Category Archives: Sports Performance

The Dreaded Hamstring Strain

How many times are we going to see an athlete suffer from recurrent hamstring strains? How many times are we going to see delayed recovery from a mild hamstring pull? Unfortunately, it’s going to continue, because some health and wellness specialists (ATCs, PTs, and Strength coaches) are looking in the wrong area. Sometime ago I had a disagreement with the parent of an athlete (the parent also happened to be a chiropractor).

The parent was upset that I was not fixing the hamstring in rehabilitation. He said, ‘She needs flexibility and strengthening of the hamstring! You are not doing that!’ The concerned parent actually complained to my athletic director. Now I have my boss challenging me on my treatment.  Ugh, such is the life of an Athletic Trainer. Thankfully, after conversation, he backed me up.

Now, before I swarmed by an angry mobs of chiropractors trying to beat me with sticks, this is not about chiropractors – this is just one example of the trap that many health care practitioners – Athletic Trainers, PTs, OTs, RKTs, DC, MD, LMTs, etc – fall in to.  Many practitioners are too concerned with ‘the what‘ rather than ‘the how‘ and ‘the why‘.

This particular parent was upset and did not understand why I was not addressing the what. In my defense, I was dedicating some time to fixing the what – using ultrasound, massage, PROM, etc – to facilitate proper tissue healing. However, I knew this would not fix the problem. In this particular instance (and most hamstring injuries) I needed to correct human movement dysfunction (poor neuromuscular recruitment, suboptimal arthrokinematics, and altered length-tension relationships). This will fix the problem and go a long way in prevention of re-injury. Flexibility and strengthening of the hamstring is not needed.

Don’t get me wrong, flexibility is a good thing, but hamstring flexibility is way overrated. Take yoga as an example, yoga is  known for improving flexibility (among other things). In fact, I’ve prescribed yoga to many of my clients. Unfortunately, many yoga poses place the already lengthened hamstrings under further stretch. Hamstring strains are very common in Yoga enthusiasts, especially amateurs. It is so common, it was given a name – Yoga Butt. Yoga butt is essentially a tear of the proximal hamstrings, subsequent to repetitive lengthening of the hamstrings.   There is a reason for this.

Secondary, to pattern overload or prolonged static posturing many individuals suffer from chronic hypertonicity and mechanical shortening of the psoas.  A chronically tight psoas will cause altered reciprocal inhibition of its functional antagonist, the gluteus maximus. With this muscle imbalance an abnormal force coupling occurs yielding poor arthrokinematics in the form of an anterior pelvic tilt. Because of the hamstring’s proximal attachment to the ischial tuberosity an anterior pelvic tilt will cause the hamstring to migrate superiorly and posteriorly, essentially lengthening the muscle. If you recall from your applied kinesiology course, muscles have optimal length tension relationships – a zone where maximal muscle force can be produced. The longer or shorter a muscle is, the less the muscular force can be applied or tolerated.

In addition to this, with the glute inactivity caused by altered reciprocal inhibition. So now a synergistic muscle must help with glutes ability to perform hip extension. Which muscle is going to this? You guessed it – the hamstring.  This is called synergistic dominance – the hamstring (synergist) must dominate the movement of hip extension.

If you recall from above, the hamstrings are working in a lengthened and suboptimal position. Coupled with this it is being asked to do more work. So, when we are applying the greatest amount of muscular tension – eccentric contraction near end ROM (such as sprinting) – the hamstring fails. Commonly it fails near the proximal attachment secondary to a line of pull change.

Why do we see so many hamstring injuries? Because health and wellness professionals are not identifying or intervening to correct human movement dysfunctional patterns.

Why do we see so many recurrent hamstring injuries? Because we are not fixing what needs to be fixed and allowing the hamstring to work inefficiently.

Why are we seeing delayed recovery? Because we are using antiquated rehabilitation techniques. We are focusing on the hamstring when the problem exists elsewhere.

Correcting movement dysfunction and optimizing function will fix the problem. This is so much easier in the long run. Recently there has been a slew of research published discussing the effectiveness of high-intensity eccentric hamstring strengthening on the prevention and rehabilitation of hamstring injuries. Yes, eccentric hamstring exercises work, but why? They work because you are making the hamstring more tolerable and able to function with poor mechanics. Again, this is not fixing the problem. To fix the problem you must address glute weakness and hip flexor tonicity.

Want to Improve Power? Improve your Core!

Do you want to increase your power – maybe to improve your vertical jump or bat swing speed or maybe to try something new? Power is very important in everyday functional movement. Athletes need power to improve performance. Parents need it to catch a kid from falling. Seniors need power to regain balance and prevent falls after tripping. Power is important and training should be part of most conditioning programs.

The mathematical equation for power is P= F*D (or Work)/T. Basically, power is the amount of work done over a period of time.  Using basic math, the higher the amount of work performed (force and distance) in the least amount of time will yield high power. So it seems logical that if I want to improve power I must perform explosive exercises such as box jumps, lateral hops, and other plyometric exercises. Right? Well although your are not wrong, you are also not 100% correct. Continue reading

The Importance of Pitch Count

Image Courtesy of: Jeff Chiu/Associated Press

As a college athlete Stephen Strasburg was one of the most sought after pitchers in the history of baseball. He destroyed opposing batters with a ridiculous fast baseball and off-speed pitches that seemed to roll off of a table. In 2009, he was the number 1 overall draft pick by the Washington Nationals. Soon after he blitzed through the minor leagues with a stat line that made fantasy baseball owners drool. In his major league debut he recorded 14 strikeouts, 0 walks and 2 earned runs. This Superman was real and he had arrived. However, this Superman also had his own kryptonite – the Ulnar Collateral Ligament.

In August, 2010, the Nationals announced that Stephen suffered a torn Ulnar Collateral Ligament (UCL) and would undergo surgery. Recovery from this surgery is at least one year. He was able to come back and finish off the 2011 season, in a limited fashion while in the minor leagues. Finally, at the start of the 2012 season he came back to the big leagues. So far all is well in 2012. He is arguably the most dominant pitcher in MLB. But his time will end in just a few days. Continue reading

Holistic Approach to Improve Running Endurance

Before I begin let me start by saying- I do not think supplements are needed. I believe the body’s physiological response to exercise, disease,
or whatever is best supported through good diet and fitness training. But, this is just me and I am certainly not in the norm. Most people – sedentary, recreational athletes, and elite athletes – consistently look for the quick and easy ergogenic aid designed to improved performance or enhance weight loss.  It’s not just sports performance or weight loss, individuals will seek out herbal supplements to enhance everything from concentration to vitality.  Echinacea is one such supplement.

For years, Echinacea has been used as an immunostimulant. In other words, to prevent colds and decrease the intensity or duration of cold/ flu symptoms. Although many studies have been done to examine these claims, the data is at times shoddy, inconsistent, unreliable, or insignificant. However, I just came across a new study and very interesting study that looked at the effects of Echinacea supplementation on improving our ability to perform endurance exercise.

In the most recent Journal of Strength and Conditioning Research (reference below) the authors study the effects of Echinacea supplementation on running economy. The authors set out to find if Echinacea improved maximal oxygen consumption (VO2Max), erythropoietin (EPO), running economy and red blood cell count.  Why is this important? The Tour de France and the Olympics have just completed and you probably heard about many athletes being tested for elevated EPO levels. Basically, EPO produces red blood cells, red blood cells carry oxygen, oxygen is needed to feed cells. Thus, more oxygen equals improved cardiovascular endurance.

This study is interesting because it shows that following 4 months of 8,000 mg/d supplementation of Echinacea resulted in significant increases in VO2Max, EPO, and running economy.  Now, 8,000 mg / day is a lot of Echinacea, almost double the normal dosage amount. I am not saying that is a bad thing – but it is much more than the typical recommended dosage. To my knowledge there has been no scientific evidence showing that Echinacea is negative side effects. This study did not mention any side effects or subject dropouts secondary to side effects. There have been some reports of nausea and dizziness, but only in individual cases and not nearly enough to make a general consensus.

As I stated in the beginning – I, personally, do not take supplements. But, others love and swear by them. This study shows pretty significant evidence that Echinacea supplementation will improve your cardiovascular endurance. With little known side effects, if I were interested in improving my running economy I would give it a whirl and see what happens, but that is up to you. It may improve your time and heck you can become the next Roger Bannister and break the 3 minute mile. Ok, maybe not.

Article reference:

Whitehead, MT, Martin, TD, Scheett, TP, and Webster, MJ.  Running economy and maximal oxygen consumption after 4 weeks of oral Echinacea supplementation. J Strength Cond Res. 26(7): 1928–1933, 2012.

Osteoporosis 101

Several physiological and anatomical changes occur within the human body as individual’s age. One of the most prevalent changes occurs in the musculoskeletal system. Bone mass declines with age similar to muscle mass. Bone mass peaks around 30 years of age and then gradually declines. The cause of bone loss is multifactorial, including inactivity, changes in hormone levels, and improper nutrition. In regards to physical activity, the age-associated decline in muscular strength parallels the loss of bone mass (1). Research shows a significant risk factor for osteoporosis is physical inactivity.

Osteoporosis is a chronic disease characterized by a thinning and weakening of bones (2). Osteoporosis is determined as having a bone mineral density more than 2.5 standard deviations below the young adult mean value (3). Once bone mineral density reaches such a low-level, any imposed stress or force may lead to a fracture.

The most common fracture sites for people with osteoporosis include the wrist, thoracic spine, and proximal femur. This is due to a greater proportion of trabecular bone, which is more fragile when calcium is lost. Here are some interesting statistics in regards to osteoporosis:

  • Approximately 10 million Americans over the age of 50 have osteoporosis.
  • Almost 35 million Americans over the age of 50 have osteopenia, which is a bone density lower than normal and can lead to osteoporosis.
  • 40% of Caucasian women will fracture a wrist, spine, or hip in their lifetime.
  • Almost 20% of hip fractures lead to permanent disability.
  • By 2020, half of all Americans over the age of 50 will be at risk for fracture due to weak bones (4).

As a living tissue, bone is constantly in a state of flux. Specialized bone cells called osteoblasts mediate the addition of calcium by adding to the bone matrix, and other cells called osteoclasts mediate the removal of calcium from the bone matrix. As we age, bone construction slows and bone degeneration accelerates, leading to osteoporosis. There are several risk factors for osteoporosis which include; history of fractures due to insignificant trauma, family history of osteoporosis, postmenopausal females, men over the age of 70, history of smoking at least one pack of cigarettes per day, and low body mass.

Unlike skeletal muscle, structural changes to bone tissue lead to very few functional decrements. That said health and fitness professionals must keep bone loss in mind especially when working with older adults who have Osteoporosis. To mitigate the loss of bone with age, older adults should engage in strategies that will have a protective effect on bone mass. The force of gravity imposes stress on bones. Gravity gives weight to an object due to the acceleration of that object toward the center of the earth. The force the skeleton is exposed to when absorbing ground reaction forces causes the skeleton to be loaded and will increase bone integrity and strength. Lifting weights will impose a stress to bone due to the articulation of the muscle, fascia, and bone.

According to research weight-bearing exercise with significant loading of bone helps to preserve bone mass in older adults (5). High-intensity resistance training with heavy loads relative to maximal strength also shows an increase in bone mineral density in older adults, while moderate intensity resistance training shows a smaller effect (6).


  1. Burr DB. Muscle strength, bone mass, and age-related bone loss. J Bone Miner Res. 1997;12(10):1547-1551.
  2. Liu H, Paige NM, Goldzweig CL, et al. Screening for osteroporosis in men: a systematic review for an American College of Physicians guideline. Ann Intern Med. 2008;148(9):685- 701.
  3. Kanis J, Melton LJ, Christiansen C. et al. The diagnosis of osteoporosis. J Bone Miner Res. 1994; 9: 1137-1141.
  4. Center for Science in the Public Interest. Nutrition Action Health Newsletter. 2005;32(3)., Centers for Disease Control and Prevention, 2008.
  5. Kelley GA, Kelley KS, Tran ZV. Exercise and BMD in men: a meta-analysis. Am J Phys Med Rehabil. 2001; 80: 65-77.
  6. Cussler EC, Lohman TG, Going SB, et al. Weight lifted in strength training predicts bone change in postmenopausal women. Med Sci Sports Exerc. 2003; 35(1): 10-17.

The Geek’s Squat: Proper Squat Techniques for Strength and Injury Prevention

There has been much debate on proper squat techniques. Is it proper to maintain a vertical shin and prevent the knees from going beyond the toes? Is it better to squat and allow the knee to go beyond the toes? Proponents of the vertical shin technique argue it is best to save the knees and this helps increase posterior chain strength. Whereas proponents of parallel lines say, distribute the weight evenly and save the back. The purpose of this blog is to shed some light on the debate and provide the rationale for proper squat technique.

Early studies state that squatting with external loads causes undue stress and damage to soft tissue at the knee joint. This precipitated many experts to change squat mechanics. A vertical shin angle prevents excessive knee flexion, thus limiting the stress placed at the knee joint and potential damage to integral knee structures such as the meniscii, articular cartilage and ligaments. In addition, many state that maintaining a vertical shin angle allows for enhanced strengthening of the posterior chain (hamstrings, glutes, low back).

I agree it is important to protect the knees. However, the lower back is much more important, in my opinion. Low-back pain is one of the major forms of musculoskeletal degeneration seen in the adult population, affecting nearly 80% of all adults (1). It has been estimated that the annual costs attributable to low-back pain in the United States are greater than $26 billion (2). In addition, 6 to 15% of athletes experience low-back pain in a given year (3, 4). The body is an interconnected chain, and compensation or dysfunction in the LPHC region can lead to dysfunctions in other areas of the body (5). So why do we squat to protect the knees? How should we squat?

Proper squat mechanics requires optimal flexibility at the ankle, knees, and hips during the descent of the squat. When these joints are moving together, forces will be disturbed optimally and equally throughout the kinetic chain. If one of the joints has limited ability to move, another joint must compensate to make up for the lost movement. For example, if you are trying to pick something off of the floor and do not bend your knees you must bend at the back. Using this example, if we squat like this (limiting knee flexion or ankle dorsiflexion) we are asking the lower back to lift weight in a biomechanically disadvantaged position. You know the phrase “lift with your legs not your back.”

Do a quick check and test your squat mechanics. Evaluate your technique by watching in a mirror.  At the bottom of the squat the torso and tibia should be parallel to each other (See image below).  Have you ever noticed how a baby squats? Do a quick google search for baby squat. You will be amazed at their technique. They lift properly, because they have the flexibility to get in to a deep squat without excessive leaning at the low back. It does not matter if the knees go past the toes. The most important thing to ask: is the back parallel with the shin?

Fry et al. (2003) examined the hip and knee torque forces of variations of parallel squats and concluded appropriate joint loading during this exercise may require the knees to move slightly past the toes. Restricting squats created significant increases of excessive forward lean and subsequent increased torque loads at the low back and hip (6). Maintaining a vertical shank did not yield change knee torque significantly (6).

Torque is a measure of rotational force about an axis of rotation.  Simply put torque is a product of force and lever length from the axis of rotation to point of force of application (Τ = r x F) where Τ is linear torque, r is the displacement vector and F is force. Look at the two images below and notice the Torque values at the knee and low back:

Squatting with a Vertical Shin

Squatting with vertical shin:

αlb= 78° αk= 102° F = 135lbs (600.5 Newtons)
B to C= 19 inches (.48 meters). A to B = 2.75 inches (0.07 meters).  A to C = 16.25 inches (0.41meters)

Linear Torque Low Back:
Τlb = r x F
Τlb = 0.41m x (600.5N)
Τlb = 246.2 N·m

Linear Torque at the Knee:
Τk = r x F
Τk = 0.07m x (600.5N)
Τk = 42.04 N·m

Squatting to allow toes go beyond the knees

Squatting with parallel lines 
αlb= 90° αk= 90° F = 135lbs (600.5 Newtons)
B to C= 19 inches (0.48 meters) A to B = 9.5 inches (0.24 meters) A to C = 9.5 inches (0.24 meters)

Linear Torque Low back:
Τlb = r x F
Τlb = 0.24m x (600.5N)
Τlb = 144.12 N·mLinear Torque Knee:
Τk = r x F
Τk = 0.24m x (600.5N)
Τk = 144.12 N·m
You can clearly see that squatting with a vertical shin reduces stress placed on the knee, but significantly increases torque on the low back. Do we really want to place an increased load at the lower back, when it is so prone to injury? The most important thing to consider is overall exercise technique. Lifting with ideal posture is paramount for injury prevention. When this occurs forces will be distributed equally throughout the kinetic chain.


1. Walker BF, Muller R, Grant WD. Low back pain in Australian adults: prevalence and associated disability. J Manipulative Physiol Ther 2004;27:238–44

2. Luo X, Pietrobon R, Sun SX, Liu GG, Hey L. Estimates and patterns of direct health care expenditures among individuals with back pain in the United States. Spine 2004;29:79–86.

3. Nadler SF, Malanga GA, DePrince M, Stitik TP, Feinberg JH. The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clin J Sport Med 2000;10:89–97.

4. Nadler SF, Malanga GA, Feinberg JH, Rubanni M, Moley P, Foye P. Functional performance deficits in athletes with previous lower extremity injury. Clin J Sport Med 2002;12:73–8.

5. Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther 2003;33(11):639–46.

6. Fry, A.C., J.C. Smith, and B.K. Schilling. Effect of knee position on hip and knee torques during the barbell squat. J. Strength Cond. Res. 17(4):629–633. 2003

Improve Your Golf Game and Reduce Injury

Injuries in golf occur as they do during participation in any athletic orientated activity. Research indicates injuries in golf relate to functions of age, skill level, and frequency of play. According to Gosheger et al., over 80% of golf-related injuries are due to overuse (1). The most common injury experienced by professional golfers is low-back dysfunction. Low-back golf injuries can be chronic in nature due to poor swing mechanics, poor conditioning, or overuse. Research has shown that golfers who have low-back pain demonstrate a decrease in range of motion for hip internal rotation on the lead leg, decreased lumbar extension, decreased activation and/or timing of the abdominal obliques, spinal erectors, and knee extensors (2-4). A common low back disorder of golfer’s is sacroiliac joint (SIJ) dysfunction.

When loads are transferred between the trunk and legs, the flat surfaces of the pelvis bones (sacrum and ilium) make the SIJ subject to considerable forces. If SIJ stability is not maintained, loads cannot be transferred efficiently between the trunk and legs, which may result in abnormal loading joint tissue and the development of pain (5). The transverse abdominis and internal oblique muscles play a significant role in resisting shear loads across the SIJ and maintaining stability (5). Proper execution of an abdominal drawing-in maneuver during performance should enhance the stability of the SIJ joint and allow for the most efficient transfer of forces between the trunk and legs.

Exercise is believed to be a vital component in preventing the occurrence of low-back pain and injury. What is unclear, however, is the type of exercises that should be performed as part of a low-back pain prevention and rehabilitation program. Liddle, et al. concluded that strengthening exercises targeting the lumbar spine, lower limbs, and abdominal muscles were the predominant exercises performed in successful exercise programs that decreased pain and improved function (6).  Conversely, Hayden, et al concluded in a systematic review that programs that strengthened the trunk stabilizing muscles were most effective. A separate meta-analysis, (7) indicated that the most effective programs consist of a supervised, individually designed set of stretching and strengthening exercises.

I am in agreement with the observations and recommendations from the scientific literature noted above. The best approach to developing a low-back injury prevention program includes a variety of inhibitory and lengthening exercises aimed at improving flexibility of tight and overactive muscles, isolated strengthening exercises for weak and inhibited muscles, and improving neuromuscular control through integrated exercise is recommended.

Golfer’s with SIJ dysfunction commonly have overactive and underactive muscles. The overactive muscles include the Tensor Fascia Latte, IT Band, Hip adductors and Piriformis. Underactive muscles include the glute medius and minuimus as well as intrinsic core stabilizers (multifidus, transverse abdominus and obliques). Inhibiting and improving flexibility of the overactive muscles followed by strengthening of the underactive muscles will help reduce or prevent low-back pain and could improve your golf swing.


1. Gosheger G, Liem D, Ludwig K, Greshake O, Winkelmann W. Injuries and overuse syndromes in golf. Am J Sports Med. 2003;31(3):438-443.

2. Horton JF, Lindsay DM, Macintosh BR. Abdominal muscle activation of elite male golfers with chronic low back pain. Med Sci Sports Exerc. 2001;33(10):1647-1654.

3. Lindsay D, Horton J. Comparison of spine motion in elite golfers with and without low back pain. J Sports Sci. 2002;20(8):599-605.

4. Vad VB, Bhat AL, Basrai D, Gebeh A, Aspergren DD, Andrews JR. Low back pain in professional golfers: The role of associated hip and low back range-of-motion deficits. Am J Sports Med. 2004;32(2):494-497.

5. Snijders CJ, Ribbers MT, de Bakker HV, Stoeckart R, Stam HJ. EMG recordings of abdominal and back muscles in various standing postures: validation of a biomechanical model on sacroiliac joint stability. J Electromyogr Kinesiol. 1998; 8:205-14.

6.  Liddle SD, Baxter GD, Gracey JH. Exercise and chronic low back pain: what works? Pain. 2004; 107:176-90.

7. Hayden JA, van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rev. 2005:CD000335.

Can you Handle an Obstacle Course Race?

Obstacle course races such as the Tough Mudder, Spartan Race or Warrior Dash have become the rage lately. Popularity is growing fast and everyone from fitness junkies to weekend warriors are braving the conditions to challenge these races. The uniqueness of this racing makes developing a training program difficult. These events range vary in length (3-13 miles) and densely populated with obstacles. What makes a mud run difficult is preparation.

Each obstacle calls on various energy systems to perform the task.  To complete the event, energy must come from all three energy systems; ATP/CP, Gylcolysis and Oxidative, much like Mixed Martial Arts, which requires a mix of quick high intensity work and sustained endurance. If you are looking to challenge yourself , how would you train for these events? As stated these events require cardiorespiratory endurance with brief bouts of  power and strength.

Interval cardiorespiratory training with a focus on Zone 3, or peak interval heart rate, which incorporates short bursts of 90% maximum heart rate exercise, would be great for these events. This method of training incorporates high-intensity exercise followed by a recovery period, much like the race itself. The body must be presented with a workload that challenges its current fitness state. This increased workload will cause fatigue and, with the proper recovery, will eventually yield cardiorespiratory improvements. Performing this type of cardiorespiratory training 1-3 times per week will provide great benefits. If you are just starting out it is not recommended to start training at such a high intensity. So begin training in lower heart rate zones, (65%-75% of MaxHR) for extended periods. As this becomes easier, compliment the workout with brief bouts of moderate to high intensity (80-85%) exercise to build a solid cardiorespiratory base. Once you have mastered this begin to tackle the short bouts of high heart rate zone exercise (90% of MaxHR).

Below is a sample Interval Training program that uses Zone 3 exercise: Beginning Level: 2-6 weeks (depending on fitness level)

  • 30 – 60 minutes at 65-75% of Max Heart Rate

Intermediate Level: 2-4 weeks (depending of fitness level and adaption rate) Phase I:

  • 5 minutes warm-up at slow-controlled pace
  • 4 minutes at 80-85% of Max Heart Rate
  • 1 minute at 65-75% of Max Heart Rate
  • 4 minutes at 80-85% of Max Heart Rate
  • 1 minute at 65-75% of Max Heart Rate
  • 5 minute cool-down

Phase II: 

  • 5 minutes warm-up at slow-controlled pace
  • 10 minutes at 80-85% of Max Heart Rate
  • 5 minute at 65-75% of Max Heart Rate
  • 10 minutes at 80-85% of Max Heart Rate
  • 5 minute cool-down

Advanced Level: 2 – 4 weeks (depending on adaptation times)

  • 5-10 minutes warm-up
  • 30 seconds at 85-95% Max heart Rate, 30 seconds at 80-85% of Max Heart Rate
  • Repeat above 3 times (total of 3 minutes)
  • 2-5 minute recovery at 65-75% of Max Heart Rate
  • 30 seconds at 85-95% Max heart Rate, 30 seconds at 80-85% of Max Heart Rate
  • 2-3 minutes of cool-down

Perform this interval training program 3-5 days per week. On lighter days include a resistance circuit training program of varied intensities. Circuit training is a good way to strengthen and improve cardiorespiratory fitness.

Women are Wimps!!

STOP! Before you start throwing knives at my head I don’t really think women are wimps. If I did my wife would be waiting for me when I get home to prove me wrong. In fact, it is quite the opposite. Women have demonstrated continued increase in sports endeavors and are much faster, more aggressive and powerful than in past decades. However, secondary to the increased participation in sport, women are sustaining many more injuries.

Females between the ages of 15-25 years are most often injured, with the majority of these injuries are to the anterior cruciate ligament (ACL).  Females are 2-5 times more likely than males to sustain an injury to the ACL. This injury is primarily noted in basketball and soccer, but is still prevalent in many other sports such as volleyball, softball and gymnastics.  Women over the age of 25 are also more susceptible to recreational sporting injuries compared to males.  Many of these injuries are also musculoskeletal in nature, such as ankle sprains, shoulder tendinopathy, and chronic knee pain such as chondromalacia, PFPS and ITB Syndrome. Looking at the glass half-full though,most of these injuries can be prevented with correction of movement dysfunction.

With the increased participation in sport and the commonality of musculoskeletal injuries it is prudent to understand typical movement dysfunction patterns that bring about these injuries.  Secondary to genetics, body morphology and muscle recruitment females are susceptible to lower extremity impairment syndrome.

Lower extremity impairment syndrome is a combination of muscle imbalances, joint dysfunction, and poor muscle recruitment patterns from the low back to the foot. The impairment syndrome can be characterized by foot pronation, knee valgus, femoral internal rotation, and lordosis at the low back.  When performing functional activities, such as running or cutting, these characterizations are amplified. Ultimately, this leads to ACL tears or the aforementioned chronic pain syndromes.

The good news is these poor biomechanical patterns can be corrected following focused rehabilitation techniques designed to improve muscle synergy as well as joint mechanics. Many studies have been done to show a significant reduction in the incidence of injuries, such as ACL tears, by correcting these impairments. If you are having chronic pain in the lower extremity, it might be a result of lower extremity impairment. This is a good thing, because it can be corrected.

No Gym, No Problem: 3 Workouts from the Trunk of Your Car

I once stated to a group of personal trainers “a good trainer can create a workout out of the trunk of a car”. To which someone laughed and stated; “I want to hear your trunk-of-a-car workout!” So, I decided it might be a good blog. Here are 3 workout programs, that use only tools that would fit in the trunk of a car and tools that are easily accessible to everyone without a gym.

Workout #1 – Low Level Program for Stabilization

Location: A Hotel Room


  1. Baseball
  2. 10# Kettle bell (x 2)

Warm –Up

Self Myofascial Release               Sets                                                             Duration

Calves                                                   1                                                              30 Seconds

IT Band                                                 1                                                              30 Seconds

Latissimus Dorsi                                1                                                              30 Seconds

Stretch                                                  Sets                                                             Duration

Gastrocnemius                                 1                                                              30 Seconds

Kneeling Hip Flexor                         1                                                              30 Seconds

Latissimus Dorsi Wall Stretch       1                                                              30 Seconds



Exercise                                                Sets              Reps                Tempo               Rest

Supine Marching                              2                   15                        Slow                0 Sec.

Floor Bridge                                        2                   15                        Slow                0 Sec.

Single Leg hop w/ Balance            2                   5                          Slow               60 Sec.



Exercise                                                Sets       Reps    Intensity   Tempo              Rest

Squat to Curl to Press                     2              15           60%          Slow               0 Sec.

Push-up w/ rotation                       2              15           60%          Slow               0 Sec

SL Balance w/ Row                          2              15           60%          Slow               0 Sec.

SL Scaption                                         2              15           60%          Slow               0 Sec.

Lunge to SL Balance                        2              15           60%          Slow               0 Sec.


Workout #2 – Moderate Intensity Program for Strength

Location: Neighborhood Park

Equipment in the Trunk:

  1. Foam Roll

 Warm –Up

Foam Roll                                            Sets                                                             Duration

Calves                                                   1                                                              30 Seconds

Adductors                                           1                                                              30 Seconds

TFL                                                         1                                                              30 Seconds

Stretch                                                  Sets                                                             Duration

Gastrocnemius                                 1                                                              30 Seconds

Standing Adductor                          1                                                              30 Seconds

Kneeling Hip Flexor                         1                                                              30 Seconds



Exercise                                                Sets              Reps                Tempo               Rest

Crunches w/ rotation                     2                   12                        3-2-1               0 Sec.

Reverse Crunch  on park bench  2                   12                        3-2-1               0 Sec.



Exercise                                                Sets       Reps    Intensity   Tempo              Rest

Chin-ups on monkey bars              3              10           80%          2-0-2               60 Sec.

Push-up off a park bench                3              10           80%          2-0-2               60 Sec.

Hanging body weight rows             3              10           80%          2-0-2               60 Sec.

Walking lunge with rotation           3              10           80%          2-0-2               60 Sec.

Bench jump-ups                                  3              10           80%          2-0-2               60 Sec.


Workout #3 – Power and Intense training

Location: Office Parking Lot

Equipment in the Trunk:

  1. Softball
  2. Medicine Ball (5kg)


Warm –Up

Self Myofascial Release                Sets                                                             Duration

TFL                                                        1                                                              30 Seconds

Adductors                                           1                                                              30 Seconds

Latissimus Dorsi                                1                                                              30 Seconds

Stretch                                                     Sets                                                          Duration

Multiplanar Lunges (Dynamic)             1                                                     10 Reps

Standing Adductor Stretch (Static)     1                                                    30 Seconds



Exercise                                                Sets              Reps                Tempo               Rest

Rotational Med Ball Slams            3                   8                         Fast                  0 Sec.

Med Ball Pull over throw              3                   8                         Fast                  0 Sec.



Exercise                                                Sets       Reps    Intensity   Tempo              Rest

Push-up                                                 5             85%          Fast                 0 Sec.

* Med Ball Chest Pass                       3              10           5%BW     Fast                 2 Min

Single Arm Body weight row         5             85%          Fast                 0 Sec.

* Wood chop Med Ball throw          3              10           5%BW     Fast                 2 Min

Prisoner Squat                                       5             85%          Fast                 0 Sec.

* Line hops                                            3              10           5%BW     Fast                 2 Min

* These exercises should be performed in a super-set fashion

You do not need a gym to workout. Sure all the toys make it easier, but exercise is simple. Start with a basic exercise then increase intensity by changing, speed, velocity, amplitude and stability to make the exercise easier to harder.

Personal Trainers, Are you Bored?

Let’s face it, everyone gets bored with day-in, day-out monotony. Although Personal Trainers have unique clients and face unique challenges everyday – they too can get bored with the gym scene. Some may begin to look for other opportunities. Personal trainers have a profound knowledge of functional anatomy and mechanics. So how can this knowledge be utilized elsewhere? I would like to open your mind to an avenue of exploration that combines, your knowledge of function with ergonomics; a practice I call BioErgonomics.

BioErgonomics comes from Biomechanics (mechanical principles in biological systems) and Ergonomics (Greek for work laws) and means addressing biomechanical dysfunction with ergonomics to prevent and correct work related musculoskeletal disorders. This practice speaks to health and wellness professionals as they are experts at identification of human movement dysfunction. Take a look at these staggering numbers:

  • Currently, corporate wellness is a $1.6 billion dollar industry and is projected to be $5.8 billion by 2015.
  • The insurance information institute says indemnity (time lost from work) rates have doubled over the past 12 years.
  • Over the past 2 years there has been a 69% increase in corporations offering corporate wellness.
  • 65% of companies recognize the value of corporate wellness and state they will increase funding and incentives for employees participating in wellness programs.
  • Avg. cost per permanent disability claim is ~$41,000
  • Musculoskeletal disorders account for 29% of all days lost at work
  • 33% of all injuries are a result of poor ergonomics and biomechanics
  • An employer’s return on investment for corporate fitness programs can be as high as 6 to 1.
  • 42% of large firms will require employees to complete health coaching or a disease management programs
  • 65% of respondents said that for 2011 they’ll increase incentives to take part in corporate fitness programs
  • Insurance companies strongly advocate corporate fitness programs
  • Lower back injuries account for 24% of all injuries and 65% of these are caused by over-exertion and poor mechanics.

These data points prove companies need help. They also prove companies recognize the value in corporate fitness and have already started to incorporate programs within the company. Many have invested big money on staffing in-house ergonomist. Unfortunately ergonomist, do not understand functional human mechanics like health and wellness professionals do. These companies need extra help! Why can’t you be the one to help them?

Many companies have ergonomic consultants or internal safety teams that purchase high-tech gadgets and ergonomically correct workstations to mitigate injury or reduce risk of injury for employees. Unfortunately, this does not fix the issue. As health and wellness professionals, we have the ability to recognize movement dysfunction. By applying the proper exercise techniques we can help employers address these issues and save companies huge money on workers compensation costs and eliminate wasted money spent on expensive equipment.

Market yourself, become entrepreneurial, several job opportunities exist for positions in corporate fitness, these include working for a company, or even better you can create your own position by becoming a consultant.