Equal But Not The Same
- 1. Female’s & Exercise Equal….But Not The Same Exercise creates hormonal balance! We need to focus on the quality of our training, not the quanCty!
- 2. About Donna • Nineteen (19) years in profession June 2015 • We are all athletes!! • Competed in Olympic Style WeightliQing at the naConal level in US • Professional background w/strong focus in physical therapy clinics dealing with neuromuscular rehab and subsequent strength programs • American qualificaCons – Associates Degree in Applied Science/Physical Therapist Assistant; NSCA Strength & CondiConing Coach; United States WeightliQing AssociaCon Club Coach; C.H.E.K. Exercise Coach • Australian qualificaCons – Remedial SoQ Tissue Therapist; Level I Strength & CondiConing; Level II Sports Trainer; C.H.E.K. Exercise Coach • Philosophy – Commit to what you want and work hard to make it your own! No Excuses!
- 3. Some History • In US as early as 1902 women were banned from parCcipaCng in sporCng events, including the Olympics • 1972 Title IX granted equal rights on and off the field in the US for women • 2004 US study -‐ 1971 only 295,000 girls parCcipated in high school varsity sports; by 2001 increase to 2.9 million girls parCcipaCng in high school varsity sports • The good – women were encouraged to get acCve • The bad – We are sCll using same programs based on and around male anatomy & physiology -‐ less muscle mass/strength; smaller nerve tunnels, smaller bones, smaller joints, underuse of close chain exercises & over reliance on open chain exercises (machines) • Biggest differences are structural & hormonal differences
- 4. Structural Differences Rib Angle • Increased/steeper 1st rib angle – females manubruim oQen sits one spinal segment below men • Increased incidence of rounded shoulders/forward head • Increased incidence of Cssue stress due to poor posture – Dowanger’s Hump • Increased incidences of stress on sternoclavicular joint – only connecCon shoulder girdle has to axial spine • Increased incidence of Brachial Plexus Pain &Thoracic Outlet Syndrome • Increased incidence of dysfunc/onal breathing pa6ern in diaphragm (1) • Posture is closely related to emoCons, state of mind & body image in females** • Need for programs designed to encourage and support proper posture – strength
- 5. Structural Difference Female Pelvis • Dr. Janda states that the pelvis is a major control center for posture • Females pelvis can be one third wider than males – more pelvic muscle (2) • Larger Quadriceps Angle – Larger the ‘Q’ Angle the greater the instability in the lower extremiCes • Larger Q Angle will lead to possible pronaCon injuries @ the knee, ankle & foot in presence of muscle imbalances • Some pronaCon injuries: achilles, posterior Cbialis, flexor digitorum longus & extensor hallucis longus tendoniCs, shin splints, ITB syndrome, lateral patella tracking, PFPS & hallux valgus • Increased need for higher level of stabilizer funcCon as compared to male counterparts
- 7. Structural Difference Female Pelvis • Females have increased pelvic Clt – wall test to determine pelvic Clt • Increased incidence of knee, ankle & foot pronaCon which increases risk of injury in the presence of muscle imbalances • Increased incidence of hip pain (iliopsoas) due to Cght facilitated muscles in the presence of muscle imbalances • Increased incidence of joint pain in the LB (facet & SIJ) in the presence of muscle imbalances • When running, as limle as a 1cm increase in normal pelvic Clt will exert forces 4-‐7 Cmes bodyweight on facet joints; joints become irritated causing LBP in the mulCfidi (3) muscles which causes Pain InhibiCon • Pain InhibiCon – pain in a joint will inhibit the muscles that act on the joint • Once again an increased need for higher level of stabilizaCon funcCon as compared to male counterparts
- 8. Facet & Sacroiliac Joints
- 9. Hormonal Differences • Estrogen increasing ligament/tendon laxity; increasing joint instability • In the pre-‐menstrual phase of cycle (~days 18-‐28) estrogen levels start to increase in preparaCon of embryo • Judy Daly & Wendy Ey 1996 Australian study on elite level female athletes that showed 64% cramps/bloaCng; 40% weight gain/breast tenderness; 34% LBP; 30% increased faCgue • Abdominal cramping/bloaCng & LBP WILL down regulate abdominal wall leading to decreased stabilizaCon ability • Same Australian study also showed that of those who parCcipated in study and had non contact ligament/tendon injury 95% of injuries occurred during the athletes premenstrual phase of their cycle • Again an increased need for a higher level of stabilizaCon funcCon as opposed to male counterparts – we must prepare!!! • Decrease training intensity with increased estrogen levels – increase training intensity with increased progesterone levels. • Females we need to 1.get in touch with our body, 2.listen to our body and 3.prepare our body • Coaches/trainers need to listen to their athletes. Do not just push through!
- 10. Other ConsideraCons • Estrogen vs. Testosterone • Lipogenic vs. lipolyCc enzymes • Females faCgue quicker with eccentric exercise than males • Females suffer more of the same types of injuries in the same sports training the same numbers of hours as their male counterparts!! Faulty program design? I think so • Does it make sense to conCnue to train females the same way we train males? • We can not conCnue to use programs that were designed around and based on male anatomy & physiology.
- 11. Some Anatomy • The Inner Unit (IU) – The TRUE Core Muscles! • Our deep abdominal wall is the bodies foundaCon for spinal integrity & where all movement begins • Fires approx 30-‐50 ms prior to ANY dynamic arm or leg movement if working properly • 8 Levels of spinal nerve communicaCon • Integrates upper & lower extremiCes • Outer Unit muscles WILL NOT funcCon • Abdominal muscle fiber composiCon • Must strengthen & train accordingly
- 12. Outer Unit Muscle Slings • Bodies Prime Movers & Gross Stabilizers • Posterior Oblique Sling – propulsion phase of gait, helps to stabilize the SIJ, stores & releases kineCc energy for subsequent heel strike • Anterior Oblique Sling – heel strike, posiCons hip & pelvis for opCmal heel strike & helps to stabilize body on stance leg • Lateral System – frontal plane stabilizer & very acCve w/single leg acCviCes; LBP, SIJ dysfuncCon & ankle sprains common when dysfuncConal • Deep Longitudinal System* – body recruits in absence of properly funcConing deep abdominal wall; headache, LBP & hamstring injury common when dysfuncConal – see following slide for example • The lack of a properly funcConing IU will overload & debilitate these Outer Unit muscle slings leading to injury such as…….muscle & joint pain, ligament & tendon injury, headaches, back pain, SIJ dysfuncCon, hamstring injury, ankle sprains, PFPS, plantar fasciCs
- 14. Muscle Slings
- 15. Keys for Proper Program Design • Must have a sound anatomical foundaCon for the selecCon and prescripCon of all exercises • Design programs to address posture and stabilizers FIRST then strength and power • Proper Technique is a must! – Law of FacilitaCon • IdenCfy athletes primary objecCve • Design programs around sporCng parCcipaCon; as work increases for sport work decreases in gym • Design programs based on athletes training age • Design programs with consideraCon of menstrual cycle • Design programs with proper warm up & cool down exercises • Design programs include squats, lunges, dead liQs & basic explosive liQs • More anaerobic training less aerobic
- 16. Example of Proper Warm Up • Light jog from side line to side line & back X1 – to increase core temperature, therefore preparing muscles, tendons & ligaments – there should be no heavy breathing while performing this – if so back down their pace • Shu:le jogs from side line to midfield & back X1 – this engages the inner & outer hip/thigh muscles -‐ maintain an athleCc stance at all Cmes • Backward jogging from side line to midfield & back X1 –this engages the hip extensors – maintain a slight bend in the knee at all Cmes and perform on toes & balls of feet • Walking Lunges – start at sideline 20 lunges toward mid field and 20 back -‐ maintain an upright trunk at all Cmes with hands on hips at all Cmes – this will help to strengthen and stretch the lower extremiCes • Single Leg Dead li@ – 8 on ea leg X2 sets – slight bend in working leg core engaged, movement comes from hip NOT back or leg -‐ this will help strengthen and stretch the hip extensors • Lateral Hop over Cone – 15 reps on each side -‐ players are given a cone and places it to one side of her, she is to hop over the cone landing on the other side in her athleCc stance and immediately hop back – this will increase power, strength, neuromuscular control and reinforce proper landing technique • Forward Run w/3-‐step DeceleraJon X5 – players place a cone ~15 meters ahead of her, she runs toward the cone and just before reaching cone she decelerates with 3 small steps while maintaining a slight bend in her hip and knee, jog back to start and repeat. – this will reinforce proper deceleraCon • Followed by dynamic stretches
- 17. NO!! StaCc Stretching Before Exercise • StaCc stretching has shown to have an inhibitory response on the neuromuscular system. Meaning…the length of the muscle determines where the majority of the force output will occur. StaCc stretching changes the muscles length, the nervous system does not recognize the ‘new’ muscle and can not incorporate it into the system. Once the athlete begins to run, kick, jump ect, the nervous system will amempt to quickly Cghten the muscle to protect the joint. StaCc stretching is best leQ for aQer acCviCes to promote and encourage muscle elongaCon while given the body Cme to adapt to the new length.
- 18. Example of Proper Cool Down • Light jog from sideline to sideling 2X • Calf Stretch -‐3X ea leg • Prone Quad Stretch – 3X ea leg • Supine 3-‐way Hamstring Stretch 2X ea direcCons ea leg • Seated Adductor Stretch 3X • Hip Flexor Stretch – 3X ea leg • Standing ITB Stretch – 3X ea leg • 3-‐way Child’s Pose 2X ea direcCon • ALL stretches are to be held for 20-‐30 seconds. Stretching should NEVER be painful just uncomfortable • I recommend the girls perform staCc stretching just prior to going to bed. It will help to promote muscle elongaCon while they are sleeping and their bodies are repairing
- 19. In Season Program February-‐October • Aim is to maintain stabilizer & prime mover strength gained in pre season training • Focus switches and precedence is given to sporCng skill required • Majority of focus is on acCve recovery – flexibility, nutriCon & adequate sleep • ConCnue to address any postural imbalances and/or stabilizer weakness • Address niggles before they become injuries w/rehab style exercises • Weight training is light & fast! Keep training volume & intensity low; 1-‐2 days, 3-‐4 exercises 2 sets, 8-‐12 reps, 60-‐70% 1RM • As long as it is not too oQen, don’t be afraid to take a day off if feeling ‘sluggish’ or during pre-‐menstrual phase of cycle
- 20. Off Season Program October/November • Typically 4-‐6 weeks used for recovery; physical & mental • Address & correct ongoing injury from season • Address & correct postural imbalances and/or stabilizer weakness • Aim is to maintain a level of condiConing with acCviCes that do not mimic sport, i.e. cycling, swimming and/or rowing -‐ 3X week 60-‐65% MHR • As with in season, weight training is light & quick -‐ 2X week, 4-‐5 exercises 2 sets, 12-‐15 reps, 55% 1RM • Find something fun to do that will keep you acCve!
- 21. Pre Season Program December/January • Typically 8-‐12 weeks in length • Aim is to increase base level of strength in stabilizers & prime movers • Aim is to increase base level of condiConing • Strength/condiConing work takes precedence over sporCng skill • Players are to set short & long term goals for themselves for the upcoming season both on the field and off • TesCng – 1RM’s; 20-‐30-‐40 m sprints; agility, flexibility • Periodized program in place based on tesCng results; intensity will progress to 90-‐95% of MHR & 1RM last two weeks of pre season, sets, reps, tempo & rest period will be based on maximum HR/1RM each week
- 22. Example Pre Season Program • Monday -‐ CondiConing & Core work; Fartlek’s progressing into sprint intervals, swiss balls • Tuesday – Plyometrics; jumping rope, med ball toss, bounding, hopping • Wednesday – Agility & Core work; speed ladder, rings, med balls • Thursday -‐ Resistance; squats, cleans, push press • Friday -‐ Core condiConing; swiss ball, med balls • Saturday -‐ Resistance; lunges, dead liQs, rows, snatch pulls • Sunday: REST!
- 23. References • Zachazewski, James E. et. al. AthleCc Injuries and RehabilitaCon.Philadelphia, PA: W.B. Saunders Co. 1996. • Kraemer, W.J. and Baechle T.R. EssenCals of Strength Training & CondiConing (2nd ed.) Champaign, IL: Human KineCcs Publishers. 2005. • Janda, Vladimir, M.D. “Muscles and Back Pain: Assessment and Treatment of Movement Pamerns and Motor Recruitment.” Los Angeles, CA., June 18-‐19, 1994. • Arendt, Elizabeth A., M.D. “Common Musculoskeletal Injuries in Women,” The Physician and Sports Medicine. Vol. 24, No. 7 (pg. 39-‐47) July, 1996 • Daly, Judy and Ey, Wendy. “Hormones and Female AthleCc Performance.” Australian Sports Commission, 1996. • Chek, Paul. Program Design, correspondence course and videocasseme series. San Diego, CA: A C.H.E.K InsCtute publicaCon and producCon, 1995. • Rivard, Jim. “Eccentric Muscle Work: Data CollecCon for RepeCCons versus Resistance.” ScienCfic Physical Therapy. Vol. 5 No. 6, 1994. • Magee, D.J. Orthopedic Physical Assessment 2nd Ed. Philadelphia, PA: W.B. Saunders Co. 1992. • Waterhouse, Debra, Ph.D. OutsmarCng the Female Fat Cell. New York, NY: Warner Books. 1993.