Advising Vegetarian Athletes

Coping with a Tighter Budget

Baring Their SolesThe many benefits of barefoot training

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17 No Meat, No ProblemAs vegetarianism and veganism grow more and more popular, many people wonder how a meat-free diet affects athletic performance goals. Our expert dishes on the risks and the rewards.By Lisa Dorfman

Optimum Performance

24 Baring Their SolesBarefoot training is this author’s secret weapon for improving movement efficiency, balance, and kinetic chain integrity in his athletes.By Art Horne

Treating the Athlete

31 Watch the Face!Facial injuries in sports run the gamut from black eyes and knocked-out teeth to serious damage that can have lasting consequences. Are you prepared to deal with all the injuries you may face?By Dr. Jaime Garza

Leadership

35 Making It ThroughSports medicine departments nationwide are dealing with tighter budgets and fewer resources in our current economic climate. In response, some athletic trainers are finding creative ways to keep their programs alive and well.By Dan Resing

Sport Specific

41 Holding CourtThe University of Minnesota’s year-round volleyball strength program incorporates movement prep, jump training, and power building with the goal of optimizing late-season performance.By Sara Wiley

Bulletin Board

5 California considers new concussion rules … Warning athletes against NSAID overuse … What type of exercise is best for bones? … A treadmill that simulates moonwalking.

Q&A9 Peter Friesen Carolina Hurricanes

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64 Next Stop: Web Site On the cover: Basketball players at Northeastern University use barefoot training to develop foot and ankle muscles that lie dormant during shoes-on exercise. Northeastern’s Art Horne describes his barefoot program beginning on page 24. Photo by Brian Tucker Bresnahan

March 2010, Vol. XX, No. 2

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Marjorie Albohm, MS, ATC/L President, National Athletic Trainers’ Association

Jon Almquist, ATC Specialist, Fairfax County (Va.) Pub. Schools Athletic Training Program

Brian Awbrey, MD Dept. of Orthopaedic Surgery, Massachusetts General Hospital, and Instructor in Orthopaedics, Harvard Medical School

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

Leslie Bonci, MPH, RD Director, Sports Medicine Nutrition Program, University of Pittsburgh Medical Ctr. Health System

Christine Bonci, MS, ATC Co-Director of Athletic Training/Sports Medicine, Intercollegiate Athletics, University of Texas

Cynthia “Sam” Booth, ATC, PhD Manager, Outpatient Therapy and Sportsmedicine, MeritCare Health System

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

Cindy Chang, MD Team Physician, University of California-Berkeley

Dan Cipriani, PhD, PT Assistant Professor Dept. of Exercise and Nutritional Sciences, San Diego State University

Gray Cook, MSPT, OCS, CSCS Clinic Director, Orthopedic & Sports Phys. Ther. Dunn, Cook, and Assoc.

Keith D’Amelio, ATC, PES, CSCS Strength & Conditioning Coach for Men’s Basketball, Stanford University

Bernie DePalma, MEd, PT, ATC Head Athletic Trainer/Phys. Therapist, Cornell University

Lori Dewald, EdD, ATC, CHES, F-AAHE Department of Health Science, Kaplan University

Jeff Dilts, Director, Business Development & Marketing, National Academy of Sports Medicine

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/ Cond. 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 and Prof., 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, ATC/L, CSCS Head Athletic Trainer, Medfield (Mass.) High School

Christopher Ingersoll, PhD, ATC, FACSM Director, 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 Director of Perf. Enhancement, Makeplays.com Center for Human Performance

Michael Merk, MEd, CSCS Director of Health & Fitness, YMCA of Greater Cleveland

Jenny Moshak, MS, ATC, CSCS Assistant A.D. for Sports Medicine, University of Tennessee

Steve Myrland, CSCS Owner, Manager, Perf. Coach, Myrland Sports Training, LLC, Instructor and Consultant, University of Wisconsin Sports Medicine

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, Sport Performance & Rehab. Ctr.

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

Kent Scriber, EdD, ATC, PT Professor/Supervisor of Athletic Training, Ithaca College

Chip Sigmon, CSCS Strength and Conditioning Coach, Carolina Medical Center

Bonnie J. Siple, MS, ATC Coordinator, Athletic Training Education Program & Services, Slippery Rock University

Chad Starkey, PhD, ATC Visiting Professor, Athletic Training Education Program, Ohio University

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

Fred Tedeschi, ATC Head Athletic Trainer, Chicago Bulls

Terrence Todd, PhD, Co-Director, Todd-McLean Physical Culture Collection, Dept. of Kinesiology & Health Ed., University of Texas-Austin

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., 31 Dutch Mill Rd., 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© 2010 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.

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Calif. Addresses Sports Medicine Concerns

When it comes to protecting high school athletes, more and more Californians are noticing their state’s shortcomings. California is one of only three states still without aTC licen-sure, and its laws regarding return to play after concussions and mandatory education for coaches lag behind those of its more proactive neighbors. But with help from the state legis-lature, change may be on the horizon.

a bill currently under consideration in the state assembly would require that instruction on head injuries, heat stroke, asthma, and cardiac arrest be added to the required CPr and first-aid education programs public high school coaches and athletic trainers must complete. a companion bill asks for tougher return-to-play standards after an athlete suffers a concussion.

“We need to do more to protect our kids, and we can do that by training the adults closest to them at the time of injury,” mary hayashi, the assemblywoman sponsoring both bills, told Capitol Weekly. “We need to train coaches to be better able to recognize the symptoms of a concussion or serious injury. They can make all the difference in saving a student’s life.”

The two bills were introduced in January during the same week the California senate held a hearing on brain injuries. The California Brain Injury association (CBIa), a non-profit organization established in 2005, had pushed for the hearing to take place.

“There needs to be more done,” Paula Daoutis, administra-tive Director of the CBIa, told the San Jose Mercury News. “If you see a player take a hit on the head, you should take them off [the field] until they can be evaluated. When they get back in too soon and another concussion occurs, this is where more serious injuries are going to happen.”

meanwhile, the California athletic Trainers’ association told the Sacramento Bee in January that it is working to reintro-duce a bill to bring aTC licensure to the Golden State. The state legislature passed a similar measure in 2006, but it was vetoed by Governor arnold Schwarzenegger.

The bills on educating coaches and return-to-play guide-lines are expected to be heard by a California state assem-bly committee this spring. To check on their status, go to: www.leginfo.ca.gov/bilinfo.html and type “1646” and “1647” into the search window.

A Warning On NSAID Use

Non-steroidal anti-inflammatory drugs (NSaIDs) are often recommended to reduce swelling and pain after an injury. But surveys and other research have shown that many athletes

ingest NSaIDs before workouts and competition, hoping to guard against inflammation and soreness. medical experts have recently begun speaking out against this practice.

Their main concern is that NSaIDs could mask an injury sustained during athletic activity. If the athlete continues to play because he or she doesn’t feel pain, the injury could become more serious.

Stuart Warden, PhD, PT, FaCSm, assistant Profes-sor and Director of research at Indiana University, wrote an august 2009 editorial in the British Journal of Sports Medicine warning athletes against preventative NSaID use. “These agents are treatments for the symptoms of an injury, not the injury itself,” Warden told Medical News Today. “They may allow an athlete to exercise or train at a certain level, but pain occurs for a reason. It is basically the body’s mechanism of saying, ‘hang on, you’ve got some sort of injury that should not be ignored.’”

masking an injury isn’t the only reason to caution athletes against NSaID overuse. Warden also wrote in his editorial that those who regularly take NSaIDs before workouts may see reduced tissue adaptation to physical demands placed on the body, which could predispose them to future injury.

Various studies have shown that prolonged NSaID inges-tion delays the healing of ligaments, muscles, and tendons. and overuse of NSaIDs may also be linked to increased risk for cardiovascular problems and stomach ulcers.

“I want people, including recreational athletes, to think about the perceived benefits versus potential risks of taking NSaIDs, and to ask themselves why they are taking these agents,” Warden told Medical News Today. “They need to ask, ‘Do the benefits outweigh the risks?’”

To read the full text of Warden’s editorial in the British Journal of Sports Medicine, go to: bjsm.bmj.com, click on “archive,” then “2009,” then “august.”

What Builds Healthy Bones?

Weight-bearing activity has long been touted as a pathway to better bone health—conventional wisdom holds that bones respond to stress by adding new cells, which in turn strength-ens them. But new research is challenging that assumption, finding other types of exercise may achieve the same effect.

Last fall, Medicine & Science in Sports & Exercise recapped an american College of Sports medicine sympo-sium titled “muscle Forces or Gravity: What Predominates mechanical Loading on Bone?” and published a series of papers on what other factors besides weight stress could lead to bone cell growth. The primary paper was written by a group of University of Colorado professors, who concluded

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that high-impact exercise was no better for bone health than low- or non-impact exercise.

“There is no conclusive evidence from clinical studies that either muscle forces or gravitational forces play a more promi-nent role in regulating bone metabolism,” they wrote in their

conclusion. “When exercise training programs that included activities that generated ground-impact forces (e.g., walk-ing, running, stairs) were compared with those that did not (e.g., weightlifting, rowing), both were found to have beneficial effects on bone mineral density.”

One reason weight-bearing exercise is thought to improve bone health better than non-weight bearing exercise is the prevalence of low bone mineral density in athletes who participate in low- to no-impact activities, like cycling and swimming. The paper’s authors say those

low levels likely have other causes.“It is important to acknowledge that the relatively low bone

mineral density levels observed in some athletes, such as cyclists, swimmers, and even long-distance runners, may result from factors other than the loading characteristics of the activity,” they wrote. “It has been estimated that der-mal calcium loss (i.e., sweating) during moderate to vigor-ous exercise is ~70 mg.h-1 [approximately 70 milligrams per hour]. Thus, competitive cyclists and swimmers, who typically train more hours per week than athletes in other sports, may have increased calcium requirements.”

Based on that theory, the authors hypothesize that too much exercise for too long could be detrimental to bone health due to calcium loss through sweat, though they were careful to point out there is currently no solid evidence to prove it. The take-home message is that exercise—of any type—is good for bone health in most circumstances, but more research is needed to determine what kinds of exer-cise regimens are best for bones.

“Anti-Gravity” Treadmill Simulates Moonwalking

It can be difficult for injured or rehabbing athletes to keep in shape when their workouts are limited to a bike or the

“It is important to acknowledge that the relatively low bone mineral density

levels observed in some athletes, such as cyclists, swimmers, and even long-distance runners, may result from factors other than the loading characteristics of the activity.”

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pool. But what if athletes could con-tinue running while rehabbing, without the downside of impact forces? Lost muscle mass and diminished aerobic capacity would be far less likely, and they could return to play more quickly if their training level never waned during the rehab process.

That’s exactly what the AlterG Anti-Gravity Treadmill aims to do. Based on a NASA prototype first developed more than a decade ago, it allows users to reduce the force of gravity on their legs by up to 80 percent, essentially simulat-ing the effect of walking or running on the moon.

The user wears a pair of shorts that zip into a waist-high enclosure called the cockpit. Once sealed in, air pres-sure counteracts the force of gravity, allowing for a low-impact workout. The runner’s upper half remains outside the cockpit, and the enclosure has four clear plastic walls so a physical thera-pist or athletic trainer can see the ath-lete’s running form while they’re on the treadmill.

“You don’t feel as if somebody’s lift-ing you,” Charles Burgar, MD, Medi-cal Director of the VA Palo Alto Health Care System and a professor at Stan-ford University, told the San Jose Mer-cury News. “You feel like you are in water that has no viscosity, like you’re floating, but when you move your legs there’s no resistance … You can teach a person to run very, very fast by off-loading their weight, and then building strength and endurance by increasing the weight.”

AlterG’s growing customer base—which already numbers in the hun-dreds—includes pro sports teams, college athletic departments, and phys-ical therapy clinics. At $75,000 each, the Anti-Gravity Treadmill is a major investment, but a new model costing around $25,000 recently debuted, and AlterG expects sales to continue increasing as a result. n

Search for past articles from T&C or browse entire issues by visiting our Web site at:www.Training-Conditioning.com

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Peter FriesenHead Athletic Trainer/Strength and Conditioning Coach, Carolina Hurricanes

might have to talk them out of doing things they’ve done their whole lives in order to minimize the chance of reinjury.

Getting those players to change their training methods can be tough. Often, Europeans have a different under-standing of what they can and can’t play through. Also, in North America, we push medication and medical care more than they do in Europe, so it’s important to explain that our doctors only prescribe things that are safe and beneficial to the healing process.

How­do­you­overcome­language­barriers­with­foreign­players?­I’ve found that body language and tone can help fill the gap. Body language is easy to pick up on, especially with a medi-cal background, because I can see players laboring in dif-ferent movements and notice what they lack mechanically. Also, most elite athletes are visual learners who pick things up very quickly if you use hand gestures to communicate your message.

What­is­the­toughest­rehab­you’ve­ever­encountered?­I worked with Hall of Fame goaltender Grant Fuhr during the latter part of his career, after he tore his ACL. He was the first goalie to really come back from that type of injury and play the position at a high level without a knee brace.

Friesen evaluates Hurricanes forward Rod Brind’amour on the ice during a game. In 2006, Brind’amour captained the team to its first ever Stanley Cup championship.

How’s this for elite company: When Peter Friesen visits the Hockey Hall of Fame in Toronto, Ontario, he can run his finger down the Stanley Cup and point to his own name etched into its silver surface, alongside legends like Howe, Gretzky, and Lemieux. Not bad for someone who’s never played an NHL game.

When Friesen started out as an athletic trainer and strength coach for the Prince Albert Raiders, a junior hockey team in Western Canada, he could hardly have imagined he’d end up immortalized on the sport’s holy grail. But after decades of climbing the professional lad-der, he landed his current job as Head Athletic Trainer and Strength and Conditioning Coach for the Carolina Hurri-canes in 1999. He’s now living his dream of working with elite pro athletes, and was on board when the franchise captured its first NHL title in 2006.

Outside the pro ranks, Friesen has spent time at the uni-versity level in Canada and advised Canadian Olympic teams in ice hockey, field hockey, soccer, figure skating, softball, wrestling, gymnastics, and volleyball. In this interview, he talks about being at the top level of a sport he loves, over-coming language and cultural barriers with players, and the annual fun run that he created for charity.

T&C:­How­did­starting­your­career­at­hockey’s­lower­levels­prepare­you­for­the­NHL?­Friesen: In the 1980s, I was a part-time school teacher and an athletic trainer and strength coach for the Prince Albert Raiders in Saskatchewan. I was also the team’s bus driver, equipment manager, and jack-of-all-trades.

I really enjoyed it, but doing a little bit of everything helped me realize that being an athletic trainer and strength coach was what I wanted most. It also taught me to appre-ciate the resources I have now. Today I have a much larger budget, but I still focus on getting the most out of every dollar because I remember the lower levels, where you’re always doing more with less.

What­are­the­unique­challenges­of­working­with­athletes­from­other­countries?­A lot of NHL players come from far away places, and they have their own training backgrounds. When they’re injured, I

Q&A

©Getty ImaGes

Q&AHe was a tremendous athlete but not necessarily known for a strong work ethic, so the trick was getting him to work hard enough to return to playing shape.

As with most of my rehabs, I used group workouts with five to seven people. In that setting, the athletes really mo-tivate each other to go harder, stronger, and faster. Grant was working with some very fit people, so he had to push himself just to keep up.

In November, Hurricanes goaltender Cam Ward’s leg was sliced by an opposing player’s skate, leaving a pool of blood on the ice. How do you handle an incident like that?First of all, I just want to make sure the athlete doesn’t die. If they’ve struck a major artery, you literally have only seconds to stabilize them. With Cam, we were thankful the blade didn’t hit a large artery or his quadriceps tendon—it just went into his vastus medialis oblique.

Once you develop a treatment plan for a laceration injury like that, the next part is minimizing the threat of MRSA and

other infections. MRSA can be very destructive and even fatal if ignored. So we made sure the wound was closed, gave him an antibiotic, and kept a close eye on the area while it healed.

What was his rehab like?The wound was slightly above his knee, so for the first two weeks he wore a straight-leg brace and had only five or 10 degrees of movement. It was a pretty simple rehab overall, we just needed to make sure the tissue healed properly. Our biggest worry was the risk of secondary changes—that his period of limited mobility and inactivity would lead to stiffness in the knee joint and weakening of the muscles in his leg. As soon as he was physically able, we started pro-gressive stretching and strengthening exercises.

What’s your approach to caring for athletes after a concussion?I tell them to stay home until they’re symptom-free, and I don’t talk to them during that time—our team physicians do. That’s because when an athletic trainer talks to an athlete about an injury, there may be perceived pressure to get back in the lineup. To avoid even any semblance of that, we have our doctors handle the first steps of injury manage-ment for concussions.

Before we consider letting them work out again, they

“If they’ve struck a major artery, you literally have only seconds to stabilize them. With

Cam, we were thankful the blade didn’t hit a large artery or his quadriceps tendon.”

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Q&Amust return to pre-injury baseline levels in their ImPACT testing.­Then we start them out doing lighter work on the ice before gradually reintroducing body contact.

Hockey­players­are­notorious­for­playing­through­injuries,­especially­during­the­playoffs.­What­is­it­like­helping­them­stay­in­the­game­when­your­gut­tells­you­they­should­sit­out?­I don’t always have much say in the matter come playoff time. Athletic trainers across the league are put in tough positions in the playoffs, just trying to keep players from making an injury worse and helping them get through it as best we can. I’m continually awestruck at the pain toler-ance some guys have, playing with broken bones and torn ligaments that would sideline them in normal situations.

Winning the Stanley Cup is a dream come true for hockey players and they don’t get many shots at it, so we have to be sympathetic to that. We want to give them ev-ery chance to succeed, so you see a lot of innovation at playoff time, especially with techniques for strapping and wrapping various body parts.

What’s­your­typical­training­approach­in­the­off-season?­My first goal is to get rid of any orthopedic problems as quickly as possible. Early in the off-season, I mostly have

guys do body weight exercises—things like push-ups, chin-ups, and squats. Those emphasize body control while not putting as much stress on the joints as heavy lifting.

Later, we get into basic weight training with a standard per-iodization cycle that addresses endurance, then strength, and then power. By August, when preseason is a month

away, we start what I call “controlled chaos,” which incorpo-rates a lot of different physical and mental elements.

What­is­controlled­chaos?We do various drills on the track, in the weightroom, in the pool, and on the ice, with a focus on presenting multiple challenges in rapid succession. For example, we’ll bring players to the track facility, and one right after another they’ll do a 400-meter run, walking over 10 hurdles, and a 20-yard bear crawl. Then they’ll immediately move to a running station and start patterns around cones, work-ing on agility and acceleration. Next, they’ll sprint over to the high jump pit and perform depth jumps. After that

“Athletic trainers across the league are put in tough positions in the playoffs, just trying to keep players from making an injury worse and helping them get through it as best we can.”

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Q&A

Peter Friesen Head Athletic Trainer and Strength and Conditioning Coach, Carolina Hurricanes

Education: BS, Bemidji State University MS, University of Saskatchewan

First Job: Head Athletic Trainer and Strength Coach for the Prince Albert Raiders, a junior hockey team in Western Canada

they’ll run to an open space and do a sled drag, pulling 50 pounds for 20 yards, followed by some forearm work using a rope with weights attached to it.

From there, they progress to speed ladder drills, fol-lowed by farmer walks with a 45-pound weight in one hand and a 25-pound weight in the other. The different weights make the exercise more awkward and force the athletes to adapt using their stabilizers. Next, they put on a 25-pound weighted vest and do 10 burpees—which some people call up-and-downs and which I think is the best abdominal exercise—followed by some low duck walks. Then they do a 100-meter sprint and they’re finished.

Most players can perform the full circuit in about 11 min-utes. In a typical workout, they’ll do it three times. They’re pretty knackered after that.

What­are­the­most­common­strength­deficiencies­or­imbalances­you­see?­Pro hockey players have the strongest hip flexors of any athletes in the world. I’ve seen a lot of MRIs and CT scans that show the hip flexors taking up almost the entire pel-vic outlet.

To withstand the forces generated by such strong hip flexors, most players’ lower abdominals and lower back need to be strengthened. Also, hockey players have tre-mendous quad strength, so we have to develop their ham-strings to prevent imbalances that can lead to injury. And they usually have great groin development, but their glu-teus medius and adductors aren’t as strong, so we work on those muscles as well.

What­prompted­you­to­start­the­Friesen­5K­Fun­Run,­your­annual­charity­event?­Everybody in the NHL dreams about what they’d do with the Stanley Cup if their team won it. I’ve always been a runner, so I wanted to do something that involved running on my day with the cup. I also wanted to share it with our great fans.

As I was thinking of how to do that, I realized I could generate some money for charity at the same time. So I decided to put on a fun run, and the team’s management and players were all behind me.

On my day with the cup, I had a breakfast with it, then took it over to our facility and took pictures of it in the weightroom, on a bike, and in my office. Then I took it to the run, and we raised over $25,000 for an organization that fights leukemia and lymphoma. We’ve been hold-ing the run for four years now and have generated over $100,000.

Anything­about­the­cup­that­surprised­you­when­you­saw­it­up­close?­My name being on it. I never, ever thought that would hap-pen. I grew up following hockey and knew almost every one of the names engraved on the cup, and it brought back some really fond memories of watching hockey with my dad as a kid. It was a humbling experience to see my name next to all those legends.

What’s­the­best­part­of­your­job?­Going into an NHL dressing room every day. This is my 13th year, and I still feel so lucky. I remember what it was like to ride buses through Western Canada for weeks at a time, stay at lousy hotels, and get by on a measly budget. So I’m whistling zip-a-dee-doo-dah every day because I’m in the National Hockey League, working with all these re-sources and some of the greatest athletes on the planet. If I can’t get fired up about that, I should get out of the profession. n

ON THE WEB For more from our interview with Peter Friesen, visit: www.Training-Conditioning.com and click on “Blogs.”

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©getty images

By Lisa Dorfman

Lisa Dorfman, MS, RD, CSSD, LMHC, is Director of Sports Nutrition and Performance at the University of Miami. She can be reached at: ldorfman@med.miami.edu.

W hat do the NFL’s Tony Gonzalez and Ricky Williams, NHL “tough guy” Georges Laraque, track and field Olympians Carl Lewis and Edwin Moses, six-time Ironman champion Dave Scott, and ultramarathon

runner Scott Jurek all have in common? For one thing, they’re all outstanding athletes. For another, they’re among the growing corps of athletes who are vegetarian or vegan.

When most people think of an optimal diet for athletic per-formance, they imagine covering all corners of the food pyra-mid—after all, that’s the best way to ensure an athlete gets the carbohydrates, protein, healthy fat, vitamins, and minerals they need to fuel their engine and promote muscle growth, right? The fact is, vegetarian athletes can and do meet all their nutri-tional needs despite limiting the use of animal products or elim-inating them altogether. In fact, some research suggests they even have an advantage over their meat-eating counterparts.

There are many reasons why someone chooses to become a vegetarian. It may be rooted in religious beliefs, animal rights concerns, environmental consciousness, economics, health, or simply that they don’t like the taste of meat. Whatever the mo-tivation, vegetarians who know how to adapt their diet to the demands of athletic performance enjoy much upside and prac-tically no downside.

CLEAR BENEFITSIn 2009, The American Dietetic Association and Dietitians of Canada endorsed vegetarian diets for sports training in a joint position statement on nutrition and athletic performance. This official “seal of approval” backed up what many dietitians had been observing for years—that all else being equal, a carefully chosen plant-based training and competition diet can actually be superior to an omnivore’s regimen.

Vegetarian diets are virtually always rich in both sim-ple and complex carbohydrates, providing efficient fuel for all training intensity levels. In addition, vegetarians tend to consume larger quantities of phytochemicals—healthy plant-

No Meat, No Problem

© getty images

As vegetarianism and veganism grow more and more popular, many people wonder how a meat-free diet affects athletic performance goals. Our expert dishes on the risks and the rewards.

NUTRITION

based compounds such as antioxidants that help protect muscle cells and assist with building strength, extending en-durance, and enhancing recovery.

With meat removed from the dietary equation, vegetarians typically don’t eat

as much fat—especially saturated fat—or cholesterol. And the fat they do con-sume is more often “healthy fat,” such as the omega-3 fatty acids found in avo-cados, nuts, and seeds.

While all vegetarians can enjoy those benefits and more, it’s important to note that vegetarianism isn’t a one-size-fits-all designation. People who self-identify as vegetarian have many different di-etary profiles, generally fitting into one of these categories:

Vegan. These individuals exclude all meat products, dairy, and eggs. In gener-al, they avoid any products derived from

animals, which may include food items such as honey and gelatin. Often they’ll even refuse to wear silk, wool, or leather clothing. Without careful dietary plan-ning, they are at increased risk for defi-ciencies in vitamin B12, zinc, calcium,

creatine, and some essential amino acids.Fruitarian. Members of this subset

of veganism restrict their diet even fur-ther, eating only raw or dried fruits and vegetables, seeds, honey, and oil. Of all categories of vegetarians, these people are at highest risk for vitamin, mineral, protein, and essential fat deficiencies.

Lacto-vegetarian. As a rule, lacto-vegetarians abstain from meat but do drink milk and eat dairy products. Accordingly, they have less difficulty meeting their dietary protein, fat, and calcium needs than non-dairy-eating vegetarians. Ovo-lacto-vegetarians are

a similar category, including eggs in their diet as well as dairy.

Pesco-vegetarian. These individuals eat fish and other seafood, but no meat. They may or may not include dairy products and eggs in their diet, and they aren’t typically predisposed to any sig-nificant nutrient deficiencies.

Flexitarian. This is just what it sounds like—flexitarians are flexible in their food choices, but typically eat meat only occasionally. Some use this term to describe a diet with low or moderate amounts of white meat such as chicken and pork, but no red meat.

With so much variety in eating hab-its among those who practice a form of vegetarianism, it’s difficult to gen-eralize about every potential deficiency risk. It’s a good idea for all athletes, and vegetarians especially, to periodically undergo a dietary assessment in which they log all food intake for several days and review the results with a nutrition-ist. Blood tests can also be used to check for low levels of nutrients like iron and calcium. This precaution may be espe-cially helpful for athletes with the most restrictive diets, such as vegans.

It’s a good idea for all athletes, and vegetarians especially, to periodically undergo a dietary assessment in which they log

all food intake for several days ... Blood tests can also be used to check for low levels of nutrients like iron and calcium.

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VITAMINS & MINERALSSome vegetarians—particularly vegans and others with highly restrictive diets—are at risk for deficiencies in specific vitamins and minerals. Below is a list of the most common ones, along with suggested foods that can help a vegetarian athlete increase their intake for each.Vitamin/mineral Function Sources in vegetarian dietsZinc Involved in immune system function, Legumes, whole grains, nuts, seeds, soy, protein synthesis, carbohydrate dairy, fortified shakes and bars metabolism, and blood formationIron Hemoglobin synthesis, transporting Fortified cereals, breads, legumes, beans, soy oxygen to muscles nuts, dried fruits, green leafy vegetables, shakes and bars Note: Consuming iron with foods rich in vitamin C increases absorption.Vitamin B12 Required for normal metabolism of nerve Dairy, eggs, fortified soy milk, sports bars, tissue, protein, carbohydrates, and fats sports drinks Vitamin D Promotes bone growth and absorption of Dairy, eggs, fortified soy products, bars calcium, nervous system and heart function, and shakes and regulation of inflammatory responseRiboflavin (Vitamin B2) Involved in energy production and Dairy, soy milk, yogurt, cheese, fortified storage in muscles cereals, grains, textured vegetable protein Calcium Promotes nerve transmission, muscle Dairy, fortified soy milk and orange juice, tofu, contraction, vitamin D metabolism, yogurt, broccoli, kale, bok choy, tahini, almonds, blood clotting, and bone growth blackstrap molasses

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DAY ONE:

BREAKFAST Egg Beaters (egg substitute) omelet with veggies and shredded soy cheese 1 cup of citrus fruit 1 whole-grain bagel with soy spread

MORNING SNACK Endurance drink with pretzels

LUNCH 1 bowl of bean soup with whole-grain crackers Veggie pizza with soy cheese Green salad with mixed veggies

AFTERNOON SNACK 2 ounces of almond cheese 1 apple 1 ounce of almonds

DINNER Salad greens BBQ soy “beef” skewers 1 baked sweet potato with soy spread Soy yogurt parfait with granola and mixed berries

LATE-NIGHT SNACK Hot chocolate made with rice milk

DAY TWO:

BREAKFAST Whole-grain waffles with mixed berry topping 1 cup of soy yogurt 1 cup of mixed citrus fruit

MORNING SNACK Soy-based energy bar 1 cup of soy, hemp, or almond milk made into a smoothie with a banana and berries

LUNCH Veggie wrap with whole-grain tortilla and grilled tempeh strips Fruit salad: melon, banana, citrus, and pear Vegetable juice

AFTERNOON SNACK Endurance drink with high-carb sports bar

DINNER 3 cups of whole-grain spaghetti with red sauce and veggies 2 whole-grain rolls Green salad with mixed veggies

LATE-NIGHT SNACK Jell-o with whipped soy cream

DAILY MENUSHere are two sample meal plans for vegan athletes that provide an adequate supply of energy, carbohydrates, pro-tein, and healthy fat along with vitamins and minerals and a broad spectrum of amino acids.

BALANCED FUELINGLike all people, vegetarians who eat a healthy, balanced diet can be assured of getting ample amounts of vitamins, minerals, phytonutrients, fats, carbohy-drates, and protein to fuel themselves for performance, while those who eat poorly are at risk for deficiencies in things like iron, calcium, zinc, vitamins D and B12, and essential fats and ami-no acids. The only major difference is that vegetarians have a smaller spectrum of foods from which to choose—much smaller in the case of the most restrictive types—so they need to pay closer atten-tion to their intake than omnivores.

When fueling for sports, one of the most basic concerns is adequate calorie consumption, which some vegetarians find challenging because plant-based foods often have lower calorie densities and more fiber. As a result, the athlete consumes less energy overall before feel-

ing full. An easy way to overcome this is to consciously include calorie-dense foods at mealtimes—excellent choices include nuts, nut butters, seeds and oils, soy- and tofu-based meat alternatives, soy milk, textured vegetable protein, tempeh, and fruit juices and smoothies. Vegetarians should also place extra em-phasis on consuming calories through-out the day in the form of snacks and beverages to increase energy intake.

Calculating protein, carbohydrate, and fat needs for vegetarians can be some-what different than for omnivores. Car-bohydrates typically aren’t a problem—in fact, a meta-analysis of 63 research stud-ies showed that vegans and vegetarians consistently had higher dietary percent-ages of carbohydrates than meat eaters.

Carbohydrates for vegetarians come mainly from grains, fruits, vegetables, dairy, and dairy substitutes, and should constitute approximately six to 10 grams

per kilogram of body weight (2.7 to 4.5 grams per pound) per day to replenish glycogen stores and fuel activity. For endurance athletes who train more than 60 to 90 minutes a day, the vegetarian diet is especially beneficial because of its emphasis on complex carbs. Most fruits and starchy foods provide about 15 grams of carbohydrates per serving, while milk and dairy substitutes pro-vide around 12 grams per cup, and veg-etables roughly 10 grams per cup.

As for protein, the American Dietetic Association advises that vegetarians eat roughly 10 percent more than the stan-dard recommendation for meat eaters, because many non-meat proteins are less bioavailable than meat-based sources. This means an optimal daily intake for vegetarian athletes is roughly 1.3 to 1.8 grams per kilogram of body weight (0.5 to 0.8 grams per pound), depending on the intensity of training.

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of total calories in an athlete’s diet. Re-search shows that vegetarians generally consume less fat than meat eaters, and this accounts for numerous health ben-efits, such as lower lipid levels and body mass index, and reduced risk for hyper-tension and diabetes. But too little fat can be problematic.

In particular, diets that do not include fish or eggs can be low in beneficial omega-3 fatty acids. Not surprisingly, vegan athletes are most at risk for defi-ciency. These athletes should be encour-aged to get their essential fatty acids through sources such as soy, walnuts, al-monds, pistachios, flax, and canola oils. There are also algae-based supplements marketed to vegetarians that are rich in specific omega-3 fatty acids such as do-cosahexaenoic acid (DHA) and eicosap-entaenoic acid (EPA).

VITAL VITAMINSWhen meat is eliminated from the diet, certain vitamin and mineral levels must be carefully monitored. Those who are new to vegetarianism may have been getting most of their vitamin B12, iron, calcium, and zinc from animal

have all the essential amino acids.In high-intensity sports, the meat-

based fuel source creatine provides ex-tra energy for working muscles. Meat eaters typically get roughly one gram of creatine per day from their diet, and the body synthesizes approximately one more gram in the liver, kidneys, and pancreas using the amino acids argin-ine and glycine as precursors. Research shows that vegetarians consistently have lower creatine levels than omnivores, so some study authors suggest vegetarian athletes may benefit from moderate cre-atine supplementation.

However, it’s important to note that the benefits and health risks of prolonged creatine use are still the subject of debate. Any athlete interested in creatine supple-mentation should first undergo a dietary analysis to see if they’re struggling with deficiencies that can be resolved to pro-vide a performance and energy boost without the use of supplements.

Fats are essential for long-term energy, hormone production, and the absorption of fat-soluble vitamins including A, D, E, and K. The standard recommendation is that fat should make up 20 to 35 percent

Even with meat out of the equation, there are many high-protein vegetarian food choices, including beans and peas, nuts, dairy products, fish, sport bars, and protein shakes, so getting enough just takes a little creativity and planning. Since vegans have fewer options due to the exclusion of dairy and fish, they can make up the difference with larger quan-tities of soy, seitan (wheat-based pro-tein), and seeds.

Different protein sources contain dif-ferent essential amino acids (EAAs)—that is, amino acids the body does not produce naturally so they must be ob-tained through diet. These amino acids comprise the basic building blocks of protein, and while they’re plentiful in animal products, they tend to be more limited in other foods: While a plant or dairy source may be rich in one particular EAA, it may contain very little of others. Therefore, variety is key for vegetarian athletes. They must be discouraged from getting into food “ruts” in which they eat similar meals day after day. Those who do struggle with variety should be pointed toward soy products, as these are some of the only plant-based foods that

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Circle No. 114

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the heme iron found in meat and fish.Many vegetarians take an iron sup-

plement to ensure they get an adequate supply of this vital mineral. But it’s not hard to get enough iron in the vegetari-an diet through beans, fortified cereals, greens, and dried fruits. Consuming iron-rich foods along with citrus fruit and other fruits and vegetables rich in vitamin C, such as broccoli, red and green peppers, and strawberries, also helps to increase iron absorption.

One other nutrient for which vegetar-ians may be at risk of deficiency is B12. Found only in animal products and foods fortified with it, B12 is an impor-tant coenzyme required for the normal metabolism of protein, carbohydrates, and fats. The daily recommendation is 2.4 micrograms, which can be obtained through fortified cereals, bars, shakes, rice and soy milk, and nutritional yeast. If a vegetarian athlete is unsure of their B12 level, a simple blood test can deter-mine if they have a sufficient supply.

Athletes who choose the vegetarian lifestyle can give themselves an edge over their meat-eating peers. Whether they do it for health reasons, moral rea-sons, or simply personal preference, as long as they monitor their intake of key macro- and micronutrients, they’re well positioned to achieve optimal fueling for performance and health. n

products without knowing it.Studies have found that zinc levels are

typically lower in vegetarians than om-nivores, which is not surprising since 50 to 70 percent of zinc in our diet regularly comes from meat and dairy. Zinc is essen-tial for protein synthesis, immune system function, and new blood cell formation.

The recommended daily amount is 11 milligrams for men and nine milligrams for women, but these values may be too low for competitive athletes, since strenuous exercise can lead to increased zinc loss through sweat and urine. To further complicate matters for vegetar-ians, a plant compound called phytate found in the hulls of many nuts, grains, and seeds may inhibit zinc bioavailabil-ity in humans.

According to The American Dietetic Association’s position paper on vegetar-ian diets, one way to increase zinc ab-sorption from beans, grains, and seeds is to soak them in water before eating them. Another effective method is to eat fortified cereals and other zinc-rich foods together with citrus fruit, which helps promote absorption.

Calcium recommendations for active males and pre-menopausal females are typically 1,200 to 1,500 milligrams dai-ly for adolescents and 1,000 milligrams for adults. Calcium is essential for bone integrity and also plays an important

role in circulatory and nervous system health. Low calcium intake can increase the risk of stress fractures, especially in amenorrheic female athletes.

Some research suggests that vegetarians may have lower calcium needs than omni-vores because the higher protein and so-dium intake typical of meat eaters leads to greater calcium excretion, but the jury is still out on that theory. In any case, there’s no need to gamble, since calcium is easy to find in dairy products and fortified dairy alternatives like soy, rice, and almond milks, tofu, juices, shakes, and greens.

Iron is critical for all athletes because it synthesizes hemoglobin and myo-globin, which transport oxygen to mus-cles. Athletes and growing adolescents are at particularly high risk for iron de-ficiency, partly because of the natural demands of physical growth and partly due to iron loss through heavy sweat-ing. Another iron-related issue is hemo-lysis, or the destruction of red blood cells, which can be caused by high- volume endurance training.

As with zinc, the standard daily rec-ommendation for iron (which ranges from eight to 18 milligrams per day de-pending on age and gender) is likely too low for vegetarians because of the lower absorption rate of non-meat iron sources. The form of iron found in plants, called non-heme iron, is less bioavailable than

ON THE SHELVESAs meat-free lifestyles continue to grow in popularity, it’s easier than ever to find quality vegetarian products at supermarkets and specialty stores. This list contains some brand names to look for at your local store. Many of the products listed can also be purchased online.

Arrowhead Mills: Grains and cerealsAmy’s: Frozen vegetarian and vegan foodsBoca: Veggie burgers and frozen vegetarian foodsClif & Luna: Vegan energy barsEarth Balance: Vegan “butter”Eden: Soy milk and pastaEner-G: Egg substitute for bakingFantastic Foods: Bean dip mixes and dried soupsField Roast: Vegan sandwich slicesGardenburger: Frozen meat substitutesLightlife: Meat substitutes and meals

Linda Loma: Meat substitutes and non-dairy beveragesMorningstar Farms: Frozen meat substitutesNasoya: Tofu and tofu-based products Soy Delicious: Soy ice creamSilk: Soy milkSoymage: Vegan “cheese”Sunergia Soyfoods: Marinated tofuVega: Shakes, bars, smoothie mix, and electrolyte formulaVitasoy: Soy milkVegenaise: Non-dairy mayoYves: Meat substitutes and vegan prepared meals

T&C marCh 2010 ­­22 TraINING-CONDITIONING.COm

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Circle No. 116

Brian Tucker Bresnahan PhoTograPhy

Negotiating an agility ladder on synthetic turf in bare feet is one exercise Northeastern University men’s basketball players use to recruit the muscles of their feet and ankles.

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©getty images

By Art Horne

Art Horne, MEd, ATC, CSCS, is Strength & Conditioning Coach and Coordinator of Care for men’s basketball at Northeastern University, and is currently serving as the Interim Director of Sport Performance. He can be reached at: a.horne@neu.edu.

At the 1960 Summer Olympics in Rome, Ethiopian runner Abebe Bikila earned worldwide fame by winning the

marathon with a world-record time of 2:15:16. The attention focused not just on his remarkable feat, but on his remarkable feet—Bikila completed the marathon without wearing shoes or socks.

Some would say that event catapulted the concept of barefoot training into mainstream consciousness. But in real-ity, athletes around the world trained barefoot in various ways long before Bikila’s accomplishment—in fact, you might argue that barefoot training is as old as athletics itself. Barefoot train-ing advocates argue that “shod” (shoe-wearing) athletes miss out on many benefits, ranging from proprioception and motor development to recruitment of important muscles that remain un-derutilized and practically dormant in-side rigid, restrictive modern footwear.

There is very little research provid-ing clear answers on how best to im-plement barefoot work into today’s training strategies. But as an athletic trainer and strength coach who has em-ployed barefoot training with basket-ball players at Northeastern University for several years, I firmly believe it’s

Barefoot training is this author’s secret weapon for improving movement efficiency, balance, and kinetic chain integrity in his athletes.

Baring Their Soles

well worth the time investment. In this article, I’ll explain the concepts behind barefoot training, outline how I use it with my athletes, and discuss the ben-efits I’ve seen from having athletes bare their soles during workouts.

THEORY BEFORE PRACTICEAnyone who has walked barefoot on a beach or grassy field can grasp the theory behind barefoot training and its athletic benefits. By letting the foot re-turn to its primitive state, in which it must grip the earth to produce efficient movement, you can feel the engagement of intrinsic muscles of the toes, midfoot, heel, and ankle—muscles that receive little opportunity for strengthening in our shoes-required world.

The idea behind barefoot training is that developing these muscles improves foot and ankle function, while also providing benefits up the entire kinet-ic chain. Barefoot proponents point to increased proprioception related to the movement of the feet and ankles in time and space, lower impact forces due to reduced heel strike, higher efficiency in running as measured by lower oxygen consumption, and an increase in bone density throughout the foot and ankle.

Humans’ relationship with shoes is a surprisingly complex one, involving both physical and psychological ele-

ments. For example, in a 1997 study, researchers had subjects repeatedly step onto and off of a box, each time landing on a pad made of material commonly found in shoe insoles. The material was the same each time, but the authors used different terms to describe the landing pad, and found that participants landed with greatest impact forces when step-ping down onto surfaces described with words like “advanced technology” and “used in the most expensive sneakers.”

The authors noted the natural human tendency “to be less cautious when us-ing new devices of unknown benefit because of overly positive attitudes as-sociated with new technology and novel devices.” If that’s true, it may mean to-day’s athletes, who wear more and more advanced footwear and often receive custom tape jobs before each practice and competition, pay less attention than ever to the fundamentals of foot move-ment and function, possibly harming their performance and increasing their risk for injury. Barefoot training can help reverse those practices.

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ity can also help athletes improve their movement mechanics.

FREE THE FOOTWhen athletes perform activities such as dynamic warmup and movement prep with bare feet, they recruit the muscles of their feet and ankles and ex-perience feedback and proprioception in the plantar surface of the foot. At Northeastern, we strongly believe this leads to better positional sense and may contribute to injury prevention and per-formance enhancement. For those rea-sons, we have implemented year-round strategies for our men’s basketball play-ers to promote the normal motion of the athletes’ feet, toes, and ankles.

During evaluations at the beginning of the year, each player undergoes goni-ometric testing of the ankle, knee, and hip, traditional movement screening (in-cluding jumping and landing measures), and an examination of their feet for ex-isting pathologies or mechanical chal-lenges. This is essential, because certain foot-related conditions can make bare-foot training counterproductive and even dangerous.

and running. For many athletes, this ef-fect contributes to an adaptive shorten-ing of the gastroc/soleus complex and Achilles tendon over time.

On the advice of our podiatrist, we have actually made lateral cuts to the bottom of many of our basketball play-ers’ shoes. The cuts extend from one side

of the forefoot to the other through the full-length fiberglass insert, directly un-der the first metacarpophalangeal (MP) joint, basically running across the ball of the foot to alleviate manufactured stiff-ness and allow for normal big toe exten-sion. We started doing this after several complaints of Achilles tendon pain and anterior knee pain, both of which were alleviated after normal foot motion was restored. Increasing natural foot mobil-

Consider a more specific example: High-top sneakers with stiff soles are worn almost universally in basketball, and many athletes wear ankle braces or tape underneath them, even for work-outs. This practically ensures a weak and dormant foot and ankle complex. Kinematic data suggests that the hal-

lux (big toe) requires 20 degrees of ex-tension and the ankle needs around 20 degrees of dorsiflexion to allow for nor-mal forward motion. Both those move-ment dimensions are commonly limited by basketball shoes, tape, and braces.

In addition, modern sneakers are usu-ally built with some form of “air cells” or other shock absorbers or supports that raise the heel above its normal rest-ing elevation during standing, planting,

For those with normal soreness, we recommend general soft tissue work, such as plantar fascia rolls ... We

tell them their foot muscles have been dormant for years in their shoes, so this new engagement and mobilization

will be fatiguing—but it shouldn’t be seriously painful.

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Optimum perfOrmance

For example, athletes with excessive-ly high arches are excluded from our barefoot work, because most physicians agree that high-arched feet require sup-port to prevent excessive plantar stress and decrease injury risk. In addition, we exclude athletes who have experi-enced a stress fracture or other serious injury, or have had surgery on the foot or ankle (such as fixation of the navicu-lar bone). To let these players’ feet strike the ground repetitively without support during barefoot training would produce injury risks that outweigh any potential benefits.

Some believe that excessive pronators must have firm support from custom orthotics during all activities, but it’s been my experience that these athletes do very well in a progressive barefoot program. In fact, I’ve found that symp-toms such as anterior knee pain typical-ly seen in pronators are often resolved when barefoot work is added to their overall training plan. Nonetheless, it’s always best to consult a physician, pref-erably a podiatrist, if you have doubts about the safety of barefoot training for a particular athlete.

BARE ESSENTIALSBefore beginning our barefoot program, we hold an educational session to intro-duce the athletes to this strategy and ex-plain what they should expect. We tell them it’s normal to feel some residual foot soreness after training in bare feet, especially if they’ve never trained this way before.

However, we note that if the soreness lasts for more than a day, if it’s accom-panied by sharp or shooting pain, or if it leads to sudden knee or back pain, they should see us for an evaluation, which might lead us to discontinue their barefoot program. These symptoms may indicate an unresolved previous injury, such as a stress reaction or fracture.

For those with normal soreness, we recommend general soft tissue work, such as plantar fascia rolls on a tennis or field hockey ball and basic warmup activities such as ankle mobility drills, static gastroc/soleus stretching, and gen-eral dynamic movement patterns. We tell them their foot muscles have been dormant for years in their shoes, so this new engagement and mobilization will be fatiguing—but it shouldn’t be serious-

ly painful. If it is, we want to know right away so we can determine the cause.

One of the first priorities when imple-menting barefoot training is to find a workspace with the right type of surface. Synthetic turf is the best choice, and we are fortunate at Northeastern to have two indoor surfaces (a field house and a turf area located in our weightroom). Since much of the benefit of barefoot training comes from athletes’ ability to use their foot muscles to “grip” the ground and feel feedback from a soft ground-foot in-terface, synthetic turf is far superior to a gym floor or weightroom mat.

So what does the barefoot portion of a workout actually look like? For us, it begins with cold stretching, includ-ing plantar fascia rolls, foam rolling, and standard static pre-workout stretch-es. We’ll then put the athletes through a series of simple dynamic movements and agility ladder drills such as skips, butt kickers, spidermans, toe kicks, inch-worms, and shuffles in all directions.

Next come mobility drills, such as lunges in various planes, hurdle walks/duck-unders, single-leg reaches in mul-tiple planes, and various balance activi-

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Circle No. 118

T&C marCh 2010 ­­28 TraINING-CONDITIONING.COm

Optimum perfOrmance

ties such as one-quarter jump-and-lands on one or two legs, hops, balancing on one leg with eyes closed, single-leg chopping patterns with core balls, and light bounding.

We also use our barefoot training time as an opportunity to develop the core with a number of upright standing exer-cises, such as partner anti-rotation, cable

chops, and resisted lumbar cable exten-sions. By placing the athletes in positions that imitate live basketball action but without the usual support of their shoes, we enhance the sport-specific foot and ankle sensory system. And by improving the foot’s tactile feedback and gripping strength, we provide benefits not only for the foot and ankle complex but all the way up the kinetic chain to the knee, hip, and lumbar spine.

At the end of a barefoot session, stretching and recovery includes strap stretches and foam rolling. We also use light jogging in the cooldown portion of some workouts, along with locomotion patterns such as walking with toes and feet pointed in, out, and up, walking on toes, shuffling in circular patterns, and backward jogging and running.

In addition to our traditional cooldown modalities, we also employ yoga during some sessions, particularly in the summer and the early preseason. This allows additional opportunities to stretch and maintain tissue quality while providing a refreshingly different type of ground-foot interaction.

The most striking thing about yoga work with our players is the extent to which they struggle to maintain the balance necessary for even basic poses such as the warrior series, high lung-es, extended triangles, and downward facing dog. But improving balance is part of the reason we use barefoot training in the first place, so as they make progress in yoga, we know they are adding a new dimension of aware-ness and proficient mobility that will transfer to the entire kinetic chain.

As our athletes grow more comfort-able with barefoot training, we gradu-ally get them out of their shoes more and more often. For example, after reg-

ular conditioning sessions, weightroom workouts, and sled work, we might have them perform cooldown and stretching in bare feet on our indoor turf to keep the foot muscles engaged and maintain the strength gains they’ve made.

One question we have considered at length is how much barefoot training athletes should perform. We believe

that once they’ve been evaluated and in-troduced to barefoot work, they should do as many training activities unshod as is practical. In our conditioning pro-gram, the barefoot portion of a work-out typically takes between five and 20 minutes—so while it’s certainly not the bulk of training, it is a significant part of the broader program.

I’ve seen very positive results from in-corporating this type of training into ath-letes’ workouts on a regular basis. Since we first implemented barefoot work in the summer of 2007, we’ve noticed a sig-nificant drop in episodes of anterior knee pain, ankle sprains, and low back pain among our basketball players. In fact, during the 2008-09 men’s season, no one missed a game due to an ankle sprain or any form of lower extremity pain.

Is barefoot training the secret to solv-ing all foot, ankle, and gross movement problems? Certainly not. But with the outcomes we’ve witnessed, we won’t be dropping it from our training program any time soon. After all, why would humans have such an incredibly com-plex mechanism as the foot if it wasn’t intended to move freely? n

By placing the athletes in positions that imitate live basketball action but without the usual support

of their shoes, we enhance the sport-specific foot and ankle sensory system.

STAYING SAFEWhile barefoot training is a safe way to enhance foot strength and func-tionality, like every training activity it carries some risk. Here are a few pointers on how to minimize the chance of injury:

• Before every barefoot training session, inspect the surface for sharp objects, such as broken glass, pieces of metal, or anything else that could cause cuts or puncture wounds.

• Athletes with a wound on their foot should not train barefoot, especially if they cannot keep the wound covered with a secure bandage. Diabetic athletes should be especially cautious, as they have an increased tendency to develop foot ulcers.

• In most cases, athletes should not go barefoot in the weightroom—the risk of dropping a plate, dumbbell, or other piece of equipment on an exposed foot is too great. There are just two exceptions in our facility: during prep work when no one in the weightroom is handling free weights, and while I evaluate squatting technique, because it is beneficial to see the unshod foot as it moves during squats.

• As mentioned in this article, athletes with high arches and those with pre-existing foot or ankle conditions usually should not go barefoot, as they may need cushioning and/or orthotic support at all times to avoid injury. When in doubt, consult a podiatrist.

• As with any new form of training, the body requires an adaptation period. When introducing barefoot training, start with just a few minutes of light stretching and movement prep at each workout, and gradually add greater challenges as the athletes grow more comfortable.

Saving Knocked-Out Teeth During Sports

Each year approximately eight hundred thousand teeth are

knocked out (avulsed) during sports activities in the U.S. alone.

Studies have shown that only 10% of athletes comply with rules

that require wearing their mouthguards during all sports activities.

Knocked-out teeth begin to die within 15 minutes, and teeth

knocked out during sports events have little chance of being saved

unless prompt action is taken.

Why can knocked-out teeth be saved…

Every tooth is connected to its surrounding bone by a ligament,

the periodontal ligament (PDL). (See figure on right.) The tooth

and surrounding cementum, bone, and gingiva receive

nourishment from the blood supply through this ligament. When a

tooth is avulsed, this ligament is stretched and splits in half; half

stays on the tooth root and half stays on the socket wall. If these

two halves can be kept alive, the tooth can be replanted and the

halves of the ligament will reattach and the tooth will remain vital.

The half that stays on the socket wall, since it remains connected

to the bone blood supply, is naturally kept alive. However, the

PDL cells that remain on the tooth root must be artificially

maintained. They must be protected from two potentially

destructive processes: cell crushing and loss of normal cell

metabolism.

Although some dentists advise that the best treatment for an

avulsed tooth is immediate replantation, for a variety of reasons

this is often difficult. Often multiple teeth are avulsed and an

athletic trainer may not know into which socket an individual

tooth belongs. The athlete may have other more serious injuries

that require more immediate attention such as a severe eye injury

or a severely lacerated bleeding lip or gum that prevent easy

visualization of the socket. Bone chips or debris may be in the

sockets, which will prevent complete reimplantation.

If avulsed teeth are not reimplanted immediately, then all

treatment between the time of the accident and the ultimate

replantation must be focused on preventing further damage to the

teeth and maintaining the PDL cells in the optimal condition.

Save-A-Tooth®…

In order to be prepared for these incidents, athletic trainers should

have Save-A-Tooth , emergency tooth preserving systems,

available with their first aid supplies. Save-A-Tooth® contains a

pH-balanced cell preserving solution, called Hank’s Balanced

Salt Solution, and a removable basket and net that suspends

knocked-out teeth in the solution preventing cell crushing.

According to Henry Rankow, DDS (from Pennsylvania), “Save-

A-Tooth overcomes all of the obstacles encountered with

avulsed tooth storage. It preserves and protects the tooth for 24

hours successfully.”

A recent study showed that knocked-out teeth stored in Save-A-

Tooth® showed 91% success and another study found that 20% of

Save-A-Tooth kits are used within the first year. One of these

kits was used by the Director of Health and Athletics for

Baldwinsville Central School District, who wrote about his

experience:

Athletic trainers must be prepared to institute the optimum

treatment for knocked-out teeth, and this includes having Save-A-

Tooth available. In the case of knocked-out teeth, being

prepared and knowing what to do can mean the difference

between athlete’s losing knocked-out teeth for life or keeping

their own natural smiles.

Last year we had an unfortunate incident at one of our

boy’s varsity soccer matches where one of our students lost

a tooth during play. Luckily, we had one of the Save-A-

Tooth kits in our medical box and the tooth was preserved

and successfully implanted back into our player.

800,000 teeth are knocked out during sports each year!These teeth can be saved, but do you know what to do?

Now you can have Save-A-Tooth® as a vital first aid component

Be Prepared! Order Save-A-Tooth® Today

(888) 788-6684www.Save-A-Tooth.com

Untitled-7 1 2/13/08 4:16:25 PM

To learn more about barefoot training, check out march’s monthly Feature column at: www.Training-Conditioning.com

Saving Knocked-Out Teeth During Sports

Each year approximately eight hundred thousand teeth are

knocked out (avulsed) during sports activities in the U.S. alone.

Studies have shown that only 10% of athletes comply with rules

that require wearing their mouthguards during all sports activities.

Knocked-out teeth begin to die within 15 minutes, and teeth

knocked out during sports events have little chance of being saved

unless prompt action is taken.

Why can knocked-out teeth be saved…

Every tooth is connected to its surrounding bone by a ligament,

the periodontal ligament (PDL). (See figure on right.) The tooth

and surrounding cementum, bone, and gingiva receive

nourishment from the blood supply through this ligament. When a

tooth is avulsed, this ligament is stretched and splits in half; half

stays on the tooth root and half stays on the socket wall. If these

two halves can be kept alive, the tooth can be replanted and the

halves of the ligament will reattach and the tooth will remain vital.

The half that stays on the socket wall, since it remains connected

to the bone blood supply, is naturally kept alive. However, the

PDL cells that remain on the tooth root must be artificially

maintained. They must be protected from two potentially

destructive processes: cell crushing and loss of normal cell

metabolism.

Although some dentists advise that the best treatment for an

avulsed tooth is immediate replantation, for a variety of reasons

this is often difficult. Often multiple teeth are avulsed and an

athletic trainer may not know into which socket an individual

tooth belongs. The athlete may have other more serious injuries

that require more immediate attention such as a severe eye injury

or a severely lacerated bleeding lip or gum that prevent easy

visualization of the socket. Bone chips or debris may be in the

sockets, which will prevent complete reimplantation.

If avulsed teeth are not reimplanted immediately, then all

treatment between the time of the accident and the ultimate

replantation must be focused on preventing further damage to the

teeth and maintaining the PDL cells in the optimal condition.

Save-A-Tooth®…

In order to be prepared for these incidents, athletic trainers should

have Save-A-Tooth , emergency tooth preserving systems,

available with their first aid supplies. Save-A-Tooth® contains a

pH-balanced cell preserving solution, called Hank’s Balanced

Salt Solution, and a removable basket and net that suspends

knocked-out teeth in the solution preventing cell crushing.

According to Henry Rankow, DDS (from Pennsylvania), “Save-

A-Tooth overcomes all of the obstacles encountered with

avulsed tooth storage. It preserves and protects the tooth for 24

hours successfully.”

A recent study showed that knocked-out teeth stored in Save-A-

Tooth® showed 91% success and another study found that 20% of

Save-A-Tooth kits are used within the first year. One of these

kits was used by the Director of Health and Athletics for

Baldwinsville Central School District, who wrote about his

experience:

Athletic trainers must be prepared to institute the optimum

treatment for knocked-out teeth, and this includes having Save-A-

Tooth available. In the case of knocked-out teeth, being

prepared and knowing what to do can mean the difference

between athlete’s losing knocked-out teeth for life or keeping

their own natural smiles.

Last year we had an unfortunate incident at one of our

boy’s varsity soccer matches where one of our students lost

a tooth during play. Luckily, we had one of the Save-A-

Tooth kits in our medical box and the tooth was preserved

and successfully implanted back into our player.

800,000 teeth are knocked out during sports each year!These teeth can be saved, but do you know what to do?

Now you can have Save-A-Tooth® as a vital first aid component

Be Prepared! Order Save-A-Tooth® Today

(888) 788-6684www.Save-A-Tooth.com

Untitled-7 1 2/13/08 4:16:25 PM

ONLINETHE SOURCE

www.CoachesNetwork.com

WHERE COACHES CONNECT

COMMUNICATE with other coaches, exchange ideas, share solutions

READ coach-specific articles and information

PROVIDE athletes’ parents with educational resources

Circle No. 119

T&C marCh 2010 ­31 TraINING-CONDITIONING.COm

TREATING THE ATHLETE

By Dr. Jaime r. Garza

Jaime R. Garza, MD, DDS, is Clinical Professor of Surgery and Otolaryngology at the University of Texas Health Science Center in San Antonio. He has served as contributing team physician for the University of Texas-San Antonio and Trinity University, and as a medical con-sultant to the New Orleans Saints and San Antonio Spurs.

WATCH THE FACE!

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TREATING THE ATHLETE

Facial injuries in sports run the gamut from simple black eyes and knocked-out teeth to serious damage that can have lasting consequences. Are you prepared to deal with all the injuries you may face?

Facial protection in athletics has come a long way since the days of leather football helmets and bare-knuckle boxing. The evolution hasn’t always been

smooth—Jacques Plante, the first NHL goalie to regularly wear a mask in games, was famously accused of cowardice by his coach in the 1950s when he donned the device after a slap shot broke his nose, and debate over the value of masks in hockey lasted for years.

Thankfully, common sense has pre-vailed throughout the sports world. To-day it’s very common to see cages on baseball and softball batting helmets, protective eyewear on field hockey and women’s lacrosse players, state-of-the-art mouthguards on football fields and basketball courts, and many other types of highly effective protection.

Nonetheless, thousands of facial in-juries occur among athletes at all levels each year. According to one report, fa-cial injuries are present in somewhere between 11 and 40 percent of all ath-letic injuries.

T&C marCh 2010 ­­32 TraINING-CONDITIONING.COm

TREATING THE ATHLETE

Sports injuries to the face can run the gamut from superficial skin dam-age to potentially life-threatening trauma affecting the integrity of the airway. While the former are happily much more common than the latter, the best athletic trainers are prepared to treat and manage the full range of possibilities.

SKIN & SOFT TISSUEThe most common soft tissue injuries to the face include abrasions, contusions, and lacerations. Not surprisingly, these injuries usually occur over the most prominent areas—the nose, cheeks, and upper and lower lips. Lacerations to the face are often described as “burst” inju-ries, with compression from an external source essentially pinching the skin and other tissue against bone or teeth until the skin breaks.

After any such injury, the immediate priorities are to stop bleeding and de-crease swelling, typically through the application of pressure and ice. The stan-dard rules of wound care apply—keep-ing the site clean and covered while it heals, irrigating it when necessary, and monitoring it for any signs of infection.

Beyond immediate concerns, a lon-ger-term priority with facial injuries is to minimize the potential for scars. Be-sides the aesthetic impact of facial scars,

scar tissue is more vulnerable to reinjury in the future. To reduce scarring, an athlete can be instructed to gently self- massage the area near a facial abrasion as it heals, as this helps break up dense collagen bonds that contribute to vis-ible scar formation. Applying antibiotic ointment or a scar-management product such as Mederma can also help. A com-mon home remedy for scar prevention is applying vitamin E to the wound site, but this should be avoided—studies have found it to be ineffective, and it causes contact dermatitis in some people.

The ears are especially susceptible to deformity due to athletic injury. If you’ve spent time around experienced wrestlers or boxers, you’ve likely seen examples of hematoma auris, com-monly known as cauliflower ear. While some grapplers consider this condition to be almost a badge of honor, it is medically undesirable, since it increases the risk of ear infections and can even contribute to hearing loss.

Cauliflower ear is caused by shearing forces on the ear that lead to bleeding below the skin surface, often accompa-nied by separation of the skin from the cartilage beneath it. Because ear car-tilage receives its blood and nutrients from the skin of the ears, the separation causes scarring (fibrosis) and death of the cartilage, leading to deformation.

This condition can almost always be prevented with proper treatment. An ear that has been subject to blunt trau-ma or shearing forces typically presents as swollen, tender, and bruised. A phy-sician can treat the subsurface bleeding with an incision and drainage under sterile conditions. A compression ban-dage is usually placed over the site and left there for at least 48 hours. The phy-sician will often prescribe an antibiotic to ward off infection, and return to full activity usually occurs within a week.

The use of headgear is an obvious pro-tective measure against cauliflower ear and similar injuries. In sports like wres-tling, which involve direct physical con-tact with the head, ear guards should be standard equipment. And in any sport, after an injury to the ear that requires in-cision and drainage, headgear should be worn for at least two to four weeks.

TO THE BONEFacial bone and joint injuries occur most commonly to the nasal bones, dentoalveolar complex (the bony area that anchors the teeth), cheekbones and orbital bones, and upper and lower jaw. These injuries often occur in combi-nation, and the most prominent facial bones—those in the nose, cheeks, and lower jaw—are the most susceptible.

When examining the face for signs of injury, one of the best visible indica-tors of fracture is asymmetry. Soft tis-sue injuries to the face can cause rapid swelling that produces obvious asym-metry, but it can also be due to fracture of an underlying bone. With fractures around the orbital cavity, the athlete may report double vision (diplopia) or loss of sensitivity around the cheek and gums of the affected side, and you may observe recession of the eyeball within the orbit (enophthalmos).

Another part of any facial examina-tion is asking the athlete to produce their normal bite with their lips open. In addition to helping identify dental injuries, an abnormal bite (for instance, one in which the upper and lower teeth are not properly aligned) may indicate trauma to the upper or lower jaw or the temple-mandible joint (TMJ). If there is any blood in or around the mouth, it’s essential to determine the source—if no laceration can be found, the presence of blood is another po-tential sign of a jaw injury. (For more on injuries to the TMJ, see “Slide and Slam” at left).

SLIDE AND SLAMThe temple-mandible joint (TMJ) is the most targeted and traumatized structure in boxing, and it’s vulnerable in other contact sports as well. The condyles, or posterior extensions of the lower jawbone, are located in a socket near the base of the skull, accompanied by a cartilage meniscus that’s very similar to the meniscus of a knee joint.

When an athlete receives a lateral blow to the chin or lower jaw, it can result in something called the slide and slam phenomenon. In essence, as the jaw is forced to move laterally, one condyle gets forced up into the man-dibular fossa (the place on the skull’s temporal bone where the jaw hinge is situated), causing damage to the meniscus, microfractures of the tympanic plate or the base of the skull, and even trauma to the temporal lobe of the brain. Repeated instances of this phenomenon in an athlete can result in progressive chronic injuries to the TMJ and the brain.

The best protection against slide and slam injury comes from a quality cus-tom-made mouthguard. Besides cushioning the teeth to prevent dental injury, an adequate mouthguard acts as a shock absorber that allows the condyles to pull away from the skull base properly, which helps prevent transmitted forces from reaching the delicate structures of the skull and brain.

TREATING THE ATHLETE

erably one who specializes in orofacial injuries. Diagnostic x-rays can deter-mine the extent of any damage (CT scans are best for this), and surgical intervention may be required to ensure that the fractures heal properly.

It typically takes six to eight weeks for full healing. But depending on the

location and severity of the fracture, a physician may allow return to play as quickly as one to two weeks post-injury, particularly if surgery isn’t required and an appropriate facemask can be found to protect the injured area.

THE ORAL CAVITYThe mouth and teeth are highly susceptible to athletic injury, par-ticularly when athletes don’t wear mouthguards. Among oral injuries, roughly 80 percent occur at the ante-

rior maxilla (upper jaw), and the most common are lacerations of the lips and surrounding tissue.

A knocked-out tooth is one injury for which an athletic trainer’s imme-diate response can play a major role in the outcome. Acting fast and correct-ly may make the difference between

a simple one-time trip to the dentist and much more complex and lengthy treatment.

First, a brief primer on dental anato-my: The outside of the tooth is covered with enamel, the middle lining consists of a substance called dentin, and the internal portion is pulp, which con-tains neurovascular tissue that supplies sensation and blood. At its base, each tooth is surrounded by tiny connective tissue fibers collectively known as the periodontal ligament, which connect it

When an athlete presents with a bloody nose (epistaxis), nasal septal fracture is a strong possibility. Bleed-ing due to a broken nose usually occurs only anteriorly (with blood draining from the nostrils), and it can be stopped with ordinary cotton rolls. However, any sign of posterior nasal bleeding, with blood draining at the back of the throat, may be a sign of a more serious injury for which the athlete should be treated by a physician or taken to the emergency room.

If the nose doesn’t appear crooked and bleeding stops within a few min-utes, the injury may heal on its own with only the application of ice and short-term use of over-the-counter na-sal decongestants to aid in breathing. But with any sign of external deformi-ty, a physician will likely recommend surgery. Persistent facial pain or head-aches after a broken nose may indicate the fracture has extended into the peri-orbital bone or down to the upper jaw, also possibly requiring surgery.

Any time a facial fracture is sus-pected, the athlete should not return to activity before seeing a physician, pref-

While some grapplers consider cauliflower ear to be almost a badge of honor, it is medically undesirable, since itincreases the risk of ear infections and can evencontribute to hearing loss.

Circle No. 120

T&C marCh 2010 ­­34 TraINING-CONDITIONING.COm

TREATING THE ATHLETE

to surrounding spongy bone and essen-tially attach it to the skull.

Even when a tooth is not completely knocked out, this connection can be damaged, typically resulting in intra-oral bleeding, pain or altered sensa-tion in the area, and the tooth being visibly out of position. When a tooth is loose but not completely out of its socket, there has been some degree of damage to the periodontal ligament. In these cases, the tooth should be gently

manipulated back into its normal po-sition, allowing the athlete to assume a normal-looking and normal-feeling bite. The athlete should visit a dentist immediately.

If a tooth is completely avulsed (knocked out), the best immediate step is to replant it in its socket as quickly as possible and refer the athlete to a dentist. Note that this only applies to adult teeth, and not deciduous “baby” teeth—when a youth athlete loses one of these, it should not be replanted, as the risk of infection outweighs any po-tential benefit.

In the case of multiple knocked-out teeth and other situations where re-planting is not possible or practical, or if the athlete finds it very painful, the tooth must be kept surrounded by moisture. Tooth-saving kits consisting of a small vessel of sterile liquid can easily be stored in first-aid bags. If none is available, workable substitutes include milk, saline solution, and sali-va. The tooth should never be scraped or brushed to remove debris, as this can further damage remnants of the periodontal ligament. In fact, the tooth should only be handled by its crown (the non-root end) to avoid damaging or contaminating the root.

If the tooth is replanted or otherwise surrounded by moisture and the ath-lete quickly sees a dentist, this injury can usually be treated quite simply. The dentist will examine the injury site to determine whether any damage has oc-curred to the alveolar bone that holds the teeth in place, and if there is any

such damage, oral surgery is usually required.

When a tooth is chipped but not loosened or removed from its socket, any retrievable pieces should likewise be stored in moisture. Depending on their size, a dentist may be able to reat-tach tooth chips through a simple cos-metic procedure.

Chipped teeth are often accompa-nied by lacerations inside the mouth, and any such wounds should be in-

spected to ensure they do not contain tooth fragments, which pose a serious infection risk. Significant lacerations of the mouth should always be referred to a physician, who may recommend sutures. Allowing intraoral lacerations to heal without treatment could lead to scarring and uneven surfaces that cause problems with chewing and speech.

An important final note on treat-ing all facial injuries is that it’s critical to establish priorities before decid-ing how to proceed with immediate treatment. For instance, after a serious blow to the chin and mouth, knocked-out teeth may be the most conspicuous visible injury, but before reaching for a tooth-saving kit, first ensure that the athlete’s airway is not affected. Trau-ma to this area may have damaged the trachea or larynx, and recognizing the more serious injury is essential.

Likewise, a blow to the upper face may result in a bloody nose, but if there’s also potential damage to the eye or its socket, that should usually take precedence when providing first-aid care and arranging for further treatment. When in doubt, bring a physician into the picture as quickly as possible.

Today’s facemasks, eye protection, and mouthguards are more advanced than ever, and happily, more and more athletes are using them. But as long as sports exist, there will be facial inju-ries. Armed with knowledge to han-dle all types of them, you can keep your athletes as safe as possible in any sport. n

After a blow to the chin and mouth, knocked-out teeth may be the most conspicuous visible injury, but before reaching for a

tooth-saving kit, first ensure that the athlete’s airway is not affected. Trauma to this area may have damaged the trachea

or larynx, and recognizing the more serious injury is essential.

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LEADERSHIP

By Dan Resing

Dan Resing is Head Athletic Trainer at Hawai’i Pacific University. He can be reached at: dresing@hpu.edu.

W hen I first arrived at Hawai’i Pacific University in the fall of 2006, the athletic training room was a

tiny office into which they had crammed two treatment tables, a computer, a refrigerator for cold packs, and a few other essentials. I was not an employee of the university, as HPU had long been contracting out sports medicine services from a private physical therapy clinic. But there was a plan in the works to bring athletic training in-house, and after my first year, that’s just what happened—with me as the department’s first true Head Athletic Trainer.

At that point, everything was look-

Sports medicine departments nationwide are dealing with tighter budgets and fewer resources in our current economic climate. In response, some athletic trainers are finding creative ways to keep their programs alive and well.

Making It ThroughDayne Teves

ing up for HPU athletic training. In ad-dition to hiring its first two full-time athletic trainers (myself and an assis-tant who had worked with me under the old contract), the school brought in two graduate assistants to expand our coverage capabilities. We doubled the size of the athletic training room by taking over an adjacent office and purchased new equipment, including a laser therapy device, an ultrasound ma-chine, and a four-channel combo tower electrotherapy unit. Our budget grew to include money for staff CEUs, CPR cer-tification, NATA and NSCA dues, pro-fessional liability insurance, and even cell phone reimbursement.

The school was making a serious in-

vestment in sports medicine, allowing us to become one of the most compre-hensive athletic training departments in Hawai’i and in the Pacific West Confer-ence. It was exciting to lead a program that was growing right before my eyes.

Then, in the fall of 2008, the reali-ties of the economic downturn caught up with us. Suddenly we faced a shrink-ing budget, and like many programs across the country, the university- imposed cuts ran deep, affecting both our resources and our personnel.

It’s never easy to deal with less than

Hawai’i Pacific University senior midfielder Max Anton (2) splits two defenders from the University of Hawai’i-Hilo.

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LEADERSHIP

ways, so this was a tough decision to make. But we had to acknowledge that convention attendance was something of a perk, and not truly a necessity in a cash-strapped year.

Our travel cuts also meant forgoing various sports medicine conferences and seminars, which in the past have pro-vided opportunities to earn CEUs. I re-searched other ways for our staff to earn CEUs, and found that if you look hard enough, there are plenty of alternatives.

For example, the NATA Web site re-cently started offering free CEU quiz-zes online to members, and the Hawai’i Athletic Trainers Association offers some free and low-cost opportunities as well. Since our department could no longer afford to pay for staff CEUs, these resources have proven invaluable. Many other state associations offer sim-ilar programs.

We learned that another way to get free CEUs is to become an Approved Clinical Instructor (ACI). This involves taking a simple one-day course that pre-pares you to work with athletic train-ing students and play an active role in their learning process. It provides

CEUs while also enhancing your de-partment—working with students is a great way to get extra help and groom the next generation of athletic trainers.

Many universities with athletic training education programs offer this course for free to any athletic trainer who has been BOC-certified for at least one year. They do this to expand the list of athletic trainers and sites that their students can work with and learn from. The course is usually offered during the summer to prepare for the upcom-ing fall semester, but it can also be held over winter break if there is sufficient demand. The certification is good for one year, and ACIs must take a short re-fresher course each summer to maintain certified status.

Those cuts were a good start, but we needed to go further—we realized we would have to cut back on athletic trainers traveling with teams to away games. As you might expect, with more than half our conference members being over 2,000 miles away on the mainland, travel is one of our greatest expenses.

This was a tough realization, as no athletic trainer wants to leave the re-

you’re used to. But until the economy recovers from its current recession, ath-letic trainers in practically every setting are having to make do. At HPU, we’ve worked hard to limit the effects budget cuts have on our athletes and the servic-es we provide. Hopefully, some of the solutions we’ve come up with can help your program get through these rough times as smoothly as possible.

CUTTING COSTS, NOT CORNERSWhen looking to trim the budget, our first decision was that direct care for athletes was the top priority—after all, that’s the reason we’re here. We would look for any other places to make cuts before altering coverage for workouts, practices, and competitions. Thus the first thing we scaled back was staff travel to non-athletic events.

For one thing, this meant we would not send anyone to the NATA Annual Meeting. Anyone who has been to an NATA convention knows it’s an incred-ible opportunity to learn about the lat-est research in our field, network with colleagues at other schools, and expand our professional horizons in countless

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sponsibility of caring for their athletes in the hands of coaches, or athletic trainers at host schools who are unfa-miliar with the athletes’ medical histo-ries. But when we saw it was a necessity, we tried our best to minimize the im-pact on our athletes.

We do this by establishing commu-nication with the home team athletic training staff every time a team will be traveling without us. Via phone or e-mail, we share any important details about individual athletes’ status and potential treatment needs.

We find it is helpful to report how many athletes may need taping or other treatment, so the host athletic train-ing staff can plan ahead for the extra demand. Luckily, our colleagues at op-posing schools have been very gracious about caring for our athletes, and we offer to return the favor when their teams come to our campus.

Another trick we learned for games when we can’t accompany a team is teaching athletes how to do a tape job themselves—especially if they require special or unique taping. Even if they can’t actually perform the taping on their own body, they can guide a host athletic trainer through the process.

For every contest where we won’t be there in person, we provide the coach with an athletic training kit containing basic supplies as well as insurance in-formation and emergency contacts for each athlete. The athletic trainers in our conference have also been working on a great new idea for this—a system where each school would have a visiting team supply bag on hand, thus prevent-ing the hassle and expense of toting one to away games. It would contain a pre-determined list of basic supplies agreed upon by each athletic trainer in the con-ference, plus any special supplies a team may request. The visiting team’s staff would then only have to worry about bringing insurance and emergency con-tact information for their athletes.

SHORT STAFFEDFor any athletic department, the hard-est cuts to make are those involving per-sonnel. But when your funding is cut, sometimes you’re left with no choice.

In our case, it was first necessary to move our assistant athletic trainer from a full-time 12-month schedule to a full-time 10-month schedule, which would save the department from paying her salary during the summer months. This

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put her in a difficult spot personally, but she found an excellent solution. She worked with the leaders of our school’s nursing department to develop some entry-level sports medicine classes she could teach over the summer to supple-ment her salary. This proved to be a win-win for the time being, as it provided the extra income she needed while giving the nursing program a simple and cost-effec-tive way to expand its offerings.

The hardest cut we had to make came just this past fall, when lower-than-expected enrollment forced us to lay off the assistant athletic trainer. At the time, she was primarily responsible for our women’s volleyball team, which was in the middle of its season and fighting for a conference title. The players felt this loss immensely, as they had formed strong bonds with their athletic trainer, and we were of course very sad to lose a valued member of our staff.

The change was logistically tough as well, as the rest of us—two graduate assistants and I—had to put in extra hours to cover the work she had been doing. We learned early on that keep-ing everyone’s sanity required frequent

short meetings to plan the schedule weeks in advance.

In addition to volleyball, we were also covering men’s and women’s soc-cer and three competitive cheer teams in the fall. At the same time, men’s and women’s basketball were start-ing official practices. It was clear we would need to ration our coverage, so we looked at the schedule and made a few common-sense decisions.

Here’s a specific example of a chal-lenge we faced with our smaller staff and how we met it: Both men’s and women’s soccer practice typically started at 4:30 p.m. and didn’t finish until at least 6:30, while men’s basketball practice started at 6:00 at a facility 13 miles away. We didn’t have enough staff to cover both in their entirety, so we talked to the coach-es and devised a plan that would meet the needs of both teams.

I decided it was most important to be there at the beginning of team practices to provide taping and any needed treatment, and to evaluate any problems athletes may have noticed once they began working out. I would arrive at roughly 3:45 for a 4:30 soccer practice and stay until about 5:15,

then head to the men’s basketball facility, where I would arrive by 5:45 so I could tape the athletes who needed it and pre-pare the team for practice.

It obviously wasn’t a perfect system, but we made it work. The players knew in advance when I would and wouldn’t be there, so they understood the need to plan their taping and treatment time around the modified schedule. And when the soccer team had a home game, I stayed with them for the entire contest and was “on call” for the basketball team via cell phone in case of an emer-gency. Likewise, when the soccer team had a light practice the day before a game, I would have soccer players who needed taping come into the athletic training room earlier in the day and get taped, allowing me to attend all of bas-ketball practice that day.

Whenever there are events without athletic training coverage, it’s especially important to ensure that coaches are certified in CPR and first aid. All our coaches are certified by the American Red Cross, and while we hope they nev-er need to use that training, we feel it’s an essential precaution.

Untitled-7 1 1/16/06 12:13:17 PM

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Anytime you lose a staff member, you lose a unique set of skills that’s difficult to replace. At such times it’s especially im-portant to look for untapped resources that may help.

For instance, the assistant athletic trainer we were forced to lay off had been our staff’s only certified kinesiotaping practitioner. That modality has become increasing popular with our athletes in recent years, so we were happy to learn one of our assistant women’s soccer coaches is also certified in kinesiotaping. We worked out an agreement whereby she tapes athletes who need the modality as long as we provide her with the specialized kine-siology tape. To make this as convenient as possible for her, we sometimes arrange to send athletes to the shiatsu clinic where she works in the daytime (just down the street from our campus) to receive their tape jobs.

EXTRA HANDSWhen budget cuts are required, it’s easy to make the mistake of thinking only about subtraction: “What will we have to do with-out?” But this is also a time to think about adding cost-effective alternatives to fill gaps and minimize the impact of losses.

Immediately after we laid off our assistant athletic trainer, I met with the athletic director to discuss what we could do to get through the busy fall semester. He understood my con-cerns, and agreed that one full-time athletic trainer and two grad assistants weren’t enough to care for the 350 athletes in our department. He was able to secure funding for a part-time athletic trainer to work up to 20 hours a week.

It’s always more difficult to fill part-time positions— especially on an island in the middle of the ocean—but we were able to find a real estate agent who was also a certified athletic trainer looking for part-time work. Her schedule was complicated by the fact that she has young children, but we found ways to schedule around her other responsibilities, and her kids became a regular fixture at games she covered.

The part-time hire was obviously a stopgap measure. For the longer term, we’ve decided the best way to meet our needs and work within our limitations is to add a third graduate assistant. For less than the cost of a full-time employee, we can cover more practices and games with this approach.

While the main impetus for adding an extra grad assistant was to save money, we felt it was important to not shortchange the applicants by skimping on the benefits package. With that in mind, we are offering a full tuition waiver, books, and a very competitive stipend that will allow the assistant to pay for rent, food, and other living expenses.

In addition to the compensation they receive directly through the assistantship, we always try to offer our graduate assistants other ways to earn money, since a stipend can only go so far. For instance, it’s a great idea to set up opportunities for them to provide athletic training services at various camps or intramural sporting events on your campus or in your area. Another nice touch is to pay NATA dues for your graduate assistants, since that can be a large expense for someone on a limited budget.

Nothing is easy about making cuts that change the way your department runs. But as economic realities force programs ev-erywhere to do more with less, I choose to see a silver lining. When we have no choice but to be more efficient, to commu-nicate better, and to get creative in dealing with tough situa-tions, we often find ways to refine our operations and the care we provide to athletes. When times improve and the funding returns, as I’m optimistic they will, our program is poised to be better than ever. n

Circle No. 127

USE TO HELP PROTECT YOUR ATHLETE.Baseball players are some of the most susceptible athletes to the threat of MRSA. Virtually every part of a baseball game can put a player at risk of infection, from direct contact with an opponent’s skin to direct contact with potentially contaminated equipment.

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MRSA stands for methicillin-resistant staphylococcus aureus. It is a strain of staph infection that is resistant to the broad-spectrum antibiotics commonly used to treat it.

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sport specific

By Sara Wiley

Y ou could justly describe the 2009 University of Minnesota volleyball season as a breakout year. Despite not cracking the top ten in

preseason rankings and entering the NCAA Division I tournament as the 11th seed, we made it all the way to the national semifinals for the first time since 2004 and finished the season ranked fourth in the country. Even Head Coach Mike Hebert admitted after our final match that he was surprised by just how far this year’s Golden Gophers advanced.

Yet while many people were aston-ished by our success, I saw it more as the logical culmination of a 12-month commitment on the part of our athletes.

Sara Wiley is Associate Director of Strength & Conditioning at the University of Minnesota. She can be reached at: wiley004@umn.edu.

HoldingCourt

We have worked hard to build a train-ing regimen focusing on the specific as-pects of volleyball performance that we believe separate the elite players from the rest of the pack.

The cornerstones of our program are mobility and flexibility, movement mas-tery, and strength and power develop-ment. We strive to help every athlete

excel in force absorption, power pro-duction, and jumping ability. To achieve those goals, we set precise priorities and devise targeted workouts all year long.

MOBILITY & FLEXIBILITYWe want all our players to move around the court in ways that maxi-mize efficiency and minimize injury risk. With that in mind, each strength and conditioning session begins with a dynamic warmup and flexibility/mobility training. We focus primarily on three body areas: the ankles, hips,

University of Minnesota

The University of Minnesota’s year-round volleyball strength program incorporates movement prep, jump training, and power building with the goal of optimizing late-season performance.

Middle hitter Lauren Gibbemeyer goes up for a kill during the Golden Gophers’ 2009 NCAA Division I national semifinal match against the University of Texas.

T&C marCh 2010 TraINING-CONDITIONING.COm

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and thoracic spine.Ankles. Our ankle mobilization ex-

ercises improve range of motion, espe-cially dorsiflexion in the sagittal plane. From a performance standpoint, espe-cially for defensive specialists and libe-ros, this type of mobility allows proper setup and alignment in low defensive power positions, which is essential for dynamic defensive movements close to the ground. Proper ankle mobility is also useful for keeping the knees opti-mally aligned, because the ankles serve as the foundation for practically every movement of the lower kinetic chain.

To achieve this mobility, we use ex-ercises such as single-leg tri-planar squats, kneeling ankle mobility (the athlete takes a knee as if in a lunge po-sition, places her hands on the ground,

and rolls her body weight forward while attempting to keep the front heel down), and ankle circles with a BAPS (biomechanical ankle platform system) board. We also have the athletes per-form squats and lunges in bare feet, which forces them to use the stabilizer muscles of the ankle to maintain bal-ance and perform the movement cor-rectly.

Hips. At the hip, mobility exercises seek to open the flexor muscles while also improving range of motion in all planes of movement. Shortened, over-active hip flexors can disrupt optimal pelvic motion and lead to lower-back pain and changes in spinal alignment. That in turn may affect scapular align-ment and ultimately play a role in a variety of shoulder ailments.

Volleyball players spend a lot of time with their hip flexors in a shortened position due to the stances and move-ments required in the sport. To coun-teract that, it’s essential to invest time re-establishing a sound length-tension relationship between the flexors and extensors of the hip, mainly by work-ing to lengthen the flexors and promote efficient firing of the gluteus muscles.

In addition, while there is not much research to prove a causal link between

injuries to the shoulder and the hip, we have noticed that many athletes with shoulder issues also seem to have a cor-responding problem with the opposite hip. For that reason, our hip mobility exercises always include at least one activity that requires coordination be-tween the hip, trunk, and shoulder.

Some of our staple exercises for build-ing hip mobility include spider lung-es and backward lunge-and-reaches. For engagement of the hip, trunk, and shoulder together, we use step-ups with rotation and reverse lunges with shoul-der proprioceptive neuromuscular facil-itation (PNF) diagonal movement (not to be confused with PNF stretches). For corresponding glute activation, we use three-way anterior reaches, the Cook hip lift, and bird dogs (opposite arm-leg

raises on hands and knees).Thoracic spine. Mobility in the tho-

racic spine is critical for practically ev-ery movement pattern volleyball players use on the court. A lack of flexibility in this area is associated with increased in-jury risk and inefficient movement. Fur-thermore, poor thoracic extension may lead to compensatory movements in the lower back to achieve adequate range of motion during the arm swing—this frequently leads to volleyball players’ lower-back problems.

To target thoracic spine mobility, we use four-point kneeling with thoracic extension and seated rotations with side bends. We also use thoracic extensions performed over a physioball.

Beyond those three key areas, we use PNF stretching throughout the year to focus on the quadriceps and shoulders. Our quad-hip flexor stretch is performed in a stretch-contract-relax-stretch se-quence, while our shoulder PNF stretch uses the same sequence but with a locked overhead position that traps the shoul-der blade. This helps the athletes stretch their internal shoulder rotators while performing trunk rotation. It also helps build sport-specific range of motion that’s especially valuable in the volley-ball take-away position.

MOVEMENT PATTERNSEven at the NCAA Division I lev-el, there is wide variation in athletes’ movement efficiency during both lateral and vertical moves. Some of the most pronounced deficiencies occur in later-al movement, change of direction, and jumping and landing technique.

By the time an athlete enters our pro-gram, it’s obvious she’s found a way to make her movement patterns work on the court. But we still believe we can often take her game up a notch by cor-recting movement flaws and teaching new patterns.

Beginning early in the off-season (mid to late January), our training sessions include individualized instruction and drills that reinforce proper jumping and landing technique. The athletes receive verbal cues and hands-on positioning—we literally manipulate their bodies into the correct positions prior to a jump or after a landing, so they can feel the dif-ference between that position and the one they’ve used in the past.

Some of our favorite drills to rein-force optimal movement patterns are the simplest ones: in-place jumps with a stick, landing both vertically and hori-zontally and both single- and double-legged. We instruct the players to land “quietly,” using full-body coordination to absorb force and soften foot impact. We also tell them to pay attention to body position from head to toe—eyes up, chest up, shoulders in line with the knees, knees in line with the toes, and toes dorsiflexed. We address lateral movement by emphasizing push-slant and push-drive mechanics, which vol-leyball players must use regularly to cover the court.

Although these drills seem rudimen-tary, they serve as the base from which we refine mechanics through more complex and intense plyometric and agility drills. Once the players display mastery of the simple drills, we add shuffling and sprinting combinations, shuffling and jumping combinations, and short sprints with multiple chang-es of direction.

We also add cone-based agility drills with various footwork patterns, using verbal or visual cues to signal changes in direction or activity, and sometimes incorporate a reaction component to the drill. For instance, when I flash a blue card, an athlete performing a foot-work drill must cut left, and if I flash a red card, she must cut right. Other

The athletes receive verbal cues and hands-on positioning—we literally manipulate their bodies into the

correct positions prior to a jump or after a landing, so they can feel the difference between that position

and the one they’ve used in the past.

sport specific

times, the athletes must react to the col-or cues by running to a cone of a corre-sponding color. The reaction challenge forces heads-up running and eliminates the potential for just “going through the motions” during a drill.

STRENGTH & POWEROur strength program is designed to be as functional and sport-specific as possible, which for volleyball means focusing on ground-based compound movements such as squats, box squats, and front squats, and their single-leg variations. We also emphasize develop-ing strength in the posterior chain using Romanian deadlifts, glute-ham work, back hypers, pull-throughs, and good mornings, again along with their single-leg variations.

During our strength development phase, which begins in March, we im-plement an isometric training block of two to three weeks followed by an eccentric block of two to three weeks, then finally a traditional concentric block. The isometric emphasis comes first because that’s the best way to teach athletes to develop tension and

stay tight during the “weaker” (less strenuous) portions of a lift. Next, when we focus on eccentric move-ments, they experience high motor unit recruitment and improve neuromuscu-lar efficiency. In the final weeks, tar-geting concentric work, we put those previous training elements together into the same workout.

At all times during our lifting pro-gram, we instruct the athletes to move the weight as quickly as possible to stimulate and recruit fast-twitch muscle fibers. Because volleyball requires fre-quent lateral and rotational movements, we complement our core lifts with exer-cises that require the athletes move into a full range of motion in the transverse and frontal planes, such as lateral squats, chopping movements, lateral step-ups, and lunging in multiple directions.

For upper-body power development, we rely mostly on traditional vertical and horizontal pressing and pulling ac-tivities. We prefer dumbbells over bar-bells, because they allow the athletes to take greater control over shoulder posi-tioning and require more engagement of the stabilizer muscles.

During balance pressing work, we pay special attention to the athletes’ tech-nique in scapular retraction, downward scapular rotation, and external rota-tion. It’s very easy for volleyball players to develop imbalances in the upper back and chest, and those imbalances must be addressed in strength training to re-duce injury risk. In addition to body rows and dumbbell rows, we target the lower and middle trapezius, rhomboids, serratus anterior, and external rotators of the shoulder with face pulls, kneeling reach roll-and-lift exercises, push-ups plus, and wall slides.

To make force gains as functional as possible for volleyball, it’s vital to fo-cus on the rate of force development. Volleyball is an explosive sport, and if explosiveness is developed at different rates in different muscle areas, players will suffer from inefficiencies and en-ergy leaks. We combat this by incorpo-rating total-body lifts into our training, including the power clean and power snatch—performed both from the floor and from hanging positions—as well as the clean and jerk, clean pulls, and snatch pulls.

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As preseason approaches, total-body lifts account for a larger portion of our training volume, and we begin to com-bine our strength exercises into com-plexes with jumping activities. The coupling of a loaded strength exercise with an unloaded explosive exercise further increases motor-unit recruit-ment and stimulates fast-twitch mo-tor fiber. We boost arm and shoulder muscle power with medicine ball exer-cises, including overhead throws, over-head triceps tosses, pullover throws off a physioball, slams, and single-arm tossbacks.

In addition, we employ timed lifts—requiring an athlete to perform as many reps as possible in four or six seconds—

to build explosiveness. Once an indi-vidual reaches a rate of more than one rep per second, we add more resistance and they work to reach the same num-ber of reps. Progressively increasing load and achieving the same number of reps with heavier weight translates into more work per unit of time: the very definition of power.

JUMPING INJump training is one of the most impor-tant forms of development for volley-ball players. From low-intensity ballistic jumping exercises to the technique refine-ment on take-offs and landings described earlier, practically all great volleyball players are highly proficient jumpers.

During the strength development phase of our program, which typically lasts from March through May, the athletes perform jump training twice a week, and the activities mirror the fo-cus of our strength training blocks. For example, during the isometric block, our jumping activities may involve an isometric push against a partner fol-lowed by jumping upon release.

As we progress through the summer, we have two unique periods of program-ming that focus heavily on shock-level plyometrics—plyo work that involves high nervous system activation, such as altitude landings and depth landings. (See “Jump Phases” below to learn how these periods fit into our broader jump

GENERAL PREP

Duration: Four weeks, beginning in January

Goals: Prepare for more intense work to come, mas-ter technique for in-place jumping and landing, build strength in landing positions, reinforce proper move-ment patterns

Exercises:

Jump rope

Line hops

Squat jumps with stick

Single-leg jumps with stick

Forward, backward, and lateral jumps with stick

Tuck jumps

Pike jumps

Barrier jumps with stick

STRENGTH DEVELOPMENT

Duration: 10 to 12 weeks, beginning in March

Goals: Introduce more complex and higher-intensity jumping, include ballistic jumping to incorporate strength speed/power activities, add shock-level plyos to maximize nervous system challenge

Exercises:

Box jumps: isometric hold to jump

Hurdle jumps

Broad jumps

Lateral bounds

Block jumps

Approach jumps

Shock-level plyos: depth landings (in the final three weeks)

POWER DEVELOPMENT

Duration: Eight to 10 weeks, beginning in June

Goals: Improve rate of force production, improve force absorption (landings), maximize sport-specific gains

Exercises:

Approach jumps

Shuffle blocks

Push drive/slant block jumps

Lateral bounds to jumps

Lateral barrier jumps to vertical jumps

Shock-level plyos: depth landings or depth jumps (in the final three weeks)

JUMP PHASESDuring the off-season, we break our jump training into three phases, each with its own unique emphasis. Here is a breakdown of the phases, including sample exercises:

T&C MARCH 2010 ­45 TRAINING-CONDITIONING.COM

sport specific

tion aims to not overstress the body be-fore competition—we use basic pulling and compound movements, such as box squats and front squats, and jumping is limited to 20 to 30 reps per session.

Using this strategy, our athletes are primed for optimum performance ev-ery time they step on the court. They hold onto the strength gains they made during the off-season, their risk of in-jury from overuse or poor mechanics is reduced as much as possible, and we hope to see them reach new heights ev-ery year. n

tensity. At this time, the goal is to main-tain strength and conditioning gains made in the off-season.

Once the competitive season begins, the players continue to strength train twice a week with low training vol-umes. Early in the week, we use lower intensities (65 to 75 percent of max effort and resistance) and emphasize speed of movement. The last session of the week before a weekend of match-es includes higher intensities (up to 85 percent) to help the athletes maintain their strength levels. Our exercise selec-

training schedule.) Each phase lasts roughly three weeks and begins with two days of drop landings, which al-low us to focus on the eccentric portion of the jumps and thereby improve the players’ ability to absorb and use accu-mulated kinetic energy from downward momentum. Absorbing force effectively results in shorter coupling times be-tween the eccentric and concentric com-ponents of a jump, leading to greater jump height over time.

During drop landings, we begin at a height equivalent to the athlete’s ver-tical jump in inches, which is tested in January right after winter break, in early May before the spring semester ends, and in August when the athletes return for preseason camp. The height then progresses slightly each week, pro-vided the athlete can maintain landings with good form in terms of knee bend, not sinking the upper body below the knees, and avoiding heel touch.

Because shock-level plyometric work is extremely stressful, we use it only during those two distinct phases of the training cycle. The last phase of shock work ends in mid-July, roughly three weeks before the start of preseason camp, giving the athletes adequate re-covery time prior to testing and the start of team training.

It’s important to note that the train-ing described above applies to all our players, but we do account for some position-specific needs. For the libero and defensive specialists, jump train-ing includes a greater emphasis on lat-eral movements, with activities such as skater hops and lateral bounding. We also stress sustaining eccentric forces in defensive postures, using Jump Stretch bands to create a speed overload into a lateral drop step. In addition, defensive players focus on push lunges—a partner applies force in the form of a controlled shove, the player lunges with the shove, and she “sticks the landing” in an ath-letic position.

TIMELY PEAKINGWhen preseason training camp begins, on-court activity is paramount. As the players increase their workload through team practices, we scale down weight-room and jump training work signifi-cantly. Strength training occurs in the form of medicine ball drills for the up-per body and trunk, and the athletes hit the weightroom roughly twice a week for short sessions at 80 to 85 percent in-

Our award-winning product line features more than 2,000 products. Go to power-systems.com today or call 1.800.321.6975 to request a FREE

2010 Catalog from our friendly team of customer service representatives.

Circle No. 130

Developing Clinical Proficiency in Athletic TrainingThe fourth edition this book takes the skills that athletic train-ing students need and organizes them into a modular system. The manual contains 146 modules to be used for assessing students’ clinical skill development over the course of their athletic training program. All current National Athletic Trainers’ Asso-ciation (NATA) Athletic Train-ing Competencies are embedded in the text.

Price: $44.00Item Number: 9780736083614

Effective Functional Progressions in Sport RehabilitationThis book provides clinicians with the strategies and tools they need to prepare their clients for the physical demands required by their sport. The content includes functional progressions for all areas of the body, sport-specific progressions, photos and art that clearly depict progressions and injured areas.

Price: $40.00Item Number: 9780736063814

Sport NutritionUsing a physiological basis, this text provides an in-depth look at the science behind sport nutrition. Readers will come away with a comprehensive understanding of nutrition as it relates to sport and the influence of nutrition on exercise performance, training, and recovery. The text presents not only nutrition principles but also the exercise biochemistry involved and the energy needs of athletes.

Price: $79.00Item Number: 9780736079624

Bigger Faster StrongerBigger Faster Stronger is now bigger and better than ever! This second edition presents the most popular strength training system for today’s high school and college athletes. Establish the solid foundation you need to compete successfully and advance your athletic career. During the in-season or off-season, the customizable programs can ac-commodate any sport, and every level of competition.

Price: $21.95Item Number: 9780736079631

Periodization: Theory and Methodology of TrainingYou’ll learn how to vary the intensity and volume of training to optimize the body’s ability to recover and rebuild—resulting in better performance and less risk of injury. Chapter summaries will help you review and reference major concepts throughout the text. Plan and document each training program with ease using the duplication-ready annual and four-year training plan charts included in the appendix.

Price: $50.00Item Number: 9780736074834

Therapeutic Modalities for Musculoskeletal InjuriesThis book provides comprehen-sive coverage of evidence-based therapies for athletic injury rehabilitation. Part of Human Kinetics’ Athletic Training Edu-cation Series, the updated edition presents the most current research regarding therapeutic modalities for athletic injuries through the alignment of the text’s content with the National Athletic Train-ers’ Association (NATA) Athletic Training Educational Competen-cies.

Price: $68.00Item Number: 9780736078917

Essentials of Strength Training and ConditioningIn this text, 30 expert contribu-tors explore the scientific prin-ciples, concepts, and theories of strength training and condition-ing as well as their applications to athletic performance. Chapter objectives, key points, key terms, and self-study questions provide a structure to help readers organize and conceptualize the information.

Price: $84.00Item Number: 9780736058032

Core Assessment and TrainingWritten for coaches and fit-ness professionals, this edition includes photos, illustrations, and instructions for more than 120 exercises. A DVD accompanying the text features video demon-strations that help readers review proper techniques and protocols for the exercises. With Core Assessment and Training, you can master the techniques for assess-ing each client’s needs and design customized training programs for maximum results.

Price: $39.00ISBN-13: 9780736073844

Learning from Peers Looking to gain a coaching edge in the off season? Order these books & DVD’s by using the form below. Learning from Peers

**PLEASE PRINT INFO.

ORDER FORM MAG, Inc.31 Dutch Mill Rd. Ithaca, NY 14850 Code TC 20.2

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Learning from Peers Looking to gain a coaching edge in the off season? Order these books & DVD’s by using the form below. Learning from Peers

**PLEASE PRINT INFO.

Sports Nutrition Keys for Performance handout series with CD-rom for col-legiate and adult athletes.Sports Nutrition Keys for Performance handout series and CD-ROM features handout ma-terial detailing specific guidelines and recommendations for your Collegiate and Adult athletes. Sample meal plans, recipes, tips for eating out, and other practical recommendations are included.

Price: $189.00Item Number: TC-0310B

The Complete Guide to Foam Roller Exercises for Improved Performance Learn how to use foam rollers through a wide range of exercises for core strength, flexibility, sta-bility, and balance. Each exercise is shown in a progression from easy to advanced. This 83 minute DVD features Staffan Elgelid PT, Ph.D., CFT; Nazareth College of Rochester Associate Professor of Physical Therapy and Irene McCormick PFT; Des Moines Area Community Col-lege Director of Fitness.

Price: $49.99Item Number: GD-02300

Movement Dynamics - Physical Competence and Assessment Manual This manual has been devel-oped to support the Movement Dynamics Progressive Exercise software resource. It is provided to support both the assessments the subsequent activities designed for athlete progression. The manual is designed to provide il-lustrations of each test, the main technical coaching points and examples of technical violations of the movements concerned.

Price: $49.95Item Number: TC-0310A

High School Fuel: Sports Nutrition for Health and Performance handout series with CD-rom from RK Team Nutrition.This is a new series of 20 sports nutrition handouts that provide copy-ready information (and a CD-rom with all handouts for easy printing) to help your middle school and high school-age athletes succeed. Up-to-date research on nutrition for athletic performance is translated into easy-to-read recommendations, food lists, and tips.

Price: $149.00.Item Number: TC-0310C

To help in the fight against MRSA, Training & Conditioning has teamed

up with its advertisers to offer readers eight educational posters.

Special Focus: Preventing MRSA

• Make sure padding and other equipment is

stored someplace where it can dry out after

each use.

• Clean athletes’ equipment regularly with a

product that will kill MRSA and other types of

bacteria.

• Don’t allow athletes to share equipment at

practice or during games.

• Whether your athletic department launders

athletes’ uniforms or athletes do it themselves,

make sure uniforms get washed after each use.

• If one or more athletes in your program are

infected with MRSA, launder their uniforms

and other washables separately from the rest

of the team’s. Sponsored by:

Athletic equipment is supposed to keep the wearer safe, but if it’s

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properly taken care of, it can create a serious health hazard. When

sweaty pads and uniforms are thrown into a bag or locker, the result is a

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The problem can be exacerbated on equipment with large surface areas

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Take these precautions to help prevent

equipment from harboring MRSA bacteria:

Equipment Management

To download as a printable poster visit: www.Training-Conditioning.com

Special Focus: Preventing MRSA

• Shower immediately after practices and com-petitions. If MRSA bacteria are present on your skin, you can wash them away before they have a chance to cause infection.• Don’t share towels, razors, soap, and other personal items and toiletries.

• Get every skin wound, no matter how minor, checked out by your coach, athletic trainer, or team physician.

• Cover all wounds to help prevent infection, especially during practice and competition. If a bandage or wrapping falls off, have it replaced immediately.

• Dry out your equipment and padding after each use. Do not store in a dark, moist, warm environment.

• Wash your hands often. Frequent hand wash-ing with antibacterial soap is one of the best ways to prevent MRSA.

If you’re like most athletes, you enjoy the camaraderie in your team’s locker room. It’s a place to relax, feel safe, and bond with teammates. But a locker room can also be a harbor for MRSA, a type of staph infection that can be deadly if left untreated. Here are some precautions for preventing the spread of MRSA in the locker room:

In the Locker Room

To download as a printable poster visit: www.Training-Conditioning.com

Prevention Through Education

Special Focus: Preventing MRSA

• Carry a bottle of an alcohol-based hand

sanitizer and perform a waterless hand

washing between athlete treatments.

• If possible, use disposable towels. If your

program only has ordinary towels, never use

the same one on multiple athletes.

• Follow the same sanitary practices with your

sideline treatment table as you do with your ath-

letic training room tables. Antibacterial wipes can

be a convenient, effective cleaning aid.

• Watch for skin wounds that occur during the

game. As soon as the wounded athlete is off the

field or court, clean and disinfect the wound site

and apply secure bandages.

• Talk to athletes and coaches about these proce-

dures before the season, and make sure everyone

on your sideline knows the importance of proac-

tive wound care.

If you’re an athletic trainer working the sidelines during a contest, you’ve

got a lot to think about—treating injuries, massaging out muscle cramps,

and making return-to-play decisions. But one thing should always be a

priority: limiting athletes’ risk of contracting an infection such as MRSA.

Here are some tips for preventing the spread of

infection during athletic events:

On the Sidelines

Sponsored by:

To download as a printable poster visit: www.Training-Conditioning.com

www.Training-Conditioning.com/mrsa.html

Warning Signs: How to spot the warning signs of MRSA

Hand Hygiene: Proper techniques for washing away MRSA

Equipment Management: Why equipment storage is critical

On the Sidelines: Important gametime procedures for ATCs

Wound Care: How to treat and cover wounds

Tips for Parents: A special poster to educate parents

In the Locker Room: Tips for athletes in the locker room

Athletic Training Room Procedures: A poster for athletic training rooms

You can download any of these posters for FREE or you can receive all eight 12” x 18” high quality color posters for $35 per set.

To order, visit:

Special Focus: Preventing MRSA

l Longer than normal healing time

l Any increase in size

l Unexplained or unusual pain or sensitivity

l The presence of pus or a pustule

l Induration (hardness)

l The sensation of heat

l Abnormal swelling or redness

l Red streaks around the lesion

l Abnormal coloration

It’s fairly common for athletes to have pimples, cuts, and abra-

sions on their skin. So how do you know when it might be MRSA

and should be referred to a doctor or hospital for a more complete

evaluation?

Here are some warning signs to look for and ask

about when deciding whether a wound requires

medical intervention:

Warning Signs

To download as a printable poster visit: www.Training-Conditioning.com

Sponsored by:

Special Focus: Preventing MRSA

To download as a printable poster visit: www.Training-Conditioning.com

• Launder workout clothing and uniforms after

each use, using hot water and detergent.• If your child brings his or her equipment home,

designate a place where it can thoroughly dry out

after each use. Wet padding and other equipment

left in a gym bag creates an ideal environment for

MRSA bacteria to grow.• Encourage frequent hand washing with antibac-

terial soap. Clean hands are a key defense against

the spread of infection.• Tell your child to shower immediately after

practice or competition, especially if he or she

participates in a contact sport.• Any time your child has a skin wound, make

sure it remains covered until it is fully healed.

MRSA usually enters the body through an unpro-

tected break in the skin. • Make sure your child reports all skin wounds,

no matter how minor, to a coach, athletic trainer,

school nurse, or someone else who can decide

whether medical attention is warranted. If it’s in-

fected with MRSA, early detection is critical.

As the parent of a student-athlete, you’d do anything to keep your child

safe. When it comes to preventing MRSA, a potentially serious bacterial

infection, a few common-sense preventative measures can make a big

difference.

Here are some ways to help your child avoid the

risks of MRSA:

Tips for Parents

Circle No. 131

TRAINING-CONDITIONING.COM T&CMARCh2010 49

Battling Bacteria Straight talk

Many of the companies that advertise in Training & Conditioning have products which are antimicrobial products. Below is information from several of these companies on a few of their products.

Athletix disinfectant wipes are regis-tered in all 50 states. They help athletic programs prepare for sickness out-breaks in their facilities. This product kills CA-MRSA, MRSA, staph, VRE, and Influenza A2 (H2N2). Athletix disinfectant wipes are free of ortho-phenylphenol, bleach, ammonia, and alcohol. The EPA believes this prod-uct’s effectiveness against Influenza A2 will also demonstrate effectiveness against H1N1.Athletix Products by Contec, Inc.800-289-5762www.athletixproducts.comCircle No. 500

Hibiclens is an FDA-approved antiseptic skin cleanser indicated for use as a surgical hand scrub, hand wash for healthcare personnel, patient pre-operative skin preparation, skin wound cleanser, and general skin cleanser. Its active ingredient, CHG, works in a unique way—it kills germs on contact and bonds to the skin to keep killing microorganisms for up to six hours after washing.Molnlycke Health Care800-843-8497www.hibiclens.comCircle No. 503

Whizzer is a concentrated cleaner and deodorizer that kills a broad spectrum of bacteria, including MRSA, as well as viruses and fungi on non-porous surfaces. Whizzer is EPA-registered, and one gallon makes 128 gallons of cleaner/disinfectant. This product inhibits the growth of mold and mildew (and their odors) when used as directed. Versatile and powerful, Whizzer kills HIV-1 (the AIDS virus), hepatitis B and C, herpes simplex 1 and 2, SARS, and other viruses. It also kills strep, staph (including MRSA), and fungus on contact. In addition, it helps prevent the spread of athlete’s foot.Mueller Sports Medicine800-356-9522www.muellersportsmed.comCircle No. 504

With its formulation of 70 percent isopropyl alcohol + 0.5 percent chlorhexidine gluconate (CHG) and emollients, Hibistat® healthcare personnel hand antiseptic has been proven to provide fast acting antimicrobial protection on contact. It provides a broad spectrum of activity, continuing to fight germs much longer than soap and water, or isopropyl alcohol alone. Requiring no water for use, Hibistat is ideal for use in the field or the facility. It is also safe for frequent daily use and has a quick-drying formula.Molnlycke Health Care800-843-8497www.hibiclens.comCircle No. 505

New GymWipes FORCE is an EPA-registered disinfectant product designed to clean and sanitize health club surfaces and equipment, including seat pads, leg/arm rests, benches, hand grips, chrome plating, painted surfaces, steel and rubber surfaces, tanning beds, and electronic panels. It protects against 50 pathogens, including MRSA and the H1N1 virus. The pads are pre-moistened and disposable, with a fresh scent and no phenol, bleach, or alcohol. Stands and wall mounts are available. GymWipes888-977-3726www.2xlcorp.comCircle No. 502

TELFA wound dressings by Covidien are effective against MRSA and Staphylococcus aureus. AMD dressings contain PHMB (polyhexamethylene biguanide), an antimicrobial component proven to resist bacterial colonization within the dressing and also resist bacterial penetration through the dressing. At just pennies per day, this product offers inexpensive infection control. It is compliant with existing protocols, and proven to prevent bacterial proliferation and limit cross-contamination. Studies have demonstrated AMD’s effectiveness against a host of bacteria, including Staphylococcus aureus and MRSA.Covidien800-962-9888www.covidien.comCircle No. 501

Prevention Through Education

50 T&C marCh 2010 TraINING-CONDITIONING.COm

CATALOG SHOWCASE

New From Pro-TecPro-Tec Athletics is a leading sports medicine company specializing in orthopedic supports and hot/cold and massage therapy products. In 2010, Pro-Tec Athletics will maintain its innovative edge by introducing four new foam rollers, two foam roller covers, LiquiCell® Nipple Protectors, an ankle brace, and plantar massage balls, while continuing to improve existing product designs. Most products and this year’s catalog include “Injury Guides,” which recommend stretching and strengthening exercises to expedite the recovery process.Pro-Tec Athletics800-779-3372www.injurybegone.comCircle No. 529

Joint EffortKnees, legs, ankles, elbows, and arms take a beating. Cho-Pat’s innovative preventive and pain-reducing sports/medical devices incorporate unique design characteristics, excellent craftsmanship, and quality materials to help reduce pain and discomfort and assist in healing. All of the company’s American-made products allow full mobility and are highly recommended, easy to use, comfortable to wear, and available in sizes for more specific and effective results.Cho-Pat800-221-1601www.cho-pat.com Circle No. 512

Advance Your Career Since 1987, the National Academy of Sports Medicine (NASM) has been a global leader in providing evidence-based certifications and advanced credentials for health and fitness professionals. Training and conditioning professionals can earn the preferred injury prevention or sports performance training credentials of professional athletes and teams with the NASM Corrective Exercise Specialist (CES) and Performance Enhancement Specialist (PES) advanced specializations. NASM also offers access to the CES and PES credentials through two online master’s degree programs in conjunction with the academy’s higher education academic partners. The NASM education catalog features course descriptions, customer testimonials, continuing education, and athletic trainer gear.NASM800-460-6276www.nasm.org Circle No. 515

The Leverage AdvantageFitness Anywhere produces and sells Suspension Training equipment and programs to athletic trainers, clubs, athletes, the military, and fitness enthusiasts. Suspension Training body weight exercise develops strength, balance, f lexibility, and core stability simultaneously. It requires the use of the TRX Suspension Trainer, a highly portable performance training tool that leverages gravity and the user’s body weight to enable hundreds of exercises for every fitness goal.Fitness Anywhere, Inc.888-878-5348www.fitnessanywhere.com Circle No. 513

Find What You Need This is the 2010 Perform Better catalog—76 pages of selected equipment that becomes your reliable guide to functional training. The catalog is neatly divided into 18 specific categories for easy reference. Typical categories are balance and stabilization, band and tube training, body weight training, cardiovascular training, f lexibility and recovery, and much more. Items have been carefully pre-tested by the Perform Better staff for quality, function, and value. This catalog is available free upon request. Perform Better800-556-7464www.performbetter.com Circle No. 514

Many Innovations OPTP is proud to present the new Volume 24 catalog, complete with over 60 new products, including Sanctband, the SmartRoller, Treat Your Own Shoulder, and SpiderTech. The Volume 24 catalog also includes a new foot management section as well as a complete index, making it even easier to find what you need.OPTP800-367-7393www.optp.com Circle No. 517

Heat and Support Offering more than 20 patented products, PRO Orthopedic is constantly upgrading designs and materials to give you the best support possible. The four-way stretch properties of neoprene, combined with therapeutic heat retention, make neoprene so effective in controlling edema. Compression alone cannot produce the same results, and all PRO neoprene products are latex-free.PRO Orthopedic Devices, Inc.800-523-5611www.proorthopedic.comCircle No. 518

TRAINING-CONDITIONING.COM T&CMARCh2010 51

CATALOG SHOWCASE

Strong Designs Since 1976, Samson Equipment has designed, manufactured, and sold heavy-duty industrial-strength weightlifting equipment to all five branches of the military, top high schools, colleges, and professional teams, health clubs, and recreational facilities all over North America, Europe, Asia, and the Caribbean. Samson’s equipment line includes a wide variety of freeweight racks and benches as well as selectorized machines and plate-loaded equipment.Samson Equipment, Inc.800-472-6766www.samsonequipment.com Circle No. 519

Defy GravityThe AlterG Anti-Gravity Treadmill features revolutionary unweighting technology that’s reinventing rehabilitation. Recover from surgery and injury faster and with less pain, and work toward regaining function like never before. Leading hospitals and professional sports organizations use this revolutionary machine to help patients train through injury by walking on air. Go online to learn more. AlterG, Inc.510-270-5900www.alter-g.com Circle No. 520

Everything You NeedThe 35th-anniversary New York Barbells catalog is now available. Since 1974, New York Barbells has been a leading supplier of sports performance, fitness, and strength equipment. The 24-page catalog displays the company’s products from flooring to the latest biometric unilateral equipment. Call or go online to find out more.New York Barbells800-446-1833www.newyorkbarbells.com Circle No. 516

Versatile and EffectiveThe Athletix Products line from Contec is the solution for your members and staff and was specifically developed for health clubs, wellness centers, and athletic facilities. Athletix products are effective, affordable, easy to use, and safe for use on heavy-duty as well as delicate equipment. Athletix Products by Contec, Inc.800-289-5762www.athletixproducts.comCircle No. 521

Outstanding SelectionCreative Health Products offers a variety of rehabilitation products at discounted prices. Items include resistance bands, hand and finger exercisers, vinyl-coated dumbbells, thermophore heating pads, step benches, medicine balls, physioballs, goniometers, f lexibility testers, strength testers, heart rate monitors, spirometers, anthropometers, and posture and alignment grids. Creative Health Products800-742-4478www.chponline.comCircle No. 522

Goes Down Like Milk100-percent pure liquid egg whites are heat pasteurized and salmonella tested, making them liquid but not “raw.” They are double-filtered to have the smooth consistency of milk and are completely tasteless and odorless, making the perfect add-in to your protein shakes. Eight ounces will supply 26 grams of protein with no fat, two grams of carbs, 120 calories, and the essential amino acids. Egg Whites International 877-344-9448www.eggwhitesint.comCircle No. 523

Trusted for DecadesThe Thera-Band catalog features professional training, fitness, and rehab products for every lifestyle. Introduced by the Hygenic Corp. in 1978, the Thera-Band brand has gained an international reputation with athletic trainers and personal trainers for quality, proven efficacy, and leadership in research and new product development. The catalog provides product specifications plus information on the searchable database of exercises, instruction guides, research, and case studies, all available at www.thera-bandacademy.com. Performance Health800-321-2135www.thera-bandacademy.comCircle No. 524

More Than EverAward-winning equipment provider Power Systems has released its newly redesigned 2010 catalogs. The Sports Performance catalog packs 80 pages with both traditional and innovative sports training products, while the comprehensive Performance Equipment catalog has been expanded to 112 pages to offer more sports and fitness products. Power Systems800-321-6975www.power-systems.com Circle No. 525

52 T&C marCh 2010 TraINING-CONDITIONING.COm

TesTimonials

Your Body Is The Driver“Just wondering if you received my last order for four more Buddy Systems. The product is just fantastic! What a complete workout! There is nothing you can’t do with this piece of equipment. I have introduced it to my exercise science students, and they all love it. Talk about conditioning for athletes—you won’t find a better piece of equipment. From working the core to strength, stamina, and cardio, you get it all. Hats off to you for introducing a new revolution in training equipment.”

—John Krentz, Department Chair, Exercise Science,

Bay Mills Community College

“Very rarely does a product come into my training studio that is found to be highly useful by all of my trainers. The simple Lebert Stretch Strap is one of those exceptional products. My studio’s most experienced trainer mentioned several times how much he thought the Stretch Strap added to his sessions. This product is a must-have for any trainer, but especially those who train less flexible or reduced-mobility clients.”

—Product Review, PFP Magazine

“Lebert Equalizer: Twin free-standing supports, made of 28-inch-tall steel tubes with foam handle grips in the middle, allow a variety of exercises. Likes: Surprisingly effective—even for hard-core athletes. My initial skepticism over the bare-bones devices disappeared with an opportunity to do real dips, push-ups, one-legged squats, knee-raises, and weird but hard supine pull-ups. A laminated chart offers several more body-weight exercises, stretches, and even an upright row (using one support as the weight). Easy 20-minute assembly consists of screwing in eight Allen bolts; wrench included. Dislikes: None.”

—Product Review, Los Angeles Times

Lebert FitnessOlean, NY, USAMississauga, ON, Canada905-785-0626www.lebertfitness.com

“There Is No Comparison”

“In the past I’ve used several different brands of resistance bands without putting much thought into which brand I was using. But I recently started using the real Thera-Band exercise tubing with handles and new resistance loops, and I realized that there was a big difference. Sometimes you forget how superior Thera-Band is to the competition. It is worth the extra pennies to go for the real Thera-Band products. There is no comparison to the feel and quality of resistance they provide.”

—Michael Reinold, PT, DPT, SCS, ATC, CSCS, Head Athletic Trainer,

Boston Red Sox; Assistant Director, Medical Services-Coordinator of Rehabilitation

Research & Education, Massachusetts General Hospital, Department

of Orthopedic Surgery, Division of Sports Medicine

“I have used Thera-Band products for over 25 years for clinical treatment of injuries, preventative conditioning programs for athletes, and research applications. I trust and have come to rely on the consistent resistance levels and high quality of the Thera-Band product line. I greatly appreciate the considerable body of evidence that supports the clinical application of Thera-Band products, as well as the resources made available to our profession regarding evidence-based progressions and product use. I would recommend these products to any physical therapist or rehabilitation professional, especially those involved with sports medicine and performance enhancement training.”

—Todd Ellenbecker, DPT, MS, SCS, OCS, CSCS, Clinic Director, Physiotherapy

Associates Scottsdale Sports Clinic; National Director of Clinical Research,

ATP Tour

Performance Health1245 Home Ave.Akron, OH 44310800-321-2135 • Fax: 330-633-9359www.thera-band.com

“We Have Not Had One Case of MRSA So Far”

“This fall, we installed Hibiclens dispensers in all our locker room showers and provided education and instruction for our student-athletes regarding its use. We have not had one case of MRSA so far.”

—Melinda Larson, ATC,Whitworth University

“We clean all our turf burns and minor wounds with Hibiclens, and have never had one case of MRSA or any type of infection. Our athletes ask for Hibiclens because they know how widely the product is used in hospital settings. Hibiclens is our product of choice for cleaning wounds, and it is in all our med kits for the teams at all practices and games.”

—Dave Teo, ATC, Eastern Connecticut State University

“When looking for a cleaning solution for wounds and general personal hygiene, Bowdoin College instituted the daily use of Hibiclens. This efficient multi-purpose product is easy to use and fits specifically to our athletic needs. After implementation of the Hibiclens solution, Bowdoin athletics did not have a MRSA case during the fall athletic season for the first time in four years. I could not be more satisfied with Hibiclens, and I would highly recommend this antiseptic/antimicrobial solution to any athletic trainer. I would like to thank Hibiclens for this amazing product.”

—Dan Davies, Director of Athletic Training,

Bowdoin College

Molnlycke Health Care5550 Peachtree Pkwy., Ste. 500Norcross, GA 30092800-843-8497 www.hibiclens.com

..

TRAINING-CONDITIONING.COM T&CMARCh2010 53Give us five minutes and we’ll get you ahead of the game.

www.training-conditioning.com

Circle No. 132

Start your week off right with Training-Conditioning.com’s Weekly Blog series.

Can’t get enough Training & Conditioning ?

Every Monday, our award-winning authors and industry leaders post a new article profiling what’s hot in the fields of athletic training and strength and conditioning.

T&C Weekly Blogs provide a valuable resource for tracking trends and sharing industry ideas. It’s information you won’t find anywhere else.

54 T&C marCh 2010 TraINING-CONDITIONING.COm

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TESTERS TESTERS• STRENGTH TESTERS • SCALES• STETHOSCOPES • GONIOMETERS• ERGOMETERS • METRONOMES• EXERCISE BANDS • STOPWATCHES• FITNESS APPRAISAL KITS• ANTHROPOMETRIC CALIPERS• BLOOD CHEMISTRY ANALYZERS

QUALITY PRODUCTSGUARANTEED LOWEST PRICES

PROMPT FRIENDLY SERVICE

CREATIVE HEALTH PRODUCTS5148 Saddle Ridge, Plymouth MI 48170

800-742-4478WWW.CHPONLINE.COM

e-mail: sales@chponline.comAUTHORIZED SERVICE CENTER

800-287-5901WWW.POLARSERVICECENTER.COM

Circle No. 133

evenly DistributedTo reduce stress on the lower back and assist in maintaining a vertical position during aquatic workouts, strap on the Power Systems Premium Water Flotation Belt. Its contoured shape provides comfort and long-lasting support by distributing buoyancy around the torso. The flotation belt is constructed with soft, non-abrasive closed-cell EVA foam with an adjustable nylon waist belt. It’s available in small, medium, and large sizes based on weight. Power Systems, Inc.800-321-6975www.power-systems.comCircle No. 540

the choice of those Who KnowSwimEx and Woodway have partnered to create the ultimate aquatic

therapy environment. Combining the smoothest water f low and smoothest running environment brings you the ultimate in aquatic therapy. SwimEx’s unique paddlewheel technology offers the deepest, widest current to provide a better therapy environment than jet pools. SwimEx and Woodway deliver one of the industry’s most challenging running/walking workouts, making conditioning and protocol possibilities unlimited. SwimEx, Inc. • 800-877-7946www.swimex.comCircle No. 541

For extra challengeTo increase the intensity of your aquatic workouts, fasten on a pair of Premium Water Cuffs by Power Systems. Designed for versatility, these cuffs can be worn on the ankles or wrists. Simply adjust the nylon strap to the desired size and secure it with the Velcro™ closure. The cuffs are made of soft, non-abrasive closed-cell EVA foam, so they won’t chip or absorb water. One size fits most. Power Systems, Inc. • 800-321-6975www.power-systems.comCircle No. 545

anyone can FloatThe AquaJogger Pro Plus belt is ideal for athletes with minimal body fat who need maximum flotation for vertical aquatic training and rehab. This belt option is 50 percent more buoyant than the Classic model. The maximum waist size is 44 inches, but longer elastic belts are available for wider waistlines if needed. This product was specifically designed for “sinker” body types. AquaJogger • 800-922-9544www.aquajogger.comCircle No. 542

Flexible FunctionalityThe 900T offers the ultimate in f lexibility. With an overall depth of 5’6”, the 900T can be adapted with a second floor to offer another water depth anywhere from 3.5 to 4.5 feet, with or without an integrated treadmill. Patients gain the benefit of shallow workstations, an optional integrated motorized treadmill, and deep-water exercise all in the same pool. SwimEx, Inc. • 800-877-7946www.swimex.comCircle No. 544

to Better times Olympians and novice swimmers alike rely on StrechCordz to improve stroke, stamina, power, and individual medley times through in-water and dry-land training activities. Developed by NZ Manufacturing, a leader in resistance training and physical rehabilitation products, StrechCordz provide maximum function and comfort, while withstanding the rigorous demands of team, clinic, and personal use. NZ Manufacturing also engineers MediCordz and TurfCordz resistance products.NZ Mfg., LLC • 800-886-6621www.nzmfg.comCircle No. 546

TRAINING-CONDITIONING.COM T&CMARCh2010 55

product launch

athletix™ disinfectant Wipes lebert Stretch Strap™Unique features:• EPA-registered in all 50 states and the U.S. territories• Kills CA-MRSA, staph, MRSA, VRE, Influenza A2, and many other germs• Non-hazardous chemistry makes it safe for people and equipment• Free of o-phenol, alcohol, and bleach

Benefits for the user:• Because of the fast surface contact times, the trained staff members can disinfect equipment during peak usage hours.

Unique features:• Padded handles allow for a comfortable grip while reducing wrist tension• Strap is a double-loop system (much like a figure-8) that easily wraps around hands and feet for a secure and confident hold• Portable, versatile, and an exceptional value—comes complete with two straps, color poster, 55-minute instructional DVD, and carrying pouch

Benefits for the user:• A safe stretching product that will assist you in not overdoing your stretches• Will help you reach positions more comfortably that may not have been possible before, and let you hold stretches longer• Education is provided by Olympian and Master Yoga Instructor Ann Green

Lebert Fitnesswww.lebertfitness.com905-785-0626Circle No. 551

Athetlix Products by Contec, Inc.

www.athletixproducts.com864-503-8333Circle No. 550

Smartroller®

Unique features:• Patented two-in-one foam roller • Rounder side increases roller movement, while flatter side decreases movement• Ideal exercise prop for yoga, Pilates, Feldenkrais®, and more• Approximately 36” x 4”

Benefits for the user:• With the flatter side down, it can be sat or stood on for balance movements• With the rounder side down, it provides a more challenging dynamic workout

OPTPwww.optp.com800-367-7393Circle No. 553

new Biofreeze® pain relieving Wipe

Unique features:• First pain relieving wipe in the market • First high potency product in the Biofreeze line

Performance Health/Hygenic Corporationwww.biofreeze.com800-246-3733Circle No. 552

Benefits for the user:• Provides maximum intensity making it strong enough for the deepest pain• Convenience - single-use, disposable wipes are available in 24-count packs• Biofreeze® Pain Reliever is the #1 clinically used and recommended topical analgesic in the US

56 T&C marCh 2010 TraINING-CONDITIONING.COm

Directories

Advertisers Directory

Products Directory

117. . Ab coaster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

112. . AlterG. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

125. . AquaJogger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

121. . Athletix Products by contec . . . . . . . . . . . . . . . . . . . . . . . . 34

107. . Biofreeze®/Performance Health . . . . . . . . . . . . . . . . . . . . . . 8

135. . Budgetsavers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

104. . california University of Pennsylvania . . . . . . . . . . . . . . . . . . . 6

101. . cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

119. . coachesNetwork.com . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

102. . covidien . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

133. . creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . 54

111. . egg Whites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

123. . GymWipes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

128. . Hibiclens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

114. . HQ, inc. (cortemp) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

103. . Mueller sports Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

137. . Muscle Milk (cytosport) . . . . . . . . . . . . . . . . . . . . . . . . . . .Bc

120. . NAsM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

136. . New York Barbells of elmira . . . . . . . . . . . . . . . . . . . . . . . iBc

109. . oPtP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

106. . Perform Better . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

118. . Perform Better (seminars) . . . . . . . . . . . . . . . . . . . . . . . . . 27

130. . Power systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

127. . Pro orthopedic Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

129. . samson equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

100. . spidertech . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iFc

113. . swimex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

105. . the PolarPool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

131. . MrsA Prevention Posters . . . . . . . . . . . . . . . . . . . . . . . . . . 48

132. . t&c Web . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

108. . total strength and speed . . . . . . . . . . . . . . . . . . . . . . . . . . 10

122. . trX suspension training (Fitness Anywhere) . . . . . . . . . . . 36

124. . turfcordz/NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

110. . Weitz & Luxenberg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

126. . VacuMed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

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570. . Ab coaster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

582. . AccuFitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

571. . AlterG (Anti-Gravity treadmill) . . . . . . . . . . . . . . . . . . . . . . 58

520. . AlterG (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

542. . AquaJogger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

500. . Athletix Products by contec . . . . . . . . . . . . . . . . . . . . . . . . 49

521. . Athletix Products by contec (catalog) . . . . . . . . . . . . . . . . . 51

550. . Athletix Products by contec (new product) . . . . . . . . . . . . . 55

512. . cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

501. . covidien . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

580. . creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . 59

522. . creative Health Products (catalog) . . . . . . . . . . . . . . . . . . . 51

560. . egg Whites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

523. . egg Whites (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

502. . GymWipes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

561. . HeartFlex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

581. . HQ, inc. (cortemp) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

551. . Lebert Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

503. . Molnlycke Health care (Hibiclens) . . . . . . . . . . . . . . . . . . . 49

505. . Molnlycke Health care (Hibistat) . . . . . . . . . . . . . . . . . . . . 49

562. . Mueller (MAX knee strap) . . . . . . . . . . . . . . . . . . . . . . . . . 57

504. . Mueller (Whizzer) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

515. . NAsM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

516. . New York Barbells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

563. . NUcAP Medical (K-Active europe) . . . . . . . . . . . . . . . . . . 57

569. . NUcAP Medical (UsBsF partnership) . . . . . . . . . . . . . . . . 58

517. . oPtP (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

553. . oPtP (new product) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

565. . oPtP (treat Your own shoulder) . . . . . . . . . . . . . . . . . . . . 57

543. . Perform Better (Aqua Bags) . . . . . . . . . . . . . . . . . . . . . . . . 57

514. . Perform Better (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . 50

531. . Performance Health (Biofreeze®) . . . . . . . . . . . . . . . . . . . . 58

524. . Performance Health (catalog) . . . . . . . . . . . . . . . . . . . . . . . 51

564. . Performance Health (Latex-Free Bands) . . . . . . . . . . . . . . . 57

552. . Performance Health/Biofreeze® (new product) . . . . . . . . . . 55

525. . Power systems (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

540. . Power systems (Flotation Belt) . . . . . . . . . . . . . . . . . . . . . 54

545. . Power systems (Water cuffs) . . . . . . . . . . . . . . . . . . . . . . . 54

518. . Pro orthopedic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

529. . Pro-tec Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

519. . samson equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

576. . save-A-tooth® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

544. . swimex (900t) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

541. . swimex (Woodway) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

532. . the PolarPool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

513. . trX suspension training (Fitness Anywhere) . . . . . . . . . . . 50

546. . strechcordzNZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

568. . turfcordz/NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

575. . VacuMed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

TRAINING-CONDITIONING.COM T&CMARCh2010 57

MORE PRODUCTS

Goes Down Like MilkEgg Whites International’s 100-percent pure liquid egg whites are heat-pasteurized and tested for salmonella, making them “liquid” but not “raw.” They are double-filtered to achieve the smooth consistency of milk, and they’re completely tasteless and odorless for making the perfect protein drink. An eight-ounce serving supplies 26 grams of protein with no fat, no cholesterol, two grams of carbs, 120 calories, and all the essential amino acids. Egg Whites International877-EGG-WHITESwww.eggwhitesint.comCircle No. 560

Lightweight ComfortThe Mueller MAX knee strap is a lightweight and comfortable support for relieving pain associated with soreness, stiffness, and arthritis. Compression tubes target above, below, and on both sides of the knee. This lightweight and comfortable support provides targeted compression without reducing mobility. Upper and side compression tubes target misalignment and help improve patellar tracking. Breathable mesh fabric allows for an all-day comfortable fit. Mueller Sports Medicine800-356-9522www.muellersportsmed.comCircle No. 562

Crossing the OceanEurope is about to get taped in an entirely new way. NUCAp Medical, developer of SpiderTech pre-cut tape-based therapeutic supports, has partnered with K-Active Europe for the European distribution of SpiderTech products. Made from the proven Nitto-Denko tape—the original kinesiology tape from Japan—SpiderTech will be distributed through K-Active Europe’s extensive network of providers and medical product distribution groups under the brand name K-Active Tape preCut. Nucap Medical • 416-494-1444 www.nucapmedical.com Circle No. 563

Winning Resistanceprofessional sports teams and international Olympians train and condition with TurfCordz to increase speed, endurance, and flexibility through explosive start drills, footwork exercises, and simulated play action. Developed by NZ Mfg., a leader in resistance training and physical rehabilitation products, TurfCordz provide maximum function and comfort while withstanding the rigorous demands of team, clinic, and personal use. NZ Mfg. also engineers StrechCordz and MediCordz resistance products. NZ Mfg., LLC • 800-886-6621www.nzmfg.comCircle No. 568

The Name Says It AllTreat Your Own Shoulder, by Robin McKenzie, educates readers on the importance of self-management and self-treatment when shoulder problems arise. It provides a step-by-step overview of how to manage present symptoms and help prevent or minimize future problems. Informative and easy to read, Treat Your Own Shoulder provides a detailed exercise program and guidance on when to incorporate the exercises to help treat pain and stiffness. Call or go online for more information or a free catalog. OPTP • 800-367-7393www.optp.comCircle No. 565

It’s In the Bagperform Better introduces the new Aqua Bags. These bags are the ultimate tools for unstable training. Fill them with water to change the weight and instability—the fuller the bag, the heavier and more stable it will be. Less water makes them lighter but more unstable. These bags are great for all Olympic movements, as well as swings, chops, step-ups, rows, and more. Adjustable handle positions allow for more variety in your exercises. These bags are available in two sizes and can hold approximately 70 pounds of water. Perform Better • 800-556-7464www.performbetter.comCircle No. 543

Energize Your WarmupsHeartFlex strengthens the wrists, forearms, shoulders, chest, and back. Its passive resistance helps treat tendonitis. Its compactness and portability make it convenient for warm-ups, maximizing physical performance and assisting in preventing cold muscle injuries. HeartFlex • 800-920-8118www.heartflex.com North Coast Medical • 800-821-9319 www.ncmedical.comCircle No. 561

Same Performance, No LatexIntroducing Thera-Band Latex-Free professional Resistance Bands, a latex-free alternative that matches the performance of the Thera-Band latex bands trusted for 30 years. The new formula delivers identical performance to latex and is scent- and powder-free. Latex-Free professional Resistance Bands are provided in the established Thera-Band colors and resistances of yellow/thin, red/medium, green/heavy, blue/extra heavy, and black/special heavy, making them easy to identify and integrate into your practice. Performance Health • 800-321-2135 www.thera-band.comCircle No. 564

Great Ideas, Great Value

58 T&C marCh 2010 TraINING-CONDITIONING.COm

MORE PRODUCTS

Perfect FormThe commercial-strength line of Ab Coaster exercise equipment provides a challenging core workout for athletes at every level. Winner of the FIBO Global Innovation Award for 2008, the Ab Coaster features a patented curved track design that allows the user to perform a lower abdominal lift in perfect form. The Ab Coaster is currently being used in over 3,000 health clubs around the world, as well as by universities, professional sports teams, and the U.S. military.The Ab Coaster Co.866-219-5335www.abcoasterclub.com Circle No. 570

Space-Age TechnologyThe AlterG Anti-Gravity Treadmill is reinventing rehabilitation by advancing recovery from injuries and surgery. It is the only unweighting fitness equipment developed by NASA and tested by Nike’s Oregon Research Project. It is the first FDA-cleared medical device of its kind. Athletes can enhance performance and reduce the frequency of injury by using the AlterG. Leading professional sports teams, athletes, and fitness programs use the AlterG as part of their training regimen. AlterG510-270-5900www.alter-g.comCircle No. 571

Exciting New SponsorshipThe U.S. Bobsled and Skeleton Federation (USBSF) has announced a new two-year partnership with NUCAP Medical, maker of SpiderTech kinesiology and therapeutic tape. It is the first major foray into winter sports for SpiderTech. “We are proud to be the newest sponsor of U.S. Bobsled and Skeleton. They are one of the top U.S. teams heading into the Vancouver Games, a team that is competition-tough, and we love to see our products on the world’s best athletes,” says Bill Payne, NUCAP’s Vice President of Marketing. NuCAp Medical416-494-1444www.nucapmedical.comCircle No. 569

A New OptionThe Biofreeze Pain Relieving Wipe is the first pain-relieving wipe in the market, and the first high-potency product in the Biofreeze line. The high potency is obtained through an integrated cooling technology and

provides maximum intensity, making it strong enough for the deepest pain. These single-use disposable wipes are available in 24-count packs. Biofreeze is the number-one clinically used and recommended topical analgesic in the U.S. performance Health800-321-2135 www.biofreeze.comCircle No. 531

No Plumbing RequiredThe PolarPool™ cryotherapy spa offers cold water therapy, hot water therapy, and saltwater therapy—all in one. It’s completely portable, so you can provide athletes with state-of-the-art treatment and pain relief without installing new plumbing or redesigning your entire facility. Users can sit or kneel in the pool, and the purification and sanitization systems keep the water clean while the solid-state cooling system maintains the temperature you want. The polarpool617-480-7683www.thepolarpool.comCircle No. 532

Great Way to TestHow high? How fast? How far? How often? If you want the answers to these questions about your athletes, you’ll want to try the Electronic Jump Mat, a high-precision contact device for biometric cinematic tests. The tests include six evaluation groups including velocity, frequency and fatigue, and provide real-time training feedback. In addition, you can couple multiple mats for distance and speed and compare test results of single or multiple athletes. Includes PC software. VacuMed800-235-3333www.vacumed.comCircle No. 575

Because Time MattersWithout proper care, a knocked-out tooth begins to die in 15 minutes. The Save-A-Tooth emergency tooth preserving system utilizes Hank’s Balanced Salt Solution (HBSS) to not only preserve, but also reconstitute many of the degenerated cells. The patented basket and net container are designed to protect tooth root cells. This is the only system that keeps tooth cells alive for up to 24 hours. Save-A-Tooth®888-788-6684 www.save-a-tooth.com Circle No. 576

TRAINING-CONDITIONING.COM T&CMARCh2010 59

ATHLETE MONITORING

Monitor EverythingSince 1976, Creative Health Products has been a leading discount supplier of rehabilitation, fitness, exercise, and athletic equipment, as well as health, medical, and fitness testing and measuring products, all available at reduced prices. Creative Health Products offers heart rate monitors; blood pressure testers; pulse oximeters; body fat calipers; scales; strength testers; flexibility testers; stethoscopes; pedometers; exercise bikes; ergometers; stopwatches; fitness books and software; exercise bands; step benches; hand and finger exercisers; heating pads; and more. Creative Health Products, Inc. 800-742-4478 www.chponline.comCircle No. 580

Accuracy Matters“Compared with rectal temperature (the criterion standard), gastrointestinal temperature was the only measurement that accurately assessed core body temperature. Oral, axillary, aural, temporal, and field forehead temperatures were significantly different from rectal temperature and therefore

are considered invalid for assessing hyperthermia in individuals exercising outdoors in the heat,” says an article in the Journal of Athletic Training from 2007. The CorTemp wireless monitoring system, featuring the CorTemp ingestible temperature pill, is FDA-registered and has been used by sports professionals for over 22 years. HQ , Inc. • 941-723-4197www.hqinc.netCircle No. 581

Weight Monitoring Made EasyMeasure, track, and chart body fat with the Accu-Measure Personal Body Fat Tester, or FatTrack Gold Digital Body Fat Caliper and Body Tracker software. Calipers are compact, portable, and accurate, making them perfect for athletic trainers. Enter results into the Body Tracker software to track and chart them over time for each athlete, and upload photos for visual progress comparisons. AccuFitness offers outstanding tools for training and conditioning professionals. AccuFitness • 800-866-2727www.accufitness.comCircle No. 582

Circle No. 135

60 T&C marCh 2010 TraINING-CONDITIONING.COm

Case study

A leader in functional exercise equip-ment for athletic training and physi-cal therapy, efi Sports Medicine has announced the results of a groundbreak-ing rehabilitation study using the Total Gym, efi’s f lagship body weight resistance training apparatus. The study, recently published in the North American Journal of Sports Physical Therapy (NAJSPT), was conducted by researchers at San Diego State University (SDSU) and the University of Toledo’s Health Science Campus, who found that Total Gym could be used to accurately measure the func-tional status of patients recovering from lower-extremity injuries. Few options exist for rehabilitation specialists to precisely measure lower-extremity performance in individuals with restricted weight-bearing ability. In the past, rehab specialists had to conduct manual muscle tests to determine strength and functional performance in a patient’s lower extremities (hip, knee, foot, or ankle) in order to bear full weight without aid, which is often an inaccurate measure. The study’s lead investigator, Daniel Cipriani, PhD, PT, an associate professor at SDSU, saw the need for a more reliable partial weight-bearing (PWB) test to track patient progress earlier in the rehabilitation process. He helped develop a consistent tool to measure leg strength using Total Gym. A total of 37 adult patients recovering from an injury and/or surgery to the ankle, knee, or hip were recruited from orthopaedic surgery and physical therapy clinics in San Diego, Calif., and Toledo, Ohio. All patients were tested using the Total Gym PWB performance tests, which included the number of one-legged

squat repetitions a patient could do in 30 seconds and the time needed to complete 20 squat repetitions on one leg—all at an incline level that used 55 percent of the individual’s body weight as resistance. Patients also went through timed ascending/descending stair tests, walking speed tests, and single-leg hop tests. “Measuring leg performance on Total Gym provides meaningful information about the current functional status of a patient earlier in the rehabilitation and recovery process,” says Cipriani. “The Total Gym tests were able to reliably detect change in patient status, such as functional improvement, or whether a patient exhibited no change or loss of performance.” The research found a significant connection between how many repetitions a patient could do on the Total Gym and how fast that patient could walk and climb stairs. After four to six weeks, patients returned for follow-up testing and those who showed improvement in the Total Gym performance tests also showed improvement in their stair-climbing ability and walking speed. “Total Gym has evolved from solely an exercise apparatus for rehab patients to now a measurement tool to provide valid information about a patient’s progress toward full weight-bearing function,” explains Cipriani. “The research proves that the partial weight-bearing tests on Total Gym were responsive to the positive changes in patients’ progress.” In addition, Cipriani noted that patients were very receptive to the Total Gym tests, whereas “stair climbing and hop tests could cause anxiety or fear.” The Total Gym tests allow patients to “really give their best effort” without fear of falling or injury. In addition, the potential benefits for safely training the deconditioned population—such as individuals 55 years of age and older—are significant. To view an abstract of the original research, visit: www.spts.org/_Assets/Media/Uploads/files/Public/CiprianiAbstract.pdf.

Total Gym/efi Sports Medicine7755 Arjons DriveSan Diego, CA 92126-4366800-541-4900Fax: 858-764-0018www.totalgym.com

Revolutionary Rehab Study Reveals Most Reliable Measure of Post-Rehab Functional Performance

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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 & Courses” to take the quiz online. You may also mail your quiz to us: Fill in the circle on the answer form (on page 63) that represents the best answer for each of the questions below. Complete the form at the bottom of page 63, include a $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 20.2 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850. Readers who correctly answer 70 percent of the questions will be notified of their earned credit by mail within 30 days.

Bulletin Board (pages 5-7)Objective: Learn about recent research, current issues, and news items of interest to athletic trainers and other sports medicine professionals.

1. California is currently one of only three states in the U.S. without:a) Licensure for ATCsb) State subsidies for first-aid carec) A law requiring AEDs in schoolsd) Mandatory medical training for high school coaches

2. A recent editorial in the British Journal of Sports Medicine warns athletes against overuse of:a) Creatineb) Human growth hormonec) Non-steroidal anti-inflammatory drugs (NSAIDs)d) Whey protein

3. Prolonged NSAID ingestion has been linked to:a) Delayed healing of ligaments, muscles, and tendonsb) Increased risk for diabetesc) Increased risk for hemolysisd) Hypertrophic cardiomyopathy

4. A recent paper from the University of Colorado suggests that high-impact exercise is no better for bone health than:a) A sedentary lifestyleb) Calcium supplementation with no physical activityc) Low- or non-impact exercised) Isometric exercise

5. A new anti-gravity treadmill is based on a prototype developed by:a) NOAAb) NORADc) USA Hockeyd) NASA

No Meat, No Problem (pages 17-23)Objective: Learn about the nuances of vegetarian and vegan diets and how to advise non-meat-eating athletes on optimizing their nutritional intake.

6. Vegetarians tend to consume larger quantities of healthy plant-based compounds called:a) Omega-3 fatty acidsb) Phytochemicalsc) Retiariid) Free radicals

7. Of all categories of vegetarians, ______ are at highest risk for vitamin, mineral, and protein deficiencies.a) Pesco-vegetariansb) Fruitariansc) Flexitariansd) Lacto-vegetarians

8. Vegetarians who eat fish and other seafood often self-identify as:a) Veganb) Pesco-vegetarianc) Fruitariand) Ovo-lacto-vegetarian

9. The American Dietetic Association advises vegetarians to eat roughly ______ more protein than meat eaters.a) 10 percentb) 30 percentc) 40 percentd) 50 percent

10. Soy products are some of the only plant-based foods that have all the essential:a) Complex carbohydratesb) Flavonoidsc) Antioxidantsd) Amino acids

11. The form of iron found in plants is called:a) Biotrophic ironb) Heme ironc) Non-heme irond) Hydrolyzed iron

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Baring Their Soles (pages 25-28)Objective: Understand the theory behind barefoot training and how performing exercises in bare feet can provide significant benefits for athletes.

12. Kinematic data suggests that the big toe requires ______ of extension to allow for normal forward motion.a) 10 degreesb) 15 degreesc) 20 degreesd) 30 degrees

13. At Northeastern University, athletes with excessively ______ are excluded from barefoot training.a) Long toesb) Short femursc) Flat feetd) High arches

14. Athletes with ______ should be especially cautious in barefoot training because of their increased tendency to develop foot ulcers.a) Immune deficienciesb) Influenzac) High archesd) Diabetes

15. Since implementing barefoot training in 2007, the author has noticed a significant drop in athletes’:a) Quad-hamstring imbalancesb) Ankle sprainsc) Shin splintsd) ACL injuries

Watch the Face! (pages 31-34)Objective: Learn about the full range of facial injuries that can occur in athletics and how to provide immediate and longer-term care and treatment.

16. The author advises against using the “home remedy” of applying ______ to facial wounds to prevent scarring.a) Vitamin Eb) Vitamin Bc) Vitamin Dd) Vitamin C

17. The slide and slam phenomenon describes trauma occurring at the:a) Orbital cavityb) Nasal septumc) Temple-mandible jointd) Lower forehead

18. Hematoma auris is better known as:a) A black eyeb) Caulif lower earc) Swimmer’s eard) Malocclusion

19. Fractures around the orbital cavity can cause double vision, also called:a) Enophthalmosb) Strabismusc) Pseudostrabismusd) Diplopia

20. Each tooth is connected to the skull by a collection of fibers known as the:a) Dentinb) Enamelc) Periodontal ligamentd) Mandibular fossa

Holding Court (pages 41-45)Objective: Follow the training program used by the women’s volleyball program at the University of Minnesota and learn how the team meets specific conditioning goals.

21. In mobility and f lexibility training, the Minnesota volleyball program focuses mainly on the ankles, hips, and:a) Elbowsb) Thoracic spinec) Neckd) Wrists

22. The author’s program for ankle mobilization aims to improve range of motion, especially dorsif lexion in the:a) Sagittal planeb) Transverse planec) Calf musclesd) Coronal plane

23. Volleyball players typically spend a lot of time with their ______ in a shortened position.a) Trapeziusb) Sartoriusc) Anterior cruciate ligamentsd) Hip f lexors

24. The author has observed that many athletes with shoulder issues also have a corresponding problem with the opposite:a) Ankleb) Kneec) Elbowd) Hip

25. Plyometric work that involves high nervous system activation is know as:a) Fast-twitchb) Verticalc) Shock-leveld) Integrated

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Web Exclusives

Q&A with Aaron NelsonTalk to any veteran NBA player, and he’ll tell you that the fountain of youth does exist—in the Phoenix Suns athletic training room. But in reality, those healing and career-resurrecting powers can be attributed to cutting edge techniques practiced by Aaron Nelson, MS, ATC-L, PES, CES, CSCS, the team’s Head Athletic Trainer. One of the most respected voices in his field, Nelson’s views on life in the NBA and his approach to corrective exercise are a must-read.

Next Stop: Web SiteOur editorial continues on www.Training-Conditioning.comHere’s a sampling of what’s posted right now:

Phoenix Suns Head Athletic Trainer Aaron Nelson wraps forward Amar’e Stoudemire’s left wrist. We profiled Nelson, last season’s NBA Athletic Trainers Association Athletic Trainer of the Year, in a recent Monthly Feature online.

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Creating Value in Your WorkplaceIn an industry where supply far exceeds demand, those who have a job as a strength coach are extremely fortunate. Read what Rich Jacobs, MS, SCCC, CSCS, Assistant Strength & Conditioning Coach at Xavier University, has to say about acquiring and keeping a strength coaching position in this tough and competitive economic environment.

Elements of MotivationAt Wayzata (Minn.) High School, Head Strength and Condition-ing Coach Ryan Johnson has cultivated program-wide pride among all of the school’s athletic teams. By simplifying its training approach and actively recruiting new participants, Wayzata has turned its off-season training program into “the place to be.”

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