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February, 2011
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Pilates is a great way to continue sports specific training in the off season.
In order to stay at the top of their game most professional athletes need an off-season to re-cooperate from their grueling seasons of overuse and trauma to their musculoskeletal system.  Pilates is a great way to continue sports specific training in the off-season.  It strengthens the core, reduces muscle imbalances while improving joint mobility, and reinforces pelvic and scapular stability.  This article discusses skeletal muscle strength and how to stay at the top of your game longer.

How Can I Stay At the Top of My Game Longer?

Robert Donatelli, PhD PT
January 31, 2011

There are a couple of sports that can be played year round. Indoors or outdoors, spring, summer, winter, and fall. So, how can these professionals stay at the top of their game year in and year out? Many amateur athletes are able to play their sport several days per week for years and never have an injury that is severe enough to end their career.

The amateur athlete can take off several weeks or several months and recover. However, professional athletes that play their sport 24/7 cannot afford to sustain an injury that will keep them from their competitions or tournaments for more than several days. Can specific training help to keep the amateur and the professional player at the top of their game longer?

There is one simple answer to maintaining your level of performance in any sport, skeletal muscle strength. The contribution of skeletal muscle strength and mass to health is under-recognized. It is a well-established fact that loss of muscle strength reduced the ability to perform daily activities and increases the incidence of death. For example, in men greater than 60 years old, lower grip strength values were associated with an increase risk of mortality (Machida Med Sci Sports Ex,‘04). A sedentart lifestyle results in premature physical frailty. As we grow older we lose muscle mass. From the fifth decade of life to our eighth decade we lose approximately 20 percent of our muscle mass.

In order to stay at the top of their game most professional athletes need an off-season to re-cooperate from their grueling seasons of overuse and trauma to their musculoskeletal system. Sports Specific Training in the off-season to improve performance starts with an evaluation of the musculoskeletal system. Evaluation of individual muscle strength deficits, agonist/antagonist muscle imbalances, muscles ability to stabilize joints, explosive power of muscle, the endurance to perform at your sport and joint range of motion measurements are necessary to design an optimal sports specific program for each athlete.

Sports like tennis is not an activity that builds skeletal muscle strength. It is a good activity to help improve cardiovascular fitness. Tennis activities, such as overhead serves, may cause a reduction in strength of the rotator cuff muscles of the shoulder. The cutting and twisting on the court to get to and hit returns are common causes of knee injuries and strain to the upper and low back. While traveling with the Champions Tour of Tennis, which included tennis legends such as Jimmy Conners and John McEnroe, the most common injuries I treated were shoulder, knee, and upper and low back problems.

Individual Muscle Deficits

The best way to determine individual muscle strength is to measure the ability of the muscle to generate torque. Peak torque is measured by a dynamometer. Peak torque is an objective measure of muscle strength. If we can give muscle strength and object number the therapist can then determine ratio’s between agonist and antagonist muscles, such as the rotator cuff muscle group of the shoulder. The external rotators of the shoulder need to be at least 70% of the strength of the internal rotators. If the external rotators muscle strength is less than 50% of the internal rotator muscle strength, the athlete could be in danger of injuring their shoulder. Not only are the rotator cuff muscles protective to the shoulder, they are also very important for improving performance in overhead throwing athletes. A study published in the Am Journal of Sports Medicine by Dr. Mont, demonstrated an increase of 11mph in the velocity of a tennis serve after strengthening the rotators of the shoulder (glenohumeral joint).

Muscle Stabilizers

The shoulder blade acts as a dynamic base that moves with the shoulder and allows the rotator cuff muscles to be explosive. The pelvis also acts a dynamic base to allow the muscles of the lower leg to be explosive. Recently I have seen an epidemic of knee pain related to muscle weakness of the pelvic and hip muscles (The Core). How can the muscle of the pelvis and hip effect the knee you might be asking yourself? In order for muscles to move bone, other muscles need to hold onto bones creating a solid base. Therefore, the muscles in the core function as stabilizers and/or mobilize bone to allow movement. How do the muscles know what to stabilize or mobilize? The muscle is told what to do by the brain. All we have to do is think go… and the brain sends a message to the muscles that are needed for the activity, e.g. Sprint to the left, slide to the right, or jump. Sometimes the muscles are injured or fatigued or out of shape and then, automatically, other muscles take over to help out. This is when we get injured, for example pull a muscle or suffer a sprained ankle.

Good muscle strength within the Core is very important to athletes. If we attempt change directions, we need to move laterally and move our body to land on one leg while at the same time rotate our hips. Also, while balancing on one leg we need a stable base. If the strength of certain muscle groups in the pelvis and hip are not strong enough, our pelvis becomes unstable. Have you ever tried to hit a tennis ball while standing on a wobble board? You will make all sorts of adjustments in order to hit the ball accurately. Those adjustments could develop into an injury or poor technique. Andy Roddick’s coach told me after we strengthened Andy’s pelvis and hip muscles that he was able to hit his passing backhand shot more effectively.

How can we know if we have weakness of the Core muscles?

I have put together an evaluation of specific tests to determine muscle strength of the Core muscles. One of the tests I use is a simple single leg stance position. It is amazing how many athletes have difficulty standing on one leg for 6 seconds. Then, I ask the athlete to do a partial squat while attempting to maintain their knee over the foot. Many times I observe no control of the leg. As the athlete performs a partial squat they start to lose their balance or are unable to maintain their knee over their foot, as the knee moves from side to side during the squat. I have observed many athletes with low back pain,hip pain, and knee pain and patellofemoral pain syndrome as a result of weakness of the core muscles. The lack of strength of these stabilizers can cause chronic injury or poor performance on the field or court. A strong and stable core can improve optimal performance throughout the lower leg and enable the athlete the speed and endurance to get to the ball and a better base to hit off of.

The following links are great core strengthening and balance exercises videos.
Trunk and Core Exercises
Arm & Leg Raises for Core Strength Exercises
Transverse Abdominal Press
Strengthen Your Trunk. Prone Bridge
Core Strength Exercises: The Side Bridge
The Bridge for Hips and Core Exercises
Standing Balance Exercises
Balance Exercises with Physio Ball

Joint Range of Motion

An important evaluation to design a sports specific programa  is to determine joint mobility. For example, sports that involve an overhead motion lends itself to developing specific joint limitations in the shoulder. Jeff Cooper the head trainer for the Philadelphia Phillies, was able to keep 22 pitchers over 3 seasons injury free by maintaining the shoulder range of motion. None of the pitchers were taken out of a game because of shoulder pain, nor did they need to be treated for shoulder problems.

Endurance Specific for Sport

Finally, in order to develop a sports specific program the athlete must train to improve endurance specific to their sport. For example, an athlete needs to improve their ability to be explosive. Running long distances is actually detrimental for the development of explosive power. Therefore, athletes like tennis players need to train by doing explosive leg powerg short quick movements such as sprints, plyometrics, and explosive weight training.

Training for your sport can either be a shot gun approach of strengthening, endurance, and some form of explosive exercises not specific to the muscles involved in your sport, or it can be specific to their sport. Changing the athletes’ muscle deficits by performing specific muscle strengthening exercises reduces muscle imbalances and improves joint mobility. This along with work on specific endurance training exercise is the make up of a sports specific training program. However, the first step is to be evaluated by a clinician who specializes in the musculoskeletal system and can offer sports specific testing.

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