Brian Schiff’s Blog
Injury Prevention, Sports Rehab & Performance Training Expert
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Unfortunately, too many athletes who recover from ACL tears go on to suffer another injury within a short period of time. Click here to read a prior post on secondary injuries. There are differing opinions on when or if there is an exactly “right time” to clear an athlete for return to play.
We already know that athletes have persistent weakness and asymmetry at 1 year post-op and even beyond. I recently had one of my collegiate soccer players re-tear while helping out with a youth soccer camp. She had not yet done hop testing with me or been cleared for full soccer, but as she was 1 year out she did not think it would be an issue playing with 12 year-old girls. It only took 20 minutes before she suffered a non-contact re-injury and lateral meniscus tear.
Consider the following paper that reveals low rates of patients meeting return to sport (RTS) criteria at 9 months post-op:
https://www.ncbi.nlm.nih.gov/pubmed/29574548
Another paper recent published in the Journal of Sports Rehabilitation revealed marked deficits in balance and hop testing at 6 and 9 months post-op:
https://www.ncbi.nlm.nih.gov/pubmed/29466066
A recent paper in the American Journal of Sports Medicine (https://www.ncbi.nlm.nih.gov/pubmed/29659299) lists positive predictors of a return to knee-strenuous sport 1 year after ACL reconstruction were male sex, younger age, a high preinjury level of physical activity, and the absence of concomitant injuries to the medial collateral ligament and meniscus.
In 2016, research in the American Journal of Sports Medicine revealed delaying return to sport at least 9 months markedly reduced re-injury risk in those who passed RTS testing. Click below for more on that study:
https://www.ncbi.nlm.nih.gov/pubmed/27162233
So, where are we now? I employ multiple functional tests including the Y-Balance Test, FMS, single leg squatting, hand held dynamometry, hop testing, qualitative movement assessment and jump landing assessments. But, is that enough?
One of the benefits of being an online columnist for PFP Magazine is having an opportunity to test out the latest training tools in the fitness industry. recently, I received a PowerWave 2.0 Constrainer from Power Systems. I really liked the versatility and ease of use with this particular apparatus. It is portable, yet challenging and offers various models for the end user.
I have included the two videos I put together for my column ‘Functionally Fit’ that emphasize how to use the PowerWave to perform cleans and the bus driver. I think you will find that the PowerWave 2.0 Crosstrainer is much like the TRX in that it offers lots of options in a limited footprint if you want to work out at home. You can target strength, explosive training and metabolic conditioning using it.
Check out the videos below:
See the full columns at www.fit-pro.com.
I am pleased to announce that my new e-book on overcoming knee injuries and maximizing running performance is now available! As someone who has run 4 half-marathons, a full marathon and several 5Ks, I know firsthand how frustrating an injury can be. Perhaps worse than the injury itself, is the fear of re-injury when every step brings trepidation in the back of your mind that the same pain could come back at any moment.
Over the course of my fitness and therapy career, I have worked with hundreds of runners ranging from beginners to competitive runners. Many have been sidetracked by anterior knee pain and IT Band Syndrome. While there is no way to prevent all injuries, I have found that learning to assess the body and incorporate corrective strategies to eliminate asymmetries and imbalances along with proper conditioning allows individuals to run faster, longer and relatively injury free.
Up to 50% of all lower extremity injuries with runners involve the knee. I have been working on a manual that summarizes my approach to injury prevention, rehab and training for runners. You see, many people are not really fit to run when they start running. If more people knew how to detect potential issues and train adequately to prepare their bodies to run, injury rates would decrease and performance would subsequently increase.
As such, I wrote Fit For Running: Overcome Knee Injuries and Maximize Performance. This 70 page e-book covers assessment, stretching, strengthening, soft tissue mobilization, plyometric training and injury recovery guidelines. It focuses on preparing the human body for optimal performance – a manual for physical readiness if you will. It is perfect for runners of all ages and abilities, running coaches and fitness trainers working with runners.
While my book aims to target knee pain, it really offers considerable knowledge and insight that would help a runner with any overuse injury. Given the proportion of knee injuries, I chose to focus the injury/rehab portion of the manual on this topic.
Click Here to download a free sample and learn more about this great new resource.
So, I just returned from the Combined Sections Meeting for the APTA that was held in Indianapolis. There was lots of great networking and presentations to be sure. I attended sessions on ACL rehab/prevention, femoroacetabular impingement, elbow injuries in throwers, running gait analysis, and shoulder plyometric training with the legendary George Davies. I thought I would give you my top 10 list of helpful nuggets I picked up over the weekend in no particular order of importance.
1. Performing upper body plyometrics has no effect on untrained subjects so don’t waste time putting it into the rehab program, where as it does benefit trained overhead athletes. The one caveat is it also increases passive horizontal external rotation so keep this in mind when working with athletes who have shoulder instability.
2. A new study coming out in 2015 in AJSM revealed no major differences in throwing kinematics between those following UCL reconstruction (Tommy John) and age-matched controls. This is good news for those worried about pitching mechanics after the procedure.
3. According to Dr. Reiman at Duke, the orthopedic hip exam does a better job of telling us they do not have a labral tear than it does telling us they do have an intra-articular problem. The tests have poor specificity. In fact, he goes on to say that the “special tests are not that special.” That brought a chuckle from the crowd including me. Bottom line – we are not really able to conclusively say “yes you have a labral tear based on my exam today.
4. Reiman also feels we must consider look for mechanical symptoms during the lowering portion of the Thomas test, while considering the fact that fat pad impingement may cause anterior hip pain as opposed to joint pain. Again, things are not always as they appear in the “FAI” crowd so we need to take a great history, look at the classic tests and also see how squatting and loading affects the hip.
5. More experienced pitchers do not drop the glove side arm, but instead tend to move their body toward the glove to conserve angular momentum and overcome small moments of inertia. Less experienced pitchers rotate their trunk sooner in pitching cycles whereas pitchers who threw at higher levels rotated later and produced less torque at the shoulder. Consequently, many players with higher elbow valgus torque and distraction force at the shoulder rotate too early.
Athletes are always striving to be the best. There are lots of great coaches out there with different approaches. A few months back I had a trainer, Travis Hansen, approach me to see if I might be interested in reviewing his speed product.
These types of requests are commonplace in the industry, and I have several requests to review and endorse products. While I am generally hesitant to promote other products, I am always looking to expand my current knowledge base and learn something new. I was naturally very skeptical when asked to recommend this product, but I can honestly say that after reading this book that it is a great product for any coach or trainer, or even athlete looking to learn the ins and outs of speed development.
The package is purely digital which allows immediate access, and it’s currently being offered at a very reasonable “summer discount” price of just $37. Order it here
Here are 3 reasons I like this resource:
#1- “Encyclopedia” is an accurate name for it
It takes all the different elements of speed development and condenses them into manageable chunks of content. Sometimes I nerd out and will read a 300 page book just on special strength training. Sometimes that’s just too much. But, if you’re having a thought or working through an idea, it’s probably covered here and it’ll give you some insight to answer your question or send you to a more detailed resource or direction.
#2- It doesn’t try to reinvent the wheel
I really like that Travis isn’t trying to push some already established format of training on you and the call it a cute name and say that he invented it. Some of the concepts you may actually know really well. Others you’re probably aware of, but have only a passing knowledge of. Regardless, it’s all in there. It’s like a central hub for training topics.
“Oh man, how does Post Activation Potentiation work again?” Just go to the book and get a Cliff’s Notes sized version on the topic. Maybe it scratches your itch or maybe it sends you off somewhere else for a deeper look. With so much training info in my library, sometimes I’m just looking for confirmation of my own thoughts, not a research project.
#3- It gives credit where credit is due
If the book talks about a topic, Travis cites the original author/creator. He’s not saying this is all coming from his brain, he’s just done a lot of research and clearly cites whose idea it was originally. Many of us who put out information have been bashed by people in the industry who took credit for other peoples’ information or ideas. Whether or not you believe anyone who sells any information can actually take credit for inventing it (since everyone’s coaching philosophy is just a personalized interpretation/presentation of other peoples’ information) this book won’t offend. And since it cites all its material, you can be confident it wasn’t pulled out of the others.
All in all, it is a very solid product. It’s only $37 right now. Considering I rarely promote other peoples’ stuff, I feel confident in telling you it is $37 well spent.
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