Core strengthening with foam roller

by Becky McClure (MPT) and Nami Stone (MPT)

Although recent studies on the benefits of core strengthening to an athlete’s performance have produced few findings, there is a direct link to improved balance, stability, and overall decreased incidence in low back in all populations. A study by Indiana State University in 2007 was unable to show any “significant” improvement in sports performance by healthy athletes who underwent specific core strengthening. However, it can be argued that the benefits to athletes with ongoing back pain can be significant. In order to have an effective core program, it is important for the individual to understand how to control the pelvis in a neutral, anterior, and posterior position.

Please see the following video as we explain and demonstrate how to achieve neutral spine, posterior pelvic tilt, and anterior pelvic tilt using a foam roller:

Once these three positions are understood, it is easier to add leg and arm movements while holding the spine in a neutral or posterior position. Examples of these progressive movements would be alternating arm lifts, alternating straight leg lifts, or alternating leg marches while maintaining neutral or posterior pelvic position.

The below video is a more advance exercise that demonstrates how to hold neutral spine while moving the arms and legs in what is called the “dead bug” exercise:

If you are interested in purchasing a foam roller, search for "foam rollers" at amazon.com. The 6” x 36” foam rollers by Exertools and Isokinetics are around $10 a piece. Gary Gribbles in downtown Lawrence has also been known to carry the 6” x 36” foam rollers.

In our next blog, we plan to demonstrate upper extremity, lower extremity, and trunk stretches as well as spine mobilization techniques utilizing the foam roller.

Aquatic Fit for Life:Knowledge to Keep you Fit

           
              Presents                  

Aquatic Fit for Life

Who:

LMH Therapy Services

What:

Aquatic Fit for Life is a program designed transition aquatic therapy patients to independent aquatic exercise. The program gives patients the freedom to continue individual exercise at their own pace.

Where:

Lawrence Indoor Aquatic Center

4706 Overland Drive

When:

Monday and Thursday anytime between 8:30-10:30AM each week during the months of September through May

How:

$35 for 12 visits

Contact Lawrence Memorial Therapy Services at 785-505-2712 for more information

Why?:

Aquatic therapy was implemented 92 years ago into the physical therapy profession. However in the last 20 years it has developed and grown in to a specialty for therapists. Therapists are now trying to educate the public and health professionals that aquatic therapy is not just for rehabilitation, but also contributes to overall general wellness and fitness. Education of aquatic therapy can help acknowledge the fact that it is not something just anyone can do and patients aren’t just going to the pool and swim laps. They need help to implement an aquatic program that brings a wide range of exercises in the water. Using the resistance of the water to strengthen the body and relieve pressure on the joints is extremely important in some patient cases. Those which that can truly benefit from aquatic therapy are those that have weight-bearing limitations or weakness when moving on land. Others that make large strides quicker from aquatic therapy are those with chronic pain, arthritis, and back injury. A long list of other types of patients can benefit from aquatic therapy, but most see amazing gains in their every day function in no time at all. So get ready to take the plunge to increase overall physical fitness and overall health by joining LMH and get fit in the pool and have the freedom to come when you want.

Article composed by Daryl Green, University of Kansas exercise science intern at LMH South Therapy Services.

Sports Concussion: Guidelines for Parents and Coaches

In 2004, Jake Snakenberg was a 15 year-old freshman football player at Grandview High School in Aurora, Colorado when he died after suffering a concussion too soon after a previous concussion. This second concussion followed a mild head trauma (concussion) that recently occurred. For Jake and many other teenage athletes in the past have lost their life to “Second Impact Syndrome” due to consecutive head trauma injury before the brain had fully healed from the initial injury. of concussions do not involve loss of consciousness Disturbance in brain fu

  

A concussion is defined as a disturbance in brain function that occurs following a blow or violent shaking of the head. Less than 10% of people with concussions actually demonstrate a loss of consciousness. Persons sustaining a sports concussion will typically demonstrate amnesia, confusion, feeling foggy and a headache. Commonly reported symptoms following a concussion include the following:

Headache

Dizziness

Blurred Vision

Feeling Slowed Down

Nausea

Vomiting

Balance Problems

Sensitivity to Light or Noise

Change in Emotional Behavior

Irritability

Fogginess

Attention/Concentration Difficulties

Memory Problems

Sleep Disturbance

Drowsiness

 Fatigue

To take action to prevent death and chronic post-concussive symptoms, concussion awareness is on the rise with 31 states passing concussion legislature since 2010. The State of Kansas passed the Kansas School Sports Head Injury Prevention Act in 2011. This law requires any athlete with suspected signs or symptoms of a concussion be removed from athletic participation and be cleared by a physician (M.D. or D.O.) before returning to play. Once a concussed athlete’s brain or cognitive function has returned to baseline and symptoms of a concussion are resolved, athletes can begin a supervised return to exertion protocol to prepare the body to return to contact. Taking these appropriate steps to ensure the brain is ready for activity decreases the incidence of chronic headaches, sleeplessness, poor academic performance and possible death that have plagued many youth athletes by returning to the field or court too soon.

Affiliated physicians of Lawrence Memorial Hospital are medically managing patients who are diagnosed with a concussion by implementing neuro-cognitive testing. Physicians at Mt. Oread Family Practice and Eudora Family Care are utilizing ImPACT™, a computer test program, which measure how the brain is functioning. Utilizing this tool as part of a comprehensive examination provides physicians with important information to determine if an athlete is safe to return to sports participation. 

ImPACT™ is a computerized battery of neurocognitive tests that can be used as a baseline prior to a concussion and post-concussion testing. Following a concussion and medical examination, the post-concussion test can track the recovery of the brain compared to the baseline test taken when brain function was not altered.  This testing is an important part of the medical decision to return the player back to sport participation safely.

It is important for parents, coaches and the athletes to be aware of concussions and its impact it has in the health of an individual. Early recognition of a possible concussion to prevent further head trauma is imperative. Education by parents and coaches to the athletes in regards to the symptoms and signs of a concussion should be explained at the beginning of each sport season to athletes in all sports. For more information regarding signs/symptoms of concussions can be found at the Center for Disease Control.

  www.cdc.gov/Concussioninyouthsports

Sports Concussion Services

LMH affiliated physicians at Mt. Oread Family Practice (Lawrence, KS) and Eudora Family Care (Eudora, KS) provide concussion management services to patients following a sports related concussion utilizing ImPACT™ testing. LMH Therapy Services in partnership with these physicians provide concussion prevention and education geared toward youth athletes, parents and coaches. Pre-season baseline testing is available at the affiliated practices for a $25 charge.  Post-concussion evaluation and management are available for athletes with sports-related concussions to consult in return to play decisions. Parents who are interested in individual baseline testing or post-concussion evaluations for their child/adolescent athlete may contact the practices directly.

Mt. Oread Family Practice: (785) 842-5070

Eudora Family Care: (785) 542-2345

Cheerleading Injury Prevention: Cardio, Core, and Plyometrics

Written by:
Nami Stone
Physical Therapist at Lawrence Memorial Hospital, and
Asst. Cheerleading Coach at the University of Kansas


My prior blog post gave a background on injury prevention in cheerleading, including how to improve the safety of you or your child while participating in cheerleading. As previously mentioned, there is no way to completely ensure the lack of injuries. However, with the proper conditioning, you can decrease the likelihood of injuries.

In my 9 years of collegiate coaching, I have discovered 3 important areas of physical conditioning as they pertain to cheerleading.

Cardiovascular conditioning

Collegiate football games can last up to 4 hours. Although they may not be doing skills the entire 4 hours, cheerleaders are expected to stay on their feet and keep the crowd energy up via chants, skills, and fight songs that can all be quite taxing. I find that as the cheerleaders fatigue, their technique gets worse thus increasing the risk of injury. I recommend at least 30 minutes of cardio 3-5 times per week at the very least.

Core fitness

This was covered earlier in a great post on Core Stability Training. In cheerleading, the tighter the core of the girl in the air, the less the stunt will move, thus minimizing the risk of falling. For bases, the better the core strength, the less likely the cheerleader is of getting back injuries while putting up and holding stunts.

Plyometrics

Plyometrics develop leg power and explosiveness, which helps with a wide range of cheerleading skills. For bases, leg power allows bases to get stunts up smoother and faster with proper technique. For flyers, the quicker a girl can “step and lock” or “jump and flick”, the easier the stunt will go up. For standing tumbling, most of the power and speed comes from the legs. With the lack of a nice strong jump, cheerleaders’ standing tumbling will be lower, which increases the risk of injury by “landing short.”

Shown below are several plyometric exercises you can do at home three to five times per week. Try working up to doing one continuous minute of each exercise with one minute of rest between exercises.

Lunge Jumps

10 reps of each lunge should take about one minute.

Frog Jumps

Box Jumps

Fall Sports Performance Group Sessions

     

Starting September 17th, LMH Therapy Services will be offering Sports Performance training to athletes to help prepare for the upcoming winter and spring sport season.  Participants can choose to join a group or train as an individual to enhance speed, strength, agility, conditioning and jumping skills. The fall training session will be available for athletes age 10-18 and will train in the newly updated 3^rd floor suite in the LMH 4^thStreet Health Plaza building.

The primary goal is for athletes to develop their athletic skills by training with modern strength and conditioning principles for their age. Performance Coaches utilize drills and equipment to train athletes on a padded turf surface. Athletes are trained by qualified performance coaches that are Certified Strength and Conditioning Specialists (CSCS) recognized by the National Strength and Conditioning Association. 

The training program is the foundation to an athlete's entire game. A solid strength and conditioning base provides the ability to take skills to a higher level and reduce injuries. Train with professionals that will push you to reach your potential by becoming more explosive and coordinated. Train at LMH and feel the difference in our approach to training you to be a better player in your sport, not a better "weight lifter."

Fall session registration opens September 4th. Please call LMH Therapy Services at 785.505.5975 or email adam.rolf@lmh.org to enroll or request more information.

Fall session begins September 17th and ends November 15th

High School (Ages 14-18)
Strength, Speed and Agility Training Group
4-5:30 pm Monday, Wednesday, Thursday
$18 per class

Speed and Agility Training Group

5:30-6:30 pm Tuesday & Thursday

$15 per class

Middle School (Ages 12,13,14)

Speed and Agility Training Group

5:30-6:30 pm Monday & Wednesday

$15 per class

Youth Development (Ages 10,11)
Learning to Train Group

6:30-7:20 pm Tuesday & Thursday

$12 per class

                                          

Proper Hydration is Crucial 
for Good Performance

Have you ever been on a long run or bike ride and all of a sudden start feeling a “little off” maybe lightheaded, dizzy or fatigued???  You could be dehydrated.

Proper hydration is crucial for performing at your best.  Approximately 60% of body weight is water, that is if you weigh 150#, 90# is water weight.  If you lose 3% or more of your body weight, that is 4.8# or more for a person weighing 150#, you are dehydrated and performance will decline.    

A quick way to assess if you are properly hydrated is to check the color of your urine.  If it is light yellow, the color of lemonade or straw, you are adequately hydrated.  If it is dark yellow the color of tea you are under hydrated and if it is clear in color you are over hydrated.

Daily hydration need (not including activity) is 0.5 -0.6 times body weight.  A person weighing 150# should consume 75 – 90 oz. of fluid per day or 9 to 11 cups.  All beverages including water, sports drink, milk, juice or watermelon which is 92% water can be counted as part of your fluid intake.  Use drinks that contain caffeine, like coffee and tea, with caution and sparingly as they can act as a diuretic.  Alcohol acts as a dehydrator.  If you drink a beer, drink a glass of water with it.

If you are an athlete or exercise regularly your fluid intake needs to increase.  Most athletes will be adequately hydrated with 80-100 oz. of fluid per day.  An exception where more fluid is needed would be heavier athletes, athletes competing at a high VO2 max percentage and/ or those exercising in severe environmental conditions.

As a general rule of thumb, keep fluid intake at 16 to 24 oz. of fluid per hour, yes…2-3 cups. Most people should not exceed more than 28 oz. of fluid per hour.  It takes time for your body tissues to absorb water.  Don’t just sit down and drink a gallon of water.  You will be better off drinking 4-6 oz every 15 minutes than drinking all at once. In most circumstances, one water bottle per hour will give you the right amount of fluid.

Now just a few more helpful hints:

1.   Train to get fit in the heat.  Heat acclimation and being in shape can reduce fluid and electrolyte loss by up to 50%.  On those first few hot days to help you acclimate cut your workout short, drink extra fluid, use an electrolyte supplement or eat a banana. 

2.   Wear the lightest evaporation-friendly clothing you can afford.  Cotton is not on the list.

3.   Use cold fluids.  Your body absorbs them better than warm fluids.

4.   During the hottest weather conditions, sponge off with cold water and give yourself a short, periodic rest break from race pace.  This will provide heat relief.

5.   Know the symptoms of dehydration.  STOP immediately if you feel lightheaded, dizzy or get the dry chills.  No race or training is worth compromising your health.

July 2012

Submitted by Becky McClure, PT, MOMT

Sports Physical Therapist at LMH South Rehabilitation

           

The Dynamic Warm-Up

Many of us breeze through a warm up (if we complete one at all).  Instead of properly preparing our body for the task at hand, we simply walk out the door and run.  However in order to prevent injury and improve performance, our body needs proper time to warm-up and prepare.  What does a proper warm-up consist of?  A light jog for 5-10 min followed by a series of dynamic exercises.

Why a dynamic warm up?

Dynamic exercises prepare your body for the activity ahead.  Dynamic exercises elevate your heart rate, increase blood flow, prepare your muscles and joints, and engage your nervous system.  Furthermore, dynamic warm-up exercises incorporate multiple large muscle groups in one exercise leading to overall improved warm-up with fewer exercises.  All of these reasons lead to better performance and fewer injuries.

Start with 5-10 min of light jogging and follow these simple 6 exercises to properly prepare for competition.  Complete each exercise for 25-50 feet.

Heel Pulls

 

•       PROCEDURE: Start in standing position with back straight. As you step forward with right leg, bend left leg, grab toes with right hand, and pull foot towards body. Contract right glute and lift up on right toes. Return to starting position and repeat on other side.

•       COACHING KEY: Keep your chest up. Contract the glute of the leg you are standing on.

•       YOU SHOULD FEEL: A stretch in the glute and quadriceps.

Knee Hug

 

•       PROCEDURE: Start in standing position with back straight. As you step forward with right leg, grasp below the knee of the left leg and pull knee toward chest. Contract your right glute and lift up on right toes. Return to starting position and repeat on other side.

•       COACHING KEY: Keep your chest up. Contract the glute of the leg you are standing on.

•       YOU SHOULD FEEL: A stretch in the glute and the hamstring of your front leg and in the hip flexor of your back leg.

Straight Leg March

 

•       PROCEDURE: Stand straight with arms extended in front of you at shoulder height. Step forward with left leg and flex right hip, bringing right leg up with toes pointed towards fingers. Lower right leg in front of you and repeat with left leg.

•       COACHING KEY: Keep back straight and engage abs for balance. Keep both legs straight.

•       YOU SHOULD FEEL: A stretch in the hamstring.

•       Straight Leg Skip: Add more action to exercise by skipping while leg is raised.

                                              High Knee Walk

•       PROCEDURE: While walking forward, lift one leg up so knee and ankle are parallel to the floor. Grasp leg with hands and gently pull ankle up for a stretch.

•       COACHING KEY: Keep back straight and engage abs for balance.

•       YOU SHOULD FEEL: A stretch in the piriformis and glute.

Sumo Squats

 

•       PROCEDURE: Start with feet shoulder width apart. Take a step out to the left side and lower into a squat with arms extended in front of you. Return to standing while stepping in with right foot, so feet are back to shoulder width. Take another step to the left side and repeat.

•       COACHING KEY: Keep back straight and knees behind toes. Push through your heels.

•       YOU SHOULD FEEL: Activation of the hips and legs.

Forward Lunge with Twist

•       PROCEDURE: Start with feet under hips placing hands on hips or behind head. Take a large step forward with right leg and lower left knee straight down, almost touching the floor. Keeping hips facing forward, twist torso to the right. Hold for a stretch. Return facing forward and raise left knee up. Repeat with a large step forward with the left leg.

•       COACHING KEY: Knees should be in line with toes facing straight ahead.

•       YOU SHOULD FEEL: A stretch in the hip flexors, glutes, and lateral torso. Activation of the long adductors.

Composed by

Adam Rolf and Julia Noonan

Physical Therapists at Lawrence Memorial Hospital

Cheerleading Injury Prevention: 

The Background

By Nami Stone, Physical Therapist and College Cheer Coach

Cheerleading started in 1898 when a few male college students formed the first “pep club” to lead the crowd in cheers during one of the first American football games. It wasn’t until the 1920’s that women started cheering, and skills such as tumbling, fight song motions, and other acrobatics started to emerge to help lead the crowd.

Training camps and the National Cheerleading Association (NCA) emerged in 1961, spurring cheer to be one of the fastest-growing youth activities in the nation. But it wasn’t until the Universal Cheerleading Association (UCA) was formed in 1974 that cheerleading started to look like it does today with partner stunts, pyramids, and routines choreographed to music, culminating in the first ESPN-televised UCA Cheerleading National Championship in 1982.

At the collegiate level, the KU Cheer squad’s primary purpose hasn’t strayed far from the intent of the original pep clubs: to support our athletic teams and energize the crowd. But like most modern squads, we also entertain the crowd by performing difficult and physically demanding stunts, pyramids, basket tosses, and tumbling – the same skills we perform in a routine trying to win a UCA College Cheer National Championship.

But with the advent of modern skills, the physical demands and risk placed on cheerleaders have grown so much that from 1982 to 2008, over half the catastrophic injuries in female athletes involved cheerleading, and was 2^nd overall only to football. The good news is, there has been a marked decrease in cheer injuries over the past several years, probably due to the emergence of the American Association of Cheerleading Coaches and Administrators (AACCA).

The NCAA partnered with AACCA and Varsity Brands (the leading provider of cheer camps, and parent company of UCA and NCA) to create new high school and college cheer rules to decrease injuries. AACCA made major changes in the skills allowed based on the performance surface. For example, basket tosses can’t be performed on any hard surface, and only limited basket tosses on grass surfaces. From a coaching perspective, all college cheer coaches must be AACCA certified and present in order for their cheerleaders to perform skills. Although it is not mandatory at the high school level, it is highly recommended.  If a coach does not follow the rules and regulations set by AACCA, their certification can be revoked and they cannot coach at the collegiate level. ACCAA certification can also provide some added liability coverage to the coach in the case of injuries.

So how can a cheerleader or parent of a cheerleader keep a participant safe from injury? My most honest answer is that you can’t. Just like all other sporting activities, you can follow all the rules and safety guidelines but there is always a risk of injury. However, there are ways you can decrease your chance of injuries. Below are the recommendations I give to coaches at our summer camps:

1. Know and follow all safety guidelines set forth by ACCAA as well as any additional rules your particular program may have in place.
2. Know the proper progression of skill advancement (i.e. cheerleaders should not be attempting the more advanced skills if they have not mastered the intermediate skills).
3. Know the physical limitations of each member of your team.
4. Do not let an injured cheerleader return to activity until a doctor or a school trainer has released them.
5.  Leave enough time for proper warm up and conditioning at each practice.
6. Make sure your cheerleaders are educated on proper nutrition and conditioning to be in the best physical shape possible.

Also, when choosing a cheer program, try to find one whose coaches are properly trained to ensure that injuries are only a risk, not a probability.

In my next blog entry, I’ll provide exercises and conditioning to help cheerleaders of any age or skill level maximize their performance and minimize their chance of injury.

Introducing Summer Speed and Agility Training at LMH

Starting this June, LMH Therapy Services will be offering youth athletes Sports Performance services.  Participants can choose to join a group or train as an individual to enhance speed, agility and plyometric skills.  This initial summer performance training session will be available for athletes age 12-18 and will kick-off training in the newly updated 3^rd floor suite in the LMH 4^th Street Health Plaza building. 

Athletes will train with suspension trainers, resistance bands, weighted sleds, training ropes and medicine balls on a 15’ x 60’ padded field turf surface. Athletes are trained by qualified performance coaches that are Certified Strength and Conditioning Specialists.

The summer session will feature small group sessions of athletes of similar age working with the performance coach on acceleration, cutting and jumping.  High school athletes typically lift weights and run in the summer, but forget to spend specific time training speed, agility, and plyometric skills to enhance performance next season.  Each challenging speed and agility session at LMH will compliment these programs without overworking the athlete.

Exclusively at LMH, each athlete is individually assessed by a Sports Physical Therapist. The athlete receives a comprehensive screening and analysis of posture, muscle imbalances, flexibility, balance and injury prone areas.  Training goals and advice regarding injury prevention will be provided to the athlete as part of the assessment.

Speed and Agility Training groups are forming now and class sizes are limited.  To register in the summer training program, call LMH Therapy Services (785) 505-2712. Individual and Team Training sessions are available as well.

Training Schedule: June 11-August 3rd 2012

SPEED & AGILITY  TRAINING (Ages 12, 13, 14)

Acceleration/Quickness/Coordination

Group Sessions ……………………………………...$315 per person

16 sessions: 8 weeks, 2x/week, 50 minute sessions

Includes Individual Assessment ($75 value)

Males & Females: Monday and Wednesday—3:00 pm

                                                     Or

                                Tuesday and Thursday—4:00 pm

SPEED & AGILITY TRAINING (Ages 15,16,17,18)

Acceleration/Reaction/Jump Training/Coordination

Group Sessions ………………………………….....$365 per person

Includes Individual Assessment ($75 value)

16 Sessions: 8 weeks, 2x/week, 60 minute sessions

Males:      Monday and Wednesday—11:30 am  or   Tuesday and Thursday—2:00 pm

Females:  Monday and Wednesday—2:00 pm  or Tuesday and Thursday—11:30 am

Part II:Eliminate Running Injuries -> Hip Strengthening Exercise Progression

Hip strengthening exercises as discussed in the "Part 1: Eliminate Running Injuries" post can be progressed. Check out the exercises below and perform 2-3 sets of 10 repetitions twice a week to keep you off the training table and on the running path.

Forwad Lunge

•        

           PROCEDURE Stand with feet together and take a large step forward with one foot.  Lower opposite knee towards the floor while keeping trunk upright.  Use front foot to push back to standing position.

•         COACHING KEY: Activate your core to keep body straight and be careful your front knee does not pass your toes.  Keep hips level—do not let your back hip drop.

       Lateral (Side) Lunge

       PROCEDURE: Standing with feet together, take a large step sideways with one foot.  Bend knee and drop buttocks backwards while keeping opposite knee straight.  Use front foot to push back to starting position.

·         

·         COACHING KEY: Be sure your bent knee does not advance forward over your toes and your feet remain pointing forward.  Keep hips level—do not let your back hip drop.

Forward Step Up 

PROCEDURE: Using a 4-8 inch step, place foot on step and raise body while focusing on pushing knee as straight as possible. Simultaneously pull the opposite leg up in front of you with knee bent. Try to raise thigh over 90 degrees and stabilize for 3-4 seconds. Keeping bottom leg secured on step, reach back with raised leg to touch the ground behind the step with toes. Quickly return to raised leg position.

COACHING KEY: Focus on keeping planted leg straight. Engage abdominals and explode up onto step after touching toes to ground.  Keep hips level when stabilizing on top step—don’t let your hips drop!

Forward and Side Touchdowns

•       PROCEDURE: Standing with one foot on a step, lower the heel of the other leg until it just touches the floor. (Do NOT shift your weight onto this leg). Push through leg on the step to return to a standing position.

•       Start with 4” step and progress up to 6-8”.  If you don’t have a 4” step, put a book on the floor to decrease the step height or only lower leg as far as you can without your hip dropping

•       COACHING KEY: Focus on keeping your waistline level (do not let your hip drop) by pushing back your buttocks and engaging your hip stabilizers.  Be sure your knee does not extend over your toes.

Have more questions regarding these exercises or need help getting back to your running program?  Contact a sports physical therapists at one of our LMH locations:

Hospital (785) 505-2712

South (785) 505-3780

Eudora (785) 542-3344

Julia Noonan, DPT

Sports Physical Therapist

LMH Therapy Services