Oct 24, 2022·edited Oct 25, 2022Liked by Dr. Michael Chivers, John Quint
Hard to speak specifically about any of the cases without gathering more information on the athlete’s Point A, the roadmap to Point B and all the other determinants that lead to these events, but here are some thoughts:
1- I think we always have to consider that goaltending or any other sports specific activities are not something we evolved to do, and they always going to pull from the internal environment, which may lead to injury and it’s reoccurrence.
2- A common trend I see particularly in pro sports is an overemphasis on collecting external load data without understanding how that load is going to influence the internal environment. I think we figured out how to gather data on readiness and fatigue at the CNS level but not really at the tissue level. I wonder how this could be tested?
3- Training/rehab programs still focus on movements and not necessarily on tissues specifically. Just look at college and professional teams weight rooms... lots of standard model training, thinking, and obviously suboptimal results.
4- Not super familiar with the hockey culture, but in basketball sometimes strength coaches and therapists don’t have as much saying as they should...
5- Players leaving the city and seeing different trainers in the off-season may lead to a discontinuation of the necessary programming needed to achieve an optimal point B, considering off-season is the best time to do it.
6- Sometimes diagnosis are very generic. Last week I had a pro basketball player overseas telling me he went to the doctor that told him he had pubalgia 🤷♂️
7- Also, as we discussed at the FR course this weekend, the medial thigh muscles have different functions, and there’s different functions in the same muscle, depending in which area. I think we need to be more specific in what areas we need to apply training inputs to rehab specific tissues, specially with the resources available at the pro level.
8- I think that at the pro level there’s always a tendency to push players into practice/game situations without being fully rehabilitated. Like Dr. Spina mentions in the control yourself podcast, rehab can’t be limited to bringing the tissues to the initial levels of capacity, as it was at that level they got injured. I think this can be hard to manage effectively if the player is under lots of practice loads.
9- We also need better ways to test the actual state of the athlete. Joint function and tissue behavior are easily assessable through the FRA, but when it comes to reactive strength and speed strength, how can we determine an optimal point B for the adductors in specific?
Some good thoughts here. Regarding #2 - there are some options for looking "internally" that may or may not be applicable here: Moxy and Tensiomyography are two that come to mind.
Moxy - Andrew Hauser has discussed the unit quite a bit. I believe you may have his contact? Moxy has a podcast but it is rapidly gaining traction in professional sports though endurance sports (cycling, running, rowing) have been using it for a few years now.
Oct 24, 2022Liked by Dr. Michael Chivers, John Quint
A deeper insight of focused training for the athletes human body to establish point A in order to understand what’s needed to establish point B optimally. Thank you for asking this question!! This is post graduate case study knowledge! The FRS system is becoming more powerful than ever through the “Absolute” experience.
Oct 24, 2022Liked by Dr. Michael Chivers, John Quint
Hi everyone!
The key point, I think, is the rush to get back on the pitch, and the misunderstanding that an injiured tissue needs the appropriate progressive loading to restablish the normal tissue architecture that is the prerequisite for the normal tissue behaviour. Probably a good start, from a reabilitating prospective, could be assessing the different adductor compartment, finding the MT in a specific line of tissue (more an more probabily in an reinjured tissue), to put in a directional loading, low dose of PAILs contraction over time ad after a while increase the load, the speed and strenght.
Goal could be increase the quality of connective tissue and so load bearing capacity necessary to mitigate the different variable present in the specific sport!
Oct 24, 2022Liked by Dr. Michael Chivers, John Quint
From my own antidotal evidence when started messing with the westside conjugate system and doing a lot of wide stance movements which were new to me I noticed because of compensations I would preform the movement in a decent pattern but not feel the adductors especially. This became even more pronounced to me when starting FRC. I started over from there with isometrics along with some different PAILs/RAILs that would give me the stimulation I was looking for in trying to train the adductors to fire and contract. Through this I am now able to feel not only more adductor in wide stance things but hips as well. So I believe my ability to compensate so well at first even with fairly heavy load would of ended with an injury if I had not noticed the lack of control I had in FRC.
As there have already been some great comments in terms of assessing the athlete’s current kinematics and physiology, we also have to look at typical off-season and in-season preparatory activities.
What does their off-season training look like? We should take a bell curve approach to specificity, especially in hockey. Where we look to remove or drastically minimize frontal and transverse plane activities to deload those tissues. Mid-way through the preparatory period we should look to return to loading these planes to prepare for an increase in skating activity mid-way through the summer, and again deload these patterns as skating volume increases in the preseason and competition period.
This all sounds good on paper, but we need to understand the nuances that occur logistically in elite athlete’s training schedules: i.e.
-did they have a bad season and feel like they immediately need to get to work with a skating coach?
-Are they going away for a major chunk of time half way through their off-season training routine?
-what are our resistance training vs. conditioning strategies? Is it a good idea to condition them with sport specific strategies on the ice if we are loading those patterns that day in the weight room?
Oct 25, 2022Liked by Dr. Michael Chivers, John Quint
The adductors are unique in terms of architecture and origin/insertion sites:
Pectineus, brevis, longus, magnus have insertions on/close to linea aspera of the femur (the back side of the femur).
Training/Rehabilitating only in abduction/adduction without hip rotational specific inputs is becoming limited in terms of fibers directionality and specific stimulus, at this levels of performance details are crucial.
Also, all the adductors have origin on the pubic ramus and ischum bones, same, a unique common attachment site where the muscles/tissues have to counteract when unilaterally engaged…
Oct 24, 2022Liked by Dr. Michael Chivers, John Quint
I would think that assessing the joint capsule would help us understand if the adductors are able to receive the inputs required to increase the load bearing capacity of the adductor tissue.
🤔🤔🤔there must me also a difference between type of fibers, some of the adductors (fibers closer to the pubis ramus) may have more slow twitch fibers with a different approach to training inputs, closer to knee or further away with n the femur fibers behave faster.
Hard to speak specifically about any of the cases without gathering more information on the athlete’s Point A, the roadmap to Point B and all the other determinants that lead to these events, but here are some thoughts:
1- I think we always have to consider that goaltending or any other sports specific activities are not something we evolved to do, and they always going to pull from the internal environment, which may lead to injury and it’s reoccurrence.
2- A common trend I see particularly in pro sports is an overemphasis on collecting external load data without understanding how that load is going to influence the internal environment. I think we figured out how to gather data on readiness and fatigue at the CNS level but not really at the tissue level. I wonder how this could be tested?
3- Training/rehab programs still focus on movements and not necessarily on tissues specifically. Just look at college and professional teams weight rooms... lots of standard model training, thinking, and obviously suboptimal results.
4- Not super familiar with the hockey culture, but in basketball sometimes strength coaches and therapists don’t have as much saying as they should...
5- Players leaving the city and seeing different trainers in the off-season may lead to a discontinuation of the necessary programming needed to achieve an optimal point B, considering off-season is the best time to do it.
6- Sometimes diagnosis are very generic. Last week I had a pro basketball player overseas telling me he went to the doctor that told him he had pubalgia 🤷♂️
7- Also, as we discussed at the FR course this weekend, the medial thigh muscles have different functions, and there’s different functions in the same muscle, depending in which area. I think we need to be more specific in what areas we need to apply training inputs to rehab specific tissues, specially with the resources available at the pro level.
8- I think that at the pro level there’s always a tendency to push players into practice/game situations without being fully rehabilitated. Like Dr. Spina mentions in the control yourself podcast, rehab can’t be limited to bringing the tissues to the initial levels of capacity, as it was at that level they got injured. I think this can be hard to manage effectively if the player is under lots of practice loads.
9- We also need better ways to test the actual state of the athlete. Joint function and tissue behavior are easily assessable through the FRA, but when it comes to reactive strength and speed strength, how can we determine an optimal point B for the adductors in specific?
Thanks Miguel.
Some good thoughts here. Regarding #2 - there are some options for looking "internally" that may or may not be applicable here: Moxy and Tensiomyography are two that come to mind.
Hey Jeff. Got any links or sources to the above methods? Would like to read
Sure.
TMG - Carl Valle is a big proponent and he's written a lot about it over the years. Here's an example.
https://simplifaster.com/articles/tmg-secret-weapon-sports-performance-rehabilitation/
Moxy - Andrew Hauser has discussed the unit quite a bit. I believe you may have his contact? Moxy has a podcast but it is rapidly gaining traction in professional sports though endurance sports (cycling, running, rowing) have been using it for a few years now.
https://simplifaster.com/articles/tensiomyography-tmg-hyperspeed-exercise/
What are your thoughts on thermography?
Good read this, nice one Miguel
A deeper insight of focused training for the athletes human body to establish point A in order to understand what’s needed to establish point B optimally. Thank you for asking this question!! This is post graduate case study knowledge! The FRS system is becoming more powerful than ever through the “Absolute” experience.
Thanks Byron. Appreciate it!
Hi everyone!
The key point, I think, is the rush to get back on the pitch, and the misunderstanding that an injiured tissue needs the appropriate progressive loading to restablish the normal tissue architecture that is the prerequisite for the normal tissue behaviour. Probably a good start, from a reabilitating prospective, could be assessing the different adductor compartment, finding the MT in a specific line of tissue (more an more probabily in an reinjured tissue), to put in a directional loading, low dose of PAILs contraction over time ad after a while increase the load, the speed and strenght.
Goal could be increase the quality of connective tissue and so load bearing capacity necessary to mitigate the different variable present in the specific sport!
Great points Andrea!
From my own antidotal evidence when started messing with the westside conjugate system and doing a lot of wide stance movements which were new to me I noticed because of compensations I would preform the movement in a decent pattern but not feel the adductors especially. This became even more pronounced to me when starting FRC. I started over from there with isometrics along with some different PAILs/RAILs that would give me the stimulation I was looking for in trying to train the adductors to fire and contract. Through this I am now able to feel not only more adductor in wide stance things but hips as well. So I believe my ability to compensate so well at first even with fairly heavy load would of ended with an injury if I had not noticed the lack of control I had in FRC.
As there have already been some great comments in terms of assessing the athlete’s current kinematics and physiology, we also have to look at typical off-season and in-season preparatory activities.
What does their off-season training look like? We should take a bell curve approach to specificity, especially in hockey. Where we look to remove or drastically minimize frontal and transverse plane activities to deload those tissues. Mid-way through the preparatory period we should look to return to loading these planes to prepare for an increase in skating activity mid-way through the summer, and again deload these patterns as skating volume increases in the preseason and competition period.
This all sounds good on paper, but we need to understand the nuances that occur logistically in elite athlete’s training schedules: i.e.
-did they have a bad season and feel like they immediately need to get to work with a skating coach?
-Are they going away for a major chunk of time half way through their off-season training routine?
-what are our resistance training vs. conditioning strategies? Is it a good idea to condition them with sport specific strategies on the ice if we are loading those patterns that day in the weight room?
The adductors are unique in terms of architecture and origin/insertion sites:
Pectineus, brevis, longus, magnus have insertions on/close to linea aspera of the femur (the back side of the femur).
Training/Rehabilitating only in abduction/adduction without hip rotational specific inputs is becoming limited in terms of fibers directionality and specific stimulus, at this levels of performance details are crucial.
Also, all the adductors have origin on the pubic ramus and ischum bones, same, a unique common attachment site where the muscles/tissues have to counteract when unilaterally engaged…
Thanks for commenting Monica!
I would think that assessing the joint capsule would help us understand if the adductors are able to receive the inputs required to increase the load bearing capacity of the adductor tissue.
Capsular space is part of Point B. Thanks James!
🤔🤔🤔there must me also a difference between type of fibers, some of the adductors (fibers closer to the pubis ramus) may have more slow twitch fibers with a different approach to training inputs, closer to knee or further away with n the femur fibers behave faster.
Great answer. Thanks Ben!