What happens behind injuries? Key players missing important matches - PDF document

5/12/2012 ADVANCED ATHLETE MONITORING FOR INJURY REDUCTION Jose Fernandez BSc (Hons), PostGraDip (S+C) , CSCS BSMPG Conference 19/20 May 2012 Boston What happens behind injuries? Key players missing important matches (bad) Injuries leave consequences (bad) Previous injury is the most important risk of injury factor (bad) Pressure for the team (bad) The EPL by Numbers Season 00/02 = £74.7 in injuries Hamstrings 14% 17-24 Injuries / 1000h of practice Adductors 9% Ankle Sprain /… 7% 47% footballers in the UK retire due to injuries Quadriceps 6% Muscle Injuries = 30% of the total Knee Sprain /… 5% Back Pain 4% 12 muscle injuries/ season / team Calves / Soleus 4% 22.3 days absent / injury Foot 3% A team of 25 players will suffer 40-45 injuries/ season Muscle contusion 3% ( 16-20 minor, 16-20 moderate, 8-10 severe) Achilles… 3% UEFA Study Woods et al, 2002 1

5/12/2012 The challenge in professional teams 1 game/week 4.1 injuries / 1000h 2 games / week 25.6 injuries / 1000h! No effects on performance NBA Season Schedule 2011 / 12 Athlete Monitoring A Practical Need 2

5/12/2012 “ We live in a dynamic environment ” Benchmark ourselves Information stays … Is it worth the change? Are we getting better? Information = Intelligence Measure Model “ Predict ” Accumulate Suggest the Intelligence right move We need models … “ We can ´ t anticipate the future but we must know what can perturb our plan ” 3

5/12/2012 Fatigue affects the efficiency of the neuromuscular system increasing the likelihood of injury. For example … Contraction Times Stiffness Functional Synchronisation Fatigue correlates with slower contraction times. Injuries are more likely to happen towards the end of the game (acute) or final part of the season (chronic) Fatigue affects neuromuscular delay Speed of contraction Decreased propioception Compromised RFD actions (P+S) Accumulated delay Alterations in muscle compliance are directly related to injuries… Biarticular muscles are especially affected Type II athletes are under more risk Decreased Joint Stability Increased likelihood of injuries 4

5/12/2012 Speed is the sum of muscle (intra muscle coord) and neural components (inter muscle coord and functional synchronisation) Increased energy expenditure Altered Timing Decreased power and speed Decreased mechanical efficiency Minimized performance Mental Biomechanical Biochemistry Integration Tensiomyography (TMG) Non invas asive Selec ective No inte terf rferen ence ce with training No effort t from m the athlet ete Highly rep epea eata table Low varia riability ty Quick asses essmen ent Imme mediate te results ts 5

5/12/2012 <Tight Stiffness Loose> mm Td – Delay Time 7 (neuromuscular delay) 90% -90% 6 Tc – Contraction Time (speed of contraction) 5 Tr – Relaxation Time 4 (time remain contracted) Dm – Displacement 3 (stiffness) 2 10% 1 0 0 100 200 300 400 500 600 ms <Fast Contraction Time Loose> Athlete Readiness Slow Great Fatigue Contraction Stiffness Times Fast Great Increased Contraction Stiffness Activation Times Slow Poor Muscle Contraction Stiffness Weakness Times Ricky Rubio during a TMG Screening. FEB …how is your best player feeling today? 50 C. Time 40 30 20 10 10 Stiffness 8 6 4 2 Right Right Right Right Right Right Right Right Right Right Left Left Left Left Left Left Left Left Left Left Slow Times Great Stiffness Fatigue Increased Fast Times Great Stiffness VL VM RF RA GT BF ST GM GL AL Activation Muscle Slow Times Poor Stiffness Weakness 6

5/12/2012 Longitudinal data Integration with training? Integration with training? PERIODIZATION Arbitrary Units INTENDED 6 3.5 4 0.5 1.5 5 4 3 1.5 5 1.5 3 5 3 3 3.5 1.5 5 4 4 0.5 3 1.5 5 1.5 5 3 2 1.5 ACHIEVED 5 3.5 3 3 1.5 5 5.5 3.5 1.5 5 1.5 2 5 5.5 3.5 2.5 1 5 5.5 5.5 4 2 1.5 5 1.5 5.5 3 2.5 1.5 LOAD (RPE) INTENDED ACHIEVED MUSCLE SORENESS WILLINGNESS 7

5/12/2012 Data Visualization? HRV SLEEP RPE TMG BLOOD DAILY WEEKLY SEMESTER ithlete Zeo TL S TC DM Synch Hm Fe G+ Ca vD B 12 Mg FA Zn CRP Wb T E+ Ch CK Player 1 Player 2 Player 3 Player 4 Player 5 Player 6 Player 7 Player 8 Player 9 Player 10 Player 11 Player 12 Case studies … Fiber Composition, Muscle Imbalance, Rehab Athlete Profiling 8

5/12/2012 < 25% % Type I Muscle Fiber 75%> Adductor L. 33.2 36.5 Fast Profile Lat. Gastroc Slow Profile 35.4 38.7 M. Gastroc 30.9 39.3 Semitendin 62.6 72.3 Biceps Fem 28.8 59.8 Gluteus M. 39.2 62 Rectus Abd 44.5 54 Rectus Fem 41.5 43.4 Vastus Med 31.5 35.3 Vastus Lat 34.8 37.3 Average 38 47.7 EPL Average Team Average Estimation of Type I Muscle Fiber • 3 Assessments during pre season • % Type I Muscle Fiber = Average from the 3 assessments • The following muscle groups were analysed on both sides: TMG Screening GL,GM,VL,VM,RF,BF,ST,GM,AL,ES,RA,OE Pro Basketball Team Pre Season 2011/12 Slow Slow Slow 46% Slow Slow 38% 32% 32% 31% Athlete “1” Athlete “2” Athlete “3” Athlete “4” Athlete “5” Fast Fast Fast Fast Fast Slow Slow Slow Slow Slow 41% 40% 34% 33% 28% Athlete “6” Athlete “7” Athlete “8” Athlete “9” Athlete “10” Fast Fast Fast Fast Fast 9

5/12/2012 Muscular Potentiation 34.8 34.9 34.6 C. Time 29.2 26.6 26.6 +44.3% 26.3 -16% +1.1% +50% -10% +2,7% -4% TMG Screening Stiffness Pro Basketball 8.3 -40% Player 7.5 7.4 7.2 Rectus Fem. 5.5 Right side 4.5 4.3 Potentiation Befo W. 1st 2nd 3rd 4th 5th re up Set Set Set Set Set What about Foam Rolling? Detect the area of max pain Protocol 1 Hold for 30” + roll 5/6 times Cont. roll over the muscle Protocol 2 surface during 60” 30” HOLD ON TRIGGER POINT 60” CONT. ROLLING 22.7 22.5 21.4 21.5 22.7 22 22.7 20.5 5.8% 2.7% 3.1% 9.9% 13.6 11.8 12.5 10.7 5.9% 6.2 6.2 6.1 22.2% 5.1 Relaxation Activation 14.8% Td Tc Tr Dm Td Tc Tr Dm 10

5/12/2012 Rehab Monitoring Right Day 1 Left Before Injury 2 days after 43% diff Tc 5 days after Right Day 14 12 days after Left Stiffness 17% diff Tc TMG Screening Pro Football Player Biceps Femoris Strain Right Day 21 Left Rehab screening 5% diff Tc Contraction Time Evaluate progress. Best moment to resume competition? Knee Assymetry. 4 days after surgery Contraction Time Muscle Tone Graph Right Left RF 59% Right Left Right Left Right Left VL 79% Right Left Right Left Right Left 53% VM Right Left Right Left Intermuscular Coordination 40 RF 35 VM Contraction Time VL 30 BF 25 TMG Screening Pro Basketball Player 20 Right Thigh Contraction Speed 15 Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 11

5/12/2012 Muscular Balance “Monitor Sequential changes in muscle function after an injury ” … what are the experts saying? 12

5/12/2012 Coaching and performing in the competitive arena is real, three dimensional, beautifully random and chaotic. Numbers by themselves are one-dimensional and without context. High performance demands a delicate balance between the qualitative and the quantitative. Don’t believe the moneybull. Vern Gambetta Functional Path Training Blog April 5 2012 "Lack of published research should never deter clubs from using technology to monitor players and performance. Clubs should however, ensure the data they collect is both reliable and valid, at least for their playing group. This can be difficult in such an applied environment but it’s essential that these tools are used in a robust environment in order to assess their true effectiveness." Darren Burgess Head of Sport Science Liverpool FC Leaders in Performance Interview April 5 2012 Training monitoring becomes a useful thing to do ONLY if guides practice and informs the coaching process. Otherwise it becomes just a data collection exercise. I have seen many S&C coaches use a variety of tools and tests and despite the fact they have some nice continuous data it is clear that such data did not affect practice as training programs continued in the same way despite the information available on training load and some effects. Marco Cardinale Head of Sport Science & Research BOA www.marcocardinale.blogspot.com September 2010 13

5/12/2012 Fergus Connolly Sport Science Consultant Twitter February 20 1012 …so Monitoring …final thoughts I mportance of technology N ever forget the human factor T ime is limited…use it wisely E nsure reliability throughout the process G enerate new information constantly R ecovery…recovery…recovery! A chieve better results through simplicity T imeline: look back in order to move forward E nhance, modify and quantify your interventions Muchas Gracias! Thank You! E. josedelvalle23@hotmail.com T. @jfernandez__ 14