Why Distance Doesn’t Tell the Full Story During Hop Testing

Over the last year or so, I’ve taken a keen interest in how rehabilitation professionals qualify athletes to resume sports participation following injuries (“return to play”). It’s a natural area of research for me, as it’s essentially the bridge between rehabilitation and performance training.

One of the biggest conundrums in rehabilitation is the high rates of re-injury -- and whether current return to play testing protocols are even helpful for reducing re-injury risk.

One injury with alarmingly high re-injury rates is the ACL, or anterior cruciate ligament. Return to play testing protocols during ACL rehab typically consist of measures of range of motion, single-leg strength, and hops for distance.

Four different hops for distance

Much of the debate centers on which hop tests should go into the testing battery, as there are about a million and one options: single hop, triple hop, triple crossover hop, six-meter timed hop, side hop, etc.

But there’s relatively little talk of a simple way to derive way more information out of whichever hop tests are used.

My friend Tim Rowland and I teamed up to shed light on this subtle addition to testing procedures that we believe can have a major payoff for return to play decision-making:

https://www.physio-network.com/why-distance-doesnt-tell-the-full-story-during-hop-testing/

Is Your Inability to Crawl REALLY Killing You?

As children, we’re taught that “sticks and stones can break our bones, but words can never hurt us.” While a nice sentiment, the more I learn, the more I realize that old adage simply isn't true. Words do have the potential to harm. And the way some movement and rehabilitation professionals have chosen to wield them is doing just that.

For example:

• “If you can’t roll, crawl, and squat like a baby, you’re destined for pain and dysfunction. Take my course to learn how.”

• “If you do bench dips, upright rows, or behind-the-neck presses, you’ll wreck your shoulders. Buy my book to learn about optimal movement.”

• “If you don’t learn how to breathe, you’re gonna die! Come with me if you want to live.”

Okay, so maybe that last one about breathing is literally true, but still. 

WTF is “Load Management"?

Since the turn of the century, the San Antonio Spurs are the winningest team in the NBA. No doubt, a lot of their success can be attributed to having had a bevy of current and future Hall of Famers on their rosters. But perhaps no single person has been more influential in their success than head coach (and famous curmudgeon) Gregg Popovich.

Under Popovich, the Spurs have run off a stretch of 18 straight 50-win seasons and 22 consecutive playoff appearances. Obviously, Popovich is a brilliant basketball strategist; you don’t win that many games by accident. But his brilliance appears to extend off the court, too -- specifically, to the human body and its need for rest and recovery. (Note: he likely also has the help of a world-class sports medicine team.)

Case in point: in 2012 Popovich famously rested his four best players on the night of a nationally televised game. It was an unfortunate decision for fans around the country who were stuck watching the Spurs’ B-squad. Although the Spurs ended up losing the game, the move proved to be the right one for them in the long-run. They won the championship that season.

The Two Most Common Misconceptions about the FMS

Over the past three years as part of my PhD, I’ve been researching the relationship between movement and injury. A recent Twitter discussion reminded me that people on either side of the great FMS social media debate are still confused. I figured I’d put my research efforts to good use to clear up a couple of common misconceptions.

Misconception #1: The FMS composite score can predict injury.

When the FMS first became popular in the late 2000s, its creators touted it as an injury prediction tool [1,2]. The trouble was, at the time they had zero scientific evidence to back that claim up.

It turns out scoring low on the FMS does increase a person’s risk of injury slightly [3,4], but it doesn’t guarantee it. In other words, while low scores are associated with injury, the FMS does not predict injury on an individual basis. Big difference [5].

Specifically, when the FMS is conducted on a large group of people, as in a scientific study, we tend to see a lot of false negatives (people who score high but still get injured).

The fact that the FMS can’t predict injury actually isn’t that surprising. There’s no one thing that predicts injury [6]. This is because injuries aren’t caused by just one factor. Instead, they’re the result of a complicated web of interrelating factors -- a web that’s different for every person based on the types of activities they do [7].

Bittencourt NFN, et al. Br J Sports Med 2016;50:1309–1314.

What is Pain, and How Should We Manage It?

Today's post is written by a very special friend of mine, Dr. Fred Goldstein. Dr. Goldstein is a Professor of Clinical Pharmacology at Philadelphia College of Osteopathic Medicine. Dr. Goldstein and I go WAY back to when his daughter and I played in the same basketball league as kids.

The topic of today's post is pain, which Dr. Goldstein is a true authority on. He's been teaching about and researching pain for even longer than I've been alive! I learned a ton from reading his article, and I think you will, too. -Travis

WHAT IS PAIN, AND HOW SHOULD WE MANAGE IT?

Frederick J. Goldstein, PhD, FCP

Professor of Clinical Pharmacology

Philadelphia College of Osteopathic Medicine

What is pain? Toothache? Sprained wrist? Broken femur? Myocardial infarct (MI)? Obviously, all such conditions are “nociceptive,” meaning they send signals from pathological sites to brain areas for interpretation. Simultaneously activated are emotions which can certainly increase the intensity of such cellular indicators of tissue damage.

However, it is also known that circumstances exist where pain is attenuated or, in some cases, not even felt. A person who has experienced three MIs over the years will probably feel less alarm with a fourth one than the first. Soldiers in a fierce battle may not even be aware of severe wounds until that firefight has ended.

Of course, there is also psychological pain which occurs upon losing a loved one or receiving news that the cancer which has been discovered is, unfortunately, terminal.

Thus, there is always an interplay between physical and psychological aspects of pain.