Healthy Athlete Seminar August 17th- Free Information session

For a decade now I’ve seen players from all over the DMV lose part of their soccer development, burn-out, and education from injuries that simply rob them of their youthful health.  A part of our model for success at ASA is that the players are learning and feeling as one part of a team effort to better themselves.  

 

Our progressive injury prevention mindset at ASA wants our community to avoid the harsh reality of overuse and non-contact injuries in youth sports.

  • Each year 1.5 million kids suffer a serious sports related injuries

  • The new norm is that a 14 year old athlete knows a peer that has torn his/her knee ligament (ACL)

  • Overuse injuries are damaging more children than concussions, which puts them at risk for arthritis in their 20’s.

  • To learn more please see this 60 minutes Sports clip https://youtu.be/XXsxnUa56z8

 

I believe that the majority of non-contact injuries are avoidable.  And so far, myself and the team at ASA have placed resources and energy into making ASA the outlier for the ‘norm’ of American youth sports injury rates.

 

We cannot achieve this goal without our community being aware of the risks and adopting a healthy lifestyle.  Please join myself and Dr. Miranda Wall for a seminar on developing a healthy athlete on a budget.  This is for long-term growth and success in youth sports.

 

When: August 17th 7-8:15pm

Who: Parents and players

Where: Lee Center

 

Clips from 2016’s seminar can be seen here

https://www.youtube.com/channel/UCc9isfiyzyi4niyoaEPZynA

 

 

How & When to Use Active Stretches

What are active stretches?

It is an advanced form of flexibility training.  This form is different from static passive and dynamic stretching.  Placing an outstretched leg on a chair and using the bodyweight to bring about a stretch is an example of static passive stretching.  Active stretches includes a component of active muscle contraction called an isometric. An isometric contraction occurs when tension is created in the muscle group without a change in its length.  These active stretches have two parts.  The first is an isometric contraction and a subsequent light stretch.

Here is the 4 minute routine

Best time to use this routine:
1. Morning of a game or training session
2. As a cool-down
3. Evening before bed

Why not old school ‘static stretches’?
This type of stretching is what a lot of parents and coaches were taught. Presently, the science has evolved and we now know that this type of stretching is ineffective for warm-ups and may not increase flexibility at all!

 

One habit that could prevent injury- post game/session cool-down-

The ASA active stretch sequence is designed to target movements that are vulnerable to overuse that could cause injury to the lower extremities.  It just makes sense to help these areas recover after stressing them.

For the travel soccer player each day brings a new opportunity to improve and adapt.  To ensure that the player is able to take advantage of this they should be focused on helping their muscles and brain recover from periods of  physiological and school stress.  A fine line exists between expected fatigue and chronic fatigue. That line is quietly crossed when bad habits like an unbalanced diet or lack of sleep and high loads of soccer occur consistently.  The active stretch sequence can help halt a deleterious cycle.

HuffPo says "Stop Stretching Your Hamstrings"

I've seen it more than once; a client meets with me with measurable discomfort and/or significant injury because they were pushed and stretched excessively in a yoga setting. 

Injuries* that my clients have reported that yoga was a causative factor:

  • muscle tear (hamstring)
  • aggravate bulging disc
  • strained back (not able to stand up right)
  • hip and sacral ligament injury

The HuffPo article, mentioned and attached below, offers a very reasonable explanation as to why stretching hamstrings to relieve tightness is an antiquated myth.  That reason being that the hamstrings do not exist in isolation.  An anatomical explanation is that hamstrings (like all other muscle groups) need an appropriate amount of tension to function properly.  When they do not operate with an appropriate amount of tension motions may feel tight and restricted.  Similar to how a rope or belt needs tension to fulfill it's duties, the muscles operate on a feedback system of tension generation (strength) to know which are fulfilling their skeletal and movement duties.

What would prevent someone from being able to touch their toes or move into a yoga forward fold?  

  • strength imbalance of abdominals and hip flexors
  • strength imbalance of the lower back extensors
  • strength imbalances of the knee extensors and flexors (quads and hamstrings)
  • strength imbalances of the plantar and dorsiflexors (calves and shins)

So this information doesn't change the fact that you feel tight during;/before/after your chosen activities; soccer, yoga, running, weight lifting, cross-fit, boot camp, lacrosse, etc. You aren't alone.   Step one, change the current approach.

There are several modalities that will add value to flexibility training. Simply changing one's yoga practice is an example.  The new practice approach would be to negate the risk of injury that comes with stretching too much by actively contracting the involved muscles when transitioning and holding poses.  This would be to only move into positions that are executed with full control.  

The more specific approach to complete exercise safety is exploring what positions could potentially degrade or improve the muscular system.  Remember the big idea with exercise and preparing for competition/sport is eliciting positive change, not injury.  If you'd like more tailored advice or need help resolving a specific issue, book a free  consultation with me.

So please stop stretching your poor hamstrings and remember that the nervous system controls tension in the hamstrings and stretching them to make them ‘longer’ is an antiquated myth, not grounded in any anatomical reality.
— Michelle Edwards for Huffington Post

Doing this simple exercise can help prevent injury in the ankles and knees

Single Leg Banded (RDL)

How to use this exercise: 

  1. Each repetition should be guided by the bullet points in the video. Control of motion is a very important goal for knee strength gains.  This should be accounted for with slow and thoughtful repetitions. 
  2. For injury prevention and no pain present- perform twice a week for 10-15 repetitions with Core Basics (video) and the balancing lunge from the video  (0:15) (2 min of lunges). Repeat entire sequence three times. 
  3. For injury concern with tightness and discomfort present- perform this exercise barefoot following Active Stretch sequence (video).  

 

Why does this help? 

A player can potentially achieve multiple effects from including this exercise into their in-season program. They include:

  • Improved strength symmetry- dominant to non-dominant leg
  • More strength where soccer players critically need it- ankles, feet, and hamstrings
  • This exercise could be extra helpful for balance and foot strength if it is performed barefoot.
  • Improved control of knee motion
  • Increased lower back flexibility
  • Decrease injury risk in regards to awareness of knee function and lowering overuse of muscles around the knee. 

It's very easy to take the ankles and knees for granted.  They withstand a lot of stress and are under a lot of pressure when sprinting and decelerating on the soccer field.  By focusing on small daily activities and details, athletes can learn how they become stronger and faster while protecting themselves in these vulnerable joints.  

The best players cannot rely on talent alone.  The total package is leadership, strong, good decision-makers, agile, relentless in their effort, and less likely to injure.  To achieve physical durability and be less likely to injure add this 15 minute routine two times into the weekly routine. 


Equipment: 

Red Mummy Band

http://a.co/9ZOsY6V

Carabiner (Optional) to anchor the band appropriately

Research Findings: Stress fractures and Nutrition are Indicators for a Season Ending Injury

As a parent of a female athlete there are inherent risks that we should discuss. In fact, a longitudinal study identified High School girls soccer as the sport with the second highest rate of knee injury behind football (Sports Med 2014). Of the 186,000 soccer injuries reported in 2006, 80% were under the age of 24 and 44% of those were in kids younger than 15 (Journal of American Pediatrics 2010).

 

Recent findings in the American Journal of Sports Medicine have also reported on injury rates for females.  Specifically, season ending injuries related to female nutrition and bone density.  The study tracked 239 female athletes at Stanford.  This resulted in a risk stratification that can help identify injury risk based on points, 0 for no risk and 6 for high risk.  The biggest red flag seems to be low calorie intake for female athletes.

 

During the study period, 25 of the 239 athletes suffered a bone stress injury within an average of about a year – and, as predicted, the moderate-risk athletes were twice as likely to suffer an injury, and the high-risk athletes were four times as likely.

 

Study available online

 

Risk Factors:

 

- Low energy availability or loss in body weight: past disordered eating (1) or current disordered eating (2)

- Low Body Mass Index (BMI): 1 point for 17.6 to 18.4, 2 points for below 17.5 (for reference my own BMI is 25)

- Irregular periods: 1 point for 6 to 9 periods in the last 12 months, 2 points for 6 or less periods

- Delayed menarche: 1 point for between 15 and 16 years of age, 2 points for older than 16 years old

- Low bone mineral density (medical test)

- Previous stress fractures: 1 point for one fracture, 2 points for two or more

 

Why is this important for our ASA players

Our injury prevention screenings and baselines are conducted at the start of our soccer year for both boys' and girls' ages U13 and up. Our philosophy is that using baseline assessments and measurements is the first and most important step in keeping our kids safe and continually improving in the ASA curriculum.

The use-ability of this information is dependent upon cooperation, communication, and identifying clusters of injury over a season.  As an ASA parent we want you to stay aware of injury prevention key factors and communicate your injury concerns effectively.

 

Building resistance to injury is key!

One thing is for certain, all injuries have a single common denominator- injuries occur when the athlete cannot absorb the forces from the contact of the ground, the ball, or another player. All of these things will be more likely if the muscles and bones are weak and dehydrated from a lack of nutrients.

 

If you have concerns about your athlete's fuel and food intake:

 

- Contact Jenn to get set up with nutritional information or consultation

- Practice healthy habits like planning what kind of protein to consume.

- A post training or workout smoothie is a fun and smart habit to start immediately.

If you have concerns about past or present stress fractures, I urge you to have an injury prevention consultation and take a look at other underlying factors of stress fractures such as shoes and nutrition.

 

Holistic approach to stress fractures

The commonly overlooked muscle group for soccer strength and durability

 

Soccer players talk a lot about their hamstrings and hip flexibility. When in reality the muscles in the ankles and calves are working the hardest during the motions of soccer. In other words, the ankles and feet are completely taken for granted in our sport. 

During a match the player will only touch the ball 2-3% of its entirety.  When I start team fitness sessions I remind the players that the physical side of the game makes up about 98% of the 90 minutes (running, sprinting, speed, and endurance).  Therefore this is where most of the athletes fuel is used.  If the muscles are better at performing all of those functions, the more fuel can be used for decisions and executing decisions, hence the stronger player can also be the smartest player.

Going forward you will want to do these 3 things to ensure you are doing right by the muscles that serve a lot of purpose in all aspects of the physical game:

1. Purchase cleats that work with the shape of the foot

2. Perform isometric bodyweight exercises for the foot muscles

3. Perform resistance based exercises for the ankles

 

I'm biased towards this view.  Well, because the experience of strengthening and rehabilitating my feet and ankles has insurmountably influenced my broken knees in a positive way  (both of my ACL ligaments are torn).  I've also worked closely on a cleat design for injury prevention. I see potential in strengthening the feet and avoiding overuse in these areas. 

 

So I'm not the only one who sees the importance of these strong machines. Here's the research that helps my plea for more respect for our glorious muscles below the knee.

 

Keep in mind this is a glimpse into running mechanics and how important the feet are and that soccer is a running heavy sport*.

 

  • The best runners in the world have a short amount of time that the foot is on the ground (contact time). This means their ankle and foot muscles in particular are very good at absorbing shock and energy. If they were not efficient in this way the foot would stay in contact with the ground longer to perform this function (longer contact time).
  • Those findings are related to a 2013 study that tested a similar group of 'best in the world' runners. These finding were that the same type of runners were very good and efficient at hopping. This was in in comparison to other running groups.
  • This brings us to the muscles that out perform others in hopping and ground contact time.  They are called 'ankle extensors'. We know them as calves.
  • The calf muscles (ankle extensions) out work the quadriceps (knee extensors) in sprinting and walking.  Where the quadriceps take over in a jog or run. 

 

The conclusion is that the muscles below the knees work much harder and more frequently then the bigger ones above the knee. To be the strongest and most durable player we have to think about it from the ground up.

 

Our next video series will feature isometric and resistance based exercises for the feet and ankles.

 

Link to a comprehensive guide of soccer ankle injuries

 

* The intricacies of ball movement and how the feet help engineer those motions is too complicated for this blog but read more about that here.

 References 

Kulmala, Juha-Pekka, Marko T. Korhonen, Luca Ruggiero, Sami Kuitunen, Harri Suominen, Ari Heinonen, Aki Mikkola, and Janne Avela. "Walking and Running Require Greater Effort from the Ankle than the Knee Extensor Muscles." Medicine & Science in Sports & Exercise 48.11 (2016): 2181-189. American College of Sports Medicine. Web.

 

Sano, K., Ishikawa, M., Nobue, A., Danno, Y., Akiyama, M., Oda, T, Ito, A., Hoffren, M., Nicol, C., Locatelli, E., Komi PV. "Muscle-tendon interaction and EMG profiles of world class endurance runners during hopping." European Journal of Applied Physiology 113.6 (2016): 395-403. EPub.web

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Concussion Prevention By Dr. Miranda Wall DC, MS

In addition to wearing adequate equipment and taking proper safety precautions, it is important to take other proactive measures to prevent head injuries and decrease the chance of lasting damage. These measures include maintaining proper biomechanical  alignment and providing your body with adequate nutrients to repair everyday micro trauma.

Chiropractic care:

Chiropractic care will help ensure proper spinal alignment and biomechanics, enabling your spine and head’s shock absorbing mechanisms to dissipate any forces of impact more effectively. This results in less damage directly following a head injury.  An athlete with a healthy spine and nervous system is much more likely to bounce back from injuries and head trauma quickly, with little to no loss in play time and a much lower chance of lasting damage.

Nutritional Care:

Proper nutrition is vital to injury prevention and recovery as well as overall performance.

  • EPA and DHA: These are essential omega-3 fatty acids found in fish, algae/sea vegetables, flaxseed, and fortified egg and dairy products. They increase fluidity of cell membranes, reduce inflammation and enhance blood flow to the brain. 

  • Zinc: A mineral necessary for optimal brain function. Deficiency of this mineral may compound oxidative damage from concussions. Some pre-clinical studies suggest that zinc supplementation may increase resilience to traumatic brain injury, making it potentially useful in populations at risk for injury.  (The Upper Limit for zinc is 40 mg per day.)

  • Protein:  Aim to consume 1 – 1.5 grams of protein per kg body weight per day for muscle repair and growth.

  • Curcumin: a phytochemical found in turmeric. There have been many animal studies showing positive results both before and after a concussion occurs.

  • Fruits high in antioxidants and vitamin C such as berries and citrus fruits

  • Avoid: Fried and processed foods, sugar, caffeine, alcohol, artificial colors and flavors

Miranda can be found at

The Chiropractic Associates ● 1240 North Pitt St. Alexandria VA 22302 ● www.chiroassoc.net