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Posts Tagged ‘injury’

As an athletic trainer, we are all familiar with the principle of the weakest link.

A related term that I have become more familiar with lately is the term energy leak.

Gray Cook, in his book Athletic Body in Balance, states that an energy leak occurs “when all of the energy generated to perform a certain task or movement does not go specifically into that task or movement.”

Mark Verstegen, in his book Core Performance Women, has this to say about energy leaks: “Energy leaks occur when your body tries to produce force, such as when your foot hits the ground while walking or running. The energy goes up your leg into the rest of the body and finds an area of instability, perhaps around a hip. There the energy dissipates or “leaks” into this unstable joint creating greater trauma on the joint and surrounding connective and muscular tissue.”

Interesting enough – energy leaks don’t necessarily scream out to the casual observer – “LOOK AT ME, I’M AN INJURY WAITING TO HAPPEN!!!.” Individuals can still perform “normally” with energy leaks.

A pitcher can still perform at a high level…an assembly line worker can still perform their job…an individual still can be an avid exercise enthusiast – and all have energy leaks.

Those energy leaks result in microtrauma that will eventually manifest themselves in the form of an injury.

We sometimes have this perception that pain and discomfort are the main markers of microtrauma and injury. We tend to use that as our chief identifier instead of trying to identify  mobility and stability deficits. (Similarly, we use the absence of pain as the chief identifier that the injury is “gone” – again, a flawed strategy.)

The body is incredibly adept at doing “what needs to be done” in order to accomplish a task. That may even include performing a task to the eventual detriment of the body. The body is a great compensator but these compensations lead to the energy leaks that cause problems down the road.

So the assignment for you – don’t wait for pain to manifest itself in order to identify an injury. Assess and evaluate in order to identify energy leaks before they land your athlete or industrial athlete in the training room.

Do you have any examples of energy leaks to share? What are your thoughts?

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Earlier this week, I wrote about how Lindsey Vonn was having cheese applied to her injured shin as a part of the treatment regimen. I went on to discuss how the how a patient’s confidence in treatment can affect the end result.

As I was thinking this week, I recalled a webinar on the low back by renowned Physical Therapist, Dr. David Magee. He made a couple of interesting points on this subject during the webinar.

  1. He spoke of a case in which he was treating a woman with back pain who was from the Middle East region and still had family living there. It was during a time of war and upheaval in the particular region that I cannot recall. If the woman had recently talked with her family and had recently had a good report about the safety of her loved ones, her mood was improved and her back symptoms were improved. If she hadn’t heard from her loved ones in several days, her anxiety increased – as did her back symptoms.
  2. He also spoke of a strategy where after treatment, the physical therapist would remark – “well, that feels better doesn’t it.” This wasn’t done to pull the wool over someone’s eyes so to speak but to simply reinforce some of the good things that have taken place during the treatment session.

Psychology does collide with the treatment process and I was reminded of these examples this week.

I am treating a patient right now with a shoulder injury. He is making a lot of progress at this time and is headed in the right direction. He was treated for the same injury at a local clinic this past summer and I remember seeing him at the time and he was talking about his treatment experience. For whatever reason, he had no confidence in the treatment strategy that was being used and the results were limited. With the treatment he is currently undergoing, his confidence level has been high and the results have been very positive thus far.

I don’t say that to brag because I have been on the flip side many a time. I have been the person “at that other clinic before.” Patient’s begin to question to process and the rationale and that does affect their willingness to participate in treatment and their confidence about the process.

And as always – psychology must also be paired with sound treatment strategies in order to really have a chance to achieve the results you and the patient are hoping to achieve.

Some more things to consider regarding the intersection of treatment and psychology.

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The final part of this series will briefly address the mental aspect in relation to functional flexibility. As has been discussed in this series, Functional Flexibility is being used as a bridge. It allows the body to ramp up and progress from one series of events to another. This progression also helps the mind as well prepare for the next stage in the process.

In anything we do, the mental aspect is very important. We go out into our cars on a snowy day and most drivers would begin thinking something like: “The roads are going to be slippery.  I need to drive more slowly, brake a little earlier, and keep my eye out for reckless drivers.”  All systems are on go and ready. The posture is a little more upright, the feet are more ready, and we have a tighter grip on the wheel. Why? We are mentally prepared and this also allows our body to respond appropriately as well.

So, let’s go back to the example of the halftime intermission. Any coach will tell you that many contests are often won and lost within the first few minutes of third quarter. Coaches stress coming out strong to start the second half and yet most teams are sitting down in a relaxed position while listening to their coaches.

I’ll go back to the refereeing example. I mentioned in my last post that at the beginning of the third quarter it is often difficult for me to focus. Again I go from activity to 10 minutes of inactivity and sitting and then back to activity again. The body has physically slowed down, the heart rate is decreasing, and all signals are that we are calling it a day. Then all of the sudden we have to resume what we were doing with no significant lead in. The mind now has to refocus and get in sync with the body. I often find that it takes a few minutes to “get back into the flow”. For an athlete or someone in your care, those few minutes can be the difference between winning and losing or between performing safely and sustaining injury.

Functional flexibility can play a significant role in many facets. It is a bridge from stretching to activity. It can be used to progress that injured athlete, industrial athlete, or patient back into activity. It can be utilized during intermissions or breaks to keep the body prepared for additional activity. And finally, functional flexibility can also help individuals become more mentally prepared for additional activity requirements.

If you haven’t already, please take the time to view the video on Functional Flexibility and then your next task is to see how you can use this strategy in whatever setting you work. As we continue to strive to better serve those in our care, I hope this series has challenged you to develop some new ideas and strategies.

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