The straw that broke the camel's back...

Have a look at the article in the link below.

http://www.tsn.ca/mlb/story/?id=331780

It was passed on to me by Dr. Anthony Lombardi* of the Hamilton Back Clinic. The article is about Washington Nationals Pitcher Stephen Strasburg. Strasburg recently had surgery on his right elbow and he will subsequently be out until the 2012 season. At the time the above article was written Strasburg had just injured the elbow. Interestingly it mentions that Strasburg was on the DL a month prior to the injury with an inflammed right shoulder. Dr. Lombardi followed up the article with the following:

"I am of the opinion the signs of shoulder dysfunction were there before the tear occurred. The shoulder pain 3 weeks ago played a role in shoulder stabilization and ability to decelerate the shoulder and elbow. Sensory-motor integration of throwing mechanics in used muscles then become altered and any compensation in the cocking phase of the elbow will put increase stress on the medial elbow (especially when pitchers are throwing the ball 160 km/hr). "

There are several great take home points here.
- The first is that dysfunction often exists for a long time prior to the onset of pain or "bigger" problems.
- Secondly, assessment has to go beyond the site of pain. For example, wrist pain would require assessment of the entire upper extremity, including the cervical spine and scapular mechanics. Fascial manipulation or Anatomy Trains are great places to have a look at fascial planes.
- Thirdly, the ability of a muscle to contract or move is not only based on the strength of the actual muscle doing the movement but also the opposite muscle. To use one possible scenario from the above example, imagine throwing a ball as hard as you can. Now think about what happens after you release the ball. The arm has to stop moving, which requires the muscles on the back of the shoulder to contract as they lengthen. These muscles are often referred to as the rotator cuff. Again of course this is just one example of where something may go wrong. There may be other inhibitions or soft tissue changes along the kinetic chain.

So how does this affect performance and what can you do about it? To use the above example, Charles Poliquin has developed a set of ratios that he uses for strength training with his clients. You should be able to use ~9% for 8 reps of your 1RM 14" bench press in the external rotation exercise in the link below (i.e. 100 lbs bench press = 9 lbs x 8 reps on the exercise).

http://www.youtube.com/watch?v=JK9mFQZViXc

Keep in mind that although the article in the link is about a high level athlete the same principles apply to the rest of us. For example, back pain could be coming from a bum ankle. If you are having pain or experiencing diffculty completing an activity that you want to do make sure you get someone to complete a comprehensive assessment system throughout the entire kinetic chain.

*Dr. Lombardi is an expert in the treatment of musculoskeletal injuries. He can be found at  http://www.hamiltonbackclinic.com/ . He has some great educational videos on Youtube.

Reaching your peak...

So what is peak performance? Have you reached your peak? What is it to me? Well first of all it's my business but more importantly it's a concept that requires clarity. In this circumstance the word "peak" is used an adjective. I googled the definition and found "Approaching or constituting the maximum". However I'm not fussy on this definition as it implies that a "peak" is an absolute and time limited state. A person has reached their peak or not. And then what happens after you reach your peak?

My idea of peak performance is broader without the cognitive distortion (all or nothing aka stinky thinking). Being at your peak is about an optimal state of health and well-being, which is reflected in the performance of everyday activities. It's not limited to one day or one moment. It's reflected in every moment. Simply put peak performance is being at your best. How do you do that? Well most importantly it requires living according to your strengths and values. A simple exercise; next time you have a difficult choice to make ask yourself where it fits within your values.

Until next time.