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WARM-UP Before the Chill by Dr. Andrew Levanti, DPT, ATC

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The days are getting shorter and colder which can make sticking to your training program tough. Cold weather training can also lead to unwanted injuries, slowing down your progression and keeping you from participating in your favorite winter sports. A good dynamic warm up prior to activity is key to keeping your body healthy. Not warming up prior to your workout can leave your muscles feeling tighter throughout the workout and at an increased risk of injury. Below is a quick way to warm up and get keep you going through those chilly workouts.

Get the Blood Flowing:

Getting your heart rate up and the blood flowing to the muscles is the first step to a good warm up. A review of literature published in Sports Medicine concluded that increasing muscle temperature prior to activity can improve performance by decreasing the stiffness of muscles and joints, increase the transmission rate of nerve impulses, and producing a positive change of the force-velocity relationship (Bishop, 2003). Increasing blood flow and muscle temperature can be done in a few ways and really doesn’t require much space at all. If you have a stationary bike or elliptical at home you can hop on there for a quick 3-5 minutes at low intensity to get your heart rate up and blood flowing. If not, give these a try:

  1. Jumping Jacks:

    1. Start position: standing with your hands at your side.

    2. Movement: Start doing jumping jacks, raising your hands over head and jumping with your feet wide at the same time.

  2. Burpees:

    1. Start position: standing with your hands at your side

    2. Movement: Bring hands on the floor in front of you, then kick both of your legs backward, landing into a plank position. Perform a push up, then hop your legs back in toward your hands. Jump off the ground raising your arms overhead, then gently land, and repeat.

  3. Mountain climbers:

    1. Start position: Push-up position.

    2. Movement: Quickly alternate bringing your knees to your chest.

Dynamic Stretching:

The next step to a good warm is dynamic stretching to loosen up the muscles in preparation for the work out. A review of literature published in Current Sports Medicine Reports by the American College of Sports Medicine recommended dynamic stretching immediately prior to activity for a majority of athletes (Peck, 2016). Dynamic stretching consists of functional movements to bring the muscles into a lengthened position. They differ from static stretching in that the stretch is not held for prolonged amount of time. Once again, a ton of space is not needed to get this done in the house before heading out into the cold. It can be done in a hallway or even right in the living room. Here are a few dynamic stretches to try out.

  1. Walking Knee Hugs:

    1. Start position: Standing in a open and flat area.

    2. Movement: While walking lift one knee up to your chest and hug it with your arms. Hold 2-3 seconds, release, and take 2 steps, then repeat on the other side. Repeat 10-15 times of each side.

  2. Walking Quad Stretch:

    1. Start position: Standing in a open and flat area.

    2. Movement: While walking, bend one knee bringing your ankle to your bottom grabbing it with your hand. Hold 2-3 seconds, release, and take 2 steps, then repeat on the other side. Repeat 10-15 times of each side.

  3. Frankenstein's:

    1. Start position: Standing in a open and flat area.

    2. Movement: While walking kick one leg straight out in front of you hip high while reaching with your opposite arm to touch your toes on the leg you are kicking up. Take 2 steps, the repeat on other side. Repeat 10-15 times of each side.

  4. Walking Lunge Twist:

    1. Start position: Standing with your hands behind your head in a open and flat area.

    2. Movement: Take a large step forward, lowering into a lunge position with your knees bent to 90 degree angles. Keeping your chest up, twist your trunk to the left, then right, and back to center. Then raise yourself up and take a step forward with your other leg without letting your foot touch the ground in between and repeat motion. Repeat 10-15 times of each side.

  5. Walking Hamstring/Calf Stretch:

    1. Start position: Standing in a open, and flat area.

    2. Movement: Take a step forward placing your heel on the ground in front of you with your leg straight. Slowly bend forward at your hips with your back flat reaching your hands toward your toes until you feel a gentle stretch in the back of your thigh and calf. Then keeping your back flat return to as standing position as you reach your hands over your head before bringing them back to your side. Take 2 steps and repeat motion on other side. Repeat 10-15 times of each side.

At Complete Game Physical Therapy injury prevention is one of our primary goals. We provide wellness movement screens to ensure that your body is moving properly and efficiently. With the results of the screen we are able to provide you with a set of corrective exercises to improve your mobility and keep your body moving the way it should. If you are are interested in a wellness movement screen or have any questions please contact us at 978-710-7204 or via email at alevanti@completegamept.com

*Bishop, D. (2003). Warm Up II. Sports Medicine, 33(7), pp.483-498.

*Peck, E., Chomko, G., Gaz, D. and Farrell, A. (2014). The Effects of Stretching on Performance. Current Sports Medicine Reports, 13(3), pp.179-185.


Low Back Pain in the Youth Athlete

At Complete Game Physical Therapy, we have performed injury risk screens over the last two weekends for Storm Club Lacrosse, a local girls lacrosse program.  During the screening, we identified several athletes who required further evaluation for lower back pain.  This screening, along with a couple baseball players who see me due to lower back problems, made me think about the prevalence of lower back pain in youth athletes.

Though low back pain is more often associated with an older, sedentary population, it is actually quite common in youth athletes.  An estimated 10-15% of young athletes will experience low back problems.  With over 30 million kids participating in sports, this is no small number.  Here is a brief review of common causes of lower back problems in youth athletes and some prevention strategies to help reduce the likelihood of low back pain occurring.

Posture

Though the exact role of posture in relation to lower back pain has been debated, it is certain that poor posture will lead to problems.  A good way to think about posture is through a comparison to the alignment of your car.  You may be able to get away with your car being out of alignment for a while, but eventually misalignment will cause problems. 

Posture problems can generally be simplified to either overly extended or rounded.  Over extended (or lordotic posture) is often associated with athletes and, in particular, gymnasts, figure skaters and cheerleaders.  Rounded posture is what we commonly think of as slouched posture.  It is especially common in kids who spend a great deal of time playing video games, on computers/phones or watching television.  Either way, I like to simplify posture and tell my patients to just think of keeping your ear, shoulder and hip in line when standing and sitting.  You can also do some gentle shoulder blade pinches to help remind you to maintain good posture, especially when sitting for long periods.

Flexibility

Flexibility can certainly be an issue with youth athletes.  Combine the sitting we mentioned above with the possibility of recent growth spurts where muscle length may not keep up with bone growth and you end up with muscle tightness.  It is particularly common in two muscle groups: the hip flexors and the hamstrings.  

Hip Flexor Stretch

This can be particularly helpful with an athlete with more extended posture.

Hamstring Stretch

This can be helpful with an athlete with rounded posture.

Strength

Strengthening is also important, as many athletes with back pain tend to have weak core musculature.  I will review two exercises:  the pelvic tilt and back bridge

Pelvic Tilt

This exercise is accomplished by gently pressing the lower back down into the floor as you lay on your back.  The pelvic tilt has fallen out of favor with some who prefer to teach more of a neutral isometric exercise.  The pelvic tilt can, however, be very useful, especially with the athlete with extended posture.

Back Bridge

This is a great exercise to strengthen the core and glutes which can help take pressure off your lower back.

The exercises and stretches listed above may be helpful in reducing the likelihood of experiencing lower back pain and keep an athlete on the field.  This information is by no means, however, a complete review of lower back pain.  If you (or your athlete) are having lower back pain, you should be evaluated by a medical professional.

Thank you for reading.  Please sign up for my newsletter to receive more injury prevention tips.