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Core Management

Core Management. From Weightroom to the Playing Field. Back Pain. Many athletes will be sidelined every year due to back pain Our jobs are to help get the players healthy and back on the field Not all MRI diagnosed back injuries are symptomatic

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Core Management

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  1. Core Management From Weightroom to the Playing Field

  2. Back Pain • Many athletes will be sidelined every year due to back pain • Our jobs are to help get the players healthy and back on the field • Not all MRI diagnosed back injuries are symptomatic • A 1994 study in the New England Journal of Medicine looked at 98 asymptomatic backs, 82% showed some abnormality under imaging • All the more reason to be proactive

  3. Relationship Between Athletic Training Staff and Strength and Conditioning Coaches • Communication needs to be a two way street • Respect for each others area of expertise and share information • Meet regularly • Always thinks what’s best for the athlete

  4. Where Do We Start? • Athlete has to be cleared by the medical staff • Identify what the limitations are • Ex. No axial loading • Formulate a plan together • Figure out what will be done in the training room vs the weight room

  5. What Do We Look At ? • Overall Posture • Movement pattern deficiencies • Where do they bend • How do they move • “athletic stance” • Daily Habits • 23/1 rule

  6. What Do We See? • Anterior tilt of pelvis • Forward rounded shoulders • Short tight hip flexors • Lengthened and weak abdominals (especially the rectus abdominus and external oblique) • Excessive hypertrophy of low back muscles

  7. What Else? • Inactive glutes • Substitute extension action of glutes with extension of the lumbar region of the spine • Constant feeling of hamstrings being “tight”

  8. What Now? • Check mobility at hip, ankle, and thoracic spine • Check ability to stabilize torso • Low back extensor endurance is a great predictor of LBP “The most successful rehab programs appear to emphasize trunk stabilization through exercise with at neutral spine while stressing mobility at the hips” Ultimate Back Fitness and Health, p.38 • Keep our strength as we work back to playing

  9. Mobility • Joint by joint approach • If pain is present often times look at the joint above and below and see if there is a deficiency of movement • In regards to the low back specifically check thoracic spine and hips. • Thoracic often rounded with lack of extension, limiting in OH movements • Hips tight in all motions and in particular internal rotation • Ankles also play a role • Soft tissue work (ex. foam roll)

  10. Role of the Abdominal Muscles • “The most important aspect of abdominal muscle performance is obtaining the control that is necessary to: • (1) appropriately stabilize the spine • (2) maintain optimal alignment and movement relationships between the pelvis and spine, and • (3) prevent excessive stress and compensatory motions of the pelvis during movements of the extremities.” Diagnosis and Treatment of Movement Impairment Syndromes, p.69.

  11. Thoughts on Strengthening the Torso • Everyone wants to develop “core” strength • Too many crunches and other floor based flexion exercises • Pulls rib cage down and reinforces rounded posture • Care about the “six-pack” more than function • Hollowing vs bracing • Both have their benefits • Movements have to be coached, just like all other exercises

  12. Stabilization • Many athletes lack the ability to hold and maintain proper posture during movement • Categorizing of stabilization exercises helps in designing balanced training • Anti-Flexion • Anti-Extension • Anti-Rotation

  13. Anti-Flexion Stabilization • Squat and deadlift variations provide a good amount • Not much need for direct work for healthy individuals

  14. Anti-Extension Stabilization • Anterior abdominal strength • Prone bridge variations • Can add unstable surface or perturbations • Progress to OH Med Ball Work • Even OH pressing

  15. Bridging

  16. Beginner Roll-out

  17. Ab Wheel

  18. Rings

  19. Anti-Rotation Stabilization • Becoming more popular • Very important for rotational athletes • Often times marked side-side differences • Side Bridges • Press, lift, chop variations all incorporate entire body • Work on stability first. Then progress to MB tosses

  20. Anti-Rot cont.

  21. Keeping the Strength Up • Athletes work hard for strength gains in the weight room we want to make sure they hold on to it. • Strength can be held on to and even improved during times of rehabilitation • Start light and progress slow with most exercises • Continue to incorporate activation/corrective exercises, easy to add into warm-up • Continue to find was to challenge the athlete

  22. Single Leg Is The Way To Go • Many benefits to performing single leg movements • Much of our time in sport is spent on one leg • Much easier to maintain a neutral spine even under load - less likely to go into flexion • Improved abductor control and strength • Greater relative intensity to the movement

  23. Single Leg Examples • Lunges fwd/bkwd/lat/walking • Step-ups fwd/lat • Combination lunge to step-up • Split squat variations • Pistol Squats • 1-leg RDL’s

  24. One Of My Favorites

  25. Getting Back Under the Bar • Hard to keep athletes from wanting to get back to squatting • Once again start light and progress slow • When/If ready to start squatting, begin with DB’s then BB front squats • Safety Squat Bar is another great tool in the weight room • Sometimes better tolerated than front squats

  26. Other Ways To Train Lower Body • Belt Squats • Sled Pulls/Pushes • Band Squat and Lunge variations • Great for stability • Vertimax • Great for power development

  27. Upper Body Considerations • Bench press • Start with BB • Provides more stability throughout the movement • Avoid having to pick up DB’s off the floor • Place plates under the feet, or switch to Incline Bench Press • Switch to floor press if need be to help keep back pressed flat to floor

  28. Upper Body Cont. • Don’t forget about push-ups • Great closed-chain exercise that requires you to stabilize torso • Inverted rows • Challenges mid-section to stabilize • Train the lats • Attaches to a large number of vertebrae • Add in unilateral work in both presses and rows

  29. Athletic Movement • Mobility, Stabilization, and Strength are all important, but athletes also need to learn how to move better in order to stay healthy • Starts from the ground up • Balance over the mid-foot • Body has to move together • Sport coaches have to do their part

  30. Just Because

  31. Thank You • GLATA • Columbia University Sports Medicine • All the great people I’ve the pleasure to work with in the past • All of you for listening to me • Mrh2125@columbia.edu

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