Home Blog Lose Fat, Gain Muscle, Get Strong, and Laugh a Little – Installment 5

Lose Fat, Gain Muscle, Get Strong, and Laugh a Little – Installment 5

Written on June 30, 2011 at 8:01 am, by Eric Cressey

I haven’t published much strength and conditioning randomness of late, so here goes.

1. Here’s a research study that demonstrates relationships among a variety of scheduling and recovery factors and injury rates.  The part I found most interesting was that researchers observed that sleeping fewer than six hours the night prior to a competition led to a significant increase in fatigue related injuries.

Additionally, while it wasn’t specifically observed in the study, my anecdotal observations are that kids who play 14 games in a weekend are more likely to hate their sports, have too many insignificant trophies, and live in their parents’ basement until age 35 because they have a weird sense of entitlement and absolutely no idea how to interact on a social level with anyone who isn’t on their AAU teams.

2. Speaking of young athletes, interval training works better for them, too.  There’s absolutely no reason for a young soccer player to be running miles and miles at a steady-state.  Kids need to get strong and learn to run fast before they try to run fast for a long time.  Interval training is a nice “bridge” between the two when applied correctly during the off-season period.

3. Here’s an excellent study with a biomechanical analysis of the hex/trap bar deadlift technique as compared to the conventional deadlift technique.  It backs up a lot of the comments I made last month with my deadlift series from last month, which you can find at the following links:

How to Deadlift: Which Variation is Right for You? – Part 1 (Conventional Deadlift)
How to Deadlift: Which Variation is Right for You? – Part 2 (Sumo Deadlift)
How to Deadlift: Which Variation is Right for You? – Part 3 (Trap Bar Deadlift)

4. Here’s an interesting article in Radiology Today about the use of MRI in college athletes as a pre-screening tool – and potentially even an aid in optimizing strength and conditioning programs.

Because a lot of the observations on MRI may be “subclinical” (meaning they are findings that occur without the presence of symptoms), there may be merit (albeit at a big cost) to using screens like this as part of an initial (or on the fly) evaluation of an athlete to dictate a training or “prehab” program.  For instance, observing a subclinical patellar tendinopathy may mean you do more soft tissue work around the knee and more heavily emphasize glute activation and minimize quad dominant squatting (among other things) to keep that tendon from reaching a symptomatic threshold.

There are, of course, some significant drawbacks.  For starters, MRIs are expensive and time consuming, so not everyone could get them.  How do you decide who deserves it – especially in the era of Title IX?

Second, you’re assuming that strength and conditioning coaches are qualified and capable to organize programs around what’s found on a radiology report.  Generally speaking, there isn’t a ton of individualization in collegiate strength and conditioning because coaches have so many athletes assigned to them and it isn’t feasible.  It makes me wonder if you could prevent more injuries if you simply hired 3-4 more strength and conditioning coaches for what it would cost you to get an extra radiologist and imaging technician.

Third, and perhaps most importantly, there are a lot of “false positives” on MRI.  I’ve written about this quite in the past and covered it in our Optimal Shoulder Performance DVD set, but you are headed down a very slippery slope when you start treating the image rather than the athlete.  In other words, how one moves and feels is far more important than how one’s MRI looks.  I can guarantee you that the overwhelming majority of my overhead throwing athletes have labral fraying, partial thickness supraspinatus tears, and a host of other “normal” findings for this population.  If I immediately contraindicated a ton of exercises in my program because I knew this, I’d likely be setting them back with regressions in their programming when they actually needed progressions.

What are your thoughts on this final issue?  If you had the resources, would you MRI every athlete in a college athletic program?  How would you pick which region to MRI?

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9 Responses to “Lose Fat, Gain Muscle, Get Strong, and Laugh a Little – Installment 5”

  1. Greg R. Says:

    I cried a little today when I witnessed a group of HS football players meet at 6:15a on the football field. I thought, wow, these guys are committed, at the track early on summer vacation to get some sprint work in. Unfortunately, after some preliminary stretching (done in a circle while mostly sitting), the group took off for a nice long run…they still had not returned by the time I left.

  2. TJ Says:

    That is a tough one. I would have to agree with you that hiring 3 or 4 more strength coaches (that are qualified) would be the best financial choice. It would be great to see an MRI on all athletes, but like you said, movement and how they feel are more important! Finally, I think the body area that you would MRI would be based on the sport of the athlete. Unless you are going to spend all sorts of money and MRI everything.

  3. Rob Says:

    Great stuff as always,
    In regards to the MRI issue, I appreciate your comments contraindicating the use. Whether it be cost or false positives, not to mention exposing all these kids to MRIs, xrays, etc.- i agree that it certainly becomes a slippery slope as to what you do with the results. Are you going to hold a college pitcher from competetion if he throws 92 with movement and is asymptomatic because his MRI looks aweful? Chances are you are going to make sure he is compliant with mobility drills, scap work, etc (Which you did not need a $1500 MRI to tell you that he should be doing anyways)

    Using your example with the subclinical patellar tendinopathy- who couldnt benefit from emphasizing glute activation and focusing more on posterior chain work? I remember listening to Michael Boyle talk about the funtional movement screen and saying all of his athletes do exceptional well on it (and strong to boot). This is not to discredit movement screens because in any strength and conditioning program they are important in helping to determine progressions, regressions, etc- and a hell of a lot cheaper than diagnostic imaging. Also, reading his article on ACL “prevention” with the title “ACL injury prevention is just good training?”
    Id be willing to bet that all the athletes at CP perform well on movement screens as they are training at a high level with quality coaches and programs. I feel the risk-reward with all the imaging is more risk than reward.

  4. Teun Schoones Says:

    What are your thoughts on this final issue? If you had the resources, would you MRI every athlete in a college athletic program? How would you pick which region to MRI?

    My thoughts are as follow; Don’t use MRI for screening athletes. Because of the reason you wrote; false positives. Rather spend time for screening athletes in body posture, motor program’s, dis balance in posterior and anterior chain and dis balance in mobilizing musculature and stabilizing musculature etcetera. With the aim to prevent injuries.

    Say, one of your overhead throwing athletes has injured himself and has specific clinical symptoms which are pointing in a specific pathology. I say, Yes. Use a MRI to search for that specific pathology, to ensure your treating your athlete the right way.(In this case you use the MRI as a addition to the clinical symptoms and increase the predictive value).

    Sorry for my incompetent English.

    Physical therapy student.

  5. Stephen Thomas, PhD, ATC Says:

    Eric nice post. As for the MRI as a screening tool, it is a tough decision. We are starting to identify certain adaptations that occur in throwers (posterior capsule thickness, GIRD, scapular alterations) that are associated with injury so screening for those might be useful. However, like you said many throwers may have labral fraying or other such things that are normal and not necessarily causing them problems. In that case I would say “if it ain’t broke don’t fix it.” The cost would also be astronomical and would not be possible. However, ultrasound is gaining popularity and is much more cost effective and convenient. I have used it for the past several years to identify structural adaptations in throwers. It may serve as a great options in the future.

  6. Lindsay Says:

    Oh man that is tough. Depending on everyone’s insurance, that’s a tough call. If MRI’s were free, that would be the day. However, like Stephen said, ultrasounds are becoming more popular and cost effective. The thing is, I don’t think those would be able to pinpoint the problem as well as the MRI. Like you said, Eric, the picture doesn’t always display the problem. You have to watch how the athlete moves and ask how they feel and think of alternative methods to correct those areas. When I get clients complaining about chronic knees, hips, or shoulder problems, I send them to the doc to get an MRI. I’m no doctor, but it’s best to know what’s really going on then diagnosing myself. I always watch how they move and ask how they feel to correct their patterns. But before moving onto any other movements, we get those areas checked out 🙂

  7. Maurizio Paolini Says:

    It’s at least 10 years that I recommend the hex-bar dead as a better choice, especially for athletes and older lifters, so it’s a great satisfaction to see that exercise scientists have proven that I was right….Thanks for your great infos Eric.

  8. Bob G Says:

    MRIs tell you very little about some very important concerns. How does the athlete function? How does he or she respond to specific movements and positions?

    An asymptomatic twenty-something sprinter who shows degenerative changes and/or disc herniations in his lumbar spine…do we start having him do prone press-ups? Probably not. Who knows (based on the MRI)?

  9. Stefan Says:

    Disagreed with the conclusions about HIIT. Both methods achieve different things and are both needed for optimal performance.
    -5 weeks is a short time, and as seen in even the Tabata study the improvements from interval training (and even they included 1x30min steady state session) are very quickly effective but stop just as fast.
    -VO2 max is not the only relevant predictor of performance.
    -Long duration activity definitely has it’s place in soccer training as an aerobic-alactic sport including: eccentric cardiac hypertrophy, capillarization, mitochondrial number and density al important adaptions brought about from longer duration aerobic work.

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