While working a volleyball tournament this weekend I am reminded of how common ankle injuries are in these athletes. The most common mechanism for suffering a sprain is when an athlete lands on an opponents foot coming down from a jump. This mainly happens around net play.
There have been a couple of studies looking at ways to decrease ankle injuries and they fall into a couple of strategies: ankle strengthening, preventative bracing and coaching to change the approach and stop landing across the net. The good news is that all 3 effectively decrease rates of injuries. The take home message is that there are plenty of ways to decrease ankle injuries in volleyball. Work on balancing daily to strengthen the muscles that stabilize the ankle and wear a brace of you feel you need the extra support.
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If you train high school athletes this will get you thinking about your value to the high school athlete. I can understand both perspectives for the personal coach and team coach. At the end of the day, it is about what is the most beneficial for the student athlete.
I have had the pleasure of working with quite a few high school athletes and teams over the years and I have seen the good and the bad. I have seen coaches who did not understand athletics training athletes inappropriately (in my opinion) and I have seen coaches poorly condition and prepare their athletes (in my opinion). I have also had overzealous parents who thought that this is what their athlete needed, when in fact that athlete needed a rest and not to train 7 days a week. Any good coach or trainer will take the time to talk with the athlete about their goals, understand their personal and training history and observe their movements. I agree that a lot of schools utilize a cookie cutter strength program that is not appropriate for every member of the team. Whoever is running the program needs to understand human movement, and athletics in general, as well as how to assess a movement and progressions/regressions. Tossing a player into a poorly organized and controlled program is a recipe for poor results. If a personal coach is able to work with athletes and improve their form, movement, strength and speed then they have a role. But, let’s also keep this in perspective, great athletes will be great athletes regardless of who they train with. The main thing is to keep them healthy and gradually progress them. Too often these athletes are pushed farther and farther because of their raw athleticism and the basic patterns are ignored. In this instance, the training is inappropriate, regardless of who is in charge of it. Is there a place for the personal coach, I think so. As long as they keep the long term health and goals of the player in mind when developing a program to maximize their performance and decrease their injury risk. http://www.athleticbusiness.com/high-school/personal-trainers-for-prep-athletes-is-there-value-br.html?eid=277204494&bid=1156965 I saw an athlete today complaining of ongoing hamstring tightness and strains that I have seen in the past. Based on the exam I noticed he had very tight hamstrings and restricted movement. He also displayed a quad dominant squat pattern with patellofemoral overload and some instability with single leg squats.
Based on his presentation we discussed a multi faceted program to improve his mobility and decrease his constant strains. We started doing 1 leg drops for movement and stability ball curls for hip and hamstring strength. We reviewed squatting and single leg squatting to engage his glute muscles to alleviate knee pain and we perform multi directional lunges for hip mobility. As an added bonus we worked on planks to strengthen his core and ensure that he can maintain adequate alignment. Since his hamstring is the main link between the pelvis and lower body it is easy to get tight and strained. In order to combat this we need to build a strong stable base for the pelvis and core muscles. When these are stronger the hamstring his not under the same amount of tension trying to provide stability. We will recheck his progress but this program should improve his strength and improve his motion leading to less recurrent strains. You can see the quad dominant start in the picture below Most States have concussion management programs in place, but they focus on high school athletes. This has left some confusion for non athletes or younger students who suffer a concussion. There is nothing special about the management of concussion for athletes or non athletes. It is rest until symptom free with a graded return to activity. The majority of students recover in 7-10 days and do not require any school accommodations.
The challenge is in handling the outliers. What to do with the ones that don't get better. We know that girls take longer to heal than boys and that younger students take longer than older students. We do not know definitively why this is the case, but there is some speculation. If any individual sustains a head impact and a concussion is suspected it should be evaluated by a qualified medical professional. If they are taking longer to heal then accommodations for school may be suggested. This can be in the form of half days, limited homework and testing, the use of a tutor or physical changes like lower light and decreased computer screen use. All of these can be put in place by the school, but should be overseen by the physician. I don't think that anything different needs to be done to handle concussions across the board, but more education and policy development may be needed so that everyone understands what to do. http://www.athleticbusiness.com/civil-actions/legislation-would-toughen-concussion-law.html?eid=277204494&bid=1290676 The NFL released their concussion data and reported a 58% increase in the number of concussions sustained this football season. There was also an increase in the number of head to head collisions that led to a concussion. While it is good that athletes are being screened and picked up at a higher level, it is concerning that rule changes to limit head to head contact do not seem to working as of yet. The new standard in youth football is to teach heads up contact. This means that athletes look at their opponent, engage their neck muscles and use their chest and shoulders to initiate contact. This tackling style has led to a decreased incidence of concussion in youth athletes. I think this focus on tackling is fantastic and I am hoping that it changes how athletes tackle when moving up their playing career. I am concerned, however, that professionals are not modeling proper tackling behavior. If professionals do not use proper technique, how can we expect younger athletes to do so? When they watch their idols playing every weekend and using their head to make contact how can we tell them on Monday that they did it wrong? For concussion education and tackling technique to make an impact it has to be both a top down and bottom up approach. The rules need to be upheld and proper technique needs to be stressed in order for substantial change to occur. I fear that if we don't stress the importance of technique at every level that we will continue to see head to head contacts and concussion rates that don't change over time. http://www.athleticbusiness.com/athlete-safety/nfl-report-concussions-spiked-in-2015.html?eid=277204494&bid=1297447 |
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January 2024
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