My Experience With Performance Therapy & ART

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. 

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.

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.

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.

ACC Skate Test

As we continually try to evolve our evaluation system at the ACC, we attempt to look at all things that can help us determine points that can make our athletes the best they can be.

This spring we converted all of our Keiser air pieces to their new display option that provides more information to the user and to us as coaches.  The internal mechanism is fitted with a force transducer to allow us to monitor the amount of watts performed with each repetition.   This is indicative of power and more importantly as the athlete completes an entire set, we can monitor the drop off.  This is important, because unlike high intensity circuit training, where you reps continually loose speed with no feedback, and you loose training power, this Keiser system allows us to completely focus on the quality of the reps and provides feedback to the athlete on how much harder he or she should be pushing.

One interesting new test we have created, is the Lateral Skate Test.  The idea of this test was provided to me by Pierre Allard, strength coach of the Montreal Canadiens.  I made a few modifications and came up with the test we have today.

As you can see in the video, the load is set up to be in line with the athletes waist.  The board they are jumping off of is set at a 20 degree angle, biomechanical research into the skating stride demonstrates that the skate is at an 18 degree angle with the ice.  The Athlete gets low, and explodes off of one leg.  They land on both, and re-set for the next rep.  We use a load of 20% of body weight for resistance, and measure the left and right leg to determine if there are any discrepancies that should be addressed.

Have a look below as Zach Bogosian of the Winnipeg Jets goes through his evaluation, and one of the players from the Nepean Wildcats women intermediate team.  Great form here and excellent power by both of them.

ACC-BIOSTEEL FOOTBALL TRANSFORMATION PROJECT

Anthony Iafelice has had a busy year.  He is a 17 year old student at St. Marks High School in Ottawa, and also played football for 2 teams.  The South Gloucester Raiders Bantam Team, and for his high school team.

Anthony started the last football season in the summer with the Raiders at 180 lbs.  practicing 3-4 times per week plus games.  Then in the September he began practicing and playing with St. Marks.  He was on the field at times twice per day with a very physically demanding schedule in addition to his school work.

By the end of the football season he had lost 20 lbs and dropped down to 160 lbs.  Then he developed mono and his weight dropped down to 153 pounds.  Anthony was doing everything he thought was right get his weight back up.  He started lifting weights at school, was eating what he thought was appropriate, and unfortunately was not making any progress.

His father had contacted me about weight gainers etc and what he should do to try to put the weight back on, safely and progressively.  It was from here that we put the plan together to transform Anthony back in to the beast he was on the football field and more.

Anthony's day 1 picture is below.  As you can see he is lean and lacking in muscle mass, but with a good frame.  Here he is 157.5 lbs, 12.3% body fat, with a breakdown of 138.16 lbs of lean muscle mass and 13.36 lbs of fat.  His test results were as follows Jump squat with 40kg = 1.52 m/sec. Body weight squat .94 m/sec.  Shuffle test 12 in 15 seconds, Woodway curve speed test 22 mph.

Through his assessment we found many issues with his biomechanics that would limit him in his quest of getting bigger, stronger and faster.  He had specific weaknesses in his posterior deltoid, supraspinatus, lower trapezius, and his gluteus medius.  His abdominals also showed a significant weakness in their ability to stabilize the pelvis.  In combination all of these issues would slow him down without directly addressing them via corrective exercise.  This will set the stage for his ability to lift big and heavy as we progress over the next 12 weeks.

Anthony's next issue was to address his caloric intake.  Like a typical teenager, his meals where healthy, but lacked the volume and protein content necessary to build muscle.  Through the ACC we created a weight gain meal plan that included 4,500 calories a day based on a 40/30/30 macronutrient breakdown.  I did not want to go too high protein as some might suggest, as Anthony is a growing teenager and requires a good balanced diet.  We included Biosteel (www.biosteel.com) sports supplements as part of his meal plan, mostly because it is the safest product on the market, and certified to be clean.  He is taking the recovery protein formula twice per day, as well as their High Performance Sports Drink prior to and during his workouts to ensure his amino acids levels are appropriate.

AFTER 8 WORKOUTS HE HAS PUT ON 7 LBS....LOTS MORE TO COME

I am going to be posting Anthony's gains over the next 12 weeks, along with video and pictures.  I am going to go out on limb and predict that Anthony's gain is going to be 25 pounds of ACC built muscle.

Stay Tuned.

Gary Roberts Seminar @ ACC April 18th 7pm

Gary Roberts Visits ACC with Juno Nominee Brad Rempel of High Valley

The Juno's are in town and with that the Annual Juno Cup will be played at the Nepean Sportsplex tonight.  My good friend Gary Roberts is in for the event, looking to run a few musicians in the corners.

As his normal routine was when he played he needed his pre-game lift and workout.  So Gary came into the ACC along with Brad Rempel of the country band High Valley.  High Valley is up for a Juno for best country album.  I took both of these guys through a little ACC training, peppered with some Gary Roberts High Performance Training.

Brad does lift, but lets just say not at the intensity of Mr. Roberts.  After Gary took him through the 20 minute warmup, Brad thought he was done... Gary gave him a great introduction to preparing for the workout.  We then got into a great functional lift, with Gary leading the way.  We finished off with a few intervals and some core work and downed some biosteel.

A great day in the end, hoping Brad will be able to skate tonight...LOL..

Gary Roberts Performing the Trap Bar Deadlift

Gary & Brad Rempel performing a SB ab crunch with static rotation

Grinding it out!

Brad, Lorne & Gary....Still smiling after a good workout

Gary Roberts Summer Training 2004

Here is a great clip of the Beast Gary Roberts.  This is from 2004 summer workouts.  We are at Jeff Oneil's cottage doing some plyos, and in Gary's cottage gym doing some lifting.  He is ripped and weighing in at about 215 here.  If you watch closely, during the hurdle jumps (in slow motion) you can see a movement fault in his hips as his hip externally rotates on his 2nd jump.  Being a well trained machine, he is able to correct this on his next jump....

Here is a great training shot of Gary back squatting, with teammate Mats Sundin spotting from behind.  Station 7 was the gym that was owned by Gary, Bryan McCabe, and Lorne Goldenberg.  Awesome gym at the time, unfortunately located in an area that was difficult for young players to get to.

Tommy & Lefebvre - ACC Golf Preparation

Here is Coach Goldenberg's go to exercises that every golfer should be working on pre-season to get ready for successful golf year.  

Please note that golfers, should NOT be doing any kind of circuit training to prepare for Golf.  The movements to train for golf require focus, specific movements, and appropriate loads. 

The areas these exercises will concentrate on is mobility and flexibility in the core musculature.  Strength for the thoracic area of the spine and posterior shoulder, and stability of the spine.

Follow the variables as outlined.

Wall Swing

This is a great movement along the wall to help stretch those muscles so critical for the golf swing.  If you are a left handed swing, The right posterior shoulder will receive an excellent stretch, as well as the left external obliques and right internal oblique.  The left pec and anterior shoulder will also receive a great dynamic stretch.  Try to maintain proper foot position and hip movement/weight shift.  Hold the top of each stretch for 15-20 seconds. Perform 3 sets of 5 15-20 second holds to each side.  And yes work each side to provide balance to the body even though you know you hit in one direction.

Standing Axe Chop With MB Squeeze

This is a great movement for stabilizing the hips,  enhancing proper trunk posture, and rotational strength.   Squeeze a 6-8 lb med ball between your thighs, while holding onto a high positioned cable.  Use an appropriate load that will challenge your core, yet not force your hips out of proper mechanics as you swing through.  Perform 3 sets of 8-10 reps on each side.

Supine Linear Foam Roller Lying
By lying on a  foam roller, you allow your poor posture to be placed in a more correct position to help re-enforce shoulders back.  This happens as a result of the removal of a kyphotic thoracic spine, and a neutral neck position.  By resting the arms by your sides, or even spread out in a T-position, will stretch out a tight anterior shoulder capsule, as well as the pectorals.  Try to begin by lying for 5-8 minutes and build towards 15 minutes total.  When you get up you will feel taller.

The Bow & Arrow

The bow and arrow is a great exercise for strengthening the posterior deltoid, and rhomboids.  Stand tall,  in this video, the left arm is extended holding the bow, and the right arm is pulling on the arrow.  Do not allow your body to rotate, focus on the shoulder.  Do not let your elbow drop as you pull, keep the arm parallel to the ground.  Complete 3 sets of 8-10 reps on each side.

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