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Youth Sport Injuries versus Performance

10/26/2017

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At some point you were probably a young athlete with aspirations of playing a sport in college or even professionally.
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Think back to that time and answer this question as your 15-year-old self.

Would you rather run faster or be less likely to get hurt?

If you were anything like me at a 15-year-old kid, an injury was probably the last thing you cared about. When we’re 15 we are bulletproof. We’re borderline superheroes with mega amounts of hormones flowing through our system that help us grow, recover, and have tons of energy. If you had tried to sell me on injury prevention program, I would have laughed at you and walked away (yes I was a little jerk at 15).

Now, let’s talk about development of speed. If you had asked me at 15 if I wanted to be faster, I would have been all ears. I once spent 6 weeks doing a program to improve my vertical jump when I was 16 years old. My family was living in an apartment in Columbus, Georgia at the time. We had a storage garage in the apartment complex. I would go there everyday over the summer and do different plyometric jumping exercises onto a metal ladder because I didn’t have a box to jump on. I wanted the glory of being able to jump higher, run faster and being an overall better athlete.

Here’s the interesting part about performance improvement and injury prevention. If done correctly, performance improvement and injury prevention are the same exact thing.

Let’s take the example of a 15-year-old female soccer player for this next example. Let’s say that every time she lands or changes direction her knee caves in. This is a strong indicator that this athlete has an increased likelihood of having an ACL tear.

To correct this we can improve landing mechanics, hip strength, foot and ankle control and general body positioning awareness. To do so, this athlete would need to complete a structured program to develop these weaknesses in her athletic movement.

Now on the other hand, an athlete that has knee collapse when they cut will also be slower and less efficient. So, if we take this same athlete through a structured program to decrease their ACL injury risk, they also get faster. This means they will win more ball challenges. They will be able to jump higher and change direction faster. They will become an overall better mover and athlete on the field.
The program is not the hard part. Buy in from the athlete is where the real magic is. If you can get a 15-year-old athlete(tough sell) to buy in on your program, you win.

Buy in is a concept of getting our athletes to do what we want. It’s phrasing things correctly to gain the trust of that athlete. WIth trust comes effort and with effort comes results.

It’s sort of like when I want my 5-year-old son to do something. I could ask him to clean his room and it’s likely that he will do it. Now, if I ask him to clean his room and tell him I’m timing him to see how fast he can do it, I get a much better result. One step further, if I tell him I’m timing him and his sister is cleaning her room at the same time, we now have competition. Competition between kids can be a gold mine of buy in.

If you’re reading this and you have an adolescent kid playing a sport in the Decatur, Georgia area, we need to talk. We see countless youth athletes from sports like soccer, lacrosse, swimming, baseball, football, golf and even ultimate frisbee! Each one of these athletes comes to us because of an injury. Almost all of these athletes lacked basic movement coordination that lead to the injury.

It’s hard to get your kids to listen to you. You can tell them all day to do exercises to decrease their likelihood of injury. It’s very unlikely they will take action and implement what you tell them.

Send them to Athletes’ Potential and we delve into how to improve their performance on the field. We use a unique a proprietary athlete assessment to isolate where the strength and movement limitations are. We get them strong, moving well and winning more. One really nice side effect to all of this is….they become significantly less likely to have an injury.

Now it’s your turn to make a decision. Do you wait for your youth athlete to get hurt or do you proactively get them checked out? The decision is yours and time starts now.

Give us a call at 470-355-2106 or request to chat with one of our Doctors for free by clicking on the link below.
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Thanks for reading,

​- Dr. Danny, PT, DPT
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Warning: Youth Soccer Injuries Are On The Rise

10/19/2017

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With over 3 million registered athletes under the age of 19, soccer is one of the fastest growing youth sports in the United States, especially here in Atlanta (if you haven’t made it out to an Atlanta United game yet, put that at the top of your to-do list!). Along with its increase in popularity, youth soccer has drastically changed over the past 25 years. We are now seeing youth athletes play at higher intensity levels than ever before and, because of year round premier leagues and clubs, are doing so with less time to recover. This rise in popularity and increased physical demand is a recipe for disaster. In fact, a recent study found that from 1990 to 2014 total number of recorded injuries in youth soccer players skyrocketed by 111 percent, with the vast majority (80%) involving the musculoskeletal system.

These statistics should absolutely be eye-opening, but fear mongering is not the point of this article, quite the contrary. Youth soccer players are some of the most fun and competitive people I work with, and with some basic understanding of preventive techniques we can help stop injuries from occurring in the first place and boost performance along the way.

Lower extremity injuries are by far the most injuries I see in the clinic when working with youth soccer players. In soccer your hips are your power house and they constantly take a beating due to all the changes in directions, kicks, passes, lateral movements, and rapid accelerations and decelerations. Not surprisingly, because of these demands, the muscles around the hip are some of the most susceptible to injury (hamstrings, groin, etc).

To prevent injuries and improve the performance of your hips there are two main components you want to look at: hip mobility and hip stability.

Hip Mobility:

Good hip mobility means your hips are capable of moving uninhibited and pain-free throughout their full range of motion. There are a number of directions your hip needs to have good movement in and there are many reasons your hip may be limited, but two of the most common problems I see in the clinic are limited hip internal rotation and tight hip flexors. Let’s take a look at a couple quick ways to check your out these two problem areas
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The above picture shows how to check your hip internal rotation. To perform the test correctly you want to:
  • Sit at the edge of a surface, making sure your feet can’t touch
  • Rotate your hip so that your foot moves as far out as possible.
  • Make sure not to lean or lift your butt off the surface to try to get more range.

​You are looking to get about 40-45 of hip internal rotation and if you can’t get to a minimum of 40 degrees, then the mobility drill shown below is for you.
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There are a number of ways to test and see if you have limited hip flexor mobility, but a safe and simple way to do so is demonstrated in the picture below. To perform this test correctly you want to:
  • Start laying on your back with both knees at your chest
  • While holding onto one of your knees, slowly lower the opposite leg the table
  • Stop lowering your leg once resistance resistance is felt
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If the leg you’ve lowered down cannot easily touch the table of your knee has to straighten in order to get your leg to the table, then try the mobility drill below.
Any time you do a mobility drill, you’ll want to perform a re-try the testing positions we went over to see if you notice a difference. If you do notice a difference great!, you’ll want to add that mobility work to your daily routine and can be done as part of your warm-up. However, If you’re not noticing an improvement than these specific mobility drills may not be the best option for you and you might want to give us a call.

Hip Stability:

Hip stability can mean a variety of things, but for the purpose of this article hip stability means being able to load and control your hip joint throughout its available range of motion. In other words, to prevent injuries from happening, not only must you be able to move throughout an acceptable range of motion, but you must be control the forces you exert throughout that range of motion. Poor hip stability is a huge problem in youth soccer and is a main reason why you’ll have experience a soft tissue injury such as a hamstring strain or pulled groin. Below you’ll find three exercises that target specific movements commonly found in soccer and are a great addition to your warm up before a game or practice.
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​The goal of any injury prevention program should be to first make sure you can move through an appropriate range of motion and then to make you strong through that range. At our clinic in Decatur, GA we have successfully treated numerous youth soccer players, and when we do we make sure we arm them with the knowledge and ability to stay healthy and keep competing out on the field versus with us in the clinic. If you’re in the Atlanta area and you either play soccer or have a child who plays soccer and you’d like to learn more about how to prevent injuries or overcome an existing injury, give us a call at 470-355-2106 or fill out the contact request form below and we will be happy to contact you. 

Thanks for reading, ​

-Dr. Jake, PT, DPT
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Personalized Blood Flow Restriction: A Paradigm Shift in Human Performance

10/11/2017

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To put it bluntly, being strong makes life easier. Humans don’t have the ability to create more muscle fibers (hyperplasia), so in order to get stronger we have to work tediously to increase the size of our existing muscle fibers (hypertrophy). According to the American Academy of Sports Medicine, gaining strength through hypertrophy takes 8-12 weeks of moderate to high intensity resistance training (>65% of your one rep max) utilizing 8-10 upper and lower body exercises at a rate 2-3 times per week.

A relatively easy formula to follow; right? Well, what happens when you are recovering from an injury and can’t safely use loads heavy enough to improve strength and size? Or when you’re an athlete who is in-season and can’t tolerate the drop in performance associated with the muscle soreness that follows heavy lifting?

Up until now those have been troubling questions for medical professionals and strength coaches alike. However, there is a new tool with over 160 peer reviewed research studies and documented success across the military, college, and professional sports arenas; something that is creating increased size and strength in as little as two weeks and is completely changing the game of how professionals approach rehab and sports performance…Personalized Blood Flow Restriction Training (PBFRT).

What is Personalized Blood Flow Restriction Training and How Does it Work?
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PBFRT is the brief and intermittent use of a tourniquet in order to restrict the amount of blood flow from coming into your limb (arterial flow) while performing low-load resistance training. There are numerous types of blood flow restriction devices available, but the gold standard occlusion device is the Delphi Personal Occlusion Tourniquet. The Delphi Personal Occlusion Tourniquet the only device have FDA approval to be safely used for medical use  and is essentially a modified surgical tourniquet that contains a doppler system. This doppler system allows so you read a person’s arterial flow in live time, so you know exactly how much blood you are occluding, and it will adjust its pressure automatically throughout an exercise to maintain a designated percentage of occlusion that is personalized to each individual person. ​

The way PBFRT works is it reduces the amount of oxygenated blood reaching a working muscle in order to trick your body into thinking it’s working at a higher intensity than it actually is. By using this form of engineered suffering you’re able to use extremely light resistance and still get the same increases in size and strength as lifting at higher intensities with heavy weight! Exactly how this happens is laid out below:

  • Occluding your limb creates an anaerobic environment by limiting the amount of oxygenated blood that reaches a working muscle.
  • This anaerobic environment stimulates your fast twitch muscle fibers (the fibers responsible for power, speed, and strength).
  • In an anaerobic environment with your fast twitch muscle fibers activated, a convoluted process starts called the Cori Cycle, which leads to the production of lactate in the muscles (fun fact: lactate production creates that burning sensation you feel).
  • Because your limb is occluded, the lactate being produced begins to pool in the working muscles, which signals multiple metabolites leading to protein synthesis, muscle stem cells, capillary beds, and a 290% increase in human growth hormone (HGH).


So who exactly would benefit from Personalized Blood Flow Restriction Training?


Prehabilitation
  • Contrary to popular belief, HGH does not directly relate to increased muscle size or strength gains. Instead it increases collagen synthesis, which serves as a protective role to muscle tendons and ligaments. In other words, the significantly increased levels of HGH can lead to improved tendon health, which can help prevent common overuse injuries such as strains and tendonitis.

Rehabilitation
  • Muscle breakdown (atrophy) after a surgery or injury happens incredibly fast. For example, when you’re injured or you’re not allowed to put any weight through one of your limbs, in as little as two weeks that limb goes into a state of anabolic resistance and protein synthesis shuts down leading to a 30% loss of muscle mass in that limb!
  • Obviously, this is extremely problematic and slows down recovery from an injury dramatically. However, with PBFRT we now have the ability to combat that significant muscle loss because we are able to use low intensity and weight levels that are safe and tolerable to the patient and get the same increases in muscle size and strength as lifting at 65% of your one rep max or higher.
  • A great example of just how beneficial PBFRT can be for patients rehabbing from injury comes from Dr. Zach Long who was working with an elite level olympic lifter after tearing his ACL. With this type of injury, more than 65% of patients demonstrate quadricep weakness even a year out from surgery. However, Dr. Long’s patient’s surgical leg became one inch larger than his healthy leg in just three months time after his surgery!

Sports Performance
  • PBFRT has shown numerous benefits to enhancing sports performance, but perhaps the most documented is the ability for athletes to maintain muscle size and strength without a the dip in performance caused by muscle soreness. This is possible because there is no muscle tissue breakdown associated with PBFRT since the intensity is kept so low.
    • This is a great way for barbell, endurance, and in-season athletes to compliment their current training programs without worrying about over-training.
  • PBFT has also been shown to have a profound effect on your aerobic capacity as well by increasing your VO2 max and capillary beds.
    • Meaning research has demonstrated the ability to improve both your cardiovascular endurance and muscular size simultaneously!

Personalized blood flow restriction training has been one of the largest advancements for injury rehabilitation and sports performance and we are so excited to offer it at our clinic in Decatur, GA. Whether you are training through a nagging injury or preparing for your next triathlon, we would love to help you achieve your performance goals. Give us a call at 470-355-2106 or fill out the contact request form below and we will be happy to contact you.

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Thanks for reading,

-Dr. Jake, PT, DPT
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Will Your Daughter Tear Her ACL?

10/10/2017

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​Females are up to 7x more likely to tear their ACL playing sports than males.

​Soccer and basketball are the leading sports in ACL tears.

These statistics should really make you raise your eyebrows.  Studies about ACL tears showed that over 50% of female soccer players tore their ACL through their career.  Why is it so prevalent?  Is there something you can do to help keep your daughter’s knee healthy?
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The truth of the matter is- we are very different than men, in many ways!  But there are some factors that predispose females to knee injuries.
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Anatomical Make-up: Female have wider hips that makes it more common for girls to be “knock-kneed”.  This can lead to collapsed arches or knees caving in with jumping and cutting- a serious threat to the integrity of the ACL.  Females are generally smaller than males, meaning the ACL itself will be smaller and thus more prone to injury.
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​More Flexible: Females tend to have hyper-mobile joints.  This is sometimes called “double jointed” but can be more than that.  If very flexible, each joint will allow extra movement that leads to decreased stability and usually less strength.
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Less Motor Control: This goes right along with flexibility and strength, but decrease motor control means females are less likely to know how to move their body in space.  There is not as much awareness about the movement at the joint, thus are more likely/able to move in extreme ranges of motion.
​Hormones: After onset of menstruation, it is likely that your daughter’s performance will ebb and flow with her cycle.  It is possible that in the lower performance window of her cycle, she will be more likely to sustain an injury.  As preteens and teenagers grow and develop, they require adequate recovery, rest, nutrition for health.  Unfortunately, this overlaps with a time when many athletes are playing their sport at every season with little rest and no time to recover.

Lack of Warm-Up: Many student-athletes are sitting 7 hours during the day then jumping on the field with little to no warm up.  Group warm-ups tends to be very general and not including stability, strength and power development that they need!  Coaches are often focused on skill development at this stage rather than fundamental strength and conditioning.

What can you do to decrease your daughter’s risk of an ACL tear?
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If your daughter is playing sports, she is already 7x more likely than her male classmate to experience this injury.  Many of the differences that contribute to ACL injuries are simply anatomical and physiological differences that we can’t alter.  However, there are some variables we can control, or at least mitigate: strength and conditioning training, proper warm ups and instruction, adequate rest and nutrition for optimal performance.

If your daughter’s coach(es) are not equipped or educated to focus on strength and conditioning, get her set up with a coach that understands her needs. Especially through the younger years, encourage her to play multiple sports with different seasons and demands on her body. As much as she focuses on training and practice, instill the importance of nutrition and rest!
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At Athletes’ Potential, we work with many student athletes, females and males alike!  We understand the unique gender differences and biomechanical demands for performance enhancement.  If you want your kid to be faster, stronger, better and  less likely to sustain a season-ending injury, then give us a call!

Thanks for reading,
​

    Dr. Jackie, PT, DPT
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