I was prompted to write this
blog post after reading Stuart McMillan’s own post on Performance Therapy http://tinyurl.com/aocnjv4
and Matt Price’s tweet on twitter asking “Should
a trainer/coach do therapy? When is it ok & when is it not?
Before I begin
I wanted to say Stuarts post was extremely informative and real world. This is how it works in legitimate high
performance sports. Athletes are given
every opportunity to train, recover, and rehab in an optimal setting.
I was exposed
the benefits of therapy in a training environment back in Ottawa in the mid
1990’s when I was a strength coach for the Quebec Nordiques. I was
introduced to Dr. Mark Lindsay, who was working in Ottawa at a local sports
clinic. He introduced me to ART and some
of his therapy techniques which were way ahead of their time. Dr. Lindsay began working on a number of my
clients who suffered different issues that I saw in the gym and through my own assessment. To witness these athletes receive 2-3
treatments and step back into the gym and perform was incredible. For many years I worked with a number of
athletes in the area of what I will call post physio rehab. Mostly mobility, corrective exercise and
strength training, but nothing as quick or as efficient to what ART could
do. With that, I felt the need to set
myself apart and enhance my tool kit, this technique would be of great value to
my career.
In 1998 in
Chicago Illinois I took part in the first group ART course for the upper
extremity. It was the most intensive 5-day
course I had ever taken, which required 2 months of prep work and practice
before I ever got there. I was fortunate
to have the help of Dr. Lindsay at that time to help me with the moves and
completely understand the neuromuscular anatomy. Ironically in this particular ART course, it
was the first time they allowed non-chiropractors to attend. In addition to myself, there was strength
guru Charles Poliquin, Gina Perez an Ottawa strength coach now based in Calgary
and another massage therapist whose name escapes me. The course was a little intimidating to say
the least but we all graduated to become ART providers for the upper extremity.
This new tool
was just so valuable to my clients. The
ability to get my hands on an athlete’s subscap or teres minor when the
shoulder was not moving properly gave them instant relief and allowed them to
continue training with no issues. My
intent was never to be an ART therapist, my intent from the very beginning was
to enhance what I do in the strength and conditioning room. I leave the real therapy to the AT’s and
physio’s who in most cases oversee the athlete’s rehab program.
So with that
all being said, Matt Price’s tweet question of the day “Should a trainer/coach do therapy? When
is it ok & when is it not? And Stuart’s post was all very interesting to
me. My direct answer to Matt would be
yes. In my opinion good Strength coaches
do therapy every day in some form or another in the conditioning room. That might be a rotator cuff exercise that
was necessary as a result of an assessment, it might be a hip and back exercise
as a means to progress the rehab the athlete may have received from an AT, or
its just ensuring proper movement patterns for positive transfer to sport. But….. there are times when us strength
coaches cross that so called barrier that have been put up by the “therapists”
that can result in trouble. Let me share
with you a story that happened in 2009/10 season with the Montreal Canadiens.
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| Yes I made it onto the big screen at the Bell Centre |
In January of
2010 Mike Cammilleri who was one of our top forwards at the time suffered a
grade 2 MCL sprain that was close to being a grade 1. If anyone knows Mike Cammilleri, he plays and
trains with great intensity. (with Matt
Nichol @M_nichol from www.biosteel.com a cheap
plug for a good friend & colleague).
So 5 days after the injury, Mike approached me and asked me give him
everything I can do in the weight room to help his knee.
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| This was taken before the MCL injury |
He was out of
his walking brace and moving along fine, but was wearing a custom brace, just
in case. Generally with an MCL injury,
once the swelling is down and the pain has somewhat subsided, you can focus on
sagittal plane work. The sooner you can
do this without any significant pain, then the quicker potential you have to
recover by re-engaging the nervous system to fire muscles that have likely been
dormant for a while.
So I had him
cycle for 6-8 minutes to loosen up, we did some foam rolling and we then worked
on the following:
Vibrating
platform static bilateral stance 5 x 60 sec @40hz in a quarter squat position –
the result was pain free
Supine Ankle
Hops on a MVP Shuttle with the equivalent of him using only 30% of his body
weight (this piece unloads the body of its own weight) 3 x 10 hops – the result
was pain free.
Front squat 3
x 8 on a slow 3:0:3 tempo with 65 lbs – result was pain free.
DB RDL 3 x 8
with 30lb DB’s – the result was pain.
So what did I
do? I could have just said “ok Mike you
are done, everything else was good but the RDL caused pain so lets stop” this
would have been the safe thing to do.
But I had an athlete with me, who was extremely motivated to get better
and an issue with an exercise that seemed to cause some pain. I knew because of the MCL injury the fascial
lines up the adductors were going to be very tight, leading all the way down to
the pes
anserinus ligament. So instead of shutting him down, I put him on
the massage table, I gave him some ART all along his adductors down to his VMO,
but not over the ligament. I also worked
a bid of medial hamstring. I treated him for a total of 6 or 7 minutes. Mike got off the table and tried the RDL
again. After 8 reps he looked at me and
smiled and said “Goldy, that is perfect” We finished the sets, he iced down
after and went home in a great state of mind.
The next
morning as I walk into the Habs strength room, I have to pass through the
therapy area. As I go by, I notice Mike is on the table getting his treatment
from one of the therapists. He looked up
at me, smiled and winked. Just then the
therapist looked up at me and said “hey Lorne, I don’t know what you did to
Mike last night, but he looks better and feels better, what did you do? I then started to tell him the whole story as
described above. He was nodding his head
in agreement the whole time, until I got to the description of the ART of his
adductors. The guy started yelling at me
“NO NO NO you cant do that, you just broke up a self adhesion mechanism that
protects his knee” I just about lost it
with this guy right there. I responded,
“did you just hear what you said to me? He looks better and feels better!!!
That is what it is all about!” and I slowly walked away.
I had never
heard of this so called “self protective adhesion” before. So I called Dr. Lindsay and asked him about
it. He had not ever heard of such a
thing and indicated the most important thing in a speedy rehab is getting
function back ASAP and re-setting the nervous system. I thought we had accomplished that. Nevertheless, the therapists then reigned in
Mike and slowed down his training to a level they were comfortable with.
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| Is this performance therapy, training, or just stretching? |
Was I wrong
for doing what I did? I don’t think
so. Should I have consulted the team
therapists first, maybe….and this is where there is an issue. It seems that instead of working as a team,
certain people like to take ownership of specific areas in pro sports
therapy/training. I have seen this often
in my 20+ years in the NHL. The unfortunate
part here is sometimes the athletes suffer the result of the training and
strength staff not working well enough together. I know in my private business this never
happens, as I have a good team of therapy and coaches working together to
ensure the focus is on the athlete. At
the end of the day this is the only thing that matters.
I have never
scored a game winning goal in the NHL, but I have trained many who
have….Hopefully they keep on doing it, and we can all just get together for a
common goal and keep our athletes healthy.
