Saturday, November 21, 2009

Thanksgiving: The Test for Disciplined Athlete's

Becoming a better athlete is a goal that many people have, but the discipline required to be elite is elusive. Time, physical/mental exertion, and a host of various other disciplines of restraint are often what set the weekend warrior apart from the elite athlete. One of the chief areas where athletes must use restraint is in what they consume. Unlike the average Joe who is only concerned with keeping there beer belly to under three square feet, the athlete in most cases must not only eat properly to remain lean, but eat to aid there body in performance and recovery. This raises the question, "What is the perfect diet for athletes?" My answer is there isn't one. Here is a brief synopsis of a relatively new movement in athletic nutrition.

The paleo diet is derived from the word “Paleolithic” which refers to the stone age. The diet was made popular by Dr. Lauren Cordain's book entitled "The Paleo Diet." The paleo diet is essentially the diet of a Stone Age caveman. "The Paleo Diet" book sites that because the genetic make up of the human body has changed only .02% over the last 40,000 years why should our diet change? The diet preaches that all the food you consume should be in its most natural form (fish from the ocean not from a farm) and non processed fruit's, vegetables, nuts and legumes. The Paleo diet is very high in protein, due to proteins believed ability to increase insulin sensitivity which helps keep you feeling full. All of the science behind the paleo diet is pretty heavy into evolutionary biology. Dr. Cordain even says in his book that. "I didn't design the diet, nature did." This diet has recently received a lot of attention through the rise of "crossfit." It is the official diet of crossfit.

While I think some of the phyletic gradualistic evolutionary theory entangled with the Paleo Diet is pretty self refuting, I think the paleo diet is generally a pretty good way to go. How can you go wrong with all natural fruits, grains, and vegetables, for complex carbs and fiber, and naturally raised "lean meats", nut's and legumes for protein sources. No matter what your view is on the creation/evolution of the human body most everyone can agree that our bodies were not designed to consume transfats, Red dye #40, and every form high fructose corn syrup Coke can throw at us. I think the Paleo Diet is pretty sensitive to this fact, and that's why it's a healthy diet in my book.

Have a Great Thanksgiving; take it easy on the eggnog (not paleo friendly).

-Will Hawkins

Cordain, Loren. The Paleo Diet: Lose Weight and Get Healthy by Eating the Food You Were Designed to Eat. New York, NY: Wiley, 2002. Print.


Tuesday, November 17, 2009

The Female Athlete's Epidemic

In 1998 the American Journal of Sports Medicine featured an article titled “The Association Between the Menstrual Cycle and Anterior Cruciate Ligament Injuries in Female Athletes.” This article confirmed the suspicion that many coaches already had, which is that hormonal, as well as anatomical, predispositions were to blame for the seeming epidemic of female athlete ACL tears. I have come to the conclusion that there are three major reasons that women are more than four times more likely then men to tear there ACL’s playing sports(1).

In order to make hypotheses about women’s increased susceptibility to ACL tears, one must first understand the basic anatomy of the knee, and the purpose of the ACL. First, the knee is a joint comprised of four bones; the femur, the tibia, the fibula and the patella. The knee joint is padded by sections of cartilage (menisci) on both the medial and lateral side. The ACL is one of four major ligaments responsible for stability in the knee. The ACL originates in the notch of the distal portion of the femur, and inserts into the tibia. Due to its origin and insertion, its primary purpose is to protect the knee from too much anterior translation of the tibia.

The first portion of the hypothesis we will discuss is the hormonal reason for women’s increased susceptibility to ACL tears. Dr. Kurt Spindle, an orthopedic surgeon in Nashville, has done some of the most relevant research on this portion of the female athlete’s epidemic. In his study, he discovered that women were three times more likely to tear the ACL when they were on their period. He explains this by stating that during a female’s period the hormones luteinizing and follicle stimulating hormone are allowed to enter the blood stream and these hormones comes into contact with the ACL’s recently discovered active hormone receptors. It is believed that this spike in hormonal levels can actually temporarily alter the composition of the ligament, therefore leaving the ACL more prone to tearing. Dr. Spindle also cited that women who had been taking oral contraceptives were less likely to tear their ACL’s. This is due to the fact that oral contraceptives skyrocket estrogen and progesterone levels, causing luteinizing and follicle stimulating hormones to not be released.

The second reason female athletes are at least four times as likely to tear their ACL is because of the difference in the anatomy of the hip. The term “Q-Angle” is defined as “a measurement of the angle between the Quadriceps (Rectus Femoris is usually used) and the patella tendon (3).” Q-Angles in women are generally at least five degrees larger than that in men, which causes an increased tension on almost all of the ligaments of the hip and knee. The hip structure most women have is great for giving birth, but not so great for playing sports that require lots of multidirectional movement.

The third reason for female ACL tears is an anatomical predisposition as well. The intercondyler notch is a portion of the knee, between the condyles, that the ACL glides through during extension and flexion of the knee. There are two rounded portions one on each side of the notch that are called condyles. These condyles provide a large source of stabilization for the knee. Think of the condyles as your knuckles when you put two fists (femur and tibia) together. One of the condyles main purposes is to give the ACL additional support in preventing to much anterior movement of the tibia. Women have smaller condyles (less knee stability) as well as a smaller intercondyler notch. The fact that women typically have smaller condyles is a distinct mechanical disadvantage that leaves women with less knee stability in general. Additionally, the smaller intercondyler notch, women have, can lead to the ACL being pinched or torn inside the joint. So there are a host of anatomical differences in the knee joint of women that leave them more susceptible to ACL tears.

So, what’s a girl to do? Should girls with wide hips avoid playing sports requiring multi directional movement? Should girls sit out from playing sports when they are on their period? Should collegiate athletic programs require their female athletes to be on oral contraceptives to lower their chances of season or career-ending ACL tears? There are obvious legal and moral issues involved with asking female athletes to take oral contraceptives but it’s an option I would not be surprised to see this option explored. However, my answer to this question is a resounding NO. A study done by the American Journal of Sports Medicine declared the women who undergo lower extremities injury prevention workouts are sixty-two percent less likely to suffer traumatic knee injuries (5). This tells us that corrective/preventative exercises are definitely the way to go.

All three factors related to women’s relative knee instability are intertwined with the fact that women typically have roughly thirty percent less muscle mass then men. Muscle mass is one of the joints greatest stabilizers. There is a stigma in the exercise science field about training for large muscles, but this stigma is largely unfounded. There is a belief that flexibility and muscle mass are mutually exclusive qualities. This is not true. Gratuitous amounts of muscle mass and flexibility, however, are mutually exclusive.
Flexibility is defined as, “the ability of your joints to move throughout a full range of motion. (6)” Flexibility is talked about a whole lot in the athletic performance field, but sometimes we forget that being super flexible isn’t always good. Being too flexible can lead to joint instability due to the joints extremely large range of motion. This is why training for hypertrophy and balanced muscle ratios is so important. By training to achieve a proper quadriceps to hamstring strength ratio female athletes can drastically decrease likelihood of ACL tears (4). Most females, just like their male counterparts, are quadriceps dominant. Having strong quadriceps is great, but the hamstring complex by virtue of its origin and its insertion help to prevent too much anterior translation of the tibia from occurring. This anterior translations of the tibia is the reason most ACL’s tear.

Additional forms of corrective exercises should include multidirectional neural activation/enhancement drills. The quicker and stronger muscles can fire while an athlete is making a cut, the quicker the joint will be stabilized. Oftentimes ACL tears occur when an athlete plants a foot to cut and immediately the plant leg is compromised by a collision. It is not speculation to say that if surrounding musculature can fire quicker and stronger (more fibers), then these plant and twist tears would become less likely.

In conclusion, it is an undeniable fact that female athletes are up to four times more susceptible to ACL tears than their male counterparts. There are at least three scientifically proved reasons for this, and perhaps more that we have not discovered. There is, however, hope for the female athlete. There is a vaccine out there to help to aid in putting an end to the “female athlete’s epidemic.” Through the combination of preventative exercises aimed at producing neural adaptation and balanced hypertrophy, there can be more healthy knees out there on the field of play.

-Will Hawkins

1. Wojtys, EM, LJ Huston, TN Lindenfeld, TE Hewett, and ML Greenfield. "Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes.." The American Journal of Sports Medicine 26.5 (1998): 614-619. Print.

2. Spindler, Dr. Kurt. "The Effect of the Menstrual Cycle on Anterior Cruciate Ligament Injuries in Women as Determined by Hormone Levels." American Journal of Sports Medacine 30.2 (2002): 182-188. Print.

3. "The Q Angle." The Virtual Sports Injury Clinic - Sports Injuries. N.p., n.d. Web. 12 Nov. 2009. .

4. Pettineo, et. al. Female ACL Injury Prevention With a Functional Integration
Exercise Model. Strength and Conditioning Journal. Vol 26 No1, pp.28-33.

5. Joseph, M. Knee Valgus During Drop Jumps in National Collegiate Athletic
Association Division I Female Athletes : The Effect of a Medial Post. American
journal of sports medicine. 2008, vol. 36, no2, pp. 285-289

6. Marieb, Elaine N.. Essentials of Human Anatomy & Physiology (9th Edition) (Essentials of Human Anatomy & Physiology (Marieb)). San Fransisco: Benjamin Cummings, 2008. Print.

Sunday, November 15, 2009

Awsome Quotes by Awsome Coaches

I'm currently working on writing a longer article, on female's predisposition for ACL tears, so here are some quotes to keep everyone entertained. I should be done with the article in the next day or two, then it's editing time. The final draft should be out in a week or so.

"Gold medals aren't really made of gold. They're made of sweat, determination, and a hard-to-find alloy called guts." - Dan Gable

“I don’t look at myself as a basketball coach. I look at myself as a leader who happens to coach basketball.” -Coach K

"The Six W's: Work will win when wishing won't." -Todd Blackledge

"When people ask me how to raise their level of performance, the first thing I ask is, How important is it to you?" -Dan Gable

"The harder you work, the harder it is to surrender." -Vince Lombardi

“I’m a big believer in starting with high standards and raising them. We make progress only when we push ourselves to the highest level. If we don’t progress, we backslide into bad habits, laziness and poor attitude." -Dan Gable

-Will Hawkins