Practitioner Seed # 6: Gain exposure to S&C

Just a few exercises that might be present in your modern athletes strength program, presenting a whole new world to the graduating clinician.

With the undergraduate curriculum limited for space, omission of strength and conditioning content is reasonable.

Expecting this content to be a hallmark of the Postgraduate masters program?

Think again!

Although I am certain the academic world is moving heaven & earth to get this as a staple part of the masters program.

It’s not until you enter the sporting industry, or have a passion for shifting tin yourself, that you begin to grasp some of the concepts. We also have a lot of practitioners opting for post graduate education in specific S&C courses.

Whichever way you gain your knowledge, it is a vital tool in the belt of a sports rehab practitioner.

But what are the core basics that you need to know?

Let’s explore some of the important S&C exercises and concepts that form the building blocks toward becoming the complete sports rehab practitioner.

 

Understanding what an athlete is trying to achieve in the gym will give you an insight into their program. What are they training for:

• Strength or pure force production?
• Hypertrophy
• Speed
• Reactive strength

The program structure will be directed by the goal.

So often the early stages of rehab will be focused toward regaining muscle activation / endurance & hypertrophy. Our dosages will reflect this with high volumes of sets, reps & frequency.

Read more on current recommendations for exercise dosage.

Once you have a rehab athlete with these basic qualities restored,  you must be working toward improving maximal force production.

There will be crossover here with moving on to the next phase which incorporates a speed element. Strength, strength/ speed, speed/ strength, reactive strength are all terms that you will encounter. The force/ velocity curve below will assist you in being able to formulate your exercise dosage.

 

 

 

Through our experience these are the most common exercises used in the weight room, plus some nuances around their application:

 

The Back Squat

This is a lower limb staple of any S&C program. Put a bar on the back. Hint: High on the shoulders or low on the scapula – pending where you want to target ,high bar = more quads, low bar = more posterior chain.

Adjust to a box squat to promote more posterior chain/ hip involvement

Also use a higher box setting if your athlete has stiff hips /FAI, or is suffering proximal hamstring tendinopathy.

A limitation of this exercise is the axial loading that that spine experiences. To gain strength adaptations, 80-90% 1RM must be applied, which equates to high spinal forces.

This is where the sport plays a significant role.  Your high volume running sports are likely to be lumbar extension dominant, and placing these heavy axial loads might be detrimental to the lumbar spine. On the other hand, your big rugby players or NFL linesmen might need this level of spine strength, and is the only means to get enough load through their legs.

To counter the axial load issue, you might opt for a hip belt squat, where the load is magnified to the hips.

 

The Front/ Hack Squat

Used more for its anterior chain isolation, the front squat is perfect for improving quad strength. We use these in situations where quads have become deficient most notably post ALCR and ongoing PFJ pain, where the athlete has developed a fear/ aversion to anterior knee translation. Obviously the PFJ irritability must be managed.

 

Deadlift Variations

The trap bar deadlift can be a great substitute to the back squat as the major lower limb force producing exercise. Still producing great posterior chain activity, it can be a nice change to loading a bar on the back.

Start the bar higher, off plates for your stiff hips types.

The Romanian deadlift will encounter less knee flexion and really ramp up activity of the posterior chain, especially the hamstring.

This can be a nice variation for your hamstring prevention.

Try doing a single leg RDL using a torsonator bar and the weight in the opposite hand to the hamstring to create a hip rotational torque and fire up Biceps fem.

 

Single Leg Variations

Bulgarian splits, lunges, narrow split squats, single leg squats and step ups are all variations of single leg exercises. In our opinion this is where the ‘money is made’ in sports that involve high volumes of running, speed and power – Take AFL as an example.

We know the importance of single leg strength in athletic groin pain & hip related issues – Click here too learn more

Athletes with a history or predisposition toward athletic groin pain  – Take care with loading them into a wide exercise such as a lunge or bulgarian.  Using a narrow split  or step up would be much safer here, by reducing distractional forces across the pubic symphysis.

 

Hip Thrust

A posterior chain force producing exercise when applied as a double leg variation, can be a nice alternative when the athlete has some issue that precludes them from doing one of the bigger functional lifts.

Change this to a Single leg and now we are introducing the pelvic stability element, while drilling down on the unilateral lower glute max specifically.

Speed & Power

A long list of alternatives exist in this domain. Exercises that we see transfer most successfully from the weight room to the field:

• CMJ – Double or single
• Broad jumps – Double or single
• Box jumps – Double or single
• Sled push/ pull

 

A note on Olympic lifts – cleans, jerks etc. In our opinion, unless you are training for the Olympics, there are better options to transfer the training. The inherent technical requirement of these exercises are better left to the experts. You’re standard AFL player will generally not exhibit these skill requirements.

 

So there is a very brief snapshot of our experience in the realm of S&C. We haven’t even covered upper body or core, but that might be a story for another time……..

Our advice to maximise your understanding of these exercises – Get in the gym and have a go!

Feeling the effects of hamstring DOMs after a session of deadlifts, reinforces the loading pattern of this exercise. Try some of the modifications described above, small changes in technique can = big changes in load magnification. The is reinforced by the common occurrence of proximal/ medial hamstring DOMs when squat depth is increased by small margins.

& Finally……

Remember to always consider the athletes past history and physical make-up, when collaborating with your S&C colleagues around their gym programming.