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Proprioception, Core
Strength, and Plyometrics
For The Injured Athlete
Grady J. Hardeman, M.Ed., LAT, ATC, CSCS
Cabarrus County Schools
Cabarrus County Sports Medicine Symposium
January 20th, 2007
Objectives
1. Define Core Strength, Proprioception, and
discuss how they relate to Plyometrics.
2. Review the basic muscle physiology of
plyometrics.
3. Discuss the factors to consider when
implementing plyometrics into the
rehabilitation program.
4. Understand how plyometrics can benefit the
injured athlete
5. Provide Sample Plyometric Exercises for the
Upper and Lower extremities, and the Trunk.
What is The Core???
• Where the bodies
center of gravity is
located, and all
movement is
initiated
– Anatomy:
• Hip, Back, and
Abdominal
musculature
Proprioception
• Knowing where the body is in space.
• Also known as Kinesthetic Awareness or
Sense.
• Becomes impaired after injury, and needs
to be re-trained in order for the athlete to
return to activity safely.
• Required for plyometric and other closedchain rehabilitation activities.
Proprioception Exercises
Plyometrics
• It is not always the strongest
OR the quickest athlete that
prevails. It is usually the one
who is the strongest AND the
quickest.
• Plyometric exercise enhances
both strength and speed.
• Speed + Strength = POWER
Muscle Physiology Review
• Muscle Spindle: A specialized proprioceptor that
is sensitive to both muscle length and the rate at
which the muscle lengthens.
• This structure is what is responsible for the
stretch reflex.
• This reflex is important in the development of
good kinesthetic sense, and is also responsible
for the increased force production during the
stretch shortening cycle (Plyometric).
Muscle Spindle
Diagram taken from The Essentials of Strength Training and
Conditioning 2nd Ed. Pg. 19: Fig. 2.2
Stretch Shortening Cycle
• Three Phases
1. Eccentric or Pre-loading phase
 Muscle lengthens as it contracts.
2. Isometric or Amortization phase
 Muscle length does not change.
3. Concentric or Explosive Phase
 Muscle shortens as it contracts.
How Does It Work
• During the eccentric phase elastic energy is
stored within the muscle. It is released during
the concentric phase and provides a more
forceful contraction.
• The muscle spindle is activated during the
stretch (eccentric phase), and sends a signal to
the spinal cord which activates the agonist
muscle to contract. This is known as the “stretch
reflex”.
Benefits To The Injured Athlete
• Aids in the restoration of the
“Neuromuscular Control” that is lost due to
injury.
– The athlete is more capable of subconsciously
reacting to unanticipated joint loads during
activity.
• Enhances mental preparation for return to
sport.
– Restores confidence
• Enhances muscle force production.
Factors To Consider When
Implementing Plyometrics Into A
Rehabilitation Program.
• Three Important Questions?
– What was the injury?
– Where is the athlete in the healing/rehab. process?
– What is the athletes history with plyometric
exercises?
•
•
•
•
Progression
Volume
Frequency
Specificity
Progression To Plyometrics
• There must be a
solid foundation
of core strength
and
proprioception
prior to initiating
plyometric
activities.
Plyometrics
Core Strength
Proprioception
Progression
Strengthen the “Core” first.
Learn how to land (Proprioception)
May begin the process in the pool to decrease the stress
applied to the lower extremities.
Start slow and then increase intensity and speed
when necessary.
Move from bilateral to unilateral.
Progress from stable to unstable surfaces when
appropriate.
Volume
• Measured by foot contacts.
– Per exercise
– Per session
• Dependant upon the intensity of the exercise.
• The higher the intensity, the lower the volume.
• Example:
– The Jump Rope Exercise may have more foot
contacts than the Box Jump Exercise.
Frequency
• There should only be Mon Tues Wed Thurs Fri
1-2 exercise sessions
x
x
per week.
• There should be 48 –
72 hours in-between
x
training sessions.
• Expect Delayed
Onset Muscle
x
x
Soreness (DOMS)
Specificity
• When possible
try to make the
exercise mimic
the movements
of the athletes
sport.
Make It Safe
• Warm-up properly prior to plyometric exercise.
• Make sure that the exercise area is free from clutter.
• Work on the appropriate surface.
– Rubberized flooring, gymnastic floor, soft dry
grass.
• Use plyometrics at the beginning of the rehabilitation
session.
• Monitor the athlete for fatigue.
• Focus on Quality of exercise not quantity.
• Give the athlete appropriate feedback.
Upper Extremity
• Push-up → Plyometric Push-up
• Medicine Ball Exercises
• High-speed tubing exercises that
incorporate an eccentric contraction.
Eccentric Phase of the Plyometric
Push-Up
Concentric Phase of the High-Speed
Tubing Exercise
Lower Extremity
•
•
•
•
Jumps in Place
Multiple Jumps
Standing Jumps
Box Jumps
(Chu, ATT, Plyometrics in Sports
Injury Rehabilitation, May, 1999)
Diagram taken from NBA Power Conditioning
Page 136 Rim Jumps
Trunk
• Rotational Twist with Medicine Ball
– Standing
– Sitting on Physio-ball or Floor
• Sit-up with medicine ball toss
• Bilateral Straight Leg Raise
Eccentric Phase of the Rotational
Trunk Twist
Concentric Phase of the
Rotational Trunk Twist
Eccentric Phase of the Rotational
Trunk Twist
Conclusion
• Prior to performing plyometric exercises the
athlete should have a good foundation of
core strength and proprioception.
• Plyometric exercise, when performed
correctly, can be a great tool during the
rehabilitation process.
• Plyometric exercise used in conjunction with
other forms of strength training provides a
greater benefit than plyometric exercises
used alone.
References
•
•
•
•
•
•
•
•
Luttgens, Kathryn, Deutsch, Helga, and Hamilton, Nancy. 1992. Kinesiology –Scientific
Basis of Human Motion, 8th Ed. Madison, Wisconsin: Brown & Benchmark..
Chu, Donald. 1998. Jumping Into Plyometrics, 2nd Ed. Champaign, Illinois: Human
Kinetics.
Chu, Donald. 1999. Plyometrics in Sports Injury Rehabilitation and Training. Athletic
Therapy Today. Vol.4, Num. 3. Pages 7-11.
Harris, R.T., and Dudley, Gary. 2000. Essentials of Strength Training and Conditioning, 2nd
Ed. Champaign, Illinois, Human Kinetics.
Riewald, Scott. 2003. Energy Storage in Muscle. NSCA’s Performance Training Journal.
Vol. 2 , Num.2 Pages 8-9.
Kutz, Matthew R. 2003. Theoretical and Practical Issues for Plyometric Training.
NSCA’s Performance Training Journal. Vol. 2, Num. 2. Pages 10-12.
Swanik, Buz C, Swanik, Kathleen A. 1999. Plyometrics in Rehabilitating the Lower
Extremity. Athletic Therapy Today. Vol. 4, Num. 3 Pages 16-22,
Handzel, Tracey M. 2003. Core Training For Improved Performance. NSCA’s
Performance Training Journal. Vol. 2, Num. 6. Pages 26-30.
Thank You
Living well is the best revenge
George Herbert