STEP UP YOUR GAME: Increasing Performance

and Health

Naresh C. Rao, DO FAOASM

Objectives !  To understand the Osteopathic approach to the

everyday athlete

!  To learn easy to teach techniques to help athletes understand how to achieve their best performance

!  To realize Osteopathic Primary Care Sports Medicine is the future of medicine

Osteopathic Tenets !  1. The body is a unit; the person is a unit of body,

mind and spirit.

!  2. The body is capable of self-regulation, self-healing and health maintenance.

!  3. Structure and function are reciprocally interrelated.

!  4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

USOC MODEL

High Performance

Nutrition

Sport Psychology

Strength and

Conditioning

Physiology

Sports Medicine

Team approach !  Team Physician

!  Physical Therapist

!  Trainer

!  Dietitian

!  Coach

!  Competitor

!  Psychologist

!  Role Model/Hero

!  Spiritual Leader

ENTOURAGE

Athlete

Team Physician

Physical Therapist

Trainer

Dietitian

Coach Competitor

Role Model/Hero

Sport Psychologist

Spiritual Leader

Creating mission statement !  Mission statement “defines

the personal, moral, and ethical guidelines within which you can most happy express and fulfill yourself.”

Stephen Covey, The 7 Habits of Highly Effective People

Mission Statement !  The Mission of USA Water

Polo shall be to grow the sport of water polo throughout the United States and win medals in Olympic, World Championship, and Pan American Games.

Mission statement !  Meditative breathing

!  Visualization

!  Interpretation- 30 words

!  Core values

Mission statement

!  How do you want to be remembered?

!  What matters most to you?

!  What are your family’s values?

!  How would you define success?

!  What would your friends, spouse, or partner say about your athletic venture?

!  What does happiness feel like when you are playing your chosen sport?

!  What would your children say about your athletic venture?

!  If you were 30 years older, what would you say to your present day self?

Mission statement !  Examples:

!  “To be healthy”

!  “To get back to what I enjoy”

!  “To explore my athletic potential without incurring injury”

SMART GOALS !  Specific

!  Measurable

!  Attainable

!  Relevant

!  Time-bound

POLL QUESTION TIME! (#1)

Sports Grid Sector 1 • Arm-Wrestling • Bobsledding • Cheerleading • Climbing

Sector 2 • Ballroom Dance • Body Building • Cycling–BMX • Downhill Skiing

Sector 3 • Boxing • CrossFit • Triathlon • Water Polo

Sector 4 • Archery • Base Jumping • Diving • Motocross

Sector 5 • Dodgeball • Figure Skating • Football • Synchronized swimming

Sector 6 • Basketball • Road Cycling • Ice Hockey • Team handball

Sector 7 • Bocce Ball • Riflery • Shuffleboard • Skeet Shooting

Sector 8 • Baseball • Fencing • Hiking • Volleyball

Sector 9 • Badminton • Field hockey • Tennis • Ultimate Frisbee

Team Physician !  The team physician provides for the well-being of

individual athletes, enabling each to realize his/her full potential.

The American Osteopathic Academy of Sports Medicine

Team Physician !  Conversation 1: Share Your Athletic Goals

!  Conversation #2: Injury/Illness Prevention

!  Conversation #3: The Role of Supplements

!  Conversation #4: Your Concussion History

Team Physician !  “Trust your doc. You want

the doctor to have your best interest. That’s part of the reason you go there. The fact that they went to school more than most people is probably the best reason to be honest. Doctors know all about the human body and have that edge on you. If they are able to work with you and you’re honest, and that channel is open you are going to be a lot more successful.”

Physical Therapist !  No matter what the injury

—unless it’s completely debilitating—I’m going to be the same player I’ve always been. I’ll figure it out. I’ll make some tweaks, some changes, but I’m still coming.

Kobe Bryant

Self- PT tools !  Foam Roller

!  Stability Ball

!  Trigger Point Massager

!  Resistance Bands

!  Lacrosse Ball

!  Stretching Belt

!  Balance Board or Stability Trainer

Prehab exercises

Prehab Exercises Prehab exercises

Trainer !  If you train hard, you’ll not only be hard, you’ll be

hard to beat.

!  Herschel Walker, former NFL player

Sector 1 low aerobic, high anaerobic • Arm-Wrestling • Bobsledding • Cheerleading • Climbing

Sector 2 med aerobic, high anaerobic • Ballroom Dance • Body Building • Cycling–BMX • Downhill Skiing

Sector 3 high aerobic, high anaerobic • Boxing • CrossFit • Triathlon • Water Polo

Sector 4 low aerobic, Med anaerobic • Archery • Base Jumping • Diving • Motocross

Sector 5 med aerobic, Med anaerobic • Dodgeball • Figure Skating • Football • Synchronized swimming

Sector 6 high aerobic, Med anaerobic • Basketball • Road Cycling • Ice Hockey • Team handball

Sector 7 low aerobic, Low anaerobic • Bocce Ball • Riflery • Shuffleboard • Skeet Shooting

Sector 8 Med aerobic, Low anaerobic • Baseball • Fencing • Hiking • Volleyball

Sector 9 High aerobic, Low anaerobic • Badminton • Field hockey • Tennis • Ultimate Frisbee

POLL SLIDE TIME! (#2) Dynamic Warm-up

Level 1 Level 2

Level 3 Aerobic !  After the warm-up, start with a 5 minute aerobic interval

at 70–85 percent max (can barely talk).

!  Continue but lower your intensity to 60 percent max for 1 minute (can barely sing) ‘rest’ period.

!  Ramp up to a second interval for 30 seconds at 85 percent max (cannot talk).

!  Repeat this cycle 15 times. After you finish the 15 cycles, do a 5 minute interval at 70–85 percent max (can barely talk).

!  Finish off with a 10 minute cool down at 50 percent max (can sing).

Dietitian !  Our food should be our

medicine and our medicine should be our food.

Hippocrates

Basal Metabolic Rate Formula

!  For Women: BMR = 655 + (4.35 x your weight in pounds) + (4.7 x your height in inches) - (4.7 x your age in years)

!  For Men: BMR = 66 + (6.23 x your weight in pounds) + (12.7 x your height in inches) - (6.8 x your age in years)

Sports Grid Sector 1 • Arm-Wrestling • Bobsledding • Cheerleading • Climbing

Sector 2 • Ballroom Dance • Body Building • Cycling–BMX • Downhill Skiing

Sector 3 • Boxing • CrossFit • Triathlon • Water Polo

Sector 4 • Archery • Base Jumping • Diving • Motocross

Sector 5 • Dodgeball • Figure Skating • Football • Synchronized swimming

Sector 6 • Basketball • Road Cycling • Ice Hockey • Team handball

Sector 7 • Bocce Ball • Riflery • Shuffleboard • Skeet Shooting

Sector 8 • Baseball • Fencing • Hiking • Volleyball

Sector 9 • Badminton • Field hockey • Tennis • Ultimate Frisbee

Harris Benedict Formula !  • Sector 1 Daily Calories = BMR x 1.725

!  • Sector 2 Daily Calories = BMR x 1.813

!  • Sector 3 Daily Calories = BMR x 1.900

!  • Sector 4 Daily Calories = BMR x 1.463

!  • Sector 5 Daily Calories = BMR x 1.550

!  • Sector 6 Daily Calories = BMR x 1.638

!  • Sector 7 Daily Calories = BMR x 1.200

Sports Grid-Dietitian Sector 1 50% Carb 26% Pro 24% Fat 1 whole wheat pita + 1 oz roast beef + sliced tomato

Sector 2 53% Carb 26% Pro 21% Fat 1 cup low-fat Greek yogurt + 3/4 cup blackberries

Sector 3 56% Carb 26% Pro 18% Fat 20–25 whole grain crackers + 1 cheese stick

Sector 4 50% Carb 23% Pro 27% Fat 30 grapes + 2 ounces sliced turkey

Sector 5 53% Carb 23% Pro 24 % Fat ¼ cup cooked quinoa + 1 tsp olive oil + 1 oz feta cheese + chopped tomatoes

Sector 6 56% Carb 23% Pro 21% Fat 1 quesadilla: 1 12-inch whole grain tortilla + 1 oz melted cheese

Sector 7 50% Carb 20% Pro 30% Fat 1 whole grain pita + 1 cup celery + 2 tb hummus

Sector 8 53% Carb 20% Pro 27% Fat 1 slice whole grain bread + 1. tsp cashew butter + 1 small sliced banana

Sector 9 56% Carb 20% Pro 24% Fat 10–12 whole grain crackers + 12 grapes + 2 tb hummus

Coach !  Coach players like

they are all game-winning players.

Rick Pitino

Coach !  1999 Michigan State University, Deborah Feltz, PhD

!  4 important qualities ideal coach: !  Motivation !  strategy !  technique,

!  character building

Coach !  Mistake ritual

!  a physical motion you use to remind yourself to get past a mistake and focus on the next play. !  brushing off your jersey

!  taking both hands and smacking helmet

Competitor !  It’s great to win, but it’s

also great fun just to be in the thick of any truly well and hard fought contest against opponents you respect, whatever the outcome.

!  Jack Nicklaus

Competitor !  Competing Against Yourself

!  Competing Against Idealized Standards

!  Competing Against Other Athletes

Role Model !  All the courage and

competitiveness of Jackie Robinson affects me to this day. If I patterned my life after anyone it was him, not because he was the first black baseball player in the majors but because he was a hero.

!  Kareem Abdul Jabbar

Role Model

POLL QUESTION TIME! (#3) Role Model !  2015 study Johns Hopkins University

!  spouses influence each other’s exercise habits. !  one spouse follows an exercise program, significantly

and positively influenced the other spouse to start exercising

Psychologist !  The ideal attitude is to be

physically loose and mentally tight.

Arthur Ashe

Psychologist !  Mindfulness

!  effective tool- clearing thoughts of everything besides the present moment

Psychologist !  Music- Dr. Costas Karageorghis

!  Found tempo is important: the sweet spot is between 120 and 140 beats-per-minute

!  corresponds to the average person’s heart rate during energetic workout.

Spiritual Leader !  “I give all the glory to God.

It’s kind of a win-win situation. The glory goes up to him, and the blessings fall down on me.”

Gabby Douglas, USA gymnast and 2012 Olympic Gold Medalist

Spiritual leader !  Coakley found that

spiritually-focused athletes: !  a coping mechanism during

stressful situations

!  to help guide a morally sound life

!  To dedicate their commitment to their particular sport

!  to put their athletic endeavors into perspective

!  to establish a strong bond of attachment between teammates

!  to maintain social control

Creating a Unified Program !  Ensure all roles are present in athletes life

!  Team physician-leader of entourage

Thoughts !  Osteopathic primary care sports medicine

differentiates primary care from physician extenders

!  Can be an add on to primary care offices or at least a referral

!  Applies to more than athletes

!  Low cost- empowers athlete

!  Osteopathic primary care sports medicine in unique position to make meaningful impact on healthcare

Research !  Test athletic population to see if osteopathic model

can improve biometrics VO2, RMR, body fat

!  Implement in high school athletics

!  Apply model to performance in general

Thank You