Heads & Headers A look at concussions in women’s soccer

The Power of Vitamins n Improving Grip Strength n A New Type of Clinic

September 2013 Vol. XXIII, No. 6, $7.00

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AutoPrismUnattended light therapyAutoPrism is equipped with super luminous diode (SLD) clusters that provide energy with a combination of predominantly infrared (870 nm) and visible red (633nm) diodes. AutoPrism provides an even distribution of light energy over the entire area, allowing unattended treatments. The provided protocol manual determines the treatment parameters and anatomical locations.

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Circle No. 100

Optimum Performance

19GetaGripGrip strength training is not very glamorous, but it is an important part of the University of South Carolina football program. By Joe Connolly, Justin Markley, & Michael Pimentel

Treating the Athlete

26Heads&HeadersAfter football, the sport with the highest rate of concussions is women’s soccer. A veteran athletic trainer takes a look at the causes and offers new ideas on prevention.By Maria Hutsick

Nutrition

33ThePowerofVitaminsFor athletes striving to reach the top of their game, understanding how vitamins work and which ones are most important can make or break a season.By Amy Culp

Leadership

41ASMARTIdeaAt Illinois State University, the opening of the SMART Clinic has provided more hands-on opportunities for athletic training students and a place for recreational athletes to receive treatment.By Dr. Justin Stanek

Sport Specific

47PowerPlayHow do you develop a training plan for athletes who need to maintain strength and balance while competing on a sheet of ice? Notre Dame’s coach explains.By Tony Rolinski

Bulletin Board7 Preventing muscle atrophy after ACL surgery … Mental health knowledge lacking … Improving performance through halftime activity … Shoe traction and injury rates.

Q&A

12 Melinda Larson Whitworth University

Sponsored Pages 4 Gatorade 11 Athletes’ Performance 17 Hi-Trainer 45 Balanced Body

Product News 56 Nutritional Products 57 Pilates 58 Leg Strengthening 59 More Products

CEU Quiz 51 For NATA and NSCA Members

63 Next Stop: Web Site

64 Advertisers Directory

On the cover: U.S. women’s soccer star Abby Wambach, who has scored over one-third of her goals on headers, competes in a con-test against Japan last year. Our cover story examines concussions, headers, and physical play in women’s soccer, starting on page 26. Photo by APImages/Shizuo Kambayashi.

September 2013, Vol. XXIII, No. 6

contents

33

T&C SEPTEMBER 2013 1 TRAINING-CONDITIONING.COM

19 47

­­2 TRAINING-CONDITIONING.COMT&C SEPTEMBER 2013

Publisher Mark Goldberg

Editorial Staff Eleanor Frankel, Director R.J. Anderson, Patrick Bohn, Kristin Maki, Mary Kate Murphy, Dennis Read

Circulation Director David Dubin

Art Direction Message Brand Advertising

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T&C editorial/business offices: 20 Eastlake Road Ithaca, NY 14850 (607) 257-6970 Fax: (607) 257-7328 info@MomentumMedia.com

September 2013 Vol. XXIII, No. 6

Marjorie Albohm, MS, LAT, ATC Director, Ossur Americas Past President, NATA

Jon Almquist, ATC Athletic Training Program Administrator Fairfax County (Va.) Public Schools

Jim Berry, EdD, ATC, SCAT, NREMT Head Athletic Trainer Conway (S.C.) High School

Christine Bonci, MS, LAT, ATC Associate Athletics Director Sports Medicine/Athletic Training University of Texas

Leslie Bonci, MPH, RD, CSSD, LDN Director of Sports Medicine Nutrition Center for Sports Medicine University of Pittsburgh Medical Center

Cynthia “Sam” Booth, PhD, ATC Visiting Assistant Professor SUNY Brockport

Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center

Cindy Chang, MD President, American Medical Society for Sports Medicine

Dan Cipriani, PhD, PT Associate Professor Deptartment of Physical Therapy Chapman University

Gray Cook, MSPT, OCS, CSCS, RKC Clinic Director Orthopedic and Sports Physical Therapy Dunn, Cook and Associates

Keith D’Amelio, ATC, PES, CSCS Nike Sparq Training

Bernie DePalma, MEd, PT, ATC Assistant Athletic Director Head Athletic Trainer/Physical Therapist Cornell University

Lori Dewald, EdD, ATC, CHES, F-AAHE School of Public Safety and Health American Public University

David Ellis, RD, LMNT, CSCS Sports Alliance, Inc.

Boyd Epley, MEd, CSCS Director of Coaching Performance National Strength & Conditioning Association

Peter Friesen, ATC, NSCA-CPT, CSCS, CAT Head Athletic Trainer/Conditioning Coach Carolina Hurricanes

Lance Fujiwara, MEd, ATC, EMT Director of Sports Medicine Virginia Military Institute

Vern Gambetta, MA President, Gambetta Sports Training Systems

P.J. Gardner, MS, ATC, CSCS, PES Athletic Trainer, Liberty High School, Colo.

Joe Gieck, EdD, ATR, PT Director of Sports Medicine Professor, Clinical Orthopaedic Surgery University of Virginia (retired)

Brian Goodstein, MS, ATC, CSCS, Head Athletic Trainer, DC United

Gary Gray, PT President, CEO Functional Design Systems

Maria Hutsick, MS, LAT, ATC, CSCS Head Athletic Trainer Medfield (Mass.) High School

Christopher Ingersoll, PhD, ATC, FACSM Director of Graduate Programs in Sports Medicine/Athletic Training University of Virginia

Allan Johnson, MS, MSCC, CSCS Sports Performance Director Velocity Sports Performance

Tim McClellan, MS, CSCS Owner and Strength and Conditioning Coach StrengthAndPeace.com

Timothy Morgan, DC, CCSP Professor of Exercise and Health Sciences University of Massachusetts

Jenny Moshak, MS, ATC, CSCS Assistant AD for Sports Medicine University of Tennessee

Steve Myrland, CSCS Owner, Manager Myrland Sports Training, LLC Director of Coaching, Train-To-Play

Tim Neal, MS, ATC Assistant Director of Athletics for Sports Medicine Syracuse University

Mike Nitka, MS, CSCS Director of Human Performance Muskego (Wis.) High School

Bruno Pauletto, MS, CSCS President, Power Systems, Inc.

Stephen M. Perle, DC, MS Professor of Clinical Sciences University of Bridgeport College of Chiropractic

Brian Roberts, MS, ATC Director of Sports Medicine and Business Operations, Xcelerate Physical Therapy

Ellyn Robinson, DPE, CSCS, CPT Assistant Professor of Exercise Science Bridgewater State College

Kent Scriber, EdD, ATC, PT Professor/Clinical Education Coordinator Ithaca College

Chip Sigmon, CSCS*D Speed and Agility Coach OrthoCarolina Sports Performance

Bonnie J. Siple, EdD, ATC Assistant Professor, Department of Exercise and Rehabilitative Sciences Slippery Rock University

Chad Starkey, PhD, ATC, FNATA Division Coordinator, Athletic Training Program, Ohio University

Ralph Stephens, LMT, NCTMB Sports Massage Therapist, Ralph Stephens Seminars

Jeff Stone, MEd, LAT, ATC Head Athletic Trainer, Suffolk University

Fred Tedeschi, ATC Head Athletic Trainer, Chicago Bulls

Terence Todd, PhD Lecturer, Kinesiology and Health Education University of Texas

Training & Conditioning (ISSN 1058-3548) is published monthly except in January and February, May and June, and July and August, which are bimonthly issues, for a total of nine times a year, by MAG, Inc., 20 Eastlake Road, Ithaca, NY 14850. T&C is distributed without charge to qualified professionals involved with competitive athletes. The subscription rate is $24 for one year and $48 for two years in the United States, and $30 for one year and $60 for two years in Canada. The single copy price is $7. Copyright© 2013 by MAG, Inc. All rights reserved. Text may not be reproduced in any manner, in whole or in part, without the permission of the publisher. Unsolicited materials will not be returned unless accompanied by a self-addressed, stamped envelope. Periodicals postage paid at Ithaca, N.Y. and additional mailing offices. POSTMASTER: Send address changes to Training & Conditioning, P.O. Box 4806, Ithaca, NY 14852-4806. Printed in the U.S.A.

Editorial Board

Circle No. 101

STRENGTHENDURANCE

ANAEROB ICRECOVERY

CARD IOF I TNESS

SPEED

POWER

BALANCE

REACT ION

ENDURANCE

ACCELERAT ION

HITRAINER IS REVOLUTIONIZING SPORTS TRAINING WITH ACOMBINATION OF ADVANCED PERFORMANCE ANALYSIS SOLUTIONS

AND HIGH INTENSITY TRAINING ON A SINGLE MACHINE

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UNBEATABLECONDITIONING

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STRENGTHENDURANCE

ANAEROB ICRECOVERY

CARD IOF I TNESS

SPEED

POWER

BALANCE

REACT ION

ENDURANCE

ACCELERAT ION

HITRAINER IS REVOLUTIONIZING SPORTS TRAINING WITH ACOMBINATION OF ADVANCED PERFORMANCE ANALYSIS SOLUTIONS

AND HIGH INTENSITY TRAINING ON A SINGLE MACHINE

INSTANTPERFORMANCEFEEDBACK

TOLL FREE 1 855 726 3300

UNBEATABLECONDITIONING

WWW.HITRAINER.COMCircle No. 102

All athletes require dietary carbohydrate as a fuel source for working muscles. However, carbohydrate needs can vary significantly depending on the type of sport and even within sport, by event or position. As a general rule, athletes participating in aerobically-based sports will require higher amounts of carbohydrate than those competing in anaerobic sports. The nutritional needs of athletes who participate in stop-and-start sports such as soccer, basketball and football need to be specialized not only by sport but also by position.

THE AEROBIC ATHLETE Aerobic sports include distance runners/swimmers, triathletes and cyclists. The oxidation of glycogen (the storage form of carbohydrate in the body) and intramuscular triglycerides are the predominant form of energy in the aerobic athlete. High intensity endurance events (>85%

VO2 max) maximally sustained for 90 minutes require large stores of glycogen, so adequate stores are critical. These athletes benefit most from carbohydrate loading (glycogen supercompensation) in the days leading up to competition. On low to moderate training days, these athletes’ carbohydrate needs are estimated at 5-7 g/kg/day. On harder training days and during the active season, these endurance athletes will require 10-12 g/kg/day. Without adequate carbohydrate, these athletes will not be able to perform at maximal capacity.

Before Exercise: Consume 1-4 g carbohydrate per kg body weight up to 4 hours prior to exerciseDuring Exercise: Consume 30-60 g carbohydrate per hour up to 2.5 hours or 90 g carbohydrate in events lasting >2.5 hoursAfter Exercise: Consume 1-1.2 g carbohydrate per kg/hr for the first 4 hours following exercise

THE ANAEROBIC ATHLETE Anaerobic sports include but are not limited to sprinters, power lifters and gymnasts. Creatine phosphate is the primary source of energy for anaerobic athletes but is not readily stored in the body. In a 30-second sprint, creatine phosphate stores can be decreased by as much as 75%. The reduction in stores and the demand for continual energy, the secondary source of energy, is glycogen oxidation. Since anaerobic events are short in duration, the anaerobic athlete will require substantially less carbohydrate than the aerobic athlete. The regeneration of phosphocreatine is actually an aerobic process although little is known regarding the carobohydrate demand for recovery of stores. Most studies do not observe a significant benefit of a high-carbohydrate diet over a moderate-carbohydrate diet in these athletes. It is important to reme ber that although the event may be anaerobic in nature, it is the practice that can drive the carbohydrate need. The carbohydrate requirements for the anaerobic athlete are 5-7 g/kg/day and these athletes will most likely not benefit from carbohydrate loading days prior to competition.

THE STOP-AND-START ATHLETEStop-and-start sports include basketball, soccer and football. These athletes have complex carbohydrate needs due to the fact they are activating both aerobic and anaerobic pathways throughout competition. Increased reliance on carbohydrate as an energy substrate parallels the increase in intensity. Conversely, the oxidation of intramuscular triglycerides and plasma-free fatty acids increase as duration increases (and intensity naturally decreases). Glycogen depletion is directly associated with fatigue and exercise intensity and, therefore, adequate carbohydrate in the diet is important in the stop-and-start athlete.

Carbohydrate guidelines for stop-and-start athletes (Adapted from Sports Nutrition: A Practice Manual for Professionals 5th Edition)

TIME AMOUNT OF CARBOHYDRATE

SPECIFICS

1-4 hrs prior to competition

1-4 g/kg Low-glycemic carbohydrates

1 hr prior to competition

25-30 g Liquid carbohydrates may be beneficial due to rapid stomach emptying

During Exercise 0.5-1.0 g/kg/hr; 30-60 g/hr

6% carbohydrate solution- Gatorade Thirst Quencher

After Exercise 1.0-1.2 g/kg Every 15-30 min for up to 4 hrs

CARBOHYDRATE COMMITMENTWhile most athletes fit into the three categories mentioned previously, the International Olympic Committee has created general recommendations for athletes based upon time commitment per day. These guidelines can be beneficial for the busy high school athlete as well as the elite athlete. The commitment to adequate carbohydrate is often challenging with school and practice schedules as well as common misinformation. Sports dietitians, strength coaches and athletic trainers need to follow evidence-based guidelines and use individual assessment skills to assist athletes in meeting their nutritional goals.

COMMITMENT AMOUNT OF CARBOHYDRATE

Low intensity exercise; athletes with energy restriction

3-5 g/kg/day

1 hr per day 5-7 g/kg/day

1-3 hrs per day 7-10 g/kg/day

>4-5 hrs per day 8-12 g/kg/day

Carbohydrate needs cannot be addressed in a one-size-fits all approach. Prioritize carbohydrates appropriately depending on intensity, duration and nature of your sport for maximal performance benefits.

GATORADE SPORTS SCIENCE INSTITUTETHE CARBOHYDRATE COMMITMENTRoberta Anding, M.S., R.D./L.D., C.D.E., C.S.S.D.Director of Sports Nutrition, Texas Children’s HospitalSports Dietitian, Houston Texans

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References: 1. Rosenbloom CA, Colemen EJ. (2012). Sports Nutrition: A Practice Manual for Professionals. Sports, Cardiovascular, and Wellness Nutrition Dietetic Practice Group. Academy of Nutrition and Dietetics. 2. IOC Consesus Statement on Sports Nutrition. J Sports Sci. 2011; 29: Suppl 1:S3-4.

m

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Gatorade �irst Quencher is scientifically formulated with essential fluids

and electrolytes to help replace what they've lost in sweat. Plus, it contains

the necessary amount of carbohydrates to help stimulate fluid absorption

and fuel their active bodies so they can continue to push even harder.

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Electrolytes to help replacewhat they sweat out

Learn more and get yours at gatorade.com/coachesGATORADE, G Series and G Design are registered trademarks of S-VC, Inc. ©2013 S-VC, Inc.

Proud partner of

®

All athletes require dietary carbohydrate as a fuel source for working muscles. However, carbohydrate needs can vary significantly depending on the type of sport and even within sport, by event or position. As a general rule, athletes participating in aerobically-based sports will require higher amounts of carbohydrate than those competing in anaerobic sports. The nutritional needs of athletes who participate in stop-and-start sports such as soccer, basketball and football need to be specialized not only by sport but also by position.

THE AEROBIC ATHLETE Aerobic sports include distance runners/swimmers, triathletes and cyclists. The oxidation of glycogen (the storage form of carbohydrate in the body) and intramuscular triglycerides are the predominant form of energy in the aerobic athlete. High intensity endurance events (>85%

VO2 max) maximally sustained for 90 minutes require large stores of glycogen, so adequate stores are critical. These athletes benefit most from carbohydrate loading (glycogen supercompensation) in the days leading up to competition. On low to moderate training days, these athletes’ carbohydrate needs are estimated at 5-7 g/kg/day. On harder training days and during the active season, these endurance athletes will require 10-12 g/kg/day. Without adequate carbohydrate, these athletes will not be able to perform at maximal capacity.

Before Exercise: Consume 1-4 g carbohydrate per kg body weight up to 4 hours prior to exerciseDuring Exercise: Consume 30-60 g carbohydrate per hour up to 2.5 hours or 90 g carbohydrate in events lasting >2.5 hoursAfter Exercise: Consume 1-1.2 g carbohydrate per kg/hr for the first 4 hours following exercise

THE ANAEROBIC ATHLETE Anaerobic sports include but are not limited to sprinters, power lifters and gymnasts. Creatine phosphate is the primary source of energy for anaerobic athletes but is not readily stored in the body. In a 30-second sprint, creatine phosphate stores can be decreased by as much as 75%. The reduction in stores and the demand for continual energy, the secondary source of energy, is glycogen oxidation. Since anaerobic events are short in duration, the anaerobic athlete will require substantially less carbohydrate than the aerobic athlete. The regeneration of phosphocreatine is actually an aerobic process although little is known regarding the carobohydrate demand for recovery of stores. Most studies do not observe a significant benefit of a high-carbohydrate diet over a moderate-carbohydrate diet in these athletes. It is important to remeber that although the event may be anaerobic in nature, it is the practice that can drive the carbohydrate need. The carbohydrate requirements for the anaerobic athlete are 5-7 g/kg/day and these athletes will most likely not benefit from carbohydrate loading days prior to competition.

THE STOP-AND-START ATHLETEStop-and-start sports include basketball, soccer and football. These athletes have complex carbohydrate needs due to the fact they are activating both aerobic and anaerobic pathways throughout competition. Increased reliance on carbohydrate as an energy substrate parallels the increase in intensity. Conversely, the oxidation of intramuscular triglycerides and plasma-free fatty acids increase as duration increases (and intensity naturally decreases). Glycogen depletion is directly associated with fatigue and exercise intensity and, therefore, adequate carbohydrate in the diet is important in the stop-and-start athlete.

Carbohydrate guidelines for stop-and-start athletes (Adapted from Sports Nutrition: A Practice Manual for Professionals 5th Edition)

TIME AMOUNT OF CARBOHYDRATE

SPECIFICS

1-4 hrs prior to competition

1-4 g/kg Low-glycemic carbohydrates

1 hr prior to competition

25-30 g Liquid carbohydrates may be beneficial due to rapid stomach emptying

During Exercise 0.5-1.0 g/kg/hr; 30-60 g/hr

6% carbohydrate solution- Gatorade Thirst Quencher

After Exercise 1.0-1.2 g/kg Every 15-30 min for up to 4 hrs

CARBOHYDRATE COMMITMENTWhile most athletes fit into the three categories mentioned previously, the International Olympic Committee has created general recommendations for athletes based upon time commitment per day. These guidelines can be beneficial for the busy high school athlete as well as the elite athlete. The commitment to adequate carbohydrate is often challenging with school and practice schedules as well as common misinformation. Sports dietitians, strength coaches and athletic trainers need to follow evidence-based guidelines and use individual assessment skills to assist athletes in meeting their nutritional goals.

COMMITMENT AMOUNT OF CARBOHYDRATE

Low intensity exercise; athletes with energy restriction

3-5 g/kg/day

1 hr per day 5-7 g/kg/day

1-3 hrs per day 7-10 g/kg/day

>4-5 hrs per day 8-12 g/kg/day

Carbohydrate needs cannot be addressed in a one-size-fits all approach. Prioritize carbohydrates appropriately depending on intensity, duration and nature of your sport for maximal performance benefits.

GATORADE SPORTS SCIENCE INSTITUTETHE CARBOHYDRATE COMMITMENTRoberta Anding, M.S., R.D./L.D., C.D.E., C.S.S.D.Director of Sports Nutrition, Texas Children’s HospitalSports Dietitian, Houston Texans

ADVERTISEMENT

References: 1. Rosenbloom CA, Colemen EJ. (2012). Sports Nutrition: A Practice Manual for Professionals. Sports, Cardiovascular, and Wellness Nutrition Dietetic Practice Group. Academy of Nutrition and Dietetics. 2. IOC Consesus Statement on Sports Nutrition. J Sports Sci. 2011; 29: Suppl 1:S3-4.

HELP THEM SAFELY GIVE IT EVERYTHING THEY'VE GOT.Keeping your athletes safely hydrated during any activity is essential. And

Gatorade �irst Quencher is scientifically formulated with essential fluids

and electrolytes to help replace what they've lost in sweat. Plus, it contains

the necessary amount of carbohydrates to help stimulate fluid absorption

and fuel their active bodies so they can continue to push even harder.

Your winning season starts now.

Electrolytes to help replacewhat they sweat out

Learn more and get yours at gatorade.com/coachesGATORADE, G Series and G Design are registered trademarks of S-VC, Inc. ©2013 S-VC, Inc.

Proud partner of

®

Circle No. 103

Stick it to them

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Circle No. 104

T&C SEPTEMBER 2013 ­7 TRAINING-CONDITIONING.COM

BoardBulletin

Knowledge Gap

There appears to be a “striking discrepancy” between college athletic trainers’ perception of their ability to recognize the signs and symptoms of mental health dis-orders in student-athletes and their actual capacity to do so. This is the conclusion of a study titled “Athletic Train-ers’ Understanding of and Experience in Managing Men-tal Health Disorders,” authored by Andrew Krause, PhD, ATC, from Ohio University and presented at the American College of Sports Medicine meeting in May.

The researchers surveyed 211 NCAA athletic trainers about their experience working with athletes with mental health disorders. While 70 percent of respondents said they felt competent in recognizing the signs and symp-toms of mental illness, and 63 percent felt confident in their ability to manage mental health disorders acutely, many of them lacked crucial knowledge in this area. For example, when the athletic trainers’ ability to use diag-nostic criteria for mental health disorders was assessed, only 44 percent “clearly understood the issues” and only 24 percent were aware of the norms in the most recent Diagnostic and Statistical Manual of Mental Disorders.

“Nearly 90 percent of athletic trainers have encoun-tered and managed at least one athlete with a mental health disorder,” Krause says. “However, the understand-ing of the spectrum of disorders […] and how to manage patients beyond referral appears to be lacking.

“The take-home message from this study is that men-tal health diagnosis and management are complex,” he continues. “Entry-level professional competencies ask more of an athletic trainer than to just recognize and refer an athlete with a mental health diagnosis. The approach should be to recognize signs and symptoms, make appropriate clinical and referral decisions, and maintain a strategy throughout the duration of patient-centered care.”

Just Getting Warmed Up

Halftime is usually seen as an opportunity for players to catch their breaths, hydrate, and listen to the coach’s plan for the rest of the game. However, a study pub-lished in the February issue of the International Journal of Sports Medicine found that athletes might be better off spending some of this time completing high-intensity, short-duration physical activities to boost performance for the second half.

The randomized, crossover study involved eight male soccer players from the Victorian Football Federation in Australia. To simulate the level of exertion achieved dur-ing a soccer game, the subjects completed two identi-

Preventing Muscle Atrophy

New research from the University of Michigan has identi-fied myostatin as a major inhibitor in the growth of muscle tissue following anterior cruciate ligament (ACL) recon-struction surgery. Produced primarily in skeletal cells, myostatin is a hormone that circulates in blood and acts on muscle tissue by binding to a cell-bound receptor. According to a study appearing in June’s online version of the American Journal of Sports Medicine, the discovery of myostatin’s presence following ACL reconstruction may spur the creation of a drug that would block its negative effects, and result in a quicker return to sport.

“We’ve had several advances in technology to improve the recovery process for an ACL tear, but most patients still experience 30 to 40 percent muscle weakness—and that weakness largely limits the ability to return to the same level of sports,” Christopher L. Mendias, PhD, ATC, the study’s lead author and an Athletic Trainer and Assistant Professor of Orthopaedic Surgery and Molec-ular and Integrative Physiology at the University of Michi-gan, said in a school press release. “This is the first study in humans to open the door to a potential therapy to prevent muscle atrophy. We see this as an important step in restoring athletic and functional abilities in the short term, and in preventing osteoarthritis in the long term.”

In the study, patients were examined before and after having ACL reconstruction surgeries following non-con-tact sports injuries. Prior to the procedure, scientists measured circulating levels of biomarkers for each patient and took objective knee strength calculations. They were then re-evaluated during six postoperative visits. In the end, it was noted that myostatin levels increased signifi-cantly early in the postoperative period and returned to pre-surgical baseline levels later in the rehab process.

“In the sports world, there’s great concern about the short-term and long-term affect of an ACL tear on not only an athlete’s physical skills and ability to return to play, but also the longevity and health of the knee joint,” Asheesh Bedi, MD, senior author and Assistant Profes-sor in Orthopaedic Surgery at the University of Michigan, stated in the release. “This is the first study to look into the biology of muscle tissue involved in an ACL tear and to show how Myostatin affects the muscle damage we see following surgery.”

To read the study’s abstract, visit: ajs.sagepub.com and type “Changes in Circulating Biomarkers of Muscle Atro-phy, Inflammation, and Cartilage Turnover in Patients Un-dergoing Anterior Cruciate Ligament Reconstruction and Rehabilitation” into the search window.

BoardBulletin

BoardBulletin

cal 26-minute sets on a non-motorized treadmill, with a 15-minute “halftime” break in between. During this time, players were either inactive or did “re-warm-ups”—five leg press repetitions or a three-minute soccer passing drill.

Measurements for vertical jump (including the flight-time to contraction-time ratio), sprinting endurance, blood lactate concentration, and heart rate were taken before and after each group had completed its halftime activity and immediately following the second treadmill set. Each athlete also took the Loughborough Soccer Passing Test (LSPT) at these times.

The athletes who completed the re-warm-ups were more powerful, more skilled, and faster than the inactive group. For example, when everyone was measured in the vertical jump at the end of halftime, individuals who par-ticipated in the leg press activity had a higher flight-time to contraction-time ratio than those in the other two groups. This ratio remained higher for the leg-press subjects when all were tested again after the second 26-minute set of running. Scores for maximum rate-of-force development, repeated-sprint ability, peak velocity, mean velocity, and acceleration were also greater for those who performed the leg press.

Players who completed the three-minute passing drill during the break saw their end-of-halftime LSPT scores

increase 6.4 percent over their beginning-of-halftime numbers. The LSPT is a timed activity that requires ath-letes to execute 16 passes and hit a series of targets within a circuit of cones and grids. Points are deducted for inaccurate or poor passes.

James Zois, PhD, lead researcher and Lecturer in the College of Sport and Exercise Science at Victoria Uni-versity, suspects that halftime re-warm-ups may be as beneficial as pregame warm-ups when it comes to improv-ing performance. “The findings encourage coaches…to really scrutinize how they warm up their athletes [before the second half] and to professionalize that component of preparation, as there is real performance-enhancing and injury-preventative potential,” Zois told The Conversa-tion, an Australian news Web site that frequently features sports medicine research.

To view the abstract of the study, “High-Intensity Re-Warm-Ups Enhance Soccer Performance,” visit www.pubmed.gov and search for the title.

Injury Risk & Traction Testing

When it comes to shoe traction, most athletes believe

Circle No. 105

Circle No. 106

Stay in the game with the all-new DonJoy Stabilizing PRO ankle brace. This low-profile, versatile brace has been designed for tough players who expect the best in ankle protection. Made of rugged materials and built to meet the needs of the most demanding athletes. Strap on the DonJoy Stabilizing PRO and know that your chances of ankle injury have just been reduced by 61%.*

DJO Global offers a comprehensive portfolio of ankle braces including our Procare® and Aircast® brands. Call your local DJO sales rep or DJO Global direct.

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Circle No. 106

BoardBulletin

T&C SEPTEMBER 2013­­10 TRAINING-CONDITIONING.COM

BoardBulletin

more is better. But is there a point where too much traction negatively affects performance or even increases injury risk? Researchers at the Human Performance Lab at the University of Calgary recently set out to answer this ques-tion with help from a unique test subject: a shoe-wearing robot.

Traction can be broken down into two classifications: forward, which is when a spike, cleat, or sole digs into the surface to help propel the athlete straight ahead; and rota-tional, which allows the athlete to move sideways or shift directions. Many researchers have long hypothesized that rotational traction plays a much more significant role in injury risk than forward traction, but it’s a difficult theory to test without putting human subjects in harm’s way.

To address this dilemma, researchers created a rail-mounted, shoe-wearing robotic tester. Able to move both sideways and straight ahead on a field at various speeds, the robot has “feet” that remain in contact with the ground. To collect data, the feet featured sensors that measured forward and rotational traction levels.

For the study, which was published in May on the Medicine and Science in Sports and Exercise Web site, researchers borrowed shoes from local high school foot-ball players and had the robot calculate each shoe’s for-ward and rotational traction levels. After testing, the shoes

were returned to the players who wore them in the sub-sequent season, during which time athletic trainers from participating schools tracked non-contact leg injuries.

Study leader John Wannop, PhD, a kinesiologist at the University of Calgary, told The New York Times that rates for non-contact ankle, knee, and ligament injuries were highest among players whose shoes provided the most rotational traction. In addition, shoes that provided the most forward traction tended to lead to fewer injuries. Meanwhile, injury rates for shoes worn on grass were simi-lar to those worn on synthetic turf.

Wannop told The Times that to provide ideal athletic per-formance benefits and minimal injury risk, a shoe should have high translational traction values and relatively low rotational traction values. He added that athletes would do well to avoid models with “multiple large, toothy cleats or rubbery nodules along the outside of the sole,” since they contribute to more rotational traction. Instead, he said, “look for groupings of shorter cleats in the forefoot, which provide safer, more forward-oriented traction.”

For more information on the study, visit www.pubmed.gov and type “Footwear Traction and Lower Extremity Noncontact Injury” into the search window.

As strength coaches, athletic trainers, physical therapists and registered dietitians we understand the value of information and staying on the cut-

ting edge of our perspective fields. However, with the overabundance of available information and the next great training tool waiting to emerge, what can we do to capture and contain the most important informa-tion? How can we avoid this “re-invention of the wheel syndrome” that we replay over and over every time we learn about the next greatest training method or device? To answer this question we have to dissociate between methods and systems.

A method can be considered a technique, protocol, or singular way of doing something, while a system is a coordinated body of methods or components that form a singu-lar whole. Said another way, the method can be considered the tree and the system can be considered the forest. If we only prescribe to methods then we are limited to the capacity of that method to produce results, engage our clients, survive scientific rigor, and last the test of time. For example, someone who only uses kettlebells, weightlifting, or power lifting will only receive the benefit those meth-ods supply. Conversely, if we develop a system, we have principle-based training components that seamlessly integrate to create a complex whole, and it is within each training component that we apply the best training methods.

At Athletes’ Performance we have spent the last 14 years creating and perfecting our training system, and we have been teaching this system to industry profes-sionals through our Athletes’ Performance Mentorship program for the past 8 years. The goal of the Athletes’ Performance Mentorship program is to provide each par-ticipant with a training system that can house what they currently know, what they will learn through their Ath-letes’ Performance education experience, and what they will learn throughout the remainder of their career. This system allows each participant to be a better consumer of information and never again re-invent the wheel. A quality training system inevitably acts as a filter for in-formation with the output uncovering if a new method,

A method can be considered a technique, protocol, or singular way of doing something, while a system is a coordinated body of methods or components that form a singular whole.

& the evolution of Performance education training device, or piece of research will make the system better, worse, or make no change at all.

The Athletes’ Performance Mentorship series provides every participant with transparent access to the system behind the top champions in sport, military, and the cor-porate space. Through practical and applied education sessions across mindset, nutrition, movement, and recov-ery, every participant leaves with a training system that can be molded to their unique environment and evolve as our field progresses. Our goal is to provide every

participant with the most cutting-edge training tools, but at the same time provide the training toolbox to house the many tools that can be used to correct and develop the hu-man system. In the end the methods we employ are only as good as the system from which they come.

Nick Winkelman MSc, CSCS*D, USAW, USATF, is the Director of Training Systems and Education at Athletes‘ Performance. Winkelman leads the Athletes‘ Performance

Education programs in addition to providing training to the elite and professional athletes that train at Athletes‘ Performance.

Athletes‘ Performance Education programs offer the Per-formance Mentorship program teaching the integrated Athletes‘ Performance Training System, in addition to accredited education courses for rehabilitation specialists and registered dietitians.

For a complete list of courses, dates and to register, visit AthletesPerformance.com/Education.

Learn more at AthletesPerformance.com/Education | facebook.com/APEducation

By Nick Winkelman

Honoring the Most Valuable

Bob Marley receives a plaque commemorating his Most Valuable Athletic Trainer award and a Sports Health gift card from Sports Health’s Christine Carlton, during the 2013 Southwest Athletic Trainers’ Association meeting in Houston.

During the Southwest Athletic Trainers’ Association 2013 annual meeting in Houston, Bob Marley, MA, ATC, LAT, CSCS, was honored for being named the inaugural winner of the Most Valuable Athletic Trainer award from Sports Health and Training & Conditioning magazine. The Senior Outreach Athletic Trainer in the Department of Orthopaedic Surgery at the University of Texas Health Science Center at Houston, Marley was recognized for going beyond his job duties to ensure high school student-athletes are receiving the best possible care. His job with the Health Science Center entails providing care to 22 school districts in 10 Texas counties, and he also serves as a contract athletic trainer for Needville High School.

In addition to school sports coverage, Marley develops professional and community education seminars and assists with UT Health’s Memorial Hermann Ironman Sorts Medicine Institute Outreach Program. He has been awarded the Greater Houston Athletic Trainers’ Society’s Tom Wilson Service Award and the group’s Logan Wood Award for Meritorious Service. He has also won the Southwest Athletic Trainers’ Association’s John Harvey Humanitarian Award and the Greater Houston Football Coaches’ Association’s John Kelly Distinguished Service Award.

As strength coaches, athletic trainers, physical therapists and registered dietitians we understand the value of information and staying on the cut-

ting edge of our perspective fields. However, with the overabundance of available information and the next great training tool waiting to emerge, what can we do to capture and contain the most important informa-tion? How can we avoid this “re-invention of the wheel syndrome” that we replay over and over every time we learn about the next greatest training method or device? To answer this question we have to dissociate between methods and systems.

A method can be considered a technique, protocol, or singular way of doing something, while a system is a coordinated body of methods or components that form a singu-lar whole. Said another way, the method can be considered the tree and the system can be considered the forest. If we only prescribe to methods then we are limited to the capacity of that method to produce results, engage our clients, survive scientific rigor, and last the test of time. For example, someone who only uses kettlebells, weightlifting, or power lifting will only receive the benefit those meth-ods supply. Conversely, if we develop a system, we have principle-based training components that seamlessly integrate to create a complex whole, and it is within each training component that we apply the best training methods.

At Athletes’ Performance we have spent the last 14 years creating and perfecting our training system, and we have been teaching this system to industry profes-sionals through our Athletes’ Performance Mentorship program for the past 8 years. The goal of the Athletes’ Performance Mentorship program is to provide each par-ticipant with a training system that can house what they currently know, what they will learn through their Ath-letes’ Performance education experience, and what they will learn throughout the remainder of their career. This system allows each participant to be a better consumer of information and never again re-invent the wheel. A quality training system inevitably acts as a filter for in-formation with the output uncovering if a new method,

A method can be considered a technique, protocol, or singular way of doing something, while a system is a coordinated body of methods or components that form a singular whole.

& the evolution of Performance education training device, or piece of research will make the system better, worse, or make no change at all.

The Athletes’ Performance Mentorship series provides every participant with transparent access to the system behind the top champions in sport, military, and the cor-porate space. Through practical and applied education sessions across mindset, nutrition, movement, and recov-ery, every participant leaves with a training system that can be molded to their unique environment and evolve as our field progresses. Our goal is to provide every

participant with the most cutting-edge training tools, but at the same time provide the training toolbox to house the many tools that can be used to correct and develop the hu-man system. In the end the methods we employ are only as good as the system from which they come.

Nick Winkelman MSc, CSCS*D, USAW, USATF, is the Director of Training Systems and Education at Athletes‘ Performance. Winkelman leads the Athletes‘ Performance

Education programs in addition to providing training to the elite and professional athletes that train at Athletes‘ Performance.

Athletes‘ Performance Education programs offer the Per-formance Mentorship program teaching the integrated Athletes‘ Performance Training System, in addition to accredited education courses for rehabilitation specialists and registered dietitians.

For a complete list of courses, dates and to register, visit AthletesPerformance.com/Education.

Learn more at AthletesPerformance.com/Education | facebook.com/APEducation

By Nick Winkelman

Circle No. 135

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T&C SEPTEMBER 2013 TRAINING-CONDITIONING.COM­12

Melinda LarsonWhitworth University

trainer, I found that I enjoyed and was successful at administra-tive duties. And the support I’ve received over the past several years from the athletic department, university, and our presi-dent has helped me develop professionally. I can think of no better place to start this portion of my career.

I’m not just a placeholder, and I’m certainly interested in the permanent position, so my next thought was that we needed to fill my old roles for the upcoming academic year. We have opened up a visiting faculty position and the head athletic training duties will be transferred to my most senior assistant.

How­did­the­administration­at­Whitworth­help­you­prepare­for­this­role?Our previous athletic director delegated a lot of respon-sibility throughout the department. We’ve never had any full-time assistant or associate athletic directors, so he put together a leadership team to handle duties such as athletic communications and event management. I became a part of the team and was exposed to many areas beyond athletic training, which gave me great experience and reinforced that administration was something I wanted to do.

For example, one of my responsibilities was serving as advisor to the Student-Athlete Advisory Committee. One

After serving as a professor and Head Athletic Trainer for 18 years, Melinda Larson was given the job of Interim Athletic Director at Whitworth this summer.

It’s a good thing Melinda Larson, MS, ATC, AT/L, is used to having a lot on her plate. When June began, she was serving in her dual role as Head Athletic Trainer and Associate Professor of Health Science at Whitworth University. But after the school’s athletic direc-tor announced he was leaving on June 12, Larson was immediately appointed Interim Athletic Director—trading in her position as the supervisor of the four-person sports medi-cine staff for a job that would have her lead a department with more than 60 employees.

In 1995, Larson began juggling the responsibilities of teaching classes and providing hands-on care at Whitworth, while also being involved in many activities and committees both on and off campus. She currently serves as a member of the NATA’s College/University Athletic Trainers Commit-tee and was selected in 2012 for a term on the NCAA Com-mittee on Competitive Safeguards and Medical Aspects of Sports. Over the last five years, she has also gone on two mission trips to Guatemala through Athletes in Action.

Larson’s service has not gone unnoticed. In 2007, she was named Outstanding Educator by the Northwest Athletic Trainers Association, and in 2010, she received the NATA’s Outstanding Service Award.

In July of 2012, Larson was invited to be a part of the Substance Abuse Prevention Program Delivery Group for a first of its kind partnership between NCAA Division III and NASPA, a professional group for student affairs administra-tors in higher education. The initiative aims to curb alcohol use and abuse among college students and athletes by de-veloping educational and institutional programming.

In this interview, Larson provides a glimpse into her three roles—athletic trainer, professor, and now, administrator. She explains how she found herself in the athletic director’s chair, how she has balanced all her responsibilities, and what she has learned from her student-athletes.

T&C:­What­were­your­thoughts­when­you­were­named­Interim­Athletic­Director?­Larson: I was really happy about the opportunity. For some time, I was hoping my next step would be into athletic adminis-tration, whether that was on a college or high school campus, for a conference, or on a national level. Being a head athletic

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T&C SEPTEMBER 2013 TRAINING-CONDITIONING.COM­14

Q&A

eye on what was happening on the field. In addition, I would grade papers during lulls in practice.

What­were­the­positive­aspects­of­the­dual­position?­In order to teach a course, I had to know as much as pos-sible about the content it was going to cover, so I was con-stantly reading and studying about various aspects of health care. It allowed me to continue my education as a clinician. And being an active athletic trainer gave me practical expe-rience and examples that I could share with students in the classroom.

How­do­you­achieve­work-life­balance?It’s something that I’ve worked on over the years. For me, it starts with a few daily habits. One is going for morning walks by the river with my Australian Shepherd who is my “exercise accountability partner.” That gives me a chance to pray and reflect before starting my day. It’s what I call “Melinda time.”

I also try to do as much recreation as possible. To make sure I exercise at least a little every day, I ride my bike to and from work. I’m also a co-leader of a group called Believers on Mountain Bikes, which is a way to serve the community while also going out and enjoying the area’s mountains and trails.

How­is­Whitworth­implementing­the­new­Division­III­rule­on­sickle­cell­testing?­In the past, we would ask athletes for their sickle cell trait status, but we wouldn’t always get answers from every-one. The new policy requires that student-athletes know their status and bring us proof of testing. For those who don’t know this information, we provide resources at Whit-worth—from how to get in contact with the right physician to contacting the state board of health. We also have an ar-rangement with a local lab that offers convenient testing for our student-athletes.

Why­did­you­work­primarily­with­Whitworth’s­soccer­

Melinda Larson Interim Athletic Director, Former Head Athletic Trainer Whitworth University

Serves on the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports

Member of NCAA Division III and NASPA’s Substance Abuse Prevention Program Delivery Group

Named Outstanding Educator by the Northwest Athletic Trainers Association in 2007

Received the NATA’s Outstanding Service Award in 2010

of the most rewarding projects I did with that group was to help organize a last-minute food drive that brought in more than 500 pounds for our local food bank. We heard they were running low on supplies right around the holidays, so we decided to collect goods at a men’s basketball game. We rallied the Whitworth students into contributing to the cause, and I was amazed at everyone’s willingness to jump in, fill a need, and serve the community.

What­were­the­initial­challenges­of­your­new­position?­­Making myself known to the community. As an athletic trainer, I’m used to working out of the spotlight. So some Whitworth supporters didn’t know who I was when I was announced as the interim athletic director.

Once they met me, some said, “I’ve seen you on the side-lines or in the gym,” but they hadn’t yet connected my name to my face. In some ways, I think I’ll always feel like a be-hind-the-scenes support person, but I’m working with our president on ways to become a more public face of the de-partment.

How­did­you­balance­teaching­and­athletic­training­over­the­past­18­years?The first key to managing it all was routinely meeting with my department chairs so they understood the demands and unpredictability of the athletic schedule. They were usu-ally helpful in making considerations regarding my class times and faculty responsibilities. For example, if I worked a weekend as an athletic trainer, I was permitted to miss the department meeting on Monday.

It also required a lot of creative scheduling and efficient time management, which frequently meant combining two separate job responsibilities into one time frame. For exam-ple, I would sometimes meet with a student from my class while I was watching practice. I also supervised most of my rehabs during practice times. That way, I could dedicate the care needed to my injured athletes while also keeping an

Q&A

T&C SEPTEMBER 2013 ­15 TRAINING-CONDITIONING.COM

teams­when­many­head­athletic­trainers­typically­prefer­to­cover­football?­During my undergraduate years, one of my roommates played on the school’s soccer team, so I started going to her games and learned about the sport. But it wasn’t until I was in graduate school at Florida International Univer-sity and worked with the women’s soc-cer program that I really fell in love with it. The team was ranked in the top 10 nationally and made the NCAA Di-vision I tournament both years I was there.

I’ve become a fan of pretty much ev-ery sport I’ve worked with, but I think I fell for soccer because of the type of athlete it requires and the overall flow of the game. It’s like no other sport. For example, I grew up playing bas-ketball, and I played in college, but working soccer is much more enjoy-able to me as an athletic trainer.

What­are­the­benefits­of­working­with­the­NCAA­Division­III­Substance­Abuse­Prevention­Program­Delivery­Group?­I am thankful to be given the opportu-nity to be a part of this collaborative effort, because I’ve gotten to meet people in various fields from Division III schools all across the country. I’ve also learned a lot from experts about substance abuse, substance abuse prevention programs, and what goes into putting a plan together to combat abuse on the national level.

What­came­out­of­your­time­with­the­collaborative?­We developed a three-part web portal to help institutions tackle substance use and abuse on their campuses. The first component is a Personal-ized Feedback Intervention, which surveys students about their alcohol and drug practices and then immedi-ately provides a response about their usage. In the past, this tool has been shown to decrease negative alcohol-related consequences among college students.

The second piece is a campus as-sessment that requires schools to identify what aspects of drug and al-

cohol prevention and treatment they can improve upon. In the final part, the National Institute of Alcohol Abuse and Alcoholism will deliver informa-tion on how schools can implement their own best practices with alcohol and drug curriculum.

Twenty D-III schools started the two-year pilot program at the begin-ning of the 2012-13 academic year with the Personalized Feedback In-tervention. The remaining tools will be implemented in the 2013-14 academ-

ic year, and the full initiative will launch in the fall of 2014.

How­did­you­get­started­doing­service­work­in­foreign­countries?­­Several years ago, I became friends with a woman who was a missionary for the organization Athletes in Ac-tion, and in 2008, I decided to sign up for a service trip. I was enrolled in a five-day trip to Guatemala with a handful of other sports medicine

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Q&Apersonnel.

We spent our time there teaching at a training center for elite athletes. The medical professionals at the facility had an amazing desire to learn anything they could. For example, one day they led me around the clinic by the arm to ask my opinion on the treatment of some of their patients. I also sat down with a Guatemalan orthopedic surgeon who asked me every question he could think of regarding ACL recovery.

Last summer, I decided to go there again with a new group. We went to a few different places near Guatemala City and had another fabulous trip. One of my recently grad-uated students also went on a trip this summer, and I was excited that she wanted to jump in and serve.

How­do­you­help­injured­athletes­handle­the­emotional­aspect­of­a­rehab?­I think that sometimes you need to have tough times to truly appreciate the positives in life. So I ask my athletes what they learned about themselves after recovering from an injury. I think it would be a tragic missed opportunity for a student-athlete to go through a life-altering event like an injury and not take the time to respond to and reflect on it. I encourage them to think about how the rehab changed them, their relationships, and their life. Having to fight back through the recovery process alters your identity and daily habits, so I think it would be a shame to pretend like those hard months didn’t happen or mean anything.

Of course, this self-reflection comes easier to some than others. A few student-athletes have that lightbulb moment right away while others take longer to realize how valuable the recovery process was to their growth.

What­was­the­key­to­developing­your­interpersonal­skills­with­student-athletes?I tried to learn something from each student-athlete I in-teracted with. I heard a lot about their families, where they came from, and what was important to them. From these conversations, I learned that everyone is unique, and it was important for me as an athletic trainer to know my athletes as a person, not just as an injured ankle.

I also made a rule for myself to always have the most char-itable thought about any athlete I worked with, even if they were cranky, rude, not showing up for rehab, or not working as hard as I thought they should be. More often than not, there was a reason for their behavior. I would ask myself, “What’s the whole person here? What else could be going on in their life?” Then when I found out more about the situ-ation, I would understand why they were acting that way.

The nature of athletics and injuries brings so many emo-tions bubbling up to the surface. So as an athletic trainer, and now an athletic administrator, I have learned to be sen-sitive and aware of the effect it can have on people. Some-times that means not being grumpy back to an irritable student-athlete or taking the extra time to talk with them. n

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The ImporTance of capTurIng DaTa

collecting, compiling, and intelligently analyzing data is synonymous with sports. from the nfl scouting combine and sabermetrics (the term coined to describe baseball statistics analysis) to monitoring athlete’s training and rehabilitation progress, data analysis has been the key to optimum progression in athletes and best predicting future success.

When coaches have in-depth information on their athletes, they can create training programs that will help drive the athlete forward to success. a lack of data means individuals’ weaknesses may not be getting addressed, leading to a training program with a lot of working but little meaningful results.

Dr. Bob Ward, Strength Coach for Dallas Cowboys (‘76-’89) and Performance Theory Expert (relating data to predicting success) states “Finding how an athlete is perform-ing is absolutely essential prior to prescribing training programs.”

in addition, there can be weaknesses hidden to the naked eye that are preventing an athlete from making those critical improvements. this could be hesitancy off the starting blocks or poor anaerobic recovery between plays.

At the top level 0.1% makes all the difference but it cannot always be seen without technology. But there are some major roadblocks to collecting data in training. Whether a coach is working one-on-one with an Olympic champion or in a high-turnover environment such as a high school, the process of collecting and compiling data can be time consuming.

What if a coach could quickly collect and compile data and get detailed snapshots of his or her athletes without taking time away from hands-on coaching? What if the data was simple to manage and easy to present to athletes? The answer is simple: Performance improvement and progress can be made faster and results seen more quickly.

Enter the HiTrainer Pro. this innovative high intensity training equipment has an onboard touch screen computer that provides real-time, detailed, and precise data on the user’s physical condition. it specifically measures speed and power outputs against various sprint and high-intensity interval workouts, giving coaches and athletes inside information on the users explosiveness, acceleration, power, peak speed, fatigue and balance. the numbers have all been proven to correlate to athlete performance in sports from ice hockey to track & field. it is an exciting game changer in sports data collection and an essential tool for coaches and athletes.

some of the ways a 20-second sprint test on the Hitrainer can help a coach is by:

• evaluating an athlete’s current performance and physical condition• giving instant, detailed feedback to athletes to help them make changes on the fly• Monitoring an athlete’s progress over time and identify over-training before it’s too late• adapting training schedules based on results• Building a database of athletes to make tangible comparisons• reducing your workload • Minimizing risk of error in training modifications• Measuring an athlete’s individual leg strengths to identify imbalances prior to injury• tracking an athlete’s rehabilitation progress after injury

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T&C SEPTEMBER 2013 ­19 TRAINING-CONDITIONING.COM

optimum performance

G rip strength is one of the most underrated and neglected aspects of training football players. Most people don’t even think about its importance until it changes the course of a game.

There’s no better example of this than the last play of the first half in the 2012 Capital One Bowl between the University of South Carolina and the

University of Nebraska. With seven seconds remaining and the Gamecocks down 13-9, South Carolina quarterback Connor Shaw took the snap, pump-faked, and launched the ball toward the goal line where three of his receivers were flanked by four Nebraska defensive backs. Each player in the pack leapt for the ball, but wide receiver Alshon Jeffery came down with it, turned, and dove into the end zone to give South Carolina the lead as time expired.

Joe Connolly, MS, SCCC, CSCS, USAW, is entering his second season as the Head Strength and Conditioning Coach for the University of South Carolina football team. Justin Markley, working on his master’s degree at Michigan State University, and Michael Pimentel, CSCS, working on his master’s degree at Bridgewater State University, completed summer internships at South Carolina. Connolly can be reached at: connollj@mailbox.sc.edu.

By Joe connolly, Justin Markley, & Michael PiMentel

Grip strength training is not very glamorous, but it is an important part of the University of South Carolina football program.

Get a GripUn

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Connor Shaw lost only one fumble as the University of South Carolina starting quar-terback last season, thanks in part to the grip strength training he and his Gamecocks teammates perform throughout the year.

Many praised Shaw’s scrambling and the timing of Jeffery’s jump, but very few noticed the impact grip strength had on the play, starting with Shaw’s pump fake. The success of this move-ment relies on the quarterback’s abil-ity to make it look like the ball is going to be thrown, so he needs to apply the

same force as if it is going to be re-leased. Without a firm grip, this can result in a fumble.

Next, Jeffery showcased his grip strength by bringing in a ball that six other players were fighting for. Fre-quently in Hail Mary situations, mul-tiple hands are in contact with the ball, and more often than not, the player with the strongest grip comes down with it. Jeffery’s touchdown shifted the momentum of the game, as the Game-cocks rattled off an additional 14 points to eventually win 30-13.

Whether it’s a defensive lineman shredding through an opponent’s block, a cornerback attempting to jam

T&C SEPTEMBER 2013 ­­20 TRAINING-CONDITIONING.COM

optimum performance

a receiver at the line, or a running back fighting against a strip attempt from a linebacker, grip strength is essential in football. But its benefits extend beyond the playing field. This article shows how we incorporate grip strength train-ing at South Carolina, the dividends it pays in the weightroom, and how it can help prevent injuries.

GRIP BASICSContrary to popular belief, grip strength involves more than just the hand. In fact, 35 muscles are utilized when mov-ing the forearm and hand, and most of these play a part in gripping.

For starters, solid grip strength wouldn’t be possible without the elbow joint. When programming for grip, it is important to train the flexion and ex-tension actions of the elbow in order to keep a balance between its anterior and posterior muscle insertions. This results in better elbow stability, which in turn leads to increases in grip performance.

It is also important to incorporate a variety of wrist and forearm posi-tions when training for grip, such as extension, flexion, ulnar and radial de-viation, pronation, and supination. Us-ing different movements ensures that athletes maintain balance between the forearm flexors and extensors, which helps prevent injury.

The final piece in training for grip strength is the hand. There are two

primary hand movements to consider: flexion and extension.

All of the muscles, bones, and joints in these areas work together to form the three different grip actions—crushing, pinching, and supporting. The crush grip is the action of closing the fin-gers against a resistance, whereas the pinch grip (see Figure One, above) oc-curs when an athlete grasps an object with the thumb and opposing fingers. And the support grip (see Figure Two, above) is when the fingers take on the majority of a load.

There are a variety of concepts and equipment implemented in training for grip strength. Tools such as fat bars,

Figure One: Pinch grip

Figure Two: Support grip

One of the exercises we utilize is the isometric hold with a jersey ... because it is less stable than a bar or other

firm object. Using unstable tools forces the athlete to balance himself, resulting in greater proprioception.

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T&C SEPTEMBER 2013 ­­22 TRAINING-CONDITIONING.COM

optimum performance

kettle bells, pull-up bars/balls, and even a household towel can be used to work a wide array of movements and muscles used for grip.

One of the exercises we utilize at South Carolina is the iso-metric hold with a jersey. The athlete is required to complete a pull-up using a jersey without losing his grip.

The jersey helps build grip strength because it is less stable than a bar or other firm object. Using unstable tools forces the athlete to balance himself, resulting in greater proprioception. This exercise is especially beneficial when training for football, because our athletes become acclimated to gripping jerseys, which they often have to do on the field.

Another exercise we do with our football athletes is the fat bar reverse-grip curl to overhead press. The fat bar offers a greater grip challenge than a standard barbell due to its larger circumference.

Have the athlete stand in an athletic stance with their hands in a pronated position. With their shoulder blades depressed and retracted, the athlete should curl the bar up to their col-larbone. From this position, the athlete should press the bar over their head and bring their head through their arms, lock-ing their elbows and squeezing their shoulder blades together.

We also utilize the farmer’s walk to work on the support grip action. Set an implement at the start of a prescribed dis-tance (typically 20 or 30 yards) and have the athlete grip it at the start line. Then, they walk with the weight held away from the body, constantly squeezing the handles.

WEIGHTROOM BENEFITSBesides the advantages that grip strength provides to on-the-field performance, it pays off in the weightroom as well. As an athlete’s grip becomes stronger, they gain better grip endur-ance when weight training, resulting in a greater work capac-ity. The reason behind this is the concept of “radiant tension,” which occurs when an object, such as a barbell, is effectively squeezed. With a firmer, stronger grip on the bar, the athlete produces more tension, creating an increased physiological response throughout the set. Continued squeezing causes the tension to be dissipated throughout the rest of the body.

For example, let’s look at a shoulder military press or bench press. Attempting either of these movements with a loose or open grip will cause the bar to stray from its path, resulting in a po-tential safety risk and inconsistent performance for the athlete. When a firm, closed grip is used and tension radiates through the body, the bar path will be much smoother. In turn, this will both lead to more efficient lifts and ensure safety.

The positive impacts of a developed grip can be seen in a variety of ways when training athletes, including better repeti-tion endurance. In a movement where grip can be a limiting factor, such as high-rep heavy pulls like dead lifts, cleans, and

Athletes are also likely to see increased strength gains, particularly when it comes

to testing new weights on a lift. Because grip strength will not be a limiting factor in

their success, the individual may be capable of working with heavier loads.

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Circle No. 114

T&C SEPTEMBER 2013 ­23 TRAINING-CONDITIONING.COM

clean-pulls, a stronger grip will lead to more reps. Athletes are also likely to see increased strength gains as a result of grip training, particularly when it comes to testing new weights on a lift. Because grip strength will not be a lim-iting factor in their success, the indi-vidual may be capable of working with heavier loads.

INJURY PREVENTIONEven with all the performance and training gains grip strength provides, it is important to remember that the first priority of a strength and conditioning coach is injury prevention. Athletes in training are going to get sore and run the risk of an overuse injury. With that in mind, coaches should employ vari-ous preventative techniques during all weightroom sessions.

When it comes to grip training, tak-ing care of muscle tissue should be the top priority. If the tissue is healthy, it is less likely that an athlete will expe-rience an overuse injury. Stronger tis-sue also leads to a stronger grip. There are several ways to prevent injuries to the muscles and tissues associated with

Circle No. 117

grip, including self-myofascial release techniques and static stretching pro-gressions.

Self-myofascial release techniques deal predominantly with tissue health. Whenever a muscle contracts and re-

laxes—which it does almost constantly when training for or competing in ath-letics—it accrues tension. The stronger or more frequent the contractions, the more tension builds up in the muscle fi-bers, where adhesions, or “knots,” can eventually develop. These can be ex-perienced as palpable nodules or tight bands of muscle tissue. Knots are es-pecially common during weightroom work because as athletes lift greater masses, they force their muscles to pro-duce stronger contractions.

Adhesions can restrict the athlete’s range of motion. If they remain un-

treated, and the athlete performs a movement that pushes them beyond this limitation, injury can occur in the form of muscle strains, pulls, tears, and even tendonitis.

The muscles in the forearms and

hands that are used for grip are no different than any other muscles in the body and are prone to developing adhesions. If the flexors are carrying tension or knots, the athlete may expe-rience pain when performing an action or find their range of motion limited. The same could be said for the exten-sors.

Releasing this tension will not only ease discomfort and provide freedom of movement, but it will also allow the athlete to achieve a full contraction, resulting in greater grip strength. In order to release muscle fiber tension,

There are several ways to prevent injuries to the muscles and tissues associated with grip, including self-myofascial release techniques and static stretching progressions.

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T&C SEPTEMBER 2013 ­­24 TRAINING-CONDITIONING.COM

optimum performance

different implements can be utilized to perform self-myofascial release. To be-gin, an athlete needs to select an object that is appropriate for the area they will massage. For example, an athlete performing myofascial release on the forearm should use a golf or lacrosse ball rather than a softball.

To treat the flexors, the athlete be-gins by sitting at a table or lying on the floor. They should position their fore-arm on top of the ball so the flexors are in contact. Then, have them gradu-ally work the ball across the proxi-mal end of the forearm while applying pressure and utilizing a small, rocking motion throughout (see Figure Three, above left). The athlete should slowly apply pressure across the entire soft tissue area, all the while feeling for knots in the muscle.

To break up the adhesion and re-lease the tension in a particularly sensi-tive area, the athlete should relax their muscle and position the ball under-neath the troubled spot, slowly putting pressure on it for up to 30 seconds. Athletes should be advised against pushing too hard and causing the mus-cle to lock up, which makes it more dif-ficult to break up the adhesion. Once they have successfully treated the ten-sion, they can move on and search for other knots. Then, flip the arm over and repeat for the extensors (see Figure Four, above left).

After myofascial release is complet-ed, the athlete needs to stretch the area to regain any reduced flexibility or range of motion. To accomplish this, they should use a static stretching pro-tocol of elongating the muscle fibers in the flexors and extensors.

The first progression of the stretch has the athlete standing at arms’ dis-tance from a wall. Have them place their hand flat up against the wall in a supine position above parallel (see Fig-ure Five on page 25). If their flexors are particularly tight, they might not be able to do this movement, in which case they should slide their hand down the wall to a more comfortable posi-tion. Then, they should remain in the stretch for 30 seconds to a minute. The athlete should continue this stretch un-til they can comfortably get their arm above parallel. To stretch their exten-sors, the athlete can flip their wrist to a pronated position and again attempt to place their palm flat against the wall.

Once the athlete can accomplish this

Figure Three: Flexor self-myofascial release

Figure Four: Extensor self-myofascial release

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T&C SEPTEMBER 2013 ­25 TRAINING-CONDITIONING.COM

optimum performance

Figure Six: Static stretch, second progression

Figure Seven: Static stretch, third progression

stretch, they can move on to the sec-ond progression, which occurs on the floor. While on their hands and knees, the athlete will externally rotate their arms and position the back of their hands flat on the floor with their fin-gers pointing toward their knees and their wrists facing out (see Figure Six, above). From this position, the athlete can progress the stretch by gradually applying more pressure and moving the palms up the floor until a desirable position is reached. To stretch their ex-tensors, the athlete can flip their hands

so their wrists are pronated.The final piece of the progression

calls for elevated hands so the athlete can increase the range of their stretch. Have the athlete kneel by a bench or box and repeat the same stretching motion (see Figure Seven, below left). From this position, they will be able to put more pressure into the activity than they did against the wall or floor.

In order to save time during a work-out, a coach can fit these stretches into other lifts or warm-ups. For ex-ample, the “inch worm” stretches the hamstrings but can also work the flex-ors and extensors by telling athletes to keep their palms flat against the floor. Another option is pairing wrist flex-ibility with stretching the psoas.

Although grip is often overlooked when it comes to strength training, a little emphasis can make a big differ-ence during crunch time. Grip strength is something every strength and con-ditioning coach—especially those who work with football teams—should grab onto, because you never know when you might need a Hail Mary. n

Figure Five: Static stretch, first progression

Circle No. 117

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treating the athlete

HEADS & HEADERS

Abby Wambach competes for the U.S. national team in a contest against Japan last year.

T&C SEPTEMBER 2013 ­27 TRAINING-CONDITIONING.COM

treating the athlete

By Maria Hutsick

Maria Hutsick, MS, LAT, ATC, CSCS, is Head Athletic Trainer at Medfield (Mass.) High School and former Director of Sports Medicine at Boston University. She is a past president of the College Athletic Trainers’ Society and was honored with an NATA Athletic Trainer Service Award in 2010. She can be reached at: mhutsick@medfield.mec.edu. AP PHOTOS/SHizuO kAmbAyASHi

HEADS & HEADERS

W omen’s soccer superstar Abby Wambach is known for her dynamic and dramatic headers.

She is admired by fans and competitors alike for her ability to leap in the air, perfectly position her head, and force-fully slam the ball into the back of the net. There is no better example of this than during the 2011 FIFA Women’s World Cup quarterfinals when Wambach scored on a game-tying header during overtime that forced the match into a shootout, earning the 2011 ESPY Award for Best Play of the Year.

This past spring, Wambach was in the news for a very different type of head-on-ball occurrence. While play-ing a National Women’s Soccer League contest in April, an opposing player kicked a ball that struck Wambach in the head with great force and sent her tumbling to the ground. Wambach re-turned to her feet and continued to play. Although medical personnel were not called on the field at the time, it was determined after the match that she had suffered a concussion.

In many ways, Wambach’s experi-ences sum up a growing and difficult problem in women’s soccer: Heading the ball has become a bigger part of the game and so have concussions. There is some confusion, however, over the correlation between heading the ball and concussions and why female soccer players seem to be increasingly at risk for this injury compared to their male counterparts.

When we think of concussions, foot-ball is often the first sport that comes to mind. But according to recent research, soccer is not far behind. A study that examined the prevalence of concussions during the 2005-06 high school year found that while the most resulted from

football-related contact at 40.5 percent, the next highest sport was girls’ soccer at 21.5 percent.

Also significant are the findings on boys’ soccer players as compared to girls. As detailed in the same study, girls also experienced a higher rate of concussions (.36 per 1,000 athlete exposures) com-pared to boys (.22 per 1,000).

Concussions are taking a toll on fe-male soccer players in a big way. As athletic trainers, we need to better un-derstand the mechanism of injury, how to work with coaches, and how to bridge the gap with parents and youth leagues.

THE CAUSESOne of the more difficult aspects of preventing concussions in soccer is pin-pointing the reason behind the injury. According to statistics compiled by the U.S. Consumer Product Safety Com-mission on concussions in high school soccer, 40 percent are attributed to head-to-player contact, 10 percent are head-to-ground, goal post, wall, or oth-er surface, 13 percent are head-to-ball (including accidents), and 37 percent are unspecified causes.

Clearly, concussions are occurring in many different ways. There is no one culprit. But from my seat on the side-lines, it’s clear that increased physical play has been a big contributor to the uptick in injuries.

After football, the sport with the highest rate of concussions is women’s soccer. A veteran athletic trainer takes a look at the causes and offers new ideas on prevention.

T&C SEPTEMBER 2013­­28 TRAINING-CONDITIONING.COM

treating the athlete

The game has gotten rougher for both genders, but I’ve found that male play-ers seem to fend off the physical play more effectively. Females often lack un-derstanding of how to protect them-selves during contact. This leads to the type of head-to-player impact that can easily result in a concussion.

When two girls are competing for a ball in the air, they usually don’t keep the space around them protected. They reach for the ball with their necks ex-tended like a turtle coming out of its shell, while their arms remain down by their sides or at waist level. Most boys, on the other hand, will raise their arms to their shoulders in an effort to ward off their opponent and keep them at bay to avoid a collision.

I’ve also seen way too many girls shove an opponent from behind during a play, which can also cause a concussion. While they more frequently occur when

an athlete is hit straight on, a whiplash type of injury where the head is snapped backwards and the brain is shaken can be as bad as receiving a direct blow.

Heading the ball can also be a mech-anism of injury. A perfectly positioned head supported by a strong body rarely receives a concussion when performing a header. But improper form, as well as a heavy accumulation of head-to-ball contacts, appears to be detrimen-tal. This is an area that needs more research, although it’s hard to ignore the anecdotal evidence.

While I was the Director of Sports Medicine at Boston University, I had the opportunity to work with both the men’s and women’s soccer teams. The men’s squad experienced very few head injuries, and most were from hitting the ground after having their legs undercut by an opponent. I do not recall very many issues due to heading the ball.

I can’t say the same about the women’s team, which had several concussions due to repetitive heading of the ball. One particular player who comes to mind was a midfielder known for her heading prowess. She began to have headaches,

trouble in school, and a hard time com-prehending information that she was learning in class. While she never had a specific concussion diagnosis, she even-tually began showing signs and symp-toms of post-concussion syndrome. She ended up having to take time off from the sport and was advised to avoid head-ing the ball when she returned. Athletic trainers at other schools have relayed similar stories to me.

How can we know if and when cu-mulative hits are causing harm? Un-fortunately, there is not a clear answer to this important question yet, but one recent study on men’s soccer players has shed a light on the topic.

Published online in June in the jour-nal Radiology, researchers at Albert Einstein College of Medicine at Yeshi-va University studied 37 amateur adult soccer players (with a median age of 31) who had all played the sport since

childhood. The study compared their self-reported frequency of heading the ball with scans of their brains using diffusion tensor imaging, an advanced MRI-based technique. It found that the players who accumulated between 885 and 1,550 headers a year had white-matter abnormalities similar to what is seen in patients with concussions.

“Our study provides compelling pre-liminary evidence that brain changes resembling mild traumatic brain injury are associated with frequently heading a soccer ball over many years,” said lead author Michael Lipton, MD, PhD, Associate Director of Einstein’s Gruss Magnetic Resonance Research Center, in a university press release. “While further research is clearly needed, our findings suggest that controlling the amount of heading that people do may help prevent brain injury that frequent heading appears to cause.”

PREVENTIONAs researchers continue to work on discovering more about the causes of concussions, I believe we need to up-grade our prevention efforts in soccer,

especially the girls’ game, immediately. These efforts should focus on two areas: helping soccer athletes better prepare for rough contact and addressing the role of heading the ball in concussions.

One way to help ward off dangerous collisions is to enhance proprioceptive skills. Two of our concussions this year at Medfield (Mass.) High School were the result of the players not knowing who was around them.

There are many exercises for teaching proprioception and awareness skills. Such activities will also enhance ath-letic ability, so they should be an easy sell to coaches.

Also, the stronger the athlete, the bet-ter prepared they are to handle rough contact. Instead of playing on club teams year-round, it may be beneficial for soccer players to be in the weight-room during the off-season building body strength, with a focus on devel-oping the upper back and neck mus-cles. Improved neck strength can help players absorb the impact of a hit and may help protect their brain by keeping their head stabilized. Neck and upper body exercises can easily be incorporat-ed into on-field practice drills.

Ideally, the athletic trainer and the strength coach can devise strength pro-grams that address each athlete’s func-tional limitations. Functional movement screens that assess the athlete can help in developing a program tailored to-ward remedying weaknesses.

Reducing concussions that result from heading the ball starts with talking to soccer coaches about preventive mea-sures. The first step is to make sure they are teaching proper heading form with the right progression. Some coaches may believe that their players have already been taught how to head the ball at the youth level, but with the significant con-sequences of concussions, I would like to see coaches err on the side of caution and reteach proper form, at least at the j.v. and middle school levels.

The Web site CoachingAmerican Soccer.com provides good instruction for how to teach heading. For new-er players, it suggests a progression of starting with a balloon, then moving to a sponge ball, play ball, volleyball, par-tially deflated soccer ball, and finally a properly inflated soccer ball.

When performed properly, head-ing should not hurt. This is because of thicker bone in the skull at the forehead to protect the brain from injury when

“Our study provides compelling preliminary evidence that brain changes resembling mild traumatic brain injury are associated with frequently heading a soccer ball over

many years ... controlling the amount of heading that people do may help prevent brain injury.”

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T&C SEPTEMBER 2013­­30

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TRAINING-CONDITIONING.COM

treating the athlete

falling forward. If heading causes pain, it is likely being performed improper-ly, or a physical condition may exist that needs to be explored. If a player complains of headaches, dizziness, or blurred vision, they must stop partici-pating in heading drills immediately.

Coaches also need to consider the vol-ume and frequency of heading drills their

players do in practice. I have been for-tunate in that the soccer coaches I have worked with have solid backgrounds in coaching the sport and never conducted repetitive drills for heading. The heading work was spread throughout the practice, so players were not exposed to multiple head blows in a short period of time.

When it comes to head safety, many coaches and parents want to know if helmets are a preventive option. Sev-eral head guards have been developed to reduce the risk of head injuries in soccer, but the jury is still out on their effectiveness. One independent research study found that no product on the market provides substantial benefits against minor impacts, such as heading a soccer ball. A helmet may possibly re-duce some of the impact when a blow is straight on but will not prevent a con-cussion that results from whiplash or rotational forces on the brain.

Ideally, athletic trainers will work closely with their soccer coaches to im-plement prevention strategies. If your coach is not open to the idea, or if you cover too many sports to do this on a day-to-day basis, at least try to discuss the topic during the preseason.

PROTOCOLS & PROCEDURESOver the past few years, more and more high school athletic departments have begun implementing thorough concus-sion protocol and education programs. The one I’ve developed here at Medfield is focused on all sports, including soc-cer, and has worked well. I collaborated with both the school nurse and guid-ance department in developing it.

Our program begins by administer-ing a computerized baseline concussion test to all incoming ninth graders and

new students the first week of school during their wellness classes. Those re-sults are kept on file and used for com-parison when an athlete is suspected of having a concussion.

For their part, coaches are asked to take an online course on concussions. Afterward, a certificate of completion is kept on file with our athletic director. The

rest of our faculty is provided with an in-service on what a concussion is and how academic workload must be modified to allow the concussed student to recover both physically and cognitively. Some modifications may include complete rest at home, a partial school day, reduced homework, or going to the nurse’s office to rest during the day. It might also in-clude longer time for test taking.

To get full school buy-in, I have found it important to be up to date on con-cussion research and reach out to other school personnel. I have attended a num-ber of concussion education programs and webinars. And the nursing staff ac-companies me to an annual concussion symposium offered nearby at the Har-

vard University Medical School.Massachusetts law allows an athletic

trainer to evaluate a concussed athlete and decide when that athlete can return to play. To ensure others feel 100 percent confident in my ability to make these important decisions, I have implemented a thorough return-to-play protocol. It includes using both the baseline comput-erized test and a physical test. When the symptoms of a concussion have resolved, the athlete must run for 15 minutes, perform 10 sit-ups, do 10 squat jumps, and then retake the computerized test. The results are compared to their base-line scores, and I communicate with the guidance department to see how the ath-

lete is doing academically. Next, I contact the parents to discuss

the athlete’s progress. If all seems okay, the athlete is allowed to transition back to full participation. I notify the nurse when an athlete has returned to play, and the academic accommodations are removed from the student’s plan.

Of course, my work on the sidelines is also important. Along with assessing any athlete who appears to be shaken up, if I see an athlete receive a blow to the head or hit their head on the ground, I ques-tion and evaluate them on the spot.

I also do everything I can to relay the seriousness of concussions on a daily ba-sis. From talking to parents to relaying recent news stories to putting up post-ers throughout the building, our school population understands where I stand. Because of the education component we have in place, I have had players report teammates who displayed concussion symptoms during football games.

STaRTing yOUngWhile there’s a lot we can do to decrease concussions in female soccer players in high school and college, what about at the youth level? With very few ath-letic trainers covering these programs, there is a dangerous gap in parents’ and coaches’ understanding of concussions.

Recently, I have started a small side business that offers baseline concussion testing to the youth sports programs

in town at a reasonable price. This has enabled me to get involved in the youth soccer community, and I’m hoping to do more in this area.

Parents at this level could benefit greatly from knowing more about recent research and recommendations pertain-ing to concussions. Robert Cantu, MD, FACS, FACSM, Chair of the Depart-ment of Surgery at Emerson Hospital in Concord, Mass., and co-director of the Center for the Study of Traumatic Encephalopathy at Boston University’s School of Medicine, made headlines when he published an eye-opening book last year titled, Concussions and Our Kids. In it, he explained how young brains are

To get full school buy-in, I have found it important to be up to date on concussion research and reach out to other

school personnel ... The nursing staff accompanies me to an annual concussion symposium offered nearby at the

Harvard University Medical School.

How do coaches feel about removing heading from the youth game? “It is hard to picture the game of soccer without heading, but given the possibility of trauma and the lack of neck strength and brain development, I think it sounds reasonable that heading is not introduced until high school.”

Returning to play needs careful evaluation. So does returning to the classroom.

Following a concussion, the decision to return to

play is only one part of the equation. It’s just as

important to consider the decision to return to

the classroom. Demands from schoolwork may

be too taxing for the recovering brain and could

affect students’ grades and even their recovery.

Concussion Vital Signs, designed for student

athletes’ developing brains, offers a valid, reliable

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T&C SEPTEMBER 2013­­32 TRAINING-CONDITIONING.COM

treating the athlete

more susceptible to injury and suggests no contact in sports before the age of 14. With regards to soccer, he recommends eliminating heading until at least age 13, preferably waiting until the player is 15.

Cantu explains that before the age of 14, children’s heads are larger than their bodies, and their neck musculature is not developed. By age 14 the head, body, and neck strength are better proportioned.

Another medical fact that Cantu’s book discusses is the lack of myelin (fat) that insulates and covers the fiber tracts in youth brains. Cantu explains

it this way: “Think of a copper wire in-side the wall of your house and the plas-tic or rubber coating around the wire. The coating insulates, protects, and strengthens that wire. The fiber tracts of an adult have a coating of myelin that acts the same way, protecting the fibers from injury or insult. Children’s brains have less myelin and structures in their brains are more easily damaged.”

How do coaches feel about remov-ing heading from the youth game? “It is hard to picture the game of soccer without heading, but given the possi-

bility of trauma and the lack of neck strength and brain development, I think it sounds reasonable that heading is not introduced until high school age,” says Nancy Feldman, Head Women’s Soccer Coach at Boston University. “It might even help kids improve their foot skills. This is a radical idea and it will be in-teresting to see if it can get traction.”

“The soccer coach in me strongly be-lieves heading does need to be taught,” says Deb Raber, Head Women’s Soc-cer Coach at Massachusetts College of Liberal Arts and an instructor for the National Soccer Coaches Association of America. “But coaches need to learn how to teach it properly and incorpo-rate safe heading drills into their prac-tices. I have seen youth coaches have ‘heading practices,’ which are not good. Teaching that way for a long period of time will result in headaches, and kids will eventually shy away from heading.”

Many parents coaching youth soccer have little to no background in physi-cal training principles nor any techni-cal understanding of how to teach the fundamentals of the game. In these cas-es, heading drills should certainly be avoided.

It can also be helpful to relay to par-ents the stories we see or hear about as athletic trainers. While attending the Harvard Medical School annual con-cussion symposiums over the years, I have had the chance to hear former pro football and ice hockey players reveal what they have gone through after sus-taining multiple concussions.

For example, during one session, Ted Johnson, former linebacker for the New England Patriots, told us about being concussed and unable to see the side-lines to get the defensive play signals. One of his teammates had to tell him what the coaches were calling so he could relay the play to the rest of the defense. Today, he suffers from memory problems, depression, and irritability.

While most of the heart-wrenching stories about the long-term effects of concussions currently come from the football community, I don’t think it will be long until we hear about simi-lar problems from soccer players. In the meantime, as athletic trainers, we should put prevention measures in place and continue to educate athletes, coach-es, and parents. Along with football players, female soccer players need our attention in order to reduce the risk of concussions in their sport. n

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NUTRITION

It may be the most-asked question sports dietitians get from athletes: How do I know if I’m getting enough vitamins and minerals for optimal performance? Right

behind it come two more questions. What foods pack the most punch for vitamins and minerals? Should I take a supplement?

Here at the University of Texas, I am fortunate to collaborate with a dynam-ic group of athletic trainers, strength coaches, and sports medicine physi-cians to ensure our athletes are not de-ficient in their nutritional intake. Our student-athletes are screened for iron and vitamin D blood levels and offered nutritional consultations when they first arrive on campus. When needed, they are also provided nutrition inter-vention. And we continually educate Texas Longhorn student-athletes on all aspects of dietary health.

But even if you don’t have access to the same resources—or are a one-person team for your school’s sports medicine needs—there is much you can do to help your student-athletes meet their nutrient needs. It starts with un-derstanding how micronutrients assist the body and continues with knowing the specifics of the key ones.

ATHLETES’ NEEDSStudent-athletes are often confused about how vitamins and minerals work, thinking they provide energy. Because they do not contain calories, micronutrients cannot boost energy stores. However, they are crucial for turning food into energy through met-abolic pathways. For example, many B vitamins aid in energy being released from carbohydrates.

Other important roles of micronutri-ents include aiding in the production of oxygen-carrying proteins, maintenance of bone health, proper immune system

By Amy Culp

Amy Culp, RD, CSSD, LD, is an Assistant Athletics Director and the Sports Dietitian at the University of Texas. She has been coaching athletes on all aspects of fueling for optimal perfor-mance and health for over a decade and can be reached at: Amy.Culp@athletics.utexas.edu.

The Power of Vitamins

Players on the NCAA Division I defending champion Univer-sity of Texas women’s volleyball team receive screenings and edu-cation to ensure they consume enough micronutrients.

For athletes striving to reach the top of their game, understanding how vitamins work and which ones are most important can make or break a season.

AP IMAGES/GARRY JONES

T&C SEPTEMBER 2013 ­­34 TRAINING-CONDITIONING.COM

NUTRITION

function, and fluid balance. They also help with the synthesis and repair of new muscle tissue and protect against oxidative stress.

Since athletes have high rates of en-ergy metabolism and need their bodies to function at intense levels, they tend to have higher micronutrient needs than non-athletes. In addition, exercise stresses the metabolic pathways where vitamins and minerals are utilized and may also result in biochemical adap-tations that increase micronutrient needs. Routine exercise may also speed up the turnover and loss of vitamins and minerals from the body.

But how much additional vitamins and minerals do athletes need, and which ones? To begin to answer that question, it’s important to understand Dietary Reference Intakes (DRIs), which are established by the Food and Nutrition Board of the Institute of Medicine. These provide a set of val-ues used to plan and assess nutrient consumption and vary by age and gen-der. They include:

Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient require-ments of nearly all (97 to 98 percent) healthy people.

Adequate Intake (AI): established when evidence is insufficient to de-

velop an RDA and is set at a level as-sumed to ensure nutritional adequacy.

Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects.

Because some athletes are tempted to mega-dose on vitamins and min-erals, thinking it will give them a performance boost, they need to be acutely aware of UL numbers. Taking too much of a micronutrient will not help them play better and can cause harm by increasing the risk for toxic-ity (especially with fat soluble vitamins A, D, E, and K), as well as interfering with absorption and function of other micronutrients or medications.

The key is for athletes to figure out where they may be deficient and come up with a dietary plan to rectify those

problems rather than popping sup-plements left and right. This doesn’t mean they have to analyze all of the food they eat. But it does mean ath-letes should be aware of how their food choices affect their intake of vitamins and minerals.

FOOD FIRSTSports dietitians tend to practice a “food first” approach. We feel it’s important for athletes to get a base performance-eating plan in place, and then fill in the gaps with dietary supplements. This is for many reasons, starting with the fact that eating is more fun than tak-ing a pill!

Just as important, many of the nutri-tional deficiencies seen in athletes can be related back to an energy intake def-icit in their daily diet. It is best to first identify and understand the barriers that stand in the way of meeting these needs, and then help athletes strategize for success. Satisfying caloric needs is essential for making gains in strength and performance goals, overall ener-gy levels, immune system functioning, and hormonal balance. That cannot be replaced with a supplement.

Foods also appear to have a syner-gistic effect when consumed as part of a varied diet, which is difficult to duplicate by solely ingesting micronu-

trients. A great example of this is that some types of iron are difficult for the body to absorb and utilize when eaten alone, but when consumed with a food high in vitamin C, absorption is enhanced.

In order to ensure adequate amounts of micronutrients are obtained from whole foods, there are five factors to keep in mind:

Nutrient Density: Eating nutrient-dense foods is the best way to get vita-mins and minerals. This means foods with lots of color (fruits, vegetables), whole grains, nuts, seeds, and a vari-ety of lean protein sources (including some vegetable sources of protein, such as beans).

What I’ve found works well is to ask athletes to choose nutrient-dense foods

80 percent of the time. That leaves 20 percent of food choices for fun. Athletes can relate to this balance, and most find it doable.

To assist athletes in making their choices a little easier, I also provide recipes for foods that are nutrient dense. One is a kale, oat, and blueberry smoothie and another combines butter-nut squash with quinoa, spinach, and walnuts for a hearty side dish. An easy snack food I recommend to our athletes is mixing a variety of nuts such as pea-nuts, almonds, walnuts, and Brazil nuts with raisins, dried fruit, sunflower and pumpkin seeds, soybeans, and granola.

Balance: Athletes should also focus on getting the correct balance of macro-nutrients (carbs, protein, fat) from each of the food groups. Inevitably, some will try diet fads that will either include too many carbs or not enough carbs. Consuming the right ratio of carbs and protein will translate to having enough micronutrients in their diets.

Variety: Choosing a variety of foods from each of the food groups can help greatly with getting adequate vitamins and minerals. The more variety, the more likely it is athletes will satisfy all of their micronutrient needs.

Fortified Foods: Many foods today are fortified, especially those marketed to athletes. As athletes strive to get the right dosages of micronutrients, they need to be aware of the levels of vita-mins and minerals in the fortified foods they consume. For example, nutritional shakes and bars can have large amounts of certain micronutrients that could cause an athlete to meet or exceed their needs without supplementation.

Food Quality: Advise athletes to choose fresh fruits and vegetables that are in season or frozen when they are not. Frozen fruits and vegetables are picked at the peak of their ripeness (when they contain the most nutrition) and flash frozen. Look for those that are in their original form and not cov-ered in sauces or breading.

In addition, athletes should avoid overcooking vegetables, which causes micronutrients to diminish. Instead, they can steam, microwave, grill, or roast. These are all easy ways to cook vegetables and retain their nutrition.

pack a punchIn the above list, I put nutrient density first because it is the most important. Some foods are simply better than oth-

Eating nutrient-dense foods is the best way to get vitamins and minerals ... What I’ve found works well is to ask

athletes to choose nutrient-dense foods 80 percent of the time. That leaves 20 percent of food choices for fun.

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CalciumRDA: Adult males and females: 1000 mg UL: 2500-3000 mgBest food sources include dairy products, leafy greens, calcium-fortified foods (juice, dairy alternatives), and legumes

IronRDA: Adult males: 8 mg, adult females: 18 mgUL: 40-45 mgBest food sources include liver, oatmeal, dried peaches and apricots, spinach, and meats

ZincRDA: Adult males: 11 mg, adult females: 8 mgUL: 40 mgBest food sources include meat, fish, poultry, shellfish, eggs, whole grain foods, vegetables, and nuts

MagnesiumRDA: Adult males: 400-420 mg, adult females: 310-360 mgUL: 350 mgBest food sources include dairy products, meat, nuts, whole grains, leafy greens, and fruit

Thiamin (B1)RDA: Adult males: 1.2 mg, adult females: 1.1 mgUL: None known/establishedBest sources include whole grain cereals, beans, pork, and enriched grains

Riboflavin (B2)RDA: Adult males: 1.3 mg, adult females: 1.1 mgUL: None known/establishedBest sources include dairy products, eggs, leafy greens, whole grain cereals, and enriched grains

NiacinRDA: Adult males: 16 mg, adult females: 14 mgUL: 20-35 mgBest sources include dairy, eggs, whole grains, meat, fish, poultry, and enriched grains

Pyridoxine (B6)RDA: Adult males: 1.3-1.7 mg, adult females: 1.3-1.5 mgUL: 60-100 mgBest sources include meat, fish, poultry, eggs, beans, whole grains, seeds, and oysters

Pantothenic AcidRDA: Adult males and females: 5 mgUL: None known/establishedBest sources include poultry, seafood, nuts, seeds, avoca-

dos, and whole grains

BiotinRDA: Adult males and females: 30 mcgUL: None known/establishedBest sources include egg yolks, legumes, leafy greens, and fish

Folate RDA: Adult males and females: 400 mcgUL: 600-1000 mcgBest sources include enriched grains, dark leafy greens, whole grain breads and cereals, and citrus fruits

B12RDA: Adult males and females: 2.4 mcgUL: None known/establishedBest sources include seafood, meats, dairy, eggs, and for-tified breakfast cereals

Vitamin DRDA: Adult males and females: 400-600 IUUL: currently set at 4000 IUBest sources include fortified milk and cereals, cod-liver oil, seafood, and eggs

Vitamin CRDA: Adult males: 90 mg, adult females: 75 mgUL: 1200-2000 mgBest sources include citrus fruits (oranges, grapefruits, and tangerines), strawberries, sweet peppers, tomatoes, broccoli, and potatoes

Vitamin ERDA: Adult males and females: 15 mgUL: 600-1000 mgBest sources include vegetable oils, nuts, and seeds

Beta-Carotene RDA and UL: Not established Best sources include red, orange, yellow, and dark green fruits and vegetables. Note: Excess intake of preformed vitamin A (retinol) has clear toxic effects when taken in excess of the maximum upper limit, but beta-carotene does not have these same toxic effects (although it may turn the skin a yellowish color!)

SeleniumRDA: Adult males and females: 55 mcgUL: 400 mcgBest sources include meat, fish, seafood, whole grains, nuts, and seeds

Breaking it downThe following provides information on the most important vitamins and minerals for athletes. The Recommended Dietary Allowance (RDA) amounts listed for athletes and Tolerable Upper Intake Level (UL) are per day. The listings with ranges depend on caloric consumption.

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NUTRITION

ers for providing a lot of micronutri-ents. Below are some great choices for nutrient-dense foods:

Kale: This dark leafy green vegetable has become increasingly popular in the past few years. Part of the reason is be-cause it is packed with nutrition. It is a good source of vitamins K, C, A, and B6, as well as calcium. It also contains natural antioxidants and fiber. Kale can be eaten raw in a salad, roasted with a little salt to make kale chips, or sautéed into a wide variety of recipes.

Butternut Squash: This orange veg-etable is high in fiber and antioxidants. It is also starchier than other squashes, making it higher in carbohydrates and a cleaner-burning fuel source. It is packed with vitamins A and C and potassium. It can be roasted, boiled, or mashed, and is great in risotto.

Whole Grains: Grains, in their unre-fined form, provide important vitamins and minerals as well as fiber. They are also a fuel source, and some (such as quinoa) contain higher amounts of ami-no acids than others. In addition, whole grains have a lower glycemic index than other carbohydrates, which causes less

of a spike in blood sugar levels and al-lows for a longer duration of satiety.

Beans: Edamame, kidney, lentil, garbanzo, and black beans are con-sidered excellent sources of both pro-tein and carbohydrates. They provide a fair amount of magnesium, iron, fo-late, potassium, and fiber. They can be prepared in soups or stews, made into spreads, or placed on a salad.

Nuts: While nuts are high in fat, they provide unsaturated fats that have been shown to help decrease inflammation. They also provide protein, fiber, potas-sium, vitamin E, and folic acid. They are easy to make into a snack, can be added to many recipes, or used in cereal.

A CLOSER LOOKAlong with choosing a variety of nutri-ent-dense foods, some athletes should take a closer look at their micronutri-ent needs for a better understanding of each’s significance. Most important to focus on for athletes are calcium, iron, zinc, magnesium, the B vitamins, and vitamin D, as well as some antioxi-dants such as vitamins C and E, beta-carotene, and selenium.

Let’s start by looking at the key min-erals: calcium, iron, zinc, and mag-nesium. Levels for these can be low, especially in female athletes. Inadequate energy intake or avoidance of animal products are typically the culprits.

Calcium: Most athletes understand that calcium is important for the growth, maintenance, and repair of bones. It has many other important tasks, such as regulation of muscle con-traction, nerve conduction, and blood clotting.

There are two main forms of cal-cium supplements, if supplementation is needed: carbonate and citrate. Both forms are well absorbed, but individu-als with reduced levels of stomach acid can absorb the citrate form more easily. Calcium carbonate is commonly avail-able and inexpensive, and its absorp-tion rate is most efficient when taken with food. Calcium citrate is absorbed equally effectively when taken with or without food. No more than 500 mil-ligrams of calcium should be taken at a time to ensure optimal absorption and utilization.

Iron: An inadequate iron status is

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NUTRITION

probably the most common micronu-trient deficiency among athletes. En-durance athletes require approximately 70 percent more iron on a daily ba-sis than the general population. When this goal is not achieved, performance declines because of less than optimal levels of hemoglobin, as well as chang-es in the muscle—reduced amounts of myoglobin and iron-related enzymes that are involved in energy production.

Hemoglobin and myoglobin are both oxygen-carrying proteins. The capac-ity to carry oxygen is essential for en-durance exercise as well as for normal function of the nervous, behavioral, and immune systems. Iron deficiency, with or without anemia, can impair muscle function and limit work capac-ity.

Iron depletion is typically related to inadequate energy intake. There are other factors that can affect iron sta-

tus, including following a vegetarian diet with poor iron availability, times of rapid growth in adolescence, train-ing at high altitudes, and increased losses (sweat, urine, feces).

It is prudent to perform routine iron screenings, including serum ferritin levels, to determine possible supple-mentation needs. Also note that revers-

ing iron deficiency anemia can take three to six months.

Good sources of iron include chick-en and beef liver, Cream of Wheat, dried fruits, oatmeal, beans, lentils, and meats. Certain forms of iron from non-meat sources are absorbed more readily when foods with vitamin C are consumed at the same time. Also important to consider is that absorp-tion is decreased when taken with tea, coffee, chocolate, dark leafy greens, whole grains, soda, and certain miner-als. A good rule of thumb if iron stores

are low is to consume calcium-rich foods and tea between meals. Also, fo-cus on getting vitamin C-rich foods at meal times, especially when consum-ing non-meat iron sources.

Zinc: This mineral aids in the growth and repair of muscle tissue, energy production, and immune sta-tus. Basal metabolic rate, thyroid hor-

mone levels, and protein utilization have been shown to be directly affect-ed by zinc status. Athletes, especially women, who are at risk for impaired zinc status are those who consume a diet low in overall calories and animal protein, but high in fiber.

Athletes should be cautioned against single-dose zinc supplements because they often exceed the UL of 40 mg. Consuming too much zinc can lead to low HDL cholesterol and nutrient im-balances by interfering with absorp-tion of other minerals, such as iron

Athletes should be cautioned against single-dose zinc supplements because they often exceed the UL of 40 mg.

To view and download a handout on meeting iron needs, please visit www.Training-Conditioning.com/Iron_Handout.pdf.

Circle No. 124

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T&C SEPTEMBER 2013 ­39 TRAINING-CONDITIONING.COM

NUTRITION

and copper.Magnesium: Playing many roles in

the metabolism of carbohydrates, pro-tein, and fats, magnesium also regu-lates neuromuscular, cardiovascular, immune, and hormonal functioning. Endurance performance is impaired by magnesium deficiency because of in-creasing oxygen requirements to com-plete submaximal exercise. Inadequate magnesium intake is typically related to overall energy deficit and an inad-equate balance of food groups.

Besides the four key minerals, the B vitamins are next on the list of impor-tant micronutrients and include thi-amin, riboflavin, niacin, pyridoxine (B6), pantothenic acid, biotin, folate, and B12. The B vitamins thiamin, ri-boflavin, niacin, B6, pantothenic acid, and biotin are involved in energy pro-duction during exercise. Folate and B12 are required for the production of red blood cells, protein synthesis, and in tissue repair and maintenance.

There has been some data to suggest that exercise may double the need for B vitamins. Severe deficiency of B12, fo-late, or both may result in anemia and reduced performance.

In terms of supplementation, B vi-tamins are water-soluble, thus are not stored in the body in the same way as fat-soluble vitamins. Also know that excess intake can lead to problems.

Vitamin D intake related to athletic performance is currently a hot topic. Although technically not a vitamin, this hormone is necessary for the ab-sorption of calcium, making it essen-tial for bone health. It also plays an important role in immune function and reducing inflammation.

In recent years, more research has been done on the consequences of vi-tamin D deficiency in athletes. It has been shown that low levels can de-crease physical performance and in-crease the incidence of stress fractures. The RDA was increased from 400 IU to 600 IU in 2010 as more informa-tion about the prevalence of deficiency and its role in maintaining good health and optimal athletic performance was uncovered.

One more area to cover is antioxi-dants, particularly vitamins C and E, beta-carotene, and selenium, which play important roles in protecting cell membranes from oxidative damage. It has been hypothesized that frequent exercise produces a chronic oxidative

Circle No. 125

Circle No. 126

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NUTRITION

The author would like to thank Maria Pugliese, dietetic intern, for her assistance in conducting research for this article.

stress on the muscles since exercise in-creases oxygen consumption, and thus ups the need for antioxidants. This idea remains controversial.

There is some evidence that a combi-nation of antioxidants may be helpful at reducing inflammation and muscle soreness. Strenuous and prolonged ex-ercise has been shown to increase vi-tamin C needs from 100 to 1000 mg/day. Athletes need to be advised to not exceed the UL for any antioxidant be-cause higher doses could be pro-oxida-tive with possible negative effects.

ADDING IN SUPPLEMENTSWith our student-athletes at Texas, the goal is that they meet increased micro-nutrient needs through food alone. But that can be difficult to achieve con-sistently. This is especially true with athletes who have restricted eating patterns (intentional or unintentional), such as severe weight loss practices, disordered eating, a food allergy, or by following fad diets. A balanced, varied diet can also be tough for athletes with poor eating habits, inadequate financ-es, or an overcommitted lifestyle that

causes erratic meal patterns.Athletes falling into those catego-

ries would benefit from meeting with a sports dietitian and considering a daily multivitamin/mineral supplement. A basic multivitamin/mineral supplement can fill in the gaps when eating right is an issue. In some cases, here at Texas, individual nutrient supplementation, such as iron, calcium, or vitamin D, is recommended based on our protocols and my assessment of the athlete.

If an athlete’s diet is adequate in cal-ories and balanced most days with just some inconsistencies, I will often pre-scribe taking a multivitamin/mineral supplement every other day instead of daily. Another strategy I often use is to fill the nutritional gaps with fortified sports bars and other fortified foods that provide micronutrients.

Choosing a multivitamin/mineral supplement can pose challenges due to limited regulation of dietary supple-ments. This issue will not be discussed in detail here, but there are some im-portant points to consider:

• Look for third party verification, such as Informed-Choice or NSF,

which helps to ensure the safety of the dietary supplement.

• Avoid supplements marketed to burn fat, increase energy, or promise anything that sounds too good to be true.

• Avoid supplements that offer mega-doses of vitamins and minerals.

• For more in-depth information about dietary supplements, visit the helpful Web site:

www.usada.org/supplement411.In order to hammer home the im-

portance of nutrition, we often tell our athletes, “You can’t out-train a poor diet.” The same could be said for sup-plements: “You can’t out-supplement a poor diet.” Multivitamin/mineral supplements are intended to fortify a strong nutritional foundation, and teaching athletes the importance of an overall adequate diet is the key to long-term success. n

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LEADERSHIP

At Illinois State University, the opening of the SMART Clinic has provided more hands-on opportunities for athletic training students and a place for recreational athletes to receive treatment.By Dr. Justin stanek

Justin Stanek, EdD, ATC, is an Instructional Assistant Professor and the Clinical Education Coordinator for the CAATE Athletic Training Program in the School of Kinesiology and Recreation at Illinois State University. He can be reached at: jmstane@ilstu.edu.

It’s a Thursday afternoon and the Sports Medicine and Rehabilitation Therapy (SMART) Clinic at Illinois State University is humming. In one corner, an ultimate player is receiving rehab for a shoulder injury. In another, a dancer with a big performance over the upcoming weekend has a stim machine working on her lower leg. And just outside the door, members of an intramural basketball team are lined

up to get their ankles taped in preparation for their title game that night. You won’t find any intercollegiate athletes in our space, but our patients are ath-

letes who need the services of athletic training professionals. We have been able to meet their needs through a unique new program.

Opened one year ago, the SMART Clinic is a result of collaboration among many entities at Illinois State to provide advanced care for ISU students in the areas of pre-vention, evaluation, and rehabilitation of athletic-related orthopedic injuries. It also allows clinical experience for our athletic training students, as well as a research re-source for professors in our School of Kinesiology and Recreation.

While it took a few years to get the project up and running, it has proven to be hugely successful. The SMART Clinic recently won the 2013 ISU Student Affairs

A SMART IdeA

Some of the services offered at the SMART Clinic include (clockwise from top left) trigger point performance therapy, Graston Technique, stretching, and manual mobilization.

T&C SEPTEMBER 2013 ­­42 TRAINING-CONDITIONING.COM

LEADERSHIP

pus location for treatment and rehab of athletic injuries. Second, it could provide an additional clinical educa-tion site for athletic training students. Third, professors could use the space for both teaching and research.

Our proposal was approved, but there were hurdles to clear before the clinic could be up and running. One was to secure startup funding, which was needed to cover staffing, purchase a credit card machine, and pay for some minimal advertising and supplies, in-cluding collared shirts for staff. This money came from Student Health Ser-vices, the College of Applied Science and Technology, and the School of Ki-nesiology and Recreation. Fortunately, the majority of the necessary equipment was already owned for didactic instruc-tion in the university’s athletic training program.

We also needed to consider the inter-ests of local rehabilitation clinics. These clinics have a direct relationship with the ISU undergraduate and graduate athletic training programs, as well as university intercollegiate athletics. We wanted to reassure them that the aim of the SMART Clinic was not to serve as a competitor to their operations—Stu-dent Health and our clinic would still be referring patients to them regularly. These communications were important in getting two prominent orthopedists in the area to agree to continue working with both our educational and athletic programs.

The result of our efforts is a 3,500 square foot, state-of-the-art facility with an attached classroom. It is equipped with numerous treatment tables, a pri-vate examination room, an office, ther-apeutic modalities, and rehabilitation equipment commonly found in an ath-letic training facility. In the morning, it is used by professors as an instructional or research area, and in the afternoon it becomes a functioning clinic.

As you might expect, the daily opera-tions of the clinic require the combined efforts of numerous stakeholders from across the university. The clinic works closely with Student Health Services through the Division of Student Affairs. Additionally, the clinic shares resources with the College of Applied Science and Technology and School of Kinesiology and Recreation. Lastly, Campus Recre-ation handles all of the building main-tenance, and maintains the schedules for the space.

gram difficult to continue. In addition, the athletic trainers were finding it hard to work for two different entities in multiple places. As a result, the pro-gram was terminated after only two se-mesters of operation.

In the fall of 2008, the idea for a therapeutic rehabilitation clinic for stu-dents was revisited thanks to new con-struction on campus. McCormick Hall, which serves as home to our athletic training program, was being expanded to include a fitness center and addi-tional classrooms. Administrators and professors from the School of Kinesiol-ogy and Recreation proposed includ-ing a fully functioning athletic training room/laboratory in the design.

The thinking was that this space could serve many needs. To start, it could expand the services of Student Health by offering students an on-cam-

Outstanding New Program award and received Honorable Mention for the Team Excellence Award at ISU’s 2013 Founder’s Day Convocation.

STARTING UPThe seeds for the SMART clinic were planted about seven years ago. At that time, two staff athletic trainers from the university’s athletic department be-gan providing services to the general student population through Student Health Services as part of a pilot pro-gram. The collected data and patient feedback showed positive results. The patients treated by the athletic trainers regained their function and returned to activity, while Student Health ap-preciated the ability to closely monitor progress.

However, limited space and resources within Student Health made the pro-

Two sTudenTsOne of the most rewarding aspects of overseeing the SMART Clinic is watching an athletic training student thrive through hands-on experience. This was the case for one of our students (whom I’ll call Alvin) and a recent patient (Tim).

Tim came to us two-weeks post-op ACL reconstruction. This was the sec-ond time he had torn his ACL, so he was not looking forward to the rehab process. He had a fairly significant amount of edema and was completely non-weight bearing when he arrived for his first visit.

Alvin was a junior athletic training student and was taking our therapeutic rehabilitation class at the time. He had seen many acute injuries but had not been able to work with a post-op patient through an entire injury reha-bilitation. He was excited by the opportunity.

Knowing Tim’s history, Alvin was determined to not allow him to become bored with rehab. After carefully studying the protocol, Alvin worked dili-gently to create a variety of exercises that would keep Tim motivated but also on track to progress quickly. As Tim warmed up each day, Alvin was busy tweaking exercises based on Tim’s previous visit.

Slowly, both began to see results. Hobbling along on crutches soon became pain-free for Tim, and his normal gait returned. Wall slides for mobility were replaced with stool scoot races and balancing contests between Alvin and Tim. Rehab games that Alvin had easily won were soon being won by Tim. As Tim continued to progress, Alvin began modifying portions of the treatment and searching for new exercises.

By the end of the semester, Tim was running again and was able to begin more sport-specific training. As a result of their time together, both Tim and Alvin had gained confidence from the experience—along with a genu-ine mutual respect.

T&C SEPTEMBER 2013 ­43 TRAINING-CONDITIONING.COM

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mick Hall. Additional publicity included flyers placed at Student Health Services and ads in the student newspaper. A ribbon-cutting event was held shortly after opening, allowing local media the chance to tour and ask questions about the facility, resulting in some indirect advertising.

We also provide a lot of information on our Web site (kinrec.ilstu.edu/smart), which serves as an advertising tool. The site details the services we provide, who we are, how to make an appointment, and costs. It also explains what an ath-

ten stretched too thin. During a typical week, I spend approximately 20 hours in the clinic on patient care, which can take away from my teaching and de-partment duties. We are working on remedying this by shifting some respon-sibilities to our graduate assistant and students.

CLIENTS & SERVICESTo get the word out about the new clinic, we partnered with Campus Rec-reation to advertise on the television monitors placed throughout McCor-

DAILY OPERATIONSThe current hours of operation are from 2:00 to 6:00 p.m. Monday through Thurs-day, and 1:00 to 5:00 p.m. on Friday. We sometimes adjust our regular hours to ac-commodate patients and allow weekend appointments as necessary.

As the Clinical Education Coordinator of ISU’s Undergraduate Athletic Train-ing Program, I serve as Director of the SMART Clinic and spend my afternoons there. The other certified athletic trainer on staff is a graduate student. She receives a graduate assistantship for this work as well as the opportunity to further her clinical skills and develop her leadership and mentoring abilities by overseeing the work of undergraduate students in our athletic training program.

The two of us practice under the direction of the physicians at Student Health Services, as required by the Il-linois State Practice Act, and are re-sponsible for overseeing the day-to-day operations of the clinic. Some of our duties include patient care, scheduling, record keeping, communicating with Student Health, inventory and ordering of supplies, and tracking patient satis-faction and outcomes.

However, a big part of our responsi-bility is overseeing the work of our un-dergraduate athletic training students. As the students progress through the program, they take on greater respon-sibilities with patient care. These ex-periences allow the students to transfer their classroom knowledge to a real-world context under the direction of preceptors who know and understand their current skill level. An added bo-nus for our students is that working at the SMART Clinic gives them athletic training experience in a unique setting with a relaxed atmosphere.

A typical day begins around 1:30. The patient files for the day are pulled, and paperwork for new patients is as-sembled. Patients are greeted at the door upon arrival, payment is secured, and the plan of care is started. Each visit is documented via the daily SOAP note and rehab log. The graduate as-sistant and I work with the students to adjust rehab exercises and care based on the patient’s progress. After the last client has been treated, folders are filed and necessary records are faxed to Stu-dent Health.

This schedule has worked well for patients and our students. The big-gest challenge is that my time is of-

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LEADERSHIP

letic trainer is and how we collaborate with other groups on campus.

Most of our patients are referred to us by Student Health, which faxes the student’s diagnosis and any spe-cific instructions for care directly to us. A crucial part of our client services is to take patient privacy very serious-ly. Student Health only shares neces-sary information related to the patient’s current athletic-related condition and SMART Clinic patient records are kept in a locked file cabinet, housed within the clinic office. Only the athletic train-ing graduate assistant and I have imme-diate access to these records.

Additionally, undergraduate students fulfilling their clinical education ro-tation with us sign verification forms indicating they understand the confi-dentiality and protected health infor-mation policies and procedures prior to any exposure to patient care. Also, all patients sign a student authorization/

consent form for disclosure of protected health information.

During the patient’s first visit, a thor-ough evaluation is performed and a plan of care is developed. Patient education of the diagnosis and treatment is em-phasized during this initial visit and, if applicable, a home exercise program is developed. This information is sent back to Student Health to ensure they are aware of all rehabilitation procedures.

If a student sustains an orthopedic-related injury during regular SMART Clinic hours, but outside of Student Health Services hours (weekdays from 9 a.m. to 5 p.m.), an agreement is in place to allow myself or the athletic training graduate student to perform an initial evaluation and any necessary im-mediate care. However, if we determine care beyond basic first aid is needed, the student is referred to the emergency room for further evaluation by a physi-cian. The student may be referred back to the SMART Clinic after this visit for follow-up care.

We have been pleasantly surprised by the variety of students utilizing the clin-ic. Prior to opening, we thought the ma-jority of our patients would be club sport

and intramural participants. While we see a fair number from this population, it is certainly not the majority. We have learned a lot about the types of injuries that can occur in quidditch, ultimate, boxing, team handball, ROTC, rugby, and equestrian. We also have treated a number of runners training for half or full marathons and students from the College of Fine Arts who have suffered an injury during classes or rehearsing for an upcoming performance.

A wide variety of both acute and chronic orthopedic conditions have walked (or hobbled) through our doors. Examples include post-operative rehabil-itation procedures for ACL reconstruc-tion, patellofemoral pain syndrome, ankle sprains, muscle strains, medial tibial stress syndrome, and low back pain. We utilize many different treat-ment approaches to address these condi-tions, such as myofascial release, muscle energy technique, Graston Technique,

joint mobilization and traction, thera-peutic ultrasound, electrical stimulation, balance training, stretching protocols, and strengthening exercises.

The clinic also offers students preven-tative joint taping (ankles, wrist, etc.) for a nominal fee. No appointment is necessary for this service. If the patient wishes to bring his or her own supplies, we offer the taping for free. In addition, sport clubs on campus may hire an ath-letic trainer for event coverage and are charged on an hourly basis.

In terms of billing, the clinic charges $10 per visit, the same fee used by Stu-dent Health, and students can pay us-ing a major credit card, cash, or check. Due to feedback from patients, this fall we’ve begun allowing patients to charge the fee to their student account.

One challenge we have faced is pa-tients not showing up for scheduled appointments. Unlike a traditional ath-letic training facility where you typical-ly see the athlete daily, the clinic usually schedules patients for two to three visits per week. This seems to make it harder for them to remember their appoint-ment. Additionally, we find that despite being referred from Student Health Ser-

vices, some patients never show up for their initial treatments.

This leads to loss of revenue for the clinic, as it results in an open time slot. In response, we have instituted a no-show policy. Modeling this after Student Health Services, we now charge the stu-dent’s account $10 for the missed ap-pointment if the student fails to notify us in advance.

Our overall goal is to fund all athletic trainer stipends and salaries, clinic equip-ment, and resource expenditures from pa-tient fees, and thus have a self-sustaining operation. After our first year, the clinic is on target to be self-sufficient, and all re-maining profit will be put towards paying back our startup funding.

WIN-WIN-WINThe SMART Clinic has proven to be a successful endeavor at ISU. Along with providing a unique and cost-effective service to our student body, it has pro-vided many other benefits.

First, the clinical opportunity for our students has been tremendous. The stu-dents assigned to the SMART Clinic say that the atmosphere allows them more independence than an intercollegiate athletic setting and they feel more con-fident in the low-risk environment.

Second, the SMART Clinic has pro-moted the profession of athletic train-ing and the athletic training major on campus. Not only do injured students receive education about their injuries, they also receive excellent care and some education about the knowledge and abilities of athletic trainers.

Finally, the collaboration among groups on campus has been a very re-warding experience. The clinic has gar-nered the attention of administrators from across the campus and opened up doors for research partnerships between faculty and the physicians at Student Health. We have also joined with Health Promotion and Wellness to put together information on injury prevention.

If the idea of starting a clinic like ours is something you are interested in exploring at your school, the impor-tance of garnering support from many different constituents cannot be over-stated. In our first year of operation, we have found these relationships to be extremely important and supportive in our efforts. Overall, the response we have received from both patients and the campus community has been very positive. n

Our overall goal is to fund all athletic trainer stipends and salaries, clinic equipment, and resource

expenditures from patient fees ... After our first year, the clinic is on target to be self-sufficient.

Loosen those hamstrings and lower back!

Hip Sways

Exhale – Start with both knees bent and the feet off the floor in a chair position. Inhale – Rotate the torso and lower both knees to-ward one side.

by Ken endelman

Ken Endelman is the Founder and CEO of Balanced Body.

Psoas/Hamstring StretchMovement Sequence

Inhale and Exhale – Straighten one leg down along the floor to stretch the psoas and hip flexors and reach the other leg up to the ceiling to stretch the ham-strings. Place your hands behind the thigh of the leg that is reaching up to the ceiling.

Repeat for 3 to 8 breaths.

Variation:

Psoas only: Keep the top knee bent to focus on the psoas alone.

Exhale – Draw the abdomi-nals in to bring the legs back to the starting posi-tion.Switch sides.

Repeat 4-8 times in each direction.

Variations:

Pelvic Clock: Roll the sa-crum in a circle on the

roller rather than just mov-ing side to side.

Straight legs: Straighten both legs for either the Knee Sways or the Pelvic Clock.

See why Pilates has becomea crucial component is thetraining regimen of eliteathletes all over the world -visit pilates.com.

Two areas that are al-ways a problem point

for athletic injury are tight hamstrings and a tight lower back. The beauty of Pilates is that the exercises can work and stretch every part of the body effectively. Here are two stretches – one each for the hamstring (and psoas) and the lower back. All you need is a foam roller and mat!

Psoas Figure 1

Psoas Figure 2

Hip Sways Figure 1

Hip Sways Figure 2

Loosen those hamstrings and lower back!

Hip Sways

Exhale – Start with both knees bent and the feet off the floor in a chair position. Inhale – Rotate the torso and lower both knees to-ward one side.

by Ken endelman

Ken Endelman is the Founder and CEO of Balanced Body.

Psoas/Hamstring StretchMovement Sequence

Inhale and Exhale – Straighten one leg down along the floor to stretch the psoas and hip flexors and reach the other leg up to the ceiling to stretch the ham-strings. Place your hands behind the thigh of the leg that is reaching up to the ceiling.

Repeat for 3 to 8 breaths.

Variation:

Psoas only: Keep the top knee bent to focus on the psoas alone.

Exhale – Draw the abdomi-nals in to bring the legs back to the starting posi-tion.Switch sides.

Repeat 4-8 times in each direction.

Variations:

Pelvic Clock: Roll the sa-crum in a circle on the

roller rather than just mov-ing side to side.

Straight legs: Straighten both legs for either the Knee Sways or the Pelvic Clock.

See why Pilates has becomea crucial component is thetraining regimen of eliteathletes all over the world -visit pilates.com.

Two areas that are al-ways a problem point

for athletic injury are tight hamstrings and a tight lower back. The beauty of Pilates is that the exercises can work and stretch every part of the body effectively. Here are two stretches – one each for the hamstring (and psoas) and the lower back. All you need is a foam roller and mat!

Psoas Figure 1

Psoas Figure 2

Hip Sways Figure 1

Hip Sways Figure 2

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T&C SEPTEMBER 2013 ­47 TRAINING-CONDITIONING.COM

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Tony Rolinski, MS, SCCC, CSCS, is Director of Strength and Conditioning for Olympic Sports at the University of Notre Dame, where he oversees training for 25 sports and works directly with the men’s ice hockey team. He has been a strength coach at Notre Dame for 15 years, and served as the Head Strength and Conditioning Coach at Duquesne University and North Hills High School in Pittsburgh, Pa. He can be reached at: arolinsk@nd.edu.

By Tony Rolinski

Like other sports, the physical demands of ice hockey dictate that players perform complex motor skills at a high rate of speed. During the course of a game, they have to rapidly accelerate and decelerate to change direction, deliver and absorb physical contact from opposing players, and react to a constantly changing environment. Unlike other athletes, though, hockey players have to

do all that on a sheet of ice while balancing on one-eighth inch wide blades of steel.Hockey players require power to propel themselves around the ice. And they need

strength to maintain balance through quick starts and stops, sharp turns, and devas-tating body checks. Here at the University of Notre Dame, we help them build that strength and power through a well-designed progressive plan based on Olympic lifts and other multi-joint movements.

Then there’s the interval nature of the game. Typically, players are on the ice for 45 to 60 seconds, giving maximum effort. Then they get three to four minutes of rest before taking the ice for their next playing shift. So in addition to maximizing their strength and power, we must also condition these athletes to recover quickly.

Over the past decade, Fighting Irish players have been able to transfer success in the

How do you develop a training plan for athletes who need to maintain strength and balance while competing on a sheet of ice? The University of Notre Dame’s coach explains.

Dave

Reg

iNek

Notre Dame powered its way to a 25-13-3 record and the Central Collegiate Hockey Association tournament title in 2012-13.

POWER PLAY

T&C SEPTEMBER 2013 TRAINING-CONDITIONING.COM

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weightroom to the ice. The team has reached the NCAA Division I Frozen Four twice in the last six seasons while winning two Central Collegiate Hockey Association tournament titles and earn-ing four NCAA playoff berths. While the credit for these successes undoubt-edly belongs to the players and coaching staff led by Head Coach Jeff Jackson, I am confident that our strength and con-ditioning program has helped the team reach its full potential.

BUILDING A FOUNDATIONHere at Notre Dame, we identify two simple, straightforward goals for all stu-dent-athletes, including our hockey play-ers. The first is to help reduce the risk of injury. Because hockey is a physical and violent game played at high velocities on a very unforgiving surface, we know there is no way to completely prevent them from occurring. However, by help-ing the athletes strengthen their bodies to build a figurative suit of armor, we help them more safely absorb the inevi-table collisions they will experience and reduce their odds of getting hurt. These efforts can also decrease time lost from any injuries that do occur.

Our second overarching goal is to help improve sport performance. I view strength and conditioning as an oppor-tunity to develop the raw materials of performance, namely the players’ bod-ies. Therefore, the mission is to provide

Off-seasOn strengthHere is a week of sample off-season strength-training workouts for the Notre Dame men’s ice hockey team.

Monday Wednesday Friday

Total Body Upper Emphasis Lower Emphasis

5-way neck machine & 5-way neck machine & Hang snatch manual resistance manual resistance

Hang clean Snatch pull Back squat clusters

Front squat DB split jerk SL RDL

Glute/ham Weighted towel pullups Walking hockey lunge

Thick bar row Bench press SL leg curl

Thick bar incline press Step-ups Messier squat

Reverse lunge TRX inverted row Nordic hamstring

DB floor press 3-way shoulder Hip/leg press

Pistol squat Reverse hyper Banded monster walks

a well-designed training program that is based on sound physiological principles. We do this by incorporating a sport spe-cific focus on conditioning based on the energy systems used in hockey while utilizing safe strength training methods within a periodic plan.

However, we rarely try to mimic hock-ey movements in the weightroom. Hock-ey specific skills are developed on the ice by our sport coaches through team and individual practice. Instead, we believe that improvements in strength, power, speed, agility, and conditioning will al-low our hockey athletes to perform their sport specific skills at higher levels. All we ask is that players give great effort, engage one another, and pay attention to detail during each training session.

THE MENUBefore they enter the weightroom at Notre Dame, we make sure all our ath-letes understand the basic underpin-ning of our strength and conditioning program—the repetition. When de-signing training sessions for hockey, as well as all our other sports, we build up from the perfectly executed repetition. Whether we are training for strength, power, or speed, the repetition and how it is performed lay the foundation for performance gains. Even the most well designed plan will be of little use if repe-titions are done in a haphazard manner.

We take the time to coach consistent

technique before effort, and we talk about the importance of rep integrity every day. We explain to our players that it will take hundreds of properly performed sets and reps before they will see a change in their physical attributes, but a few poorly per-formed repetitions can hinder their prog-ress or put them at risk for injury.

The philosophy in the weightroom is based on training compound, multi-joint movements. We use variations of the Olympic lifts for power development, especially clean and snatch pull varia-tions (from both the knee position and the floor), hang cleans, dumbbell snatch-es, dumbbell split jerks, shrug pulls, and dumbbell or kettle bell swings.

Our primary compound lower body strength movements are squatting (back and front), trap bar deadlifts, hip press-es, Romanian deadlifts, and glute/ham gastroc raises. Our auxiliary lower body movements include lunge and step-up variations, single-leg Bulgarian squats, single-leg pistol squats, single-leg Ro-manian deadlifts, hamstring eccentrics, and reverse hypers.

The players especially enjoy our hock-ey-specific variations. One is the walk-ing hockey lunge, in which they step out at a 45-degree angle similar to what they do when skating. We also have them perform Messier squats where they use a wider base and lighter weight than regular squats. Once they are in the squat position, they rock back and forth similar to a side lunge, but instead they swivel their hips. This helps stretch and train their groin, which is a com-mon source of injury in hockey players.

We maintain a range of three to five reps for strength and power movements throughout the year. This allows for continued improvement in technique, reduces fatigue, and improves the ath-lete’s rate of force development.

The players also perform plyometrics during the off-season and preseason as another way to train athletic triple-ex-tension movements. The stretch-short-ening component of these bounding exercises helps maximize speed of move-ment and develop the horizontal power a hockey player needs.

Our upper body compound move-ments provide a balance between pull-ing and pressing exercises designed to help increase shoulder stabilization and integrity. We build around major pulling exercises such as heavy row-ing movements and weighted pullups and chinups. Push presses as well as

T&C SEPTEMBER 2013 ­49 TRAINING-CONDITIONING.COM

sport specific

bench, incline, and narrow grip press-ing are also frequently used. Additional upper body exercises involve single-arm dumbbell work, weighted dips, upright rows, shrugs, and direct three-way shoulder work (posterior, lateral, and anterior deltoid focus). We also use medicine ball throws and slams and Keiser functional trainers to perform chopping motions that build rotational power through the torso.

The head, neck, and trap areas are especially vulnerable to injury from col-lisions. Development of the trapezius takes place through heavy pulls and shrugs done throughout the workout.

To strengthen the neck, we use a five-way neck machine like many schools, but we also do some manual resistance work as well. In these exercises, a player lies on a bench and a strength coach puts one hand on the player’s forehead and the other under his chin. He then applies resistance as the athlete moves his head through four planes of movement—flex-ion, extension, and laterally in each di-rection. The speed-controlled movements typically last two seconds in the concen-tric phase and four to six seconds in the eccentric phase. Once players have mas-tered this exercise, we teach them how to properly supply resistance to a teammate, allowing them to work in pairs.

FOUR PHASESWe break our training year into four phases: off-season, preseason, in-season, and postseason. Here’s a look at the train-ing regimen for each of these periods.

Off-season: This phase covers 16 weeks from the beginning of summer break to the start of official team work-outs in September. While these ses-sions are voluntary under NCAA rules, we have traditionally had very good turnout with most, if not all, players remaining on campus to train while taking summer classes.

During this period, we work hard to build the physical attributes that hockey skills draw upon as well as improving the players’ overall athleticism and ad-dressing individual weaknesses. There is no hockey practice, film study, or meet-ings during this time, so our players can focus on enhancing their strength, speed, power, and agility.

We split this phase into two eight-week cycles, which are then divided into four-week blocks. The plan is pro-gressive within each four-week block as well as over the full 16 weeks.

Our players do three strength train-ing sessions a week during the off-season phase. These are evenly split between weeks of three total body ses-sions and weeks consisting of one to-tal body day, one upper body day, and one lower body day. (See “Off-season Strength” on page 48 for sample work-outs.)

Each strength session also includes post-workout exercises that focus on players’ specific needs. We split the team into groups based on the area that needs to be developed. Typically these areas in-

clude shoulder stability, groin isometrics, and posterior chain/core activation.

Twice a week, our players do dry land training, which is a hockey term for con-ditioning and agility work that takes place outside the weightroom. The main goal here is to start training the aerobic system to assure a fitness base in prepa-ration for anaerobic sprint work. Hock-ey is not an aerobic sport, but having the ability to recovery quickly for the next high-intensity shift is critical. However, since we’re most interested in building a strong base at this point, we use a work-

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to-rest ratio of 1:5 for speed work and 1:4 or 1:3 for agility and conditioning.

We also use plyometrics as part of our dryland training, starting with ba-sic exercises performed in a single re-sponse manner (vertical, horizontal, and lateral movements), then progress-ing toward more complex multiple re-sponse jumps and bounds at the end of the phase. This helps build both power and endurance at the same time.

Before each dryland session, athletes perform a dynamic stretching routine as a warm up. This typically includes 20-yard down-and-backs, butt kicks, carioca walks, toe touches, inch worms, and simi-lar exercises. (See “Off-season Dryland” at left for sample workouts.)

Preseason: Shortly after the start of the fall semester, the team begins its official preseason workouts. We use one six-week cycle during this time and are limited by NCAA rules to eight hours per week.

In this phase, our weightroom vol-ume drops from high to moderate as individual on-ice skill development with the hockey coaching staff takes priority. Our exercise selection generally stays the same as the off-season, although we do incorporate more plyometrics into our weightroom work by using a heavy strength movement, such as a 3RM squat, prior to an explosive activity, such as a tuck jump. The goal is to in-duce central nervous system stimulation for greater motor unit recruitment.

Our players lift four days a week, with two upper body days and two lower body days. The intensity of our lifting sessions remains high, but the total volume of sets and reps is reduced. Speed and agility sessions are still held twice a week, but we change the work-to-rest ratios for these six weeks to 1:2 or 1:1 and focus on intervals of 15, 30, or 45 seconds, depending on the drill.

Because these workouts are very in-tense, they are also very brief, lasting 15 to 20 minutes. The purpose is to induce a level of hypoxia similar to how they feel at the end of a shift. I want our play-ers to understand what that feels like before the season starts so they’re not surprised when it happens in a game.

To avoid overworking their joints, much of the metabolic work is done on stationary bikes. We’ll also use slide boards, which prepare and condition the hips, glutes, and groin area.

In-season: For me, this is the most im-portant of the four phases. Our players spend months working to increase their

Off-seasOn DrylanDHere is a week of sample off-season dry land workouts for the Notre Dame men’s ice hockey team.

Tuesday Thursday

Plyos: Plyos:

Hurdle jumps 4x3 and 5-yd sprint x4 Squat jumps 2x8

Tuck jump into 3 broad jumps x4 sets Lateral tuck jumps 2x8 R/L

Skate jumps 3x6 R/L Power skip 2x40 yards

Split squat jumps 3x6 R/L Heidens 3x5 R/L

Acceleration drills: Acceleration drills:

One knee starts (lateral push) Cat/mouse scramble

Max effort sprints 4x15 yards (2R/2L) Max effort sprint and chase 4x10 yards

Agility drills: Agility drills:

5-yard square patterns (x4 each) Figure 8 drill x 4 (2R/2L)

Sprint/shuffle diagonal/sprint 3-cone drill x 4 (2R/2L)

Sprint/backpedal/sprint diagonal Pro shuttle x 4 (2R/2L)

Shuffle R/shuffle L/sprint diagonal 5-yard continuous shuffle x 2 at 15 seconds

Sprint diagonal/shuffle L shuffle/R diagonal

Conditioning: Conditioning:

Shuttles (50 yards and back x6) Shuttles (50 yards and back x6)

In-seasOn strengthHere is a week of sample in-season strength-training workouts for the Notre Dame men’s ice hockey team.

Monday Wednesday

5-way neck machine Manual 4-way neck

Clean pull DB single arm snatch or shrug pull

Front or back squat Step-up

Glute/ham or RDL SL hamstring curl

DB or seated row Weighted pullups or chinups

Bench press DB SA incline press

SL compound movement (choice) 3-way med ball groin

Cable pulldown 3-way shoulder raise

Keiser rotational chopping Reverse hypers

T&C july/augusT 2013 ­51 TRaININg-CONDITIONINg.COM

sport specific

power and strength, and letting up on strength work once the season starts would put that time to waste. In addition, players need to maintain, or ideally increase, their strength levels to help reduce injury risk and sustain a high level of performance throughout the six-month season.

Games, practices, meetings, film study, and individual skill development leave little time for strength training, though. Our coaching staff allots me two of the 20 hours the athletes are available each week based on NCAA rules.

To make the most of this limited time, once the playing season begins, we dial back the strength training to two times per week (three for players not regularly in the line up) while work-ing around the game schedule. With most games played on Friday and Sat-urday nights, our typical training days are Mondays and Wednesdays. Both sessions have a total body focus, and we rely on compound multi-joint move-ments to maintain players’ strength ef-ficiently and effectively. As we get into the dog days of February and March, we usually drop to one session a week to assist with recovery of those players

logging a lot of ice time, while devel-opmental players will continue to train with two to three brief sessions during the week. (See “In-season Strength” at left for a sample workout.)

Postseason: After the season ends—hopefully at the Frozen Four in early April—we give the players about two weeks off to recover physically and mentally from the grind of the long sea-son. This usually leaves us with four to six weeks of work before the end of the semester.

I use this period to jumpstart activi-ties in the weightroom by gradually in-creasing the training volume through general physical preparedness activi-ties. I will also re-introduce some of the more demanding exercises we may not have performed during the season. The goal is to establish the work capacity the players will need to see gains during the upcoming off-season phase.

To allow their bodies to heal, all con-ditioning work during this postseason period is non-impact. This includes sta-tionary bike sprints, upper-body ropes exercises, slide boards, and non-tradi-tional activities, such as sledge hammer

swings and tire flips. The hockey coach-ing staff may also do some on-ice in-struction during this time, which usually includes a conditioning component.

While our philosophy of using Olym-pic lift variations in conjunction with compound, multi-joint movements works for us at Notre Dame, I recognize that it’s not the only way to train hockey players. But regardless of the specific ex-ercises you use, the ultimate goal is to show the players a vision of what they can become and then help them achieve it. To do that, you have to coach them with firmness, fairness, and dignity; get them comfortable with being uncom-fortable; and hold them accountable for their actions. Only then will you and your athletes be able to enjoy success. n

The author would like to thank the Notre Dame hockey coaching and support staff for their confidence and support in the development of hockey athletes. He would also like to thank his staff (Elisa Angeles, Craig Cheek, Kaitlin Sweeney, Matt Howley, Glenn Clarke, and Geoff Puls) for the knowledge and dedication they share on a daily basis.

Circle No. 131

52 T&C SEPTEMBER 2013 TRAINING-CONDITIONING.COM

Case Study

Strength and conditioning coaches never have enough space in their weight rooms—even at the top level of college athletics. With so much they want to accomplish, they often run out of room before they run out of ideas.

But when a couple of NCAA Division I strength coaches went looking for a way to get the most out of their facilities, they found Infinity Performance Flooring willing and able to help. At The Ohio State University, Mickey Marotti, Assistant Athletic Director for Football Sports Performance, recently had Infinity Max flooring installed in his weight room. As part of the flooring project, he also had the raised weightlifting platforms replaced with inlaid Infinity Max solid, seamless rubber platform centers that left the lifting areas flush with the rest of the weight room floor. “Having the inlaid platforms gives us a lot more space to work with,” Marotti says. “We now have a lot more flexibility to do conditioning, agility, and speed work in the room since we don’t the raised the platforms in the way. Plus, to be honest, I was getting tired of always tripping over the platforms as I moved around the room.” Marotti also likes the way the Infinity Max surface performs, for both athletes and coaches. “It’s a very user-friendly floor,” he says “You can do foot quickness and plyometrics on it, yet it’s held up well to the weights that get dropped on it. “Another thing I really like about the surface is that it doesn’t get slippery when athletes sweat on it,” Marotti continues. “Other floors you’re always having to wipe the sweat off to keep the athletes safe, but I really don’t have to worry about that now.” Emil Johnson, Director of Strength and Conditioning at Yale University, also chose to replace wood platforms with Infinity Max’s inlaid “Synthetic Wood” rubber platform centers when the school renovated its weight room earlier this year. “We usually have three or four teams training in the weight room at one time, so we need a lot of open area for everyone to move around without having to worry about tripping over a raised platform,” he says. “Plus, it’s a great lifting surface because it has a lot of grip. When our athletes are squatting or doing dead lifts, they feel secure because they know they won’t slip at all.” In addition to the Infinity Max flooring, Johnson also had the Yale facility outfitted with Infinity’s new iTurf, which is specially designed for running, jumping, and agility drills. Yale has a 10-foot wide, 42-yard long strip of 1.25” thick iTurf running down the center of its weight room. It’s marked for three lanes with a two-yard start box at one end and crash pads on the wall at the other. “This is one of the best indoor surfaces I have ever trained on, and we do all of our speed, acceleration, and change-of-direction work on the iTurf now,” Johnson says. “It’s got great grip, but at the same time it has a little more force absorption to

it, which makes it perfect to jump on and do plyometrics on. And, it’s not at all abrasive, so the athlete can do kneeling exercises on it comfortably as well.” Johnson says the athletes’ reaction has been nothing short of tremendous. “They absolutely love it,” he says. “And it’s really helped our football team prepare for the season. We like to finish fast and this surface is a perfect way to end our workouts with some 5-10-5s or practice our starts without having to leave the weight room.”

Maximizing Weight Room Space

Infinity Performance, Inc. | (888) 479-1017 | www.infinityperformance.com

TRAINING-CONDITIONING.COM T&CSEPTEMBER2013 53

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T&C September 2013Volume XXIII No. 6

Training & Conditioning is pleased to provide NATA and NSCA members with the opportunity to earn continuing education units through reading issues of the magazine. The following quiz is based on articles that appear in this issue of Training & Conditioning. By satisfactorily completing the quiz, readers can earn 2.0 BOC Athletic Training and 0.2 NSCA (two hours) continuing education units.

Instructions: Go to www.training-conditioning.com and click on “CEUs” to take the quiz online. You may also mail your quiz to us: Fill in the circle on the answer sheet (on page 55) that represents the best answer for each of the questions below. Include a $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 23.6 Quiz, 20 Eastlake Road, Ithaca, NY 14850. Readers who correctly answer at least 70 percent of the questions will be notified of their earned credit by mail within 30 days.

Bulletin Board (pages 7-10)Objective: Learn about recently published or presented research.

1. What did researchers discover about myostatin’s role in recovery from ACL reconstruction? a) It encourages growth of muscle tissue b) It inhibits growth of muscle tissue c) It has no effect d) It does not return to pre-surgical baseline levels during the rehab process

2. According to the study authored by Andrew Krause, PhD, ATC, nearly what percentage of athletic trainers have encountered and managed at least one athlete with a mental health disorder? a) 90b) 70c) 63d) 44

3. Which of the following is not one of the entry-level competencies Krause suggests athletic trainers possess in regards to mental health diagnosis and management? a) Recognize signs and symptoms b) Make appropriate referrals c) Diagnose the disorder d) Maintain a strategy throughout the duration of care

4. What did the study on high-intensity re-warm-ups discover? a) There was no difference in performance with a re-warm-up b) The re-warm-up had a negative effect on players c) The results were inconsistent between the two re-warm-up groups d) The athletes who completed the re-warm-ups were more powerful, more skilled, and faster than the inactive group

5. After studying a high school football team’s shoes, what type of traction did the study leader recommend? a) Groupings of shorter cleats in the forefoot b) Large, toothy cleats along the outsole c) Shoes with a high “rotational” traction d) None of the above

Get a Grip (pages 19-25)Objective: Discover the benefits grip strength provides when training for football and how it can help prevent injuries.

6. Why should a variety of wrist and forearm positions be used in grip training?a) They reflect the movements used during a competitionb) Each grip style can be trainedc) Athletes are less likely to become bored with the exercisesd) They maintain a balance between forearm flexors and extensors, which could help prevent injury

7. Which of the following is not a type of grip?a) Crush gripb) Pinch gripc) Press gripd) Support grip

8. Which of the following is cited by the author as a benefit grip strength provides in the weightroom?a) Better repetition endurance b) Ability to perform a greater variety of exercisesc) Decreased chance for an overuse injuryd) Increased range of motion

9. Why is self-myofascial release important in grip training?a) It increases grip strengthb) It releases the tension that builds up in the forearm musclesc) It allows for greater endurance when strength trainingd) It decreases the recovery time between exercises

10. Why should static stretching be completed after self-myofascial release?a) To regain any reduced flexibility or range of motionb) To break up any remaining forearm adhesionsc) To locate any knots that weren’t treated d) To serve as a cool-down activity

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54 T&C SEPTEMBER 2013 TRAINING-CONDITIONING.COM

CEU QUIZ

Heads & Headers (pages 26-32)Objective: Learn about how concussions are becoming a growing concern for female soccer players.

11. According to the article, approximately what percent of concussions during the 2005-06 high school year resulted from girls’ soccer?a) 10 percentb) 21 percentc) 35 percentd) 42 percent

12. Which of the following does the author not give as a potential factor to explain why girls’ soccer players suffer more concussions than boys’ players?a) Inherent genetic differencesb) Improper heading formc) A lack of understanding in how to protect themselves in the aird) A tendency to shove an opponent from behind

13. Which of the following is mentioned in the article as a possible concussion prevention strategy?a) Enhancing players’ proprioceptive skillsb) Developing players’ upper back and neck muscles during offseason weight trainingc) Coaching proper heading techniqued) All of the above

14. Which of the following was not included as a part of the author’s return-to-play protocol?a) 20 minutes of sport-specific drill workb) A 15-minute runc) 10 sit ups and 10 squat jumpsd) Re-taking the computerized baseline test

15. According to a study referenced in the article, how many headers per year resulted in white-matter abnormalities similar to what is seen in patients with concussions? a) 250-750 b) 885-1,550c) 1,750-2,300d) 2,500-3,200

The Power of Vitamins (pages 33-40)Objective: To understand the role of vitamins and minerals for athletes seeking top performances.

16. According to the article, which of these statements about micronutrients is FALSE. a) Micronutrients turn food into energy through metabolic pathwaysb) Micronutrients boost energy storesc) Micronutrients aid in the production of oxygen-carrying proteinsd) Micronutrients help with the synthesis and repair of new muscle tissue

17. Adverse effects of taking too much of a micronutrient include: a) Increasing the risk for toxicity b) Interfering with absorption and function of medicationsc) Both of the aboved) None of the above

18. Which vitamin best helps with the body’s absorption of iron? a) Vitamin Ab) Vitamin Bc) Vitamin Cd) Vitamin D

19. According to the author, antioxidants, particularly vitamins C and E, beta-carotene, and selenium, play important roles in:a) Protecting cell membranes from oxidative damageb) Increasing oxygen consumptionc) Calcium absorptiond) Production of red blood cells

20. The following food choices are examples of nutrient dense foods: a) Lean protein sourcesb) Whole grains, nuts, and seedsc) Fruits and vegetablesd) All of the above

Power Play (pages 47-51)Objective: Learn about the strength training program used by the Notre Dame men’s ice hockey team.

21. How long is an ice hockey player on the ice during a typical shift?a) 5 to 10 secondsb) 20 to 25 secondsc) 45 seconds to one minuted) Two to three minutes

22. What is the basic approach behind the Notre Dame hockey strength training program?a) Help players improve by making them stronger and better conditionedb) Teach players hockey skillsc) Focus on upper body lifts and exercisesd) Work on endurance over strength and power

23. Which of the following is not a lower-body exercise used by the Notre Dame hockey training program?a) Romanian dead liftb) Squatsc) Hip pressesd) Jumping jacks

24. Which phase of the Notre Dame hockey training program does strength coach Tony Rolinski believe is the most important?a) Off-seasonb) Preseasonc) In-seasond) Postseason

25. What work-to-rest ratio does Notre Dame hockey use during the preseason phase of its training program?a) 1:1b) 3:1c) 1:3d) 5:1

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Bulletin Board 1. m m m m

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5. m m m mGet a Grip 6. m m m m

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10. m m m mHeads & Headers 11. m m m m

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15. m m m m The Power of Vitamins 16. m m m m 17. m m m m 18. m m m m 19. m m m m 20. m m m mPower Play 21. m m m m

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56 T&C SEPTEMBER 2013 TRAINING-CONDITIONING.COM

Nutrition

Fuel They NeedGive it everything you’ve got. Gatorade is dedicated to providing high school athletes with the fuel they need to achieve their best during practice and competition. That’s why Gatorade offers G

Series performance packages to high school coaches and athletic trainers at a significant discount. To get the most out of every play and every player, visit the Web site to learn more and place your order.Gatorade • 800-88-GATOR www.gatorade.com/coaches Circle No. 500

INvIgoraTe your regImeNFor athletic performance, eye health, brain health, joint health, cardiovascular health, and beautiful skin, there may be no better suite of evidence-based ingredients than Astaxanthin, Omega 3 Fish Oil, and Vitamin D3. In 1800ATHLETE’s new Certified Astaxanthin with Fish Oil, you’ll find all three of these

popular super-nutrients in a unique triple-action formula that goes a long way to invigorate your health regimen.1800athlete.com • 516-301-5015www.1800athlete.com Circle No. 501

ulTra-CoNCeNTraTedMonster Amino™ is an ultra-concentrated BCAA formula that delivers an 8:1:1 ratio of leucine to isoleucine to valine. Recent university research shows that a leucine-enriched beverage consumed along with exercise synergistically activates and prolongs activity of the mTOR signaling pathway,

which increases muscle anabolic potential (muscle growth). The mTOR pathway is the “trigger” that signals the very genesis of muscle protein synthesis.CytoSport, Inc. • 888-298-6629 www.cytosport.com Circle No. 502

opTImal reCovery raTIoRockin’ Refuel is a high-quality, natural protein beverage with the great taste of real milk. Rockin’ Refuel Intense Recovery provides the 2:1 carb-to-protein ratio optimal for muscle recovery with 20 grams of protein. Muscle Recovery has 17 grams of protein, with no added sugar.

And it’s NCAA compliant, which is why more than 140 college and university athletic departments choose Rockin’ Refuel. It starts with real milk, and ends with real results.Shamrock Farms • 602-272-6721www.rockinrefuel.com Circle No. 503

Keep your BraIN healThyBrain Armor is formulated for athletes to help support brain and cardiovascular health by delivering 1,050 milligrams of DHA per serving. Brain Armor was developed by DSM Nutritional Products, a leading innovator in the development of algal-based DHA omega-3 products that promote health and wellness through every stage of life. DSM Nutritional Products • 888-OK-BRAINwww.brain-armor.com Circle No. 504

SImple aNd delICIouS Science supports what elite athletes have known for years: low-fat chocolate milk has what it takes to help recover after a hard workout. High-quality protein helps rebuild, the right mix of protein and carbohydrates refuels, while fluids and electrolytes help replace what’s lost in sweat. It’s a simple, effective, and delicious way to help your body recover so you can perform at your next race, game, practice, or workout.MilkPEP • 202-737-0153www.gotchocolatemilk.com Circle No. 505

IgNITeS perFormaNCe Harnessing the power of Creapure® Creatine, Certified Creatine™ works like a battery charger in your muscles. It regenerates ATP and ignites superior performance. Featuring a proprietary combination of Creapure® Creatine in combination with Vitamin D3, CoffeeBerry®, and patented FruiteX-B® Boron, Certified Creatine™ is NSF Certified for Sport and available exclusively from 1800ATHLETE.com. Certified Creatine™ supports muscle strength and size, endurance in training, and fast recovery—as well as healthy brain function.1800athlete.com • 516-301-5015www.1800athlete.com Circle No. 507

dropS oF eNergyCytomax Energy Drops™ are a portable and chewable means to deliver a precise blend of carbohydrates and essential electrolytes. Cytomax Energy Drops™ may be used before and during training. Each portable pouch provides 10 individual chews. Cytomax Energy Drops™ are available in two great-tasting flavor options: Tropical Fruit + Pomegranate Berry (non-caffeinated), and Orange + Tangerine (50 mg of caffeine per pouch). Tropical Fruit + Pomegranate Berry is collegiate compliant.CytoSport, Inc. • 888-298-6629 www.cytosport.com Circle No. 506

TRAINING-CONDITIONING.COM T&CSEPTEMBER2013 57

Nutrition

Gentle SupportUnlike firmer rollers, the OPTP PRO-ROLLER™ Soft provides gentle support that yields to the body’s natural pressure points and is easy on tight, sore muscles. Even though it’s soft, the closed-cell construction will stand up to heavy use and is perfect for multi-user environments, like Pilates studios. The PRO-ROLLER Soft is an ideal complement to Pilates, core work, self-massage, and relaxation techniques.OPTP • 800-367-7393www.optp.com Circle No. 522

IntuItIve and SImpleThe Allegro® 2 Reformer was designed in collaboration with fitness professionals to be intuitive and simple to use. It helps enhance

the flow and effectiveness of Pilates-based and functional athletic conditioning sessions. The Allegro® 2 Reformer features a footbar that adjusts vertically by lifting it up and moving it, even with the feet, and it slides the entire frame length to accommodate different body sizes. The Allegro 2 also allows users to make instant, one-touch, rope adjustments—even while they are lying on the carriage.Balanced Body • 800-PILATESwww.pilates.com Circle No. 520

Improve BalanceThe Orbit® is ideal for athletic conditioning professionals who would like the functional training benefits of Pilates but don’t have space for larger equipment pieces. The Orbit is lightweight and small enough to store anywhere. Athletes can sit, lie, kneel, or stand to perform a variety of exercises designed to challenge the entire body and keep the core engaged. It can improve balance, coordination, and strength. Includes a 35-minute workout DVD.Balanced Body • 800-PILATESwww.pilates.com Circle No. 521

challenGe core StrenGth Explore movement with 40 intermediate to advanced exercises using the OPTP PRO-ROLLER™ in PRO-ROLLER™ Pilates Challenge, by Angela Kneale, OTR. Combine these exercises into a personalized routine that emphasizes key principles like proper alignment, control, fluidity,

concentration, and breath. Incorporating the PRO-ROLLER with Pilates exercise is a motivational way to deepen mind-body awareness, promote better posture and symmetry, and challenge core strength and balance.OPTP • 800-367-7393www.optp.com Circle No. 519

Pilates

IncreaSe mItochondrIal FunctIonN(r) is a breakthrough natural supplement with dramatic potential to help athletes and health conscious individuals worldwide. N(r) has research proven application for increasing mitochondrial biogenesis and function, which can greatly increase performance and

metabolism. N(r) can also assist in protecting neurons for brain and nerve health and optimizing sirtuin function for anti-aging.High-Performance Nutrition • 206-232-9138www.HPNFormula1.com Circle No. 543

proper proportIonSKlean Multivitamin, part of the Klean Athlete™ line of nutritional supplements, is specially formulated for the unique needs of athletes. Each tablet has been carefully developed to contain the right proportions of vitamins, minerals, trace elements, and other nutrients without the danger of toxic build-up or other side effects. The unique fruit and vegetable blend contains ingredients such as Lutein, Lycopene, Zeaxanthin, Astaxanthin, and Pterostilbene, which are not found in other multivitamins. Klean Multivitamin uses EZ Swallow Technology and a twice-daily dose to assist with compliance for daily consumption. Klean Multivitamin is NSF Certified for Sport®. Klean Athlete by Douglas Laboratories • 855-255-5326www.kleanathlete.com Circle No. 544

58 T&C SEPTEMBER 2013 TRAINING-CONDITIONING.COM

Lower-Body Strengthening

Competitive AdvAntAgeAthletes’ Performance is an expert in human performance, delivering an unparalleled competitive advantage to the world’s top

athletes, teams, and military operators. Athletes’ Performance shares its integrated methodology that has supported the world’s top champions in sport through industry-leading accredited education programs. Education programs focused on performance training, nutrition, and rehabilitation are offered at Athletes’ Performance’s world-class facilities, providing hands-on, practical, and research-based education to industry colleagues.Athletes’ Performance • 480-449-9000www.athletesperformance.com/education Circle No. 508

essentiAl Addition The HiTrainer Pro is designed to significantly improve an athlete’s fitness in the minimum amount of time, making it an essential addition to training routines for any high-intensity sport. It helps significantly develop anaerobic recovery, strength

endurance, and cardio fitness. The less time an athlete requires working on conditioning in the gym, the more time that athlete can dedicate to his or her real sport-related training.HiTrainer • 855-726-3300www.hitrainer.com Circle No. 509

tone And ConditionThe TDS Pro Sissy Squat is useful for toning, reducing, bulking, or conditioning the hams, glutes, and quadriceps. Use the TDS Pro Sissy Squat with bodyweight for toning and conditioning, or with dumbbells for bulking and building

mass. This product is a commercial-quality machine, with heavy-form padding for a comfortable feel and an adjustable front foot holder and rear pad for a precise fit. The TDS Pro Sissy Squat is white powder-coated and made of 2” x 4” steel tubing. New York Barbells of Elmira, Inc. • 800-446-1833www.newyorkbarbells.com Circle No. 510

good vibrAtionsExervibe is a whole-body vibration stepper that provides athletic enhancement when used in either the static (standing) or dynamic (stepping) position. Vibration stimulation is applied simultaneously to the feet, hands, arms, and core. The Exervibe has a step range from one to 18 inches, an adjustable seat, and a control module with four settings. It is an extremely versatile device that efficiently and effectively implements the benefits of vibration. VersaClimber/HeartRate, Inc. • 800-237-2271www.versaclimber.com Circle No. 511

elevAte performAnCe The Thera-Band® Roller Massager+ is an innovative tool for myofascial release and deep-tissue massage. Its unique patent-pending ridged design supports both superficial and deep-tissue mobilization while providing a massage-like experience. Use of the Roller Massager+ can help increase blood flow and circulation in targeted areas, while helping to increase muscle flexibility and range of motion. The Thera-Band Roller Massager+ is available in a standard and portable version with retractable handles. Performance Health • 800-321-2135www.thera-band.com Circle No. 512

push or pull The Drive Sled II is the perfect sled for pushing and pulling exercises. The handles allow for quick changes of direction, while the flat bottom allows for smooth pushing and pulling on multiple surfaces. The sled is constructed of heavy-duty welded steel for maximum durability and has multi-point attachments, which allow for even loads during exercises. The Drive Sled II is available in Perform Better’s 2013 catalog. To request your free copy, please call Perform Better or visit the company’s Web site.Perform Better • 800-556-7464 www.performbetter.com Circle No. 513

inCreAse stAminAWith the Step360™ Pro, you can step, stand, jump, and lie on it. This unique tool provides a safe and superior balance challenge for all core, range of motion, strength, power, and performance workouts. The secret is the two inflated air chambers beneath the flat, stable platform. Increase your quality of movement, body alignment, posture, and balance with the Step 360 Pro. It will also improve your muscle stamina and strength, as well as enhance explosiveness and agility. SPRI Products • 800-222-7774www.spri.com Circle No. 514

trAin Your legsThe Power Lift® 40-degree Uni-Lateral/Bi-Lateral Leg Press features a uni-lateral/bi-lateral locking mechanism, adjustable back pad with lumbar support, weight storage, seven-gauge steel construction, and an adjustable

start position. The Uni-Lateral motion is ideal for users who want to train each leg individually. Sixteen high-grade liquid-cast polyurethane wheels guarantee smooth operation of carriage. Alternative angles are also available. Power Lift • 800-872-1543www.power-lift.com Circle No. 535

TRAINING-CONDITIONING.COM T&CSEPTEMBER2013 59

Lower-Body Strengthening

ToTal leg DevelopmenT The TDS Tibia Dorsi Calf Machine is great for runners, jumpers, and those interested in general leg sculpting. This product exercises the gastrocnemius and soleus, and has superior isolation of the tibia. Users can exercise each leg independently or both simultaneously. The TDS Tibia Calf Machine pivots on two industrial-grade pillow blocks. It is also commercial-quality with a steel deck plate and heavy padding for comfortable use. New York Barbells of Elmira, Inc. • 800-446-1833www.newyorkbarbells.com Circle No. 515

STreTch The limiTS The Super Bungie kit allows you to push the limits of agility and strength training. Designed to meet the rigorous demands of professional athletic conditioning, the Super Bungie Kit features three interchangeable Super Bungie Cordz. The cords come in 75-, 150-, and 200-pound resistance levels, and the included handle and belt allow athletes to increase core strength and agility by training individually or with a partner. The patented safety elements found in TurfCordz® resistance products provide a safer, more comfortable workout. NZ Manufacturing • 800-886-6621www.turfcordz.com Circle No. 516

STrengTh anD STabiliTyPower Lift® offers a unique method of exercising the glute and hamstring muscles with the Rotating Glute-Ham Bench. This machine more effectively works the hamstrings, gluteus maximus, gastrocnemius, and erector stabilizers for more

pelvic stability than traditional methods. The large rotating pads greatly reduce discomfort in the thighs, allowing for complete stretches and contractions of the hamstrings. An Easy Glide sliding mechanism effortlessly adjusts the machine so lower knee pads can properly position the body for a more fulfilling workout. Power Lift • 800-872-1543www.power-lift.com Circle No. 534

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mulTiple grip opTionSThe First Place Sandbag Pods are durable, neoprene sandbags that are great for strength training, dynamic movements, and any bodyweight activity. The shifting sand inside the Pods challenge targeted muscles and core stability. Their unique shape provides multiple grip options, making them ideal for throwing and slamming. These First Place Sand Pods are a great alternative to use instead of a medicine ball, dumbbell, or kettlebell. Perform Better • 800-556-7464 www.performbetter.com Circle No. 518

effecTive challengeThe XTS Training System is a uniquely designed, total-body training tool that increases the intensity of upper-body, core-muscle, and lower-body workouts.

The optional XTS thick-grip, anodized aluminum handles, available in two- and 2.5-inch diameter, are the perfect next progression from the 1.5-inch handles. The easily interchangeable handles add an effective grip challenge to enhance chest, back, shoulder, and arm muscle activation, while promoting optimal hand/wrist/forearm alignment. SPRI Products • 800-222-7774www.spri.com Circle No. 517

proTecT aThleTeS’ fuTureSConcussion Vital Signs® (CVS), designed for student-athletes’ developing brains, aligns to current sports concussion management

guidelines. This scientifically based system, used as part of a medical evaluation, enables confident return-to-play decisions while helping to protect the future of your athletes in sports, academics, and life.Pearson • 800-627-7271www.concussionvitalsigns.com Circle No. 539

no-meSS SoluTion Gel-SHOT is the next generation of patented ultrasound technology from Rich-Mar. Gel-SHOT provides a no-mess, high-outcome solution to treatments. It features no freight cost, lower application cost, sterility, no mess, superior coupling, dosage control, extended treatment area, and better efficiency and outcomes.Rich-Mar • 423-648-7730www.richmarweb.com Circle No. 537

cuSTomizable flexibiliTyThe new ProStretch Plus delivers unparalleled benefits for increasing flexibility in the plantar fascia, Achilles tendon, calves, shins, and hamstrings. Uniquely customizable, the patent-pending ProStretch Plus includes an adjustable, elevated heel rest, which both

customizes fit and increases stability. An exclusive adjustable toe lift provides superior plantar fascia and toe stretch, and a larger platform comfortably fits most shoe sizes and allows for progressive stretching without readjusting the foot.Medi-Dyne Healthcare Products, Ltd. • 800-810-1740www.medi-dyne.com Circle No. 546

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Reduce Risk Hibiclens® is a skin-friendly liquid antimicrobial skin soap that bonds to the skin and provides up to six hours of continuous killing action. Hibiclens is proven

to kill many harmful bacteria including MRSA, viruses, and fungi. Washing with Hibiclens before contact with potentially harmful germs will significantly reduce the risk of transfer. Hibistat® wipes do not require water and offer the same continuous killing action (up to six hours) found in Hibiclens.Hibiclens/Hibistat • 678-250-7940www.hibiclens.com Circle No. 523

PeRfect cold theRaPyPRO ice wraps are the perfect method for applying cold therapy to most minor injuries. Made with quality neoprene for durability, these wraps are perfect for treatment of pulls and strains. Wraps are quick and easy to use, allowing for adjustable compression to

keep ice packs in place. Available for the shoulder (#439), knee (#103) or back (#208). These wraps are available in black only.PRO Orthopedic Devices, Inc. • 800-523-5611www.proorthopedic.com Circle No. 524

unRestRicted MoveMentThe ESS Ankle Compression Sleeve’s patented articulated ankle joint allows for unrestricted movement while providing mild compression and support to the joint. Compression provides a performance-enhancement benefit as well as mild muscular support. The unique knitted design allows for lightweight fit and

exceptional stretch and comfort.Cramer Products, Inc. • 800-345-2231 www.cramersportsmed.com Circle No. 525

Recycle light Celliant is one of the world’s leading responsive textiles with clinically proven benefits. Celliant mineral technology is designed to recycle visible and infrared light into the body in a form it can use for energy. Moisture-wicking clothing, socks, orthopedic wraps, and bedding containing Celliant can enhance tissue oxygen and circulation, leading to better performance, quicker recovery, faster healing, and balanced temperature. Enhance your life with Celliant and claim your free socks online at the company’s Web site. CelliantTX • 866-315-4891www.EnergyTextiles.com Circle No. 527

effective ReliefMedically designed, athlete-proven Medi-Dyne products are easy-to-use tools that relieve tight muscles, stretch important muscle groups, and prevent pain and injury. With patented stretching, strengthening, foot, knee, and blister products, the Medi-Dyne family of brands includes: Cho-Pat®; Tuli’s®; ProStretch®; StretchRite®; CoreStretch®; Skin-on-Skin®; and RangeRoller®. These products are known for both their effectiveness and ease of use. Medi-Dyne is dedicated to providing innovations in pain relief and prevention.Medi-Dyne Healthcare Products, Ltd. • 800-810-1740www.medi-dyne.com Circle No. 528

fits youR scheduleAmerican Public University offers more than 170 undergraduate and graduate degree and certificate programs designed for sports and health science professionals, coaches, athletic directors, and working adults like you—completely online. APU has been nationally recognized by the Sloan Consortium for effective practice in online education. Classes start monthly with eight- and 16-week courses. For more information, visit APU online. American Public University • 877-777-9081www.studyatapu.com/sports Circle No. 529

cliMb youR Way backThe SRM Rehab Model VersaClimber is a total-body, closed-chain, rehabilitation exercise machine. The SRM allows patients to progress from non- to partial- to full-weight bearing, full-body exercise. It is fully adjustable to fit the height, weight, and length of all types of athletes and patients. Rehabilitation routines have been developed to provide a continuous arm and leg action in a seated or standing position, using varying stroke lengths, rates, and resistance levels.VersaClimber/HeartRate, Inc. • 800-237-2271www.versaclimber.com Circle No. 530

PRofessional-gRade PRotection

Used by many professional and college football players, the VETTEX DoubleGuard mouth guard features lip protection and breathing channels. Made by

Markwort and available at IthacaSports.com, this one-piece, custom-fit mouth guard has double impressions with an adjustable strap. It’s available in 23 colors and comes in three sizes—pee wee, youth and adult. For free shipping, contact Ithacasports.com today.IthacaSports.com • 800-716-9382www.ithacasports.com Circle No. 545

TRAINING-CONDITIONING.COM T&CSEPTEMBER2013 61

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ConCussion PreventionMission Competition Fitness Equipment launched The Halo at the CSCCa Convention in May 2012, and the company marked it’s one-year anniversary by introducing the product’s new name: The Iron Neck—a dynamic rotary neck strengthening cable attachment. The Iron Neck works out the neck by applying horizontal resistance during neck rotation. Mission Competition’s goal is to help prevent concussions and neck injuries by increasing the athlete’s neck strength.Mission Competition Fitness Equipment • 310-776-0621www.ironneck.net Circle No. 526

simPle solution Ice bath therapy can be a very effective modality. Unfortunately, this therapy regimen can elicit complaints of extreme discomfort in personal areas. The PRO #805 Ice Bath Therapy Briefs, which are constructed of 1/8-inch-thick neoprene with hook and loop fasteners

on each side for easy application, are an easy solution to this problem. Available only in black, the Ice Bath Therapy Briefs come in sizes medium, large, x-large, and xx-large.PRO Orthopedic Devices, Inc. • 800-523-5611www.proorthopedic.com Circle No. 531

unwinds ConsistentlyEvery roll of Cramer 100-percent cotton porous tape is like the next, which means you can count on it to unwind consistently, conform

better, and adhere longer. Cramer 950, constructed with a latex-free adhesive, is perfect for athletic trainers or athletic programs looking for a high-quality, economically priced porous tape alternative. Cramer Products has been an industry leader in sports medicine and athletic training room supplies for more than 85 years.Cramer Products, Inc. • 800-345-2231 www.cramersportsmed.com Circle No. 532

toP ProfessionalsThe National Strength and Conditioning Association (NSCA) is an international educational association.

The NSCA develops the most advanced information regarding strength training and conditioning practices, injury prevention, and research findings. Unlike any other organization, the NSCA brings together a diverse group of professionals from personal trainers, strength coaches, researchers and educators. These individuals are all in pursuit of achieving a common goal—improve athletic performance and fitness.NSCA • 800-815-6826www.nsca.com Circle No. 533

manaGe inflammationPolyMem is an innovative, adaptable, drug-free wound care dressing. PolyMem dressings have been shown to reduce swelling, bruising, and pain associated with both open and closed wounds. PolyMem also helps localize the inflammatory reaction to the actual zone

of injury, reducing the spread of inflammation and swelling into surrounding tissues. PolyMem dressings are available in both standard and antimicrobial silver formulations and come in a wide variety of shapes and sizes.Ferris Mfg. Corp. • 800-765-9636www.polymem.com Circle No. 536

Comfortable shoulder suPPortBrace International offers the MAX™, a major advancement in the design of shoulder girdle supports. The snug-fitting, lightweight material allows for comfort with movement while protecting the glenohumeral joint from subluxations and dislocations. Its strap design system offers many options for maximal stability where needed, allowing athletes to reach their required range of motion.Brace International, Inc. • 800-545-1161www.braceint.com Circle No. 538

athletiC traininG eduCationFlorida International University (FIU) offers an accredited, professional Master of Science in Athletic Training degree through its College of Nursing & Health Sciences. Students are educated in cognitive and psychomotor skills related to recognition, treatment, and rehabilitation of injuries involving the physically active as well as risk management, healthcare administration, pharmacology, diagnostic imaging, and medical ethics. Upon graduation, students are eligible to challenge the national certification exam. Florida International University • 305-348-3398www.go.fiu.edu/at Circle No. 542

toP-notCh heatinGRich-Mar debuted a state-of-the-art composite heating unit at the 2013 NATA Convention. With no metal, this unit does not rust. It also features a low-voltage control digital thermostat, digital low water sensor, isolated heating element, and five composite slide-out dividers for packs—no tongs are necessary. The deluxe model features a dual-purpose circulation/drain pump, and a folding shelf. This product is available in 12-pack, six-pack, and four-pack models.Rich-Mar • 423-648-7730www.richmarweb.com Circle No. 540

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Web site features...

• Headlines of the day

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Our redesigned

Web site features...

• Headlines of the day

• A blog dedicated to sports medicine and strength training

• CEU opportunities

• Special digital supplements

• A searchable database of articles

VISIT US AT training-conditioning.com

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64 T&C SEPTEMBER 2013 TRAINING-CONDITIONING.COM

Directory

Circle # Company Page # Circle # Company Page # Circle # Company Page #

Advertisers Directory

Products DirectoryCircle # Company Page # Circle # Company Page # Circle # Company Page #

121 1800Athlete com 35

127 AlterG 40

117 American Public University 25

136 Athlete’s Guide to Nutrition 62

135 Athletes’ Performance 11

128 Balanced Body 43

110 Brace International 16

118 Brain Armor by DSM Nutritional Products 29

119 Concussion Vital Signs® - Pearson 31

104 Cramer 6

106 DJO Global (Donjoy® Stabilizing PRO) 9

133 DJO Global (Fast Freeze) IBC

126 Ferris Mfg Corp 39

109 Florida International University 16

103 Gatorade 5

115 Hibiclens® & Hibistat® 23

122 High-Performance Nutrition 37

102 HiTrainer 3

123 IthacaSports com 37

125 Medi-Dyne 39

113 MilkPEP (Ironman®) 21

112 MilkPEP (Refuel Buddies) 20

134 Muscle Milk® (CytoSport™) BC

129 New York Barbells of Elmira 46

124 NSCA 38

131 OPTP 51

108 Perform Better 15

111 Power Lift® 18

114 PRO Orthopedic 22

100 Rich-Mar IFC

130 Samson Equipment 49

107 Shamrock Farms Rockin’ Refuel 13

116 SPRI 24

120 The Iron Neck (Mission Competition) 32

101 TurfCordz®/NZ Manufacturing 2

105 VersaPulley & VersaClimber 8

501 1800Athlete com (Astaxanthin with Fish Oil) 56

507 1800Athlete com (Creapure®) 56

529 American Public University 60

508 Athletes’ Performance 58

520 Balanced Body (Allegro® 2 Reformer) 57

521 Balanced Body (Orbit®) 57

538 Brace International 61

504 Brain Armor by DSM Nutritional Products 56

527 CelliantTX 60

539 Concussion Vital Signs® - Pearson 59

532 Cramer (950 tape) 61

525 Cramer (ESS Ankle Compression Sleeve) 60

506 CytoSport (Cytomax Energy Drops™) 56

502 CytoSport (Monster Amino™) 56

536 Ferris Mfg Corp 61

542 Florida International University 61

500 Gatorade 56

523 Hibiclens® & Hibistat® 60

543 High-Performance Nutrition 57

509 HiTrainer 58

545 IthacaSports com 60

544 Klean Athlete by Douglas Laboratories 57

528 Medi-Dyne 60

546 Medi-Dyne (ProStretch Plus) 59

505 MilkPEP 56

526 Mission Competition (The Iron Neck) 61

510 New York Barbells (Pro Sissy Squat) 58

515 New York Barbells (Tibia Dorsi Calf Machine) 59

533 NSCA 61

516 NZ Manufacturing 59

519 OPTP (PRO-ROLLER™ Pilates Challenge) 57

522 OPTP (PRO-ROLLER™ Soft) 57

513 Perform Better (Drive Sled II) 58

518 Perform Better (First Place Sandbag Pods) 59

512 Performance Health 58

535 Power Lift® (Leg Press) 58

534 Power Lift® (Rotating Glute-Ham Bench) 59

531 PRO Orthopedic (Ice Bath Therapy Briefs) 61

524 PRO Orthopedic (ice wraps) 60

537 Rich-Mar (Gel-SHOT) 59

540 Rich-Mar (heating unit) 61

503 Shamrock Farms Rockin’ Refuel 56

514 SPRI Products (Step360™ Pro) 58

517 SPRI Products (XTS Training System) 59

511 VersaClimber (Exervibe) 58

530 VersaClimber (SRM Rehab Model) 60

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