Friday, November 16, 2012
How do you measure upper extremity dynamic stability? The recently described UQ-YBT offers a reliable way to objectively measure upper trunk stability and mobility in a closed kinetic chain position. The UQ-YBT allows us to measure limb symmetry and identify potential limitations that could contribute to an individuals injury risk. Limb Symmetry Index: The LSI provides a ratio comparing the performance between 2 lower extremities of the same individual; this is clinically useful in determining lower extremity asymmetry.J Orthop Sports Phys Ther 2001;3 1:145-151.
The video link below gives a quick over view of how to perform the Upper Quarter Y Balance Test.
Test, Don't Guess.
Thursday, October 18, 2012
As Athletic Trainers we spend a great deal of time and effort preparing our athletes physically for their return to sport participation after injury & surgery. Another aspect that we need to address is their mental preparation. Having a better understanding of the individuals expectations and concerns creates an opportunity for us to do a better job of facilitating a smoother transition back to sport. Dr. Weiss, PhD., ATC has prepared a great primer on this topic:
Windee M. Weiss, Ph.D., ATC
University of Northern Iowa
Wednesday, October 17, 2012
Here is an article from JOSPT (Journal of Orthopaedic & Sport Physical Therapy) that sheds light on what we should be doing.
Keep up the good work!
Wednesday, September 19, 2012
Tuesday, September 11, 2012
Wednesday, September 5, 2012
Why do I care so much about how we perform Pre-Season Screening and Return To Sport Testing? Passion, I believe that we can change the current "way of doing things" by questioning our current system and challenging our old beliefs.
What do I think we can accomplish together?
A Paradigm Shift, I believe that together as passionate sports medicine professionals we can reshape the approach to screening and testing of athletes, soldiers and police & fire personnel.
How will this be accomplished?
By Daring to Dream & A Commitment to Lifelong Learning.
I dream of a way to improve the objectivity of how we in the sports medicine community determine if and when an athlete is ready to begin or resume participation in competitive sports & physically demanding occupations. I spent my early years in the sports medicine community watching and listening to experienced clinicians, physicians, athletic trainer's and coaches debate and argue about if and when an individual was ready to return to action. These heated debates taught me that passionate debate about gut feeling really got us nowhere. We had little more than our opinion of what we thought was in the best interest of the athlete and took an educated guess about what the chances of re-injury/new injury were to that athlete is they went back to soon.
Test Don't Guess
My dream is centered around the idea that we use an integrated & collaborative approach to determine objective tests and measures to help us determine if an individual is ready to participate.
We have a tremendous amount of information available to us from some of the greatest researchers of injury prediction and little collaboration or integrated communication between them, all the while the majority of our colleagues (Sports Medicine Professionals) continue to "do what we have always done" because no one has taken the initiative to lead the necessary conversation to get the ball rolling. When we test pre-season we Gain the advantage of foresight. If we test/screen pre-season we will know who is ready and who is not. We gain the opportunity to proactively take action, to stop saying "I wish I knew about__________ before the season started, I would have done something about it". We gain the ability to target our resources to the appropriate athletes. We gain the knowledge needed to make an informed decision regarding when to return an athlete to participation.
A Call To Action
Why do you do what you do? What's next?
Wednesday, August 29, 2012
By The Way; we have objective science now that helps us answer these questions confidently.
Friday, August 24, 2012
When Pre-Participation Physicals Become Return to Sport Testing
High School and College sports are in high gear, your the only ATC or Sport Physio at the school and now in addition to having to cover 3 levels of football, 2 soccer teams, volleyball, cross country, & fall tennis you have a few club sports that are requesting that you help out with an injured athlete; oh I forgot that the initial injuries that are coming in the doors to the training room to be assessed/evaluated and treated.
How do you determine when to return athletes to play?
Athlete "Can I play today?, Friday night?, When?."
Coach " When will they be ready?"
My answer "When Your/their LQ-YBT and FMS scores return to baseline or better and you/they no longer have pain".
Do you have an objective baseline measure that indicates level of injury risk (any objective measure for that matter) from Pre-Season Physicals that you can use to answer the above questions? If not you should.
Test Don't Guess!
Tuesday, August 21, 2012
Governing associations may add another layer of complexity to the paper trail. Most of these PPE's consist of check list(s) that meet legal requirements at best and add little value to efficiently identifying and categorizing athletes for future injury risk.
Currently there is little consensus in the sport medicine community about what should be (must be) included when determining the readiness of our athletes to begin/ or return to participation in competitive sports.
How do you answer these questions?:
Who decides what constitutes a thorough Pre-Participation Physical?
What objective tests and measures are included?
Which ones are meaningful? Which ones (risk factors for future injury) are modifiable?
When are physicals scheduled? When do we re-test prior to Return to Sport?
Where do we conduct the testing/screening? Why?
How does the information collected help the athlete, coach & medical staff?
Why do we do what we do?
Does the PPE add value to our athletic program and sports medicine team?
Or does it just meet a requirement and drain the resources and energy of the staff?
I believe it is time for us to offer better than a check list to our athletes.
Wednesday, August 15, 2012
"Current research on the Functional Movement Screen suggests that the test is a reliable way to objectively measure fundamental movement patterns that are modifiable and indicative of an elevated likelihood of sustaining a musculoskeletal injury." KEY POINT the FMS helps us identify modifiable risk factors. We as Sports Medicine professionals have been searching for a meaningful approach to clearing athletes for competition for a long time, this is a great start.
"The average score in 20-40 year olds is approximately a 15......; approximately a 1.2 composite decrease for the 50-59 year old group and an additional 1.2 composite decrease for the 60+ group." KEY POINT we can reasonably expect that FMS scores are different for different age groups. This helps us make appropriate comparisons when interpreting scores.
" ;..... it is likely that not all corrective exercise programming or strength and conditioning programming may results in a change in FMS scores." KEY POINT corrective exercise programs and performance improvement programs should be individualized; a One Size Fits All program approach does not yield optimal results.
When discussing how the FMS relates to specific sport or skill performance: "The primary take home message across these studies is that a single performance effort is not strongly correlated with FMS scores." KEY POINT the FMS allows us to assess different aspects human movement that contribute to athletic skill.
"In summary, the Functional Movement Screen is a reliable tool that can be used to identify individuals who are more likely to become injured." KEY POINT we can identify limitations and asymmetries that have the potential to contribute to future injury.
"It has also been observed that improvement in the composite FMS score can occur through some movement related training programs." KEY POINT we can make a meaningful difference for our athletes and clients by lowering their potential for future injury by applying an individualized approach.
Thank you Dr. Butler for summarizing the research.
Tuesday, August 14, 2012
Our next stop on this journey:
The Upper Quarter Y Balance Test (UQ-YBT) is a relatively new test that looks at the upper extremities in a closed kinetic chain posture. The test is performed starting from the "Up" position of a push up; the athlete maintains single hand balance (the stance hand) on one side while simultaneously reaching to the edge of their ability (stability) with the other in 3 directions. The test is then repeated on the other side and results are compared for symmetry and against their peer group (same age, gender, sport, & competition level).
It can be a challenging test for many as it can quickly identify an individuals Right/Left differences (asymmetries) and add to the objective measures we are basing our Pre-Participation & Return to Sport recommendations on.
Here is a quick video demonstrating the UQ-YBT (Upper Quarter Y-Balance Test)
Friday, August 10, 2012
If you are part of the sports medicine team and desire to improve our current system for determining readiness of individuals for athletic participation (injury prediction & prevention), please comment &/or contact me, together we can go further faster.
Saturday, August 4, 2012
Hop testing is another great objective measure to include in your screening and testing of athletes and individuals prior to beginning or returning to activity and sport. Later we will discuss why we utilize many different tests and measures in musculoskeletal screening.
Sunday, July 29, 2012
Hoch et. al. 2011 & Hoch et. al. 2012: The weight bearing lunge test (WBLT) explained a significant portion of the variance within the anterior reach distance signifying this direction of the Star Excursion Balance Test (SEBT) may be a good clinical test to assess the effect of dorsiflexion range of motion restrictions on dynamic balance. The Y Balance Test was developed in order to improve methodology and testing efficiency of the SEBT.
Marcrum et. al. 2012 Results- Altering ankle DF starting position during double leg squat resulted in increased knee valgus and medial knee displacement, decreased quad activation & increased soleus activation. These changes are similar to those seen in individuals with PFPS.
Keep up the great work; Your building a better testing system.
Saturday, July 21, 2012
|up next: Side Sit Bridge|
|Ready to FMS|
|Back Light Pictures|
|Tom checking sound|
Friday, July 20, 2012
Part 1 was the webinar with StrengthandConditioningWebinars.com
Part 2 was the follow up podcast with Joe Heiler at SportRehabExpert.com
Part 3 is our video series that will complement and expand upon the material.
I'll keep you posted on the progress and be on the look out for updated and new videos on TankGym TV on Youtube
Wednesday, July 18, 2012
When I am talking about Pre-Participation Physicals I am describing what we do with all athletes to identify movement limitations/asymmetrical patterns in the non-painful athlete. These screens and tests allow us to categorize an individuals musculoskeletal injury risk (that is there potential for future injury compared to their peer group) . As we test individuals we include pain provocation tests to help us capture outliers, those that may have unknown or un-diagnosed pathology. When we identify pain in an individual we evaluate them differently and here is a great link to help you understand why: The Influence of Pain on Movement, by Dr. Kyle Kiesel.
Sunday, July 15, 2012
You will be able to deliver the Right Intervention, to the Right Person, at the Right Time. And to top it off you will communicate confidently to the athlete, parents, coaches and sports medicine team about the recommendations and follow up needed for each individual.
So, our next step to to begin to introduce you to the Functional Movement Screen. Dr. Lee Burton, co-developer of the FMS, has put together a great intro video that is must see tv: check it out Here
Saturday, July 14, 2012
If you have not already checked into the Y Balance Test videos to see how fast and easy it is to test an athlete you owe it to yourself to do so. Again, part of my goal as a Certified Athletic Trainer is to provide a better, more meaningful way to contribute to sports physicals. For several years I covered a large Indiana high school and had to plow through hundreds of athletes during a mass physicals nightmare. We did what every other school did, the check list. At best the form covers Past Medical History; and previous injury is by far and away the leading predictive variable of future injury, no doubt. But we can not modify previous injury, we need information that allows us to be proactive, we need to do better than a check list for our athletes.
Thursday, July 12, 2012
|FMS and UQ & LQ YBT|
Great work so far! We are covering alot of ground quickly in an effort to get you up to speed to the fall school/sports year so hold on tight. By now I hope that you have checked out the Y Balance Test . I also hope that you have looked around the web, read other pre-participation screening research, talked with your colleagues and started to formulate your own thoughts about what we should be looking at in our physicals. My hope is to provide a template for Standard of Practice for the screening of athletes from pre-season screening to return to sport testing. Lets strive to provide objective measures to our clients that are meaningful, lets show that our "sports enhancement/performance improvement/jump/landing/speed/agility/skill/fancy name" make you a better athlete training program really makes you better by lowering your individual injury risk classification and I will continue to guide you to the tools that do just that, we have the research to to it. By the way this is also the leading way to test the Warrior Athlete to help predict musculoskeletal injury risk.
Sunday, July 8, 2012
to utilize and begin to interpret the UQYBT test can be found in the links provided; How to utilize and to interpret LQYBT. I gave you alot of homework, take a few days to look it over, ask lots of questions. And remember your goal should be to change how you practice and test athletes first. Change the rest of the world sometime after that.
Monday, July 2, 2012
This fits squarely into the Pre-Participation Physicals we have been discussing recently; Stay Tuned..
Saturday, June 30, 2012
Thursday, June 21, 2012
Tuesday, June 12, 2012
Sunday, June 3, 2012
Wednesday, May 30, 2012
I am excited to be plannning an up coming video shoot that will expand on and better demonstrate our Dynamic Shoulder Stabilization progression from TankGym. I will keep you posted on our progress and encourage your feedback and request. It will be answer on the webinar we gave in Dec '11 with strengthandconditioningwebinars.com
Wednesday, April 18, 2012
Latest research on the Y Balance Test: LQ-YBT as well as the UQ YBT.
More great research coming from our very own TankGym training staff.
If you are not familiar with the Y Balance Test and you are in fitness or rehab these tools should be in your client/patient pre program design and included in return to sport testing.
To learn more about Y Balance Testing check out all the latest on Move2Perform . Here you will find all the information to help get you started utilizing this valuable tool that will help give objective information to the effectiveness of your clients program. To get tested contact us at www.TankGym.com