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Rehabilitation Techniques for Sports Medicine and Athletic Training William E. Prentice.

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Presentation on theme: "Rehabilitation Techniques for Sports Medicine and Athletic Training William E. Prentice."— Presentation transcript:

1 Rehabilitation Techniques for Sports Medicine and Athletic Training William E. Prentice

2  Specificity is an important parameter of an exercise training program  Jumping movement is inherent in most sports  Running is a repeated series of jump-landing cycles  Therefore, jump training should be used in the design and implementation of the overall training program and rehabilitation

3  Success in most activities is dependent upon the speed at which muscular force and power is generated.  Power combines strength and speed  Can be increased by increasing the amount of work or force that is produced and decreasing the amount of time required to produce force  Plyometrics is a form of training that attempts to combine speed of movement with strength

4  Plyometrics=quick, powerful movement involving pre-stretching of muscle and activating the stretch-shortening cycle to produce a subsequently stronger concentric contraction.  Takes advantage of stretch-shortening cycle (SSC) to increase muscular power

5  Main purpose of plyometric training is to heighten the excitability of the nervous system for improved reactive ability of the neuromuscular system

6  Myotatic stretch reflex used to produce powerful response of contracting muscles  Upon landing muscles undergo a lengthening eccentric contraction to decelerate movement and pre-stretch the muscles  Pre-stretch energy is then immediately released in an equal and opposite reaction  Produces kinetic energy  Neuromuscular system must react quickly to produce concentric shortening contraction to produce upward change in direction

7  Plyometric exercise should be used to prepare athletes for return to activity  Train specific movements in a biomechanically accurate position  Specific functional exercise used to emphasize the rapid change of direction  Can be used for upper and lower extremities  Whether athlete is jumping or throwing the musculature around the joint must first stretch and then contract to produce explosive movements

8  Stretch-shortening cycle:  Coupling of eccentric-concentric muscle contraction  Movement rarely begins from static position  Preceded by eccentric pre-stretch that loads muscle and prepares for concentric contraction  2 components work together to produce response:  Proprioceptive reflexes  Mechanical: Elastic properties of muscle fibers

9  Three component model  Contractile component (CC)  Series Elastic Component (SEC)  Parallel Elastic Component (PEC)  All interact to produce a force output  CC focal point of motor control, however SEC & PEC provide stability and integrity to fibers as muscle is lengthened  During lengthening energy is stored within the musculature in the form of kinetic energy

10  When a stretch is applied, potential energy is stored  That energy is applied as it returns to its normal length when the stretch is released  Analogy: stretching a rubber band  Significant increases in concentric muscle force production has been documented when immediately preceded by an eccentric contraction  Uses the elastic energy stored during eccentric contraction

11  Ability to use stored elastic energy affected by 3 variables  Time  Magnitude of the stretch  Velocity of the stretch  In order to increase concentric force production eccentric contraction must be of short range and performed quickly without delay  If large range, slow, with delay stored energy will be lost

12  Proprioceptive stretch reflex:  Involve the mechanoreceptors in the muscle:  Muscle spindle:  When muscle spindle is stretched sensory response sent to CNS and neurological impulses sent back to muscle causing motor response  Strength of muscle spindle response is determined by rate of stretch  More rapidly load applied, greater firing frequency of the spindle and stronger muscle contraction

13  Golgi Tendon Organ:  Inhibitory effect by contributing a tension limiting reflex, restricting the amount of force that can be produced  Theorized that Plyometrics desensitizes GTO and allows more force to be produced

14  Increased force production seen during SSC due to combined effects of stored elastic energy and the Myotatic stretch reflex  Increased amount of force production dependent upon the time frame between eccentric and concentric contractions  Defined as Amortization Phase  Electromechanical delay between eccentric and concentric contractions  Muscle must switch from overcoming work to acceleration in opposite direction  Increased time in amortization phase will lead to decrease in force production  Dependent on time frame between eccentric and concentric contraction  Amortization phase  Electromechanical delay between eccentric and concentric contractions when muscle must switch from overcoming work to acceleration in opposite direction  Increased amortization phase leads to decrease in force production and vice versa

15  Plyometric training can promote changes within the neuromuscular system  Allow individual to have better control of contracting muscle and synergists  Can increase performance by enhancing nervous system to become more automatic

16  Should begin with establishing adequate strength base  Allow body to withstand large stress placed on it (Safety)  Allow for greater force production  Increase in CSD of muscle will increase potential to store greater amounts of elastic energy

17  Biomechanical Examination  Functional movement screening  Strength test  Poor strength and mechanics will result in loss of stability and increased stress absorbed in wt. bearing tissue  Decrease performance and increase risk of injury  Stability Test  Static and Dynamic Balance Test

18  Dynamic Movement Test  Single Leg Hop test-LE  Seated chest pass or sit up and throw test -UE  Flexibility  General and specific flexibility  High amount of stress applied to musculoskeletal system  Should do general and specific warm up before plyometric exercise

19  Classify individual as beginner, intermediate or advanced  Dependent on information found through biomechanical, stability, and dynamic testing  Will determine where athlete begins plyometric program  Take into consideration tissue healing if post-injury  Take into consideration sport so Plyometric training can be specific to athletes position  SAID Principle!!!!!

20  Direction of Body Movement  Weight of Patient  Speed of Execution  External Load  Intensity  Volume  Frequency  Training Age  Recovery

21  Beginning of plyometric program emphasize technique and principles of Plyometrics  For example, the importance of short amortization phase  Minimal time on ground, reverse the landing as quickly as possible  Focus on body, control, posture and mechanics  As intensity increases, volume should decrease  Plyometrics should be used in later phases of rehabilitation.  After appropriate strength base established and athlete has performed closed chain exercises

22  Sound, technical foundation  Force reduction and force production should be absorbed throughout entire body  Ankle, knee, hip, trunk, arms  Time and coordination of these body segments will yield positive ground reaction and high rate of force production

23  Specific to individual goals of athlete  Quality of work more important than Quantity  Greater intensity the greater recovery time required  Low to medium intensity if done at conclusion of workout, high if done before  When to fatigued to maintain proper technique exercise should stop

24  Progressive in nature  Only 2 to 3 times a week depending on periodization  Dynamic testing on regular basis to provide motivational feedback  Proper equipment: footwear, landing surface, external loads…Safety First!!

25  Involve loading of the healing tissue  Medial and Lateral Loading  Ability to accept weight on injured extremity and change direction  Imperative to return to sport with cutting maneuvers (Most Sports)  Rotational Loading  Same as above  Shock Absorption (Deceleration Loading)  Eccentric load of muscle and tendon  Increase in tensile strength

26  Double extremity to Single Extremity  Vertical Hops to Lateral Hops to Diagonal Hops  Flat surface to box jumps  Non weighted to weighted  Jumps to Hops to Bounding  Manipulate Volume, frequency, and intensity to advance program appropriately  Re-evaluate and re-assess athlete to prevent injury and provide motivational feedback

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