Thursday, May 25, 2017

Is There A Secret Sauce?

Let me start by saying, there is no secret sauce.  In this next series of blogs we will be providing you with what we would consider some unique methodology behind what we do.  Is it rocket science?  No.  We have simply taken what the research has told us for the last 12 years and applied it in a very unique way.  Over the course of the last 5 years, we have been blessed to perform movement assessments on over 5,000 athletes.  As such, you tend to see patterns or trends for what is normal and abnormal.  You tend to get a clear indication for what works and what does not work.  That is what this series of blogs will consist of.
Over the course of the next 5 weeks, we will provide some insight in the following areas:
1.      Impact of verbal instruction and video on movement assessment and outcomes
2.      How to integrate knowledge of fatigue research in correcting lateral shift
3.      How to determine weak link in the system
4.      Importance of multiple single limb tests to determine symmetry
5.       Gradients of gluteus medius weakness and how to assess and correct
So, let’s start with the first one.  I call this one “You Talk Too Much”.  When it comes to assessing movement, one of the biggest mistakes we make is over instructing athletes in movement.  What we want to capture is what is the athlete’s natural motion versus the movement that we tell them we want to see.  Natural motion is more reflexive (CPG driven) in nature versus motion which brings in a lot of higher center (cerebellum and PMC) input. 
You ever wonder why when you ask someone to squat and you describe that motion that we end up with this really funky movement.  Yet, if you put a chair behind them and ask them to sit down, they do a perfect squat.  Why is that?  In the first movement, the individual has to process what you are saying, create a motor plan (in the primary motor cortex), perform the movement, get feedback (via proprioceptors and mechanoreceptors) compare the actual to intended (via cerebellum) adjust (create new motor plan in primary motor cortex) and execute.  That is a lot of thought process.  When we put a chair behind the athlete and have them sit down, this becomes more reflexive in nature which is primarily a spinal driven (via central pattern generator).  What we are trying to assess is the athlete’s natural motion or reflexive motion.  To do this, it requires less higher center input.  So how do we do that?
Simple, don’t talk too much.  Whenever movement assessment you do, you will get more of a reflexive motion if you keep your verbal instruction to a minimum.  The easiest way to do this is demonstration.  Now, giving visual demonstration can influence an athlete’s motion but not near the same degree as if you give instruction.  What is another way that people influence an athlete’s natural motion?  Facial expression.  I will guarantee you, if you have not thought about it, then you are not controlling it and somehow influencing their natural motion.  Take the following example.  Let’s say you are doing a movement assessment on the following female DI athlete.  Every time she steps up on the step, you make the following face.  What is going to be the response of the athlete?  They will either stop and ask you “What?”.  Or they will make adjustments to their movement based on your expression.  Now this is an over dramatized point, but you get the idea because it does happen and it will influence natural motion. 
We called this post, you talk too much for another reason.  If you are doing movement assessment on a young high school freshman versus a movement assessment on an elite DI athlete, there is a psychology that you must overcome with the athlete.  This is especially true when you are pointing out deficits in their motion that leads to potential injury risk and performance issues.  If you are saying I see this or I see that there is an automatic arrogance that you have to overcome in most athletes.  The higher the level of the athlete you are dealing with the more likely you are to deal with it.  In their mind, they are saying, yeah right do you know who I am and who are you to tell me I have this or I have that.  As we all know, it is vital that we build confidence in the athlete!  Without that, compliance with what we ask them to do is greatly reduce and hence the outcome will be less than desirable.  So how do you overcome this?
Simple, video.  When you provide video of an athlete and specifically video of their worst movement, you are not saying I see this or I see that you simply say….This is how you move.  So, whether it is an elite athlete, the star athlete or just a young athlete, for them visually seeing how they are moving gives you instant credibility and them instant buy in to what you are telling them.  That said, a word of caution.  NEVER underestimate the psychological impact that the visual presentation of their movement to them can have on them.  It can be devastating so exercise caution!
We hope that you found this blog insightful and useful.  Next week we will discuss how you integrate the fatigue literature into correcting a lateral shift.  As we stated previously, stay tuned and if you like what you see, SHARE THE PASSION!  It is the biggest compliment you can give.  Follow us on Twitter @ACL_prevention and tweet about it.  #ACLPlayItSafe and help us spread the passion.

Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment.  He is the developer of an athletic biomechanical analysis, is an author of a college textbook on this subject  and has performed >5000 athletic movement assessments.  He serves as the National Director of Sports Medicine Innovation for Select Medical, is Chairman of Medical Services for the International Obstacle Racing Federation and associate editor of the International Journal of Athletic Therapy and Training. 

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