Tennis is an asymmetric sport with specific muscle-activation patterns, especially eccentrically in the supraspinatus, infraspinatus, and teres minor during the complex and rapid serving motion. In particular, the external rotators are highly loaded eccentrically during the deceleration phase by resisting shoulder internal rotation first, then sharing the deceleration of horizontal adduction at the glenohumeral joint with the rest of the body. A high percentage of athletes will have infraspinatus atrophy without apparent clinical significance. The external rotation strength deficits, whilst apparently not affecting tennis performance, has been reported as a risk factor for shoulder pain (Clarsen et al, 2014).
Clarsen, B., Bahr, R., Andersson, S. H., Munk, R., & Myklebust, G. (2014). Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study. Br J Sports Med, 48(17), 1327. bjsm.bmj.com/content/48/17/1327.abstract
Our current and future generations are losing the ability to think without technology. There's a generalisation - I hate generalisations (I also understand the contradiction I just made). It seems if you want to begin a discussion, you need to start with a generalisation, then say it depends, of course. So, Our current and future generations are losing the ability to think without technology, except the ones who aren't. I'm seeing fewer of those in some parts of the world and more in others.
Let me give you an example: A young girl is at a boarding school. She must hand in her phone each night. She's caught with a second phone. The process of removing the second phone leaves her distraught. She's had a phone since she was six years old. Without a phone, literally, her brain works differently in a way she has anxiety about. What is her life experience without her phone? What language must she now use to communicate to the outside world if not in characters expressed through her fingertips? What are her memories that provide her with context about past decisions, or the development of values, attitudes and value of time? What is her ancestral program of beliefs if not those given her by her phone and internet connection?
Since our outputs are the sum of processing of our inputs, what will her outputs be like when she can not rely on her phone and internet connection to process? How will she handle inputs from a sensory world that isn't restricted to that coming from her phone?
I've come across many remarkable children in the current generation who stand out because they can....wait for it....look at you, smile, hold a conversation, listen and consider and reply accordingly. I would have thought that was a relatively normal occurrence in previous generations. I've come across exceptional clinicians and coaches with the same competency to think critically - it's exciting. And then there are those reliant on decision making based on what they can glean after referencing their phone...Trump-like.
I'm wondering whether there'll be a correlation with devolution of human intelligence as a stand-alone from technology, an evolution of human intelligence inseparable from technology or a revolution to excel with human critical thinking to make best use of technology. If you're in a position of service to a young generation - what are we up to, these days, Generation Alpha? - then think of this... who amongst them operates amongst others without their technology, and if you spot them, don't they stand out? Do you see how ridiculous that is? That standing up on your own two brains is the new standing out?
In Roman times, the populace was contained with entertainment in the great Colosseum. Since then, sport does the same. Be not a slave to it, though. The easier way to suppress critical thinking is to provide entertainment to the masses instantaneously, or drama, to have them unable to function properly until their next fix.....think gambling advertisement, Married At First Sight advertisements, The Bachelor advertisements....that is the de-volution of human intelligence as a stand-alone from technology and standards of critical thinking.
The teaching of courses in some parts of the world are challenging because without phones, students are unable to function. They take less in while recording on their phone (in case they ever want to watch or listen later, which they never do). If you insist that phones are put away, anxiety sets in and they take less in. And then we are back to the concept of education - from the latin, to educe, to bring out. It has been said by many, "Tell me and I'll forget. Show me and I may remember. Involve me and I learn."
Technology can involve people, no doubt. It is indeed telling and showing. I wonder, like anything, whether it can take over ones ability to think for yourself, to experience the great physical world we live in and I'm sure as hell it can't help you speak to someone in a normal way - 90% of the impression someone has of you occurs with your first words. It shouldn't be, "ok, google".
The "she'll be right" attitude that is necessary in survival circumstances does not belong in the first 6 weeks after joint injury. Let's get science-y on you. Fancy losing your cartilage FOREVER after a joint swelling when you ignore sound clinical care and guidelines? If you don't value your cartilage, ignore the following advice.
Here's the gist:
Should a person have a swelling in a joint, it is expected that the joint cartilage will NOT tolerate the same load as that experienced when they got injured, for at least 6 weeks. IF.....IF the person has another swelling, be very very careful, because if you have a 3rd setback within 6 weeks, expect an irreversible loss of articular cartilage. That's right - you will never again get joint cartilage to repair. Now you're set for osteoarthritis,
Pivotal research in rabbit articular cartilage has shown that synovitis induces a 20% loss of proteoglycans within 24 hours, and 30-60% within 5-7 days (Lowther and Gillard, 1976). The chondrocytes replaced the proteoglycans within 42 days, unless visible erosion was present and unless two repeat stimulus-led inflammations occurred, at which point chondrocytes were seen to be dead (Carmichael et al, 1977), visible erosion exists (Gillard and Lowther, 1976) and unable to replace lost proteoglycans (Lowther and Gillard, 1976; Carmichael et al, 1977). This is accompanied by a general decrease in metabolism in articular cartilage following an inflammatory response (Byers et al, 1985).
Lowther, D. A., & Gillard, G. C. (1976). Carrageenin-induced arthritis. I. The effect of intraarticular carrageenin on the chemical composition of articular cartilage. Arthritis Rheum, 19(4), 769-776.
Carmichael, D. J., Gillard, G. C., Lowther, D. A., Handley, C. J., & Santer, V. B. (1977). Carrageenin-induced arthritis. IV. Rate changes in cartilage matrix proteoglycan synthesis. Arthritis Rheum, 20(3), 834-840.
Gillard, G. C., & Lowther, D. A. (1976). Carrageenin-induced arthritis. II. Effect of intraarticular injection of carrageenin on the synthesis of proteoglycan in articular cartilage. Arthritis Rheum, 19(5), 918-922.
Byers, S., Handley, C. J., Lowther, D. A., & Sriratana, A. (1985). Carrageenin-induced arthritis. VI. Alterations in amino acid transport by articular cartilage in acute inflammatory arthritis. Ann Rheum Dis, 44(7), 477-484.
"significantly increased sustained attention"
"significantly lower cortisol level after training"
"significant decrease in negative affect after intervention"
Those are the summarised findings of an eight-week training program of diaphragmatic breathing, where participants were taught to breathe at 4 breaths/minute. Quite a drop from the typical adult who breathes at 12 breaths/minute.
Here's a link to the article.
And to kick start you to learn diaphragmatic breathing, try this facilitated breathing and facilitated breathing 2.
And here is Gray Cook's take on breathing.
The use of a movement-based assessment model can help identify weak links affecting overall function.
The inter-rater reliability depends on training. Intra-and inter-rater reliability of categorical scoring and criterion checklist scoring of the ten fundamental movements of the SFMA was higher in raters with greater experience.
Goshtigian, G. R., & Swanson, B. T. (2016). Using the Selective Functional Movement Assessment and Regional Interdependence Theory to Guide Treatment of an Athlete with Back Pain: A Case Report. Int J Sports Phys Ther, 11(4), 575-595.
Glaws, K. R., Juneau, C. M., Becker, L. C., Di Stasi, S. L., & Hewett, T. E. (2014). Intra- and inter-rater reliability of the selective functional movement assessment (sfma). Int J Sports Phys Ther, 9(2), 195-207.
Busch, A. M., Clifton, D. R., Onate, J. A., Ramsey, V. K., & Cromartie, F. (2017). RELATIONSHIP OF PRESEASON MOVEMENT SCREENS WITH OVERUSE SYMPTOMS IN COLLEGIATE BASEBALL PLAYERS. Int J Sports Phys Ther, 12(6), 960-966.
Riebel, M., Crowell, M., Dolbeer, J., Szymanek, E., & Goss, D. (2017). CORRELATION OF SELF-REPORTED OUTCOME MEASURES AND THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT (SFMA): AN EXPLORATION OF VALIDITY. Int J Sports Phys Ther, 12(6), 931-947.
Your corrective exercises shouldn't be done for repetitions, but with attention and intention to correct the fault - which could take 2 reps (the first being outside acceptable, the next being acceptable).
Repeating it after that is conditioning.
I put it to you that if you correct a movement, rather than continue to condition in that position/pattern combination, progress to a higher position with the same pattern, until you're performing the pattern in standing. Along the way, load can be used to help the pattern or stimulate it to be better.
Once your pattern is acceptable in standing, adding load to resist the pattern begins the conditioning process.
Doing it any other way is borrowing movement from somewhere else to finish a pattern.
The stickler for being acceptable is three-fold:
For safety reasons.
For efficiency reasons.
To improve the chance of success of completing the pattern.
Here's an example:
Overhead reaching is dysfunctional.
Lower body rolling from prone to supine is dysfunctional on the first rep because the person leaves the eyes facing the floor and head facing the floor. The second rep is corrected (the eyes turn to the side of the arm reaching, and the neck remains rotated throughout, then movement is smooth and easy. A Cook band can provide compression to stimulate stability elsewhere.
Instead of doing reps, progress to quadruped and pattern reach forward, side and then reach back to include thoracic extension/rotation. Then progress to tall or half-kneeling lifts. Then split standing or bilateral stance lifts, add resistance tubing and then med-ball for conditioning.
The 3 'ions
Attention first, then intention, will get you extension.
Attention requires healthy senses, including mechanoreceptors - this is where being healthy and having minimum mobility is important. It also requires intrinsic feedback in response to augmented feedback.
Intention requires task-focus, external cueing, and knowledge of the result, looped with augmented feedback and intrinsic feedback to provide reflection on whether to adjust for the next rep.
Extension means growth.
A decision that turns you can ruin a moment, or worse. So how do you make a higher % decision?
I ask the 8 year old Greg.
I look down to my left where he stands beside me. He goes everywhere with me, you see. I hold his hand often, sometimes not. He has no one better to guide him but the adult Greg. He also makes better decisions than most, including me at times, except for the decisions based on information only the adult Greg could know.
Do I trust this person? What does 8yo Greg think? He gives me a nod. He's a good judge of character. He has a sensational bullshit sense - always has.
Do I take the leap on this venture? What does 8yo Greg think? He says no way - absolutely not interested. Boring, just doesn't give any spark of what's interesting. He remembers when we spent time with thoroughbreds - such an energy. Such spirit and nature. That's what we measure interest on.
If you're not convinced, check out this video of how to speak to your 10 year old version of yourself.
Exceptional results start with one realisation.... you become what you think about.
Now, say that to yourself, and add a compliment. For example, "you become what you think about, Genius".
At 4.12 seconds, Christian Coleman's 40 yard dash beats Bo Jackson's claimed 4.13 seconds.
But could he break 4 seconds?
Coleman takes 20 steps to finish his 40 yard run. In this video, you'll see, and read, how the leaks in energy storage may be lengthening his ground contact time, which may be slowing him down.
For those performance coaches, sports physiotherapists and sports chiropractors looking for an exciting challenge, Beijing Yanding company are receiving CV's to consider for work in sport in preparation for multiple upcoming events, including Tokyo Olympics.
See the attached pdf's for more information, including a contact email at the bottom of the pdf named by_pt_ad_-23jan18.pdf.
Looking to get more out of your sessions with clients?
Harnessing the power of the brain is one way to look at what we can do.
Here's a snippet from the Mobility and Stability for Performance Course in Taipei this weekend.
"To change behaviour, first get your client's attention. This will break their current pattern and improve sensory environment. This is one role of mobility interventions (via improved mechanoreceptor sensititivity). Then, create circumstances and challenges to stimulate the sensory environment, towards an external focus. This is done with tasks, auditory cueing, visual cueing, somatosensory (tactile) cueing and play. Use “best practice” feedback and use “best practice” dosage for regaining motor control (different for best practice dosage for improving capacity)."
The type of feedback is important. Let's look at that.
Intrinsic feedback relates to how a person feels. It draws attention to their kinematic performance. For example, when the client performs better, correctly, ask them how that feels or what it looks like to them. Use their words for how it feels. Instruct them to repeat the movement to get that feeling again.
Augmented feedback (that which comes from the instructor) has the goal to change behaviour by alerting the individual to the closeness to the correct result. This gives them knowledge of the result.
The correctness of the result is within the topic of performance bandwidth. The keen eye of the professional uses the process of training movement to look for mistakes that are outside the realm of acceptable. This should be a “performance bandwidth” based on performance parameters of population and task specificity (where they exist) or safety ranges. A movement that has a mistake deemed undesirable or unacceptable is one that reduces the efficiency of the movement; lessens the chance of success; or increases the risk of injury.
Combining intrinsic and augmented feedback is about giving the individual knowledge of the result as well as knowledge of the intrinsic performance. On it's own, knowing about intrinsic performance is not as effective as knowing about intrinsic performance and knowing about the result, or magnitude and direction of error from the correct result.
Augmented intrinsic awareness should occur when the person performs correctly, or more correctly compared to a previous repetition. This gives them knowledge of their kinematic performance as well as knowledge of the result.
Augmented feedback has the goal of learning - to change behaviour - to improve understanding, by the client, of how "their feeling" (intrinsic feedback) relates to performance in the "test" situations. When the client performs better, correctly, ask them how that feels or what it looks like to them. Use their words for how it feels. Instruct them to repeat the movement to get that feeling again.
When an error exceeds a tolerance for being correct, it is outside the bandwidth and should be corrected. By providing a bandwidth with tolerance, retention of learning is improved. It reduces the amount of corrective feedback and balances out corrective feedback to positive comments. Bandwidth feedback limits feedback only to "significant" errors.
In: Chapter 5, Schmidt, R.A. and T.D. Lee, Motor control and learning : a behavioral emphasis. 3rd ed. 1999, Champaign, IL: Human Kinetics. xvi, 495 p.
Coming up next....the importance of timing your feedback.
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