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It was the beginning of the season, and my team was getting ready to practice. As I walked alongside them to the track, the athletes were talking about how hungry they were. Some mentioned they hadn’t eaten since 10 a.m., and others couldn’t wait until after practice to run across the street to grab a donut because it was “buy one, get one free” day. As we passed the long jump pit and headed to the spot under the scoreboard where we meet before warm-up, they continued to talk about how hungry and tired they were.

At that moment, I realized that if my team is distracted every day by feelings of hunger and fatigue, something needs to change.

Even though we talk about the importance of a good diet and its impact on health and performance, these high school kids still don’t know HOW to implement the information. Share on X

I was surprised, because I make a point of constantly discussing the importance of a good diet and its impact on health and performance. Even though we talk about it, however, these high school kids still don’t know how to implement the information. I also realized that they were student-athletes, and their schedule isn’t meal friendly.

The reality for many high school kids is that they want to eat better, but since they are overscheduled with school, sports, and social activity, nutrition gets put on the back burner. Most of their meals are on the go from fast food restaurants, and many parents are busy working so they order out. You listen as athletes tell their friends about skipping breakfast because they aren’t hungry in the morning, then running across the street after practice to grab some fast food because by that point they are starving. They barely drink water during the day and often don’t know the difference between a carbohydrate and a protein.

I realized, “Oh boy, I need to do something. After all, I am the coach, and athletic performance depends on nutrition!” I decided I needed to condense the ABCs of nutrition and lay it out for them: It would be important to give them strategies on how to implement nutritional priorities into their already busy schedule.

Where Do You Start?

First, communicate with your athletes about how it can affect them if they don’t eat right versus what it can do for their performance if they do. Below is an outline of the information I speak about—I simply write it on a whiteboard and work my way down.

You don’t need to make a slide presentation—you can do it on the field in a relaxed environment and make it interactive. This might be a good thing to do on a light day of practice or a recovery day. In the end, I provide strategies on how to implement nutritional priorities one at a time. I start with how to stay hydrated; once they have achieved that, I layer on another one. I keep it simple and attainable, so they feel successful and not defeated. I also learned they will need constant reminders; it’s not a one-time conversation.

The reality is that the schedule for a high school student-athlete doesn’t make it easy to eat a balanced diet. Some work and preparation are definitely needed. Begin with a conversation and ask the athletes how they are feeling, how is their sleep, what have they eaten during the day, whether they understand how those eating habit may impact performance, etc.

The reality is that the schedule for a high school student-athlete doesn’t make it easy to eat a balanced diet. Share on X

I also include links with infographics that are great references for the athletes—I find it beneficial to email or send them in a group text so they can pull them up on their phone.

What We Think Athletes Know About Nutrition and the Reality Are Two Different Things

After talking to my high school athletes, I realized they don’t truly understand how poor nutritional habits can affect them on and off the field. When we started to talk about nutrition, they shared with me how they are too busy with school, social life, and athletics to think about what they are going to eat. Here is a perfect example of how teenagers operate—one day, I noticed an athlete struggling with training. He continued to stop and complain of cramping. The first things I asked was whether he drank enough water and what did he eat today? He told me he’d had an apple and a cup of water, and that was it!

Common habits amongst these athletes were skipping meals, grabbing the first thing they see, and not giving nutrition a second thought. As far as macro nutrients, most didn’t have a clue—they had no idea that food could affect how they felt or how they performed. As a coach, I found this to be the perfect opportunity to make a difference and educate them.

I start the conversation with facts about poor versus healthy habits and how each can make them feel. A few of my athletes shared how when they stopped eating fried food at lunch, they didn’t get stomach cramps anymore and didn’t have to run to the bathroom in the middle of practice.

I explained to my athletes that eating a poor diet could result in:

• Low energy levels.
• Reduced athletic and academic performance.
• Trouble focusing and concentrating and poor memory recall.
• Increased risk for injury, illness, and infection.
• Fatigue and reduced reaction time.
• Muscle loss and an inability to gain lean mass.
• Reduction in strength, power output, and speed.

Then some facts about how a good diet can benefit them:

• Increased ability to focus and memory recall.
• Better ability to recover.
• Increased strength and power.
• Reduced risk of injury and illness.
• Better long-term health.
• Increased overall energy.
• Ability to get the most out of your training.

Give them a convenient visual of what a balanced diet looks like.

I also find it beneficial to educate them on the specific nutritional demands of their sport. For example, if they are a distance athlete, they will benefit from a diet with a higher percent of carbs versus a strength or power athlete who will need more protein.

We’ve Educated Them: Now Let’s Offer Strategies on How to Eat Throughout the Day

As coaches, we need to remember high school students don’t have a meal-friendly time schedule. They usually are up very early and may have lunch at 10 or 11 a.m. (and some students don’t have a lunch period because they’re overloaded with honors classes). By the time they get to practice, they have low energy and can’t focus. These are some of the strategies I recommend:

• Eat early: Train the digestive system to tolerate food in the morning just like we train to get stronger and faster.
• Choose wisely: Give them morning options that are time-efficient and nutrient dense. For example, Ezekiel bread with peanut butter and banana, Greek yogurt with berries and granola, eggs on whole grain toast and fresh fruit, a protein shake with frozen or fresh fruit. I also suggest if they want leftover steak and veggies from last night’s dinner, it’s better than a sugary cereal.
• Eat well: Healthy carbohydrates, proteins, and fats to meet the nutritional demands of their growth and sport.
• Eat often: When possible, a high carb and easily digestible snack approximately 30 minutes before training and simple carbs when training is longer then two hours (fresh or dried fruit, fig bars, granola).
• Consume recovery nutrition: This should be 0-2 hours post training. (If an athlete is unable to have a nutritious meal soon after practice, suggest they have chocolate milk or a protein shake post training to help them with recovery instead of going hungry).
• Time full meals: Consume a full meal 3-4 hours before a training session and don’t try new foods with this meal.

I’ve used the information below as examples of ways they could implement this information:

• It could look something like this: meal-meal-snack-snack-snack-meal. Meal in the morning before school, or if they have lunch at 10:30, then pack snacks for the day. Have one at noon, then another an hour or so before practice, and another after. When they get home, they have another meal. The high school setting is never optimal, but neither is life—we must adapt and prepare accordingly.
• Replenish protein to repair muscle damage accumulated during training and carbohydrates to replace glycogen for energy used during training.
• Rehydrate—drink fluids to replace fluid during training in addition to about half their weight in ounces. Example: a 140-pound female should drink about 70 ounces on a regular basis.
• Get in the habit of reading food labels (e.g., how does sugar hide in ingredients, the importance of fewer ingredients, “low fat” means nothing, whole foods better than processed, etc.). I did this when we traveled and made a food stop…

The high school setting is never optimal, but neither is life—we must adapt and prepare accordingly. Share on X

1. When we travel with the team, we can teach them how to snack! (Coaches too!)

• Teach them how to eat a healthy meal before traveling. If athletes will be on the go for several hours, they should eat something satisfying beforehand, so they don’t end up hungry and reaching for junk.
• 1-2 palms of lean protein.
• 1-2 cupped hands of carbs.
• 1-2 fists of veggies.
• 1-2 thumbs of fats.
• Pack a snack or several: nuts, seeds, hard-boiled eggs, celery with nut butter, raw veggies or fruit, quality protein bars.
• At a travel stop, make good choices: Greek yogurt, string cheese, raw veggies and hummus, fruits.
• In a hotel? Consider booking a room with a kitchenette or arrange the team meals at a restaurant with healthier choices.

2. Let’s get them to understand the importance of hydration. (See this infographic on what to drink more of, some of, and less of.)

• Teach your athletes to look at the color of their urine. They may not associate the headache, cramping, and fatigue with dehydration, but they will remember this. Explain to them it should be pale yellowish and clear. If it’s darker, they need to drink more water. Depending on how much info you want to give your athletes, you can explain further. I use the example of a dry sponge and a sponge soaked in water and how it can bend without damage compared to the dry one—I tell them now imagine the sponge is your muscle.
• I explain that if their output of fluids exceeds their intake of fluids, an imbalance occurs, and dehydration can develop. I discuss how much they sweat, how this influences dehydration, and how it can be measured by weight loss as a percentage. The weather, the activity, and the length of the activity will impact how much the athlete sweats. Have the athletes look at their clothes after practice—some sweat so much they can ring out their shirts. I use this visual, so they know they need to replace what they lost.

I discuss with athletes how much they sweat, how this influences dehydration, and how it can be measured by weight loss as a percentage. Share on X

I talk about how dehydration can cause these symptoms:

• Thirst
• Dry skin
• Fatigue and weakness
• Increased body temperature
• Muscle cramping
• Headaches
• Nausea
• Darker-colored urine
• Dry mouth

 Next, I go over what severe dehydration can feel like: 

• Muscle spasms
• Vomiting
• Dark urine
• Vision problems
• Loss of consciousness
• Kidney and liver failure

When you end practice, ask your athletes is anyone thirsty? Wouldn’t an ice-cold glass of lemonade be great right now? Tell them if you’re thirsty, it’s a signal you’re dehydrated.

If some of your athletes have a tough time drinking during practice, figure 1 below is a guide on hydrating for coaches. If they don’t drink during practice, use this as a guideline to teach them:

• 500 milliliters (16 ounces) of fluid the night before exercise.
• 500 milliliters in the morning.
• 500 to 1,000 milliliters (16-32 ounces), one hour before exercise.
• 250 to 500 milliliters (8-16 ounces), 20 minutes before exercise.

It’s a good idea to have your athletes get in the habit of eating nutrient-dense foods/beverages after exercise to assist in the rehydrating process.

• Those with a history of cramping and “salty sweat” should consider adding salt to foods/beverages after exercising (a quarter to one-half teaspoon).
• For every pound of sweat lost during exercise, rehydrate with two cups of fluid.
• Dark-colored urine can be a sign of a low water reserve in the body. Make sure your urine is light-colored and clear.
• Watermelon, strawberries, peaches, cucumbers, celery, pickles, coconut water, and oranges are good suggestions for hydration post training.

3. Convey the importance of allowing treats.

I find it valuable to teach our athletes that *treats* are something we eat on occasion. We don’t want teenagers to think they can never have ice cream or pizza; we educate them on eating nutritiously most of the time, and that food is our friend. If they know what a healthy diet looks like, then they can have those foods in moderation. I use the 80/20 rule with my athletes: eat a healthy, sound, nutritious diet 80% of the time, then the other 20% you can eat treats in moderation.

If teenagers know what a healthy diet looks like, then they can have foods like ice cream and pizza in moderation. Share on X

4. It’s not one conversation; it’s an ongoing process with constant reminders.

I have found if they know why they should eat better, then they’ll want to. (When they start performing better, they are even more motivated.) Giving them the how strategies is extremely important. Shortcuts I have shared with my athletes are to eat more fresh fruit and also put fruits like bananas, grapes, and any kind of fresh berry in the freezer—they can reach for it when they want something sweet or throw it in a smoothie.

I also suggest eating more veggies, such as cut-up carrots, celery, and peppers as a quick snack with some hummus or whatever dip they might have in the house. I recommend they share the info with their parents so the whole family is onboard. I have had athletes ask me for recipes, because I regularly post meals I make at home and nutrition tips. Sharing nutritional information on social media or group chats has also worked well for me.

Seeing an Impact on the Track

We all know we can’t out-train a bad diet and healthy habits should start young. I have found the best way to do this is to be a resource for my athletes and to sift through the information and give them the facts. For teen athletes, most just eat when they are hungry and don’t give much thought to what it is. I have found that when I start to bring up the subject of nutrition, they start to ask questions and want to know more about how to eat better.

My presentation to my athletes about nutrition has always been positive and prompts them to ask follow-up questions. I bet most coaches would be surprised their athletes don’t know the difference between a carb and a protein. At the end, I always leave time for questions, and there are always plenty that lead to more conversations and education. When we travel for meets and stop to get food, I find this a perfect time to help them make better choices. An athlete of mine brought this up years later, telling me she remembered me explaining how unhealthy soda was and then she stopped drinking it.

When we travel for meets and stop to get food, I find this a perfect time to help them make better food choices. Share on X

Over the years, one behavior I have noticed that has made an impact is improved hydration—with better hydration habits, the athletes who would complain of headaches and muscle cramps stopped complaining and had fewer of these. The athletes who had stomach cramps at practice after eating fries and chicken fingers for lunch changed that dietary habit to a healthier, more digestible choice and didn’t have to run to the bathroom in the middle of practice.

I always remind them on the night of a competition to not try any new foods and to stick with what works for them. We teach our athletes to reach for the low-hanging fruit of nutritional habits and layer one on top of the other. Not overwhelming them with info and giving them other options is key—it’s an ongoing process, so let’s keep the conversation going and MANGIA BENE!

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In the rehab and strength and conditioning communities, it is widely accepted that programming within a stress-recovery-adaptation (SRA) cycle is an effective methodology for creating sport-specific, targeted adaptations in our high-performance and tactical athletes. Considering the connections between movement quality and stress/physiology that have been established in research, it may be beneficial to use assessment of movement quality (motion analysis) to determine where an athlete’s movement patterns are revealing current stress on the system.

Based on this objective data for each athlete, we can then set specific training and rehab goals and develop highly individualized programming to facilitate precise positive adaptations. Motion analysis also gives us a measurable way to track athlete progress over time—a valuable tool to validate the effectiveness of programming efforts.

Programming Within an SRA Cycle

While many coaches and therapists agree with SRA ideology for promoting positive performance adaptations, few truly understand the underlying neurological mechanisms involved and how to begin designing programs to maximize positive adaptations based on these principles.

Traditionally, the focus of the SRA cycle has been on the physical aspects of stress, recovery, and adaptation. This makes sense in our industry, as improving motor performance and physical readiness is the goal of all training programs, and it is typically the most observable of the adaptations that occur within the cycle (e.g., increased strength, speed, endurance). However, the ability of our bodies to detect, withstand, and adapt from stress is largely a neurological process, primarily dictated by healthy structure and function of the vagus nerve. In order to optimize our athletes’ ability to adapt from stress, we need a deeper understanding of the systemic impacts of stress on the body—and particularly the impacts that stress has on motor performance. Let’s start by looking more closely at the SRA cycle.

To optimize our athletes’ ability to adapt from stress, we need a deeper understanding of the systemic impacts of stress on the body—particularly the impacts it has on motor performance. Share on X

The process of deviating from baseline and returning is commonly described as resilience. The overall goal of the SRA cycle is to prescribe the optimal amount of stress and recovery to the individual athlete, so that the result is a measurable positive adaptation in the targeted baseline skill set. We can strategically apply stress and recovery principles within programming to continuously facilitate positive performance adaptations while simultaneously improving baseline tolerance for the applied stress.

Another important note from the graph is that once the stress is applied, we see a temporary decrease in the targeted skill set. When appropriately assessing our athletes using motion analysis, we can detect stress as a decline in movement quality from the athlete’s baseline. This decline in movement quality (a readiness indicator) is a normal part of our systemic stress response and a valuable clue as to when our programming focus should shift to support recovery and facilitate positive adaptation.

The Vagus Nerve, Stress, and Movement

The vagus nerve (cranial nerve 10) is the longest and most complex of the 12 cranial nerves. It emerges directly from the brain and has both sensory and motor functions. One of the primary roles of the vagus nerve is to modulate activity within the autonomic nervous system, specifically regulating sympathetic (fight-or-flight)/parasympathetic (recovery/relaxation) tone.

The vagus nerve also controls heart rate variability (HRV), which is a measure of a person’s ability to adapt to stress. The sensory and motor fibers of the vagus nerve travel throughout the fascia system, and therefore structure and function of the vagus nerve are largely dependent on a healthy musculoskeletal system and efficient movement patterns. In this sense, when used appropriately, movement has the potential to regulate our physiology and promote positive adaptations from stress. Conversely, movement, especially loaded movement, also has the potential to inhibit positive adaptations when applied without mindfulness regarding the current level of stress. Let’s go a little deeper.

Conversely, movement, especially loaded movement, also has the potential to inhibit positive adaptations when applied without mindfulness regarding the current level of stress. Share on X

The vagus nerve acts as the body’s surveillance system, designed to detect any imbalance or threat to homeostasis, both internally and externally. A threat to homeostasis can be anything from an increase in heart rate during exercise to a heavy external load or an actual physical injury. Any time a threat is detected, the vagus nerve sends warning signals to the brain, which triggers a series of cellular, chemical, and physical reactions to restore homeostasis within the body. This series of reactions to return an individual to baseline is called allostasis.

When an athlete is placed under stress and they are in an allostatic response, we should expect to see a temporary decline in motor functions (recall the graph). Once the person reaches their homeostatic baseline through recovery, the vagus nerve sends signals to the brain that the threat has passed, and the nervous system is in a prime position to integrate the stressful experience and create positive physical adaptations specific to the type of stress. In the case of a stressful situation turning into a positive adaptation, the stress is classified as eustress (good stress/adaptive stress). This is the goal of training within an SRA cycle.

If the athlete does not adequately recover and never reaches their baseline, however, the stress response continues—then, they are unable to transform the experience into a positive adaptation. A positive adaptation cannot occur until the vagus nerve sends signals of safety to the brain. If the stress response continues long term, with no return to baseline, the athlete is at greater risk for negative outcomes, such as injury and even illness. Our bodies are made to withstand short periods of stress, not chronic stress. In the case of an athlete having inadequate recovery, the stress would become distress (negative/maladaptive stress) and would be visible over time with faulty movement patterns and compensations.

One of the most important points from above is that if an athlete is in stress, their motor performance and movement quality will inevitably suffer (decrease from baseline on SRA graph). This provides implications for professionals working with tactical athletes and high-performance athletes to be assessing movement quality at various intervals, to monitor the athlete’s adaptive response to prescriptive programming and applied stress.

Note: Understanding the difference between eustress and distress as it relates to performance is especially important for professionals working with tactical populations, where operational stress puts these athletes at higher risk for allostatic overload (chronic inability to return to baseline). Research is showing that these athletes demonstrate a decline in motor performance and readiness indicators long after intense operational training has ended, and even longer after combat deployments. For best practice, this should be considered when prescribing stress and recovery programming for this population.

Motion Analysis for High-Performance and Tactical Athletes

We’ve established that using standardized assessments of motor performance and physical readiness enables therapists and coaches to develop highly individualized prescriptive programming within a stress-recovery-adaptation cycle. But how do we actually perform a movement assessment? While most coaches rely on their own trained eye to spot imbalances in the musculoskeletal system and faulty movement patterns, recent advances in the fields of bioengineering and sports science have led to the development of high-tech motion analysis equipment, which is slowly being integrated into the industry by various professionals.

Technology from BTS Bioengineering allows for the assessment of neuromuscular activation, multiplanar accelerations/rotations, range of motion, and spatiotemporal parameters within a variety of movement patterns. The data provided allows for the most objective assessment of current performance abilities, including where they might fall on the SRA cycle graph. We can then use this information to develop individualized programming to facilitate specific positive performance adaptations.

BTS Bioengineering

BTS Bioengineering is an Italian-based company that has been researching and developing innovative technologies for motion analysis since 1986. BTS has a plethora of options when it comes to motion analysis equipment. At Elite Performance Concepts (EPC), we have 3D motion capture cameras, force plates, wireless EMG sensors, and inertia sensor all from BTS. BTS equipment has been validated and used in peer-reviewed scientific journals—they are truly a leader in the field.

The equipment comes with some protocols that have normative data already within the software (for example, gait and running analysis, vertical jump indexes, drop jump test, and cervical spine test). These tests have been well researched and allow us to see where an athlete’s scores place them when compared with a group of the normal population.

I can pick and choose which assessments will give the best data based on the athlete’s goals and how they are currently presenting, to create a completely individualized assessment. Share on X

I have also worked with BTS to create custom EMG and 3D motion capture protocols for squat, deadlift, and bench press. While these protocols do not have normative data, they allow me to assess symmetry throughout a movement pattern, as well as track symmetry over time in response to programming. With all the available testing options, I can pick and choose which assessments will give the best data based on the athlete’s goals and how they are currently presenting, to create a completely individualized assessment.

Case Studies

At EPC, we see two sets of clients:

1. Traditional rehab clients. These are people coming to us with a specific injury or issue. On an SRA cycle graph, they would be below their baseline and in stress.
2. Athletes. These clients are at their performance baseline and are looking to improve skills related to a specific sport or activity. These individuals would be at their baseline on the SRA curve or maybe a little below baseline if they have been neglecting recovery.

Despite one set of clients coming in with injuries and the other looking to improve baseline performance abilities, both are in a prime position to strategically apply motion analysis and SRA principles to promote positive performance adaptations. Let’s look at the data of two different clients to get a better understanding of how we can use this equipment to program for our athletes within an SRA cycle.

Case Study 1: Rehab Client

The first client that we will look at is a rehab client. This client is an older adult who has remained extremely physically fit throughout her life. Up until earlier this year—when she tore the meniscus in her right knee—she was strength training regularly in the gym. She had the tear repaired surgically and used traditional physical therapy for her rehab. In one session, she had extreme pain when the therapist forced her knee into terminal extension. She has had swelling and pain in the knee ever since, and recently had an MRI that showed two new tears in the same knee. The client is scheduled for another surgical repair in a few weeks.

For her assessment, I chose to do a gait analysis using EMG and inertia sensors. We did two assessments: one with a crutch on the right side and one without the crutch. We wanted to compare her gait with and without the crutch to determine whether she should continue to use it. Our goal was also to get a pre-op analysis to compare postoperatively. Having data to show progress over time can be an extremely valuable tool for the rehab client’s mentality throughout the process.

The BTS protocol that I used for this client is the Freewalk Protocol. This protocol collects data regarding neuromuscular activation through use of 8 EMG (electromyography) sensors and spatiotemporal parameters of the gait cycle via the G-Sensor (inertia sensor). The G-Sensor is placed at the level of the pelvis and measures angular accelerations in three planes of movement, as well as events within the gait cycle. The EMG probes are placed on the following muscles (right and left sides): tibialis anterior, gastrocnemius medialis, rectus femoris, semitendinosus. Gait kinematics have been researched extensively for several decades, and therefore, the protocol has a high level of validity and compares our client’s data to normative data of the general population.

Data Analysis

Going through the protocol report, the first aspect of gait that we will look at are temporal parameters collected by the G-Sensor. Events would be things like heel strike, toe-off, single support phase, double support phase, stance, and swing phase. Through data analysis, we get multiple symmetry indexes, which give information about timing of events within the gait cycle compared to normative data. Below, find the symmetry indexes for this client with and without the use of the crutch. There are three indexes provided:

The next part of the report we will look at are the pelvic kinematics. These graphs allow us to evaluate pelvic movements in the frontal, sagittal, and transverse planes. The green graph lines represent data from the right gait cycle, while the red graph lines represent data from the left gait cycle. Normative data is represented by the gray band. Pelvic kinematics that are considered “normal” would fall within the gray band.

Pelvic kinematics for this client were pretty similar with (right side) and without (left side) the crutch. The most significant deviation that we see in this client is excessive anterior tilt throughout the entire gait cycle. The norm for adults is about 10 degrees of anterior tilt throughout the cycle. This client has almost 25 degrees of anterior tilt throughout the gait cycle. She also falls outside of normal range for right and left pelvic obliquity; however, the deviation is not as significant as the anterior tilt.

The last piece of data is the EMG data within the gait cycle. First, we will look at the data from the lower leg. The graphs on top look at timing of the right (green) and left gait cycles (red). The gray part of the graph is when we should see peak EMG activity, such as is seen in the left gastroc both with and without a crutch. We should see almost no activity in the white areas (a flat line). As you can see, there is very little activity in the right lower leg both with and without a crutch. We also see the right gastroc firing in the white areas of the graph, where it should be almost flat.

This brings us to the next part of the data, the coactivation index (figure 4).

The coactivation index assesses simultaneous agonist and antagonist muscle activation. Normal values are listed in black on the right side. A coactivation index greater than the normal values would indicate co-contraction of agonist and antagonist muscles (gastroc and tibialis), and poor synchronicity of muscle activation within the gait pattern. Both RLE and LLE showed a high level of coactivation in the lower leg throughout the gait cycle both with and without the crutch. This is typical in clients who have an active injury, as it is the body’s way of protecting the joint.

Looking at the EMG data for the upper leg, we see very little activity in the right quadriceps (rectus femoris) both with and without a crutch. We also see excessive hamstring activity bilaterally in white areas, where there should be almost no activity. This is likely a compensation for the lack of rectus fem engagement.

Coactivation indexes both with and without the crutch fell within normal limits (except left swing phase with crutch), indicating no excessive agonist/antagonist co-contraction in the upper leg, bilaterally.

Interpretation of Results

Based on the data, this client did not have a significant difference in gait cycle quality with or without the crutch. However, since she did have slightly better symmetry without the crutch, I recommended she only use the crutch when leaving her house for community ambulation, as it gave her some peace of mind when walking longer distances.

Overall, this client’s assessment reveals a high level of stress within the musculoskeletal system. We see this with poor temporal symmetry, decreased neuromuscular activation in the lower leg and quads, high coactivation within agonist/antagonist muscle groups, and excessive anterior tilt within the pelvis. Based on this data and her presentation as highly anxious regarding this injury and her current quality of life, I would start this client on a rehab program that initially focuses almost entirely on systemic recovery. This client is stressed physically, mentally, and emotionally over this injury, and is well below her functional baseline on the SRA curve.

The recovery methods we use at EPC include:

• Myofascial release therapy/bodywork.
• Movement re-patterning (Masgutova Neurosensorimotor Reflex Integration techniques).
• Sensory integration techniques (MNRI, Safe and Sound Protocol).
• Far infrared sauna.
• Mild hyperbaric oxygen therapy (HBOT).
• Red light therapy/low-level laser.
• Normatec compression equipment.

Just as we can pick and choose which motion analysis protocols we use for each individual athlete, we can also pick and choose which recovery methods we use, based on individual needs identified on assessment. All of the recovery techniques described are done in a gravity-eliminated position (on a massage table or supported sitting). This decreases external load on the body from gravity and is “safe” for the nervous system since it is how we first learn to move as infants.

I would start this client with passive recovery methods (for example, sauna, red light therapy, myofascial release). After several sessions, I would move toward more movement-based recovery, primarily movement re-patterning (MNRI techniques), still in the gravity-eliminated position. These techniques progress the client through foundational movement patterns starting passively, progressing to isometric, and then to isotonic when the client shows readiness.

Once this client presents with less systemic stress and better foundational movement patterns, I would progress her program to integrate corrective exercise techniques (upright/against gravity), starting with isometrics and progressing to isotonic exercise. We would then strategically increase loading within the corrective exercise phase while continuing to incorporate recovery methods, likely with less intensity and frequency. The strategic application of dense recovery methodology in the initial phases of rehab establishes a strong foundation for this client to be able to move from distress to eustress, returning to baseline and adapting beyond it on the SRA graph.

The strategic application of dense recovery methodology in the initial phases of rehab establishes a strong foundation for this client to be able to move from distress to eustress. Share on X

It is important to periodically reassess movement quality, especially for the rehab client. In this client’s case, I will reassess postoperatively and once a month after that to monitor progress and individual response to programming.

Let’s look at another data set from a performance-based athlete.

Case Study 2: Performance-Based Athlete

The next data we will look at is from a healthy athlete in his late 20s. He is a personal trainer and follows a pretty intense (5-7 days/week) training regimen. He describes his training style as “heavy strength and conditioning,” focused on improving performance and athletic development. This athlete is also very active outside of the gym, with activities such as biking and rock climbing. His injury history is significant, with a right shoulder injury requiring surgical repair, right foot fracture, right knee injury, and possible labral tear in the right hip.

The athlete wanted to use motion analysis to look at neuromuscular symmetry within his squat. The EMG arrangement for the squat protocol is as follows (right and left side electrode placement): rectus femoris, biceps femoris caput longum, rectus abdominis, latissimus dorsi, gluteus maximus. In addition to the squat analysis, I also did a gait analysis to get information about pelvic kinematics. I chose to do the G-Walk protocol for the gait assessment, which uses only one inertia sensor at the level of the pelvis for spatiotemporal kinematics within the gait cycle.

The gait assessment using the G-Walk does not assess neuromuscular activation. The pelvic kinematics analyzed with this protocol are the same as discussed with the previous client. The pelvic data gives a good picture of multiplanar orientation of the pelvis, which is beneficial for planning targeted fascia release within the recovery aspect of treatment. I find it beneficial to correlate the data from these two protocols (gait and squat) to get the most detailed picture of the athlete’s baseline related to posture and motor control.

I find it beneficial to correlate the data from the gait and squat protocols to get the most detailed picture of the athlete’s baseline related to posture and motor control. Share on X

Data Analysis

Pelvic kinematics within the gait analysis reveal several deviations outside of the normative data. In the top graph, which looks at anterior/posterior tilt throughout the gait cycle, we see about 20 degrees of anterior tilt throughout the gait cycle. This is about 10 degrees more anterior tilt compared to the normative data. In the second graph, we also see significant deviation from normative data for left and right pelvic obliquity. The graph basically shows elevation of the left side of the pelvis (approximately 10 degrees) and depression of the right side of the pelvis (approximately 10 degrees). This is maintained throughout the gait cycle.

Moving on to neuromuscular analysis of the athlete’s squat technique, we did trials using bar weight (45 pounds), 135 pounds, and 225 pounds. The goal of our data collection was to identify muscle imbalances within the squat, as well as the most optimal load to re-pattern these imbalances to promote positive neuromuscular adaptations within the movement pattern.

The two muscle groups that showed the greatest asymmetry during the squat cycle were the quads (rectus femoris) and gluteus maximus.

See the data below for neuromuscular activation of the rectus femoris. Green represents the right RF, red represents the left RF, and the gray vertical line represents the bottom of the squat. The top graph is the data for all three squat reps, and the bottom graph is data for each of the trials individually over time.

This client’s left rectus femoris consistently had higher EMG activity compared to the right. The greatest asymmetry was with bar weight (45 pounds), while the most symmetrical activation was at 225 pounds. This is typical with athletes who are consistent lifters, to see better symmetry at higher loads. Their proprioceptive systems become accustomed to being loaded, and they have better body awareness under loads.

It is typical for athletes who lift consistently to see better symmetry at higher loads. Their proprioceptive systems become used to being loaded & they have better body awareness under loads. Share on X

Based on the data, when we work on re-patterning this muscle group for this client, we would choose a load somewhere between 135 pounds and 225 pounds. For re-patterning, I recommend starting with a load where the athlete’s RPE is around a 4, and then progressing through loads of 5-7 RPE. We want enough weight to activate optimal proprioception; however, we don’t want them to struggle under the weight. The struggle (stress) for re-patterning should be in maintaining the mind-body connection of the targeted muscle group throughout the squat cycle.

Now let’s look at data from the gluteus maximus at 45 pounds, 135 pounds, and 225 pounds. Just like we saw in this client’s quadriceps, he shows higher neuromuscular activation in all trials and all weights in the left glute compared to the right. However, the client showed the most symmetrical neuromuscular activity with the 135-pound load. We would likely work on re-patterning this muscle group at or around 135 pounds, depending on RPE.

Figure 9. Gluteus maximus activity at 45 pounds, 135 pounds, and 225 pounds.

Interpretation of Results/Programming Notes

For this client’s programming, I would prioritize working on improving the position of the pelvis and re-patterning muscle activation of the quadriceps femoris and gluteus maximus in the squat. This client presents overall with much less systemic stress than the first client. I would still prioritize recovery initially with this client—primarily fascia release around the pelvis and re-patterning (gravity-eliminated position) of the core and lower extremities. However, his recovery phase would be much shorter prior to moving on to corrective exercise programming. As with the previous client, I would incorporate recovery at a lesser intensity and frequency once moving on to corrective exercise.

Biofeedback techniques that strengthen the mind-body connection, or awareness of muscle activity, are an effective means to create more functional movement patterns. Share on X

The goal of corrective exercise programming is to replace the athlete’s dysfunctional movement patterns with more functional patterns. For this athlete, we would work to improve symmetry within the quads and glutes during the squat cycle. Biofeedback techniques that strengthen the mind-body connection, or awareness of muscle activity, are an effective means to create more functional movement patterns. We can use the BTS EMG sensors in biofeedback mode, which gives visual and auditory cues to the athlete when they deviate from targeted muscle activity range.

Proper cueing from the coach or therapist and use of a mirror are other low-tech biofeedback methods. Since this client showed higher muscle activation on the left side, I would cue them to focus on the right-side muscle group. Typically, this is a good cue to use to balance neuromuscular asymmetries.

See the chart (figure 10) below for a visual of progression of how our athletes replace dysfunctional movement with functional movement using biofeedback methods. When our athletes come to us with a dysfunctional movement pattern, they are likely unaware of the specific faulty pattern (unconscious dysfunction). Through the use of motion analysis, we can bring awareness to these dysfunctional patterns (conscious dysfunction).

Using biofeedback to strengthen mind-body connection to specific muscle groups, we can consciously achieve a more functional movement pattern (conscious function). Repetition of functional movement patterns under an optimal load allows the brain to create new neural pathways, replacing the dysfunctional movement pattern with a more efficient motor pathway. This is through a process called neuroplasticity—this more efficient motor pathway then becomes the dominant pathway and the athlete’s new baseline (unconscious function).

In order to establish that our programming is facilitating the positive adaptations we are targeting, we would complete repeat assessments at various intervals. For this athlete, I’d recommend a reassessment in two to three months to give the body enough time to adapt to programming efforts.

Conclusion

There should be no doubt that using high-tech motion analysis equipment allows professionals to develop highly individualized programming, based on the most objective data available. This has obvious benefits when working with high-performance athletes of any specialization. However, not all equipment is created equal, and this is one area where you truly pay for what you get. While lower cost motion analysis options might seem flashy and appealing, it is important to determine whether the equipment you are considering purchasing for use with your athletes has been validated and used in clinical trials.

It is important to make sure the motion analysis equipment you are considering purchasing for use with your athletes has been validated and used in clinical trials. Share on X

Using research-backed motion analysis systems, such as our BTS system, truly has the potential to revolutionize our industry while maintaining evidence-based practice ideals. It is our goal at EPC to use our equipment to set standards and push forward the boundaries of the human performance industry.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

If you are like me, when you first started in the sports performance field you had no idea what you were doing. And years later, you still have no idea what you are doing—you just have a better idea of what doesn’t work as well. I used to be a clean guy. I used to box squat. I bought all the bands, chains, and prowlers. They were good, and I developed strong athletes, but something was missing.

After years of trial and error, I was bitten by the speed bug. And bitten hard. I bought jump mats, timing systems, better prowlers, etc. I went all in. However, just like with the bands, chains, and months of trying to teach a clean, something was still missing.

My timing system was good, but I only got times—it did not reveal the full story of the sprint. Was this athlete a good starter? A poor starter? If I wanted to create force-velocity profiles, I had to buy how many more timing system units?

Even a prowler sled—a great tool for acceleration—has its flaws when it comes to individualization in a team workout. As coaches, we have all put one weight on a sled or maybe had the heavier sled and the lighter sled in a workout. The issue there was using the same weight for different athletes, with different body weights, heights, and abilities. For some it would be strength work, some power, and others speed work.

This year, as a change, I only worked with men’s and women’s ice hockey—in terms of specificity, there was now the issue of how to utilize the aforementioned tools on the ice. Timing systems present a similar challenge on ice, in terms of not telling the entire story of a sprint. Resisted skating on ice has its own unique challenges, such as how do you individualize and monitor loads and how do you stop a sled on a frictionless surface?

Resisted skating on ice has its own unique challenges, such as how do you individualize and monitor loads and how do you stop a sled on a frictionless surface? Share on X

It’s not that I had a problem, necessarily; it was more my tools didn’t provide the individualization, data, or instant feedback that I wanted. If you can handle the “Ninja Turtles” reference, over the last few years my Master Splinter has become Chris Korfist. I found him through podcasts, tons of articles on SimpliFaster, and his Track Football Consortium. If you are a fan and follower of Chris Korfist like I am, you know that he is a proud owner and promoter of the 1080 Sprint.

This machine could provide all of the things I was now wanting in my training.*

Getting to Know the 1080

When I knew my 1080 was on the way, I called Chris Korfist to ask for advice. He told me that the first three weeks I have it, I needed to create a velocity decrease of 50%, which would increase the athletes’ power production.

The velocity of a sprint is decreased by adding resistance—and we should try and have the highest resistance possible while only decreasing velocity by 50%. In the figure below, 5 kilograms of load is being used for this athlete to create a velocity decrease (not 50% though). He also mentioned basing things off averages because someone tripping could actually show a higher peak velocity (which I later found to be true). After a repetition, the tablet that operates the 1080 will give you a readout of:

• Distance and time.
• Peak and average speed (velocity).
• Peak and average force.
• Peak and average power.

Armed with Chris’ advice, I did some experimenting and familiarized myself and a few athletes with the unit. The 1080 Sprint has two gears of resistance. The first gear ranges from 1-15 kilograms of resistance and the second gear ranges from 16-30 kilograms. Second gear is smooth, and it is heavy, but it does not allow for as quick a transition from athlete to athlete. When you go into second gear, athletes cannot simply undo the belt around their waist and let the 1080 pull the belt back to the start line.

Second gear requires anchoring the line to an immovable object next to the 1080 unit and a pulley system tethers the line through the belt. If an athlete drops the belt and lets the 1080 pull it back in second gear, the line gets all wrapped up and around the pulley and you spend unnecessary time untangling it. The alternative is having each athlete sprint out in second gear, slowly walk backward to the start, then remove the belt to hand to the next athlete.

I decided to only use first gear to make transitions between athletes as quick as possible. This would allow more efficiency and more repetitions for athletes. Share on X

With only a one-hour workout twice a week in season as my training option, I decided to only use first gear to make transitions between athletes as quick as possible. This would allow more efficiency and more repetitions for athletes. Something to also keep in mind: These workouts were not just 1080 workouts—athletes were completing other strength and performance-related exercises within this hour block.

Video 1. Athletes demonstrating the workout flow with the 1080 Sprint in the Lahaye Ice Center hallway. One athlete completes a sprint and drops the belt, which retracts to the starting point. While this is happening, the operator should pull up the next athlete’s profile and make any necessary adjustments.

However, in first gear, the maximum resistance of 15 kilograms was not enough to get a 50% or even 25% velocity decrease. Uh oh. I had to use a 10% velocity decrease, which worked in first gear. Despite Chris’ advice of a 50% velocity decrease being optimal, in my setting it was not practical. If I were to attempt a higher percent decrease and use second gear, I feared I would not accumulate enough repetitions for a training stimulus. Instead of potentially getting 4-8 repetitions with a 10% decrease, in second gear I may only have time for 1-2 repetitions.

Next, after a few conversations with Vicki Bendus of Brock University, in an attempt to correlate on- and off-ice speed, I decided to have players utilize a crossover start both on and off the ice during training and testing. Excited to see what would happen from a three-week, 10% average velocity decrease program, I looked forward to January when the athletes would return from their winter break and start the spring semester. Once athletes got back, we would have more than 10 full weeks to prepare for Nationals in April.

Video 2. Athlete sprinting with resistance from the 1080 Sprint using a crossover start in the Lahaye Ice Center hallway.

Off-Ice, During Workouts

January finally arrived, and at that point, the women were the number one team in the country and the men’s team was in the top five. With the teams’ success to that point in the year, I was very cautious in introducing this new training variable. I was extremely elementary in my approach, essentially only using the 1080 for resisted sprinting, even though it is capable of so much more. Also, before running my velocity decrease program, I wanted to make sure all athletes felt comfortable using the unit, no one was noticeably sorer a day or two later, and that groins and hips could handle the resisted sprinting on top of all the skating they do in practices.

Here is the fun part of this semester… It was a coronavirus year semester, which means things never went according to plan. Both teams lost two weeks of training time due to a COVID-19 shutdown. We took all of our January and February training weeks to acclimate to the machine. These weeks were spaced out, again, due to a COVID-19 shutdown. Because of the inconsistent training and on-ice practices, it took much longer than anticipated to acclimate athletes to a point where I felt comfortable that my data would be valid and reliable.

After the athletes trained a bit and got familiar, in the first week in March, after weeks of getting used to the 1080 and with six training weeks left before Nationals, we began a 5- to 6-week program. Here’s how each week looked:

• Week 1 – Two workouts where athletes ran 10 meters, crossover start, 1 kilogram of resistance. The highest average velocity was then taken, and a 10% decrease was calculated to be used for the next three weeks.
• Week 2-4 – One to two workouts a week. Athletes ran 10 meters and resistance was added or subtracted to get the athletes as close as possible to a 10% average velocity decrease.
• Weeks 5-6 – Two workouts a week where athletes ran 10 meters, crossover start, 1 kilograms of resistance. The highest average velocity was compared to the highest average velocities from week one.

That is the beauty of the 1080 Sprint: the training is the test; the test is the training. Share on X

Weeks 1, 5, and 6’s testing days were simply mixed into a normal workout. That is the beauty of the 1080 Sprint: the training is the test; the test is the training. I collect useful data, more than just the time, on every single repetition, and it is all individualized.

During the training cycle, all of the athletes followed the same template for their workouts:

• Either a split squat or trap bar deadlift.
• A weighted or unweighted jump.
• A single leg assistance exercise, such as an RDL or step-up.
• Individually resisted, 10-meter sprint with a crossover start.

After they completed their single leg exercise, they would walk out into the hallway of the ice rink and perform their resisted sprint there. I had a designated 1080 operator who would add or subtract resistance based off the player’s previous average velocity in order to maintain a 10% average velocity decrease. The goal for the players was to use the highest resistance possible.

Results

After three weeks of sprinting with a 10% velocity decrease, here are the results for the men’s and women’s hockey teams.

Of 15 men who finished the program, nine saw improvements in their time to 10 meters, as well as their average velocities.

Of 15 women who finished the program, 12 saw improvements in their time to 10 meters, as well as their average velocities.

On Ice

In the entire spring semester, I was able to get seven on-ice sessions, measuring 60 good repetitions. I did not pull away any conclusive data from these, unfortunately. They were too spread out and sporadic throughout the semester. This was not executed as planned—I was hoping for more ice time, but that is not always how it goes.

To test and train athletes on ice, I brought the 1080 to the end of the ice surface, where the ice cleaning machines come out of (the “zam room” for those who speak hockey). I simply used an extension cord to bring the 1080 to the edge of the ice and was fortunate that the lip of the ice surface was just low enough that I could set my 1080 on the ground off ice and it was fine. I ran the unit by sitting in a chair on or off the ice surface. Players typically skated 30 meters, which is from the goal to mid-ice.

Video 3. Athletes skating with 1080 Sprint, using a crossover start, in Lahaye Ice Center.

Despite all of this, when the hockey seasons ended, I compiled data into an Excel sheet to compare on- and off-ice force production, something I was always curious to investigate. To do this, I broke each 10-meter sprint down into 5-meter splits. I wanted to know if athletes’ forces on ice were similar to off ice, in the hallway of the ice rink. In my mind, this would indicate transfer from the hallway to the ice.

I only analyzed 1-kilogram resisted sprints, and hand selected off-ice times to be near on-ice times. For example, Athlete 1 has a personal best 10-meter sprint off-ice of 2.10 seconds, but I selected one of their 2.33 second sprints to compare to a 2.38 second on-ice sprint.

The chart below displays two off-ice and two on-ice 10-meter sprints, with 1 kilogram of resistance and a crossover start. I found it very interesting that despite wearing ice skates and being on ice and wearing equipment and holding a stick, the force production numbers were not far off when comparing on and off ice.

Furthermore, I found on the ice that it was best to use first gear instead of second gear. Second gear was so heavy their stride simply broke down too much. Next, I realized it was easiest to have the players attach the carabiner at the end of the 1080 cord to the loop on the back of their hockey pants.

This was very interesting to me. I thought it would be easier to use the same system as we did in the hallway: one person goes, drops the belt, and the next person puts the belt on.

However, when it comes to having gloves and sticks, it got complicated. On top of that, after reading an article he wrote about the 1080 Sprint, I reached out to Jacob Cohen, Illinois University’s sprints coach.

Jacob mentioned that he does not use the 1080 as a timing system because his athletes are so dialed-in that the belt throws them off, and it may get in their head. I felt like I was experiencing the same thing with my hockey players—despite wearing tons of equipment, they were using the belt as a crutch for a potentially poor time. Therefore, we used their loops instead.

Key Takeaways

First, this experience reestablished in my mind how much athletes love to compete. Whenever a time or certain metric is put to a sprint, everyone competes. Whatever you make a big deal out of, the athletes make a big deal out of.

Resisted sprinting also proved to be extremely valuable for improving acceleration. Sprinting in first gear, dropping the belt, and having it retract is a very efficient way to run larger groups through on the 1080 Sprint. It gives the tablet operator time to click to the next athlete and add or subtract necessary resistance.

Sprinting in first gear, dropping the belt, and having it retract is a very efficient way to run larger groups through on the 1080 Sprint. Share on X

Finally, it seems the forces produced on the ice are similar to the forces being produced off the ice in a 10-meter sprint. This further leads me to believe there is a direct transfer between off-ice and on-ice speed.

Thoughts for the Future

As I look ahead, over the summer I plan to utilize more of the overspeed capabilities of the 1080 Sprint. Keep in mind we were in-season this entire semester. The last thing I could do is risk injury. This summer, I planned to have one or two days where we sprinted overspeed.

On ice, I plan to distinguish training and testing days. On testing days, I may pull the timing system back out for ease of setup and efficiency in running athletes through. On the training days, I may set the 1080 up on a bench and only have players skate 10-15 meters, or the width of the ice. This will make it easier and faster to get it out there, set it up, get the training in, and then I may easily close the bench door. With that setup, I may be able to get players through for 20 minutes before or after a practice.

Other considerations are, what happens when COVID-19 restrictions are over? How will I use this when I have my full 24-26 man/woman roster? For now, I am thinking of something like splitting the team into two groups: one group for speed and power focus, and the other for strength and accessory work.

For those wondering about the results of the teams at the end of the semester, the men’s team lost in the semifinals and the women won. Top 4 and National Champions. Not too bad.

*Author’s Note: Fortunately, through a miracle, Dr. Jared Hornsby of the Allied Health Professions Department reached out in Summer 2020 and asked if we would be interested in conducting research using a 1080 Sprint. I said yes. Through Dr. Hornsby‘s hard work, and convincing my AD it was worth the investment, my 1080 arrived on campus a few months later. I’m very grateful to Dr. Hornsby for his efforts on our behalf.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

You’ve probably never heard of John Boyd, but there is a good chance that you’ve heard of his most famous creation: the OODA loop. Boyd, who died in 1997, was a United States Air Force Fighter Pilot who became a consultant to the Pentagon before retiring and moving into his own form of academia. Boyd has been highly influential on military strategy across a number of projects—his early work led to the development of the F-15 “Eagle,” F-16 “Fighting Falcon,” and F-18 “Hornet” fighter planes, all of which are still in use today. Following the completion of these projects, Boyd turned to an overall strategic approach and developed his OODA loop, a viewpoint which set the basis for US military strategy in the first Gulf War and which is still in use today.

In Boyd: The Fighter Pilot Who Changed the Art of War, author Robert Coram presents Boyd’s biography. In a time of so much information enabling us to shortcut our thinking practices—often not beneficially—never before have we needed a role model like Boyd: someone who could think so differently from everyone else that it led to extreme innovation, effective outcomes, and strategies that are powerful today.

We needed a role model like Boyd: someone who could think so differently from everyone else that it led to extreme innovation, effective outcomes, and strategies that are powerful today, says @craig100m. Share on X

The picture Coram paints is that Boyd was not an easy character to get on with; he had no respect for authority and was more than willing to be difficult to get what he wanted. He was so fixated on his life’s work that, after retiring from the Air Force in 1975, instead of getting a well-paid job as consultant or defense contractor, he instead decided to reduce his needs to zero, so that he could fully focus on developing his theories. This, on the surface, is admirable—but when you have a wife and five children to support, it’s perhaps a very selfish decision to make. Boyd’s children still largely resent his decision to this day.

I highly recommend you read Coram’s book in full, but I want to pull out some key points from Boyd’s story which we might be able to use to better prepare athletes to perform. I’m going to do this through the lens of middle-distance running, which is unusual for me—but I think it’s an area in which Boyd’s concepts can be highly applicable.

Energy-Maneuverability Theory

The first major innovation Boyd produced is termed the Energy-Maneuverability Theory. Boyd was a fighter pilot, accustomed to being involved in air-to-air combat against an enemy. In the mid-1950s, when Boyd was actively flying, traditional fighter pilot training techniques tended to focus on the method of shooting down the enemy fighter—bullets and rockets—or on providing support to ground troops through the use of bombs. Boyd, however, had a different idea on what was important: being able to place a fighter in the best position to shoot down their opponent.

This meant that in order to be successful a pilot had to be able to get directly behind the enemy and maintain that position for long enough to be able to fire their weapons. At the time, fighter training didn’t prioritize this to the extent Boyd felt it deserved—and when they did teach it, he thought they taught it incorrectly. Boyd’s model of flying a plane was linked to energy; when flying in air-to-air combat, the ability to lose speed rapidly (i.e., dump energy) to increase maneuverability was crucial, as was the ability to regain that speed rapidly. Pilots, however, were being taught to turn their plane in a dogfight by using the stick first, then the rudder; Boyd instead taught his students to use the rudder first, as it led to a greater loss of speed in a shorter period of time—decreasing the turning circle and increasing maneuverability.

Boyd’s approach was not to teach a new method of air-to-air combat, but to teach a new way of thinking, says @craig100m. Share on X

In essence, Boyd’s approach was not to teach a new method of air-to-air combat, but to teach a new way of thinking. Using Boyd’s model, pilots were taught to consider their movement options in terms of airspeed—If I do maneuver X, what effect does it have on my speed, and is this positive or negative for what I want to achieve?—while also considering:

• The countermoves available to the enemy pilot.
• The ability to anticipate those countermoves.
• How to maintain sufficient airspeed in order to counter the enemy’s countermoves.

This essentially turned combat in flight into a game of airborne chess.

The Boyd Effect

Boyd’s theories not only changed how pilots were trained, but how their planes were designed. In 1960, Boyd enrolled in Georgia Tech to study for a degree—his second—in industrial engineering. There, Boyd further developed his thinking into what would eventually become his Energy-Maneuverability Theory. Basically, a fighter plane can be viewed as having either kinetic energy or potential energy. Flying at a high altitude—but at low speed—the plane has a lot of potential energy, but very little kinetic energy. When diving from this altitude to engage an enemy, the plane increases its speed (and hence its kinetic energy) but loses its potential energy (because it is converted to kinetic energy).

This is fine when the plane is attacking, as it allows it the element of surprise, but it leaves it vulnerable to counter-attack; as the plane climbs following the attack, it loses kinetic energy, which again becomes potential energy. This has important implications when it comes to designing a fighter plane; it needs to be light enough that it requires little energy to speed up, but also able to link from one maneuver to another in rapid succession.

As the plane climbs following the attack, it loses kinetic energy, which again becomes potential energy, says @craig100m. Share on X

This was in direct opposition to the approach utilized by the US Air Force when it came to designing fighters, which can be summed up as bigger-higher-faster-further; build planes that can fly higher, faster, and further than ever before, and make them increasingly large. This all came with reduced maneuverability, putting Boyd in conflict with his bosses; Boyd wanted to remove as many extraneous pieces of equipment from his design as possible, but his bosses kept wanting to add things (radar, guns, etc.). Boyd had to compromise on the first plane—the F-15—which came in at 12,000kg (considerably less than its closest competitor, the F-111, which weighed 22,000kg), before getting his way with the F-16, which weighs only 8,000kg.

Relating Boyd to Runners

So what does this mean for middle distance runners? Firstly, the goal in these events, at major championships at least, is not necessarily to run fast but to win. This means that athletes who are able to both dictate the tactical flow of the race and respond to the tactical movements of their competitors are at an advantage. As such, we can even view middle distance races as a dogfight, in which everyone jockeys for the right position to be able to deliver the killer blow.

For middle distance runners, this means they need to be maneuverable; they can modify their pace rapidly in response to tactical changes and possess sufficient speed, acceleration, and agility abilities to get themselves out of tight spots. The flip side of this is that repeated accelerations and changes in pace are relatively expensive from a metabolic perspective. Utilizing training sessions that enable the athlete to develop their ability to change pace quickly and efficiently is therefore important. As an example, instead of running a session of, say, 400m repeats at a given target pace for the whole distance, it might be worthwhile to vary the target times for each 100m split, both within the individual rep (e.g., 14 seconds for the first and third 100m, 12 seconds for the second 100m, and then 15 seconds for the last 100m) and between reps (e.g., rep 1 has a fast first and third 100m segment, while rep 2 has a fast first and last 100m segment).

Boyd’s method of training fighter pilots in line with his newly developed theory was to have a student get on his tail and then attempt to throw them off. The longer the student could stay in the firing position directly behind him, the better they were. Again, this could be used in training for middle distance runners: in training sessions where a group is undertaking training reps together, they could have different roles—one is tasked with setting the pace, one with sticking with him, and one to try and block off any counter moves.

Boyd’s method of training fighter pilots in line with his newly developed theory was to have a student get on his tail and then attempt to throw them off, says @craig100m. Share on X

This is in line with Boyd’s key practical take-homes from his Energy-Maneuverability Theory:

• Having pilots consider their movement options in terms of airspeed while also considering the countermoves available to the enemy pilot.
• Being able to anticipate those countermoves.
• Maintaining sufficient airspeed in order to counter the enemies’ countermoves.

For a middle distance runner, this means understanding their various movement options during a race, the movement options available to their competitors, and how to counter their opponents’ moves and nullify their strengths, under the stress and pressure of a race situation.

The OODA Loop

Boyd’s most famous creation, the OODA loop, stands for:

• Observe
• Orient
• Decide
• Act

Here is the OODA loop in diagrammatic form:

This figure makes it look complex, but in essence the OODA loop describes what happens in support of effective outcomes. First we observe what is going on, then we orient ourselves with this information and our own knowledge before making a decision, which we then act upon.

First we observe what is going on, then we orient ourselves with this information and our own knowledge before making a decision, which we then act upon, says @craig100m. Share on X

In air-to-air combat, this would be watching an enemy pilot’s movements, orienting ourselves to their approach (what are they doing and why), making a decision around what to do (e.g., gain altitude), and then carrying out the action. But OODA is a loop, which means we then restart the process: how did the enemy pilot respond to our actions (observation)? The enemy pilot also has their own OODA loop. They watch what you’re doing, orient themselves to your actions, make a decision, act, and then repeat the cycle depending on how you act. The key to success, according to Boyd, is to have a tighter OODA loop than your opponent—you need to be able to observe, orient, decide, and act quicker than they can.

If you’re able to do this, then you can respond to their actions much quicker than they can to yours, leading them to confusion as they try to catch up.

OODA Loop in Running

As you might now be guessing, the OODA loop can be utilized in a tactical middle-distance race. At the start of the race, we look at the start list, understanding the athletes we’re racing against (observation). We then use our prior knowledge of these athletes (their strengths, weaknesses, and tactical preferences) to understand their potential game plan and develop our own approach (orientation). Then, we make a decision on our tactical approach for the race, based on the information worked through in orientation, before starting to deliver that tactical plan in the race (action).

Crucially, however, the process is not finished; we then have to observe the tactical behaviors of our opponents, orienting their actions with both their and our own plans, and then making decisions about how to respond to their movements. Being able to observe-orient-decide-act quicker than our opponents puts them on the back foot; perhaps they don’t respond to a breakaway quite as quickly and so are dropped, or find themselves boxed in close to the inside of the track. As such, middle distance racing is not just a physiological problem to be solved, but it also has a cognitive, decision-making component, which has to be delivered quickly, while fatigued and under stress.

Being able to observe-orient-decide-act quicker than our opponents puts them on the back foot, says @craig100m. Share on X

Understanding this then dramatically changes how you might design training sessions, because now you have to prepare athletes to make tactical decisions quickly—which involves increasing the library of tactical choices available to the athlete, as well as their ability to think. Similar to Boyd’s Energy-Maneuverability Theory, we can even match tactical behavior with physiological requirements: can our athletes respond physically to the change in tactics that unfolds during the race?

As there are four different stages to the OODA loop, there are four different places that mistakes or errors can occur:

1. Errors of observation: the athlete might be fixated on one particular athlete and miss another’s tactical move. Conversely, they might not be tuned in to the need to observe what is going on, and simply don’t have the awareness that they need to be paying attention.
2. Errors of orientation: they are unable to adequately understand what is happing in the race—or to do so in a sufficiently speedy manner—and so then cannot make the right decision. Experience likely plays a large role here; more experienced athletes will have found themselves in a wider variety of situations and will have undertaken more orientations under these circumstances, allowing them to become oriented quicker than novices. Exposing athletes to different tactical scenarios, either through racing or training, is therefore an important part of developing a tighter OODA loop.
3. Decision-making errors: they have all the information through the observation and orientation stages to make the right decision, but they don’t. Again, this can be down to a lack of experience, further underpinning the need to expose athletes to a variety of different situations that require different decisions be made. Feedback as to the effectiveness of any decision made by the athlete is also important in supporting their development.
4. Action errors: in middle-distance events, these are likely to be due to a lack of physical ability (e.g., speed, endurance, agility) to make the required movement—further underpinning the link between physiological and cognitive processes in racing.

Final Thoughts

After Boyd retired, his ideas began to gain traction is the US Military. Dick Cheney, the US Secretary of Defense during the first Gulf War, had met with Boyd many times, and these meetings factored into the development of US Military strategy during the conflict. The US forces were highly agile; they had multiple thrusts against the Iraqi forces which, when combined with deception operations, caused the enemy to struggle to understand what was truly happening and become slow in their decision-making. US forces were able to “get inside” the OODA loop of the Iraqi forces, which enabled them to operate at increased tempo.

It took years for Boyd’s ideas to become accepted, but following the success of the F-16 fighter and military tactics in the first Gulf War, his approach has become far more accepted. There’s something for all of us involved in sport to ponder here—who has ideas or ways of thinking that are truly innovative (and likely not currently accepted), and how can we utilize these ideas before our competitors do? Finally, it took over 30 years before Boyd’s ideas influenced military strategy—can we afford to wait as long in sport?

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

The high school space may be the fastest growing and most controversial place for the use of velocity-based training. This shouldn’t be a surprise, considering high schools probably have the widest range of coaching philosophies, experience, and education in the field of human performance, as well as a wide variance in athlete skill and training age.

The argument that an advanced protocol like VBT has no place in training for developmental athletes at the high school level is a strong one. Although more-experienced high school athletes may reach a point where they are ready for advanced technology, is it really necessary for the majority of student-athletes to dip into the technology pool? The relative ease of pushing a strength adaptation through simple, slow-paced progressive overload makes it easy for many coaches to dispel the idea of using an additional tool in that process.

There is no doubt that traditional progressive overload will get you where you want to go, just as I can eventually get to California by hopping in my car and starting to drive west. The optimal way of making that trip, however, is to use a map to get there as fast and directly as possible. Leave the old, folded-up map behind and upgrade my tool of choice for this trip to my phone equipped with GPS? Even more precision and saved time.

I propose that not only is VBT something that can be used to optimize the training of your advanced athletes, but if used correctly, it can become an indispensable tool in the development of your student-athletes.

Technology for All Levels

The common misconception with technology such as VBT is that it can only be useful for higher- level, more advanced athletes. In my experience, however, the coach implementing the technology is most often the limiting factor in that situation. The time to use VBT (or other technologies) isn’t when the athlete is strong enough or fast enough or when they have reached a certain randomly-selected training age—it’s when the coach is experienced enough, talented enough, and willing enough to be a great practitioner and excel at the art of coaching.

The time to use VBT is when the coach is experienced enough, talented enough, and willing enough to be a great practitioner and excel at the art of coaching, says @YorkStrength17. Share on X

The key factor is to understand that velocity-based training is a tool. Webster’s definition is fitting: A tool is a device or implement used to carry out a particular function or aid in accomplishing a task; a means to an end. As a tool, VBT can carry out the particular function of optimizing training and accomplish a multitude of tasks that help the coach build precision and intent while assisting the athlete to become more technically sound (at least when utilizing Vmaxpro).

VBT helps us to weaponize and gamify the means to all of our ends in this field: transfer of training in an optimal manner. One of the big advantages of using Vmaxpro over other devices is it truly helps the athlete understand the why behind their training. But that why—as well as the how—must already be mastered by the coach or else VBT is a tool best left in the toolbox, regardless of the level of the athlete.

Bar Path Is a Big Deal

There was definitely a time that I too believed using VBT was just for my most advanced athletes from a leveling perspective. That changed after a face-to-face conversation with one of my mentors in the field, who told me that using a velocity floor would allow athletes with lower training ages to find optimal loads for strength training without rushing these inexperienced lifters into a 1RM test. Learning how to train with heavier loads with a guidance system and a way to place a governor on exactly how intense the workout can get is useful in the development of less-experienced athletes. That conversation sent me on a quest to find a method to use VBT technology as a teaching tool and an important part of our overall progression.

When I was introduced to Vmaxpro, within minutes of using the product I recognized that not only could we use the device as a way to set loads and teach intent, but also as a way to teach technique and educate the athlete. Vmaxpro provides instant bar path and bar displacement feedback; not only instant, but with video-game-like graphics.

I had been told about the bar path feature prior to use, and at first, I honestly didn’t think it was that big a deal. My experience with bar path was mostly with the Coach’s Eye app and Olympic lifts: It was time consuming and individualized, and the post-workout feedback made that a less than optimal tool when dealing with team sport athletes. I quickly recognized that instant bar path feedback during the workout could be a seriously powerful tool in the development of our young athletes.

I quickly recognized that instant bar path feedback during the workout could be a seriously powerful tool in the development of our young athletes, says @YorkStrength17. Share on X

The device itself can act as an assistant coach simply by providing technique feedback. If we teach our athletes how to use this tool, it allows the process to be less coach-driven and more athlete-driven, even from a technical aspect. I could use this feature to meet my athletes where they were.

The VBT Hook

My first step in developing my process of using VBT as a big part of our progressions for younger athletes grew out of a process that I had already been using but felt VBT could optimize. I was in the process of transitioning our freshman football players from the 1×20 program they had been following since middle school. We work our athletes from 1×20 to 1×14 to 2×8. Eventually, we begin to split off our “big rock” movements into a modified tier using a 5×5 progression.

Day One of that week, I told our athletes that we would be doing sets of five and working up to a 5-rep max—they were excited, as this was the first time I was going to let them load the bar freely and work up to a true rep max lower than 8. The caveat, however, was that I would be attaching a device to the bar that would give us the “speed” the bar was moving. They were allowed to load the bar until their set average was .35 m/s.

Of course, at that point, they all looked at me and had no idea what I was talking about. Mostly, they were just happy I had used the word max. So I let them get to it. As we all know from working with teenage males, they have one goal when lifting: put as much weight on the bar as possible. After a couple sets, I could already see the velocity dropping, so I stopped the entire group.

It was time to educate them.

I gathered them in and asked, “what did you notice happening with the number popping up for each lift as we added weight?” Soon, a hand went up. “The number goes down the more we add.” Hook #1 in place. “So, if .35 is the lowest we can go, how can we make sure we lift the most weight for five reps?” Soon a hand went up again. “We need to make sure we are moving the bar as fast as we can.” Boom. In that instant, every athlete (whose single purpose that day was to lift as much as they could, same as every day) realized that intent mattered. The faster they move the bar, the more weight they can add.

The impact was immediate. I let them go through another set before I stopped them a second time. Hook #2 is the real secret sauce, and it was time. I called the group back again and pointed to the TV screen, which was mirroring one of the iPads. On the screen, I had the bar path from an athlete for a few back-to-back reps: one rep where the bar path was outstanding and one that was not so good.

“So, this is two reps, in the same set, from the same athlete at the same weight. We already know that the heavier the weight, the slower the velocity, correct?” I asked, and all the athletes nodded. “Well then why is one rep .54 m/s and one .44 m/s? Did he get weaker really fast? What’s different?” There was silence for what seemed like 30 seconds, before one of the guys said “Coach, the line is different. The faster the rep is, the more up and down.” Boom. Again. He had said exactly what I hoped he would.

“What’s that mean when it comes to adding as much weight to your 5-rep max as we can today, guys?” I asked. The answer changed the game for our young athletes. “It means if we use better technique but move the bar as fast as we can, we can lift the most weight possible.”

Within five minutes, we had a room full of ninth-grade males watching the bar path and talking bar speed, discussing technique and how to load the bar optimally, says @YorkStrength17. Share on X

Our athletes only cared about how much they could lift. As coaches, we mainly cared about technique and intent. By making those two things very important in the eyes of the athlete, we had met them where they were. Within five minutes, we had a room full of ninth-grade males watching the bar path and talking bar speed, discussing technique and how to load the bar optimally. Educated and motivated athletes who care about the things that will actually transfer to the field is a powerful place to be.

Squat Depth Made Easy

The very next workout, we decided to ramp up our squat progression. This was not by choice—our head coach asked me to provide him a pathway to get a 1RM back squat number on all our players, including our freshmen. While I had my concerns, we went forward. I knew the Vmaxpro would be a powerful tool in moving our freshman football athletes into the full use of the barbell bilateral back squat: not only would bar path play a huge role, but the live bar displacement feedback would as well. The bar displacement metric would allow us to set a numerical metric for a mutually agreed upon parallel squat depth.

We began our warm-ups with an empty bar, and I had each athlete squat to a depth that they, their rack team, and I all agreed was an acceptable depth. We then had them get to that depth while staying in a ribs stacked position dictated by the live bar path feedback. Not every athlete can get into a perfect, stacked squat but you can ensure optimal performance and spot weakness that may lead to excessive lean and potential injury issues by using bar path as a tool.

We followed a very similar process to the previous session, allowing the athlete to load the bar based on a .35 m/s set average floor. One of the things we agreed upon as a staff was that we would stop each athlete at “technical failure.” Using the feedback from the Vmaxpro to not just set or project load, but also to assess for the squat depth and technique, we were able to judge technical failure with a precision the naked eye does not provide. The coach, the athletes, and their training partners can actually see on the screen where performance begins to drop below the desired level for that session.

Using the feedback from the Vmaxpro to assess for the squat depth and technique, we were able to judge technical failure with a precision the naked eye does not provide, says @YorkStrength17. Share on X

The biggest takeaway from this way of using VBT is we do not just present the athlete with the output and say “get to .35 m/s.” We also teach them the why behind the process that gets them to that final output. They learn very quickly how to look at the feedback and adjust to train with optimal technical skill and intent. Simply providing them with a video of themselves and the velocity and/or power outputs is no different than popping on game film for football players who you have not educated on the process of learning from film study.

Moving Forward in the Progression

Now that we have educated and motivated athletes who understand how to use the feedback, we can move to the next step in our progression for the intermediate athlete: using APRE (autoregulatory progressive resistance exercise) combined with VBT to take strength development to new heights.

We run our 5×5 program using just the mean velocity to adjust loads and let the athletes get the feel for how VBT works. Now, we want to add one more layer to that. We have the athlete work up to their previous 5RM at a .35-.45 m/s range. (We moved to ranges from floor for this step, as it is much easier for the athlete to get to that range than to an exact number.) They have three sets of five to get to that goal load using this protocol:

We use the Vmaxpro to measure sets 3 and 4. Set 3 is used as a monitoring set. We tell the athlete if they are above .55 m/s or below .40 m/s on that set to let us know so we can discuss a potential adjustment to the original goal. This is just another important step in the education of our athletes on the VBT system.

We use 85% as the projected goal to start the process, but once we have a goal weight based on mean velocity and adjusted, we simply use that as the goal weight for set 4 of the following week. This combination of VBT and APRE has proven to be a superior process for driving the strength adaptation process for our intermediate athletes.

Once they reach set 4, they will do a maximum of seven reps that must be above .35 m/s. Once they either drop below that velocity or hit seven reps above it, they use the following chart to adjust their load for their final set of five reps. They DO NOT use Vmaxpro for set 5. They simply use it to adjust and attempt to get five reps at that adjusted load.

If they make five reps? Then that is their goal weight for next week’s set 4. If they do not? Then set 4 remains the goal weight for the following week.

Bonus Material

We run that 5×5 program for our “big rock” movements of squat, hex bar pull, and bench press for most athletes until the end of their sophomore year, when they move into our advanced level. During that time, we begin to add in some “bonus” material that helps to tighten up the athletes’ experience even more.

Percentage of Time of Acceleration

The Vmaxpro not only builds out a velocity profile for each athlete and each exercise, it does so for each individual repetition. What we can get from that information is what percentage of the rep the athlete is actually accelerating the bar. The developers of Vmaxpro informed me that based on the studies they have done, the sweet spot for acceleration of the bar producing the best outputs of velo and power is at or above 70% of the total time of the rep.

The developers of Vmaxpro informed me…the sweet spot for acceleration of the bar producing the best outputs of velo and power is at or above 70% of the total time of the rep, says @YorkStrength17. Share on X

While this isn’t as quick to look at live as bar path or displacement, it has proven valuable for me as a coach to follow behind and quickly check to see which athletes are finishing their rep and which need additional cueing or help. My go-to cues are:

• Throw your fist through the ceiling on bench press.
• Squeeze the glute at the top of the squat.

In our situation, both of these have shown to improve the bar acceleration time. As your athletes begin to get closer to “strong enough,” and you begin to slide their programming more from the force side of the force velocity curve to focus on speed and power, they will be ahead of the game from a power development standpoint with this technique.

Using “Peak Power” to Drive Intent

Some may argue that peak power is not a great metric to use in a strength movement. My answer is “back to your lab.”

Peak power is a GREAT metric from a practical standpoint and highly effective in developing powerful athletes. While I would agree that peak power is not something we want to use to drive adjustments or loading parameters, it’s what mph is to speed development—and, true, some coaches are not fans of that either. I say who cares what they think. Mph is not a metric we use to drive any programming, but it is one that the kids love and want to see increase. Show me an athlete who has been stuck at 19.7 mph and breaks that 20 mark for the first time, and I will show you a highly motivated athlete.

Peak power on a strength lift is the same. It’s a motivational tool that drives them to move the bar full of plates as fast as possible. If they do that chasing peak power, but mean power, mean velocity, and projected 1RM all increase, then why in the world would I not utilize that?

Peak power on a strength lift is like mph for speed development—a motivational tool that drives athletes to move the bar full of plates as fast as possible, says @YorkStrength17. Share on X

With Vmaxpro, you can get metrics on up to two data points per rep recorded. In our strength movements, we track mean velocity (0.81 m/s in top rep of image 7 below) and peak power (2,172 w in same rep) on the instant feedback screen in the app. Guess which one gets the kids the most excited? Speed kills and our athletes see peak power as speed. As a coach, I use the mean velocity as a metric to drive adjustments. Peak power is the metric that drives intent in our kids.

While I have no idea exactly what a great peak power is globally, I do know what we are seeing. Anything over 2,000 watts has proven to be a great number for our athletes. When they hit that, it brings a similar reaction to a sub 1.0 fly 10 or 4.5 40-yard dash. Pure excitement, some fun-loving trash talk, and now a positive part of our team culture.

As with any technology, the key to using VBT doesn’t solely lie in the experience of the athlete. It truly depends on the coach and the coach’s ability to not just use the tech but understand why they are using it and how to use the metrics and data feedback to improve and optimize the athlete’s experience.

This article is not a comprehensive look at how I use VBT, nor is it a user guide to all the features of the Vmaxpro. This is just a snapshot of both that I hope inspires coaches to either utilize their knowledge or pursue the capability of not just using VBT but making it a friend and ally in the pursuit of optimal performance for all levels of athletes in your program.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Should there be different approaches to rehabilitation for elite athletes, weekend warriors, adolescents, and sedentary individuals?

At the most basic level, objective data is gathered and combined with subjective reporting and then tested against a hypothesis. This process is repeated again and again until hopefully something changes—at which point the process continues, but the intervention changes. Through this application of the scientific method, which has worked over and over and over in both medicine and science, high-level college and professional athletes around the world get back on the court, pitch, or any field of play.

Why, then, are the steps we take to rehabilitate non-elite athletes different?

There are a host of reasons I’ve seen reported by patients and clinicians as to why this method isn’t used and, subsequently, progress in rehab is not attained. Over the course of the last 15 years, I have worked in private practice with youth and recreational adult athletes, the geriatric population with a variety of diagnoses, and higher-level athletes who were specifically rehabbing to return to sport. Most recently, I have spent my time at the Hospital for Special Surgery in New York, where I have focused on the treatment of the hip and lower extremity in an active population that includes everyone from recreational adults to professional athletes at the highest levels.

Due to constraints of insurance, patients traveling nationally or internationally to come to HSS, season demands, and coordination with care teams, I can have anywhere from one to 12 sessions over 3-4 months to evaluate and treat these patients. Regardless of who comes in or how long they will be with us, it is critical to gather information that we will use to evaluate and treat them as efficiently as possible.

Addressing Challenges to the Rehab Process for Non-Elite Athletes

Time, money, insurance coverage, motivation, staff availability, and facility limitations all present challenges for the practitioner. These are all valid, but are they insurmountable? Let’s break a few of these down further.

1. Time

The time allotted for a follow-up session of physical therapy in an in-network setting is somewhere in the ballpark of 10-30 minutes of 1:1 care. In that time, the therapist must:

• Get a subjective assessment.
• Test objective measures.
• Assess what, if any, alterations to the plan of care need to be made.

Of course, the overall length of the session is longer, but the amount of undivided attention available after the initial 10-30 minutes is minimal; hopefully, the patient has been put on a path to success and can execute the goals of the session. In an out-of-network or cash-based clinic, the amount of time spent 1:1 is likely higher, but the formulation of the plan must come somewhere in the beginning of that session and needs to be efficient to make sure time—the most precious commodity of all—is not wasted.

2. Money

This is not too different from time, and here again the number of immediately available tools for the treatment of the non-elite athlete may not be as broad as one would like. Access to the combination of force plate testing data, Biodex® isokinetic testing, power testing, and dynamometry (or a similar battery of instruments) is often financially out of reach.

3. Insurance Coverage

This may need the least amount of explanation, but requesting authorization, submitting reauthorization, peer-to-peer calls, and letters of medical necessity all stand in the way of what clinicians actually want to do—which is deliver a high level of care to their patients and get them better.

4. Motivation

This is where things get interesting. Patients are typically very motivated to get better at the start of their care: how could they not be? They can’t do the thing they love, want, or need to do.

However, once they begin to improve and their function increases just enough to accomplish some of their responsibilities in life, rehab becomes a bit less of a priority both in and out of the clinic. It becomes incumbent upon the clinician to find ways to keep patients engaged and moving in the right direction, which takes a toll and often leads to diminishing results and patients falling off the schedule.

The ability to have specific numbers for the percentage of deficit when speaking to coaches, MDs, and insurance companies has proven to be very valuable. Share on X

Clearly, patients truly do want to get better, and clinicians truly do want to help them, but questions remain:

• Why do daily performance and rehabilitation and progress notes lack objective measures that can help guide the care of these patients and help further the case for insurance coverage beyond the initial six sessions that insurance companies (and sometimes patients themselves) think they need?
• Why is objective data for returning to sport taken sporadically and usually measured later in the rehab protocol without comparable data?
• Why do clinic owners invest in cumbersome, non-integrated measurement tools that are difficult to implement during the course of a follow-up session and may not give the specific data clinicians are looking for?
• Why does the interpretation and presentation of this data to clients, MDs, and insurance companies often look like an Excel spreadsheet rather than the kind of colorful and easy-to-follow PDF we can get from a kiosk at a drugstore when choosing orthotics? 

Finding Tools That Combine Performance and Rehabilitation

For many years, I had these frustrations, and I have used many hardware and software solutions with varying degrees of success. Products like the MicroFET®, Lafayette Hand-Held Dynamometer, and Biodex® are all reliable and valid and have stood the test of time. In my practice and in the practice of the clinicians around me, however, it’s very difficult to get user adoption due to time, training, data collection, and delivery. This leads to most of this equipment being bought and then lying in a drawer or taking up a corner of a clinic without being used regularly.

That said, Biodex isokinetic testing is unmatched in its ability to measure specific metrics, and it continues to be used for both practical and research purposes.¹ However, for the purpose of systematically testing patients as a part of their follow-up sessions, it is a bit too time-consuming—not to mention that unless you are a part of a research or teaching institution, the likelihood that one is available to you is low.

Over the last decade, there has been a significant increase in the crossover between performance and rehabilitation products, and companies like VALD Performance have come out with suites of outstanding products to measure strength, acceleration, and power. One major downside is the cost of both hardware and software. Another, which is more clinical, is that the standardization of strength testing with the force frame also limits the positions available to test and does not provide an option to test pull strength—rather, it opts for push dynamometers.

I have used these devices, and as I said, they are all very capable in their own right, and some are even the gold standard. However, in the context of a 10- to 30-minute session—or in the timeframe of testing and re-testing within a longer session—they are limited. The final and maybe most unique limitation is that all this hardware is used overwhelmingly for testing or measuring. It is limited in its ability to apply this data to engage and train the patient/client, making it a bit one-dimensional.

Through a fair amount of trial and lots of error I was able to find Kinvent, a French company that delivers on a very good idea: create a more efficient and effective way for clinicians to measure and implement objective data, then pair it with an easy-to-use iOS and Android app.

Kinvent has designed biofeedback games into the app so that clients and clinicians are able to use the data they have collected to exercise and develop the given body part or movement. Share on X

Having used non-connected, handheld dynamometers before, I was very happy to see max force, averages, rate of force development (RFD), and eccentric load all in real time on Kinvent. Once the app is opened, you can choose to activate a device in “quick” dashboard mode to simply take a measurement without linking to a patient, or you can link a test or combination of tests to a particular patient to track their progress.

Audio and video cues for starting and stopping help the clinician and patient/client progress through the testing, and a report is generated as soon as you’re finished. The other appealing feature is that you are limited only by your creativity in applying the devices. Utilizing the pull dynamometer, Link, you can measure isometric quad strength in patients with anterior knee pain and patella femoral dysfunction, as well as following surgical knee intervention. This has been found to be a key predictor of pain and function.² Similarly, the pull or push dynamometers can be used to measure shoulder external rotation strength when treating non-operative and postoperative shoulder pain (again, a key factor in improving shoulder function and mechanics).^3-6

As we return patients and clients to standing dynamic exercise and function, it is critical that they are able to distribute weight evenly and produce both concentric and eccentric force without deviation and pain. The utilization of force plates to assess this has been established in the literature⁷, and Kinvent’s solution with the “Plates” and the “Delta” allows you to test a wide range of movements quickly and effectively, including squatting, countermovement jump (CMJ), drop jump, single leg hopping, and so on. Further, the push dynamometers can be paired to assess more complex parameters like eccentric hamstring strength using a Nordic testing protocol, which has been shown to assess the risk for injury.⁸Finally, the force plates can be used to assess upper body stability and power using the push-up test⁹ as well as the ASH test for shoulder stability¹⁰.

If that were all Kinvent offered, it would be a very well-rounded suite of integrated hardware and software. Kinvent takes things one step further, however. They have designed biofeedback games into the app so that clients and clinicians are able to use the data they have collected to exercise and develop the given body part or movement. Based on the clinician’s reasoning, they can customize the exercise for the most appropriate amount of load for the patient or client, creating a safer and more effective exercise prescription. The result is a highly efficient and effective testing and treatment protocol.

Having used these Kinvent tools for about a year, I have noticed several things about the technology. First, it is not an alternative to taking a good history and gathering subjective and objective measures through interview, special tests, and measures. It is, however, a much more streamlined way of gathering objective strength, motion, balance, and power data during a session. By no means is it the only piece of equipment I use to assess, but the ability to have specific numbers for the percentage of deficit when speaking to coaches, MDs, and insurance companies has proven to be very valuable.

The Kinvent suite is a much more streamlined way of gathering objective strength, motion, balance, and power data during a session. Share on X

The buy-in from patients has also changed. Patients are now easily able to access their own medical record, and athletes look at how they compare to themselves and others as they train.

It’s become more important than ever to track progress and keep everyone on the same page. It is not just what we’re doing, but why we’re doing it. The objective data that backs up the why is critical to success. There has always been and will continue to be some resistance to the addition of more technology into the patient experience, but when the technology allows a clinician to evaluate and treat the patient more efficiently and effectively, it’s worth trying.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

References

1. Zawadzki J, Bober T, and Siemieński A. “Validity analysis of the Biodex System 3 dynamometer under static and isokinetic conditions.” Acta of Bioengineering and Biomechanics. 2010;12(4):25-32. PMID: 21361253.

2. Palmieri-Smith RM and Lepley LK. “Quadriceps Strength Asymmetry After Anterior Cruciate Ligament Reconstruction Alters Knee Joint Biomechanics and Functional Performance at Time of Return to Activity.” American Journal of Sports Medicine. 2015;43(7):1662-1669. doi:10.1177/0363546515578252

3. Wilk KE, Andrews JR, Arrigo CA, et al. “The strength characteristics of internal and external rotator muscles in professional baseball pitchers.” American Journal of Sports Medicine. 1993;21:61-66.

4. Reinold MM, Escamilla RF, and Wilk KE. “Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature.” Journal of Orthopaedic & Sports Physical Therapy. 2009;39:105-117.

5. Clarsen B, Bahr R, Andersson SH, et al. “Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study.” British Journal of Sports Medicine. 2014;48:1327-1333.

6. Uga D, Nakazawa R, and Sakamoto M. “Strength and muscle activity of shoulder external rotation of subjects with and without scapular dyskinesis.” The Journal of Physical Therapy Science. 2016;28(4):1100-1105. doi:10.1589/jpts.28.1100

7. Lake J, Mundy P, Comfort P, McMahon JJ, Suchomel TJ, and Carden P. “Concurrent Validity of a Portable Force Plate Using Vertical Jump Force-Time Characteristics.” Journal of Applied Biomechanics. 2018 Oct 1;34(5):410-413. doi: 10.1123/jab.2017-0371. Epub 2018 Oct 11. PMID: 29809100.

8. Wiesinger HP, Gressenbauer C, Kösters A, Scharinger M, and Müller E. “Device and method matter: A critical evaluation of eccentric hamstring muscle strength assessments.” Scandinavian Journal of Medicine & Science in Sports. 2020;30(2):217-226. doi:10.1111/sms.13569

9. Hashim A, Ariffin A, Hashim T, and Yusof AB. “Reliability and Validity of the 90º Push-Ups Test Protocol.” International Journal of Scientific Research and Management. 2018;6(06). 10.18535/ijsrm/v6i6.pe01.

10. Ashworth B, Hogben P, Singh N, et al. “The Athletic Shoulder (ASH) test: reliability of a novel upper body isometric strength test in elite rugby players.” BMJ Open Sport & Exercise Medicine. 2018;4:e000365. doi: 10.1136/bmjsem-2018-000365.

In the world of strength and conditioning for football, the true definition of “conditioning” has been lost. A lack of understanding for the true demands of the game runs rampant, as these prehistoric prescriptions of “conditioning” fail to solve the problems of football fitness that are associated with robustness and performance in the sport. How many 110 tests and 300-yard shuttles does it take to see that we, as S&C coaches, are not coming close to the metabolic or mechanical demands that sport will determine as fit?

As Tony Holler says, it’s easy to get someone tired, but does it serve the purpose of preparing the athlete for the game?

Let’s look at the root of the problem and acknowledge that most S&C coaches don’t truly comprehend the definition of the word “conditioning.” According to Webster, conditioning is to: “train or accustom (someone or something) to behave in a certain way or to accept certain circumstances.” The key words in this definition are accept certain circumstances, as this idea that coaches are conditioning for games is insane!

Football players practice four times the amount that they play. It is naive to think that the full residual effects of our summer training will still be in place five weeks post-summer. S&C coaches have a responsibility to bring these athletes into a desired state where they cannot only withstand a practice but thrive in it!

Coaches recruit speed, but then encourage training programs that not only dampen speed and power but increase injury risk by not preparing the player for the speed & violence of the game. Share on X

Many components of training are missing in the traditional run them into the ground approach. Football is a game of repeat speed bouts and repeat explosive bouts, yet we don’t identify these abilities as “conditioning.” Games are won with explosive plays by explosive athletes. Coaches recruit speed, but then encourage and welcome training programs that not only dampen speed and power but increase injury risk by not preparing the players for the speed and violence of the game. Plyometric exercises are as much conditioning as running 110’s, and a modern approach will consider two crucial factors for each position prior to prescription of conditioning means:

1. Metabolic demand of the position.
2. Biomechanical demand of the position.

Key Factors to Assess

To know how to condition, the S&C coach must know what is happening in practice. An in-depth analysis of the specific practices your organization conducts must be performed. Communication on the ebb and flow of practice from the head football coach is a necessity prior to planning out a training program.

The following general components will give the S&C coach the perspective they need:

• Duration (total time on the field)
• Time of day (determine sun exposure)
• Dress of the day (collisions increase stress)
• Type of offense/defense (main factor determining metabolic stress)
• Tempo of practice (two spot: running plays with the ones and twos simultaneously/recovery times between reps in individual periods)
• Depth of position groups (how many athletes will determine rep count)

This alone will only provide the S&C coach with a piece of the puzzle. Remember, it’s the S&C coach’s responsibility to elevate the athlete into a desired state to perform at a high level, not just survive. Understanding positional differences is crucial in the preparation process. Football is a game of many games. The demands are not the same throughout—in fact, they are very different. O-linemen and D-linemen play in a 10-yard box, whereas a DB may cover up to 80 yards on a given play.

Remember, it’s the S&C coach’s responsibility to elevate the athlete into a desired state to PERFORM at a high level, not just SURVIVE, says @CoachJoeyG. Share on X

The problem manifests itself in the fact that there is a disconnect between general off-season training and skill development. A great painter paints every day—meaning, if you want to become better at any activity, there must be deliberate practice of that activity.

As a reminder, the definition of conditioning is to become accustomed to certain circumstances. How can a player become accustomed to the demands of their position if they only practice the skill in camp and in-season? The strength and conditioning coach must develop the underlying abilities of sports skill such as speed, strength, and power. Just developing general abilities and hoping that they transfer is like playing Pin the Tail on the Donkey in the dark. Have periods of planned skill development through exposures to game movements and situations.

S.A.I.D. and Energy System Development

The beauty of programming is that there are scientific principles that govern decisions (or there should be). One of these gives us the answer to the question in the above scenario: the S.A.I.D. principle (specific adaptation to imposed demands). In its simplest form, the S.A.I.D. principle holds that the athlete’s body will adapt and become more robust to the training element it is most frequently exposed to.

So, in the absence of exposure to the most important training element, coaches can’t expect their players to be “in shape” for the actual training stimulus. S&C coaches are scared to give up “their” time to increase specific skill development for fear of feeling less valued. There must be a harmonious relationship between all coaches, as the end goal is to produce better football players and win more games.

Having an open mind to ideas and advice from the sports coaches themselves will only benefit the S&C coach and the players. Alex Bliss and Rob Harley stated, “Strength and Conditioning Coaches are encouraged to work closely with skills-based coaches in the development and implementation of appropriate small-sided games to help enhance and maintain aerobic fitness while affording physical and technical benefits.”

It’s the S&C coach’s responsibility to not just elevate general athletic qualities, but also increase robustness for the game—and the only way to do this is by exposure to regressed versions of the game. Most coaches have experienced that moment when they’ve looked around practice at the players looking gassed on day 1 and wondered how do we look out of shape with all that running we did during the summer training phase?

This all comes back to the fact that conditioning for football is more than just volume. Intensity can crush players. Coach Tom Myslinski, longtime NFL S&C coach for the Jaguars, has said: “the intensity and deliberate practice of NFL practices crushes rookies because they have never been exposed to these elements.”

This basically states that small-sided games provide growth in specific skill development and in specific fitness levels of the sport. Start with general modalities and work toward specific modalities. The puzzle becomes how to incorporate small-sided games (conditioning for specific energy system development) and technical/tactical development into your micro cycles to be compatible with the speed and power training performed in the week.

The puzzle becomes how to incorporate small-sided games and technical/tactical development into your micro cycles to be compatible with the speed & power training performed in the week. Share on X

We utilize a high/low approach where we stack our conditioning days (small-sided games) on Tuesday and Friday prior to off days. Though the volume is higher on these days, the intensity is lower, which gives great complementary training stimuli throughout the week and does not cause interference with speed and power training being performed on Monday and Thursday.

Conditioning for football is not implemented just to increase the aerobic state of the athlete. Yes, aerobic capacity will play a huge part in the replenishment of ATP throughout the duration of practice, but if the coach focuses solely on this biomotor ability, several other issues will arise. Fatigued is defined as one’s inability to maintain a desired intensity, or the body’s ability to replenish energy sources for a given rate of work. If the preparation lacks intensity, the athlete will not be prepared for the degree of stress and will look unfit when exposed to intensity in competition.

There are many examples of this, as the start of camp yields a plethora of cramps and soft tissue injuries. Conditioning supports the athlete’s ability to be explosive repeatedly, but the athlete must train explosive to raise power and speed abilities as football fitness rises. You are what you train most, so depleting metabolic resources solely on conditioning will have a negative effect on what wins games: explosive ability.

You are what you train most, so depleting metabolic resources solely on conditioning will have a negative effect on what wins games: explosive ability, says @CoachJoeyG. Share on X

The practice of building a base has been around since the creation of training, but a base is the foundation of something: meaning it is a remedial version that lacks the intensity of the event one is working toward. Due to its lower intensity, the base can be performed at a much higher volume. This is applicable as the S&C coach starts to program and prescribe volume to specific training elements.

Understanding the Two Factors Affecting Fatigue

Fatigue is multifaceted, as there are two types of fatigue: CNS and peripheral.

“Central nervous system fatigue, or central fatigue, is a form of fatigue that is associated with changes in the synaptic concentration of neurotransmitters within the central nervous system (CNS; including the brain and spinal cord) which affects exercise performance and muscle function.” (Davis J. M., Bailey S. P. (1997)). This is the intensity! To prepare the athlete for practice and be conditioned is to expose them to similar levels of intensity that will stimulate the nervous system in a way that will cause similar fatigue levels.

Looking at the chart of Al Vermeil’s hierarchy of athletic development (figure 6), training, speed, reactive strength, and explosive strength should hold more importance when planning the buildup of sport-specific fitness levels. Injuries happen at fast speeds, not at a jogging pace. Training speed and explosive abilities conditions the athlete for the tissue stresses of practice, serving as a multi-purpose function of the training process.

Video 1. Speed training is conditioning (an accumulation of high-speed demands).

It’s extremely important to understand the intensity requirements of each position group, because this is more important than just accumulating lower-intensity volumes. The athlete must be accustomed to these stresses before they set foot in the practice itself. Creativity in training comes from researching the actual demands of the game for each position. There can be no purist when it comes to increasing the durability of a football player.

Creativity in training comes from researching the actual demands of the game for each position. There can be no purist when it comes to increasing the durability of a football player. Share on X

During the course of a single practice, football players are exposed to all three elements in the above chart from Charlie Francis (figure 7). Saying it is only alactic is missing the boat—alactic abilities can determine performance, but only if they are sustainable throughout the game. Aerobic development and glycolytic development are paramount for football players to thrive in practice. To say a football player will not be exposed to extreme levels of lactate is to not understand practices. Lactate training isn’t the devil and is unavoidable in the sport. Take a player’s mmol levels after a no-huddle, 10-play drive and see if lactate training is necessary.

The second type of fatigue to consider is one S&C coaches are very familiar with: “Peripheral fatigue results from an overactivity-induced decline in muscle function that originates from non-central nervous system mechanisms” (Randall E. Keyser). This is the volume! Football S&C coaches must know and research what movements are being performed with high volume and what the average volumes are. These will be accounted for in the total volumes accumulated throughout the training week and are not limited to just yardage. Total load in the weight room will build up the body’s ability to cope with peripheral fatigue. Targeting potential injury areas that have overuse injuries will be a high priority in the weight room.

Know the Demands, Condition Accordingly

The only way to be prepared for the rigors of football is to play football. Take the demands of each position and reverse-engineer them to the remedial versions and train them. Stop doing things because someone else did it or you think it may work. If it’s not close, it’s not close!

Intensity and volume of each position group will give the S&C coach the map to proper preparation. Train general qualities, but do not neglect specific skill development.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Time moves in one direction. We wish we had more. We also believe that we can cram everything into these short time periods. The reality is that whether you are a coach, an athlete, or a person who works a 9-5 job, time will always be a limiting factor.

I had an aha moment during my recent podcast with legendary coach Dan Pfaff, in terms of using density patterns as a main driver in training. These frequent “hits” of training can be used as daily vitamins for athletes. I began to brainstorm ways in which I can pilot this approach into my own specific situation. The article that follows will hopefully outline my thought process and ways to implement the micro sessions into a physical preparation program.

My Situation

I am lucky enough to teach at a K-12 school where I also have the opportunity to coach athletic teams:

• Middle school (grades 6-8, ages 11-13)
  • Track & field
  • Golf
  • Girls’ basketball
  • Girls’ soccer
• High School (grades 9-12, ages 14-18)
  • Boys’ basketball
  • Boys’ lacrosse

With that being said, there are challenges when it comes to training student-athletes. I work at a smaller school that relies on multisport participation to field full teams. This makes for limited opportunities to expose athletes to consistent training, whether it is on-field work or in the fitness center. The emergence of club sports and non-school-related athletic programs has also muddied the waters.

Time is a major variable…and being concise is important. So, I had to ask myself, ‘how can I trim the fat off my training program to tick off the most boxes for athletes?’ Share on X

Time is a major variable for me as a coach. I always wish I had more. I also have to take into account the athletes’ time. In today’s climate, life is lived in 280 characters. Being concise is important. So, the question I had to ask myself was, “how can I trim the fat off my training program to tick off the most boxes for my athletes?”

It took some time to fully accept that there will be trade-offs and that it wouldn’t be the perfect training program according to the textbooks. But I have to live in reality here.

How It Came Together

After talking with Dan Pfaff, I started thinking about how manipulating training density patterns could fit into a developing athlete’s preparation. The concept of microdosing that has made its way into the physical preparation profession immediately came to mind. For those new to the microdosing concept, I’m not talking pharmacological intervention—I am simply using the general idea as a framework to plan athlete training. Derek Hansen has written extensively on the topic for those seeking clarification or a more detailed description.

Dan John’s “one lift a day” program completely eliminates fluff and forces you to really think about what’s important to accomplish for that day. That simplicity struck me. Share on X

Around the same time, I was preparing for an upcoming podcast with Coach Dan John. Dan is an avid writer and is well-known for his book Easy Strength. I was reading some of Dan’s work and I stumbled across one of his articles, “The One Lift a Day Program.” In it, he basically lays out that you pick one movement for that day and do it. It completely eliminates any fluff and forces you to really think about what’s important to accomplish for that day.

That simplicity struck me. There was no sense chasing my tail trying to fit all these pieces into my daily sessions. It was time to reevaluate my program (and my ego).

Where to Start?

As an assistant sport coach and lead strength coach, most of my training window falls within school and after-school athletic hours. There were two major time periods where I could insert this approach daily. The first was prior to school. This works particularly well for older varsity athletes who can drive themselves to school. The second was immediately after school or as a part of an extended warm-up before sport practice. We have the middle-schoolers during the final period of the school day, and I see my high school athletes immediately following the end of the school day.

An example of a typical daily training window is:

The most time I have on any given day is around 30 minutes. The low end would be 15 minutes. The next question is what are the essential KPIs that we want to improve? With that information and a general needs analysis, I could start thinking about how training would look.

One important piece of the puzzle reveals itself once you’ve reverse-engineered back from the target date. Your KPIs will fluctuate quite a bit if you only have six weeks with an athlete versus, say, four years. An example is if you had six weeks to make someone a better basketball player, then the bulk of your time should probably be spent on the game itself. In my case, I had to respect both the short and long term. I can slow cook development while also picking my spots to push the envelope a bit.

Two models that I’ve found useful in determining where to direct your training are Dan Pfaff’s generational framework and Dr. Bondarchuk’s exercise classifications. They both seem to get at what the differentiation between general and specific training means. In Dan’s model, the first-generation items are closely related to the sporting actions. The second generation gets less specific. The third, fourth, etc. generation menu items are basically general training means by their nature. Bondarchuk’s model provides a similar representation.

What Does It Look Like?

Once I figured out some of the training ergonomics, it was time to start determining how the program would look. Below are two examples—one lifting and the other running-based—of how I planned out these micro sessions. The first is during an off-season period. The second is during a pre-season period.

The training menu that I usually pick from contains the following main categories:

• Sprint training
• Tempo running
• Jumps/plyometrics
• Strength training
• Medicine ball training

The exercises/movements I choose will have to fit my athletes and their needs. Based on those categories, what do I believe will give them the most bang for their buck? It’s difficult at first to only choose one to two things. Mapping out a cost-benefit analysis helped ease any second guessing and kept me seeing things in a more objective light.

The amount of time I have during each daily session will dictate my options for training. This program relies heavily on consistency of training. Below is a diagram that outlines how training could be allocated based on time constraints.

Off-Season, Boys Basketball – General Strength

Here is an example of a 20-minute after-school strength training segment for grade 9-12 varsity boys’ basketball players. The goal during this period is to raise general work capacity in our main lifts. An easy way to do that is to add a set each week. These sessions served as a main stimulus for some students, and for those playing other sports or pick-up games it acted as an extended warm-up and/or maintenance.

As coaches, we can play with set/rep schemes in order to accommodate different athletes. If I have a large group without enough equipment, I’ll have some athletes start with different movements so that our rotations are staggered. Instead of doing movement A on Monday, for example, movement A will be a Thursday choice for some athletes.

When doing a program that is highly dependent on time, I found that keeping a running clock was the best way to keep things on schedule. For example, if we are doing 8×2 on the squat, I set a countdown from eight minutes, and the athlete will do a set EMOM (every minute on the minute) style. If there are two athletes working, set the clock to 8:30. One starts on the minute (00:00, 01:00, 02:00, etc.) and the other starts at the 30-second mark (00:30, 1:30, 2:30, etc.).

Video 1. Sped-up version of EMOM “daily vitamin” lift.

Exercise choices can be switched once we get through the fourth week. Examples of some transitions are deadlift to clean variation, strict press to push press, inverted row to chin-up, split squat to front squat, and bench press to incline press. Again, the goal is simplicity and compliance. The sets and reps may look low and in favor of max strength, but that’s not entirely the case.

I believe strength is a skill. Each set should work toward “greasing the groove.” We should never miss a training rep. On some days we can push the gas and work up above 85% 1RM, while on others we will drop the weight well below submaximal and add in a slow rep cadence for recovery. That’s what makes coaching a science and an art.

If I have an injured athlete or a first-year lifter, I move to plan B. However, I need to make plan B as close to plan A as possible, so I can still give the athlete something to adapt to—the flexibility of this type of program is another benefit.

One caveat is the possibility of soreness when you are doing one lift a day and that lift once per week. It’s important to progress the volume, intensity, and exercise choice appropriately. Share on X

One caveat I want to point out is the possibility of soreness when you are doing one lift a day and that lift once per week. It’s important to progress the volume, intensity, and exercise choice appropriately. Again, each training session should be in service to your major KPIs and the needs of your population.

Pre-Season, Girls Soccer – Acceleration Training

Here is an example of a 25-minute acceleration training segment during the pre-season period for some middle school and varsity girls’ soccer players.

The weekly template is planned to follow a high-low intensity scheme. The orange blocks would be considered a medium intensity. The red blocks are high intensity. The blue block acts as a low-intensity, active recovery session.

We are still following the “daily vitamin” approach during the weekly sessions, only the dosages will vary to allow the athletes to recover and adapt. To reiterate, daily vitamins in this context is an allegory that describes using small, frequent training sessions on a consistent basis. A daily vitamin is as easy as waking up, getting it, and taking it. It’s simple and easy, and the same idea applies with training sessions. You get in and you get out.

To reiterate, ‘daily vitamins’ in this context is an allegory that describes using small, frequent training sessions on a consistent basis. Share on X

Starting on Monday, the team will go through their on-field warm-up. The end of the warm-up period is when we dose in some short accelerations. The girls follow the field work with a brief strength training session. Deadlifts are done with moderate loads (80%-85% 1RM) and athletes drop the bar at the top of each rep. The press can be either horizontal or vertical. The weight will be moderate, and the focus will be on smooth, quality reps.

Tuesday is player-led pick-up games. This day is treated as a “high” intensity day.

Coming off playing on Tuesday, Wednesday is a tempo-based recovery day. Based on how the girls feel, the session will be a mix of linear and multidirectional drills. Each drill is done below 75% effort, and the focus is on movement efficiency and exposing their tissues to a variety of planes, postures, etc. Most of the movement sessions will be time-based. The total yardage is kept fairly low, between 750 and 1,200 meters, compared to a traditional off-season tempo run sessionfor a soccer player (3,000-4,000 meters).

Wednesday’s session ends with medicine ball throws. The typical menu items for throws include:

• Overhead backward throw.
• Broad jump forward throw.
• Between legs forward throw.
• Overhead step/throw.
• Rotational low to high throw.

Thursday is a similar session to Tuesday. The only difference is we use a squat variation with a lighter weight and a slow, controlled rep cadence. During these recovery squats, I like to have athletes go pretty deep so that the hamstring and calf meet.

A progression I like to use is from Coach Alan Bishop. I have athletes start with an elevated heel front squat and slowly progress to a feet flat back squat. Alan’s article outlines the full progression. The girls also perform a vertical or horizontal pull exercise. My go-tos are any chin-up or inverted row variations. If we chose a horizontal row, I might bump the reps up to 8-10 in order to build some volume and balance out the back musculature.

Video 2. Part of a “daily vitamin” squat progression.

Friday is our gas pedal session. We do hard accelerations out to 20 yards. Rest periods between sprints range from 60-120 seconds. After the first set of five sprints, the girls have a five-minute break to act as a buffer. After the break, we complete the second set of sprints. Our high-intensity acceleration day finishes up with some standing broad jumps up a hill. I typically start out with single jumps, then progress to doubles and triples once they look smooth.

Each session is subject to change based on countless factors. The training sets, reps, and volumes will fluctuate, but the graphic displays a solid general template. Based on your situation, you can expand or condense this template to fit your program’s schedule.

Practical Applications

Spots where these “daily vitamin” training sessions can fit into your program:

• The warm-up.
• During sport practice.
• During training sessions.
• During the summer or periods where you are away from athletes.

The warm-up is a perfect time to plug in some extra work. Whether it’s adding in movements that act as a screen or having athletes perform accelerations, the warm-up is an underutilized piece of a session. With more research focusing on soft tissue injury, many elite coaches are using top speed running to act as a type of “vaccination” to hamstring injuries. What this means is that athletes perform a baseline number of max velocity efforts that, in turn, expose their tissues to those high velocities and contractions.

Whether it’s adding in movements that act as a screen or having athletes perform accelerations, the warm-up is an underutilized piece of a session. Share on X

In talking with Dan Pfaff, he found having athletes perform five runs out to 40-50 yards at top speed once a week was enough of an exposure to keep them fit throughout the season. Dan has also collected data from many European sport athletes that suggests three to four accelerations out to 20-30 yards, three to four times a week was enough to maintain that sprinting quality.

Both accelerations and top speed runs can be done at the tail end of the warm-up, prior to practice. Another alternate warm-up method is to use the weight room as a bridge to sport practice. I remember listening to NBA strength coach Cory Schlesinger talk about how he had athletes come in and do a mini training session before practice. These mini sessions substituted for their traditional warm-up. In doing this, Cory not only got their strength/power work in, but he also broke up the staleness that comes along with doing the same warm-up day in and day out.

Another opportunity to microdose certain qualities is during the sport practice itself. From a purely training perspective, exposure to max velocity is a great example of this. Like Dan Pfaff said, if you have high intent and accountability, you can ask athletes to sprint out a few reps in practice to get those max velocity exposures. These longer top speed runs should be done during the first part of practice so that the athletes are fresher.

If you are lucky enough to be a sport coach, you can plan drills that will incorporate specific training targets within practice. Soccer coach Raymond Verheijen does a wonderful job laying out his principles of “football fitness.” Raymond uses the game itself to help athletes gain specific fitness. Raymond begins playing 11v11 for a set timeframe to start developing work capacity. He will use, say, a 3v3 to intensify practice and work on higher, more frequent outputs.

A perk of giving your athletes these daily vitamins is that they are easy to understand and are brief enough to hold the athletes accountable. One to two movements a day can build consistency and habits that can roll over into other aspects in life. It can also improve focus during sessions. If I only have one lift of seven sets today, I need to really focus in order to get the most out of my workout.

One to two movements a day can build consistency and habits that can roll over into other aspects in life. It can also improve focus during sessions. Share on X

If you lose your athletes during the summer or breaks, giving them one movement a day can open the door for them to film their sessions and send it to you for feedback. Again, they have to meet you halfway and make an effort. I am lucky enough to work with some students who are gym rats. I give them the one or two movements I think will help them the most and then they can go do whatever else they want. You want to do the “German Volume Arm Blaster 5000”? Go right ahead but do your sprints and squats first.

Less but Better

I try to read and consume as much information on training and the human body as possible. That has led to me trying to jam way too much into my programs. My aim was to make my athletes masters of everything. The reality was that we became masters of none.

There is a phrase in the book Essentialism that I have taped on my office wall. It reads: Less but better. Instead of trying to stuff 10 pounds of crap into a 5-pound bag, I had to identify the glaring gaps and try to fill them as best I could. For some, it is running based; for others, it could be a weight room intervention. In my limited experience, the two major limiting factors for athletes have been:

1. How they play their sport.
2. Their mental/psychological fitness.

All training goes to the wayside if they aren’t competent performers and if they don’t have the toolbox to navigate mental/emotional landmines.

If you’re looking for a switch up or you feel like you are getting lost in the granular details, try this approach. If the daily vitamins don’t work, then move on down the road. Like Bruce Lee said, “absorb what is useful, reject what is useless, add what is essentially your own.”

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Acceleration work has undeniable value to both field sport and track coaches. If sports can be chaotic and unpredictable, then movement variability should move beyond just drills and movements. Always running the same acceleration variations would seem to put a limit on solutions and scenarios to pull from in a game setting—sometimes, in the chaos of a game, athletes don’t have time to draw or rearrange their bodies into the perfect position. They just have to GO.

Sport coaches looking to transfer their speed training to the field will reap the benefits of toying with new starts. If an athlete is going to learn to accelerate effectively, then coaches must employ a vast array of starting variations that contribute to the athlete’s long-term development. Some are going to make coaches feel good because they have an air of specificity about them, while others are just plain fun.

If an athlete is going to learn to accelerate effectively, then coaches must employ a vast array of starting variations that contribute to the athlete’s long-term development, says @grahamsprints. Share on X

I must lend credit to coaches like Carl Valle and Latif Thomas and the ALTIS program for opening my eyes to many of these variations.

Various Position Starts (Disadvantageous Positions)

I have always said coaches don’t have to feel like they need to be the entertainment committee—games and activities can be fun, but athletes still want purpose, and a coach’s value is in the teaching.

Sometimes, early in the season during lower-intensity training weeks or before main sessions, we utilize disadvantageous start positions, such as the ones listed below. I classify these as such because the starting positions make it challenging to overcome inertia. These variations are a hit with all training groups, but the younger crowd and field sport athletes really seem to like them—they add just enough spice without being ridiculous or pandering.

I will admit to the field sport athletes that some of the skills and acceleration techniques that we address through track and field rarely occur in a perfect setting on the turf or court; however, we are always trying to optimize lines of attack within some acceptable bandwith. These variations shift the focus away from some perfect technical model to one that emphasizes power, separation, and balance. A coach can still use whatever cues they typically use with their athletes with these positions. The best an athlete can usually do is move with intent and achieve some fraction of proficiency.

1. Up and Go from Stomach: The athlete lies on their stomach, and their eyes should look down at the turf. The foot should be dorsiflexed so that the big toe joint has an easier time helping to separate from the ground. This is a very difficult position to accelerate from, but athletes should try to optimize getting their hips and chest out together.

2. Up and Go from Back: This is similar to the stomach variation, but it adds a layer of difficulty, as the athlete has to rotate their body while beginning to drive forward.

3. Push-Up Position: This one begins in the “up” position of a push-up and requires the athlete to fight the fall forward once their hands are removed.

4. Quadruped Roll: The athlete should start in a table-top position, with their hands under their shoulders and knees under their hips. The coach can signal the athlete to just raise their knees up and then roll in the direction of choice. The bottom of the toes should again stay down into the turf.

5. Cross-Legged Reading a Book: The legs are all pretzeled up in this variation, which adds even more difficulty to the already deadweight static position.

6. Front Roll: Athletes should first be exposed to some basic rolling. I usually have them pretend they just got pushed from behind and need to chase the action in front of them.

Coaches can explore and experiment with these as they captivate the athletes and allow for some competition. I always do these on turf since athletes occasionally fall as they are learning.

These starts are all completely static positions, from a seated or lying arrangement. For me, the common language I use with my athletes is to be powerful and not quick (push or punch, don’t spin), get the hips and chest out together (balance with projection), create pressure with the feet, keep a low shin angle the first few steps, and think about gaining ground. These variations are also indicators of who possesses a decent level of strength.

A common early session I do with athletes is run a set of five different variations for 10 yards each (60-90 seconds of rest). Run each variation one time or run a couple variations more than once.

After this set and an intermediate rest period (3-4 minutes), I have them run five variations from those listed later that are either along the lines of “the real thing” or at least more advantageous. This setup almost overloads the sprint on the first five variations before allowing them to apply it in a more traditional manner on the second set.

Video 1. Various position, disadvantageous starts are fun and challenge the athlete to overcome difficult positions. Coaches can turn them into competitions as well, so I encourage you to not hold back with creative ideas.

Various Position Starts (Advantageous Positions)

These variations are a step down on the crazy scale, but still are very fun. I classify these as advantageous positions since there is something about the movements that make the start easier to get out of. This could be forward momentum or some loading via the stretch-shortening cycle.

7. RDL Start: The RDL start allows for a big range of motion and explosion from the hip, and the athlete nearly throws themselves into a violent acceleration.

8. Parallel Start: The parallel start allows for a natural reposition step behind the body. When the foot resets, the Achilles and calf allow that stored energy to drive aggressively forward.

9. Jump Back: The jump back start builds on the same concept as the parallel start but allows for an even more dynamic loading of the lower leg since the athlete pops back into their two-point setup. Be sure that they actively POP back rather than slide back.

10. Kick-Up: The kick-up start is done out of a four-point position. The kick-up is advantageous, since when the feet contact the ground, the chest has already begun unfolding and driving forward. The hips just have to match.

11. Kneeling Start and

12. Lateral Kneeling: On both kneeling variations, I usually cue athletes to create pressure with their big toe joint and bend the shin to match the torso. If the shin is too vertical, they pop up—although some athletes prefer to roll their body and shin down from an upright position even in these variations.

13. Hip Flip: The hip flip is a great way to teach acceleration out of an athletic position. I instruct the athlete to think about separating their upper and lower body at the beltline and pulling themselves into a nice acceleration position.

I always have athletes do these on turf, and I use these variations much like I use the first group. With younger athletes, sometimes these serve as a main course; with older athletes, these could just be the last piece of the warm-up before the spiked session.

Video 2. These are a little less crazy than the disadvantageous starts but require the athlete to have a decent understanding of how to accelerate. They are closer to the real thing, but the prior movements allow for an easier time in hitting the ground running.

Drop-In/Movement Starts

On the field or court, athletes commonly accelerate out of athletic movements. A basketball player on defense may be skipping backward during transition when, suddenly, the opportunity for a loose ball presents itself, and they must drive forward.

A running back might side shuffle into a blocking position before wheeling out and catching a pass in the flat. These starts allow them to perform these movements as fast as possible with a lot of intent, which doesn’t happen in a game setting.

These starts allow them to accelerate out of athletic movements as fast as possible with a lot of intent, which doesn’t happen in a game setting, says @grahamsprints. Share on X

I always want my athletes to be as prepared as possible for anticipating sprint opportunities in game, but also be able to optimize their acceleration ability.

An added benefit of the movement in these variations is that, by not utilizing a static start, the athlete can reduce strain and extend these reps to 20 yards or so. These also start the process of blending drills to sprints, but I keep the “entry zone” really short, usually to 5 yards. These are not true blends or bleeds since the posture changes as the athlete accelerates.

14. Side Shuffle-In: The athlete doesn’t need more than a few steps of the side shuffle. At the coach’s cue, the athlete can rotate their body while repositioning their front foot under their hip, drop-step style.

15. Straight Leg Shuffle-In: The shuffle is about frequency and not power, so I usually ask the athletes to keep a high rate of switching at the hips. At the coach’s cue, athletes should accelerate out without much delay.

16. Gallop-In: The gallop-in is similar to the straight leg shuffle, but the added vertical displacement of the gallop allows the athlete to draw into a bit of a deeper position before projecting forward. They should aim to hit the ground running.

17. Walk-In: The walk-in reduces the need to overcome inertia. Athletes should walk and then let their shin and torso drop as they begin their acceleration.

18. Skip-In: The skip-in feels similar to the walk-in, with a tad more velocity upon entry. The transition should again be seamless, as the athletes roll themselves forward into a more advantageous position to push from.

19. Backward Skip: Athletes should commit to the backward separation by pushing through the big toe joint. At the coaches cue, the athletes will hit the brakes. This draws them into a nice, deep setup. I usually cue them to keep their eyes on the turf as they begin to project forward.

20. Drop-In: The drop-in features a walk followed by a subtle hop that raises the center of mass just enough to set up a two-point start that uses the stretch reflexes and momentum from the prior movements. I enjoy using drop-ins to accumulate acceleration volume early in the season. They are especially effective when done at the bottom of a hill.

21. Drop-Down: I use two variations. One utilizes a step off the bench or bleacher. The athlete should lean as they fall, so their foot slots a little behind their body. The second one involves them dropping down into a split two-point stance. The aim is to hit the ground running in both variations.

Video 3. These variations will still draw from previous acceleration teaching, and athletes should be encouraged to execute each variation with power and purpose.

I often include a clap cue for an athlete to respond to on the gallop, skip, and shuffle variations, but I am fine with a preset 5-yard entry distance as well.

Variety in your accelerations will give your athletes more solutions and more confidence to motor around at high velocities as they enter the fray, says @grahamsprints. Share on X

The one variation that I spend the most time teaching (beyond just plain skipping and galloping skills) is the drop-in. I prefer my athletes start with a walk, then raise their center of mass with a subtle hop, and from there drop to their usual two-point stance. This added drop makes this an extremely safe longer acceleration option, and this one works especially well on hills.

Medball Starts

Throwing a medball is generally without much risk, but it is still a skill. As a result, I am fairly picky with how circusy I get here. With all medball throws, the athlete is throwing with the hips and legs, while the arms generally stay relaxed, securing the ball or at best following through.

These four are pretty much the only ones I utilize:

22. Parallel Squat Throw Accel: The squat throw is really more of a squat/hinge hybrid.

23. Split-Stance Throw Accel: On both this and the squat throw, I have the athletes start with the ball straight out, and they draw it in for dramatic loading effect. I usually like to see the elbows in rather than flared, and this helps put the shoulders in a more stable position. Both of these variations allow the athletes to roll their shins and torso forward until they explode out like they were in a cannon. They are essentially throwing themselves into a sprint.

24. Underhand Forward Scoop Throw Accel: With this, I like the ball to be set up between the feet, more toward the toe. If the ball is placed too far in the back of the toes (under the body) the athlete has to almost reach through their legs, which causes them to drop their chest, lose the core, and put the lumbar in a precarious position. They should meet the ball on the way down.

25. Underhand Forward Throw Accel.

These throws often don’t yield great-looking positions—especially with the first few encounters—but the power created through the hips is enough for me to warrant their occasional inclusion. I will reserve these for athletes who know how to hinge, squat, and throw a medball with some proficiency.

Video 4. Medball starts are a great way to just encourage more OOMPH. Throw with intent and connect the chaos to the acceleration.

Resisted/Hill

Hills and resisted starts should be absolute staples of any program. Obviously, hill and sled accelerations are well known and can be tied into many of the prior variations, but the ones below are some variations that coaches can begin to think about including in their programming.

26. Heavy Sled: Heavy sleds are great for short accelerations runs—I usually go 10 yards here. I wish I could say I sit and calculate specific loads, but I don’t. I use the Gill Low Drag Speed sleds, which feature a single, small knob for plate loading. The sled weighs 7 pounds and adding a 25- or 35-pound plate usually does the trick with my male athletes without destroying their weight room session. This allows for a decently high speed without double support steps, and the ankle gets much more information about working with the earth/turf to separate. I often pair these with an unloaded rep later in the season.

27. Light Sled: Light sleds are great for extended acceleration reps of 20 yards or more, and with some athletes I even do extended runs to 50 yards. Light sleds (as little as 5%) allow for just enough resistance to help arm action, relaxation, and posture.

28. Drop-In Sled: I use drop-in sled reps if an athlete has great early acceleration that then levels off late during acceleration. The entry angles will not be as deep, and the rep can end as soon as they are upright so that it stops short of a maximum velocity style item.

29. Continuous Sled and

30. Continuous Hill: On both continuous variations (sled and hill), the athlete gets a chance to work initial acceleration in small doses close to one another. This kind of feels like using EMOM-style reps to groove a movement, like a clean or front squat. I have run three sets of 3 x 3-5 pushes this summer for both. The second and third pushes within the set almost always look better as the athlete self-organizes.

There is also opportunity here for coaches to run a cluster of multiple variations within each set.

• Five-step two-point rollover start with sled/hill
• Decelerate
• Five-step two-point start with sled/hill
• Decelerate
• Five-step three-point start with sled/hill

Video 5. Hills and sleds are excellent acceleration tools in the first place, so coaches can’t go wrong playing around with workouts and variations within this framework.

The Real Thing

I put these last in the article, but the reality is that these are the start variations that allow you to teach and refer to when exploring the other possibilities. If you are a track coach, then your block progressions probably start here as well.

31. Two-Point: The two-point position is important for field athletes like wide receivers, and I often use it at track meets with my middle school/freshman athletes who aren’t ready for blocks. This actually shifts their hips closer to the finish line as well.

I like to see a nose-to-knee type crouch setup. Many new athletes will use a hinge-like setup. Athletes should bend the shin and bend the torso to match. There should be about 12 inches or a little more space between the feet. If the feet are too close, then the athlete will take a reposition step anyway. If there is too much space, then the first step is long and loopy, often with a vertical shin cast out from the body.

The two-point start is one you want to work a lot since it is used often on flies and during jumps approaches. The shallow depth allows for an easier time overcoming the static position compared to a three-point or block start.

32. Two-Point Rollover: The athlete starts upright and rolls down into their usual two-point setup. Many jumpers use this in their approach to pattern a deliberate and consistent early step rhythm. The rollover allows the athlete to have a little momentum and a more dynamic push.

33. Three-Point Start: When coaching the three-point start, I have sprinters drop down from a two-point start. They should position their hand under the shoulders and bend the shins to an angle where they feel balanced. When they move their opposite hand back, I usually like to see a wiggle of the fingers in the free arm to get them ready to have a quick hand as the ground hand is removed.

34. Standing Block Start: The standing/rollover block start is a great first encounter with a set of blocks and how to load the whole foot with the heels down before springing forward. In video 6, I use a partner variation, but the athlete can also simply just back into the blocks while standing and perform a rollover start.

35. Opposite Leg Start: The last way to add variability to your starts is to occasionally have the athletes switch their feet so that their weak leg gets a chance to be the star. Getting better at starting with both legs can benefit the entire acceleration run. Girls often use a nine-step approach to hurdle one when they are first learning the event, which requires them to switch legs. Men who move away from the eight-step will also utilize the opposite leg to hit the odd number step pattern of seven. I run five-step start variations with advanced hurdlers to really challenge them to continue their drive through and off the hurdle and clear the next hurdle off a shortened approach.

These variations add just enough variety to keep athletes on their toes and use one position to solidify another.

Video 6. Especially for track athletes, these are your bread-and-butter starting positions. Specificity still has a range that should be explored, and a good two-point start can improve a block start.

Exploration Yields Learning

As mentioned previously, coaches are only limited by their imagination. I have many starting variations I use that didn’t make the cut in this article, and I look forward to hearing the variations that other programs use. Variety in your accelerations will give your athletes more solutions and more confidence to motor around at high velocities as they enter the fray.

The various position starts are fun and create buy-in; they also give coaches a glimpse into the general power, strength, and coordination that an athlete possesses, says @grahamsprints. Share on X

Hunting for sport specificity when sports are chaotic and unplanned is a fool’s errand. Athletes and coaches should work together to optimize as many movements as possible. The various position starts are fun and create buy-in; they also give coaches a glimpse into the general power, strength, and coordination that an athlete possesses.

• Medball starts are a great way to place the emphasis on power and projection.
• Movement starts are another great way to blend sport and speed, while also slightly reducing strain compared to static starting positions.
• Hill and sled starts should be a program staple, but there can be more creativity and variety than meets the eye.

Not all of these accelerations are rooted in perfect technical execution, but all contribute to the overall development of the athlete. Of course, you should push athletes to the edge of their ability and address technical issues as well. There is a time and place for each of these variations, and some of them will take some thought to work through.

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With a few years of experience under my belt now, I’m a little better equipped to think about the question I’ve already spent countless hours trying to answer: What does training load monitoring and injury prevention mean in the context of professional team sports?

I still don’t have a definitive answer, and I realized that the more I knew, the less certain I was. However, there are some interesting avenues for using some of the tools and techniques that are popular today—and there are plenty of reasons to question others.

Why do we need such a flawed system for monitoring training load?

Early in my career, I caught the diagnostic virus. Busy, hurrying through the corridors of Allianz Stadium, a black briefcase filled with GPS in one hand and a computer in the other, I could already see myself making the front pages of popular scientific journals: “Pierre Austruy, the Sherlock Holmes of Physical Preparation.” In my head, as a young graduate not yet dented by the reality on the ground, I imagined an ideal and perfect monitoring program. It was all about clues to find, details to highlight, probabilities to calculate, and—voila!—the game would be played and injuries and poor performance would be avoided.

Tired of accumulating data that, in the end, is often not that insightful, I dream of a monitoring routine that is both innovative and refined. Share on X

My ambition echoed the common practice in most sports teams (and practices still widespread), consisting of prescribing players a wide range of weekly tests in order “to not miss anything.” Today, I feel like I have been cured. Tired of accumulating data that, in the end, is often not that insightful, I dream of a monitoring routine that is both innovative and refined.

Functional Movements Test vs. Individualized “Risk Zone” Monitoring

This type of test is a bit like an IQ test: having a great score makes you superior in theory, but rarely extraordinary in practice. (And, by the way, are there any movements that are not, in one way or another, functional?) Very high IQs often make their commute to work standing in a crowded bus, sweating in their tight three-piece suits. They are very good employees but remain anonymous. The geniuses we admire, on the other hand, may not have the most flattering score, but their remarkable creativity or special intelligence reflects their extraordinary mental abilities.

When we consider very high-level athletes, we are dealing with “monsters”: individuals with dimensions and physical and mental potential outside the norm. And it is possible that certain imbalances between one limb and another, certain limitations in range of motion, or even certain unconventional movement strategies are what ultimately make the player remarkable. Why aim for balance and normality as the criterion for satisfactory monitoring, when the desired performance requires the exceptional and the extreme?

I don’t, however, think musculoskeletal system testing should be eliminated from a monitoring program altogether. Having tangible confirmation that, on a biomechanical level, an athlete is in a compromising situation—and therefore, being able to intervene with the individual (specific exercises, massages, etc.) or with training (load, volume, exercise selection, etc.)—is an essential part of injury prevention. I would, though, advocate a minimalist approach, far from the classic spider-web strategy where quantity trumps quality, by adopting as a mantra the sentence, “Better is less, but better!” Couldn’t weekly or daily prophylaxis only focus on previously injured areas?

I have, for example, 100 data points on ankle flexibility for players who have never missed a single practice session due to ankle problems. Does this mean that I am very good at my job and that the monitoring program in place prevents ankle injuries? Or does it mean that, for these players, ankle flexibility is not a good indicator of their readiness?

What is the first predictor of an injury? A previous injury and usually in the same place. As soon as we suffer structural damage, we are forever compromised. Sure, things get better, and we can “fix” a problem for a while (years in some cases), but we never go back to the state we were in before the injury. Perhaps a previous injury should dictate which monitoring tests are truly representative of individual-level readiness and health?

Additionally, each player faces different biomechanical challenges, whether due to anatomical constraints, compromised tissues, or poor movement habits. Just as the annual blood test your doctor prescribes doesn’t include testing for tropical diseases if you haven’t traveled abroad, why not just limit monitoring tests to specific potential problems instead of carrying out a more general screening?

Checking a bit of everything all the time “just in case” so as to “not miss” a threat of injury, in my opinion, only serves to make us feel as we are very professional and conscientious. We proudly distribute our endless spreadsheets and multiple reports, but their actual usefulness is limited. As the season progresses, players lose interest in the procedure, we have more and more data and less and less time to analyze it properly before making decisions, and injuries still aren’t eradicated.

Perhaps focusing monitoring routines on the individual profile based on injury history and biomechanics would give us better play participation and more profitable data. Share on X

Perhaps focusing monitoring routines on the individual profile based on injury history and biomechanics would give us better player participation and more profitable data. A player with a history of hamstring injuries, but who has never experienced upper body issues, may skip a shoulder mobility test to focus on a more specific exercise such as a Nordic hamstring curl before continuing on with their day. Most likely, if they were to sustain an injury in training, previously compromised tissue would be among the determining factors.

The Need for More Internal Data

Since a well-designed monitoring program includes much more than simple movement tests, let’s continue our rethinking of current practices with the same desire for renewal. Physiology may well be the mother of sports sciences, but it is poorly represented when it comes to monitoring (which is regrettable). Many practitioners are content to estimate the physiological state of an athlete through markers that are external to them, such as GPS data or RPE and wellness questionnaires (which, for a long time, was my case as well). And when taking the time to study the internal load, these practitioners are satisfied with the minimum.

Heart rate is a great indicator, revealing valuable information through a multitude of clues. Young “sport scientists” new to the world of professional sport know this well. And that’s why they eagerly pounced on studying cardiac data early in their careers. Very often, however, faced with the reluctance of players (a heart rate monitor is uncomfortable, especially in contact sports) and the poor reliability of the data (poorly placed heart rate monitor, loss of signal, etc.), the interest in the cardiac response to exertion tapers off and remains under-interpreted.

Resting heart rate then seems the easy solution, but because it’s extremely subject to fluctuations, it does not provide much critical information. Nowadays, more and more teams use a standard running test (type “box run”), always carried out on the same day in a week of preparation (in general, 48 hours post-match), during which the players are equipped with cardiac monitors. Different data, such as average or peak heart rate, is collected and compared to previous datasets.

An increase in average heart rate during this test compared to the previous week, for example, then indicates less recovery. While this procedure is a step forward, it is subject to variability, which makes the conclusions difficult to interpret.

1. If the test is performed on-field, the properties of the surface at the time of the survey partly explain the fluctuations in the results, with heart rate being related to energy demand—the latter itself being related to mechanical demand. The humidity level, the height of the grass, and other environmental concerns have a direct impact on heart rate.
2. To obtain quality data, it is necessary that the climatic conditions are standardized. The temperature outside, the dryness or humidity of the air, and even the wind partly determine the heart’s response.
3. The individual training load that precedes the test should be similar from week to week. As the goal of the procedure is to produce a physiological index capable of attesting to the player’s state of fitness, it is important to consider the context. For example, if before the previous test a player participated in 30 minutes of the match, and this time they are tested after a match in which they played 60 minutes, should we expect the same results?

Producing a better strategy to recover valid physiological data requires eliminating these fluctuations as much as possible. A stationary bike, Watt bike, or rower has the advantage of having stable physical characteristics, and an indoor test eliminates weather considerations. Instead of a collective test at a standard time, it may be better to perform an individual test when the training loads over the previous seven days are comparable: a monthly test is sufficient. It is also necessary to ensure that no psychological factor too strongly impacts the cardiac response. Conducting this test immediately after a meeting with the coaches, or a review of a match, is not a good idea.

On the other end, checking wellness questionnaires before deciding to go on with the testing procedure is a necessity. If we were to see in them unexpected levels of stress or soreness reported by a player, we would be better off reprogramming the test to a later date for that individual.

Finally, while observing average heart rate during exercise is relevant, looking at recovery heart rate is probably more informative. Recovering heart rate after exercise involves a coordinated interaction of parasympathetic reactivation and sympathetic withdrawal. Since the autonomic nervous system is linked to many other physiological systems, its ability to maintain homeostasis can provide information on the level of muscle inflammation, the amount of plasma creatine kinase due to multiple collisions, and the state of the central nervous system (parasympathetic or sympathetic inhibitions).

The two-minute recovery heart rate test is simple and effective. The athlete provides a maximum effort of two minutes on an ergometer (static bike, rower, etc.), at the end of which the heart rate is recorded (HR1). Two minutes after exercise, the heart rate is recorded again (HR2). Subtracting the HR2 from the HR1 determines a basis for improvement. For example, if HR1 is 150 beats per minute and HR2 is 95, then the recovery heart rate is 55.

Note that for athletes in high-intensity, intermittent sports, the ability to reduce heart rate between strenuous efforts is one of the most critical qualities required to perform, make a good decision under fatigue and pressure, and not get injured. This index therefore allows both monitoring the state of form and predicting the level of performance of the athlete.

It is not mandatory to turn to an active procedure that requires the player to make an effort to collect a picture of their physiological state. Some biological markers do very well and are detectable with a simple blood or saliva test. Admittedly, going down this road requires collaboration with an analysis laboratory and comes with significant costs, but many clubs fund without flinching the frequent trips their players take to and from the clinic for DEXA scans and other anthropometric tests as costly as they are futile. I can observe with the naked eye a worrying fat gain (unless I am its victim, in which case I prefer to doubt such visual evidence…). on the other hand, I am quite unable to estimate a level of blood heat shock proteins (HSPs).

HSPs participate in a cell protection system induced by the presence of reactive oxygen species (ROs), cytokines, or hyperthermia. HSPs increase stress tolerance and contribute to cell repair processes. In addition, HSPs are involved in the remodeling associated with exercise training, where they facilitate mitochondrial biogenesis, regulate apoptotic pathways, and induce improvements in insulin sensitivity. Muscle damage and stress resulting from exercise are considered two of the many stimuli that induce the synthesis of HSPs. Sustained high synthesis of these proteins may indicate a state of inadequate regeneration, even after several weeks of recovery from exhaustive exercise.

HSPs are a critical physiological marker for monitoring the athlete’s state of recovery and adaptation to training. As the understanding of the role of these proteins grows, it wouldn’t be surprising to see more and more teams take an interest in them. Along with HSPs, other reliable indicators of muscle damage can be:

• A measurement of the level of circulating creatine kinase (CK).
• An evaluation of the levels of interleukins (IL) and TNF alpha as representatives of inflammatory markers.
• A measurement of immunoglobulin A (igA), providing information on the state of the immune system.

A monthly or even quarterly profiling of the levels of HSPs, CK, IL-1, TNFa, and igA would make it possible to assess the readiness of a player in a much more relevant way than any rough estimate drawn from subjective questionnaires or derived from specious algorithms.

Glucose Continuous Monitoring

While nutrition is indeed considered one of the cornerstones of recovery and adaptation to training, it does not appear to be a priority in monitoring practices. When claiming to assess an athlete’s level of recovery, not studying what is considered a major factor in recovery is quite paradoxical. If the daily weigh-in gives relevant information to the farmer about his turkeys as Christmas or Thanksgiving approaches, such a monitoring tool is much less relevant for professional athletes.

Body weight fluctuates considerably and constantly, for obvious reasons (which I will be careful not to expose here in case you are finishing your Niçoise salad). Substantial and sudden weight loss is likely to indicate a state of overtraining or a health problem, and players generally have an optimal body weight in competition that is best kept under control. But when it comes to problematic weight loss, it usually occurs with other detectable symptoms—and when it comes to a healthy weight, players themselves pay special attention.

New glucose monitoring technologies open up new perspectives on athlete nutrition management never before considered. Share on X

New glucose monitoring technologies open up new perspectives on athlete nutrition management never before considered. The use of the continuous glucose monitoring (CGM) test makes it possible, for example, to study the evolution of the blood glucose level 24 hours a day, without resorting to an invasive method such as blood sampling. This is because the CGM machine is inserted into the back of the arm and measures glucose levels every 1-5 minutes, discreetly measuring the contents of the subcutaneous tissue.

Initially developed to support the treatment of diabetes, this technology is now used by a growing number of athletes, nutritionists, and sports scientists to assess individual responses to different nutritional strategies. As the blood glucose level is also affected by stress, this type of test makes it possible to evaluate the effects of a variety of constraints (emotional stress, jet lag, overtraining, lack of sleep, inflammation, etc.) on the metabolism and the physiological state of the athlete.

Observation of the behavior of a physiological variable for 24 hours in the real life of the athlete—and not only in a controlled environment—is a considerable asset in understanding the possible reasons for poor performance and injuries. A fasting blood glucose level of 6.1 mmol/L is considered to be normal, and within two hours of ingestion of 75 grams of glucose as part of an oral glucose tolerance test (OGTT), the glucose blood level should not exceed 7.8 mol/L. Although sports are often cited as excellent for glycemic control, several studies^1,2,3 report more mixed conclusions. Four in 10 athletes have blood glucose levels above 6 mmol/L 70% of the time under control, according to a recent study⁴, and some researchers have advanced the theory that genetic makeup associated with exceptional performance in power or endurance in elite athletes could also reflect their metabolic characteristics.

Elite power athletes appear to be more resistant to insulin than elite endurance athletes. The training loads act as a stress factor influencing insulin sensitivity—in particular, the repetition of intense efforts that generate a significant release of catecholamines and result in post-exercise hyperglycemia and hyperinsulinemia, as well as nutritional strategies based on the high consumption of carbohydrates. The use of a glucose test is important to explore the different nutritional strategies to optimize the performance of the athlete and to prevent a decrease in insulin sensitivity, which would have significant consequences on their recovery, health, and energy.

But the applications in high-performance sport related to these new technologies do not stop there:

• What strategy should coaches and athletes adopt when traveling to limit fatigue and stress?
• Does the training schedule negatively affect players “sleep quality”?
• Do we train too hard the day before the game?

All these questions can be examined through continuous glucose monitoring. Stress, through the production of glucocorticoids as well as inflammatory markers, acts on the levels of glucose and insulin, which makes the observation of glucose a remarkable physiological test for the sport scientist.

Designing Better Subjective Questionnaires

Finally, there can be no conversation about monitoring without discussing the use of subjective questionnaires. Ah!!! Running after athletes who did not complete their questionnaires on time is the flagship activity of today’s sport scientists. The idea that, coupled with objective measurements, subjective cues make it possible to pinpoint revealing discrepancies (for example, the difference between an athlete’s physical output and their feeling of fatigue) is attractive, and not devoid of practical interest.

However, are the questionnaires used ideally composed?

Let’s stop asking questions we can’t answer ourselves! For the sake of data accumulation, I felt like I was guilty of nonsense. Wellness questionnaires, RPE, play rating scales, emotional profiling… I asked a lot of questions. I thought these numbers would inform decisions about training load, player tracking, and individual management. But what kind of valuable information can you get from a crappy question (forgive my vocabulary!)? As Yogi Berra said, “If you ask me something that I don’t know, I won’t answer.”

Seriously, a lot of us have a question on our wellness questionnaire that sounds like this: “How would you rate your energy level today?” Have you tried to answer this question yourself? Personally, I don’t know if my energy this morning was a 6 or a 7 out of 10. Maybe it was even a 5. And are you talking about my energy before the first coffee or after the fourth? Before making the trip home to the gym while listening to an exciting podcast or after collecting a tax notice in my mailbox? How do we define energy itself in relation to this question? Is there a clearly defined equivalence between each number on the scale and a given series of events? What distinguishes a 7 from a 6?

Another pearl: “Rate the quality of your sleep on a scale of 1 to 10.” What sort of question is that?! We know that it is very difficult to estimate your own sleep quality. It is not something we can clearly state. Collecting RPEs after each session does not provide a complete, individual, and subtle understanding of each player’s response to training.

To me, it has become obvious that most players pick a number at the start of the season and just stick to it as their default value. And when they come up with a different number, the surprise effect isn’t there—obviously, the session was designed to be easier than usual or much more difficult. The default value strategy makes sense. Can you distinguish a “moderate” session from a “somewhat difficult” session? I’m not sure I’ve ever had a “somewhat difficult” session myself…in the Borg scale, 7 and 8 have the same definition. What, then, justifies choosing one over the other?

Players already face enough daily demands that we should not prompt them to think about this type of senseless choice. I debated which statistical methods to use and spent time on “actionable strategies,” gently and indulgently prepared Excel tables and made pretty, colorful reports filled with data that had no real value. Asking ill-conceived questions can quickly make you mistake a noise for a song.

If the primary function of a wellness questionnaire is to generate a discussion with the athlete, what prevents us from getting straight to the point with our questions? Share on X

If the primary function of this type of questionnaire is to generate a discussion with the athlete—and this exchange should shed light on the measures to be taken—what is preventing us from getting straight to the point? A coach can verbally ask his players black and white questions, the kind that demand a clear answer: Is there any reason for me to worry about your readiness to train today? These are the types of questions that identify players who are in a physical or psychological state that does not meet expectations and that is not directly the result of training loads or a clearly identifiable reason.

As for the RPE, it is difficult to question it, as it is central today in the management of training loads. This approach, however, can still be improved. The purpose of the RPE is to assess an athlete’s fatigue state by comparing the session performed to the athlete’s feelings. Then, by multiplying the number chosen by the duration of the session, an estimate of the overall workload (at least from a subjective point of view) is proposed. But is the question “Rate your perceived feeling of exertion on a scale of 1 to 10” the only or the best way to evaluate fatigue? I don’t think so.

Besides the limitations inherent in the Borg scale discussed above, this question does not really give athletes the opportunity to communicate on the reality of the effort they put in. Maybe, objectively, I spent 10 minutes above 80% of my maximum heart rate in a 45-minute session containing three 30-second blocks of runs with 30-second recovery at 100% of my maximum aerobic speed (VMA). Let’s call this workout W1.

Consider workout W2, where I do the same work, at the same intensity, and hit the same objective markers. The only difference is that the session is performed on a rower. In this case, very few athletes will score these two sessions identically, where except for the exercise mode, all other things are equal. Those who like running will find W1 easier; others will prefer session W2. From this point of view, the RPE therefore leaves a difference in taste to dictate, at least partially, the estimate of a training load.

In addition, the environment, climate, time of session, or cumulative effect of previous sessions weigh on the choice of RPE. For two similar sessions, the athlete may give two different scores—not because they feel more or less intense physical or psychological fatigue, but simply because their interpretation of elements beyond their control varies. In addition, the view that the physical trainer has of the physical demands of a session does not necessarily match the feelings of the player who goes through it. Sometimes, this discrepancy reflects something in the realm of fitness, but quite often it highlights a difference in appreciation. The RPE also contrasts what the strength and conditioning coach expects from a session with what the player feels. Two different individuals, two different understandings—a clue very open to interpretation indeed.

A more complementary RPE strategy would be to compare the expectation that the player places on themselves before the session with their feelings at the end of it. Share on X

A more complementary strategy would be to compare the expectation that the player places on themselves before the session with their feelings at the end of it. Questions could include:

• “How satisfied were you with your performance during the session?”
• “Rate your performance during the session on a simple rating scale from 1 to 10.” (Or even better, from 1 to 5 to avoid the always convenient choice of average.)

Here, the players face themselves. By entering the field and knowing the environmental factors, the type of session, and the expectations of the strength and conditioning and technical staffs, they form an idea of ​​what they are capable of delivering in terms of performance. While making their way out of the training field or court, they are in a position to take a step back from their production, estimate the differential between before and after and between expected and actual, and verbalize their scores accordingly.

Why put the feeling of the fatigue aspect into perspective in order to refocus on the appreciation of the performance aspect? Well, personally, if I have a very tired team that wins every weekend, that’s fine with me. I dare say that even if you are a sensitive soul and have a remarkable capacity for empathy, you would be comfortable in this scenario as well. On the other hand, if my team is a cohort of guys in great shape that do not win a match, I would be very worried.

Complementary to the observation of the relationship between intensity of a workout and subjective fatigue, studying the relationship between intensity of a workout and athletic performance would provide useful and relevant information for directing a physical preparation program. Understanding the effect of training load not only on a subjective fatigue level but on a player’s perception of their own performance opens up new perspectives, and when asking the athlete about their performance, two important indications for a monitoring program appear.

First, a simple number reflecting the performance level of each athlete for each session is created. This score can be analyzed in relation to other training load indices. Unlike the RPE, it does not refer to the concept of “load” itself and breaks away from the purely physical preparation aspect, which makes the comparison with other markers, such as those obtained with GPS, more balanced.

Second, this approach allows, in a mediated way, the detection of certain traits associated with abnormal psychological or physical fatigue, thus complementing the RPE data. Ask a genuinely tired player if they found a session tiring, and the chances are high they’ll say “no.” True competitors, often proud and sensitive, sometimes prefer to curl up when they are not feeling their best. But if this fatigue is indeed present, it probably leads to a decrease in performance, and the athlete knows this. To admit, on top of that, that they are suffering from the difficulty of training is akin to an admission of weakness and sounds like a message directly addressed to the coach: “Don’t select me for Saturday’s game!”

Only the star players and those indisputable spot-holders can afford to be tired. The rest—those who are fighting for their place in the selection—will likely line up with the ratings given by their competition instead. On the other hand, this same competitive spirit makes the players very critical of their performances. Everyone hates being the weak link, but they know that overestimating their performance is frowned upon in the coaching office. Caught between disappointment at a poor score and fear of an overrated score, the athlete is forced to be honest about their performance.

So when by analyzing the data collected we see that for the same typical session a player rates their performance differently, we can make assumptions. If the score is lower, as the player certainly was not intentionally less precise in their tasks, this loss is probably the result of physical or mental discomfort. If there is no clearly identifiable injury or psychological stress, then we are probably finally in the presence of this harmful fatigue that we dread.

To end with this review of a classic monitoring program, let us insist on the fact that the absence of objective measurement of the cognitive state of the athlete is justifiable only because of the absence of technology. This does not prevent us from dreaming a little, and with one foot in the future, from considering a few options.

The Future of Monitoring?

When looking at the next generation of monitoring, I begin with blink rate as a measure of cognitive fatigue. Spontaneous eye blinking occurs much more often than is necessary to maintain the tear film over the eyes. Various factors, such as cognitive demand, level of concentration in performing a task, and fatigue, influence the spontaneous blink rate. When it comes to competition day, decision-making, reaction time, and vision are as important (possibly much more important) than muscle glycogen content or strength level.

When we look at the future of athlete monitoring, blink rate as a measure of cognitive fatigue has real possibilities. Share on X

We are good at monitoring physical readiness and making sure we don’t compromise match day performance by creating too much fatigue beforehand in training. Physical fatigue is relatively easy to detect with field tests or in the weight room. In contrast, we tend to forget about cognitive load monitoring. Did we do too much video analysis this week? Is this the best time to add individual technique sessions? What about the weight of meetings?

So far, we’ve relied heavily on subjective measures such as wellness scores to try to identify this cognitive fatigue. Measuring eye blink rate can be done like any other monitoring procedure, through a simple protocol where the athlete performs a cognitive task and eye tracking technology is used. As research on this topic develops, we can imagine that an easy-to-implement system will eventually become available in the market.

If language is preferred over the study of the gaze, a system of discourse analysis could be revealing. A recent study questioned the possibility of detecting fatigue and drowsiness in airline pilots by observing their communication with the control tower.⁵ Considering that fatigue and drowsiness are the main factors in human-caused air crashes, the researchers undertook a retrospective analysis of pilot communication just before an accident.

The pilots’ speech was analyzed 35 hours before the fatal flight in normal conditions (control condition) and compared to a recording approximately one hour before the fatal flight and during the accident (drowsiness condition). The analysis focused on the temporal organization of speech: hesitation, silent pauses, prolongation of the last syllables, and speed of articulation. The results show that the speech on the day of the accident was characterized by slower speech and significantly slower articulation speed than on the previous days.

Other research, particularly in the military field⁶, has also successfully explored the relationship between speech characteristics and fatigue, demonstrating that inter-individual variability in speech, choice of vocabulary, and rhythm of syllables is an effective means of measuring cognitive fatigue. What comes up over and over in interviews with strength and conditioning coaches is that nothing beats direct contact with the player and the exchange of a few words to determine their state of form.

Perhaps. But then, if this is so productive that the exchange can also be objectified, isn’t that ideal? Create three standard questions, ask each athlete on a standardized day of the training week, record the answers, then pass these samples to a revealing system for analyzing speech and syllable flow rate…. Here, in part, perhaps lies the future of monitoring in terms of cognitive fatigue.

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References

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2. Steffes GD, Megura AE, Adams J, et al. “Prevalence of metabolic syndrome risk factors in high school and NCAA division I football players.” Journal of Strength and Conditioning Research. 2013;27(7):1749-1757.

3. Buell JL, Calland D, Hanks F, et al. “Presence of metabolic syndrome in football linemen.” Journal of Athletic Training. 2008;43(6):608-816.

4. Thomas F, Pretty CG, Desaive T, and Chase JG. “Blood Glucose Levels of Subelite Athletes During 6 Days of Free Living.” Journal of Diabetes Science and Technology. 2016;10(6): 1335–1343.

5. Vasconcelos C, Vieira M, Kecklund G, and Yehia HC. “Speech Analysis for Fatigue and Sleepiness Detection of a Pilot.” Aerospace Medicine and Human Performance. 2019;90:415-418. 10.3357/AMHP.5134.2019.

6. Greeley HP, Friets E, Wilson JP, Raghavan S, Picone J, and Berg J. “Detecting Fatigue From Voice Using Speech Recognition.” International Symposium on Signal Processing and Information Technology. 2006.