When we think of a sports physiotherapist, the image that often comes to mind is of a professional rushing onto the field, swiftly assessing an athlete’s injury, and making a critical decision about whether the player can continue or needs to leave the game. While this aspect of the job is vital for managing acute incidents and potentially making life-saving decisions, there’s much more to the role than meets the eye.
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A sports physiotherapist’s responsibilities extend beyond immediate injury management to encompass two equally important aspects: injury prevention and performance enhancement. These objectives are achieved through a systematic approach known as the performance pyramid.
A sports physiotherapist focuses on injury management, along with two very important aspects: injury prevention and performance enhancement. These can be accomplished through a series of principles, compiled in an orderly fashion through a performance pyramid.
What is the performance pyramid?
The performance pyramid, first introduced by Dr. Gray Cook, outlines the foundational building blocks necessary to develop a strong and resilient athlete. At the base of this pyramid is the athlete’s mindset — their ambition, work ethic, and mental resilience. This psychological foundation is crucial and can be explored through a psychosocial perspective.
Building upon this mental framework are the physical components: mobility, stability, and fundamental movement patterns. Let’s dive deeper into these elements to understand how they contribute to creating a well-rounded athlete.
Stability
Stability, as per an article published in the International Journal of Sports Medicine, is the ability to control the position and motion of the trunk over the pelvis to allow optimum production, transfer and control of force and motion to the terminal segment in integrated athletic activities.
The central nervous system activates trunk muscles in anticipation of loads from limb movements to maintain spinal stability. When trunk muscle recruitment is absent or delayed, it can lead to abnormal force absorption and distribution, increasing the risk of injuries in other body segments. Therefore, developing stability is the foundational step in any athlete’s training program.
How do we train for stability?
To enhance stability, training should focus on various aspects, including:
- Neutral Stability: Training the body to maintain a stable core in a neutral position.
- Single-Leg Stability: Developing stability over the planted leg to prevent imbalances.
- Multi-Planar Stability: Training in multiple planes of motion to prepare for dynamic athletic activities.
Research from the National Strength and Conditioning Association (NSCA) suggests the following methods for building core stability:
- Stable and Unstable Surfaces: Exercises performed on unstable surfaces, like Swiss balls, elicit higher core muscle activation.
- Standing Exercises: Activities in a standing position engage the core more effectively than seated exercises.
- Free Weights vs. Machines: Using free weights instead of fixed machines challenges the body’s stability.
- Unilateral Movements: Performing exercises unilaterally creates an imbalanced load, activating the core muscles to maintain body alignment.
Additionally, functional movements like squats, deadlifts, and push-press exercises can be modified unilaterally to emphasize core stability.
Apart from the following, traditional functional movements like squats, deadlifts and push-press can be emphasized unilaterally for core stability.
Mobility and Stability are like two sides of the same coin, one cannot exist without the other.
MOBILITY
Mobility and stability are two sides of the same coin — one cannot exist without the other. Mobility training is vital for enhancing performance and reducing the risk of injury. It focuses on improving flexibility across various planes, positions, and movements.
David Behm, in his book The Science and Physiology of Flexibility and Stretching, provides strong evidence that static stretching reduces injury rates, particularly in running sports. Additionally, ballistic stretching and active warm-ups are shown to prevent tendon injuries during stretch-shortening cycle (SSC) training, where a pre-stretch enhances subsequent muscle contraction.
What is the Stretch Shortening Cycle? It’s essentially a prior eccentric stretch applied to a muscle-tendon unit which improves the concentric contraction of the muscle as opposed to an isolated concentric contraction,
FUNCTIONAL MOVEMENTS
Functional training integrates stability and mobility by focusing on movements that mirror actual athletic activities. It is purposeful, multi-planar, and involves multiple joints or kinematic chains. Key functional movements every athlete should train for include:
- Squats/Knee Hinges
- Deadlifts/Hip Hinges
- Pushes and Pulls
- Lunges
- Single-Leg Balances
- Rotational Movements
How can one train functionally?
Putting aside sport-specific skills, athletes seek power.
While sport-specific skills vary, all athletes aim to increase power, which can be defined as the rate at which work is performed:
- Power = Work / Time
- P = F x d, where F represents force generated by muscles, and d denotes the distance over which the load is moved.
To maximize athletic power, focus on:
- Increasing Load: Adding weights to exercises like barbell squats.
- Increasing Distance: Extending the range of motion in activities like hip thrusts.
- Reducing Duration: Decreasing the time taken to perform movements like jump steps.
These components work together to enhance athletic performance, helping athletes to reach their full potential. ncert aids in optimum athletic performance.
Increasing weights on a barbell squat, reducing the duration of jump steps, increasing distance in hip thrusters are all examples of ways to increase work capacity.
There’s a lot that goes into developing an athlete program.
The type of sport and its requirements, the energy systems utilized, and the metabolic conditioning required for the same.
The first block tells us how we can use functional movements, flexibility training and stability exercises to create a sturdy athlete. These can be termed as blanket movements, applicable to any athlete pursuing any sport.
There may be variations in implementation based on the requirements, but the foundation remains the same for all. In the next part, we hop onto concepts of speed, agility, power, endurance and metabolic conditioning for an athlete.
