program and should be done on a daily, weekly, and/or monthly basis. This will help determine whether the off-season training program is having the desired effect on the individual athletes. Daily monitoring modalities include: 1. Quotidian Movement Screening (QMS) 2. Daily Training forms – sleep quality the previous night, training duration, rating of perceived exertion, indicator exercises, and post-training nutrition 3. Training log or diary 4. Daily analysis of life demands for athletes (DALDA) form 5. Monitoring of submaximal and maximal heart rates during and after training Weekly monitoring modalities include: 1. Hooper and MacKinnon (HMK) psychological and physical fatigue questionnaire 2. Specific gravity testing in conjunction with the HMK 3. Force and power monitoring using force plates 4. Weekly nutrition logs 5. Heart rate variability monitoring 6. Rusko test for overtraining Monthly monitoring modalities include 1. Body Composition 2. Blood analysis 3. Performance testing

Conclusion

The off-season is one of the most important times of the year for athlete preparation. A coach once told me, “The off-season is where champions are made”. To become a champion the athlete must become great at the basics, a process that takes years of hard work and dedication to achieve. The process of building champions involves following an appropriately periodized plan including an initial evaluation, properly structured training, and continuous monitoring and with these characteristics anything is possible. ∆ For references, click here

Ryan holds a Master of Science in Neuromuscular Physiology (University of Calgary), Bachelor of Science - Life Sciences (Queen’s University), and a Bachelor of Physical and Health Education (Queen’s University). He is a Certified Strength and Conditioning Specialist (NSCA), a Certified Exercise Physiologist (CSEP), and an NCCP Level 1 coach: Coaching Theory and Technical Olympic Weightlifting.

SIRCuit Volume 2 (1) Fall / automne 2011


Performance Optimizing the Warm-Up Dr. Ben Sporer MSc CSCS Rob Gathercole

Abstract

The purpose of a warm-up is to prime the body for impending exercise or competition. In reality, most warm ups are often based on commonly accepted practices within a sport rather than on desired physiological responses. As such, achieving optimal state of readiness can be limited by the strategies used. The sport specific characteristics of warm up strategies should be dictated by the physiological, neurological, and psychological demands of competition. With a focus on physiology, there are a number of responses following a warm-up that are well accepted. These include but are not limited to increases in muscle temperature, alterations of metabolic function, and elevations in baseline levels of oxygen consumption. To complicate matters, the physiological state of readiness can be influenced by environmental and logistical factors beyond an athlete‘s control. By taking into account the intensity and duration of warm-up, as well as the amount of recovery allowed between warm-up cessation and the onset of performance, these concerns can be largely managed. Where issues do exist, careful prior planning and the use of strategies such as micro warm-ups may prove useful. The purpose of this paper is to identify challenges that are faced and provide solutions in order for warm-up responses to be optimised.

Résumé

Le but de l’échauffement est de préparer l’organisme à l’exercice physique ou à la compétition. Cependant, la plupart des méthodes d’échauffement sont basées sur des pratiques courantes dans une discipline donnée et non sur des ajustements physiologiques recherchés. Dès lors, la préparation optimale de l’organisme dépend donc des méthodes utilisées. Les méthodes d’échauffement pour une discipline donnée devraient donc être dictées par les exigences psychologiques, neurologiques et physiologiques de la compétition. Sur le plan de la physiologie, certains ajustements de l’organisme au cours de la période d’échauffement sont bien admis : augmentation de la température des muscles, modifications des fonctions du métabolisme et augmentation de la consommation d’oxygène de repos. Pour complexifier le tout, l’état de préparation physiologique peut être conditionné par des facteurs environnementaux et par la logistique, ce qui n’est pas du ressort de l’athlète. Il est possible de composer avec ces facteurs en tenant compte de l’intensité et la durée de l’échauffement ainsi que la durée de la période séparant la fin de l’échauffement du début de la compétition. Quand il y a des problèmes, une planification prudente et des méthodes d’échauffement écourté peuvent s’avérer utiles. Cet article se propose de présenter les défis actuels et des solutions pour optimiser les ajustements à l’échauffement.

W

arming up is common to nearly all sporting activities with strategies typically based on the trial and error experiences of athletes and coaches 1. Although these can be effective, it is recommended that they be dictated more by the physiological and psychological demands of the specific characteristics of a sport. The purpose of this article is to focus on the physiological components of a warm-up, highlight the desired responses, and provide strategies for optimising the effectiveness of a warm-up. For the sake of clarity; the use of the term warm-up in this article refers to the use of an active process where it is exercise that is used to induce physiological change prior to activity2.

Physiological responses to a warm-up

It is perhaps not surprising that warming up results in an actual increase in body temperature. This is primarily due to an www.sirc.ca

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elevated conversion of chemical energy to mechanical work in the muscle in order to meet the demands of physical activity. This response produces a number of physiological changes that can improve subsequent performance. Elevated muscle temperature can affect the body in a variety of ways (Table 1) and although some of the effects on performance may be small2, small changes at the elite level can have a significant impact on results. Increased muscle temperature enhances muscle contractile speed through decreased muscle stiffness and joint resistance to movement 3-4, as well as accelerated neural signalling 2-3 . The relationship between muscle temperature and jump height is well established – the cooler the muscle, the poorer the performance3. Higher body temperatures also increase muscle blood flow5, the rate at which oxygen is released by the red SIRCuit Volume 2 (1) Fall / automne 2011


Warm-­‐up effects  

Temperature-­‐ specific

Decreased muscle  and  joint  resistance  

each of these factors in order to optimise the performance state. Physiological Neurological  

Greater release  of  oxygen  from  blood  to  muscles  

Speeding-­‐up of  metabolic  reactions  

Improved nervous  system  function  

Increased contractile  force  (PAP/Non-­‐PAP)  

Increased muscle  blood  flow  

Enhanced muscle  activation  

Increased oxygen  consumption  

  

 

Table 1. Advantageous responses to a warm-up and their primary causes

blood cells and utilised by the muscle2, and enzyme activity5. These changes can have significant performance implications by raising oxygen consumption levels early in competition. This decreases anaerobic energy use in this period6, and so vital energy stores are conserved for later in performance. A warm-up also induces a number of other advantageous physiological responses (Table 1). Warming up can change metabolic function through increases in muscle blood perfusion and elevated blood lactate levels6. Increased blood lactate concentrations may not seem beneficial to performance, however a slight acidaemia prior to exercise is associated with increased time to exhaustion in supra-maximal trials6. Neurologically, a warm-up can increase muscle recruitment in subsequent activity7. The metabolic demand (e.g. energy stores) on individual muscle fibres thereby decreases as more of the muscle is used at a given workload6. Another neurological adaptation is post-activation potentiation (PAP). This effect results from the performance of maximal contractions and can temporarily improve muscle performance8. Performance in power events, for example, is considered to improve when a maximal back squat is performed prior to activity9. It is clear that a number of advantageous physiological responses can result from warm-up. Although neurological function also undergoes some ‘tuning’, these effects are linked mainly to increased muscle temperature and metabolic changes which serve to increase oxygen consumption, preserve anaerobic energy stores and enhance the ability of a muscle to perform. The important question is how to structure the warm-up .

Warm-up Intensity and Duration All physiological, neurological and thermal warm-up responses are influenced by the intensity of warm-up. Since warmup duration is dependent upon the intensity and the desired response, both elements shall be discussed together. Muscle temperature is directly related to the intensity of exercise being performed 2. The higher the warm-up intensity, the quicker muscle temperature increases with the maximum intensity of the warm-up governed by the demands of the sport and the need to minimise fatigue (acidaemia, fuel supply, etc). Warm-up duration consequently requires adjustment to provide sufficient time to achieve the desired effects while avoiding those that are unwanted. For short term performance, high energy phosphate fuel stores in the muscle are of limited supply and while higher intensity activities increase muscle temperature faster, they also deplete fuel stores quicker10 and result in increased muscle acidaemia11. Fortunately lower intensity exercise can achieve muscle temperature increases without depleting these fuel supplies. In practice, at least 10-15 minutes of continuous exercise at 60-70% heart rate maximum (HRmax) has been found to increase muscle temperature by 2-3°C (Figure 2 unpublished data). Warm-up intensity also influences the extent to which the body is primed metabolically (i.e. – increased oxygen uptake and utilisation, enhanced blood flow, enzyme activity). To elevate these factors prior to moderate to long duration exercise, the intensity needs to be sufficient enough to do so at a rate that would benefit subsequent performance (at least 70-80% HRmax). Increases in oxygen consumption do not occur immediately6 and so a warm-up should be of long enough duration for the body to be able to match oxygen supply to its demand. The caveat though is that performance can be limited following an inappropriately long or unsuitably high intensity warm-up through a reduction in energy stores10. Similar to high energy phosphates for short-term performance, reducing glycogen stores in a warm-up for moderate and long-term efforts will cause subsequent performance to deteriorate sooner than it

Warm-up structure

It goes without saying that in order to structure a warm-up appropriately, sufficient understanding of the physiological and neurological demands of the performance is needed. With this information, the warm-up strategy can be tailored to the variables with the greatest impact (Figure 1) on the desired outcome (Table 2). Development of the warm-up strategy will require coaches, athletes, and practitioners to carefully balance www.sirc.ca

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Figure 1. Variables impacting the quality of the warm-up.

SIRCuit Volume 2 (1) Fall / automne 2011


Warm-­‐up responses  

Desirable

Short-­‐term Intermediate   Long-­‐term   performance   performance   performance  

Improve muscle  temperature  

Enhance muscle  force  output  

Increase muscle  activation  

Increase oxygen  availability  

Undesirable

Energy store  depletion  

Increased thermoregulatory  strain  

 

strategy to improve the readiness of an athlete to perform both neurologically and psychologically. From a physiological point of view, as long as these activities do not induce fatigue, or increase the likelihood of fatigue in competition, then they could be a useful warm-up component. Additionally, if a PAP response is desired, then the maximal movement performed should involve a movement specific to the activity. Warm-ups including task specific movements are often referred to as functional warm-ups. Although this makes intuitive sense, it is important that one does not confuse functional movement with physiological function. If too much focus is placed on the specificity of movement, the possibility exists that some beneficial physiological aspects of a warm-up can be missed.

Table 2. The desired warm-up responses according to activity duration.

would had energy stores been more conserved, clearly reducing exercise capacity. Neurological changes meanwhile, specifically improvements in contractile force via PAP, are only likely if the prior ‘activating’ activity was performed at near-maximal or higher intensities9. This concern, equally relevant to warm-up duration, highlights the importance of optimising the intensity of a warm-up so that only the desired responses present themselves.

Length of Recovery

The length of recovery following a warm-up is important for optimising the responses elicited. When designing a warm-up one needs to consider the time course of the various responses returning to baseline. Delicate balance is required to maintain the beneficial effects of warm-up while providing sufficient time for the potentially negative responses (energy store depletion) to recover. Short-term performance is dependent upon muscle temperature, high energy phosphate stores 10 and PAP 9. Muscle temperature following warm-up typically returns to baseline within 15-30 minutes (Figure 2). However, energy stores are likely to be reduced immediately following warm-up. Muscular fatigue will also mask any effect resulting from PAP unless sufficient recovery is allowed, considered to be 8-12 minutes following the maximal contraction9. Careful adjustment of the recovery period is therefore required to optimise energy stores whilst maintaining muscle temperature at sufficient levels and maximising any potentiation effect.

Environmental conditions

Environmental factors can affect physiological function. Shortterm performance is heavily influenced by muscle temperature, and so performance may be positively affected by a hot environment, but impaired by a cold one3. Figure 2 highlights the rate of muscle temperature decay once warm-up has stopped in a cool environment (10°C). Within 5-minutes of warm-up completion, muscle temperature begins to drop. The rate at which these changes in muscle temperature occur is influenced by the thermal gradients from muscle to skin to clothing to environment. In winter sport environments, the gradients can be significant with sub-zero environmental temperatures common and muscle temperature >35°C. Our work with the 2010 OTP Top Secret Program has shown that in -10°C, this decay can occur within 10 minutes even with winter clothing worn. Furthermore, the effect is amplified by body composition with leaner athletes experiencing more rapid decreases in muscle temperature. If competition isn’t occurring within 10 minutes, performance is likely sub-optimal. In warm environments, muscle temperature will likely be warmer to begin with, increase faster, and decrease slower which may allow warm-up strategy to be modified to include more prior-competition recovery. Hot environments can also hamper long-term performance

Long duration activity, and to a lesser extent moderate duration activity, require oxygen consumption to be raised. The recovery period should therefore be short enough so that oxygen consumption is still elevated at the onset of activity.

Specificity

Warm-up specificity refers to the performance of task-specific movements within the warm-up protocol. This is a useful www.sirc.ca

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Figure 2. Sample change in muscle temperature over 55 minutes of rest, exercise and recovery at 10°C. (0-10 minutes baseline sitting; 10-25 minutes of submaximal cycling @ 70% HRmax; 25-60 minutes of sitting).

SIRCuit Volume 2 (1) Fall / automne 2011


Athlete area  spacing  

Temp.  range  of  -­‐25°C  to  +5°C  

Location  of  event  

Staging  area  exposure  

Distance  of  course  from  chair/lodge  

Infrequency  of  heating  tent  

Ability  to  get  from  bottom  to  top  

Clothing  (warmth  vs.  perf.  vs.  style)  

Start  area  spacing  

Culture  of  the  sport  

Need  to  be  in  staging  area  5-­‐10  min  

Athletes  sitting  in  snow  

Delays  (event  and  individual  run)  

Distractions  (social  vs.  performance)  

Figure 1 again highlights the influence that such issues can have on the physiological responses achieved through warming up. If, for example, the time between warming up and performance is extended for a significant period then muscle temperature will return to baseline values. These results suggest that this can occur within 20-30 minutes in the environment in which the data was collected.

Table 3. Barriers to achieving optimal warm-up in various winter sports.

by excessive elevation of core temperature during warm-up. It is important that the warm up duration and intensity are tailored to minimize this effect. Different warm-up strategies should therefore be adopted when changes in conditions occur. Dramatic changes are not necessarily required, with simple tweaks to warm-up structure generally sufficient. Examples of a modification would include increasing the duration and reducing the recovery time of a warm-up in a cold environment. Care should always be taken when adjusting warm-up intensity and duration in response to environmental challenges to ensure the desired results are achieved.

Logistical issues

Logistical considerations are factors affecting warm-up effectiveness that are related to the activity or competition. Some examples from select winter sports are included in Table 3. Issues such as these can be encountered regularly during competition and will influence the physiological condition that an athlete will begin performance.

References: 1. Hajoglou A, Foster C, De Koning JJ, Lucia A, Kernozek TW, Porcari JP. Effect of warm-up on cycle time trial performance. Med Sci Sports Exerc. 2005 Sep;37(9):1608-14. 2. Bishop D. Warm up I: potential mechanisms and the effects of passive warm up on exercise performance. Sports Med. 2003;33(6):439-54. 3. Racinais S, Oksa J. Temperature and neuromuscular function. Scand J Med Sci Sports. 2010 Oct;20 Suppl 3:1-18. 4. Skof B, Strojnik V. The effect of two warm-up protocols on some biomechanical parameters of the neuromuscular system of middle distance runners. J Strength Cond Res. 2007 May;21(2):394-9. 5. Brunner-Ziegler S, Strasser B, Haber P. Comparison of metabolic and biomechanic responses to active vs. passive warm-up procedures before physical exercise. J Strength Cond Res. 2011 Apr;25(4):909-14. 6. Jones AM, Koppo K, Burnley M. Effects of prior exercise on metabolic and gas exchange responses to

Dr Ben Sporer is an applied sport physiologist working in high performance sport in Canada for the last 13 years. He is currently a consultant and has held positions of Senior Physiologist and Lead of Performance Preparation with the Canadian Sport Centre Pacific over the last 10 years. Ben is also a partner physiologist with the Own the Podium Top Secret program focusing on warm up optimization.

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Situations such as these should be planned for prior to competition, with strategies utilised to lessen their impact. One such strategy is the use of ‘micro’ warm-ups which involve quick bursts of activity with the intention of sustaining the physiological responses achieved through the initial warm-up. Our experience has found that techniques such as these are very useful in improving the perceptions of performance readiness in athletes immediately before performance.

Summary

It is clear that a warm-up appropriate to the activity being undertaken can improve performance. To maximise the responses, a warm-up should be structured according to a sound physiological rationale10 in addition to previous experiences. The primary focus in short-term performance should be on increasing muscle temperature whilst allowing energy store restoration. Warm-up’s for intermediate and long-term performance should increase oxygen consumption but minimise energy store usage, whilst warming up for long-term performance should also attempt to avoid unnecessary core temperature increases. By understanding the physiological bases behind warming up in your activity and structuring the warm-up accordingly the chances of an athlete beginning performance in an optimal state can be improved dramatically. ∆

exercise. Sports Med. 2003;33(13):949-71. 7. Layec G, Bringard A, Le Fur Y, Vilmen C, Micallef JP, Perrey S, Cozzone PJ, Bendahan D. Effects of a prior high-intensity knee-extension exercise on muscle recruitment and energy cost: a combined local and global investigation in humans. Exp Physiol. 2009;94(6):704-19. 8. Esformes JI, Cameron N, Bampouras TM. Postactivation potentiation following different modes of exercise. J Strength Cond Res. 2010 Jul;24(7):1911-6. 9. DeRenne C. Effects of Postactivation Potentiation Warm-up in Male and Female Sport Performances: A Brief Review. Strength and Conditioning Journal. 2010;32(6):58-64. 10. Bishop D. Warm up II: performance changes following active warm up and how to structure the warm up. Sports Med. 2003;33(7):483-98. 11. Bishop D, Bonetti D, Dawson B. The influence of three different warm up intensities on sprint kayak performance in trained athletes. Med Sci Sports Exerc 2001;33(6):1026-32

Rob Gathercole is a PhD student in Exercise Physiology at the University of Victoria, BC. Prior to arriving in Canada, he completed his BSc (Hons) in Sport and Exercise Science and MSc in Sport and Exercise Nutrition at Leeds Metropolitan University, UK. Alongside his studies, Rob is also involved with both the Canadian Sport Centre Pacific and the Sport Innovation Centre.

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Sport Innovation Sleep, Recovery, and Human Performance Developing a Comprehensive Psychometric Sleep Screening Program for Canadian Athletes Charles H. Samuels, MD, CCFP, DABSM

Abstract

Sleep extension and circadian rhythm research have provided objective evidence indicating that the amount and quality of sleep, as well as the circadian timing of sleep and activity, are important factors that determine an athlete’s ability to train and recover. More importantly, the ability of coaches to maintain the volume and intensity of training regimens over the lifecycle of the athlete are a function of the recovery process. In an effort to understand the relationship of the sleep to the recovery process, the Canadian Sport Centre Calgary, University of Calgary Sport Medicine Centre, and Own the Podium have collaborated with the Centre for Sleep and Human Performance to develop a comprehensive sleep and recovery research program. A pilot sleep screening project prior to the Vancouver 2010 Olympics revealed an unexpected high prevalence of poor sleep quality among the athletes. In response to this finding, a research protocol was designed to develop a valid and reliable sleep screening tool – the Athlete Sleep Screening Questionnaire (ASSQ). The research would also provide sleep and recovery education to the ISTs and athletes, and deploy sleep screening to all teams and athletes across the country. This article will summarize the work to date and provide the future plans for research and clinical application of this project.

Résumé

Les études sur le prolongement du sommeil et le rythme circadien fournissent des informations probantes sur la quantité et la qualité du sommeil de même que sur le choix du moment de l’activité en fonction des étapes du sommeil; ces facteurs déterminent la capacité d’entraînement et de récupération d’un athlète. Fait à noter, la capacité des entraîneurs à maintenir le volume et l’intensité des régimes d’entraînement tout au long du cycle biologique est une fonction du processus de récupération des athlètes. Afin de comprendre la relation entre le sommeil et le processus de récupération, le Centre canadien multisport de Calgary, le Centre de médecine du sport de l’Université de Calgary et l’organisme À nous le podium ont travaillé de concert avec le Centre du sommeil et de la performance humaine dans l’élaboration d’un programme de recherche sur le sommeil et la récupération. Une étude pilote dans le cadre d’un projet de dépistage précédant les Jeux olympiques de Vancouver 2010 révèle une forte prévalence de piètre qualité de sommeil chez les athlètes. En réaction à cette observation, des chercheurs ont mis au point un protocole de recherche pour développer un outil fiable et valide pour le dépistage de la qualité du sommeil : le Questionnaire de dépistage de la qualité du sommeil chez l’athlète (ASSQ). La recherche a aussi pour objectif de donner de la formation en matière de sommeil et de récupération aux équipes de soutien intégré et aux athlètes et d’étendre le dépistage de la qualité du sommeil aux athlètes et aux équipes dans tout le pays. Cet article présente le bilan des travaux effectués jusqu’à ce jour et donne des pistes de recherche ultérieure et d’applications cliniques.

T

he relationship between sleep and post-exercise recovery (PER) and performance in elite athletes has become a topic of great interest because of the growing body of scientific evidence confirming a link between critical sleep factors, cognitive processes, and metabolic function. There is interest within the sport science community in understanding the effect of sleep and circadian rhythms on athletic performance, recovery, and regeneration.1 Sleep extension and circadian rhythm research have provided objective evidence in well designed studies in support of this focus.2-4 The amount and quality of sleep, as well as the timing of the sleep period, are considered to be important factors that affect an athlete’s ability to train, maximize the training response, and recover.5

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The Role of Sleep in the Recovery Process

Insufficient sleep and inadequate PER are collectively characterized by a perceived state of mental impairment and physical exhaustion. The physical symptoms (e.g., staring blankly, eyes going in and out of focus, head nodding) and cognitive symptoms (e.g., negative mood, slips and lapses, impaired problem solving)6 of poor recovery are numerous and can increase in severity until reaching the point where the individual strains to retain normal functions. To the elite athlete, inadequate recovery which dampens their ability to stay on task, to focus, and perform with optimal discipline can be the crucial factor between winning and losing. Sleep extension studies have added solid foundation to the importance of sufficient recovery sleep on athletic performance. A recent study by Mah SIRCuit Volume 2 (1) Fall / automne 2011


(2011) at Stanford University found that increasing the nightly sleep period of varsity basketball players to at least 10 hours, for a duration of 5-7 weeks led to faster sprint times, increased accuracy, and improved overall ratings of physical and mental well-being during practices and games.4

Circadian and Homeostatic Balance

The circadian process regulates the timing of sleep and wake in the 24-hour day. This process is controlled by the circadian clock (suprachiasmatic nucleus) housed in the anterior hypothalamus that controls the daily rhythm of all bodily functions at a cellular, tissue, and organ level. The circadian clock is set daily by exposure to sunlight through the retina in the morning upon waking. Circadian factors follow a specific rhythm and determine the levels of alertness throughout the day and night. The regulation of this rhythm is controlled, in part, by the endogenous release of the hormone melatonin from the pineal gland. Recent studies have determined that there may be a role for circadian rhythms on athletic performance. Kline (2007), tested the maximal effort swimming performance in experienced swimmers following a strict 3 hour “ultra-short” sleep-wake cycle, involving 1 hour of sleep in darkness and 2 hours of wakefulness in dim light (to control for possible environmental and behavioural influences).3 Performance peaked 5–7 hours before the lowest body temperature recorded during the experiment (~2300). The worst performance (a 5.8 second variation) was observed from 1 hour before to 1 hour after (~0500) the lowest body temperature recorded, providing strong evidence that there is a definite circadian effect on athletic performance independent of environmental and behavioural factors.3 In concert with the circadian process, the homeostatic sleep process regulates the balance between sleep and wake. It is an endogenous drive that is sleep-dependent; meaning the need for sleep is driven by lack of sleep. The accumulation of sleep debt over the day increases the propensity to sleep, and sleep lasts longer following a period of sleep deprivation. As the body recovers (during sleep), the sleep pressure is relieved. If sleep load is not relieved, the propensity to sleep is accompanied by sleepiness and cognitive impairment. The relationship of sleep to PER and performance can be articulated in a structured fashion and has been used to guide the development of the Athlete Sleep Screening Questionnaire (ASSQ). Sleep length (total sleep requirement: hours/night), sleep quality (sleep disturbance or fragmentation), and sleep phase (circadian timing of sleep) are considered to be the key factors affecting the overall recuperative outcome of the sleep state.

Development of the ASSQ

In the initial pilot study, 65 elite athletes (range 14 – 36; mean 19.5 years old); and in a subsequent follow-up study 116 athletes (range 17 - 38; mean 24.2 years old), were screened using three standardized sleep questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Athlete Morningness/Eveningness Scale www.sirc.ca

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(AMES), and the Adjusted Neck Circumference (ANC). PSQI scores can range from 0 – 21 with scores above 5 indicating an increasing degree of sleep disturbance in a general medical population. The prevalence of poor sleep quality in the pilot study (using a conservative PSQI cut-off score > 8) was 23% (15/65). Twelve percent (8/65), scored above 10, identifying the most severe cases within the group (figure 1). The prevalence of poor sleep quality in the follow-up study using the same conservative cut-off score was 15% (17/116). Again, 12% (14/116) scored above 10, allowing the most severe cases to be identified (figure 1). The results of the two studies seemed to indicate a higher prevalence of poor sleep quality in the younger athlete population. This is contrary to the expectation that poor sleep quality would not be likely in a young, healthy athletic population. Additionally, the results allowed for the important identification and referral of 22 athletes suffering from severe clinical sleep problems for specialized assessment. These findings not only emphasized the importance of sleep screening for athletes, but also indicated the weakness of using standard sleep screening methods in a specialized (athlete) population.

Figure 1: PSQI scores for the pilot and follow-up studies. The younger athletes in the pilot study indicated a higher prevalence of poor sleep quality.

The Psychometric Development of the ASSQ

The initial findings raised two questions: 1) what is the true prevalence of sleep disturbance and sleep related impairment in a population of elite athletes, and 2) what is the validity and reliability of the methods used. A convenience sample of 80 athletes was selected from 300 eligible athletes who train out of the Canadian Sport Centre – Calgary. Sixty athletes were consented and randomized into a new study; 30 were assigned to Phase I, and another 30 were assigned to Phase II. PHASE I The goal of Phase I was to identify weaknesses in the current self-report methods in an athlete population. The information gathered was then meant to inform and guide the development the ASSQ. During Phase I, the athletes completed a selfreport sleep screen (SRSS) composed of the Pittsburgh Sleep Quality Index (PSQI), Adjusted Neck Circumference (ANC), and Athlete Morningness/Eveningness Scale (AMES). Each SIRCuit Volume 2 (1) Fall / automne 2011


athlete subsequently had a clinical interview by an expert sleep specialist based on the PSQI. Findings from Phase I supported a concordance rate of 53% between the SRSS and the PSQI retested by the sleep specialist. The findings also supported a concordance rate of 57% between the SRSS and the AMES retested by the sleep specialist. The results showed poor concordance (close to chance) and identified the weaknesses in the current self-report tools that were selected for use to assess total sleep time, sleep quality, insomnia, and chronotype when compared to a sleep expert. PHASE II Following the assessment of data from Phase I, the SRSS was revised (SRSSR) to include the Insomnia Severity Index (ISI), whereas the AMES and ANC were replaced with the Composite Scale of Morningness (CSM) and the Maislin Apnea Risk Index (MAP), respectively. The athletes completed the SRSSR once, and then repeated it 24 hours later to provide test-retest reliability. Each athlete had a structured clinical interview (SCI) by the expert sleep specialist. Clinical sleep outcomes (none, mild, moderate, or severe sleep problem) were generated from the results of the SRSSR and SCI. The SCI sessions were video recorded to facilitate rescoring by the expert sleep specialist for intra-rater reliability; and to be viewed and scored by two other sleep physicians (one general sleep clinician, and one sleep clinician practiced in assessing athletes) for inter-rater reliability testing (figure 2).

Figure 2: ASSQ development phases, methods, process, and outcomes algorithm.

PHASE III A review of sleep-related items from the Patient Reported Outcomes Measurement Information System (PROMIS)7, in addition to a review of the SRSSR questions that indicated good concordance with the SCI (clinical outcomes) and best theoretical grounding (as determined by a subject-matter expert) were used to further guide the development process for the ASSQ. The 51 questions from the SRSSR were reduced to 15 and structured around the four clinical domains used to assess sleep: total sleep time, sleep quality, insomnia, and chronotype.

Athlete Monitoring

The current version of the ASSQ will be deployed through the Canadian Athlete Monitoring Program (CAMP) electronic database to all the National Sport Organization national team athletes. An aggregate Sleep Difficulty Score (SDS) based on responses from each domain will be used to guide referral decisions. Individuals scoring below the cut-off do not suffer from a clinically significant sleep problem and are directed to general sleep education or monitoring by their integrated support team (IST). Individuals scoring higher than the cutoff value are referred through the lead IST to either a sports medicine physician for moderate clinical problems, or to one of the sleep physicians dedicated to the program in Vancouver, Calgary, Toronto, or Montreal to treat severe clinical problems. Additionally, certain combinations of responses to questions corresponding to sleep disordered breathing, chronotype, or travel disturbance can either act as modifiers to the SDS, or in some cases result in a recommendation for referral on their own. Data from this large scale screen and monitoring of outcomes (referral versus no referral) will inform further validity and reliability testing and determination of the SDS. The goal will be to determine the validity of each item, the strength of each domain and the SDS that accurately predicts the clinical outcome in an athlete population. ∆ For references, click here

Analysis of Phase II data supports the findings that common tools from sleep medicine do not associate well with clinical outcomes as determined by an expert sleep specialist – in this sample of athletes. Although athlete test-retest correlations were high (0.94 on average) for the PSQI, ISI, MAP, and the CSM, there was poor association with the clinical judgment of the sleep expert (Sleep disturbance, 10.3%; Sleep quality, 31.0%; sleep www.sirc.ca

apnea, 72.4%; chronotype, 24.1%; insomnia, 6.9%). Additional results of intra and inter-rater reliability are yet to be established. Current Phase II data continue to support the need for selection and refinement of the questions (items) for inclusion into the sleep screening questionnaire that would associate more strongly with clinical interview and provide a valid and reliable ASSQ.

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Dr. Charles Samuels is a board certified sleep physician with primary research interests focused on understanding the prevalence and effects of sleep disturbances in specialized populations. His aim is to facilitate both broad and individualized clinical treatment strategies and foster effective knowledge transfer initiatives in these groups.

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Sport Innovation CAMP Launches EMR at PanAm Games in Guadalajara The Pan-American Games in Guadalajara showcased the talents of our Canadian athletes and introduced the newest member of the team: the CAMP system. The Canadian Athlete Monitoring Program (CAMP) launched the first module for testing at the PanAm games in October in Guadalajara. The first weeks of the games provided opportunity for custom development. Listening to the feedback from our subject matter experts, the development team tailored the application to meet the requirements of physicians, therapists and other care providers supporting our athletes within the unique major games environment. CAMP EMR Project Vision: The vision for CAMP was to enable an easy to use, secure and reliable pan-Canadian electronic medical record (EMR) that is available to all team medical personnel, team managers and athletes. The focus on the athlete is unique to CAMP and provides visibility to various sections of the athlete’s record based on the appropriate level of permission. For example, to protect the privacy of the athlete, a team RMT would be able to view a relevant part of the athlete record, the dietician another section customized for their needs and the Physician would be able to view the entire record. Coaches and sports science personnel will also be able to utilize performance specific modules.

The portability of CAMP, here used on the Therapists’ own iPad, support efficient clinical practice. Khatija Westbrook uses CAMP to review patient history prior to treatment

CAMP Scope: CAMP currently supports over 3000 national level athletes. The 500 PanAm athletes all have electronic medical records that can be accessed anywhere, anytime; regardless of internet connectivity. There is also the opportunity to develop comprehensive athlete profiles. The management of the data profile, and ownership of the health record remains with the athlete. With the soon to be available sport science features, French/ English capability, focus on user-friendly design, and advantage of direct access to their records, CAMP expects a significant increase in the number of athlete records within the EMR leading up to London Olympic games in 2012. CAMP continues to work with subject matter experts to ensure the most complete EMR is available to support our teams. We have also invited the 500 athletes participating in the PanAm Games to use CAMP and share their insights to improve the user experience. CAMP Research support: It is widely anticipated that the integration of health and performance information will support essential research. CAMP can produce randomized data sets using a variety of filters, meeting the needs of researchers while protecting the privacy of the athlete.

Training with CAMP has been hands on: Sukh Mann uses CAMP to capture examination notes for beloved clinic mascot.

Next Steps for CAMP: Thanks to continued support from Own the Podium, development efforts will turn to assessing the needs of the sport science and performance community. At the SPIN Summit in Toronto, subject matter experts in physiology and sport science will be invited to participate in working groups to help determine the requirements and development priorities. An aggressive timeline to develop, test, and add content to the database in advance of the 2012 London Games is required. Collaboration will be an essential component of success. In keeping with the necessity of efficient development, CAMP will integrate with many of the data collection tools currently in use by sport professionals. CAMP’s intention is not to reinvent wheels, but to work with professionals to create better, faster and stronger data management capacity. CAMP will be accessible through different platforms, will import data from applications such as Excel and Access and accept downloaded data from some modalities. CAMP makes a Canadian debut at the SPIN Summit in Toronto. (http://spinsummit.ownthepodium.org)

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Our athletes have welcomed the system and the new access they have to their own data. Dinah Hampson used CAMP to help chart notes about high performance athletes in the clinic.

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Sport Innovation Women’s Field Sports Understanding demands with GPS technology Jason D. Vescovi, PhD Abstract

Participation in field sports such as soccer, field hockey, lacrosse and rugby continues to grow worldwide, however there is limited information available describing the physical demands experienced by female players during matches or training. This substantial knowledge gap prevents us from maximizing our ability to train, monitor and develop female athletes. New tracking devices that use Global Positioning System (GPS) technology have been developed and are now a viable option for match and training analysis in team sports. By utilizing GPS technology we can begin to reduce the knowledge gap for a variety of women’s team sports by examining competitive matches, position specific demands, fatigue rates, specific drills during training sessions as well as the relationship between match performance and fitness indices. The aim of this article is to describe the utility of GPS technology within the team sport structure and provide an overview of some unique outcomes that have been recently acquired from soccer and field hockey.

Résumé

La participation dans les sports de grand air tels que le soccer, le hockey sur gazon, la crosse et le rugby est en croissance dans le monde entier; en revanche, on dispose de peu d’information au sujet des exigences physiques sollicitées chez les joueuses au cours d’un match ou à l’entraînement. L’important manque de connaissances nous empêche de maximiser l’entraînement, d’assurer le suivi et d’améliorer le développement de nos athlètes féminines. De nouveaux dispositifs de repérage utilisant la technologie GPS ont été mis au point et constituent une option intéressante pour l’analyse des déplacements à l’entraînement et au cours des matchs. En utilisant la technologie GPS, on peut accumuler des connaissances dans divers sports d’équipe chez les femmes, et ce, par l’analyse des matchs, des exigences spécifiques des postes sur le terrain, du taux de fatigue, des exercices spécifiques pratiqués au cours des séances d’entraînement et par l’étude de la relation entre la performance sur le terrain et des indices de la condition physique. Cet article se propose de décrire l’utilité de la technologie GPS dans les sports d’équipe et de donner un aperçu des résultats particuliers récemment enregistrés au soccer et au hockey sur gazon.

W

omen’s participation in field sports such as soccer, field hockey, lacrosse and rugby continues to grow worldwide, however there is limited information available describing the physical demands experienced by female players during matches or training. This substantial knowledge gap prevents us from maximizing our ability to train, monitor and develop female athletes for these sports. Video analysis has long been recognized as the standard for determining movement pattern characteristics in time motion studies, however limitations in this labor intensive method have led to the development of newer devices that use Global Positioning System (GPS) technology. Investigators have demonstrated good validity and reliability for GPS for evaluating distance and speed during simulated match activities, thus making it a viable option for match analysis. Applied sports science research in contemporary field sports can begin to reduce the knowledge www.sirc.ca

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gap for a variety of women’s team sports by utilizing GPSbased time motion systems to determine work-rate profiles during competitive matches, examine positional demands, evaluate fatigue during a game and across a season as well as determine the relationship between match performance and fitness performance profiles. The aim of this article is to describe the utility of GPS technology within the team sport structure and provide an overview of some unique outcomes for matches and training sessions that have been recently gathered from women’s soccer and field hockey.

Match analysis

Finding match profiles for female field sports remains elusive, yet the importance of this type of information at all levels cannot be understated. GPS technology provides a unique way to assess an athlete’s potential or readiness to take a step to the next level SIRCuit Volume 2 (1) Fall / automne 2011


making them specific to each player’s respective position based on the demands of the game. Information about the physical performance of players at various stages of a season have only been reported for male soccer players5. To date, investigations on time motion for female soccer players have not evaluated changes in match performance that might occur across an entire season. Although speculative, it is plausible that a substantial reduction in match performance, as evidenced by a decrease in total distance or high intensity and sprint distance, could be an indication of maladaptation (i.e., overtraining or under-recovery) that requires a change in the approach to training and/or recovery. Figure 1. Relative amount of high intensity running performed during a On the other hand, an increase in the amount of work performed match in women’s soccer. during competitive matches later in the season could represent successful adaptations to the training loads and attainment of by capturing work-rates or the amount of high intensity running peak performance. Therefore, using GPS technology to monitor and comparing them to players competing at higher standards. the physical demands of competitive matches throughout the Indeed, investigators have reported that elite male and female season might allow for the early detection of fatigue and aid soccer players perform more total work and more high intensity in the development of more effective training and recovery work compared to sub-elite players4, 5 and evidence now exists strategies in order to optimize performance later during the that shows the developmental changes that occur for women’s season. soccer. Figure 1 illustrates the percent of high intensity distance covered during women’s soccer matches at the youth, college A wide variety of field tests are routinely used by sports and professional levels. It is not surprising that there is an scientists, fitness professionals and coaches to evaluate physical increase from one level to the next, however when taken in performance. The Yo-Yo Intermittent Recovery Test is a valid conjunction with the total distance covered in matches at each and reliable field test commonly used to assess fitness for level then the absolute amount of high intensity running covered intermittent sports1. Performance on the Yo-Yo test has a positive during a match can be determined - which is nearly 1.8 and 2.3 correlation with total distance2 as well as the relative amount of times greater at the college and professional levels compared to high intensity running achieved by female soccer players during youth games. This information is critical for sport scientists and competitive matches. Similar, yet slightly weaker, relationships fitness coaches to understand and for coaches to consider within have also been recently determined for women’s field hockey. the context of player development. So from a simple field test we can gain valuable insight into There is also evidence that positional differences in total distance and high intensity distance exist for high level female soccer 4 and field hockey players. In women’s soccer defenders cover less high intensity distance compared to forwards and midfielders; however the total distance covered during a match tends to be similar between all three field positions in the women’s game (9-10 km). Female field hockey players cover less total distance (5-6km) compared to soccer players because games are shorter (70 vs. 90 min); however the positional distinctions identified to date indicate that defenders cover the greatest total distance in a game (~6,300 m) compared to forwards and midfielders (5,000-5,500 m); whereas midfielders covered the most high intensity running (~1,900 m) compared to defenders and forwards (<1,800 m). These differences in the absolute amount of distance covered are likely the result of varying substitution patterns for each position because the relative amounts of high intensity running for field hockey players is about 28%, 34% and 35% for defenders, midfielders and forwards, respectively. In contrast, the average relative amount of high intensity distance is less than 30% for professional female soccer players. Fitness coaches can utilize this information and have a very meaningful impact on the design of training plans for high level athletes by www.sirc.ca

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potential game performance ability – that is how much high intensity work a player can perform.

Training Sessions

Developing a greater understanding of the specific demands imposed during competitive matches for female team sport

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Figure 2. Work-rate of small sided games with varying field sizes and players compared to actual game demands (red line).

athletes using GPS technology has implications for the design and implementation of more appropriate training and recovery regimens, with the ultimate goals being enhanced performance, reduced injury risk, and possibly increased career longevity. Indeed, by knowing the demands imposed during competitive matches, in conjunction with monitoring practices, coaches will have the ability to create a menu of drills and small sided games that can ultimately mimic the workloads and intensities associated with competition3, 6. A periodized plan can then be developed by selecting drills that impose demands which are above or below those experienced during games depending on the training objectives. The inclusion of small sided games is a common way to incorporate fitness training with tactical and technical elements of a practice session. The overall demands of small sided games are manipulated by modifying the number of players (e.g., 8v8) and/or size of the field (e.g., ½ field). The utility of determining the demands of various small sided games is clearly demonstrated in Figure 2, with each small sided game showing a unique profile that can then be compared to game demands (red line). There

are three key points to highlight from this figure: 1) reducing the dimensions of the field while keeping the number of players constant results in a reduction in the workrate; 2) reducing the number of players while keeping the field dimensions constant (e.g., ¼ field) increases the demands; and 3) there are some small sided games with workrates near or above actual game demands whereas other drills have lower demands. With this knowledge a coach will be able to select small sided games for a particular day to elicit appropriate demands for his/her players. For example, when a high intensity training session is planned (e.g., after a recovery day) the coach could select a drill that is equal to or exceeds game demands (e.g., 8v8 or 6v6 on ½ field). Alternatively, a training session within 1-2 days following a match would require low level demands and so specific small sided games could be appropriately chosen to suit the needs of the day. Interestingly the same small sided game doesn’t always produce the same demands. Figure 3 illustrates the workrate of identical 6v6 small sided games repeated 11 times over 3 days during field hockey training sessions. The workrate ranged was from 99 m/min to 124 m/min which spans above and below game demands, thus minimizing the potential effectiveness (from a physical demands perspective) for this particular drill. In addition to understanding the overall demands of a drill or small sided game, GPS technology can also be used to evaluate an individual athlete’s ability to handle the demands for a given training session. As an example, Figure 4 shows the sprint profile of two female players for a single practice session during the early preparation phase of the season – each line on the figure represents one sprint with the number above indicating the duration (seconds) of the sprint. Both players were midfielders and performed identical drills during practice, yet the player in the top panel performed nearly double the number of sprints compared to the player in the bottom panel (41 vs. 22). In addition to the large discrepancy between the number of sprints performed the player in the top panel covered more high intensity distance – 32% or 3 km out of 9.4 km – compared to the player in the bottom panel – 28% or 2.5 km out of 9 km. A subsequent conversation with the coach after practice revealed that the player in the top panel returned from the off-season more fit, in turn allowing for a greater amount of sprints and high intensity work to be performed.

Summary

The integration of GPS technology within the team sport structure has grown over the last several years, predominately with men’s teams. Despite the limited use of GPS systems with female field sports, sport scientist and fitness trainers as well as coaches can begin to use the information currently available to improve the development and training for female athletes. Current and future research in this area will continue to expand our knowledge about the demands of matches as well as the daily training environment, ultimately providing a stronger foundation from which to develop young athletes into elite performers. ∆

Figure 3. Variability of workrate for 6v6 small sided game (11 repetitions were from 4 training sessions performed over 3 consecutive days).

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Figure 4. Sprint profile of two midfielders during the same practice session.

References 1. Bangsbo J, Iaia FM, and Krustrup P. The Yo-Yo intermittent recovery test : a useful tool for evaluation of physical performance in intermittent sports. Sports Med 38: 37-51, 2008. 2. Krustrup P, Mohr M, Ellingsgaard H, and Bangsbo J. Physical demands during an elite female soccer game: importance of training status. Med Sci Sports Exerc 37: 1242-1248, 2005. 3. Mallo J and Navarro E. Physical load imposed on soccer players during small-sided training games. J Sports Med Phys Fitness 48: 166-171, 2008. 4. Mohr M, Krustrup P, Andersson H, Kirkendal D, and Bangsbo J. Match activities of elite women soccer players at different performance levels. J Strength Cond Res 22: 341-349, 2008. 5. Mohr M, Krustrup P, and Bangsbo J. Match performance of high-standard soccer players with special reference to development of fatigue. J Sports Sci 21: 519-528, 2003. 6. Tessitore A, Meeusen R, Piacentini MF, Demarie S, and Capranica L. Physiological and technical aspects of ‘’6-a-side’’ soccer drills. J Sports Med Phys Fitness 46: 36-43, 2006.

Dr. Jason Vescovi is currently leading the single largest study designed to determine the physical demands of women’s soccer at all levels using GPS technology. To date the study includes players from top youth leagues, NCAA programs, Women’s Professional Soccer as well as elite international athletes. His research in this area is now expanding to field hockey and lacrosse.

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Athlete Focus Jasey-Jay Anderson

Sport: Snowboarding Born: 13/04/1975 Gender: Male Birth Place: Montréal, Québec, Canada Residence: Mont-Tremblant, Québec, Canada Height: 178.0 cm Weight: 80.0 kg

HIGHLIGHTS • 2010 Vancouver Olympics Snowboard PGS Gold • Twice Giant Slalom World Championships Gold • Twice Parallel GS World Championships Gold • Once Parallel Slalom World Championships Gold • Four-time Overall Alpine (FIS Crystal Globe) • Three-time Overall SBX (FIS Crystal Globe)

Jasey-Jay is one of the sport’s most versatile and intense riders. With seven FIS coveted crystal globes to his credit, Jasey-Jay is at the top of his mountain. An international career which took off in earnest eighteen years ago has catapulted Jasey-Jay onto some of the world’s most extreme slopes and to numerous podiums in three disciplines of this Olympic sport. Jasey-Jay Anderson keeps the hammer down. Anderson is Canada’s most decorated snowboarder having achieved a World Championship gold medal in all 3 slalom events over his career, and an Olympic gold medal in parallel giant slalom. In addition to being a 4 time world champion Anderson has achieved success across the board. Anderson won four consecutive overall FIS Snowboard World Cup titles from 2000–2004 and two world cup overall titles in snowboard cross in 2001-02 and 2005-06. These titles included 19 podiums in parallel giant slalom and 19 podiums in snowboard cross. Anderson is also a four-time Olympic athlete, having represented Canada in the 1998 Nagano, 2002 Salt Lake, 2006 Turin, and 2010 Vancouver Winter Olympic games. Anderson’s best result in the Olympics prior to Vancouver 2010 was a 5th place finish in snowboard cross in Turin. Anderson finished 20th in the parallel giant slalom event at the 2006 Turin games. When he is not snowboarding, Anderson lives on a blueberry farm in Mont-Tremblant, Quebec. www.sirc.ca

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As someone who is always open to new challenges, Anderson works to continually succeed in overcoming adversity. He frequently comments on the competence of the support teams around him, from the Canadian Snowboard Federation medical and support group to his family and friends, private trainers and technical advisors.

Jasey-Jay talks about his journey to gold; the training and the team that got him there.

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Competitive Intelligence

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nowledge can give an athlete the competitive edge. Competitive intelligence equips coaches, sport scientists and practitioners with the latest information that may assist in the quest to put an athlete on the podium. SIRC receives thousands of publications from around the world each year ranging from peer reviewed journals to practical guides and our information specialists are constantly reviewing and indexing the various articles.

Talent Identification and Development A Commentary on the Literature

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any young athletes these days compete with the eyes of being the next World or Olympic Champion or the next professional athletic star. But research tells us that while many young athletes show potential for athletic talent, only a very small minority will ever reach international levels never mind become the ultimate champion. Athletically talented children are the minority, and increasingly talent is often the focus of parents, kids, and coaches when it comes to sport participation, with the notion being that to become the best you must engage in one sport from an early age and play it yearround. But how do we know which athlete has talent and which one will succeed? Although talent identification programs have gained popularity in the last decade, there is a noted lack of consensus in how talent is defined and identified. There is disagreement among researchers as to what talent is, and what can reliably used in the talent identification process. Talent has been identified as having a specific aptitude that is amenable to further development. And expert performances have been defined as those that are acquired through extended deliberate practice (Malina, 2010). Yet other authors go a step deeper and define sport skill expertise as a dynamic interaction between biological, psychological and sociological factors, the proper combination of which can lead to high levels of performance and the improper blending of which can lead to burnout and/or dropout from sport (Baker, 2005). Many countries are trying to develop programs and structures that will identify gifted athletes at the earliest age so as to be www.sirc.ca

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able to focus expenditures on those most likely to succeed and to promote their abilities. A number of early theories and speculations about the success of early talent identification stem from the former communist countries of Eastern Europe. It is commonly believed that these programs encouraged systematic training and included early specialization and yearround participation. However, many of these programs, with the exception of sports like gymnastics, diving, and figure skating, rather supported the notion of exposure to a variety of activities and skills with specialization occurring in the post-puberty stage (Malina, 2010). Almost no one doubts the importance of talent identification, however, what is suggested to be more important is the dynamic relationship between identification and cultivation of that talent. High identification rate does not necessarily mean high success rate.

Early Specialization

Research contains a variety of contradictory theories of elite sport skill development and the best pathway to follow for international success. The assumption has long been that competitive success has a positive correlation with volume of training hours and that early success is a predictor of later elite success (Gullich & Emrich, 2007). A commonly held theory in sport is that at least 10 years of experience and 10,000 hours of deliberate practice are needed for achieving success at the international level. This view has been promoted by the popular press and has most likely helped fuel the fire of early specialization. However, research provides data that suggest that early onset and higher volume of discipline-specific training and competition, and an extended involvement in institutional talent SIRCuit Volume 2 (1) Fall / automne 2011


development programs, during adolescence are not necessarily associated with greater success at senior elite levels (Vaeyens et al, 2009). We are also seeing a social environment that is playing a large role in encouraging early specialization (Malina, 2010). With less free playtime for kids, structured time is taking over. Time in organized activities is increasing and in all aspects of these activities the need to see children achieve is often a measure of success of these programs. At the same time, people are also influenced by sensationalized stories of successful people who start at early ages. Securing the future for their kids can also drive specialization decisions. Many parents see sport, whether elite, professional or college/university, as an avenue to provide a better life for their kids. Earlier success in sport might mean scholarship or scouting opportunities. However, there are inherent risks in specialization: • Social isolation • Overdependence • Burnout • Blind faith in the system • Injury including overuse injury • Compromised growth and maturation

Variable Sampling

What is also noted in the research on youth sporting activities is the concept that with the move to more organized activities, key elements of unorganized play that are identified as contributing factors to success are missed out on. Research has shown that less structured sport activities often encourage experimentation and creativity, both of which are often associated with high level performance (Malina, 2010). Skills are also better learned when there is less fatigue and stress, which may happen when only one sport is targeted. This is an area in which research is expanding. Many studies agree that success and quantity of sport-specific training at early ages do not seem to contribute significantly to explaining later performance in elite sport. However, results do suggest that early success combined with higher accumulated training volume in a variety of sports seems to benefit the development of potential (Gullich & Emrich (2007). An early diversification path seems to be a more constructive path to successful elite sport performance. The benefits of variable sampling (early age practice of a variety of sports) (Vaeyens et al, 2009): 1. may increase the probability of finding the right sport to match with the talent displayed; 2. may increase the variety of the motor skill development, through variations on training and competition experience, thereby improving the progress in the specific sport developed; 3. may reduce the risk of burnout or “plateau”-ing; 4. may increase the likelihood of mature decision making www.sirc.ca

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in focusing on a single sport; and 5. may create a larger total talent pool at the collective level

Talent Identification & Development

Much of the research on talent identification and early specialization now emphasizes how physiological characteristics and biological development of youth are also remarkably variable. This variability does lend itself to challenges in early talent identification. Different sport requirements will inevitably require different physiological and chronological maturations. Markers such as biological maturation, relative-age effect, and psychological maturation are reduced and often disappear on reaching adulthood. At the same time, some of the critical attributes of elite senior athletic success are not evident until later adolescence. In the same vein, newer training modalities, evolving technologies and new competition rules may prove to be more advantageous to different types of athletes and are also not brought into play until later down the time spectrum (Baker, 2005). Observations from the literature suggest that for senior level success in some sports it is not imperative that an athlete be part of a talent identification and development program at an early age. It is also indicated that it is possible for an athlete to be involved with, or switch to, different sports at different ages and still achieve high level sporting success. In reviewing past research it can be argued that talent development programs should move beyond looking at common optimal performance models and physical tests that are based on group norms and look to the individual nature of pathways to expertise and elite performance (Phillips et al, 2010). What is recommend is that talent identification and development programs need to take into consideration the large number of physiological, psychological, and environmental variables that go into developing athletic potential and provide the opportunity to identify and develop this potential at different ages and different levels in the process. ∆

For references, click here

Nancy Rebel is the Director of Library Services at SIRC. Nancy is responsible for content management of SIRC’s collection and its catalog database design. Nancy has been responsible for: the content submissions for the world-renowned SportDiscus database; aiding in the coordination of in-house and international terminology submissions and organizational structure of SIRCs internationally recognized SIRCThesaurus as Editor.

SIRCuit Volume 2 (1) Fall / automne 2011


Stay Informed with SIRC Dear SIRC: I received an email from one of my athletes wondering if their lack of sleep was having an impact on their athletic performance during a hard training session and recovery day. They had noticed that they were not able to train effectively in the last several sessions. I tried searching for “sleep & recovery” but didn’t find much that seemed really relevant. Any chance you could point me in the right direction?

Answer

Dear SIRC: I am doing a presentation to a local group on steroid use in adolescents. Could you suggest a list of good recent references?

Answer

Did you know...

The development of an elite athletic career generally consists of 10 years building experience necessary to become an elite performer and 5-10 years competing at the highest level.

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Did you know...

Coaching behaviors in practice, at games, and away from the sport have strong influences on players and can impact both players’ performances and continued participation.

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Did you know...

Personal characteristics of expert coaches include: drive, commitment, dedication, passion, empathy for athletes and openmindedness.

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SIRC on the Web

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Upcoming Events For more events, check out the SIRC Conference Calendar. Click on the “month” below to see all events for that month.

Pour d’autres événements, veuillez consulter le calendrier SIRC des congrès. Ci-dessous, choisissez le mois pour voir tous les événements de ce mois

November 2011 Nov 11-13

The SPIN Summit Toronto, Ontario, Canada Petro-Canada Leadership Conference Toronto, Ontario, Canada

December 2011 Dec 1-3

2nd International Sport & Development Conference Cape Town, South Africa

Dec 17-19

International Conference on Current Trends in Physiotherapy & Occupational Therapy Goa, India

November 8-­‐10      

January 2012 Jan 6-7

NSCA Coaches Conference 2012 Education for the Development of Athletic Performance San Antonio, Texas

Jan 11-15

65th NSCAA (National Soccer Coaches Association of America) Convention Kansas City, Mo.

Jan 26-29

RCA Conference & AGM Toronto, Ontario

 

Merging the  art  of  coaching  with  the  science  of  sport.   Fusionner  l’art  de  l’entraînement  avec  la  science  du  sport.  

2011

Nov 8-10

Conference details  can  be  found  at:   http://spinsummit.ownthepodium.org    

Les détails  de  la  conférence  sont   disponibles  à:   http://lesommetspin.anouslepodium.org/  

novembre 8-­‐10     Toronto  

February 2012 Feb 1-4

World Convention on Child Psychomotricity and Child Early Development Havana, Cuba

Feb 14-15

Orthopaedics & Sports Injuries 2012 7th National Conference London, UK

Feb 24-26

Ontario Coaches Conference 2012 Markham, Ontario

March 2012

Mar 12-14 Active Living Research Annual Conference San Diego, California Mar 15-17 Eating Disorders International Conference London, United Kingdom

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Proactive & Preventative Medicine Building More Efficient, Effective and Resilient Athletes. Scott Livingston, BSc., CAT(C), CSCS Damien Moroney, BSc.PT, CGIMS, CSCS

Abstract

The High Performance training process has changed a great deal over the past thirty years. Training athletes today outside the field of play is not just about improving measurable performance (bigger, faster, stronger, etc.). There has been a recognition that there is much more that can be done through an integrated model of training support. Sports performance professionals now offer effective systems for assessing and improving the fundamental foundation of athletic movement within an integrated model in which the coach still remains an integral link to the athlete. An understanding of this assessment and training process by the coach will allow off-field training and on-field skill development to occur more productively and seamlessly. This article will describe the changes that have occurred in the systematic process of athlete preparation with regard to athletic movement foundation, and use practical examples of how this process, supported by the coach, can lead to more efficient, effective and resilient athlete development.

Résumé

Le processus d’entraînement de haut niveau a évolué grandement au cours des 30 dernières années. L’entraînement des athlètes d’aujourd’hui en dehors du terrain ne consiste plus seulement dans l’amélioration de la performance mesurable (plus gros, plus vite, plus fort, etc.). On connaît maintenant la possibilité de réaliser davantage en adoptant un modèle d’entraînement intégré. Les professionnels de la performance sportive proposent donc des systèmes efficaces d’évaluation et d’amélioration des composantes de base du mouvement sportif dans un modèle intégré où l’entraîneur constitue encore le lien essentiel avec l’athlète. La compréhension du processus d’évaluation et d’entraînement permettra à l‘entraîneur de mieux encadrer l’athlète à l’entraînement hors terrain et sur le terrain, et ce, de façon transparente. Cet article expose les modifications apportées dans le processus systématique de préparation de l’athlète en ce qui concerne les bases du mouvement sportif; l’article présente aussi des exemples pratiques pour démontrer que ce processus, endossé par l’entraîneur, aide au développement de l’athlète sur les plans de l’efficience, de l’efficacité et de la résilience.

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he high performance athlete training process has changed a great deal over the past 30 years. In order to deliver on expectations for higher levels of performance year after year, athletes and their coaches have integrated performance development methods, prescribed and created in various sport performance domains, into their programs. There has been a progressive enhancement of a systematic approach to athlete development built on the backbone of the bigger, faster, and stronger philosophy. The utilization of strength training methodology from Olympic lifting and power lifting in conjunction with power, quickness, and agility training methods, as well as linear speed development systems has provided the infrastructure for performance improvements in many sports. Over-loading to produce adaptation is the fundamental premise www.sirc.ca

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of training for performance improvement. Over-load can be delivered in a myriad of ways and means to produce an effective response by the physiological systems of the human body. The human body has an ever-impressive capacity to adapt and reach higher levels. In certain phases of programming, it is expected that there will be tissue breakdown in order to create an adaptive response. Unfortunately, this process occasionally leads to structural failure thus requiring rest, rehabilitation, and re-integration back into the training environment. This reaction by the system can be attributed to overloading that goes beyond the recovery capacity of the tissues and physiological systems. However, it is the healthy state of an athletes’ foundation for performance that can determine an individuals’ relative resiliency and their ability to recover throughout the ongoing training process. The state of this foundation can be assessed and improved, just as any other element of conditioning can be enhanced in an athlete. SIRCuit Volume 2 (1) Fall / automne 2011


Understanding the Foundation for Performance

In order to determine an individualsâ&#x20AC;&#x2122; current state of physical preparation it is important to assess these 4 pillars.

Strength/Power - the ability of a muscle or a group of

anthropometry assessment, physiological tests of energetics, strength and power evaluations, timed speed, quickness and, agility drills, medical assessment, and more recently the addition of functional movement screens. While the other components of testing are likely more familiar, there may be less understanding of the role or the importance of a movement screen. Pre-participation medical assessments are often joint specific evaluations, that may flag regional problems and direct access to therapy services, but unless there are pain symptoms present, this testing rarely influences or affects strength and conditioning programming.

muscles to produce force

Stability - the efficient co-ordination of the muscular system to mange force and the transfer of loads

Mobility - the combined flexibility of specific muscles

and joints through segmental and multi-regional movement patterns

Energetics - the capacity for the delivery and utilization of

oxygen and the supporting nutrients in providing fuel to the muscles for sport specific physical demands

When there are specific imbalances or inadequacies in any of these pillars, especially if they are determined to be key requirements for a specific sport, the actual capacity for physical performance may be reduced, as well as the risk of injury to that athlete may rise. The improvement of that specific deficit should become a priority within their current training program.

Individual Athlete Evaluations

All too often, the key performance indicators are driven primarily by the achievement of set objective numbers. This can lead to a crossover assumption that good strength must mean good stability. If an athlete can lift a certain weight, they must be producing that force with optimal and healthy mechanics. There is limited accountability as to HOW an athlete performed the tasks and whether or not the pattern they employed may place them at risk for stress on regional soft tissue structures. Identifying poorly controlled compensation strategies is the role of the functional movement assessment. If an athlete engages in a training program with an unidentified dysfunction that prohibits effective and efficient movement patterning, then one of three likely results will ensue: 1. Inability to perform at their highest level 2. Compensation that reduces efficiency and therefore increases the physical energy cost of producing movement 3. Repetitive strain on tissue structures that may lead to injury

In order to enhance durability, and build more resilient athletes, each training cycle should begin with a form of physical screen. The specific tests that are performed should be selected by discussions between the coach, physiologist and integrated therapy team leader. Sport specific demands, technical skill development and common injury presentations are all important Identifying where these dysfunctions in movements occur and considerations to determining what is to be evaluated at which then providing solution based methodology to correct these dysfunctions, is becoming a relevant implication of the multitimes in the yearly training plan. domain professional or well-organized integrated support team. Physical testing is often a combination of blood testing,

BobsleighImproving spine management and positioning in training, creates a better transitional power link between the upper and lower body and directly relates to improving hit position on the sled at the start.

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prepare the athlete for the next phases of the program. Any developed screening process may have itâ&#x20AC;&#x2122;s own method of recording dysfunction, but each will have a communal purpose: to evaluate and categorize how well an athlete was able to complete each movement. In a generalized breakdown, all of these testing results would fall into one of the following categories: Category 1 - Athlete performs the test without compensation or pain This athlete is ready for the next stage of high performance loading. These are movements that this athlete performs well. If this individual produces symptoms with other test positions, these movements can still be used in their training program. Category 2 â&#x20AC;&#x201C; Is able to perform the test, but utilizes poor stabilization strategies or compensatory movement patterns In this category, it is important to be able to identify the regional risk areas that have poor load transfer strategies. The type of movement that was performed (i.e.: max vertical jump, 2 leg jump to one leg landing, lunges, ability to maintain spinal neutral with squats etc.) will assist in determining if there is an issue with proprioceptive awareness, neuro-muscular coordination, inability to deal with speed, or difficulty managing concentric and/or eccentric forces.

Cross CountryInefficient load transfer when moving to one leg stance on the left leg. In discussions with his coach, this correlates to break down in technique over the left ski with fatigue.

Functional Movement Assessments

The current trend in the model of HP athlete preparation with regard to movement assessment is to use initial pre-participation movement screens. There are some evaluations that will use the same base testing parameters for every sport, such as the Gray Cook functional movement screen (FMS). This type of testing is one example of a starting point to provide an initial appraisal of an athleteâ&#x20AC;&#x2122;s movement foundation. The ability to also incorporate selected tests and document movement faults that are specific for the required training, plus assess how the athlete manages applicable loads and/or speeds associated with their sport, will provide even more relative results to the coach, the medical staff and the service providers for that organization. The key concept with movement screening is that it is the first step in a greater process. When the goal of the coaching staff and the integrated support team is to understand the full underlying capacity of an athlete, it can provide the basis for a more detailed assessment, therapeutic interventions, or corrective reprogramming of the movement deficits that are residing in that athlete. The ideal opportunity for an initial movement assessment would be at the end of the season and the beginning of the offseason preparation period. The training volumes are low, there is unlikely to be much speed or power work, therefore it is an excellent time to start corrective strategies and develop efficient motor patterns. This evaluation will provide the strength and conditioning professional, in collaboration with the medical staff, the information with which to build a foundation that will www.sirc.ca

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Examples of movement dysfunctions that may be noted in this category would be high load muscle bracing with co-contraction rigidity or breath holding for low level proprioceptive challenges, early motion at a segment that will result in stress to the ligaments throughout the movement, the inability to stabilize one region and produce motion above or below it, poorly controlled rotational stress with linear movements, delayed anticipation and stabilization of deceleration forces resulting in body sway or segmental instability. The failure of specific tests, guides the corrective reprogramming. By providing the athlete with more movement options and enhancing stability through a variety of positional loads and speeds, they will develop more muscle recruitment options and patterns to integrate into competitive sport participation. Category 3 - Reproduces pain in a specific region during test movement These athletes will often be getting concurrent treatment with programming recommendations or modifications from the sports medicine team. It is important to keep in mind that the symptoms from a trauma or injury can completely resolve, but an underlying movement dysfunction may still be present. If uncorrected, a dysfunction will be reinforced and strengthened that can lead to injury recurrence. Repeated assessment will present insight into an individuals enhanced functional capacity and further corrective drills that may be required as part of their re-integration to the training environment. SIRCuit Volume 2 (1) Fall / automne 2011


It is also important to consider the psychological impact on athletes dealing with major traumatic injuries or the frustrations of ongoing recurrent issues that consistently limit their ability to participate in training or competition. The underlying cognitive effect can lead to functional rigidity, fear avoidance, or adaptive compensation strategies when loading through the injured region. A referral to a sports psychologist for athletes dealing with these types of injuries can be one of the critical factors in their successful return to high performance competition.

Integrating Corrective Cueing

Movement pattern correction takes time, repetition and ongoing re-evaluation. It requires continual feedback during dry-land exercises, weight room and on field training sessions. Continuous reinforcement of good patterning will deliver a new model of movement options under the pressures and stress of game day competition.

Tips for functional integration of unfamiliar motor patterns: • • • •

• • •

Review in the training environment with lots of feedback until athlete understands the difference between a corrected and a dysfunctional pattern. Develop a short routine with a lot of proprioceptive feedback and challenge to this recruitment pattern in a variety of positions. Initiate these corrective exercises at the start of standard training. Develop these exercises into focused warm up drills. This will ensure ongoing repetitions and allow the athlete to self-monitor their activation awareness and positional control prior to training or sport participation. S&C professional and the technical coach review the corrective feedback and cueing in order to link improved patterns during overload or speed programs plus technical drills on the field. Cue change repeatedly, but for a short interval within each training session. Then as long as there is not a safety issue, accept that compensation will still occur in the residual drills. It doesn’t have to be perfect immediately. Athlete should get more responsive to verbal cueing, plus find it easier to maintain positional efficiency. Gradual automated integration of improved patterns into training and competition. Key phrases or cues are used as reminders for the athlete to implement strategy during performance under pressure.

www.sirc.ca

Linking Training to Technical Skill Development

The current value of the movement screen or assessment is often lost to the coaching fraternity because a clear link to the higher potential technical skill procurement, improved movement efficiency, and enhanced durability of the athlete has not been clearly established. It is beneficial if the coach is able to sit in on movement evaluations, as these often link to technical faults that present in the arena of competition. The inability of the athlete to respond to video feedback or coaching is often a result of ingrained compensatory strategies required to perform that task. Although they are able to see and understand how they should change, their body is unable to efficiently reproduce the requested change. The better the coach can understand the specific priorities in training and important feedback or corrective cues, the more likely the integration of improved awareness of positioning during skill drills, or in competition. Integrating an applied sports biomechanist or utilizing technological advancements in movement evaluation imaging and software will produce more quantifiable results. Coaches may then see more and more relevance as to how this information coincides with skill acquisition or technical faults. This is definitely an area for further corroborative research projects in the future.

Accountability to Progress

Once a plan of action has been established, it is imperative that there are quality control checkpoints built into the yearly training plan. This will ensure inter-professional communication plus enable progression and ongoing adaptation of the primary training objectives. A short re-evaluation could be done just prior to the beginning of any new training phase where the focus and loading parameters are to change in order to determine an athletes’ readiness for increasing work volume or intensity. It is beneficial for training accountability to re-assess at the beginning of preseason to understand the improvements that have been obtained and/or the current deficits that may still exist after the off-season program has been completed. This information, combined with other assessments of the 4 pillars of athletic performance, will allow the coach to understand the level of readiness for competition of each athlete. This may be especially important when a team is not centralized in their training and athletes are working with professionals that are not associated with that team’s IST. It would also be valuable to have a mid-season assessment of movement combined with the results from supporting physiological, anthropometrical and strength evaluations. This would produce a comprehensive athlete ‘snapshot’ that would allow the supporting service experts to see how the rigors of the season have affected the ability to maintain preseason gains and also identify athletes that may be on the verge of break down. The medical staff and IST team would then be in a position to set

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up proactive strategies to minimize this risk.

Conclusion

The concept of the coach being the driver of all training planning and methodology has been transitioning. Increasingly, the development of highly specialized professionals in the areas of sports science, strength and conditioning, sports medicine, mental preparation, nutrition, etc., has created the necessity to provide teams of working support professionals around individual athletes and/or sport teams. It is essential that the coach remains an integral part of the planning process. They should be the primary link to athlete. A key role for the coach in this new paradigm is to coordinate the results from testing

and establish clear communication of objectives for each athlete between the sport scientists, medical doctors, S&C professionals, and therapy team members. The goal of this system of assessment and categorization is to create an adaptive fluid process of ongoing evaluation that becomes part of the sporting culture and guides the performance preparation of each athlete. It builds on the input and communication that is fostered amongst the professional support staff and the head coach. The ability to select sport specific tests, assess and establish key priorities for development, plus hold the athlete and the IST staff accountable to improvement, will lead to athletes that are more efficient, effective and resilient. ∆

Video 1: “Assessment and strategies to continue with overload training and power development.”

Video 2 & 3: “Improving stability evident through minimized body shift and rotational compensation required to move from left to right leg in tuck position.” Video 1

Video 2

Video 3

Scott Livingston has been working in the field of athletic performance for over twenty years as both an athletic therapist and strength and conditioning coach. He currently owns and operates his own business, High Performance Sport, in performance training and reconditioning with his wife Jaime. Scott worked for eleven seasons in the National Hockey League with the Montreal Canadiens, New York Rangers, and New York Islanders. Prior to that he worked for nine years in Concordia University’s Athletics Department, as well as serving in a part time faculty position in the Exercise Science Department.

www.sirc.ca

Damien Moroney is a physiotherapist and a certified strength and conditioning specialist. He has provided sport specific conditioning programs and/or therapy to athletes from a variety of Canadian National teams, including bobsleigh, skeleton, ski-cross, ski jumping, cross country skiing, bmx and athletics. Damien has been hired as a consultant for the Montreal Canadiens training staff, the Canadian Athletic Coaching Centre, the Canadian Olympic Centre (Calgary), and Cirque Du Soleil (Alegria) .

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Recommended Readings from SIRC When 30,000 articles cross your desk each year, you start to notice trends as well as the research that seems particularly strategic. We are pleased to highlight some of the key articles in various topics that have attracted our attention. Comme nous voyons passer sur nos pupitres près de 30 000 articles chaque année, nous avons une bonne idée des tendances et des axes de recherche privilégiés. Nous sommes alors très heureux de mettre en évidence quelques-uns de ces articles provenant de divers champs d’intérêt.

Psychology

Injury Prevention

Coaches’ Self-Awareness of Timing, Nature and Intent of Verbal Instructions to Athletes. Millar, Sarah-Kate; Oldham, Anthony R. H.; Donovan, Mick, International Journal of Sports Science & Coaching Dec2011, Vol. 6 Issue 4, p503

Thermal Imaging and Gymnastics Injuries: A Means of Screening and Injury Identification. Sands, William A.; McNeal, Jeni R.; Stone, Michael H., Science of Gymnastics Journal Jun2011, Vol. 3 Issue 2, p5.

The Influence of Red on Perceptions of Relative Dominance and Threat in a Competitive Context. Feltman, Roger; Elliot, Andrew J., Journal of Sport & Exercise Psychology Apr2011, Vol. 33 Issue 2, p308.

Management of Patellar Tendinosis in a Freestyle Mogul Skier. Samukawa, Mina, International Journal of Athletic Therapy & Training Mar2011, Vol. 16 Issue 2, p12

Anti-Doping

Health & Nutrition

Should Performance-Enhancing Drugs in Sport be Legalized under Medical Supervision? Wiesing, Urban, Sports Medicine 2011, Vol. 41 Issue 2, p167.

Risk of Nutrient Inadequacies in Elite Canadian Athletes With Spinal Cord Injury. Krempien, Jennifer L.; Barr, Susan I., International Journal of Sport Nutrition & Exercise Metabolism Oct2011, Vol. 21 Issue 5, p417.

Perception of Risks Associated With the Doping Use Among the Competitors Practicing individual and Group Sport Disciplines. Mroczkowska, Helena, Polish Journal of Sport & Tourism Jun2011, Vol. 18 Issue 2, p122

General Conditioning

Periodization Developing a Mental Game Plan: Mental Periodization for Achieving a “Flow” State for the Track and Field Throws Athlete. Judge, Larry W.; Bell, Robert J.; Bellar, David; Wanless, Elizabeth, Sport Journal Oct2010, Vol. 13 Issue 4, p1 New Horizons for the Methodology and Physiology of Training Periodization. Issurin, Vladimir B., Sports Medicine 2010, Vol. 40 Issue 3, p189

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Actovegin -- Cutting-edge Sports Medicine or “Voodoo” Remedy? Lee, Paul; Kwan, Alvin; Nokes, Len, Current Sports Medicine Reports (American College of Sports Medicine) Jul/ Aug2011, Vol. 10 Issue 4, p186.

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Application of altitude/hypoxic training by elite athletes. Wilber, Randall L., Journal of Human Sport & Exercise 2011, Vol. 6 Issue 2, p271 Using Modeling to Understand How Athletes in Different Disciplines Solve the Same Problem: Swimming Versus Running Versus Speed Skating. Korting, Jos J.; Foster, Carl; Lucia, Alejandro; Bobbert, Maarten F.; Hettinga, Florentina J.; Porcari, John P., International Journal of Sports Physiology & Performance Jun2011, Vol. 6 Issue 2, p276.

SIRCuit Volume 2 (1) Fall / automne 2011


The IST Journal Club The goal of the IST Journal Club is to share ‘must reads’ on cutting edge performance based applications, training/competition variables, and proactive medical interventions, selected by performance service experts representing various professional disciplines associated with Integrated Support Teams.

Sports Psychologists’ Experiences of Organizational Stressors

David Fletcher, James Rumbold, Robert Tester & Matthew Coombes. The Sport Psychologist, 2011, 25, 363-381

Commentary by Dr. Judy Goss Having just returned from the Pan American Games in Guadalajara, Mexico, I am recovering from some type of illness most likely acquired in the athlete’s village or on our 18 hour trip home. I write this as I prepare to attend a competition in Toronto (my hometown) before the SPIN Summit and then return to Guadalajara for Para Pan American Games. I chose to highlight this article because all Integrated Support Team (IST) members more than likely have experienced some type of job related stress. Being conscious/ aware/proactive about stress is key to sustaining your professional career and flourishing instead of floundering. This article elaborates on the factors specific to those individuals in academics and consulting which is applicable to most IST members. Issues such as presentation skills, evaluation in the workplace and ethical obligations are also identified. Some of the challenges outlined included a balanced provision of services to multiple clients such as athletes, coaches and organizational personnel. This article also elaborated on stress created by the ethical code of conduct when conflicts occur between the client’s wishes and the organizational requirements. This is more than likely difficult as most sport psychologists have little training in these types of ethical dilemmas. Suggestions or www.sirc.ca

methods of how to reduce stress from a behavioural change perspective are not mentioned, however, bringing awareness to this issue is the first step. Sport psychologists are able to provide stress management techniques to others but sometimes they must practice what is preached. As an IST member, one must be aware of the stress that you may bring to a group along with the stress other members may bring. Be aware of your stress response and how it affects your behaviour, thoughts and emotions. This goes down the line of emotional intelligence which will be the topic next time. ∆

Vitamin D and Athletes.

Larson-Meyer, D. E., & Willis, K. S. Current Sports Medicine Reports (2010): 9(4), 220-226.

Commentary by Heather Hynes

V

itamin D has many known functions within the body and it is recognized that a high percentage of the population is deficient or maintains suboptimal levels of vitamin D. Research with an athletic population is limited but this review article highlights the importance of vitamin D screening and discusses the impact that suboptimal vitamin D status may have on bone health and sports performance. It is important to mention that as you read this review article that the current Recommended Dietary Allowance (RDA) values for vitamin D and the Upper Limit (UL) values set by the Institute of Medicine were revised in 2010; the current values are 600 IU/ day for individuals between 9-70 yrs and the UL is currently set at 4,000 IU/ day. Vitamin D can be obtained from a few 33

dietary sources; fatty fish, egg yolks, fortified cereals and dairy products. The main source of vitamin D is through direct sun exposure during the summer months. Of concern for Canadian athletes is the lack of exposure for the long winter months and due to our geographical location (above 35 to 37° degrees latitude) vitamin D cannot be synthesized even on a sunny winter day. The best indicator of vitamin D status is to monitor serum 25(OH)D concentrations. Sport physicians and sports dietitians should be requesting frequent assessments during the training year; especially for athletes who train indoors (combative sports, gymnastics, etc.), have a history of bone injuries, who limit dietary sources or who train in the early or later part of the day. This research article highlights key factors when conducting a clinical assessment of vitamin D status. Understanding the symptoms of vitamin D deficiency is very important for high performance coaches. Musculoskeletal pain and weakness are mentioned as symptoms that are often overlooked or ignored. Supplementation protocols at or above the current RDA values may be needed during the winter months to ensure optimal vitamin D status. ∆

Developing Maximal Neuromuscular Power : Part 2-Training Considerations for Improving Maximal Power Production

Prue Cormie, Michael R. McGuigan and Robert U. Newton. SportsMed 2011,41 (2): 126-146.

Commentary by Mathieu Charbonneau This review discusses the parameters of power output and training with links to specific sport movement characteristics. The force-velocity relationship is the main topic and parameters we can

SIRCuit Volume 2 (1) Fall / automne 2011


manipulate to train power output are presented with evidence and practical examples. Training modalities are discussed in terms of motion pattern, velocity, and loading, regarding sport specificity. This paper helps in logically selecting training modalities. Topics covered : • Neuromuscular elements in force and power production • Movement pattern specificity of training modalities • Load specificity: How heavy; Why; What does it enhance? • Velocity specificity: Move an object rapidly or twitch your muscle fast (rate of force development)? • Windows of adaptation: It is difficult for the high level athlete to advance to the next level. There is a necessity to target the right parameters at the appropriate time (low-/high-velocity strength, rate of force development, stretch-shortening cycle, intra-/intermuscular coordination, skills) • Integration of modalities within periodization

to his power capabilities, the more competent an athlete can be on a given day. This paper brings scientific literature to common principles: train from simple to complex, work on the weakest link to get most benefit, plan to work smarter. Speed, load, and movement coordination must be adapted to meet the specific requirements of your sport. ∆

Two emerging concepts for elite athletes: the short term

effects of testosterone and cortisol on the neuromuscular system and the dose response training role of these endogenous hormones. Crewther, BT et al (2011). Sports Medicine 41(2) p 103-123

Since strength is a major constituent of power production, strength training is discussed as a neuromuscular base before emphasizing load- and speedspecificity. The proposed order is: heavy load/slow velocity, low load/ high velocity, plyometrics, sport specific coordination, and skills. I like the idea on the versatility of load-modality combinations to raise an athlete’s competence in a wide spectrum of the strength-velocity curve. It will help build a strong, healthy athlete through training and competition. Power capability should be fine tuned, depending on sport type and load characteristics the athlete must face: high load/high speed for opponent sports (with body contact, combat sports), low load/high speed for athletics type sports (running, jumping, throwing).

Commentary by Leo Thornley

The athlete has to manage his strength/ power to produce optimal performance. It’s not always an all-out effort, but controlled muscle contraction (force) to produce a given motion sequence to win. The more aware and accustomed

Crewther et al remind us that workout design, nutrition, genetics as well as training status and training type all contribute to the testosterone and cortisol response; which in turn play a large role in regulating muscle growth

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U

nderstanding the hormonal response to training has led us to refine the design of a given workout and indeed the structure for the wider training program. While the body responds to a training stimulus with a milieu of different hormones two of the more commonly discussed by athletes, coaches and sport science staff are steroid hormones testosterone and cortisol. This review paper by Crewther et al looks at the research from both a short term effect on the neuromuscular system and the dose (training) response relationship. This paper highlights that as our understanding of a topic evolves some concepts may become more complex.

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and therefore performance. Planning the workout with the stimulus in mind and using the hormone response to get the most out of the workout is good practice. The idea that utilizing hypertrophy workouts in order to stimulate a large testosterone response and over time enhance muscle form and function is common practice. This paper suggests that the notion that these hormones have little short term effects may be too simplistic. In the more acute sense these hormones may have beneficial effects on neuromuscular signaling and activation as well as contractile properties of the muscle. These more acute benefits may enhance subsequent strength and power exercises. While early gains in strength training may be mostly attributed to neural factors the elevated testosterone and cortisol may play a permissive role in these adaptations, their role being perhaps wider than previously considered. Crewther et al highlight that individual differences particularly when looking at an athlete’s career point or training status may require us to measure the these hormonal response factors in order to determine the best workout design and indeed the trainability of an athlete. This paper is a good read for anyone prescribing strength training workouts. It is clear that more research is required on elite athletes in particular to better understand the multifactorial contributions these hormones play in the athletic training environment. ∆

SIRCuit Volume 2 (1) Fall / automne 2011


Low-Load High Volume Resistance Exercise Stimulates Muscle Protein Synthesis More Than High-Load Low Volume Resistance Training in Young Men

Burd et al., 2010, Plos One, August 2010, Volume 5, Issue 8

Commentary by Matt Jordan Background Muscle hypertrophy (increase in fiber size) is an important outcome of resistance training. Typical guidelines for developing muscle hypertrophy include repetitions in the range of 5-12 and loads in the range of 70-85% of 1 Repetition Maximum (RM). This type of loading mechanically stresses the muscle fiber and recruits the entire motor unit pool. Not only can muscle fiber hypertrophy be stimulated by muscle contractions against high load but also by other forms of stress such as low load muscle contractions that restrict muscle fiber blood flow.

This may be an attractive option for developing muscle hypertrophy in populations who are unable to perform high load resistance training like athletes recovering from injury or in young developing athletes. Purpose of the Study This study attempted to evaluate the effectiveness of low load resistance training for stimulating muscle protein synthesis in the leg muscles of young recreationally trained male subjects. Study Design The investigators used three load conditions: (1) 90% of 1RM lifted until failure; (2) 30% of 1RM lifted for a controlled number of repetitions (equivalent to the work performed in the 90% condition); (3) 30% of 1RM lifted until failure. Main Findings: 1. The low-load to failure condition was as effective as the high load condition for stimulating muscle protein synthesis at the 4-hour mark and more effective when measured at the 24-hour mark. 2. The load-load failure condition increased mitochondrial protein synthesis, which might benefit the aerobic system. 3. Muscle hypertrophy is not only a load dependent process but also a volume dependent process. Limitations and Future Considerations: 1. They didn’t study an athlete population. 2. A training study should be done to confirm the benefits of this type of loading. 3. Future studies should consider loads in between 30% and 90% of 1RM as this is a very large range in intensity. ∆

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Strengthening and Neuromuscular Reeducation of the Gluteus Maximus in a Triathlete With Exercise-Associated Cramping of the Hamstrings

Tracey Wagner, Nazly Behnia, WonKay Lau Ancheta, Richard Shen, Shawn Farrokhi, Christopher M Powers, Journal of Orthopedic and Sport Physical Therapy, February 2010 volume 40, number 2

Commentary by Bruce Craven Every High Performance Athlete is a “CASE STUDY” When working with high performance athletes, we need to remember that most of these individuals do not fit within the normal population bell curve. This distribution becomes a problem when developing a treatment plan for them, as the majority of evidence based research for therapy intervention is based on normal individuals using parametric statistics. The plan that every therapist working with high performance athletes must remember, is to utilize evidence based research to create a theory behind the causative nature of the injury and then approach the athlete’s care like a case study. To complete the analysis and test the theoretical model that is directing the athletes’ treatment, it is imperative that the entire Integrated Support Team (IST) and Coach are involved in the process. The researchers of this article have presented two possible causes for the exercise-associated cramping 1) electrolyte imbalance and 2) local muscle fatigue. Although each of these theories is unlikely to occur in isolation, it is important to involve all IST members with the development and testing of the treatment theories. The IST must dissect each theory to determine the appropriate causative factor. If there is not long-term success in management of the condition, the IST must accept the possibility of not

SIRCuit Volume 2 (1) Fall / automne 2011


identifying the correct etiology of the problem. In this article, the athlete had been attempting to correct the problem through modification of training to address the muscle fatigue and correcting his electrolyte/nutrition status. There had been no long-term success in his treatment. Further investigation into the theory of isolated muscle fatigue must identify what muscles in the kinematic chain are fatiguing and what muscles over activated. To start this assessment, the athlete underwent the following: • Clinical history of presenting condition • Presenting complaints • Medical Screening to rule out any “red flags” for major illnesses or conditions • Differential diagnosis screening to localize the problem within the lower quadrant • Clinical tests for flexibility, strength and motor function • Dynamic Assessment looking at gait, and other movement tasks. Following this assessment, it was determined that the athlete’s condition was consistent with the muscle fatigue theory. Further testing was required; as the assessment to date only identified that there was diminished hip extensor muscle performance. Although the manual muscle testing can not differentiate between the hamstring function and the gluteus maximus function in certain tasks, the testing provided insight into the dysfunction as there was excessive hip internal rotation and adduction during hip extension testing. To further develop the causative theory the authors indicated that the gluteus maximus and hamstrings are agonist muscles during running. If the gluteus maximus was either weak or had impaired motor function, then the hamstrings would exert a greater effort during running causing it to fatigue earlier than it’s contralateral limb www.sirc.ca

resulting in the cramping.

minutes of rest between each set.

In this case, the athlete underwent a biomechanical evaluation of his running gait using EMG to differentiate the gluteus maximus and hamstring contribution during running. EMG found that the triathlete’s hamstring muscle was over activated during terminal swing and the first half of the stance phase during running. This supported the developed theory that the over-activation of the hamstrings may be causing the fatigue and resulting cramping. The theoretical model implemented to guide the rehabilitation process; focused on the need to improve the gluteus maximus strength and neuromuscular control to provide better recruitment during terminal swing and the first half of stance. If the gluteus maximus improved its function during these phases of gait, the load requirement and resulting decrease in work done by the hamstrings would decrease the likelihood of muscle fatigue and the resulting cramping. The physical therapy program consisted of strengthening and neuromuscular reeducation of the gluteus maximus, with exercises being progressed over 3 phases. Phase One: • non–weight-bearing exercises to emphasize isolated muscle recruitment • exercises focused on muscle recruitment • 3 sets of 8 to 15 repetitions were prescribed, with 1 to 2 minutes of rest between each set

For each phase the exercises were performed on the right and left lower extremity. During the 8 months of intervention, the athlete’s strength, dynamic control and hamstring and glut activation improved; allowing him to complete 3 half Ironman competitions without hamstring cramping issues. The case report supports the theory that improving strength and neuromuscular control of the gluteus maximus resulted in a decrease in hamstring activation during terminal swing and the first half of the stance phase during running. The authors caution the reader to take care in establishing cause and effect, based on a single case study. This paper I feel guides us to an important reminder that when evaluating and treating our high performance athletes with chronic musculo-skeletal injuries. It is imperative that we develop a theoretical model to guide our treatment plan based on evidence based practice and to test this theory using the rigors of science from all members of the IST. As with every case study report, care must be taken in establishing cause and effect, based on a single patient; however, it is also important to remember that in high performance sport there is very little evidence to support cause and effect when it comes to a successful performance. ∆

Phase Two: • weight-bearing exercises • exercises focused on muscle hypertrophy • 3 to 5 sets of 4 to 8 repetitions were prescribed, with 2 to 3 minutes of rest between each set. Phase Three: • dynamic and ballistic training • exercises focused on muscle endurance • 2 to 3 sets of 12 to 20 repetitions were prescribed, with 30 seconds to 3

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SIRCuit Volume 2 (1) Fall / automne 2011


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SIRCuit Volume 2 (1) Fall / automne 2011

HP SIRCuit Fall 2011  

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