Thursday, July 22, 2010

16 Key Points About Sports Injuries

Yesterday, I attended a Sports Injury seminar sponsored by PESI Healthcare. It was given by Justin Stanek, Ed. D., ATC who is from the Midwest working predominately with youth athletes. I was the only personal trainer in attendance. Of the 45 attendees, a majority were physical therapists and a few nurses. Here are some bullet points that I took away from the presentation, along with some observations:

1.) Of any assessment performed, the client HISTORY is the most important. Knowing the background of a client is essential when mapping out a process to get them where they need to go. For trainers, I came up with some important things to know about a client before starting with them:
- have they worked out before?
- have they worked with a trainer before?
- what types of movements or activities elicit your pain? (if they express pain history)
- what has prevented them from achieving the goals in the past?
- what types of activities or exercises do they like and dislike?

Each question serves a purpose. It gives you, as the trainer, an idea of what type of individual you are working with and what their "success rate" will be.

2.) A systematic evaluation of the kinetic chain still rules. If you don't know your anatomy, you will not get through this.

3.) Concussions can be suffered anywhere. Don't think they are limited to only a football field or court. With the popularity of high intense workouts, if a client faints and their head hits the pavement, weight tree, or bench---you need to know the signs of a concussion..)

4.) Tight hip flexors are still the root of many lumbo-pelvic problems. As society continues to become seated-dominate, the need for a corrective flexibility program is paramount.

5.) With both spondylolysis and spondylolisthesis, a core strengthening and stabilization program is in order.

6.) F.A.B.E.R. (Flexion, Abduction, External Rotation) is a test that may identify sacroiliac joint dysfunction. It is really easy to administer and can tell you if your client will be subject to lower back stress.



7.) "Muscle guarding" is real. Most clients that are tight in certain areas or have surgically repaired sites will "guard" against certain movements--especially during passive stretching. I experience this alot with new clients when we stretch for the first  time. It is part a protective mechanism and part a trust issue.

8.) The pirifomis muscle is a bitch. When a new client approaches you with "sciatica" issues; start with the piriformis muscle and go from there.

9.) The physical therapy world is  alot like the personal training industry. There are some good ones and some bad ones. There are some that attend continuing education to simply get the credits and they don't "soak" any of the material. They live on an island onto themselves. This reminds me of some trainers that don't like to think outside the box and learn new concepts.

10.) Alot of talk on tendonitis and tenosynoitis and not much mention of tendonosis (degeneration of the tendon). What most people don't understand is by the time they actually see the doctor for treatment, the injury has moved into the 'tendonosis' phase. However, most doctors still diagnose injuries as tendonitis (which usually occurs for about 24-72 hours after the event).

11.) While stretching a client, watching the facial expressions is a better sign of tolerance levels, than asking them. Learn to watch for wincing, grimacing, and face changes.

12.) The painful arch usually associated with subacromial impingement is typically painless between 120-180 degrees and 0-45 degrees. Why? Scapular rotation is the main culprit.


The painless zones are attributed more to glenoohumeral ROM. Its when you get into the scapular plane that pain is present. All the more reason to address scapular stability. That means serratus anterior and low trapezius work. 

13.) Many people that sit at computers all day suffer from thoracic outlet syndrome and don't even know it. Why? They dismiss hand numbness as "no big deal" because it comes and goes.

14.) 1/3 of people can lead normal lives without an ACL; 1/3 can alter lives and be happy without ACL reconstruction; and 1/3 fall or give-way regularly and need ACL reconstruction surgery.

15.) With all the ACL talk in the room, no one mentioned glute medius work. When I spoke aloud about the work I do on the GM to my female clients,  the room was astonished. Really??

16.) Its amazing how chronic pains disappear once someone loses excess weight.

1 comment:

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