Trainer’s Corner: Back to Basics

I think the title “Trainer’s Corner” is very applicable for two reasons: 1) This friendly post is coming directly from one of your trainers, and 2) It is analogous to a boxer’s trainer. A boxer’s trainer will do his best to provide the boxer with all the skills necessary to succeed. Your ABR trainers are charged with a similar task, so the analogy should resonate pretty well.

Round 1: Before going out into the ABR world, you should have a solid grasp of the fundamentals. In the ABR context, these fundamentals are numerous and sometimes overwhelming…however I will bring you through some of them step by step (round per round). During the majority of my evaluations, there is a common thread that weaves its way all the way through each family unit…they forget that this is a PROCESS. Process is “a systematic series of actions directed to some goal”…therefore by definition it should be clear that things have to go in sequence and in phases. The fact that you cannot skip over phases is not an arbitrary decision, rather a reality you have to understand and integrate.

Each phase is designed in preparation for the next phase and is structurally predetermined by the human motor developmental pattern…not by ABR. We are bound to this developmental path by mother- nature so any questions that relate to more complex developmental skills should be automatically answered.



In the past, I have found it useful to help parents differentiate between chronological age and developmental age. To be more precise, in healthy individuals the chronological age comes with some predictable developmental milestones. In effect, you can accurately estimate the chronological age by knowing (seeing) the developmental phase they are in.

In the above image, the developmental age (stage of development) is typically achieved at a certain age (for example: sits without support between 5-8 months). This type of chart can be somewhat confusing to many parents. Statements like “he / she is 4 years old so we have to stand them to help them develop the hips” come from this well-ingrained developmental chart. However, as mentioned before, if the previous stages have not yet been achieved (lifting and holding the head, rolling over, from prone position lifts chest with arm support, etc..) then any discussion (or statements) regarding more advanced skills is unproductive. Therefore, more emphasis and focus on the developmental age will be, not only helpful in understanding the big picture, but more accurate in assessing your child’s current progress.

If you have ever seen any of the Rocky movies, you can appreciate the image of the grizzled trainer, Mickey, yelling at Rocky and trying to motivate him through a seemingly insurmountable challenge. Although I obviously won’t yell and scream, the intensity is still there: “Get back to basics!! Remember the fundamentals, Rock!” The road is long and there will be challenges…however you have a trainer in your corner who will slap a towel around your neck in between rounds, sit you down, throw water on your face, and give it to you straight.

See you soon for round 2!

Los Fundamentos del Desarrollo Profesional...mi “desahogo” personal.

Aunque el titulo pueda ser muy interesante, la primera pregunta que viene a la mente es “¡quién se cree este tipo que es…instruyéndonos en los fundamentos del desarrollo profesional!”. La respuesta a esta pregunta es bastante simple: "Soy un hombre sencillo que conozco, no la cantidad de conocimiento que poseo, sino más bien la gran cantidad de conocimiento que aún me falta poseer”. Esto puede considerarse tanto una bendición como una maldición. Por un lado, el sentimiento de “iluminación” y claridad es de alguna forma liberador; por el otro, el darse cuenta de que "wow, realmente tengo mucho más que aprender" puede ser abrumador. La realidad es que este descubrimiento le abre la puerta a un pensamiento más analítico, fundamental y eficiente, el cual a su vez estimula los procesos de pensamiento que resultan en aumentos exponenciales en nuestra habilidad de aprender y entender.

Luego de graduarme en la universidad, pensé ingenuamente que mi “carrera de aprendizaje” había terminado y que ya sabía casi todo acerca de la rehabilitación y la evaluación. Quizás había todavía algún que otro curso o certificado que podría obtener para mejorar mi “comercialización”, pero más allá de eso ya había adquirido con éxito todo el conocimiento relevante posible. Me encantaría poder decir que me di cuenta de que esto era una noción absurda bastante rápido…pero para ser honesto, ¡no lo hice hasta 6 o 7 años más tarde! Estaba en una reunión cuando recibí una alusión muy sabia y perspicaz la cual fue bastante reveladora. Parecía ser una alusión bastante irrelevante a “como debemos aprender" y como éste conocimiento puede mejorar nuestro desarrollo profesional drásticamente. Esta pizca esencial de gran sabiduría era La Competencia Consciente de la Matriz del Aprendizaje. Es esencialmente una teoría que se desarrolló en los años 70 que describe las 4 fases del aprendizaje y la adquisición de nueva habilidades. ¿Por qué es esto relevante Gavin? Esta teoría apunta directo a mi previa manera de pensar “peligrosamente ingenua”. La misma establece que al comienzo nosotros somos inconscientes de lo poco que sabemos en realidad, y que al darnos cuenta de nuestra incompetencia, podemos entonces adquirir nuevos conocimientos y habilidades.

Las Cuatro Fases del Aprendizaje.

1. Incompetencia Inconsciente
El individuo no entiende o no sabe como hacer algo y no reconoce necesariamente el déficit. Podría aún negar la utilidad de la habilidad. El individuo debe reconocer su propia incompetencia, y el valor de la nueva habilidad, antes de proseguir a la próxima fase. El tiempo que un individuo pasa en esta etapa depende de la fortaleza del estimulo por aprender.

2. Incompetencia Consciente
Aunque el individuo no sabe o no entiende como hacer algo, el o ella reconoce el déficit, además del valor de una nueva habilidad en como tratar ese déficit. El cometer errores puede ser integral al proceso de aprendizaje en este punto.

3. Competencia Consciente
El individuo entiende o sabe como hacer algo. Sin embargo, demostrar la habilidad o conocimiento requiere concentración. El proceso puede dividirse en diferentes pasos, y hay una fuerte participación consciente al ejecutar la nueva habilidad.

4. Competencia Inconsciente
El individuo ha tenido tanta práctica con esta habilidad que se ha convertido en una “segunda naturaleza” y puede ser realizada con facilidad. Como resultado, la habilidad puede realizarse mientras se ejecuta alguna otra tarea. El individuo puede ser capaz de enseñar esta habilidad a otros, dependiendo de cómo y donde fue aprendida.


(¡Gracias Wikipedia por la descripción clara!)

Es importante recordar que este proceso es progresivo y que solo se puede pasar de la etapa 1 a la 2, luego de la 2 a la 3, y luego de la 3 a la 4. Con respecto a algunas habilidades más avanzadas (como por ejemplo evaluación y rehabilitación) puede haber en realidad algún tipo de regresión. Para ser mas especifico, de la etapa 4 a la 3 y a veces de la 3 a la 2…sin embargo, cuando esto sucede, el proceso debe volver a comenzar. Hay incluso algunas teorías vigentes de que puede existir la fase 5 la cual identifica “la habilidad de mover de manera activa a los individuos de etapa a etapa”.

Volviendo entonces a la pregunta original “quién se cree este tipo que es “...Puedo decir con confianza y comodidad que soy alguien que se encuentra dando vueltas en las fases 3 y 4 con algunos viajes regulares de vuelta a la fase de la incompetencia consciente. El paso de una etapa a la otra se siente como un “despertar" y cuando las cosas comienzan a “hacer clic” tu curiosidad y entusiasmo aumentan. Incluso puede ser considerado como “intelectualmente intoxicante” porque una vez que estas en este camino(o circulo), podes intencionalmente resetearte en este circulo de información y lograr regularmente este sentido de despertar. Como profesionales en el campo de la rehabilitación, esta implicado (quizás ingenuamente) que ya estamos en este camino. Sin embargo, la verdad encubierta es que la mayoría no lo estamos. Las motivaciones extrínsecas o externas (dinero, fama, posición) sólo te van a sostener por un periodo a corto plazo. Tu deseo intrínsico de realmente querer aprender te va a sostener por siempre...es por eso que cualquier profesional que se aprecie como tal tiene este ímpetu y por naturaleza va a empezar intencionalmente este viaje a través de las etapas del aprendizaje.

Esta publicación es mi intento inicial para que nos dirijamos a la fase 5 al “estilo Yoda” (de La Guerra de las Galaxias). ¿Tendrán éxitos mis esfuerzos para dirigir a algunos profesionales hacia esta matriz? Como Morfeo le dijo a Neo mientras sostenía las píldoras azules y rojas, “Estoy tratando de liberar tu mente, pero solo puedo mostrarte la puerta…tu eres el que tiene que atravesarla".


Gracias por leer!

Fundamentals of Professional Development...my personal rant.

As interesting as the title may be, the first question that may come to mind is "who does this guy think he is...schooling us in the fundamentals of professional development?!".  The answer to this question is relatively straightforward:  "I am a simple man who has a good understanding of, not the amount of knowledge I have, rather the significant amount of knowledge I have yet to attain".  This can be considered both a blessing and a curse.  On one hand, the feeling of "enlightenment" and clarity is somewhat liberating...on the other hand, the realization that "wow, I really have a lot more to learn" can be overwhelming.  The reality is that this realization opens the door for more analytical, fundamental, and efficient thinking...which in turn stimulates thought processes that results in exponential increases in your ability to learn and understand. 

Upon graduation from University, I naively thought that my "learning career" was over and I pretty much knew everything there was to know about rehabilitation and assessment. Perhaps there were a few courses or certifications that I could get that would enhance my "marketability", but beyond that I had successfully uploaded all the relevant knowledge possible.  I would love to say that the realization that this was an absurd notion came to me relatively quickly...but to be honest, it came to me almost 6-7 years later!  I was in a meeting and a very wise and insightful reference was given to me that was quite "eye opening".  It was a seemingly irrelevant reference to "how we learn" and how this knowledge can drastically improve our professional development.  This essential bit of sage wisdom was the Conscious Competence Learning Matrix.  It is essentially a theory developed in the 1970's that outlines the 4 stages of learning and the acquisition of new skills.  Why is this relevant, Gavin?  This theory shoots directly into my previous "dangerously naive" way of thinking.  It states that we are intially unaware of how little we actually know...and that upon the realization of our incompetance, we can acquire new knowledge and skill. 

The Four Stages of Learning



1. Unconscious Incompetence
   

   The individual does not understand or know how to do something and does not necessarily recognize the deficit. They may deny the usefulness of the skill. The individual must recognise their own incompetence, and the value of the new skill, before moving on to the next stage. The length of time an individual spends in this stage depends on the strength of the stimulus to learn.





2. Conscious Incompetence
   

   Though the individual does not understand or know how to do something, he or she does recognize the deficit, as well as the value of a new skill in addressing the deficit. The making of mistakes can be integral to the learning process at this stage.





3. Conscious Competence
   

   The individual understands or knows how to do something. However, demonstrating the skill or knowledge requires concentration. It may be broken down into steps, and there is heavy conscious involvement in executing the new skill.





4. Unconscious Competence
   

   The individual has had so much practice with a skill that it has become "second nature" and can be performed easily. As a result, the skill can be performed while executing another task. The individual may be able to teach it to others, depending upon how and when it was learned.

(thanks Wikipedia for the clear descriptions!)

Its important to remember that this process is progressive and can only move from stage 1 to 2, then 2 to 3, and then 3 to 4.  For some more advanced skills (such as assessment and rehabilitation) there can actually be some regression!  More specifically from stage 4 to 3 and sometimes 3 to 2...however when this happens, the process must begin again. There is even some current theories that there may even be a 5th stage which identifies the "ability to actively move people from stage to stage". 

So back to your initial question "who does this guy think he is"...I can confidently and comfortably position myself as someone who is circling in the eddys of stage 3 and 4 with some regular trips back to the conscious incompetence stage.  The movement from stage to stage feels like an "awakening" and when things "start to click" your curiousity and enthusiasm build.  It can even be considered "intellectually intoxicating" because once you are on this path (or in the loop), you can intentionally reset yourself in the loop and regularly achieve this sense of awakening.  As professionals in the field of rehabilitation, it is implied (perhaps naively)that we are on this path...however the hidden truth is that most are not.  Extrinsic or external (money, fame, status) motivations will only sustain your in the short term.  Your intrinsic desire to truly learn will sustain you forever...therefore any true professional worth their salt has this drive and by definition will intentionally start the journey through the stages of learning.

This post is my initial attempt to steer into that "Yoda-like" 5th stage.  Conscious introspection and self-examination are under-appreciated and sometimes purposely avoided...but it is always productive!

Cheers!

The Extended Fascial Paradigm and its Implications in Athletic Conditioning: Part 2

FASCIA AS A SENSORY ORGAN
One of the primary characteristics for any functionally relevant tissue to have is the ability to deliver some form of sensory stimulus. The specific tissue will need to be sensitive, not only the environment, but to its relative position and status. Fascia is highly innervated and is a very powerful sensory organ (4).

Golgi Tendon Organs
Senses extension and triggers appropriate nervous system reaction (firing rate)
Sensitive to muscle contraction
Will restrict motion in risk of failure
Will decrease tonus in motor fibers as a result of stimulation
10% found in tendon
90% found in muscular portion

Pacini Receptors
Responds to compressive velocity or vibration stimulations
Increases local proprioceptive attention
Variable morphology

Ruffini Receptors
Responds to lateral stretch
Increase local proprioceptive attention
Inhibition of sympathetic activity

Interstitial Receptors
High and low threshold pressure units
Increase local proprioceptive attention
Stimulation of high threshold pressure units may induce pain and thus increase plasma extravasation





The fact that fascia is highly innervated suggests that, by definition, it is able to respond and adapt to stimulus. This adaptation will be in the form of a local response or, to be precise, remodelling. Fascia will remodel by means of mechanotransduction. The term mechanotransduction is defined as the molecular response of cells to mechanical input. Many physiological responses have been observed in response to force: (5)

• In cartilage, cells secrete more glycosaminoglycan-rich matrix when stimulated with force
• In the lining of the cardiovascular system, endothelial cells change shape and properties in the presence of altered shear stress
• Cardiomyocytes get larger and generate more force when subjected to a greater demand
• Bone density increases (more osteoblast action) in response to elevated stress levels
• Tendons and fascia mechanical properties (size and strength of fibers) respond to stress

The process of mechanotransduction will solicit what is called the piezoelectric phenomenon within the targeted tissues.

• Fascia is primarily made up of collagen proteins
• Collagen has dipole characteristics (positive and negative ends)
• Deformation of tissue causes alterations in the electrical potential throughout
• Deformation creates a measurable electrical field
• This field stimulates fibroblast activity to produce new collagen deposits


As with all physiological tissues within the body, fascia will respect Wolf’s Law.

• If a tissue is submitted to more demanding conditions it will remodel to meet the demands more efficiently
• If a tissue is submitted to less demanding conditions it will resorb



This process is governed by the tissue mechanotransduction which, in turn, is governed by the stress (force) input. Therefore the mode of stress applied (speed of application) and the amount (total force) is essential to the resultant adaptation. In order to achieve positive long term adaptation, the application of the stimulus must be relatively slow and repetitive.

• Induce multiple deformations / impacts of 1-2% of initial tissue length (60 minutes)
• Creates permanent remodeling without harming health of membrane (6).

The Extended Fascial Paradigm and its Implications in Athletic Conditioning: Part 1

The Extended Fascial Paradigm and its Implications in Athletic Conditioning

Gavin Broomes B.Sc.

ABSTRACT

In the field of Strength and Conditioning, the ultimate goal is to extract the best possible results of human athletic performance and reduce the potential for injury.  Consequently, the Strength and Conditioning professional is charged with the formulation and implementation of very specific protocols that are designed to meet these goals.  The precise formulation of training protocols is significantly easier if all of the training variables are known which will therefore result in a profoundly more efficient and effective plan.  The emerging study and research into fascia has resulted in the medical community, clinicians, and strength and conditioning professionals taking a more in-depth look into the contribution of fascia across the entire human organism.  These investigations extend not only to mechanical and orthopaedic contribution, but to systemic and metabolic contribution as well.  It is this emerging interest and scientific study that lead to the investigation of the role of fascia in the development, maintenance, and rehabilitation of the high performance athlete.  There is a significant amount of research that is currently available that identifies fascia as an important sensory organ as well as a prominent contributor to force production and transfer.  Based on these facts, the implications of increased focus on the development of the extended fascial system is significant and has a direct positive effect on the desired goal of maximum potential performance.   

INTRODUCTION

The field of Strength and Conditioning has made some important progress in achieving maximum performance in the high performance athlete.  These progresses have been made on many important levels from the analytical perspective (for example, Gray Cook’s Functional Movement screen) and from the developmental / implementation perspective as well.  It is these progresses themselves that have amplified the fact that dynamic human performance is a vastly complex and comprehensive function that has a lot of untapped potential for improvement.  A large portion of the scientific focus regarding athletic training has been directed towards the skeletal muscle paradigm, that is to say that much attention is given to what is perceived to be the primary contributor to dynamic movement.  One can consider this as a specific scientific paradigm which by definition means that everything surrounding athletic training (program design, implementation, rehabilitation, and conditioning) is governed and shaped by the specific set of established protocols and beliefs.   The strength and conditioning professional is therefore guided by the specific scientific foundation and uses it as his / her platform on which the rationale of their philosophy and approach sits.  As the research and study into athletic performance increases, the number of new questions increases as well.  This triggers the search for answers that may exist outside of the established paradigm resulting in a potential paradigm shift.  Paradigm shifts typically occur during a time of crisis (1) or, to be more specific, when the number of growing questions increases at a rate much faster than the rate of answers provided by the established paradigm.  The intent of this article is not to suggest that we are in a “time of crisis” within the field of strength and conditioning, rather that there is a potential “paradigm-like”  approach to training that, not only presents realistic opportunities to improve maximum athletic performance, but ABSORBS AND INTEGRATES the current established paradigm.  Therefore, the intent of this article is to present the Extended Fascial Paradigm as a potential important approach that will result in significant improvements in the analytical approach to strength and conditioning and consequently result in profound gains in human athletic performance.

THE EXTENDED FASCIAL PARADIGM DEFINED

The term “extended” is used to highlight the vast and varied implications that fascia has on the human body and therefore athletic performance. Fascia is typically used as a group term that is meant to generalize a given set of structures; however it can be categorized as many functionally distinct tissues (2):

Superficial fascia

-Serves as storage of fat and water

-Found on face and neck while it fills unoccupied place in the body

-Composed of areolar connective tissue

Deep fascia

-Fibrous connective tissue (elastin and collagen)

-Surrounds muscles, bones, nerves, and blood vessels

Visceral fascia

-Wraps and fixes organs in position

The Extended Fascial Paradigm suggests that the reason fascia plays such an important role in dynamic performance is because it has 2 specific functional appearances: anatomical and architectural (3).  The anatomical appearance is the one that we are most familiar with; fascia as the tissue that serves as the simple “wrapping” for the more sophisticated structures such as muscle and internal organs.  The architectural appearance is what clearly identifies fascia as an important contributor to dynamic movement.  Fascia, or to be more precise connective tissue, exhibits two functionally paradoxical tendencies; it “connects” and “disconnects” (3).  The connective tendencies are the ones we are more familiar with and typically have a relatively good understanding of.  The “connecting dimension” allows for mechanical interaction of different body segments and therefore contributes to movement (fig.1 and fig.2).  The “disconnecting dimension” is somewhat more elusive and counter-intuitive.  Fascia also separates individual muscles allowing them to slide independently without interference with adjacent muscle bellies and structures (fig.3 and fig.4).  This disconnection is vital for the efficient performance of athletic movement.  The implications of fascia are far-reaching and therefore should be considered as an important focus or training variable on its own. 

Welcome to One Giant Leap!

This blog is a pilot project intended as a vehicule for intellectual debate and discussion regarding cutting edge theories and concepts in the field of human performance and rehabilitation.  I hope that it both educates and stimulates the mind! Enjoy!