Monday, March 11, 2013

Can Movement Assessment Predict Potential For Injury and Performance?

Over the course of the last 10 years, there have been some tremendous strides and advancements in technology. Many of these technologies have had a direct impact on athletics and coaching, especially in the last 5 years. With advances in motion capturing technology, like DartfishTM  , coaches now have the ability to film and take very quick and complex movements, and break them down frame by frame. This provides them with the ability to take a movement or a technique that may take seconds to complete and critically analyze it millisecond by millisecond to see where they can have the most impact. For many coaches, this has opened their eyes to ways they can be more effective and efficient in directing their intervention with the athlete. For now, they are able to see things they may not have captured before. This new knowledge has resulted in improving, not only their knowledge of the movement, but has improved their effectiveness as a coach.

However, this technology also aids the athlete that is being coached. Many times, when attempting to teach athletes complex movements, having the ability for them to “see” how they are moving and how they are supposed to move is “key” to improving the technique and motion. As a result of this technology and the impact it can have on effectiveness of coaching as well as the athlete’s ability to change motor patterns to improve technique, many organizations are implementing this as a regular part of their tool kit. Currently, this technology is being used in professional baseball, tennis and hockey, just to name a few. The US Olympic Teams have been using this same technology for over 10 years and it is an integral part of their working with their athletes.

Knowing the impact this can have on coaching and performance improvement is there a place for this technology in screening of professional athletes, Olympic athletes and tactile athletes (SEALs, SWAT, est.)? Are there certain movements that we can assess, outside the complex sport specific movements themselves, which can give us an indication of potential for injury? Are there certain movements, if improved, would result in improved athletic performance, even in higher end athletes?

Over the last decade, there has been a plethora of research that shows a strong correlation with “pathokinematics” (abnormal movement patterns) and increased risk for injury in high impact sports. These same pathokinematics present in a predictable pattern and can be assessed with certain movements. Yet, quantifying them in a meaningful way has always been difficult. However, with the use of video technologies, it is allowing clinicians to accurately quantify movement and more importantly to use that knowledge gained to improve movement. Knowing pathokinematics are more pronounced with fatigue, some researchers have even begun combining these technologies to capture and quantify movement post fatigue.

One such study being currently performed by the American Sports Medicine Institute (ASMI) is showing dramatic results. In this study, researchers are using technology and a movement assessment to identify those athletes at risk. Using the information that is gained from the movement assessment, the team developed a corrective exercise program that improves improved their performance these tests. Over the 2 year period, this has resulted in 100% reduction of non-contact ACL injuries, 58% reduction on non-contact musculoskeletal injuries and over a $200K health care savings. Based on these preliminary results, we know improving these movement patterns has been shown to not only reduce the risk for lower extremity injury but also to have a significant impact on individual and team athletic performance.

Taking a high level athlete and using video technology to assess their movement in a closed kinetic chain may reveal deficits that were previously unknown.  For a sprinting athlete, using technology as a screening tool allows us to “see” where her deficits are with movements which are representative of how she moves in sport. Using this knowledge, we can then develop strategies to prevent injuries and aid in making a great athlete a superior athlete. In this instance, improvements in these pathokinematics would equate to better power output and increased sprint speed. In a sport where rankings are determined in milliseconds, this can make a huge impact on rankings and performance.

In professional athletics, this more even more critical. In a profession where decisions are based on the last performance and player’s salaries are defined in the millions, last thing you want is to make the wrong decision on a player. The more information you have about an individual player can make the difference from playing in the championships and the team being the national champions. In tactile athletes, this can mean the difference between life and death. When using movement and technology as a screening tool with these individuals, one can have a more complete picture of what the individual will look like post fatigue, a time at which performance and injury prevention are critical.


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