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Preseason Testing



Dan Ramsden, August 2012
Contents

 Why Test?                 Tissue Quality

 What predisposes us to    Breathing patterns
  injury?
                            Conclusion
 Mobility

 Stability

 Strength / Power

 Posture

 FMS
Why Test?

 Locate possible future causes of injury

 Shows our weaknesses (only as strong as weakest link)

 Gives us good objective Markers

 Return to play protocols

 Global weaknesses in a team, WHY?
What predisposes us to injury?

 Previous Injury

 Asymmetries

 Muscle Imbalances

 Decreased joint mobility

 Muscle weakness

 Decreased neurological input (Balance / Motor Control)

 Fatigue
Mobility
 Thoracic Spine                           Decrease in stride length
     Altered breathing mechanics        Diminished proprioception
     Increase load on Cx& Lx            Decreased stability
     Affect GHJ, impingement,
         increased incidence of labral  Ankle
         damage.                           Toe Out, Pronation, Tibial
     Core function                             rotation, hip IR
                                           Load Quad and calf, toe flexors
 Glenohumeral                             Poor squat mechanics
  Decreased power output                   Excessive knee extension
  Labral, and cuff tethering / damage      Alters gait
  Elbow damage, neural tethering.

 Hip                                Assessment Methods: Tx: OH Clearing,
      Increased load on Lx           GHJ: Sahrmann, Hip, IR, Flexn / Extn
      Muscular injuries              Ankle: DF, knee to wall.
      Decreased power output
Stability
 Scapular
      Control of whole upper limb
      Good shoulder positioning / Glenohumeral
      Alignment.
      POWER.

 Lumbar Spine / Pelvis
      Lumbar spine is built for stability
      Control of whole lower limb

 Knee
      Function of posterior knee, PLC

Assessment Methods: Scap: loaded upper limb (winging, fatigue)
Lx / Pelvis, rotational stability (force gauge L & R) Knee: Reverse Plank.
Strength / Power

 Cuff Strength (also look at firing / timing)

 Adductor Strength

 Pelvic Rotary Stability

 Power Testing (Jump Squat) Just Jump mats, gym aware

 Push to Pull Ratios

 S & C testing
   3 Rep Max
   Technique assessment
                            Assessment Methods: Force Gauge, Mass
Posture / Observations
 Kypho-lordotic? Extension based LBP

 Quad / Glute dominant

 Where are they loading? Do they collapse?

 Muscle Imbalances

 Firing Patterns



                                  Assessment Methods: Visual,
                                  Video analysis
FMS

 Great for mobility and stability in combination

 Deep Squat

 Main lift technique

 SFMA




                                Assessment Methods: FMS criteria
Tissue Quality

 Hip External Rotators

 TFL

 Quads

 Adductors

 Pec Minor+++

 Sub Scap

 LevatorScap
                          Assessment Methods: Palpation
Breathing Patterns
 Diaphragm is key for inner core function

 Fascial Connections and compensations
  (Anterior Hip)

 Accessory Musculature, Levator, UT, decreased
  Scap-thoracic rhythm.

 Decreased endurance

 Decreased rib cage mobility, shoulder problems

 Deep neck flexor inhibition
Assessment Methods: breath holding with simple
movements, Initiate breath with apical expansion.
Examples
Conclusion

 Rugby League is such a hard collision sport it is virtually impossible
  to screen / Prehab against most traumatic injuries.

 In theory you can reduce all non-collision injuries.

 “overuse”, mobility based collision injuries.

 Reduce severity of injury.

 Vital that you do something with the results and players follow this.

 Where next?.... Maintenance, reassess, constant testing, self
  screen?
References

 Cook, G. (2010). Movement. Aptos, CA: On Target
  Publications

 Nickelston, P.. (2012). 10 Things Breathing Patterns Tell Me
  About Your Body. Available:
  http://www.stopchasingpain.com/2012/03/08/10-things-
  breathing-patterns-tell-me-about-your-body/. Last
  accessed 14th Aug 2012.

 O’Sullivan, D. (2010/11). Leeds Rhinos Preseason
  Screening. ProSport Physiotherapy
Preseason Screening

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Preseason Screening

  • 2. Contents  Why Test?  Tissue Quality  What predisposes us to  Breathing patterns injury?  Conclusion  Mobility  Stability  Strength / Power  Posture  FMS
  • 3. Why Test?  Locate possible future causes of injury  Shows our weaknesses (only as strong as weakest link)  Gives us good objective Markers  Return to play protocols  Global weaknesses in a team, WHY?
  • 4. What predisposes us to injury?  Previous Injury  Asymmetries  Muscle Imbalances  Decreased joint mobility  Muscle weakness  Decreased neurological input (Balance / Motor Control)  Fatigue
  • 5. Mobility  Thoracic Spine Decrease in stride length Altered breathing mechanics Diminished proprioception Increase load on Cx& Lx Decreased stability Affect GHJ, impingement, increased incidence of labral  Ankle damage. Toe Out, Pronation, Tibial Core function rotation, hip IR Load Quad and calf, toe flexors  Glenohumeral Poor squat mechanics Decreased power output Excessive knee extension Labral, and cuff tethering / damage Alters gait Elbow damage, neural tethering.  Hip Assessment Methods: Tx: OH Clearing, Increased load on Lx GHJ: Sahrmann, Hip, IR, Flexn / Extn Muscular injuries Ankle: DF, knee to wall. Decreased power output
  • 6. Stability  Scapular Control of whole upper limb Good shoulder positioning / Glenohumeral Alignment. POWER.  Lumbar Spine / Pelvis Lumbar spine is built for stability Control of whole lower limb  Knee Function of posterior knee, PLC Assessment Methods: Scap: loaded upper limb (winging, fatigue) Lx / Pelvis, rotational stability (force gauge L & R) Knee: Reverse Plank.
  • 7. Strength / Power  Cuff Strength (also look at firing / timing)  Adductor Strength  Pelvic Rotary Stability  Power Testing (Jump Squat) Just Jump mats, gym aware  Push to Pull Ratios  S & C testing 3 Rep Max Technique assessment Assessment Methods: Force Gauge, Mass
  • 8. Posture / Observations  Kypho-lordotic? Extension based LBP  Quad / Glute dominant  Where are they loading? Do they collapse?  Muscle Imbalances  Firing Patterns Assessment Methods: Visual, Video analysis
  • 9.
  • 10. FMS  Great for mobility and stability in combination  Deep Squat  Main lift technique  SFMA Assessment Methods: FMS criteria
  • 11. Tissue Quality  Hip External Rotators  TFL  Quads  Adductors  Pec Minor+++  Sub Scap  LevatorScap Assessment Methods: Palpation
  • 12. Breathing Patterns  Diaphragm is key for inner core function  Fascial Connections and compensations (Anterior Hip)  Accessory Musculature, Levator, UT, decreased Scap-thoracic rhythm.  Decreased endurance  Decreased rib cage mobility, shoulder problems  Deep neck flexor inhibition Assessment Methods: breath holding with simple movements, Initiate breath with apical expansion.
  • 14. Conclusion  Rugby League is such a hard collision sport it is virtually impossible to screen / Prehab against most traumatic injuries.  In theory you can reduce all non-collision injuries.  “overuse”, mobility based collision injuries.  Reduce severity of injury.  Vital that you do something with the results and players follow this.  Where next?.... Maintenance, reassess, constant testing, self screen?
  • 15. References  Cook, G. (2010). Movement. Aptos, CA: On Target Publications  Nickelston, P.. (2012). 10 Things Breathing Patterns Tell Me About Your Body. Available: http://www.stopchasingpain.com/2012/03/08/10-things- breathing-patterns-tell-me-about-your-body/. Last accessed 14th Aug 2012.  O’Sullivan, D. (2010/11). Leeds Rhinos Preseason Screening. ProSport Physiotherapy