5/15/2013

LateStageRehabilitationand
ReconditioningofChronicKnee
InjuriesinAthletes
StrengthandConditioningScienceandPractice
NickGrantham
PerformanceEnhancementSpecialist
MSc BSc CSCS,ASCC

ThankYou
- UnitedKingdomStrengthandConditioningAssociation
- NationalStrengthandConditioningAssociation
- GreatBritainBasketball
- BenRosenblatt EnglishInstituteofSport
- BillKnowles iSport
- HarveyGalvin AltitudeCentre
- ChrisBarnes WestBromwichAlbionFootballClub

5/15/2013

Injuryrehabilitationshouldbe
viewedasalongerperiodof
preparation,notafasterreturn
tocompetition

BillKnowles

Itsnotarace

butsometimesitis

Thesuccessofa
rehabilitationand
reconditioningplan
shouldbejudgedon
doingthebestgiventhe
circumstancesyouare
facedwith.

5/15/2013

TheChallenge
- Chronicinjuries
- Traditionaltreatmentmodalitiesarenot
alwayseffective
- Pressuretoplay
- Controllingthecontrollables
- Noplansurvivesfirstcontact

Tendonsdontlikerestor
change
JillCook

TheSolutions
-

FunctionalIsometrics
Hypoxic
Occlusion
TendonLoading(land/pool)
MovementQualityTraining
EnergySystemDevelopment(ESD)
GPS Playerload,HRResponse,
acceleration/deceleration

5/15/2013

PerformanceModeling
Whatdoweneedtoimprove?
Pain
behaviour

Tendon
Function

Muscle
Function

Energy
absorption

FunctionalIsometrics
-

Posturalintegrity
Mentaltoughness
Maximalrecruitmentofmusclefibres
Reducedwearandtearonjoints
Increasedlacticacidtolerance
Hypertrophywithoutincreasedloadingonjoints
DevelopstrengthinweakROMs
Flexibilityandmobilityimprovement
ImprovedstiffeningcharacteristicsandCSAoftendon

Brijesh Patel MikeBoylesFunctionalStrengthCoachProgramme (2005)

IMIHT IntermittentMaximal
IntensityHypoxicTraining
- Highintensity,lowvolume
- Shortbursts(<lOs)
- IncompleteRecovery(<30s)

- Improvedoxygendelivery
- lmproved performanceoutcomes
Galvinetal2012 UnpublishedResearch
Faiss etal2011 UnpublishedResearch

5/15/2013

Canrepeatedsprinttrainingin
hypoxiahelpimprove
performanceinthisgroupof
athletes?

IMIHT IntermittentMaximal
IntensityHypoxicTraining
- Totalexposure15minsActualworkefforts
6os!
- Over4weekperiodjust12mins ofIMIHT33%
improvementinperformance!
-

PracticalApplications
- LoadCompromised
- Deconditioned
- Limitedplayingtime

Occlusion UnderPressure
- Kaatsu training analternativetoheavy
loading?
- EmergingtechniquefromJapan.
- Strengthtrainingwithlowloadsin
combinationwithvascularocclusion
- Particularlyusefulintherehabilitation
setting,especiallywhenhighforcesacting
uponthemusculoskeletalsystemare
contraindicated.

5/15/2013

Doesitmakeyoustronger?
514days

852%Increase

16%increaseperday!
BenRosenblatt(SeniorRehabScientist BOMIIRU) PersonalCommunications

Whatthepaperssay
- ScandinavianJournalofMedicineandSciencein
Sports(2008)18(4)401416
- MedicineandScienceinsportsandExercise(2007)
39(10)17091713
- EuropeanJournalofAppliedPhysiology(2002)86
(4)308314
- JournalofStrengthandConditioningResearch
(2009)23(8)23892395
- InternationalJournalofKAATSUTrainingResearch
(2007)319
- EuropeanJournalofAppliedPhysiology(2010)
108(1)141146.

GPS
- CombinationofGPSandinertialsensorslike
accelerometers.
- Multiplayerwirelesslinkforrealtimecoach
monitoring.
- Monitoringathletefatigue,gamespecific
events,orrepeathighintensityefforts.
- InertialMovementAnalysistechnologywhich
measuresspeedanddirectionforindoor
application.

5/15/2013

GPS
-

Showprogressionsthroughrehab
Comparetrainingwithgamedata
Trackimprovementsincardiovascularfitness
Trackplayertrainingload
Heartrateresponse
Periodised RehabilitationandReconditioning

EnergySystemDevelopment
- Painfreemechanicalstressonthetendon
- Unloaded bikeorpool
- Canbeusedinconjunctionwithocclusionand
hypoxicconditions
- 20s:90sx 4
- 15s:90sx 4
- 10s:90sx 4
BillKnowles(2010)

EMS
- Electricalmusclestimulation
- Useofelectricimpulsestostimulate
musclecontraction.
- EMShasreceivedincreasing
attention:
- Strengthtraining
- Rehabilitationandreconditioning
- Preventivetool

5/15/2013

TakeHomes
Itsnotaracebutsometimesitis
Dowhatyoucan
Performancemodeling
Itsnotjustaboutstrength
IMIHT,ESD,GPS,EMS,Isometrics,Occlusion

ThankYouForYourAttention
E:nick@nickgrantham.com
T:coachnickg
W:www.nickgrantham.com