High amounts of stress over prolonged periods of time can wreak havoc on our bodies.  Besides the commonly talked about issues that come with a high stress life – increased blood pressure, heart attacks, depression, etc – stress can affect both sexes on a hormonal level as well.  For female athletes, intense physical and psychological stress may be a catalyst in the development of the female athlete triad.

Female Athlete Triad

The female athlete triad is a three-part, interrelated pattern of dysfunction that can evolve when the athlete is under high amounts of physical and/or psychological stress, causing a change in eating patterns, menstruation, and finally bone mineral density.

It is important to note that this pattern can happen to any physically active woman who faces physical stress, it doesn’t exclusively apply to an athlete. I would even suspect, and consider, the fact that this pattern could happen in a woman who is not physical active at all but rather faces high amounts of psychological and emotional stress, forcing any one of these three catalysts to begin the process.

Physical and Psychological Stress

As strength coaches and trainers (and even women or female athletes who train themselves) it is important to be aware of the athlete’s stress level and its impact on their training and sports program. Female athletes, especially in the high school and collegiate settings, typically face a high amount of psychological/emotional stress.  This comes not only in the form of course work and exams but can also be tied to social stress – making new friends, being away from home (for the collegiate athlete), relationship stress, body image stress, etc.

The last example, body image stress, can kick off the female athlete triad as extreme changes to diet and nutritional intake commonly follow a negative self image.  When nutritional intake is poor, energy imbalance may create a platform for amenorrhea (cessation of normal menstruation).  As well, high amounts of stress can alter hormones which can also have negative implications on normal menstruation.  A decrease in nutrients, such as vitamin D and calcium, and alterations in hormones, especially estrogen, can eventually create a loss of bone mineral density.

This example clearly shows the interrelatedness of the female athlete triad and if we had started the example with more of a physical stressor (intense training, competition, and eventual overtraining) the same type of interrelated connection would easily be seen.

According to Powers and Howley (Exercise Physiology: Theory and Application to Fitness and Performance, pg. 467) 4% of all female athletes will meet the criteria of the triad and 26% will have two of the components in the triad.  Additionally, 3% of nonathletic women (ages 13-29) display all three aspects of the triad.  Given the prevalence of this issue, we should first evaluate some of the potential signs of the female athlete triad.

Signs of the Female Athlete Triad (Morgenthal AP [PDF])

• Fatigue
• Anemia
• Depression
• Abnormal or cessation of menstruation
• Stress fracture
• Decreased ability to concentrate
• Cold intolerance
• Hypothermia
• Cold and discolored hands and feet
• Enlargement of the parotid glands
• Sore throat
• Erosion of dental enamel from frequent vomiting
• Abdominal pain and bloating
• Constipation
• Dry skin
• Face and extremity edema
• Lightheadedness
• Bradycardia
• Chest pain

What to do

Now that we have identified what the problem is (the components of the triad) and how it can be initiated (high amounts of physical/psychological stress) we can lay out a game plan with practical information for addressing the problem.

First, it is important to emphasize that due to the intense psychological component of eating disorders, coaches, trainers, and nutritionists should seek out help from a qualified psychologist who works with these individuals to ensure they get the appropriate information and are well attended to on that front.

From the training side of things, picking up on some of the warnings signs of the female athlete triad is the first step to ensuring that you address the situation promptly.  In fact, having good communication and rapport with your athlete(s) will hopefully allow you to pick up on a potential problem before it even gets this far.  Once you have identified a potential risk, it can be helpful to have or consult with a qualified psychologist on the safest and most appropriate way of addressing the issue with the athlete.  Sometimes, very direct questions will be met with a lot of denial and resistance.  You want to ensure that you handle the situation with care and respect for what the athlete is going through.

Work with a qualified sports nutritionist who can talk to the athletes and teach them about the importance of healthy eating and answer any questions they may potentially have about diets, weight loss, and certain strategies for decreasing body fat. We all know there is so much information out there and a lot of it is not only poor but potentially dangerous.  Additionally, in the high school setting, a meeting with parents may be arranged, as they are the ones typically seeing the athlete on a more frequent basis than you do. You can present this information as well as some of the potential red flags of the female athlete triad so that the parents are well-informed and know what to look for.

Finally, analyzing the training and competition schedules as well as how these schedules work in conjunction with the school schedule can be a proactive approach on the coach’s part.  Knowing when mid-terms and exams are, from a strength coach standpoint, will allow you to plan training accordingly, and back off the intensity/volume/frequency a little bit as the athletes at this time are facing high amounts of psychological stress and usually sleeping less, as they are increasing their time studying, both of which will lead to a decreased ability to recover from the training stress.  Furthermore, manipulating the training program around periods of frequent competition (as well as paying special attention to year round training in three sport athletes) can be helpful in preventing overtraining and ensuring that the athletes have appropriate time to recover both physically and psychologically from the demands of game day.

The female athlete triad is a very serious issue and should be dealt with appropriately.  Have good communication with your athletes and recognize when there is problem. These are key steps to ensuring the the issue is addressed before it develops into something far more serious.  Having a well-planned training program and educating the athletes on appropriate nutritional strategies can be helpful in preventing the female athlete triad and assisting the athlete in establishing healthy habits that they can carry with them through life beyond their sport.

Today I have a guest article by Michael Boyle regarding foot speed and agility.  Mike raises a lot of great points about improving foot speed, and especially emphasizes the importance of getting stronger, which is an often overlooked concept in younger athletes as parents are commonly looking to put their kids into “speed camps” which don’t emphasize basic lifting and strength training exercises.

Hope you enjoy the article!

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Developing Foot Speed and Agility
Michael Boyle

A couple of threads on the StrengthCoach.com forum got me thinking about the question of foot speed and athletes. I can’t tell you how often I hear a parent or a coach ask, “How can I improve my son’s/daughter’s/athlete’s foot speed or agility?” It seems everyone always wants the shortcut and the quick fix. The better question might be “Do you think you can improve foot speed?” or maybe even the larger question, “Does foot speed even matter?”
That begs the larger question, “Does foot speed have anything to do with agility?” I know coaches or parents reading this are asking, “Is this guy crazy?”  How many times have we heard that speed kills? I think the problem is that coaches and parents equate fast feet with fast and quick feet with agile.  However, fast feet don’t equal fast any more than quick feet equal agile. In some cases, fast feet might actually make an athlete slow–often I see fast feet as a detriment to speed. In fact, some of our quick turnover guys, those who would be described as having fast feet, are very slow off the start.

The problem is fast feet don’t use the ground well to produce force. Fast feet might be good on hot coals, but not on hard ground. Think of the ground as the well from which we draw speed. It is not how fast the feet move, but rather how much force goes into the ground. This is basic action-reaction physics. Force into the ground equals forward motion. This is why the athletes with the best vertical jumps are most often the fastest. It comes down to force production.
Often coaches will argue the vertical vs. horizontal argument and say the vertical jump doesn’t correspond to horizontal speed, but years of data from the NFL Combine begs to differ. Force into the ground is force into the ground. In spite of what Brett Contreras may say, vectors don’t seem to matter here. The truth is parents should be asking about vertical jump improvement, not about fast feet. My standard line is “Michael Flatley has fast feet, but he doesn’t really go
anywhere. If you move your feet fast and don’t go anywhere, does it matter? It’s the old “tree falling in the woods” thing.

The best solution to slow feet is to get stronger legs. Feet don’t matter. Legs matter. Think about it this way: If you stand at the starting line and take a quick first step but fail to push with the back leg, you don’t go anywhere. The reality is that a quick first step is actually the result of a powerful first push. We should change the buzzwords and start to say “that kid has a great first push.” Lower body strength is the real cure for slow feet and the real key to speed and to agility. The essence of developing quick feet lies in single-leg strength and single-leg stability work… landing skills. If you cannot decelerate, you cannot accelerate, at least not more than once.

One of the things I love is the magic drill idea. This is the theory that developing foot speed and agility is not a process of gaining strength and power, but rather the lack of a specific drill. I tell everyone I know that if I believed there was a magic drill we would do it every day. The reality is it comes down to horsepower and the nervous system, two areas that change slowly over time.

How do we develop speed, quickness and agility? Unfortunately, we need to do it the slow, old-fashioned way. You can play with ladders and bungee cords all you want, but that is like putting mag wheels on an Escort. The key is to increase the horsepower, the brakes and the accelerator. I think the answer for me is always the same. I wrote an article last year called “IS ACL Prevention Just Good Training?” In much the same way, development of speed, agility and quickness simply comes down to good training. We need to work on lower body strength and lower body power and we need to do it on one leg.

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I love ladder drills. They provide excellent multi-planar dynamic warm-up. They develop brain-to-muscle connection and are excellent for eccentric strength and stability. We do less than five minutes of ladder drills, one or two times a week. I don’t believe for a minute that the ladder is a magic tool that will make anyone faster or more agile, however I do believe it is a piece of the puzzle from the neural perspective. People waste more than five minutes on biceps curls, but we have long debates about ladder drills.

These are also a great tool to show to coaches who want “foot speed.” Sometime it’s easier to “yes” them than to argue with them. Give a guy with “bad feet” a jump rope and you get a guy with bad feet and patella tendonitis.

PSS- I have never used the term “speed ladder.” We always call it an agility ladder if we call it more than the ladder.

There are many approaches to strength and conditioning and all have them have probably worked at one point in time, in some capacity, with some person (or group of people).

Over the past few weeks I have had a number of questions regarding the assessment process for training clients.  Many in the profession are currently very focused on assessment and trying to make sense of all the information getting passed around on various internet forums, websites, and seminars.  Others are not “buying it” and would rather just allow people to train and pay no attention to screening their clients prior to beginning a strength and conditioning program (I do however think many of those in the “not buying it” circle do use some form of assessment, but are just arguing to argue or would rather nit-pick semantics).

I was recently asked “Why bother with an assessment?  Every workout is an assessment.  Doesn’t that tell you all you need to know?”

I’ll start by saying I feel this is a valid statement and I cannot disagree, every workout really is an assessment.  However, with regard to having a scripted assessment prior to initiating training, my stance is that I would rather be proactive  than reactive.

The screen prior to training offers a few key benefits:

1. Pain – An assessment, performed with nothing more than body weight, looks at basic movement patterns and allows us to get a feeling for whether or not the individual has pain.  Often times clients/athletes will forget to tell you about a surgery, an injury (previous or recent), or something that has been nagging them for the past few weeks.  Once you get them moving, it tends to jog their memory and they start to mention things that they may have otherwise not told you.  Additionally, if for whatever reason the individual has  pain when performing any of the assessment movements that is a big red flag as far as bringing that painful pattern to a (loaded) training environment.
2. Starting point – Not everyone will have the same abilities, and a proper assessment helps to determine what the appropriate starting point, with regard to exercise, is for each person.  If we were to just go in and start training without an assessment we are making a big assumption that back squats, or deadlifts, or power cleans, will be okay for everyone.  Some clients/athletes may have restrictions in mobility or asymmetrical movement that will prevent competent movement in those lifts and potentially make performing them an accident waiting to happen.
3. Progress – If the client/athlete does have something that can be improved upon (IE, movement capacity is lower than desired), the only way to know if they are ready for progression is to re-test the pattern(s) that were problematic to assess whether or not our current exercise program is “getting the job done”.  If changes are less than desired, we may need to make changes to the program and explore a different path to make sure we get what we want.

The main reason that I have an assessment process is that I don’t want to let things slide by (if I can help it) and have a setback in training.  The argument that “the body is smarter than we give it credit for and if we just move it will know what do to”, doesn’t sit well with me.   The body is smarter than we give it credit for and can find ways to work around our limitations and perform the movement that we are asking it to perform, even if it does so in a less than optimal way.

I’d rather be proactive and look at things from the get-go than bereactive and look at those same things only when something goes wrong.

We have had some good discussion over at Strengthcoach.com regarding energy system development training.  Dave Tenney, athletic development coach for the Seattle Sounders soccer club, as done a great job of offering some of his ideas and I have tried to add a few of my own as well.

One of the things I observed at the NSCA National Conference this year was the attention to detail the European strength coaches had with regard to a balanced approach to developing fitness in their athletes.  However, as I noted in the review linked to above, the American coaches tend to be much more concerned with the “strength/power” development and leave little room for energy system training, save for 10-15min of interval work.

When we try and discuss some of this stuff, it seems that many coaches are afraid of “cardio”.  I will admit right up front, I have been guilty of this in the past as I placed more emphasis on strength and less emphasis on a well-balanced energy system development program – opting for the ever popular intense interval training, operating under the notion that this is all someone needs to develop their fitness.

Before I go on, I want to make sure that people understand that I am not advocating just going out and jogging for 60min.  What I am more talking about is finding ways to improve your work capacity that get you away from the demanding work of interval training, which in the long run can have a negative impact on the body as it is a much greater stress than a less intensive method.  This work can be used (a) in the offseason to develop fitness and prepare you for the more intense training to come as the season approaches or (b) as a recovery day from heavy/intense training when the body needs a break from so much tearing down.  Some examples of how you can perform energy system development work:

1. Circuit Training
2. Medicine Ball Circuits
3. Tempo Runs with active rest in between reps
4. Sled dragging
5. Oxidative Work

The common recommendation has been that during this work you want to keep your heart rate between 120-140 bpm and work for 30-60min (this can be continuous or with rest intervals in between sets and series).

One of the ways to apply this is in the offseason, as I mentioned above, following some low volume of strength or power work, which would be trained at more of a retention load.  This can be on days in between the strength or power sessions or this can be the focus of the training session as it follows the low volume of strength or power work.  As training progresses on, the strength/power work would start to move into more of a primary focus, while the energy system work above will begin to adopt a more sport specific work:rest ratio.  The work capactiy stuff can still be used at this point, again as noted above, as a recovery workout, in between hard training sessions or at the end of a strength/power workout to maintain those qualities.

What are we afraid of?

People are always talking about how worried they are that strength/power athletes will start to convert fibers to having more slow-twitch/oxidative properties, leading to decreased strength and power.

Are we that afraid that people will just turn into a bundle of type I muscle fibers?

What sort of decease in power output would people expect to see by short 2-4 week blocks of this when strength and power are still trained at retention loads?  I am in no way advocating doing this for the next 12 weeks and doing this exclusively.   The same rules of periodization apply.  After all, the goal of periodization is to introduce a new/novel stimulus to the body in an effort to continue progress.  If all we do is train for maximum strength year round or do intense interval training year round, eventually we burn out, the body starts to break down, and our progress stalls, at best, and at worst we sustain an injury.

A good program should develop all energy systems to some extent as they are all important and valuable to the abilities of the athlete. Obviously some qualities (strength/power) will be more important than others (aerobic) but all athletes need to develop the other qualities as well and all need a fundamental work capacity. Are we not currently seeing a big push for endurance athletes to lift weights and do some strength training? *Gasp* Wont they get strong and lose their endurance abilities?!? Even strength/power athletes need some sort of aerobic abilities (albeit less than a marathoner) in order to recover between training sessions and recover adequately between sets.

Wrapping up

I really don’t see what all the fuss is about.  A well thought out program should focus on a variety of athletic qualities as strength and power are not the only ones.  Cardiovascular work is more than just jogging on a treadmill or riding the stationary bike.  It can reflect movements in the sport.  It can reflect rest intervals in the sport.  It can be performed with a variety of implements – body weight, resistance training, medicine balls, etc.  You are only limited by your own creativity as far as how/when to put this stuff into your program and the manner in which you perform it.

With everyone talking about barefoot running and getting out of very cushy/supported shoes over the past year, I thought it would be good to review the Janda short foot posture and go over some exercise progressions that we have been using to help re-train the intrinsic muscles of the foot.

What is it?

The Janda short foot posture is a technique that Janda proposed to teach patients to shorten the longitudinal arch of the foot, thus moving the patient out of their flat foot position.  The short foot posture offers a variety of benefits at the foot such as:

– Increased proprioception of the bottom of the foot

– Enhanced joint alignment up the chain at other joints

– Improved stability of the body

– Increased strength of the foot for better locomotion

As you will see in the below video, exercises with the short foot posture should follow similar progressions of any other exercise you would use:

Bilateral stance > Split Stance > Single Leg Stance

Important point

Refrain from curling the toes, excessively flexing them into the floor, or trying to grip the floor with the toes.  The arch should be created with the toes flat on the ground, not overly flexed, and drawing the ball of the big toe toward the heel of the foot.

As you will see in the video, when the client moves to single leg stance, his foot stability is challenged, and his big toe starts to come up off the ground (although he works to correct it right when it happens).  The goal is to perform the movement with a healthy arch and the big toe down on the ground.  Trying to push all your weight to the outside of the foot in order to create an arch is not the same as the short foot posture.

Exercises

In the video we used some single arm cable row progressions, however, there are a variety of exercises we perform to re-train the foot:

– Single leg clocks (some call this single leg excursion or star-balance)

– 1-arm cable chest press/rows

– Single legged deadlifts

– Split Squats

– Step ups

– Medicine ball throws and catches

Again, exercises should follow a logical progression:

Static (very little movement) > Dynamic movement with lower extremity stable > Dynamic movement with lower extremity mobile > Explosive movements

Always ensure that the client can handle one progression before moving to the next!

Where to place it in the workout

We use these movements in one of two places during our training sessions.  Obviously these are not heavily loaded strength exercises, so we use these either as part of our warm up, or later in the training session as an ‘accessory movement’.