RETURN TO SEASONAL SPORTS FOR YOUTH: Reversing Overuse Injury in youth

Ever have one of those weeks where random events seem to conspire to send the same message?

Wondering what the hell am I talking about here?

Well, the other evening I was driving by the local Youth Baseball/Softball Stadium, when I noticed there was a Youth Baseball Tournament with what looked to be 10-11 year old boys going on….IN NOVEMBER! I know you can guess what my thoughts were on young athletes playing baseball at night during FOOTBALL SEASON.

The next morning, I was listening to a radio interview with the shortstop of the World Champion S.F. Giants, Brandon Crawford. Crawford told how, despite the pressures to play baseball year round, he played Football and Basketball throughout his high school years.

He told the interviewer that he felt his body needed the rest/break from baseball; especially his arm. He felt other sport movements allowed him an opportunity to improve his overall athleticism while not exposing him to “overuse” injuries common to baseball. Without playing other sports through high school, he felt he might have been injured before, or during his collegiate years at UCLA.

That same afternoon I read a paper from a prominent Sports Medicine Doctor’s group that recommended keeping youth baseball players to under a 100 pitch per week count. What bothered me about that was the fact that I see young athletes aged 10-14 playing YEAR ROUND BASEBALL. Even limiting hard throwing or pitching to 100 per week seems TOO MUCH. Imagine 40 weeks (out of 52 in year) x 100 hard throws (4,00) from age 10 to 14 (20,00 hard throws or pitches).  More than 20,000 hard tosses or pitches BEFORE High School?

That very same evening I happened to get to Chapter 5 in Mark McCluskey’s “Faster, Higher, Stronger” book. Below are some of the informational highlights of this Chapter (The Fast Track to Greatness).

“…the more important difference between the fast and slow developing athletes is how much and when they came to their primary sport. The fast developers played many more sports before they started their main sport, when they started much later in life---around seventeen years old. Although they had spent their childhoods trying out various sports, once they found the one that clicked, the great fit between athlete and sport allowed for their very quick progress.”

“The huge popularity of the 10,000 hour theory has led to some real changes in how parents are managing their kids’ athletic careers….While studies like we’ve just examined (above paragraph) undercut this position, there are still lots of parents who bet that the 10,000 hour theory is the best possible way they can help their kids become great athletes. The popularity of the theory has caused a shift away from the more fluid model of sports participation we saw a generation ago toward a world where kids pick a single sport at a young age and focus on it to the exclusion of others.”

“You can see the results of that focus almost everywhere you look in youth sports. The number of ligament repair surgeries done on teenage baseball players has mushroomed as they pitch more and more innings. Overall, more than 3.5 million kids under the age of fourteen are injured annually playing sports. Nearly half those injuries are caused by overuse, according to statistics from the American Orthopaedic Society for Sports Medicine.”

“A recent study by doctors at Loyola University suggested that a good rule of thumb is that young athletes shouldn’t spend more hours per week than his or her age playing one sport. So, if you are 12 years old, you should spend 12 or FEWER hours playing a particular sport. Athletes who exceeded this guideline were 70 percent more likely to suffer overuse injuries…”

Alluding to a study of elite Australian athletes…”the majority of those elite Australian athletes played lots of different sports as a kid, rather than focusing on one. The longer the wait before specializing in one sport, the better chance that a young athlete will find a sport that he’s not only best suited for but also enjoys the most.” A German study showed similar statistics. In this recent German study over 1.500 German National Team Athletes were sampled.  “A larger proportion of the world class athletes reported to have changed their main sport during their career and the proportion of world class performers was highest when athletes had experienced more sports.”

This type of information IS HARDLY new but seems to get washed over by parents who believe their children, either because they matured earlier or started earlier, HAVE THAT SPECIAL TALENT in THAT ONE sport that will keep them at the top of the talent pool throughout their high school careers and beyond…DESPITE all the evidence showing a minuscule percentage of athletes who succeed with this process.

Here are specific factors concerning ages at which aptitudes for various athletic performance factors, such as strength, power, endurance and specific movement types are best suited to the child’s maturation level.

Ages 2-5: Children may have difficulty catching, throwing, and hitting because the brain’s vision centers aren’t fully developed. TBALL make a good entry sport and free play can help develop fundamental skills of hopping, skipping and jumping.

Ages 6-9: This is a time of significant development of visual and balance skills. Most activities at basic levels are good; such as swimming, martial arts and soccer.

Ages 10-12: Visual judgment, balance and strength improve. Children can better play sports requiring memory strategies and rapid decision making, such as football and basketball.

Ages 11-15 >Puberty depending on gender: Rapid physical growth may bring a temporary decline in balance skills and body control and improved performance in aerobic activities.

Ages 16-19: Endurance conditioning and strength training can improve aerobic and strength performance, but heavy weights should be avoided until the skeleton fully matures.

I urge you to read the article below for further evidence that seems to grow each year that young athletes flock to Year Round, Single Sport participation and the Industry that now flourishes is providing traveling teams and private coaching to parents who want to nurture their child’s talent and/or provide a head start towards a college athletic scholarship.  In addition, check out the article at the top of list on the PAGES COLUMN TO THE RIGHT OF THIS POST. ----BRING BACK SEASONAL SPORTS FOR KIDS!!!

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Arm pain in young baseball players common, preventable

November 6, 2014

Columbia University Medical Center

Arm pain is common among supposedly healthy young baseball players and nearly half have been encouraged to keep playing despite arm pain, the most in-depth survey of its kind has found. The findings suggest that more detailed and individualized screening is needed to prevent overuse injury in young ballplayers.

The most in-depth survey of its kind found that arm pain is common among supposedly healthy young baseball players and nearly half have been encouraged to keep playing despite arm pain. The findings suggest that more detailed and individualized screening is needed to prevent overuse injury in young ballplayers. The study, led by Columbia University Medical Center (CUMC) researchers, was published this week in the online edition of the American Journal of Sports Medicine.

"Both nationally and internationally, we're witnessing a troubling increase of elbow and shoulder injuries in young baseball players," said study leader Christopher S. Ahmad, MD, chief of sports medicine and professor of orthopedic surgery at NewYork-Presbyterian/Columbia and head team physician for the New York Yankees. "The likely explanation is that they're throwing too much, too early, putting increasing demands on their bodies that their bodies are not ready for. Despite current guidelines and precautions--for example, limiting pitch counts and emphasizing off-season rest--many players are still sustaining overuse injury to their throwing arm. Thus, it's vital that we develop better ways for coaches, parents, and clinicians to identify players at risk so we can prevent irreversible injury and season-ending surgery."

As a first step toward this goal, Dr. Ahmad and his colleagues designed a questionnaire to learn more about the frequency, severity, and psychosocial effects of arm pain among active adolescent baseball payers. The questionnaire was completed by 203 players from New York and New Jersey between the ages of 8 and 18. All of the surveys were completed without input from parents or coaches.
Among the survey's findings was that 74 percent of players reported having arm pain while throwing (answering that they "always," "often," "sometimes," or "rarely" experienced arm pain). Just 26 percent said they "never" had arm pain while throwing.
The study also found that:

• 80 percent reported having arm pain the day after throwing.
• 82 percent reported arm fatigue during a game or practice.
• 54 percent reported that arm pain limited the number of innings they could play.
• 75 percent reported that arm pain limited how hard they could throw.
•  

Pitchers, compared with infielders and outfielders, were especially likely to have played with pain. One-quarter of pitchers reported that they "often" or "always" had pain the day after throwing. "These pitchers likely represent one of the higher-risk groups for incurring a future overuse injury and thus warrant particularly high monitoring," said Dr. Ahmad.

Almost half (47 percent) of players reported that they had been encouraged to continue playing in a practice or game even though they were having pain. One in eight players, aged 17 to 18 reported that they "always" felt encouraged to continue playing despite having arm pain. A majority of players reported that arm pain caused them to experience less enjoyment while playing and that it was responsible for holding them back from being a better player.

"It's alarming that so many young baseball players are encouraged to play with pain," said Dr. Ahmad. "Years ago, prior to concussion protocols, we observed something similar in football, where players who suffered a concussion were routinely sent back into the game after 'recovering' for a few minutes. The initial concussion lowered the threshold for another concussion, and the repeated concussions put the player at risk for permanent damage. I think we're seeing a similar problem in baseball, where playing with arm pain is setting the stage for more serious injury."

Dr. Ahmad suspects that this phenomenon has contributed to the recent rise in "Tommy John" surgeries among college and professional baseball players. ("Tommy John" surgery is the colloquial name for reconstruction of the elbow's ulnar collateral ligament. The procedure was named after the former Los Angeles Dodgers pitcher, who was the first to undergo this repair in 1974.)

According to Dr. Ahmad, current precautions and guidelines are inadequate for preventing injury. "It's not enough to set pitch counts based on a player's age," he said. "While some 14 year olds are already quite mature, in terms of their skeletal structure, others haven't even started their growth spurt yet. We need to come up with more individualized throwing programs and better ways to detect which players are at risk for injury." Dr. Ahmad is currently investigating the use of ultrasound for correlating arm pain with tissue damage.

Eat, Drink and Be...WARE! What supplements are your kids ingesting?

 Just in time for THANKSGIVING!!!!

One of the most pressing concerns for parents and coaches SHOULD be what types of food, drinks and supplement their young athletes are consuming.

Parents and coaches should have major concerns about the information and sources of information on supplements and energy drinks that are easily available to young athletes. As I noted in past posts on supplements and energy drinks, many contain dangerous mixes of stimulants, steroids and herbs that can cause a variety of harm to liver, heart and overall health.

What should parents and coaches do? 

First, be aware of all sport or energy drinks, supplements or “powders” your athletes are consuming. Then follow the simple guidelines below to insure your athletes are practicing beneficial dietary practices.

 NUTRITIONAL GUIDELINES FOR YOUNG ATHLETES

First, you need to limit ALL sport and energy drinks to ONLY those that contain water and some lower concentration of carbohydrate. Eliminate any drinks with herbs, caffeine or supplements OTHER than electrolytes (mainly sodium, magnesium, potassium). 

If you are exercising for less than 75 minutes, water is the only fluid your body really needs and let thirst be the guide for intake before, during and after exercise of competition. Exercise less than 45 minutes do not require any carbohydrates for performance but exercise from 45 to 75 minutes MAY, if intensity is high, require small amounts of carbs like the 30-35 grams of carbs in one of the 20 ounce sports drinks like Powerade, Gatorade, etc. 

Competitive sports like soccer, basketball, rugby, field hockey, etc. that last from 60 to 120 minutes should try and consume between 30-50 grams of carbs from sports drinks at various intervals over the duration of the contest.  20 ounces of Powerade, Gatorade or 16-32 ounces of water, mixed with ¼ the amount of white grape juice, unsweetened orange or cherry juice WILL MEET the ENERGY requirements of the athletes providing they consumed a pre-competition meal 2-3 hours prior to the game.

The only additions to the daily diet of carbs, fats and protein needed by young athletes would be a MultiVitamin and perhaps Vitamin D, Calcium and Iron. For teenage athletes, who are strength training in addition to their sport practices, additional protein may be needed if their diet does not contain .6 to .9 grams of protein for every pound of body weight. The protein should be a mix of proteins, such as Whey, Egg and Milk proteins with Amino Acids being the only other additives to the protein mixture.

Athletes who compete in “high intensity, intermittent sports” and/or engage in “high intensity” strength training or interval training CAN greatly benefit from CREATINE supplementation. The supplementation should be in the consistent but “low dose” protocol of 3-5 grams per day for 3-4 week periods with one week of non-supplementation between supplementing periods.
Realize that diets and the way each individual processes the food and nutrients IS EXTREMELY INDIVIDUALIZED.THERE IS NO ON WAY OF EATING THAT WORKS FOR EVERYONE!

There are, however, some very good recommendations for everyone that can be very beneficial for ATHLETES OF ALL AGES. First, make sure you get 6-8 fist sized servings of vegetables EVERY DAY. Some of the vegetable servings can be replaced by fruits and at least 32-48 ounces of water should be included daily. 

Try to consume 75-80% of your daily intake in “whole” or unprocessed foods. Also, foods are BETTER sources of nutrients than “meal replacement” bars, energy bars, gels and sport drinks and should be used in place of these sport products whenever possible. For example, chocolate milk and/or Peanut Butter and Honey sandwich on whole grain bread is more preferable after workouts or a game than sports bars or drinks.

When in doubt about supplements, bars, herbs, etc. it IS WISE TO CONSULT National Sports Governing Body websites for information.
Probably the most clear and concise website for sports supplement classifications would be the AUSTRALIAN INSTITUTE OF SPORT (AIS) website.

I believe it is up to parents of teens to make sure they are aware of the products their children are taking. It should NOT be surprising that in the Alex Rodriguez investigation into PERFORMANCE ENHANCEMENT DRUG USE concerning BIO-GENESIS LABS that the majority of the clients using Bio-Genesis for illegal steroids and Performance Enhancing Drugs were Florida teen-agers.

Young athletes in search of performance enhancing methods would benefit more by:
1) GETTING MORE SLEEP.

 2) Train consistently under a well-designed program that is balanced in intensity, volume, density and proper recovery methods. Both proper and regular training, in conjunction with 8-10 hours of Sleep, can elevate testosterone naturally to aid in recovery, growth, regeneration and maturation processes.

3) Make sure the daily diet is consistent with “unprocessed” foods that deliver quality Fats, Carbohydrates and adequate Protein. Note: avocados, cashews, almonds and eggs are some of the whole foods that support testosterone production.

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Here is the short form of an article that should SIMPLIFY the daily diet to something that everyone can manage…if they choose!

(Only) Two Rules for a Good Diet

Selected information from the full article by Marc Bittman/ New York Times /Oct. 21

To a large extent, you can fix the food system in your world today. Three entities are involved in creating our food choices: business (everything from farmers to PepsiCo), government (elected and appointed officials and their respective organizations) and the one with the greatest leverage, the one that you control: you.

There are two big decisions that can put you on the right path and help you largely steer clear of antibiotics, excess sugar, unwanted chemicals, animal cruelty, and more.

Here then, is your two-step guide for an unassailably powerful personal food policy.

1. Stop eating junk and hyper-processed food. This eliminates probably 80 percent of the stuff that is being sold as “food.”

 2. Eat more plants than you did yesterday, or last year.

If you add “Cook your own food” to this list, it’s even more powerful, but these two steps alone allow you to reduce the amount of antibiotics you’re consuming; pretty much eliminate GMOs from your diet, lighten your carbon footprint; reduce your chances of becoming ill as a result of your diet; save money; cut way back on sugar, other junk and unnecessary and potentially harmful nonfood additives; and so on.

The power lies with you.

 PLEASE READ THE ARTICLE BELOW FOR ADDITIONAL AND BENEFICIAL INFORMATION ON THE DANGERS OF SUPPLEMENTS

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Being a long time Track and Field coach, this recent press release is one of many concerning athletes who “unknowingly” ingest banned substances. In all sports, YOU are responsible for what GOES into your body, knowingly or unknowingly!!!!! 

Energy drink to blame for Montsho’s drug mishap

Gazette Sport has established that 400m sprinter Amantle Montsho consumed an energy drink containing the banned substance prior to the Commonwealth Games. A source close to the athlete informed this publication that the former women’s 400m world champion unknowingly consumed the substance and that she was not aware that she was consuming Methylhexaneamine. One of the energy drinks believed to contain the banned substance is named Anabolic Nitro Extreme Energy Surge.
HOW CAN THIS HAPPEN?-----READ THE ARTICLE BELOW and be more cautious.

Dangerous Dietary Supplements Return to Store Shelves

By Anahad O'Connor

October 21, 2014 

The Food and Drug Administration frequently recalls dietary supplements that are found to contain banned substances. But a new study suggests that many of these products return to store shelves months later with the same dangerous ingredients.

The findings suggest that health authorities may be fighting an uphill battle against a small number of supplement companies that repeatedly sell contaminated products. The new study, published in JAMA, the Journal of the American Medical Association, found that out of more than two dozen supplements that were pulled from shelves after they were found to contain anabolic steroids or powerful prescription drugs, roughly two-thirds were back on the market a year later with the same illicit ingredients.

Most of the supplements were marketed for weight loss, exercise and sexual enhancement, and they were sold across the country at convenience stores, in health food shops and over the Internet. They were found to contain steroids and prescription drugs like Viagra and Prozac, an antidepressant.

The study also found that several of the weight-loss products contained Sibutramine, an amphetamine-like drug that was removed from the market in the United States, Asia and Europe after a clinical trial showed it increased the risk of heart attacks and strokes.

Since 2004, about half of all F.D.A. drug recalls have involved dietary supplements found to be contaminated with banned pharmaceutical ingredients. Supplement industry trade groups say that these products are usually manufactured and sold by a few bad actors who represent the fringe of the roughly $33 billion a year supplement industry. 

Under a federal law enacted two decades ago — the Dietary Supplement Health and Education Act, or Dshea — dietary supplements can be sold and marketed with little regulatory oversight. Companies do not need F.D.A. approval to sell supplements to consumers, and they do not have to provide proof that their products contain the ingredients listed on their labels.

Unlike prescription drugs, dietary supplements are considered safe until proven otherwise, and generally they are pulled from shelves only after complaints of serious injury.

In recent years, research has shown that herbal supplements such as echinacea, Ginkgo biloba and St. John’s wort are frequently mislabeled or diluted with cheap fillers like powdered rice. Last year, a nationwide study by a network of liver specialists found that the number of liver-related injuries linked to bodybuilding and weight-loss supplements was on the rise.

Jennifer Dooren, a spokeswoman for the Food and Drug Administration, said that supplement companies “are legally responsible for marketing a safe product that is not adulterated.” But because companies do not need approval to sell their products, she said, the agency cannot identify tainted supplements before they reach consumers. And even supplements that are identified as contaminated can be difficult to pursue.

“The supply chain for these products is extremely fragmented,” she said. “One product manufactured by an unknown company overseas may be sold by dozens of different distributors in the United States. The individuals and businesses selling these products generally are difficult to locate, operate out of residential homes, and distribute via the Internet, small stores and mail.”

Between January 2009 and the end of 2012, the F.D.A. recalled at least 274 dietary supplements. Many of these products returned to the market a short time later. In the new study, Dr. Pieter A. Cohen, an assistant professor at Harvard Medical School, and his colleagues purchased 27 of these products on average about one year after they had been recalled.

Although many of the previously recalled products returned to the market with slight changes to their labels or brand names, Dr. Cohen and his colleagues limited their study only to those products that returned to shelves or websites with identical packaging.

“We excluded anything that wasn’t exactly the same as it was when the F.D.A. recalled it,” he said. “But a sizable percentage of these products that are recalled, about 25 or 30 percent, are still available.”

The study found that two-thirds of the 27 supplements analyzed contained at least one unlisted anabolic steroid, prescription drug or banned substance. A majority contained the same drug or illicit ingredient that led to them being recalled by the agency. And in some cases, the products contained not only the previously identified substance, but additional drugs as well.

Twenty of the supplements that were analyzed were manufactured in the United States. Out of this group, 13 contained banned ingredients, suggesting that the problem is not limited to unscrupulous companies overseas, Dr. Cohen said.

“This is the problem with supplements: They can be introduced without any vetting at all by the F.D.A.,” he said. “These products are recalled, and then the companies keep selling the pills without making one iota of change to the product. We’re talking about very blatant flouting of the F.D.A.’s requests.”

The authors of the study called for changes to the federal law to better protect consumers from such products.

Dr. Cohen, who has published a number of studies identifying dangerous or illicit ingredients in dietary supplements, said that consumers should be particularly wary of products containing a mixture of herbs or ingredients — what he called “herbal cocktails.” Many of these products may be unadulterated, he said, but consumers usually cannot be sure, and often these are the sort of products that are most likely to be spiked with dangerous ingredients.

“If you want to buy herbal supplements, buy individual ingredients,” he said. “Buy echinacea or black cohosh separately. But don’t buy a mixture and don’t buy a supplement that’s sold to cause weight loss or improve your workouts. These are exactly the types of supplements that these drugs have appeared in.”

EAT, SLEEP & STAND UP STRAIGHT: Things you should have learned in Kindergarten!

A few posts back I talked about the San Francisco Giants use of a Sleep Coach and their dramatic travel changes to best allow for consistent sleep bedtimes. In fact, I have posted quite a bit of SLEEP information in the attempt for parents, coaches and athletes to see it as ONE of many, small performance enhancements that can make a difference.

Consider these THREE PERFORMANCE ENHANCERS that together can make monumental differences in both ACADEMIC and ATHLETIC performance improvements: 1) Consistency in Sleep Patterns and Volume of Nightly & Weekly Hours of Sleep, 2) mindful practice of correct Posture Mechanics throughout all daily activities and 3) attention to positive and consisitent nutritional practices.

I have already written posts (archives) concerning FATS, CARBOHYDRATES, PROTEIN, SUPPLEMENTS, etc. POSTURE and SLEEP.

So, "Why another one?"

 BECAUSE, improving academic & athletic performance WHILE  insuring OPTIMAL PHYSICAL, MENTAL AND EMOTIONAL DEVELOPMENT of today’s youth IS NOT A QUICK FIX.   

Just consider the Medical costs involved with treatment of athletic injuries and you would be wise to employ prudent sleep, diet and postural guidelines so as to reduce chances of injury and illness.

British Sprint and Bobsled Olympian Craig Pickering posted a list of tips on his recent blog that could help reduce injury. Here are THREE of his TWELVE tips:

 1)Make sure your nutritional status is good; you should get sufficient vitamins and minerals to insure your bones and immune system are healthy; 

2) WORK ON YOUR POSTURE and ability to hold this posture under fatigue;

3) Make sure you aid your recovery and adaptation from training by getting SUFFICIENT SLEEP.

I have attached two very informative articles regarding not only how Elite/ Pro Athletes have included GOOD SLEEP HABITS but HOW you can harness the value of Sleep by keeping track of your average nightly and weekly sleep to make sure you are getting the right amounts of this PERFORMANCE ENHANCING and HEALTH MAINTAINING activity.

So, to enhance performance, maintain good health, insure optimal physical, emotional and mental development and maturation…hit the pillow nightly for at least 8-9 hours, clean up your diet and pay attention to your posture…DAILY.

“Athletes who sleep on average < 8 hours per night have 1.7 x risk of injury and longer RECOVERY before the nest training session.”---Raymond Verheijen

“Accumulation of fatigue due to insufficient recovery or sleep deficit between training sessions and/or contests remains a main reason for injuries due to SLOWER nervous system performance.”---Raymond Verheijen

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Building Better Athletes With More Sleep//The Atlantic

Getting enough rest can be a struggle for those who play professional sports. But even among those getting enough, adding a few extra hours may dramatically enhance performance.

Mark McClusky Nov 4 2014

For us humans, sleep is completely crucial to proper functioning. As we’ve all experienced, we’re simply not as adept at anything in our lives if we don’t sleep well. Without proper sleep, whether it’s a short-term or long-term deficit, there are substantial effects on mood, mental and cognitive skills, and motor abilities. When it comes to recovery from hard physical efforts, there’s simply no better treatment than sleep, and a lot of it.

Most research on the effects of sleep on athletes has studied sleep deprivation. And those effects are quite strong. Just like the rest of us, athletes see a drop in their performance across all sorts of measurements if they are kept awake for the entire night, or even just interrupted in their sleep.
It seems like certain kinds of athletic tasks are more affected by sleep deprivation. Although one-off efforts and high-intensity exercise see an impact, sustained efforts and aerobic work seem to suffer an even larger setback. Gross motor skills are relatively unaffected, while athletes in events requiring fast reaction times have a particularly hard time when they get less sleep.

Bouncing around the country, leaving late, arriving early, having to play the next day—it’s no surprise that sleep management is a huge issue for athletes.

But instead of focusing on the effects of a lack of sleep, it’s more interesting to explore additional sleep as an advantage. If an athlete gets more sleep than his or her competitors, will that lead to an edge? That’s just the question that Stanford researcher Cheri D. Mah set out to answer. She reached out to athletes at her university, trying to find a group that would participate in an experiment in which they would first measure their athletic performance after having their normal amount of sleep, and then spend weeks trying to extend their sleep as much as possible, to see what effect it would have on objective measurements of athletic performance. Amazingly, no one had ever done a study to see the effect of sleep extension on competitive athletes.

The Cardinal men’s basketball team volunteered to be Mah’s study cohort. Eleven players used motion-sensing wristbands to determine how long they slept on average—just over 6.5 hours a night. For two weeks, the team kept to their normal schedules, while Mah’s researchers measured their performances on sprint drills, free throws, and three-point shooting. Then, the players were told to try and sleep as much as they could for five to seven weeks, with a goal of 10 hours in bed each night. Their actual time asleep, as measured by the sensors attached to their wrists, went from an average of 6.5 hours to nearly 8.5 hours.

The results were startling. By the end of the extra-sleep period, players had improved their free throw shooting by 11.4 percent and their three-point shooting by 13.7 percent. There was an improvement of 0.7 seconds on the 282-foot sprint drill—every single player on the team was quicker than before the study had started.

A 13-percent performance enhancement is the sort of gain that one associates with drugs or years of training—not simply making sure to get tons of sleep. Mah’s research strongly suggests that most athletes would perform much better with more sleep—if they could get it. But it’s not quite that easy; in fact, athletes face challenges with their sleep that many of us don’t have.

Related Story

The first challenge that many elite athletes face is the travel demands of their sport. When you’re a pro athlete, you spend a lot of time on the road. If you’re a professional sports team athlete in the U.S., you’re spending your time zigzagging across the country, flying back and forth to meet the demands of schedule-makers who don’t always take the travelers’ circadian rhythms into account.
The mileage can pile up in a hurry, especially for teams on the West Coast, which are farther away from the rest of the teams in their leagues. West Coast teams perennially have to travel more miles than their competition—in 2013, the Seattle Mariners flew more than 52,000 miles while the Chicago White Sox, with their central location and nearby division rivals, only flew about 23,000. Some years, the L.A. Kings have had to fly more than 55,000 miles to reach other teams in the NHL, while the New Jersey Devils were clocking less than 29,000. Bouncing around the country, leaving late, arriving early, having to play the next day—it’s no surprise that travel and the management of sleep is a huge issue for athletes.

To try and deal with this disruption, teams have consulted with sleep researchers like Mah. Most NBA players have adapted by taking a nap in the afternoon, between morning practice and the evening’s game. “If you nap every game day, all those hours add up and it allows you to get through the season better,” NBA all-star Steve Nash told the New York Times. “I want to improve at that, so by the end of the year, I feel better.”

Domestic travel is bad enough, but for athletes in many Olympic sports, there’s a heavy dose of international travel as well. Randy Wilber, at the U.S. Olympic Committee, notes that there’s very little published research on how to deal with jet lag even for people who travel professionally, like pilots, let alone research on how to minimize its effects on elite athletes. “We’ve had to develop those protocols ourselves pretty much from scratch,” he says.
Does traveling a long distance have a demonstrable negative effect on teams? There haven’t been a lot of studies, but Bill Barnwell, of Grantland.com, looked at 15 years of data for the NFL, examining the winning percentage of road teams by the distance they had to travel. Teams who traveled more than 2,000 miles had a winning percentage of 40 percent, while those who traveled less than 1,000 miles won 43 percent of the time.

Bad news for teams like the Oakland Raiders, who had to travel more than 28,000 miles in 2012, while teams like the Indianapolis Colts only traveled 8,494 miles.

Most NBA players adapt by taking a nap in the afternoon, between morning practice and the evening’s game.

And these travel effects seem to accumulate over the course of a season. Researchers at Vanderbilt University examined the plate discipline of hitters in baseball over the course of the season, and found that hitters swing at more pitches outside the strike zone late in the season than they do earlier in the season. Why? Dr. Scott Kutscher, the leader of the research team, said in a press release, “We theorize that this decline is tied to fatigue that develops over the course of the season due to a combination of frequency of travel and paucity of days off.”

Kutscher’s team has found that this decay in plate discipline has become more pronounced in baseball since 2006—the year that Major League Baseball banned stimulants. (For years, bowls of amphetamines, known as “greenies,” were a fixture in baseball clubhouses.) Out of the 30 teams in Major League Baseball, 24 saw this decrease in 2012, the year the study examined. That suggests that if a team can find a way to stem this fatigue effect, they might have a competitive advantage—in fact, it’s already happened. The San Francisco Giants actually improved their plate discipline over the course of the 2012 season, and the team went on to win the World Series.

Perhaps the Giants also improved what researchers call “sleep hygiene”—making sure that your bedtime is as regular as possible, removing the bright digital clock from your bedside table (studies show the light disrupts sleep), finding a comfortable temperature (research shows a cool room is best). Start viewing sleep as a performance booster rather than a chore, and the effort it takes to sleep well will seem like a smart investment.
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Morning Heart Rate and "Functional" Overtraining

Weekly averages, rather than daily measurements, help you keep tabs on fatigue.

Alex Hutchinson

There's an interesting article just published in Medicine & Science in Sports & Exercise on "evidence of parasympathetic hyperactivity" as a marker of overtraining. It has some interesting insights on the causes and underlying physiology of pushing too hard – but what I'm going to highlight here is some potentially practical findings.

The basics: French researchers took a bunch of well-trained triathletes and divided them into two groups. Both groups spent one week doing regular training; then for the next three weeks, the control group continued regular training, while the other group ramped up their training by 40%; then both groups tapered for a week before a final performance test. The goal here was to push them into "functional overreaching" – the kind of temporary overtraining that leads to worsening performance but then can be reversed with a short period of rest (as opposed to chronic overtraining that takes much longer to dissipate).
Each morning, when the subjects woke up, they took four minutes of heart-rate data before getting up for the first time, and then another four minute of data after standing up. The heart-rate data included simple measures like average heart rate, as well as more sophisticated analysis of heart-rate variability – the amount that the time between heart-beats fluctuates, which is considered a sensitive measure of autonomic nervous system function. (They also did a bunch of other tests, but I'll focus on these ones.)
Here's the data showing supine morning heart rate every seventh day (i.e. the week before the overtraining period, three overtraining weeks, and after one week of taper); the closed circles are the overtraining group and the open circles are the controls:

Hard to see much obvious pattern there. But what happens if we look at the seven-day averages instead of single-day readings?

Now we're talking! After smoothing out the day-to-day fluctuations, we see that the control group stays fairly constant throughout the experiment, while the overtraining group declines steadily during the overtraining period and then recovers a bit after the taper. This is useful information (and precisely what they expected, relecting increased parasympathetic drive). It's mirrored in a number of other measurements – standing-up HR, HR at lactate threshold, HR at exhaustion, as well as some of the HRV values. The key finding (echoing some earlier HRV studies) is that day-to-day measurements are simply too variable to extract reliable information from – but weekly averages can reliably show significant trends that reveal how your body is responding to the training load.

One other interesting point worth considering. Here are the results of the run-to-exhaustion performance tests they performed at the end of each week:

Once again, the normal training group doesn't change much – maybe a slight boost after the taper. The overtraining group, as expected, gets steadily worse as the three-week overtraining period goes on... but then, after the taper, they supercompensate and produce by far the best results of the study. It's a reminder of why "overtraining" is such a difficult beast to get a handle on: this sort of "functional overreaching" is indeed very functional, and is precisely the high-risk state you want to push experienced athletes into at certain points in the season. Push too hard, and they'll keep getting worse. But get the balance just right, and you'll get results like those shown above – because in the end, very hard training really works.

POSTURE: Key to Power/Efficiency of Athletic Movements

In my last post I promised to outline some very simple activities that can be used to develop correct postural integrity in conjunction with athletic movement-skill development.

As mentioned in my last post, correct Postural Alignment allows the athlete to be more successful at accessing the “elastic components” transfer of energy to the skeleton for more efficient athletic movements. 

When the body is in correct, postural alignment it is able to successfully utilize the energy supplied by the “fascial band” that connects all areas of the body through a web-like system of tendons and fascial bands. This “band”, made up of tendonous and fascial tissues, wraps the body in a web-like “highway” that helps transfer muscular energy to the skeleton via the “stretch reflex” mechanism.

This “stretch reflex” mechanism is created through teamwork via the muscles’ contractile ability and the “elastic” ability of the tendonous tissue. While the muscle contracts “isometrically”(stabilizing) or “concentrically” (shortening) it is stretches the “elastic” tissue (tendon), which provides the power for movement about the joint or joints.

The spring-like qualities and power production potential supplied by the “connective tissues” that make up the Fascial Band and tendons that wrap around the body and all it’s joints ARE MORE EFFICIENT AND ACCESSIBLE when proper POSTURAL ALIGNMENT has been achieved through postural strength development.

Again, as discussed in the last post, this is a 24/7 task as failure to develop correct posture throughout all the daily activities (sitting, standing, walking, etc.) will negate any efforts at postural awareness during sport training/ practice times.

Proper POSTURE allows the athlete to develop intrinsic efficiency for all movements by empowering the muscles to work as stabilizers for the more efficient tendon/fascial tissue to stretch and recoil. This stretch and recoil by the tendinous-fascial tissues of the body allow the “connective” tissue to do the work via “stretch-reflex” rather than use the bio-energetic process of the muscles, which requires fuel (ATP) and various bio-chemical processes, depending the intensity and duration of the movements.

To simplify the above, CORRECT POSTURAL ALIGNMENT allows for the development of EFFICIENT ATHLETIC MOVEMENT!

Concurrent development of Posture and Athletic Sport Movement can be done in a variety of ways in order to be both time-saving and instructionally-efficient. Creativity by coaches in developing methods that allow for development of both posture and athletic movement patterns cannot be underestimated.

Since the brain will always take the “easy” road for movement patterns to save on energy costs, it is important to understand that this means the body will “default” to adopting patterns of movement AND posture that CAN BE DIFFICULT TO CHANGE.

Athletes who have developed CORRECT POSTURE are most likely, via “default”, to adopt patterns of movement that are EFFICIENT.

Athletes who have POOR POSTURE are most likely, via “default”, to adopt patterns of movement that are INEFFICIENT. This inefficiency cause a variety of “energy” leaks throughout movements that result in LOSS OF POWER PRODUCTION, GREATER ENERGY COST AND HIGHER INCIDENCE OF OVER-USE INJURIES.

Basically methods of instructing technical sports skills that develop optimal length-tension postures of key areas of the torso CAN address both POSTURE and BASIC ATHLETIC SKILL DEVELOPMENT.

A Posture that promotes optimal length-tension posture of the hip and pelvic musculature in running, throwing, hitting a baseball, forehand swing in tennis, etc. is the LOCK POSITION of the pelvis.

Correct LOCK POSITION of the pelvis as described by Craig Ranson, PhD and David Joyce in (Chap.3/ Enhancing Movement Efficiency) HIGH PERFORMANCE TRAINING FOR SPORTS appears below:

“Drills that can be used to quickly and effectively improve trunk-muscle recruitment involve running with arms stretched overhead. Bilateral overhead arm positions cause a reflexive co-contraction of the trunk musculature on the pelvis, further augmenting potential for energy transfer and reducing unwanted rotational or lateral motion of the trunk and pelvis…….”Running with a stick held as high as possible overhead (Overhead Position in Olympic Snatch Technique) will also harness this reflex and can have immediate positive effects on subsequent running technique.”----“For lock-position walking drill, the athlete begins with a broomstick (dowel) in both hands. Walking or skipping forward, the athlete pushes the stance-side arm upward while obtaining lock-position, elevation of the pelvis on the swing-side, hip flexion to approximately 80 degrees and maximal knee flexion and ankle dorsiflextion. Elbows remain straight (locked). Simultaneously, the athlete forcefully plantar-flexes the stance ankle.”

It should be noted that the lock-position of the pelvis can only be maintained IF the strength of the lateral hip musculature is adequate enough to hold this position.

Lateral hip musculature is another key to development of POSTURAL STRENGTH/ INTEGRITY critical for athletic movement skill capacity.

Since the pelvic-lock position in mid-stance is critical to striking and throwing sports development of the lateral hip musculature may go unnoticed.

Lateral hip musculature development is also a key factor in development of ANKLE STABILITY, KNEE STABILITY and can alleviate such sprint mechanical problems as “Cross-Over Gait” and power loss during ground contact phase.

Proper strengthening of the Glutes, Core stabilizers and External Hip Rotators allows for the necessary “stacking” of knee over foot, hip over knee and provide a level and stable pelvis OVER hip. THIS IMPROVES postural control that allows for ankle stability at ground contact.

Other critical areas of ATHLETIC SKILL DEVELOPMENT that can be successfully improved via Postural Alignment and Strengthening are CHANGE OF DIRECTION (COD) and JUMPING SKILLS.

Changes of direction, cutting jumping and landing are all athletic skill competencies that depend on optimal Postural Strength/Alignment to develop EXPLOSIVE FORCE about the ankle, pelvic control during single-leg support and torso rotation toward the desired direction of travel.

PLEASE READ THE ARTICLE BELOW, which pertains to the increase in arm-related injuries in youth baseball players. Again, this stems from “specializing” in one sport instead of changing sports during the various seasons. THEN READ THE NEXT ARTICLE CONCERNING AN AYSO ARTICLE ADVISING MULTI-SPORT PARTICIPATION. 

There ARE better methods for athletic development available that are  “free” and “proven” to be more effective IN THE LONG RUN!

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New Shoulder Injury Identified

Young baseball pitchers who throw more than 100 pitches per week are at risk for a newly-identified overuse injury that can impede normal shoulder development and lead to additional problems, including rotator cuff tears, according to a new study published online in the journal Radiology.

The injury, termed acromial apophysiolysis by the researchers, is characterized by incomplete fusion and tenderness at the acromion. The acromion, which forms the bone at the top or roof of the shoulder, typically develops from four individual bones into one bone during the teenage years.

"We kept seeing this injury over and over again in young athletes who come to the hospital at the end of the baseball season with shoulder pain and edema at the acromion on MRI, but no other imaging findings," said Johannes B. Roedl, M.D., a radiologist in the musculoskeletal division at Thomas Jefferson University Hospital in Philadelphia.

To investigate the unexplained pain, Dr. Roedl and a team of researchers conducted a retrospective study of 2,372 consecutive patients between the ages of 15 and 25 who underwent magnetic resonance imaging (MRI) for shoulder pain between 1998 and 2012. The majority of the patients, which included both males and females, were baseball pitchers.

"Among high school athletes, pitching is the most common reason for shoulder pain," Dr. Roedl said.
Sixty-one of the patients, (2.6 percent) had pain at the top of the shoulder and an incomplete fusion of the acromion but no other findings. The patients were then age- and sex-matched to patients who did not have the condition to form a control group.

Pitching history was available for 106 of the 122 patients included in the study. Through statistical analysis, the researchers found that throwing more than 100 pitches per week was a substantial risk factor for developing acromial apophysiolysis. Among the patients with this overuse injury, 40 percent threw more than 100 pitches per week, compared to 8 percent in the control group.
"We believe that as a result of overuse, edema develops and the acromion bone does not fuse normally," Dr. Roedl explained.

All 61 injured patients took a three-month rest from pitching. One patient underwent surgery while the remaining 60 patients were treated conservatively with non-steroidal pain medication.
Follow-up MRI or X-ray imaging studies conducted a minimum of two years later, after the patients turned 25, were available for 29 of the 61 injured patients and for 23 of the 61 controls. Follow-up imaging revealed that 25 of the 29 patients (86 percent) with the overuse injury showed incomplete fusion of the acromion, compared to only 1 of the 23 (4 percent) controls.

"The occurrence of acromial apophysiolysis before the age of 25 was a significant risk factor for bone fusion failure at the acromion and rotator cuff tears after age 25," Dr. Roedl said.

Twenty-one of the 29 patients with the overuse injury continued pitching after the rest period, and all 21 showed incomplete bone fusion at the acromion. Rotator cuff tears were also significantly more common among this group than in the control group (68 percent versus 29 percent, respectively). The severity of the rotator cuff tears was also significantly higher in the overuse injury group compared to the control group.

"This overuse injury can lead to potentially long-term, irreversible consequences including rotator cuff tears later in life," Dr. Roedl said.

Dr. Roedl and his colleagues suggest teenage and young adult pitchers limit the number of pitches thrown in a week to 100. The American Sports Medicine Institute currently recommends that baseball pitchers between 15 and 18 years of age play no more than two games per week with 50 pitches per game.

"Pitching places incredible stress on the shoulder," Dr. Roedl said. "It's important to keep training in the moderate range and not to overdo it."

Dr. Roedl pointed out that many successful professional baseball pitchers played various positions, and even other sports, as young athletes and thereby avoided overuse shoulder injuries.

"More and more kids are entering sports earlier in life and are overtraining," he said. "Baseball players who pitch too much are at risk of developing a stress response and overuse injury to the acromion. It is important to limit stress to the growing bones to allow them to develop normally."
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"Acromial Apophysiolysis: Superior Shoulder Pain and Acromial Nonfusion in the Young Throwing Athlete." Collaborating with Dr. Roedl were William B. Morrison, M.D., Michael G. Ciccotti, M.D., and Adam C. Zoga, M.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)

RSNA is an association of more than 53,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
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Huffington Post: The Team That Did Not Practice 
November 3, 2014 
Editor's Note: Please enjoy this Huffington Post blog entry put together by Ann Brenhoff that follows the journey of a U-19 AYSO team that didn't practice, but had an undefeated season and won three Area playoffs.  
My 17-year-old daughter has been playing soccer since she was 5. One year of club soccer sent her running back into the arms of our local AYSO -- something that had little to do with her skill set and more to do with just wanting to have fun at a sport she loves.

I am happy to report that her Malibu AYSO Girls U19 team just won the area playoffs after an undefeated season. What I love most about that fact is this: They didn't hold a single practice all year. Not a one. In fact, on the roster of 21 girls, there were a couple of games where just enough players showed up to take the field and they played without subs. Still no pleading notes from the coach, no emails begging girls to show up. Nothing.

So how does a team that doesn't practice and doesn't insist that the girls come to games rise to the state level? Easy. To start, the coaches understood and made it clear from the start that this was only about having fun, so there was no pressure. We all like to win, but this wasn't about winning; it was about fun. Against a backdrop of looming college admissions, SAT prep classes and AP studies, plus stacks of homework best measured in miles not feet, the coaches realized that there wasn't room for One. More. Obligation. Not one more. So they wisely didn't create one.

Instead what they created was a breather. It was fun to hang out with whoever showed up for a game. It was fun for the parents too, especially now that most of the girls could drive themselves to the pre-game warmup and parents could just show up later to watch. Not that this team actually ever even really warmed up. Our warmups looked more like a coffee klatch the morning after a sleepover but with more stretching and a few casual practice kicks into the goal. It didn't matter; it was fun.

But there is another reason that the team that did not practice did so well. With a very few exceptions, these girls have been playing soccer together for about a dozen years. They know one another, trust each other as players, and all seem to like everybody else on the team. In more than a decade of watching them, I can't recall a single instance of a player finger-pointing or blaming a teammate for a defensive mistake or missed goal. They know each other so well that they sense where the girl playing left wing will run; they intuit which way the center midfielder will boom the ball; and the balls the mid-line kicks always land squarely at the feet of the forward because everyone knows how she runs and where the ball needs to drop. They pass the ball, they share the glory, and when a goal is scored it's a team goal not a player's goal.

So why am I writing about the team that did not practice in a column that generally discusses the experience of aging? Because there are a few life lessons in here: There are some situations in life that need to be recognized as crazy-making stressors. Practices when most of these girls were carrying rigorous course loads, play school sports and have tons of other obligations demanding their time was one such situation. Mid-lifers are known as the sandwich generation because we attempt to be all things to all people, caring for our elderly relatives and managing our families simultaneously. Maybe we can occasionally just stop practicing?

And then of course there is the real aging lesson from the team that did not practice: What you need to survive is to surround yourself with a bunch of people who actually know you well and on whom you can rely. I believe they're called friends.
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AYSO encourages younger athletes to play multiple sports to help build a better athletic foundation. If soccer players take part in a variety of activities, they will have a greater skill set and increased muscular development.