Winkelman Course in NY

Movement Skill Acquisition and Transfer:
Applying Coaching Science and Motivational Frameworks

with Nick Winkelman, MSc, CSCS*D | Director of Movement (Performance Innovation Team) @ EXOS  [formerly Athlete’s Performance]

Join us Saturday & Sunday, August 2-3, 2014 at RPI in Troy, NY for Movement Skills Acquisition and Transfer: Applying Coaching Science and Motivational Frameworks.

winkelmannickThis course is open to all professionals who strive to make people and athletes better.

Ideal for Coaches, Trainers, & Clinicians.

For those who coach movement, are your words effective?

For those who prescribe home exercise plans or design training sessions, are your designs optimal for motor learning?

For those who help create peak performance, how can you get results better and faster than you are currently?

 

COURSE OUTLINE:

  1. Movement Skill Development: Systems Overview

  2. Science and Application of Acceleration

  3. Acceleration Progressions

  4. Science and Application of Absolute Speed (Running)

  5. Absolute Speed Progressions

  6. Reactive Agility: Developing Speed that Transfers

  7. Reactive Agility Progressions

  8. Athletic Profiling: Testing for Transfer

  9. The Science of Coaching: Motor Control and Learning a Dynamic Systems Approach

  10. The Science of Coaching: Instruction, Feedback, and Cueing

  11. The Science of Coaching: Developing Environments that Motivate

The course is mixed lecture and practical.  Please come dressed to participate.  This includes bringing or wearing athletic footwear.

Date: August 2-3, 2014

Time:Saturday 9:00-6:00
Sunday 8:00-3:00

Cost:   $359
(register below)

Location: The course will be held at Rensselaer Polytechnic Institute (RPI) on their East Campus Athletic Village (ECAV).
ECAV is at 80 Peck Drive, Troy, NY 12065.  Look for D-Lot, the closest parking lot.

ECAV-RPII have the pleasure of attending Nick’s lectures in the past.  Those who attend will enjoy a very practical application of cutting edge coaching science and motor control theory.  Sharpen your practical skills by learning from someone in the trenches.

Men’s Journal article about this years NFL draft and NFL combine  preparation.

Winkelman’s Movement Lecture on The Science of Coaching.

 What We Say Matters: Part I  & What We Say Matters Part II

 Movement Skill Acquisition and Transfer:



Registration
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Nearest airport: Albany, NY (There is a complimentary shuttle to the Troy Hilton Garden Inn)

Nearest hotel: http://www.troy.hgi.com/

Hilton Garden Inn Troy

235 Hoosick Street, Troy, NY, 12180
518-272-1700

Concussion Conference

Being a strong proponent of active care I encourage many people to become more active, to move with better quality, and to then move more frequently.  For the majority, I think this is quality advice, but as with all clinical interventions a key component lies in knowing when not to apply that strategy.  Active care may be contraindicated in a few different conditions, but one is in those experiencing concussion symptoms.

Recently I had the opportunity to attend the 9th Annual Sports-Related Conference on Concussion and Spine Injury (May 18, 2012). While I must admit that my background in concussion management is not as strong as I would like it to be, I felt compelled to attend to strengthen my understanding so I would better be able to discuss this hot button topic with my patients and community.  Ultimately I see my role as a chiropractor in recognition of symptoms, prescription of sparing advice, reassurance, and referral for appropriate monitoring.  To do this effectively I needed to know more.  I found this conference to be a top notch assembly of exceptional health care professionals, former elite athletes, and researchers.  I left with an appreciation for all that goes into studying and managing concussions and appreciating that there is still a lot to learn.  Some points of interest, reviewed concepts, and things that peaked my curiosity below.

From William Meehan III, MD, the history of concussion was discussed.  It was known from the slaughterhouse that rotational acceleration was necessary to stun the animal and that blunt head trauma alone (head stabilized during the trauma) did not produce the dazed reaction they were looking for.  {Upcoming post on how often we know things before science catches up…. Soon.}  The role of second impact syndrome or repeated concussion is a hot topic these days, but was first described by Gronwall in 1975 who noted in his research that the 2nd concussion commonly took longer for recovery of symptoms.  Why are we sometimes so far behind ourselves?

(Overview) Management of a concussion:

  1. Rule out other injury (on the field ABCs, then consider fracture, intracranial hemorrhage, and other life threatening conditions)
  2. Physical rest (avoid working out so ATP & glucose is not stolen from the brain where it is needed for recovery efforts.)
  3. Cognitive rest (avoid mental activity using precious ATP & glucose that’s needed for healing.)
  4. Emotional rest (same rationale as above)
  5. Follow up and reassess for patient to be symptom free.
    1. Evaluate with PCSS- Post Concussive Symptom Scale
    2. BESS Balance Error System Score:  Double leg stance, Single leg stance, Tandem Stance (20s)
    3. Neurocognitive (ImPACT and similar tools):  Verbal memory, visual memory, processing speed, & reaction time
  6. When symptom free return to participation (RTP) stages
    1. Rest (physical, emotion, cognitive; as described above)
    2. Light aerobic
    3. Sport specific (low intensity) training
    4. Non-contact training drills
    5. Full contact
    6. Game play

 

Neuropsychologist Alex Taylor, PsyD reminded us that concussion is a silent disease.  Those suffering with it often appear healthy and normal.  Considering that 90% of concussions do not involve a loss of consciousness, MRI and/or CT are likely to be negative, and there are no dramatic outward signs (seizures, emesis, blood, bruise, cast, splint, etc), these injuries can often go under appreciated.  Particularly in students this can include parents, teachers, coaches, and friends.

He also noted significant role of computer based testing.  His explanation was that this testing was more sensitive than symptom reports only, but he emphasized the greatest sensitivity when combining the two:

–       64% accuracy with symptom reporting
–       83% accuracy with neuropsychologic (computer) testing
–       93% accuracy when combining both (the comprehensive approach is best).
–       As each individual recovers differently, evaluation and reevaluation is essential.

From Robert Cantu, MD – Ways to prevent concussions:

–       avoid taking unnecessary hits (non-contact practice)

  • CTE is more about repetition that significance of trauma; observe the most frequent positions in football – linebackers & lineman; mores than receiver.
  • Consider ‘hit’ count for kids, similar to pitch count in baseball.  Considering that pitching produces surgically repairable injuries and head trauma causes irreparable damage this should be given strong consideration.

–       proper technique (don’t lead with the head)
–       adequate hydration
–       having the right genetics  (good luck modifying this risk factor)
–       rules changes
–       strengthen your neck   *** see discussion below***

My side comment: (Note: I have no strong evidence to support this, just my thoughts.) 
Dr. Cantu was not the first or last to note ‘neck strength’ as a primary factor in concussion prevention during the conference.  As this was discussed my mind immediately jumped to the role of ‘core strength’ in prevention of back pain.  Core strength is/was commonly discussed as being preventative for back pain.  Research on this tends to be less decisive than the commonly accepted statement that a ‘strong’ core is protective for the back.  I wonder if this statement on ‘neck strength’ is equally well liked for it’s plausibility, but will also result in marginal or less than perfect correlation during research.  I suspect that the role of ‘timing’ of neck muscle activation plays a more significant role that ‘strength’. 

This was demonstrated well in Cholewicki’s work. [Here or even more clearly here.] To look at this in more common terms, let’s compare it to a car accident. I don’t think the ‘strength’ of the brake is the best determinant of injury during a motor vehicle accident, it is much more likely that the ‘speed’ or ‘timing’ of applying the brake has a more significant correlation on how well injury can be avoided.  Particularly when considering the role of external perturbation in Cholewicki’s study and the fact that some of the concussion-causing trauma is unanticipated.  The natural timing and response of the cervicocranial stabilizers appears to have the best chance of being protective by mitigated rotational forces.  (Again, this is just my speculation.)  During a brief conversation with Dr. Cantu he noted that he was unaware of any research done on concussions and cervical timing.

Childhood concussions with Dr. Gerard Gioia – a wealth of info, but this one resonated with me as it sounds much like what we (should) do to properly manage so many NMS conditions.  Have them do activities they can tolerate, help them learn what they can and can’t do, and “Teach them the sweet spot”. This results in active rest and active management which is then gradually increased.

Clinical Pearls:

-Younger brains need to be managed more conservatively.

-For unknown reasons, concussed females show a greater decrease in neuropsychological scores than males.

 

Ted Johnson (former NFL All-pro middle linebacker (paraphrased):

 

This is an exciting time for medical providers and scientists with all the new research.  It’s a terrifying time for patients as there is much attention, but so little is known.

Most of my concussions came in practice, not in games.

Players don’t know the long term effects of concussions.  I didn’t know & don’t tell me I did!

Before meeting my current concussion specialist, I was recommended for electroconvulsive therapy (ECT) because they didn’t know what else to do with me.

 

Links of interest:

Ted Johnson @ Harvard Concussion Conference NESN story & video

Ben Utecht:  Tell me if his story makes you wonder about the significance of these injuries.  Not only did he not recall being at his friends wedding, he didn’t recall that he sang at the wedding.  Doesn’t seem like an occasion you should need photographic evidence to refresh your memory.  http://espn.go.com/nfl/story/_/id/7966792/concussions-affect-now-singer-ben-utecht-life

CDC Concussion info (with good video for the lay public)

Mass Dept of Health Concussion resources

Sports Legacy Institute

 ImPACT testing

Triathlete Imaging- Supporting active care.

To view the original, well referenced blog post look here, from Toronto physiotherapist Laura McIntyre.

So is active care and exercise important?  (Yes, this is rhetorical.)

  • Compared to the top image… which do you like the looks of better?
  • Image 2: Sedentarism?
  • Image 3: Active lifestyle?

You will see the active triathlete with significantly more muscle mass, less fatty (adipose) tissue, and denser bones.  More muscle, less fat, & stronger bones. Sound like something you might want to be part of?

I once heard Craig Liebenson, DC say that we need patients to ‘fear inactivity, more than they fear activity’.  To add context this includes having someone knowledgeable helping them choose appropriate movements, exercises, and activity.

With this being said, there is another side.  Elite athletes and extreme performance are not exactly the best examples of healthy living.  While there are clear benefits to remaining active, at the extremes there is some negative consequence as well.  These feats of athleticism place a toll on the body as well.  This was very clear to me after completing my first marathon. I was convinced by personal experience that there is another extreme.  Another example is the shortened average lifespan of the NFL player.

To summarize:

  • What happens as you age is partially (& significantly) your choice? (see images).
  • There’s a middle road between the couch and ultra-marathons.  Maybe the focus should be on long term athletic participation.

Smart Training/Rehab Gaining Momementum in the NFL

As an advocate of functional assessment, high quality rehab, and mindful training I’m always thrilled when I see articles such as this. 

Atlanta Falcons Training/Rehab Program from the NY times.

 

Bonus: Previous article from Professor McGill in the NY Times. http://www.nytimes.com/2009/06/21/magazine/21FOB-physed-t.html
For the sake of our athlete’s I hope this paradigm continues to gain momentum.

FMS Study???

For those that wish to review the study, look here.

I first had this conversation with a colleague and then saw this post on Jeff Cubos’s Blog.
This study is well performed, but poorly designed.  The premise, as Jeff points out, has significant flaws.  They are taking a “screening test” for injury risk assessment and claiming to use it to measure athletic performance.  To compare how odd this is let’s think about drawing blood and measuring lipid profiles to determine the fastest runner.

A comment left on Jeff’s blog notes that improvement in the FMS screen may be implied to lead to improved athletic performance.  While not the intended goal of the screen (it is designed to test for risk of future injury), I can see that this would make sense.  For example, an athlete who scores a 13 (out of 21) and then participates in a corrective exercise program and a few weeks later able to score a 16 (with no asymmetries); I would assume that some translation to on the field performance may exist.  (Although again, this is not the goal of the FMS test.)

Parchmann & McBride not only begin their study with a flawed concept but seem to bias the test results as well.  In comparing a movement literacy test (FMS) to a power-based movement (1RM back squat) the researchers chose to use the following as benchmarks: sprint times (10m, 20m), vertical jump, T-test, and golf club head speed.

Exceptional workout power; limited performance

Suffice it to say that these are all power based movements.  The most powerful athlete will likely get the highest marks on each of these tests and therefore it is expected that a 1RM test correlates better than the FMS test.  However, this does not correlate well into determination of the best athlete.  [Think Brian Bosworth vs. Brian Urlacher].

Great workout; exceptional performance

To put this another way, I can swing a golf club really fast… however the score at the end of my round is nothing I care to brag about.  Swing velocity is not a good indicator of the best athlete, it’s indicative of the most powerful.

To recap:

  • I applaud Parchmann & McBride‘s effort to test the FMS screen.  We should challenge all concepts and make sure that we’re using what works best and not holding onto sacred cows or simply doing what “should work”.
  • This study has significant logical flaws as the FMS test is misinterpreted from the beginning and the authors base their conclusions on the flawed premise that the most powerful athlete is the best athlete.
  • As I suspect there is a mild degree of correlation from the FMS score to ‘coordinated movements’, I would be curious to see this compared to putting or chipping accuracy, or perhaps driving closest to a center line.  These non-power skills likely have little correlation to 1RM and may have some correlation to FMS scores. However we must remember that this was never the stated (or intended) purpose of the FMS test.

Sue Falsone – Breaking Barriers

The Dodgers are known for breaking barriers.  The most notable example is of course Branch Rickey’s hiring of Jackie Robinson, the first African-American major league baseball player.  The newest is Ned Colletti’s hiring of Sue Falsone, PT, MS, SCS, ATC, CSCS.   Sue will be the first female head athletic trainer in any of the 4 major U.S. pro sports.  A well deserved honor. In addition to her work at Athlete’s Performance Institute, Sue lectures on bridging the gap between rehab and performance training, a divide that must be narrowed for successful return to competition. Navigation of this bridge is currently being improved with better communication from personal trainers, athletic trainers, and coaches who are familiar with the FMS system and clinicians (PTs/DCs/MDs/DOs) familiar with FMS and/or SFMA systems.  The gap is being narrowed (or erased) with DVDs like Charlie Weingroff’s “Training=Rehab-Rehab=Training” and interdisciplinary seminars like Craig Liebenson’s Rehabilitation of the Athlete.

I reflect on this as I prepare to head to Athlete’s Performance Institute in Tempe, AZ where Sue serves as “Director of Performance Physical Therapy, Athletes’ Performance and Core Performance, & Director of Team Sports” for an upcoming seminar in DNS.  I’m looking forward to visiting this top notch facility again.