In my last blog entry on stress, Carson Boddicker asked about some ways to quantify stress without getting to extreme.  I offered a few “low-tech” methods which work very well and at the end of the article mentioned some of the more ”high-tech” methods that people can use when sufficient funds allow.

I have another review up at Fitness Research Review Website for those interested:

The Relationship Between Forward Scapular Posture and Posterior Shoulder Tightness Among Baseball Players

Laudner KG, Moline MT, Meister K, American Journal of Sports Medicine 2010 (in press)

Some of the pertinent findings:

– The dominant shoulder of both pitchers and position players were significantly forward compared to the nondominant shoulder.

– There is a relationship between posterior shoulder tightness, as measured by glenohumeral adduction, and forward scapular positioning.

– There was a negative relationship between glenohumeral adduction and forward scapular position. Those with greater posterior shoulder tightness had greater forward scapular position than those with less posterior shoulder tightness.

– No significant relationships were found between scapular posture and glenohumeral internal or external rotation.

– Differences in internal and external glenohumeral rotation were noted between dominant and nondominant shoulders, with a tendency towards greater external rotation and decreased internal rotation in the dominant shoulder. However, the total arc of motion between the two arms was similar. These findings are consistent with other findings on baseball athletes (6).

If you would like to read the rest of the review, including some practical applications of how we can use the information in this paper to help us better prepare athletes, please log onto Fitness Research Review Website.

In response to Monday’s blog post, Stress!!, the following question was asked

Getting into some of our conversation from yesterday, is there any way we can quantify this stuff without extreme ends? Have you used anything like the Profile of Mood States?

Regards,

Carson Boddicker

Carson, great question.  Quantifying whether or not the athlete is under high amounts of stress and ready for intense/high quality work that day can be done several ways.

First, on my general intake form there is a question regarding the clients own subjective stress levels.  This is something that I further enquire about when talking with the individual, as I want to try and determine where they are at before I start adding more stress.  I’ll ask them about their sleep, their overall daily mood, and times when they feel the most stress.

Having a stress profile as you suggested can be helpful.  Having the individual jot down and/or rate how well they slept the night before, how they feel today, are they sore, how hard would they rate the last workout, etc, can provide you with valuable information to plan training on a specific day.  Additionally, resting heart rate and blood pressure can be taken and compared to previous tests to determine if they are at or around their general norm.

If you don’t want to have the athletes fill out paper work every time, you can also just talk to them and observe them during the warm up.  Being a good observer is an important aspect of being a good coach.  Notice how the athlete(s) look when walking into the gym.  Are they looking sluggish?  Do they look down?  What is their overall posture like (this can tell a lot about a persons general mood)?  From there, during the warm up, you may notice the athlete(s) moving in a slower or uncharacteristic manner.  When I see things like this, I immediately start asking more questions.  If I feel that the athlete is not prepared for intense/high quality training that day, based on what I see and the feedback I am getting, then we go ahead and do a back off day or we just do some soft tissue work and mobility exercises.  I have also sent people home on certain occasions when I felt that taking a full day of rest would be the best thing for them.  Additionally, knowing when stressful periods of the year are coming up can help you plan training.  For example, you work with several collegiate athletes.  Midterms and finals time would be a good time to turn down the training stress as the athletes are usually staying up late to study or write papers, and under high amounts of stress from taking tests all week.

Finally, performance measures can be used if you have a base to measure them against.  A vertical jump or a broad jump (following a good warm up of course) can help to determine if the athlete is ready for strength or power work on a given day.  I believe in Fleck and Kraemer’s Optimizing Strength Training, they recommend taking the average of three jumps.  That number should be roughly 90% or greater than their normal vertical or broad jump if you are going to train power or strength that day.  If it is below 90%, then the athlete is not prepared for high quality work that day and should take a back off day to allow for more recovery to ensure they are ready for the next intense workout.

Those are a few “low-tech” ways of evaluating the athlete, others may have additional ideas, so hopefully they leave the in the comments section.  Of course you can also try and go more “high-tech” with things like the Omega Wave (which I confess I don’t know much about at this time) or even a Polar watch/heart rate monitor that can take your heart rate variability (HRV).

Stress plays an important part in what we do as strength coaches/trainers, as well as in other areas such as physical therapy, chiropractic, and even massage therapy.

Basically, we apply a stressful stimulus to our athletes/clients – either in the form of a training intervention or in the form of a therapeutic modality (soft tissue therapy, manipulation, stretch, etc) and we ask their bodies to respond.  When stress resistance is low, the response is not favorable as the athlete cannot recover properly and their body will not respond the way it needs to.  When stress resistance is high, we can push the envelope a bit more and train at a higher level, knowing that the individual is able to sustain this level of stress, recover from it, and come back for more.

With a sound training and recovery program we can help to enhance stress resistance.  Obviously this is also dependent on what else the athlete has going on in their lives, as this too can play a factor in how they respond to the stresses of training and treatment.

Unfortunately, stress resistance is not infinite.  We can’t increase our resistance to stress forever.  Rather, stress resistance tends to modulate depending on what we have going on.

• Your girl friend breaks up with you and you may be feeling depressed, which brings you down and lowers your stress resistance.  Alternatively, perhaps breaking up with your girlfriend is a huge relief and a large amount of stress has now been lifted off your shoulders….stress resistance goes up!!
• You start working another shift at work and your stress resistance may decrease because you are now cutting into some of your recovery time and adding more hours in an environment that can be taxing (both physically and psychologically).
• You get sick for a few days and stress resistance is impaired.

As coaches and therapists it is important to understand stress and take into account all the factors of your athletes/clients lives.  If you push an athlete with low stress resistance to hard, you may run into a rather large set back in training.

A favorite book of mine was written by stress researcher and Standford professor, Dr. Robert Sapolsky.  Why Zebras Don’t Get Ulcers does an excellent job of explaining stress and its affects on the body in a rather easy (and often times humorus)  manner.  I can’t recommend this book enough.

Additionally, National Geographic did a great piece on stress featuring Dr. Sapolsky called Stress: Portrait of a Killer.  Below, posted in six parts (about an hour), is the entire episode.

I hope you enjoy them!

Injuries are an unfortunate part of sport.  No matter how hard we try to prepare athletes prior to competition, sometimes injuries happen.

It is commonly thought that pain and injury have a one-to-one relationship – IE, I twist my ankle and I get pain.  While this may be so in some situations (especially acute situations like an ankle sprain), it is important to remember that pain is a lot more complex than that.  Pain doesn’t exist in your muscles, joints, or ligaments.  Rather, pain exists in your brain (and like Arnold says, “it’s not a tumor”….well, sometimes it might be a tumor!).

Pain is an important aspect for our survival.  It tells us something is wrong.  In fact, if you did have a brain tumor, those intense headaches that are the source of your pain would force you to go to the doctor, get a thorough evaluation, and then get appropriately treated.  However, sometimes the signals of pain can get crossed.

What about those people that for whatever reason aren’t having pain when faced with a life threatening condition?  For example, the people who have cancer eating away their stomach, yet experience no pain at all, until it is to late, only to find out about the problem a week or two before they pass away.  Where was their pain?  Where was their warning sign?

What about the people that are always in pain yet there doesn’t appear to be anything medically wrong?  What gives?!  Why are they so prone to feeling pain?

Pain is a multi-factorial process and takes into account several of the bodies systems collectively feeding information, in the form of signals, to the brain.  These signals are bombarding the brain with information and the brain is basically filtering things out and deciding what to react too based on everything else going on – which signals present a potential threat?  (Think about the soldier who gets shot but doesn’t realize it because there is the chaos of war going on aruond him.)  I liken this to those in charge of investigating every single terrorist threat that the USA receives daily.  They have to filter out all those threats and decide what is not worth reacting upon and what is really important.  They can’t react to everything, right?

This collection of inputs and outputs from various systems has been termed the neuromatrix by pain researcher Ronald Melzack.  This information can be better understood by spending sometime studying the below diagram.

As you can see, many factors/systems affect pain – visual, sensory, endocrine, vestibular, past experience, anxiety, depression, etc.

Based on what we know of the neuromatrix model it is important that we appreciate and respect the fact that the body consists of many systems that are all dependant on each other and work together to support healthy function.  Whenever we try and distill things down to one single system as the “problem” we end up missing a lot of other stuff going on.

Unfortunately, this is how anatomy and physiology is taught.  You go through chapters devoted to one single system – circulatory, lymphatic, nervous, integumentary, musculoskeletal, etc – but no one seems to teach you how to put it all together and how to address or manage these systems collectively, especially when there is something wrong.

Because pain is created by the brain as a result of information received from these systems, when dealing with athletes in pain, it would be appropriate to keep all of this in mind and not just focus on one element in the equation, but rather try and see the big picture (the full human).

Just some things to ponder.

References

Melzack R. From the Gate to the Neuromatrix. Pain 1999; Supplment 6: S121-S126.

Melzack R. Pain and the Neuromatrix in the Brain. J Dental Education 2001; 65(12): 1378-1382.