Coach and Athletic Director

June 2017

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52 J U N E 2 0 1 7 SPORTS MEDICINE SPOTLIGHT caring for athletes It seems like there is never enough time in the day to get everything done, especially for those involved in sports medicine at the secondary school level. When the school bell rings, the time crunch begins for many athletic trainers as they struggle to balance traditional duties while also acting as a strength coach or teacher. When every student seems to arrive at the door at the same time, one must be detailed yet efficient to be successful. Over time, I've learned to lean toward a few quick tests to summarize an athlete's range of motion limitations and strength weaknesses. Here are four simple, efficient and informative tests that sports medicine specialists can use in less than five minutes. Double-leg squat The double-leg deep squat is one of my favorites because of its simplicity and the large amount of detail it can quickly provide. Every athlete should be able to perform a double- leg deep squat, regardless of the athlete's sport, and an inability to properly do so provides information about the neuromuscular control and biomechanics of the body. As an evaluator, it's important to see the athlete perform two to three repetitions from each of the three different viewpoints to determine where there are limitations. It's exceedingly rare that youth or adolescent athletes can correctly perform a deep squat with the upper torso parallel to the tibia with knees and hands/dowel over the feet. Starting from the ground up from the anterior view, assessing if the feet pronate and externally rotate can quickly give information on the tightness of the gastroc- soleus complex during periods of rapid growth and other ankle mobility issues. Checking for inward collapsing of the knees, and hip internal rotation (kneecaps pointing towards each other) can also summarize gluteus maximus/ medius strength and iliotibial band tightness. Checking for any sort of lateral shift of the hips or rotation of the head can provide details about core strength and mobility that will be confirmed later. Looking up the body, paying attention to what the low back and arms do on the lateral view indirectly gives clues to core weakness. With hyperextension of the low back, the iliopsoas and latissimus dorsi muscles may become overly tight as a compensation for the poor core strength. Conversely, if the low back rounds, outer core muscles may become overactive to stabilize the core. Determining whether the arms remain parallel with the tibias provides information about how tightness in the latissimus dorsi and pectoralis muscles, while also hinting about weakness in other stabilizers, in particular the lower trapezius. Lastly, look at how the cervical spine is behaving in the lateral view. If it does not consistently remain in line with the thoracic spine, it could indicate weakness in those stabilizing muscles. Turning to the posterior view, I can more easily visualize certain areas and confirm any thoughts I may have had earlier in the assessment, looking for the heels rising off the ground or pronating. Confirming any sort of lateral shift of the hips suggests a dynamic core stability issue or the body's general compensatory patterns in the presence of pain. In this view, it's also easier to detect posterior rotational weakness. Single-leg step down Another efficient assessment is watching the athlete perform a single-leg step down. While many consider the single-leg squat an ideal test, I've found that almost every youth and adolescent athlete is unable to correctly perform it. If everyone fails the test, how useful can it be? For the single-leg step down, trying to keep the pelvis level and the knee in a properly aligned position is traditionally used to evaluate gluteus medius strength/ coordination when performed over a few repetitions. More recently, however, researchers started to look at how changing the protocol can be correlated and potentially used in place of other, longer duration tests. In 2014, JM Burnam highlighted how this relatively simple test performed repeatedly over 60 seconds is highly correlated with front plank and side plank times, as well as hip abduction, hip external rotation and hip extension strength measurements. 1 This is a lot of information that could determine limitations in a short amount of time. Combining this data with the information gleaned from the double-leg squat, we get an idea of what body parts are limiting factors and can develop a plan for how to move forward. But we still need additional tests to examine the upper body. Shoulder mobility test The shoulder mobility test from the functional By Corey Dawkins, contributing writer our tests to assess mobility AND WEAKNESSES

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