"The best practitioners work across disciplines, but they have expert-level understanding of more than one specialist discipline, and at least basic understanding of the whole of the performance ecosystem in its entirety."
While this very brief review is not intended to summarize the course itself, my aim for this write up is to provide some personal thoughts derived from working my way through this expansive resource.
At the time of writing this post, approximately one year had passed since first registering for the ALTIS Performance Therapy Course (PTC). I had been away at a training camp upon its release so had some downtime in between training and therapy each day to voraciously "consume" the first few sections. About one-third of my way through however, it became apparent that the comprehensiveness of this online course was greater than I had expected and it was evident that I would only be doing myself a disservice if I didn't return back to the beginning and take my time to slowly "digest" the information.
This course was everything I didn't expect it to be but exactly what I needed it to be.
Divided into three books - Philosophy, Science, and Art - the Performance Therapy Course renders an introspective approach uncommonly seen today. With the breath of its chapters and the depths of each, its similarity to graduate-level theses is more than apparent. Book 1 - "Philosophy" in my opinion, should be standard for all of ALTIS' online courses. It is heavy and in a way, it is exhausting.
It doesn't teach you how to think, but more importantly, it makes you think about how you think.
Throughout the entire course, relevant resources and references are exponential yet easy to access. In a positive way, this affords the student/learner the opportunity to toggle back and forth between research articles, expert lectures and guest interviews and relate them back in context to the specific topic being studied. Unfortunately (or fortunately) however, what results is a "rabbit hole" of sorts that leads one to places far removed from, yet still extremely relevant to, the original subject.
The amount of material that I have saved, printed and bookmarked from this course that I will need to revisit will keep me busy for at least another six months.
It should be noted that this is not a course for those looking to enhance their therapeutic skills in a traditional sense. That is, if you are looking for a course to teach you specifically how to assess osteoarticular (joint) mechanics, manipulate soft tissue, and/or program strength interventions, then you will need to look at other resources. This course is also not one that will provide the reader with specific protocols to assess movement. The amount of courses that cover each of the above are already numerous. What this course will most likely provide the student with however, is a re-evaluation of one's own framework for working with athletes and hopefully, some scaffolding and guidance for approaching problem identification and management. As stated in Mark Sandborn's Fred Factor,
"To know more, notice more."
Finally, completion of the PTC provides a little more context to who ALTIS has brought in as guest speakers for their Apprentice Coach Programs and why, such that future searches with the ALTIS 360 content become much more strategic. In the current, modern day space of dynamic abundance, our interventions and our learning alike need to be less resembling of "whack-a-mole" and more problem-based and ecologically-relevant. Therefore, it is my opinion that this resource is a must for those with (or eager to possess) a multi-dimensional mindset, regardless of whether they are a therapist, coach, reconditioning specialists and/or applied sport scientist.
Daily ruminations from attending the ALTIS ACP held in March, 2019.
The ACP is one of the many continuing education programs offered by ALTIS. In general, each day begins with a training session at the track followed by a session in the weightroom, with the exception of Wednesdays, which is primarily a regeneration day. Following training, a lecture or presentation is given which bleeds into a "pool-side" chat in roundtable format.
A sample of this four day program:
Rather than a review, the post below is simply a very brief summary of my thoughts at the conclusion of each day.
Day 1 - Takeaways:
Philosophy as a driver is simply reasoning as a foundation for doing. Philosophy here is all encompassing. It is a dynamic, working thought process, simply formed over time from experience and experimentation, scientific evidence, critical thinking and reflection.
Day 2 - Questions pondered:
Theory of mind is understanding that each of us has a mental state (beliefs, thoughts, etc) and that this mental state may differ from our own. So how can we become better aware of what our athletes are thinking and what they may be telling themselves? And further to this, what in our every day interactions, discussions, and manifested environments may be influencing their personal dialogues and beliefs about themselves? Are we even considering this?
Day 3 - Actionable personal intents ignited:
Questions. We need to be asking more of them. And we need to be identifying questions that may never have even been asked before?
"It is fair to say that, in general, no problems have been exhausted; instead, men have been exhausted by the problems. Soil that appears impoverished to one researcher reveals its fertility to another. Fresh talent approaching the analysis of a problem without prejudice will always see new possibilities - some aspect not considered by those who believe that a subject is fully understood. Our knowledge is so fragmentary that unexpected findings appear in even the most fully explored topics." - Santiago Ramon y Cajal
Day 4 - A key heuristic identified:
Adaptability. Trainability. Windows of opportunity.
In a nutshell, this was the underlying theme running through my head while attending the Functional Range Assessment (FRA) course.
FRA is the most recent of the Functional Anatomy Seminars to be released and essentially, what ties their ever-evolving system together. I have previously written about their Functional Release and Functional Range Conditioning courses. Although titled "assessment", this course in my opinion is actually a "thinking course". A course that when its teachings - aka mastering the systems - is applied in it's truest sense, fosters collaboration between the therapy and training worlds yet simultaneously, delegates responsibilities to the corresponding and appropriately trained professionals.
I won't go into depth on the contents of "the assessment" as doing so would be a disservice to the system itself as well as to anyone reading who may be unfamiliar with FR or FRC. However, what should be understood is this:
1) It would behoove us to first be able to attain ranges of motion prior to loading said ranges
2) Attainment of said ranges should ideally be achieved via active means utilizing internal loads
3) Control of as much of said range as possible is the goal
In other words...
a) Do they have sufficient range of motion?
b) If so, can they fully control said range?
c) If not, is it within your scope to assess and address or should you refer to a medical professional who speaks the same language?
If I were to explain the system to someone unfamiliar, that's exactly how I would do so. Again, it would be unfair to attempt to summarize and or explain the assessment process so instead, let me expand on adaptability, trainability and windows of opportunity.
In physical preparation and athletic development settings, it is not uncommon to consider a significant component of enhancing of an individual’s biomotor abilities and physiologic profiles as simply stress application and management. Clearly, this is an extreme oversimplification. However, no less than ten times did I relate back to the following words from Charlie Weingroff in my head throughout the weekend.
...the body's ability to mechanically and neurologically get into positions to absorb and adapt to stress...
Much of this "adaptability" component stems from the perspective that places high importance on optimal afferent feedback. That for optimal output, one requires optimal preceeding input. And for optimal input, one must have the ability to receive such input. Or as stated, Force Reception and Force Perception. Please feel free to look up "Core Pendulum Theory".
This is where "healthy joints" come in.
We are ecosystems. Ecosystems that are Complex Adaptive Systems who are always evolving and exhibit emergent behaviour. Behaviour that's dependant in part on the informational constraints we are exposed to. As such, we must be able to adapt to such constraints as mentioned above.
Yet often this incomplete. For loaded and / or athletic activity, it is not offbeat to suggest that our everyday ecosystems are insufficient. Thus, the importance of strategically applied stress. And subsequently, the necessity of optimal readiness and trainability. Specifically, do we at any given moment, have the tools required to even attempt to improve our strength, power, etc. Are our tissues in an optimal state to express the qualities necessary to overcome external load? And again, do we even exhibit the controllable ranges of motion necessary for force expression and locomotion?
Dr. Scott Howitt suggested that "we need to make sure the operating system supports the new app we download". Therefore, I would advise against downloading and using snapchat if one is still using an iPhone 3.
Windows of Opportunity
Roadmaps are not uncommon. And the FRA too is a roadmap. A roadmap to windows of opportunity.
We'll hit red lights and we'll hit green lights. But it doesn't mean we have to shut off our engines completely. Some windows will be closed and or unavailable. Following the algorithm will tell us when to refer to the medical team.
But many windows will be open. Small windows. Large windows. The assessment will notify us of the impending quarter Controlled Articular Rotations and the algorithm will certainly lead us to full range Eccentric Neural Grooving.
We simply have to think. Think beyond intelligent guesswork and more analytically. Think slow and think better.
It took me two years but I finally got around to taking Functional Range Conditioning. Then again, it pretty much took me two years to take a course and write another post altogether. In fact, I think my note summary on his FR course may have even been one of most "recent" posts on this blog.
Anyway, this won't be similar to my previous course summaries and reviews because frankly, I just want to cut to the chase. 1) How does it shape my clinical thinking? And 2) how can I integrate it?
I've been thinking about this for the last 72 hours and still haven't hit the nail on the head. I don't think I'm a complete tabula rasa but just like how my studies in Prague and Poland have taken me to deeper level of neuro in years past, these FR courses seem to be taking me deeper into "applied histology" (just made that up by the way...has nothing to do with AK).
So to answer my questions,
That's it for now.
Recently, I had the opportunity to attend The Running Clinic's "New Trends in the Prevention of Running Injuries" course in Vancouver, BC. This was one of those courses that I had been meaning to get to for a number of years but truthfully, my ignorance led me to believe that it wasn't a priority since I was already working directly in track and field.
However, after the impressive lecture by Blaise Dubois and Jean-Francois Esculier at the 2013 RCCSS(C) conference, I knew that it was finally time for me to pull the trigger.
Going into the weekend, I knew that those involved with this group were people of high integrity. I have read their blog for sometime and have interacted with them through social media. So unsurprisingly, this weekend led by Jean-Francois (JF for short) was one that I thoroughly enjoyed.
To start, it was made clear by JF that The Running Clinic operates with absolutely no commercial or financial relationship with any shoe company and therefore, are always unbiased in their views. This disclaimer was important because much of the course essentially was a critical appraisal of the literature. This is a good thing.
In addition to the literature and those variables relating to running injuries that possessed evidence (and those that did not), also discussed were variables that were anecdotal yet still plausible. To me, this is real world. And unlike many researchers who study running injuries solely from a scientific point of view, JF and Blaise are both therapists and scientists. Meaning, while they do understand the importance of the glutes, they know well enough to never ask a runner to try and squeeze their glutes as hard as possible while running.
One of the main themes during the weekend was "Quantification of stress" and the relationships among stress, adaptation and capacity. Running injuries usually occur when variables have been changed (ie. increase in volume, speed, etc) and in an era of minimalist shoes, it was important for them to make clear the difference between going barefoot and (re)adapting to barefoot/minimalist footwear. But this was but one variable and also discussed was the importance of understanding the effects of fatigue and unmanaged stress. So as per the research, the main cause of running injuries is misadaptation, be it intrinsic factors, mechanical stress (overload), and/or extrinsic factors.
Naturally, footwear was a big topic throughout the weekend. One of the main take home points I took away from this subject was that efficient technique looks very similar to natural barefoot running. Therefore if wearing footwear, we want to promote as natural and efficient technique as possible, particularly in light of the fact that while shoe cushioning decreases mechanical stress on the feet, mechanical stress on the rest of the body are increased.
We know through research that in order to decrease the stress on the body while running, we want to decrease the slope of the vertical loading rate (see Irene Davis' work). Since during barefoot running the vertical loading rate has been shown to have a shallower slope (similar to forefoot striking patterns), it was stressed that for performance it is important to have the lightest and minimalist shoe as possible that provides adequate protection and with minimal alteration in gait / foot strike pattern...so long as the body is well adapted to that particular footwear.
Further, in light of the fact that "shoes fragilize foot tissues, weaken foot musculature, and flatten foot arches" (as JF stated), much time was spent discussing how to choose the right footwear. Traditionally, I've felt that so long as we ensure foot/ankle strength and stability, that footwear type shouldn't matter. But in light of the evidence presented in this course, my thought processes have begun to evolve. JF discussed their evidence informed algorithms (see "Running Shoe Chart" and "Simplified Chart" ) as well as their TRC rating formula. Interestingly, they are in the process of creating and researching a new "minimalist index" for footwear that will certainly be helpful to further our knowledge of the differences in structure and effect on the body between various running shoes.
Although this summary reflects only but a fraction of the material presented during the weekend, what I would confidently suggest that I enjoyed the most was the concept behind the following statement Jean-Francois had provided:
"First think like a coach than (and then) a clinician w/ patients. Training variables are generally more relevant than anatomical ones in running injuries."
For clinicians, it is easy to get caught up in the footwear debate, biomechanical analysis and our own treatment biases, but more often than not, the most important variable is training. We must always ask ourselves the simple question, "is the training stimulus exceeding the physiological capacity"? The reality is that with injuries, the (internal and/or external) stressors are often greater than the body's capacity and building capacity in an individualized, dynamic and progressive manner is what many programs lack.
Hopefully this short summary piqued your interest. I really enjoyed the course and consider The Running Clinic "good people". They have a wealth of information on their website to share so make sure you take advantage of it.
I myself, still have questions but these specifically pertain to how I can integrate the information in a practical and prudent manner in our daily training environment at the track. As alluded to above, we need to be strategic if and when we introduce changes and since sprinting in spikes and running a marathon are not quite similar, it is now my job to apply what I have learned in as best a manner that I can.
In November I had the privilege of attending the Functional Anatomic Palpation and Functional Range Release (spine module) course hosted by Somatic Senses.
This course was taught by Drs. Andreo Spina and Michael Chivers, and while I've known both of these bright individuals for over 10 years, it's always a treat to hear what they have to say.
Because it would be difficult for me to write a summary for those who were unable to attend (the course is full of contextual information), I thought I would do something a little different and recap some of Dr. Spina's quotes from the seminar and directly ask him for follow up clarification.
He kindly agreed so enjoy!
"Don't focus on the muscles, focus on the connective tissues"
"Instead of flossing the nerve, load it"
"The first job in rehab is to influence (aka normalize) the healing of damaged tissue"
"If something is neurologically tight, do not try to 'release' it...you need to apply neurological inputs - i.e. isometric contractions"
"It's the nervous system's decision as to what it does with the muscles, not the decision of the origin and insertion"
"Force is the language of cells"
"The idea that fascial lines exist negate the idea that everything is connected...and everything IS connected"
"When taking a clinical history, think histology"
Thank you again to Dr. Spina for taking the time to clarify his thoughts (quotes). If you're a manual therapist, I highly suggest you check out his site and better yet, one of his courses. In the meantime to tide you over, here's a short video I recorded directly from the course.
I just completed a weekend of mentorship here at the University of Alberta with with Kevin Tyler and Dr. Gerry Ramogida.
Organized and hosted by the Canadian Athletics Coaching Centre, the weekend consisted of integrated and collaborative presentations by Kevin and Gerry on Friday evening and all day Saturday, presentations by Kevin on Sunday morning, and targeted feedback and mentorship (with our staff) by Kevin on Sunday and Monday afternoons.
As this was a very dynamic (as opposed to didactic) weekend, rather than summarize their presentations, I will simply post several of the key points that resonated most with me.
For those of you who were unable to attend, all presentations were recorded so they should be up on the Coaching Centre website soon.
In 2011, I had the pleasure of attending Lorimer Moseley's workshop, "Understanding Pain and Clinical Applications". My reason for re-posting this recap is because OTP recently released a 2-disc DVD set of his updated presentation.
The objective of this two day workshop was to provide us with a scientifically based and clinically relevant, guiding framework for effective patient management. The three components of this framework were:
As always, I must first disclose that the following recap is based on my own interpretations of what was covered and may not be a direct reflection of what was taught.
For those of you who work with individuals with pain, athletes or not, it is important to understand that "pain" in and of itself is a complex entity. Hopefully most of us are aware that its defiinition has long evolved past Descartes' "bottom-up model" and that this conscious experience is comprised of many systems designed to protect us from threat. The systems potentially involved include:
And as Lorimer suggests, pain can be conceptualized as a conscious correlate of implicit perception.
"Pain relates to perceived danger"
"Pain is a protective response that occurs in consciousness"
Perception, meaning that our brain is continually evaluating actual or potential threats, based on many variables (such as sensory input, previous experiences, cultural factors, social/work environments, expectations about consquences, beliefs, knowledge and logic) to provide us with a not-always-accurate conclusion of possible danger.
Lorimer stressed that pain is a conscious experience, manifested by the activation of specific and personalized, though modifiable, wired networks within our brain collectively known as neurotags. These tags, originally known as neurosignatures, exist in a snapshot in time, are precise and depend on inhibition to accurately map, in the brain, the representation of pain. In the presence of chronic pain, however, precision of mapping becomes lost via disinhibition. Essentially, the experience of pain does not necessarily change...but its contributors do.
"Pain doesn't exist until it hurts"
Throughout the weekend, Lorimer directly and indirectly provided ample opportunity to hone our skills for "explaining pain". For those of you unaware, he co-wrote the must read, "Explain Pain" with David Butler
"Pain is of the body...but of your head"
To effectively manage those experiencing pain, he suggested that we take a three-pronged approach that includes the explanation of pain, sensory discrimination, and graded motor imagery. In fact, rather than a pain management framework, he suggests that we adopt a "pain recovery" program.
"Pain is optional"
This is a pretty straight forward, though far from simple, cognitive approach of engaging the patient, identifying and reconceptualizing the threats, using humor, and providing stories, metaphors and yarns to gradually re-expose the individual. We must essentially get under their radar to understand why pain does not equal their MRI results.
"People often describe fear instead of pain"
"We need to look beyond the tissues that hurt"
To optimally create change we must:
Sensory Discrimination and Graded Motor Imagery
The concept of a body matrix was introduced as were the clinical utility of "left /right judgements" and "imagined movements". Left / Right judgements are intended to recruit the pre-motor cortex by re-inhibiting the neurotags that are inhibited in painful experiences. Imagined movements, on the other hand, may actually activate pain neurotags as they recruit the primary motor cortex so these often need to follow L/R judgements. Essentially we must provide subthreshold inputs to elicit precise inhibition of subcomponents of pain neurotags. For more information, the NOI group provides an excellent clinical tool for use in clinic. Click here to access this resource.
So, it is important to understand that graded motor imagery involves the recruitment of the premotor cortex in order to plasticize the non-painful neurotags in a staged/graded harmless manner.
"Pain more associated with the nervous system becomes even less associated with the tissues"
The Painful Athlete
While treating the athlete was not a focus of this workshop, it is important for me to discuss the relevance of an effective management plan when working with athletes who experience pain especially since pain catastrophizing and fear avoidance are common in the training room.
While exercise is perhaps the utmost priority in rehabiliation (see Putting Manual Therapy in Perspective), "training the brain" is probably the most effective way of doing so. In particular, motor control based rehab via targetting the central nervous system to induce "change"
We know that the brain is neuroelastic and since we do not want to perpetuate painful or faulty movement patterns, we must be specific with program design and implementation. Simply asking an athlete to "activate" a muscle just isn't enough. Further, cueing also plays a significant role in training the brain as Gabrielle Wulf's work tells is that we should strive to utilize external cues as much as possible.
As for sensory discrimination, kinesiotaping techniques are an excellent tool to pull from your shed to provide continuous non-noxious stimuli and facilitate biofeedback and optimal motor patterning. One way of conceptualizing this is by considering that teenager who won't step away from their video game. Think of the video game as a pain neurotag. Playing for one hour is acute pain. Playing for hours on end is chronic pain. He can't stop playing. It won't stop hurting. So you buy him an iphone. Playing with the iphone is equivalent to the non-painful neurotag. He plays with the iphone for 5 minutes. 5 minutes becomes 10 minutes. 10 minutes becomes 20 minutes and so on. This n0n-painful stimulus (the iphone) is slowly and gradually distracting him away from his painful experience, the pain neurotag, the videogames. Eventually he outgrows the video games and there you have it!
Finally, we can progress graded motor imagery to graded motor learning and control in many different ways but it is important that we respect the buffer zones that enable us to protect our athletes from crossing their tolerance boundaries. As both Lorimer and Dr. Stuart McGill suggest, it is always important to recognize and increase your athletes' capacities, but to do so in a graded and gradual manner.
A special thank you goes out to Cynergy Education for hosting this workshop but even more gratitude goes to Dr. Moseley for his wonderful insight and expertise.
From August 15-18, I had the opportunity to head down to Athletes Performance in Phoenix to attend Frans Bosch's Speed Development & Motor Behaviour clinic.
Although the Canadian Athletics Coaching Centre will be hosting him in December (which I am hoping to attend), I thought it was somewhat of a responsibility of mine to "leave no stones unturned" and attend. Since his book goes into great detail on running mechanics and given his knowledge of motor learning (his new book has yet to be translated to English), I was confident that hearing him speak more than once would be conducive to my professional development.
50+ pages of notes later, I'd say that mission was accomplished.
To say that this clinic was deep in content would be a huge understatement. And although the roads to Rome - especially as it relates to training methodology - are great in number, any course that forces cognitive overload even days after it has ended would be considered a success in my books.
Patrick Ward already wrote up a summary of his notes and thoughts, so in this post I figured I would incorporate my interpretation of some of Bosch's concepts into a guiding framework.
So consider the following:
The above was discussed in a recent conversation about effective coaching, analysis and therapeutic intervention that I had with our head coach not too long ago. In many sports, and especially track & field, I'd say that this sums up a decent sized component of coaching and performance therapy quite well. So if I had to describe or summarize the Bosch "method" as briefly as possible, it would be with the five bullet points above.
But to let me expand on each, based on my interpretation of his teachings over the course of the weekend.
Know What You See
From a standpoint related to therapists, I hold firm in my belief that it is important for the therapist and any member of the applied integrated support team be present and see the athlete in competition and especially training. During the weekend Bosch had mentioned that being able to identify the main issue (in faulty mechanics and/or mechanism of injury) is very intuitive, and I’m of the mindset that “deliberate practice” in human movement analysis facilitates the development of intuition. Effective analysis, technical coaching, and applied therapy is far from being cut and dry and requires consistent studying and practice. In my mind, from here dynamic technical models (to utilize as frameworks) will arise and hopefully be followed by relative success in being able to identify what you see.
Know What You Don't See
Once one develops an eye for being able to understand what they see, the ability to identify rooms for improvement should follow shortly behind. That is, to have a working knowledge of what should be ideal and what is lacking. Bosch was able to accelerate my learning in this department by providing us with a flowchart for error detection in “top speed” (upright) mechanics, broken down into 4 categories and possible causes. These include, but are not limited to, involuntary high frequency of running, excessive long axis rotation, lower extremity backside – “round pendulum” as he calls it - mechanics and arm action.
He then presented a similar, yet more systematic, flowchart for error detection in the start and acceleration. He strongly suggested that each of these should be addressed in a sequential order, not dissimilar to the SFMA algorithm in clinical movement assessments. His order, on a superficial level, consists of start trajectory, knee and hip collapse, ankle angle, and the amount of whole body slack - or lack of stiffness - present.
Some of the above information is in his book and DVD so feel free to check them both out.
Know Why You Don't See What You Don't See
As a motor learning and behaviour junkie (for lack of a better term), Bosch firmly believes that running is not just about optimization, but also robustness against many perturbations. Peter Reeves and his balancing stick analogy immediately came to mind during this section of the weekend and it was hard for me to not find similarities in their lines of thinking. With that said, when analyzing our athletes – again for performance enhancement and injury prevention – it is important for us to take a whole body approach in analysis and refrain from the opposite reductionist model. I think we need to move away from the single minded “just strengthen the glute med” line of thinking and better ourselves in understanding why we don’t see what we don’t see. Again, this takes practice, but truly it is never just a single joint that should be in a specific angle. It is always the relationships between the joints that matters, as Bosch suggests. That said, Bosch does recognize and suggest that good technique is often frontal plane dominance, with bad technique often emanating from sagittal plane dominance. So from a “general strength (GS)” and wholistic athletic development standpoint, I’m of the current mindset that warm up and GS exercise selection should not be limited to linear exercises.
Perhaps novel to some of the attendees (at least to myself), Bosch views traditional strength training as Isaac Newton based, with neurophysiology often being under appreciated and dynamic or variability training lying second tier to linear strength development models. Where this is relevant is in Hill's model of muscle and tendon properties, that many coaches often outweigh passive tissue (tendon and series elastic components) development in favor of active tissue (muscle and parallel elastic components) development. Bosch went to great lengths reiterating that during running, most "lengthening" ideally should occur in the tendons and thus, the importance of isometric contractions of muscle bellies. And as mentioned in my previous post , this makes me inquisitive about individuals from various demographics and specific tendon-muscle ratios. It is known (read Epstein’s “The Sports Gene”) that some demographics that have greater tendon to muscle ratios in given muscle complexes. Additionally, from my own (admittedly) anecdotal experience, there are also individuals from specific demographics whose connective tissues are thicker and more dense than others. With both of these in mind - at least in my mind - each of the above (greater tendon to muscle ratios and greater density of connective tissues) would be conducive to transmit forces more rapidly up or down the "chain", have greater resilience to neuromuscular fatigue, and be better able to possess more spring-like properties. So again from a therapeutic standpoint, would it not be wise to take a more systematic and targeted approach (with at minimum, the technical model in mind) to soft tissue therapy rather than the common application of whack-a-mole?
For example, many are familiar with the term “muscle slack” from Bosch and his views on the importance of “taking up” such slack during the initial and instantaneous phase of contraction. According to Bosch, once slack is taken up, elastic loading can occur. “Becoming supple” is currently all the rage, and while slack is important for variability - a steering mechanism in distance runners – Bosch suggests that regulating stiffness (decreased slack) is the ideal in sprinters. This is not surprising, and by no means am I suggesting that mobility is not important, but I have come to appreciate and accept – as well as relatively ignore – passive and low load mobility restrictions in certain sprinting demographics…at least when it comes to performance. Yes, I do understand that Bosch’s concept of slack has to do instantaneous contractions, but where I’m getting at is my somewhat evolved views on analyzing (walking) gait, and passive testing without regard for comparison to technical proficiency and postural stability.
Another consideration to expand upon – based on Bosch’s discussion of the series and parallel elastic components – has to do with the neutral lumbo-pelvic complex, or lack thereof. Now this is a topic that’s consistently running through my mind so please feel free to discuss, but I’m starting to wonder whether or not I would “allow” a greater saggital plane range of motion of the lumbo-pelvic complex in certain individuals, so long as control and efficiency are present. My current line of thinking is that this is still the exception rather than the rule so please bare with me, but if a given individual displays greater tendon to muscle ratios, would it not be reasonable to presume that they are better able to store and transmit forces traditionally around the hip from above the pelvis? Again, control – and in many instances, high performance - is paramount, but one would be hard pressed to convince me to alter this specific aspect of several high level sprinters’ mechanics. So for those of you wondering how this relates to “knowing why you don’t see what you don’t see”, my assumption is that contemporary “neutral” may be missing from certain individuals due to tendon-muscle ratios.
Know How to Best Get What You Want to See
The application of science across many realms is truly an art and in athletics, the same can be said for both coaching and performance therapy, as well as the integration of the two. Just ask Kevin Tyler and Gerry Ramogida. But with respect to the juxtaposed stimulus-adaptation relationship, there was no shortage of thought provoking and discussion generating topics floating around the Bosch weekend. Take, for example, the concept of muscle contraction as being 3 Dimensional, rather than simply the approximation of joints. Those of you familiar with DNS will understand this notion of muscles "bulging out" or volumizing. Because while many will throw soft tissue therapy out with the bathwater, for me the importance of tissue quality and compliance - particularly of muscle bellies – holds priority over lagging level 1 research.
The importance of coordination and the isometric role of biarticular muscles were two of several major themes throughout the Bosch weekend. Coordination I was quite familiar with but Bosch’s methods of “training the hamstring” (beyond the information contained in his book) I was not. Needless to say, his views and methods were thought provoking but I will admit that he currently has me thinking more and more about how best to facilitate isometric contractions of such muscle groups so their respective tendons can better act like springs for force transmission.
From the first day until the last, Frans spoke a great deal about Dynamic Systems Theory (DST), both in theory and application. This theoretical construct is quite deep and I would rather not to do it a disservice with misrepresentation. But still, it would be prudent for therapists to understand “the butterfly effect” - that small changes can have large and cumulative effects - from chaos theory. And within the realm of DST, there are no protocols to govern - just a few simple rules to follow - resulting in functionality and coherence in behaviour, as stated by Bosch.
One of such rules is the rule of stable attractors and variable fluctuations. An example of this is the knee as an attractor versus the ankle as a fluctuation as he discussed in his CACC podcasts. That knee angles should change little while the ankle should be trained in variable environments (grass, mats on the track, etc).
Bosch also discussed his preference of co-contracting muscles over countermovement activity, for the purpose of minimizing muscle slack buildup. He also suggested that the more (traditional) lifting an athlete performs, the greater the potential for the weights to compensate the muscle slack for the individual. That the body should learn to take up the slack itself, rather than the weights. Therefore, his summary was this - that muscle slack may limit performance, that co-contractions (without instantaneous release) may also limit performance, (and) yet co-contractions also limit muscle slack. So according to Bosch, coordination training and co-contractions prior to impact of unpredictable external forces are key in open and closed skill running. For me, I wonder if this is where EQIs fit in... Because the more isometric the biarticular muscles function, the less degrees of freedom to control, according to Bosch. This – to him - results in greater stability and force transfer due to the increased use of passive elements, but only when muscle belly length is kept in its optimal length. So he suggests to go after the SEC. To train in isometric contractions with variable conditions/environments. In sum, Bosch suggests that there should only be one degree of freedom: isometric contraction in an optimal length. This is his rationale for training the hamstrings in such specialized contractions and in higher intensity movements. Training the attractor. And since fluctuations are variable, his rationale for training ankle adaptability via – for example – running with changes in center of gravity and on variable surfaces.
Very briefly, Bosch discussed comparisons of humans to horses and kangaroos. In short, he suggested that the angle between the femur and foot while running is optimal for energy transport. That the more parallel the two, the better.
After two days of going over the ingredients, Bosch used days 3 and 4 to discuss how best to create a recipe. Again, Bosch is big on motor learning and I think we can all better ourselves in this regard. For therapists, I think our biggest downfall is knowing and studying anatomy. And if you look back to coaching in years past, I'm sure you would be hard pressed to find a successful coach who mentioned the words "glute" and "activate" on the track.
For Bosch, effective motor learning is saving directly to the hard drive and bypassing the short term, working and random access memories. Motor learning research - and good coaches - suggest that the more you (inappropriately) cue and talk, the more you activate the working memory. And this is contrary to the ideal. Learning is decentralized and not top down. Yet unfortunately, the top-down process is commonplace. And training the top-down process often leads to "reinvestment" - conscious monitoring and control - in competition. So if you are a therapist, please remember that what you say matters. And may I suggest, say as little as necessary!
I wish I had the time and patience to summarize the motor learning component of the weekend. But truly, it was content rich and I would rather not do so incompletely. So if you don't speak Dutch (again his new book has yet to be translated to English), and want to learn about types of feedback, the differences between knowledge of performance and knowledge of results, intrinsic and observational learning, and the value of metaphors and analogies, I highly suggest you take a peek at Developing Sport Expertise. The 2nd Edition was just released, and I'm excited to crack it open real soon.
...So That You Can See It Consistently
Ultimately, when you put all of the above together and constantly strive for best practice implementation, you would be hard pressed to not achieve working success in performance therapy. And as difficult as it may seem, I do agree with Bosch in that we have to deviate from the model that we normally find intuitively useful. From varying the environmental stimulus to achieve adaptation and prevent poor performance from monotony, he and others appropriately suggest that in order to get what you want to see and see it consistently,
"The best method is to vary the variation...vary the task, vary the environment...then vary these again!"
On the week of June 18, the National Track & Field Championships were held in Moncton, New Brunswick. I was here with our group from Edmonton and was fortunate to have a little downtime throughout the week. Because of this, I was able to get in a little continuing education time.
That same week Mike Reinold and Eric Cressey also released their Functional Stability Training for the Lower Body as a follow up to their Functional Stability Training for the Core so naturally it was an easy fit.
It's quite a lengthy program - I have yet to get through it all - but I was able to jot some notes down along the way. This summary was a culmination of several updated posts.
Training the Hip for FST for the Lower Body
Assessing Lower Body Alignment and Movement (Lab)
Preparing the Adductors for Health and Performance
Hip Internal Rotation Deficits: Why You Have Them and What to Do About Them (Lab)
Training the Foot and Ankle for FST for the Lower Body
Understanding and Implementing Neuromuscular Control Progressions into Your Programs (Lecture) / How to Integrate Neuromuscular Control Progressions (Lab)
Developing Lower Extremity Strength and Power Outside the Sagittal Plane (Lab)