Evidence Based Sports Medicine
This week’s Blog is about Sports Medicine for injury treatment, prevention and performance enhancement.
The information presented is based on the National Academy of Sports Medicine’s (NASM) Corrective Exercise model (CEX) that has been used successfully by professional teams, such as the Phoenix Suns.
Musculoskeletal dysfunction and injuries are epidemic
Foot and Ankle Injuries
- Plantar fasciitis accounts for more than 1 million doctor visits yearly
- Ankle injuries are reported as the most common sports-related injury and commonly result in chronic ankle instability
- Individuals commonly experience hip weakness after an ankle injury, which can lead to low back and knee problems
- Affects nearly 80% of adults and 6-15% of athletes
- 60% of work-related injuries
- Common in jobs where people sit for prolonged periods
- Annual medical costs in the US are greater than $26 billion
- 80 000-100 000 anterior cruciate ligament injuries occur annually (70-75% of which are non-contact, i.e. related to poor mechanics, not trauma)
- ACL injuries commonly result in arthritis
- Shoulder pain occurs in up to 21% of the general population with 40% persisting for greater than one year
- Shoulder impingement accounts for 40-65% of injuries
- Shoulder injuries make up annual costs estimated at $39 million
- Altered shoulder mechanics can be the primary cause of degenerative changes
The current model to address sports injuries, prevention and performance tends to be short-sighted in that the focus is generally on acute injury management (i.e. at the site of the injury), rather than addressing the faulty biomechanics that may have perpetuated the problem.
In addition, conditioning is not designed to address the functional capacity of each individual, with most conditioning routines emphasizing single plane movements rather than incorporating all planes of motions.
Further, the focus is on concentric muscle contractions (shortening), while ignoring the eccentric (lengthening) and isometric (stabilizing) components.
Lastly, the emphasis is often on machines that isolate VS performing functional movements such as the squat and lunge can lead to muscle imbalances and faulty movement patterns.
- Identify dysfunction through a movement screen
- Design a program tailored to the individuals deficiencies
- Implement a plan consisting of corrective exercise and therapy
Human movement science is the study of how the Human Movement System (muscles, joints and nerves) function interdependently. A movement screen is a series of movements designed to evaluate joint motion, muscle length, tension and strength and the nervous system’s ability to coordinate synergistic movements known as force-couples.
An effective corrective program needs to be based on an assessment. The assessment identifies:
- Overactive shortened muscles that need to be inhibited and lengthened
- Underactive lengthened muscles that need to be strengthened
- Specific areas of joint dysfunction
- Abnormal movements that need to be re-educated
It is important to recognize that each person will have unique dysfunctions. One size does not fit all when it comes to injury treatment, prevention and performance enhancement.
Evidence based Corrective Exercise Plan- CEX
Solving musculoskeletal problems requires a systematic plan. This evidence based plan should consist of:
- 1. Inhibitory techniques used to release tension and decrease activity of overactive muscles, e.g. foam roller.
- 2. Lengthening techniques used to increase extensibility, length and range of motion, e.g. static stretching.
- 3. Activation techniques used to reeducate or increase activation of underactive muscles. e.g. isolated strengthening exercises.
- 4. Integration techniques used to retrain muscles, joints and the nervous system through synergistic functional progressive movements.
Do you have recurrent injuries and/or want to enhance your performance?