News & Events

The Magical Balance Between Strength and Cardio Training

Looking for the “toned look?” We have been asked many times how to tone a specific body part. In reality, the answer is…you cannot. So how can you maximize your training program and see the results you so desire? Cardio and strength training are both useful tools when it comes to maximizing your goals. Let’s break it down…

As easy as it may sound, the body does not pull fat from specific areas we are working. During training the body will use fuel from all sources and areas, depending on the type of workout, how much you eat before training, the time of training, etc. By utilizing both cardio and strength training, we can maximize the body’s system and start seeing results.

There is a delicate balance between strength training and cardio which is different for everyone. The only way to “tone” a specific area is to lose fat and increase muscle size for that area. You are probably saying, “I do not want to get bigger, I just want to lose fat.” In a perfect world that would be nice, but as we all know, this world is not perfect. Building muscle is required to see the definition of the muscle and gives you the actual “toned” look you are looking for.

How do we reach such a magical balance?

Resistance training, although not as calorically demanding as cardio, will burn fat for the long term. With an increase in muscle or fat-free mass, your body’s resting metabolic rate will increase. Resting metabolic rate is your metabolism at rest, basically the amount of energy needed to sit around the house all day.

Increasing cardio and monitoring your food intake is the best way to reach the toned look you have been striving to get. Cardio is a great way to quickly burn extra calories throughout the day. 

Again, you may be asking yourself, “I cannot run, so I can’t achieve this dream look?” OF COURSE, YOU CAN! Cardio has become this scary word that no one wants to do because they do not have time to go run five miles a day.

“The American Heart Association recommends at least 30 min a day for 5 days a week.”  This can be anything that gets you moving and gets your heart rate up. Now, you are probably saying, “I do not have a 30-minute chunk of time in my day!” My question is, “Do you have at least six, 5-minute chunks?” That is enough time to take a break and at least walk around the block or a couple of laps around the office.

As stated before, everyone is different when it comes to how much training is required to meet your goals. I would recommend starting with MET-FIT training with our performance coaches with the goal of building a routine that is safe, comfortable and manageable. Then, use our expertise to help provide programming to help you achieve the body you have always wanted.

Written By: Trevor Krzyzanowski, BS, CSCS, USAW-1 Performance Coach

The Dark Side of Athletic Injury

I’m sixteen years removed from graduate school. The running joke in my family is I have a Master’s degree, thesis pending. True, I completed my coursework with flying stars and started my thesis… but never finished it. Life events got in the way and I had to focus on other priorities.
 
Anyone in academia knows the key to having a worthwhile thesis is to have a really long title to it.  Mine was “Certified Athletic Trainers’ Knowledge, Attitudes, and Beliefs About Post-Injury Depression”.  That was a bit on the short side, so it was probably doomed from the beginning.  All joking aside, however, the topic of post-injury depression still intrigues me today. 
 
I have many years of experience in a high school athletic training room and have seen first-hand what a season-ending injury can do to a young person. They do not get through the process emotionally unscathed.
 
I remember a particular athlete and watching her story unfold.  Her dad stopped coming up to practices so she felt she lost her relationship with him.  His approval seemed to only be for athletic achievements.  Two of her “best friends” abandoned her.  Her boyfriend broke up with her because he was not capable of supporting her through the emotions she was experiencing.  Her grades began to suffer and I saw her starting to make choices with alcohol that were going to be damaging.  Thankfully, her story turned out okay, but what about all those athletes who don’t have anyone around them to connect the dots and get them help?
 
Here are just a few of the things athletes go through in this situation (definitely not all-inclusive). 
  • Loss of identity 
    Most athletes’ identities are rooted in athletics, especially if they are not involved in other activities.  An injury happens and they are no longer an “athlete”, so who are they now?
  • Loss of friendships and their support system 
    The athlete is injured, but the team can’t just stop.  The team has to go on and continue to practice, battle together in competition and develop the bonds that athletics creates.  If the injured athlete is spending considerable time on rehab or doesn’t get to travel with the team they miss out on these opportunities and drift from their friends and teammates.
  • Extreme feelings of guilt 
    The athlete feels they are letting their team down.  They can no longer contribute to the team’s success or goals and they have to miss team activities or practices due to balancing time in rehab.
  • Impatience, irritability, and rapid mood swings 
    There is a lot of emotion swirling around during this time and many athletes lack coping skills outside of physical activity .  Having to be dependent on others, the slow pace of rehab, not having control over the situation, and the general state of where things are at contribute to these feelings.  Sometimes, it’s made even worse by pain and/or pain control medication.
  • Increased risk of suicide, alcohol or drug dependency, or other self-harming activities 
    Unfortunately, most athletes are already considered to be part of a high-risk age group for these things.  So, when compounded by a significant injury at a time where they have little to no coping skills can be a bad recipe.  It is very important for the people around the athlete to be diligent in recognizing the warning signs of these types of behaviors. This link provides some additional sites and organizations that can be used as resources:  http://athletesconnected.umich.edu/how-you-can-help/help-a-student-athlete/
 
During long rehabs I took some very intentional steps with athletes, including finding them a role with their team, setting lots of short-term goals so we had lots of “wins”, and connecting with their friends and family outside of the sports platform.  I also was not afraid to refer someone for professional help.  Just as someone would seek a surgeon for a torn ACL and a therapist for their rehab, it is okay to address the mental health side of the injury with an expert in that area.  
 
And, lots of times, I just had to be there for them while they felt their feelings.
 
The good news is the sports community is talking about athlete mental health more than ever before.  In recent years the NCAA recognized the importance of addressing mental health issues in athletics and enhanced available resources.  Today, there are so many phenomenal resources available to athletes struggling with depression and other mental health issues.  I recently learned about Athletes Connected and it has quickly become one of my favorite resources available to athletes, especially the videos that share real athlete’s stories about battling depression or other mental health issues.  (Thank you Dr. Erin Haugen of www.drerinhaugen.com for the reference).
 
If you are a parent and have a child that is enduring an injury, don’t forget this aspect of their care.  If you are an athlete, you are not alone and there is help out there for you!  
 
Question: If you’ve experienced a season ending injury, what things did you experience?
 
Written By: Danielle Kleber, ATC

Myths about Youth Strength Training

I have heard some concerns and confusion from parents about the proper age to begin strength training for their daughter or son.  Everyone has heard horror stories of kids who started strength training at a young age and thus had negative effects on their health as adults.   With proper guidance, strength training for young athletes and children, in general, can be very beneficial to their on-field performance and overall health.

We are going to cover three common myths associated with youth strength training and how Athletes’ Training Center is overcoming those challenges.

Myth #1 Strength Training is all about Moving Heavy Weight and Increasing Size.

When it comes to high school and collegiate strength training, this phrase is true: A part of those programs is to develop the athlete’s overall strength and power development.  During the off-season of these programs, we want to make the athlete as strong as possible.  This is true for experienced athletes who can handle that amount of load.

Youth strength training is a whole different ball game. When it comes to strength training for children who are prepuberty and beginners, a different tactic is used to produce strength gains.  Youth strength training commonly uses body weight or light free weights, with an increase in total volume, i.e. increased reps per set.  With the watchful eye of a certified strength coach, these moves are performed in a safe manner to eliminate the dangerous stress put on the body.

Myth #2. Strength Training Will Stunt the Growth of Young Athletes.

The only time this would happen is if the growth plates are affected during exercise.  Again, with proper coaching and weight selection, growth plates will continue developing at a natural pace.  In a 2009 literary review, the risk of injury during strength training for youth athletes was explored.

This review looked at a multitude of different training procedures and the injuries reported from those studies (Faigenbaum).  The authors comment on the growth plate injuries as being caused by improper technique and loading procedures for the athlete themselves.

Myth #3. Strength Training is Dangerous.

Strength training, just like any practice or daily movement has a risk of injury.  Just how we can stub our toe by getting up off the couch, tweak our ankle as we go for a walk or simply slip as we walk up our front steps; strength training safety all boils down to coaching and exercise selection.

To wrap things up, youth strength training is a very good thing for young athletes as long as they have proper guidance through a scientifically based and personalized program.  In the study stated above, a very small amount of injuries were reported during the studies.  At Athletes’ Training Center, we take on youth strength training in the safest manner.

We make sure the athletes are moving correctly before we load the movement, thus decreasing the risk of injury and establishing proper muscle control and memory to maintain safety throughout their athletic endeavors.

With strength training, the athlete can develop the proper strength and stamina needed to minimize this risk of injury.  Our athletic development programs focus on meeting the goals of each athlete.  We accomplish this by utilizing a comprehensive evaluation to gain valuable information to develop a custom program that is progressed to meet the athlete’s specific goals.

Learn more about our programs and sign up for a FREE Trial today.

Written By: Trevor Krzyzanowski, BS, CSCS, USAW-1

Bibliography

Faigenbaum, A., & Myer, G. (2009). Resistance training among young athletes: safety, efficacy and injury prevention effects. Journal of Strength and Contioning.

How to: Improve Your Health Through Breathing

Is your breathing helping or hurting your daily performance?

The average person will take more than 8 million breaths per year! Yet, chances are you may not be taking the proper steps for your breath to properly serve you in day-to-day activities and workouts. Today, I will go over three simple tests you can use to improve your workout, mood and manage stress levels. 

Breathing Test:

  • Start by lying on your back.
  • Place your right hand with the thumb below the ribs and the center of the palm on the abs (as if you had a tummy ache).
  • Take the left hand and place it on the chest, centered on the ribs.
  • Finally, inhale through your nose and out through your mouth.

What did you feel?

Ideally, you should feel your stomach begin to expand before your chest and shoulders move. There should have been minimal movement in your upper hand. This means your extremely strong breathing muscle, called the diaphragm, is doing its job!

The diaphragm pulls the lungs down during proper breathing, expanding the lungs in a 3-D like a pattern, top to bottom, front to back, and to the sides

Breathing is an involuntary muscular action, meaning we don’t have to think about it. Because of this, many people are not able to fill their lungs to full volume. When this occurs, it is called a “chest breath”.

A chest breath is a type of breathing when the diaphragm is not involved, and we are not using our lungs to their full capacity. This type of breathing causes the body to enter a response state called “Fight or Flight”. This type of body response is what we feel when we encounter a bear and must make the choice to defend ourselves or run. When our bodies are in this type of response, it causes a release of stress hormones to the body. These stress hormones are highly inflammatory and negative to the brain and body’s performance over a long period. 

3 Breathing Exercises:

To help eliminate the release of stress hormones throughout the day, try this exercise.

  • Inhale for 6 seconds
  • Hold that breath for 4 seconds
  • Exhale for 10 seconds

If you feel groggy or tired, try this exercise. 

  • Inhale for 6 seconds
  • Hold for 2 seconds
  • Exhale forcefully

Finally, to prepare your body for a workout, try this breathing exercise. 

  • Inhale for 4 seconds
  • Hold briefly
  • Exhale forcefully

As we breathe all day without much thought, it is important we become aware of how we are breathing. Being able to control breathing will help you become more mindful and feel better throughout the day!

Try these three exercises out and see a difference in your mood and activity.

Happy breathing,

Parker Victor, MA, CSCS, USAW-1, Head Performance Coach

5 Reasons to Prep For Football During Baseball

I got a great question from a parent the other day I wanted to share with you:
 
“What are your thoughts about strength and conditioning during baseball season to prepare my 14-year-old son for football?”  
 
I think every parent has an assumption about this topic that is either rooted from their personal experience as an athlete and what they were exposed to and/or what they have researched on the internet.   
 
What is your assumption?
 
The truth is, if your player is in a good program that is tailored to them, then strength training and conditioning can be powerful in helping their performance in-season on the field or court.  In breaking down this parent’s question as it pertained to her son, here are five reasons why I said “yes” he can and should be training.
 

football, baseball glove and baseball
5 Reasons to Train For Football During Baseball Season

 
1. Helping to maintain body weight
 
Often baseball players will lose weight over the course of a baseball season. Some of that weight will be water volume and some will be lean muscle tissue. Losing body weight via water or lean tissue loss will negatively affect performance.  A dehydrated and thinner body will not produce the same power and explosiveness as a healthy, hydrated body. This parent’s son will be transitioning right from baseball season into football. This transition time is not enough time to likely restore the body to where it was prior to baseball season.
 
2. Maintaining strength
 
Maintaining strength directly ties to the first point.  Strength training is the stimulus the body needs to continue to build lean muscle tissue and reverse the natural decline that happens when strength training is stopped.  Maintaining strength really is not the most accurate way to phrase it.  In reality, we are either gaining strength or losing strength.  For this parent’s son, to walk into a football season in the “losing strength” mode is not going to lead to the performance outcome he is looking for.
 
3. Helping the body adapt to football demands faster
 
Football and baseball are very different in their physical demands and athletes transitioning from baseball to football will have a shock to their bodies that they will have to overcome.  That shock comes from the lack of preparation of the specific physical intensity football creates.  An in-season program has the opportunity to progressively build the athlete’s body up to those more intense requirements without overtaxing them physically for their in-season sport.  This preparation will help the athlete adapt sooner, be less sore, and perform closer to top performance right away when football practice starts.
 
4. Preparing the athlete to get into “football shape”
 
The fitness demands in football easily exceed that of baseball.  In baseball, there could be upwards of a 1:20 work to rest ratio whereas in football the ratio is closer to 1:6.  In football, a 1-way player will have about 70 plays while in baseball there might be 30 balls put into play in a 9-inning game.  In football, a player will run twice as many plays with 70% less time between plays.  An in-season strength and conditioning program will help the athlete’s fitness to be gradually built up so they will be at or close to “football shape” when making the transition between sports.
 
5. In-season training should not affect your performance
 
The first goal of in-season training is to make sure the athlete can continue to perform when it matters at a high level.  An athlete cannot do that if they are sore. 
 

Soreness comes from inappropriate exercise selection, inappropriate progressions in volume and/or intensity, and an inability to recover from previous bodily stresses (which could be exercise or sports induced).   

 
In a youth baseball season the schedule can be erratic, so the in-season program has to be constructed in such a way that takes into consideration the weekly volume and intensity as well as game and practice schedules.  
 
If an athlete normally trains Monday and Wednesday and this week only has games on the weekend, then our volume and intensity could be a little more intensified as the athlete will have time to fully recover.  On the flip side, if a makeup game is scheduled for Tuesday then we know we need to have less volume and intensity Monday but on Wednesday we could amp it back up and focus on those key area needed to prep for football.  
 
In-season training is something that many parents and coaches tend to overlook the value in.  For a multi-sport athlete who goes from one in-season to the next, they inevitably will see a drop in performance.  
 
Remember, your athlete is either “gaining” or “loosing”. 
 
Written By: Travis Manners, PT, SCS, CSCS, Owner & Founder 

How to Self-Diagnose Your Athlete’s Arm Pain

Late spring into early summer is one of the most common times we see shoulder and elbow injuries.  A lot of parents often ask me what “warning signs” they should be looking for with their son or daughter’s arm pain. Most importantly they want to know if the pain is serious or not. 

To a certain extent, we come from a place where we believe the motto “no pain, no gain”, and in some cases, I fully agree with that mindset. But at other times, this mindset can be very detrimental. How do you determine which pain is okay to play through and which pain is not? Here are four common arm pain areas to evaluate and guidelines to help you decide if your athlete should get the area checked out.

Pain Area #1:
Front or the back of the shoulder

Back of Shoulder Pain 

Pain and soreness in the shoulder are not uncommon with athletes, but the key is where the pain is located. Pain and soreness in the back of the shoulder usually occur when athletes use their arm to throw or serve. The muscles in the back of the shoulder often get strained.  They are small muscles and take on a lot of force when the arm is stopping after a throw or a swing.  Typically, this soreness gets better by the next day and eventually the muscles get stronger so the pain does not return.  

Front of Shoulder Pain

Front shoulder pain is a whole different issue.  We consider this pain to be concerning, and it should be closely monitored. Structures like the front ligaments of the shoulder, the labrum (cartilage in the shoulder), and parts of the rotator cuff are all stressed during overhead movements.  If your athletes are complaining of pain here, this is NOT the pain they should try to play through.  The pain can go away on its own; however, if the pain persists for more than three days or if it occurs every time they try to play their sport, go have it furthered examined by a physical therapist or a licensed health care professional. 

Pain Area #2:
Outside of the upper arm

Pain and soreness aren’t commonly experienced on the outside of the upper arm as the deltiod muscle is just about the only muscle in that area. Pain here, especially in adolescent athletes, is usually a sign of an injury to the growth plate of the upper arm.  Have you ever heard the term “little leaguer’s shoulder”?

Little leaguer’s shoulder can have delayed healing and significant downtime if left unaddressed.  Again, like in the shoulder, this pain can go away fairly quickly.  However, if it becomes persistent or happens every time the athlete tries to use their arm for activity, it is time to have it checked out.

Pain Area #3:
Inner or outer elbow  

Inner elbow pain

Pain and soreness in the elbow are not as common as the shoulder and tends not to be bothersome – unless the athlete is throwing or serving. This infrequency is why I think people don’t have this area looked at as much or soon enough.  The inner elbow is home to some key structures that are stressed during overhead movements.  The ulnar collateral ligament (Tommy John ligament) and the inner elbow growth plate (little leaguer’s elbow) are the most significant.  Once these areas start developing pain, they are usually past the mild stage and are typically in the damage stage.  

Outer elbow pain

The outer elbow rarely develops pain and usually does not develop pain without previously having inner elbow pain.  Pain in the outer elbow can be significant such as a cartilage lesion on one of the forearm bones.  This damage happens from over-compression in the joint, commonly due to a loose ulnar collateral ligament.  Like the inner elbow, by the time this area becomes painful, the damage has already set in.  

Pain localized to the inner or outer elbow should not be dismissed as the consequences can be detrimental to the longer term health of the elbow.

Pain Area #4:
Biceps or triceps muscles

Pain and soreness in muscle tissue is rarely a “red flag” for us.  Injuries to muscles can definitely be painful but more times than not, they will resolve on their own in a reasonable amount of time.  The biceps and triceps are the muscles most susceptible to getting strained in sports like baseball, softball, and tennis.

 

A lot of the time the pain is located in the middle of the muscle or, for tricep pain, down by the elbow joint. Again, these pains usually go away quickly and usually respond well to light to medium massage.  If for some reason, the pain is not fully gone in a couple weeks, then I would recommend getting it checked out.


Conclusion:

As your athlete participates in the common summer sports, pain and soreness can and will happen.  The key as parents is to continuously monitor the symptoms and use the guidelines above to help determine severity.  If the pain falls into one of the key areas, don’t be that parent that finally takes their kid in only to find out they fractured their growth plate.  On the flip side, if the pain isn’t too bad, “go rub some dirt on it” is sound advice!

When in doubt give us a call 402.932.7111 if you have any questions about your athletes’ arm pain.  We’d be happy to answer any questions you may have! 

Written By: Travis Manners, PT, SCS, CSCS

Shin Splits, How to Reduce Your Risk – 3 Strategies

I have two words for you.  Two words which give runners everywhere nightmares.  “Shin splints”. Most people are familiar with this diagnosis; and if you have had them before, you know that they are highly irritating!

In this blog, I want to talk about three strategies you can use to help reduce your risk of developing shin splints symptoms. 

1st: Buy a Good Pair of Running Shoes

Just like anything else shoes break down and need to be replaced. How often they need to be replaced depends on how far you are running in a week.

As a general rule of thumb, running shoes should be replaced every 300 to 500 miles, which means you can’t simply replace them once a year (if you are averaging 50 miles a week).

2nd: Slowly Ramp up Your Running Distance

Have a plan for building up your running distance. If you want to run a half-marathon this summer, but have not been putting in any miles during the winter, you should not start off running 30 miles a week.  You should instead begin by building up your walking tolerance, move to walk/run intervals, then build your running distance from there.

Going from spending most of your time sitting on the couch and binge-watching Netflix straight into hardcore run training is a sure fire way to end up with a case of shin splints.

3rd: Stretch Your Calf Muscles 

Finally, make sure you stretch out your calf muscles before and after your run. When stretching out your calves, it is important to ensure you stretch out both of the major muscles which reside there, your gastrocnemius and soleus muscles.

The gastrocnemius is stretched when your toes are pulled toward your head with your knee straight as this muscle spans across the knee. In order to stretch the soleus, you must have your knee bent as this muscle stops short of the knee.

soleus stretch

gastrocnemius stretch

 

Each of these three strategies can play an important roll in helping you to avoid shin splints and helping runners everywhere to get a better night’s sleep!

 

 

If you or someone you know is already dealing with this condition, then set up an appointment today to be seen by one of our physical therapists.  There are many strategies to help speed up recovery!

Written By: Josiah Parker, PT, DPT

5 Common Pitching Mistakes & How to Avoid Them

I hate seeing young athletes hurt.  There may not be a worse feeling than telling a young, energetic, baseball loving athlete they need stop playing for a while so we can get them through an injury.  Now, I appreciate there are some injuries that are completely unavoidable and these injuries are the nature of playing sports. 

On the other hand, some of the injuries I see in the clinic have the potential to be avoided with a little extra knowledge and a keen eye.  

In this post I will cover some of the common mistakes to look for in your young throwers.  I will also share how these mistakes can lead to less than optimal performance and how they create the potential for injury.pitcher

Mistake #1 – Getting out of the glove late

 

This error is one that can have a detrimental effect on the rest of the throwing cycle because if the hand break is delayed it forces the thrower to have to catch up in the sequence of the throwing motion.  As the pitcher begins to come out of his balance position and his front knee begins to lower, his hands should begin to separate from the glove.  In doing so, he will not be rushed to get the arm into the proper position or slot when he starts delivering the ball.

 

Mistake #2 – Faulty arm path
 

Faulty Arm Path

We were all taught as kids when you bring the ball out of the glove the arm should follow a “C” path or “down, back, and up”.  The reason we were taught this was because it gets the arm in the right position for effective delivery. The common faulty arm path I see is the ball coming down and behind the pitcher after it exits the glove.  Now the pitcher has to hurry up to get his arm in the proper position for delivery.  If his timing is not just right, it leads to the next mistake.
 
Mistake #3 – Lagging coming through the slot

Pitcher dragging

Once a thrower starts turning his chest toward the target, the throwing arm should be in sync with the torso, or in other words, they should move together at the same time. Have you ever seen a young pitcher make a throw and it looked like his hand was still pointing at the short stop when his chest was facing the catcher?  That is lagging.  The arm is trailing behind the body’s movement toward the plate.  In my opinion, this mistake is the NUMBER #1 cause of shoulder and elbow injuries in young throwers.
 
Mistake #4 – Glove side arm flying open

Glove side openRight up there with “down, back, and up”, “tuck your front side elbow” was probably the next thing I remember all my coaches preaching – and rightfully so.  When a thrower is delivering the ball to the catcher, all his momentum should be driven forward toward the catcher.  If the front side arm is away from the body, it creates a spinning effect drifting the pitcher off to the side and not toward the catcher.  

This error has two consequences.  First, the pitcher has a harder time locating his pitches because it is hard to time a spinning motion.  Second, now the pitcher lands unbalanced and often is not ready to field a ball or protect himself if the ball is hit back toward him.

 

Mistake #5 – Breaking Lead Leg

Now this on2Breaking kneee sounds bad.  I do not mean the pitcher actually “breaks” his lead leg.  I mean the pitcher is applying the brakes through his lead leg.  When a pitcher is delivering a ball, his momentum shifts his weight from his back leg to his lead leg.  When this happens the lead leg’s knee is supposed to be athletically bent.  Breaking the lead leg is when the pitcher rapidly and often violently snaps his knee straight as he is shifting weight onto it.  This error stops all forward momentum and energy thus forcing the arm to make up the difference in order to attain to the desired velocity. This mistake is the NUMBER #2 cause of shoulder and elbow injuries I see.
 

Coaches have an incredibly tough job when it comes to developing young pitchers.  I have discovered in my time of working with young baseball players there are a lot of kids ‘throwing’ off the mound and very few ‘pitching’ off the mound.  Having a keen eye and keeping these mistakes in mind will help your young pitcher stay healthy and develop a great foundation for pitching!

 
Written By: Travis Manners, PT, SCS, CSCS

 

Question: How are your young thrower’s mechanics?  Have you noticed any other common mistakes? You can leave a comment below.
 

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Tips for Managing Sleeping After A Concussion

Guest Blogger Introduction: Rebecca Lancaster, MD – Methodist Physicians Clinic

Rebecca is a graduate of Creighton University Medical School and Clarkson Family Medicine Residency.  She is a board certified Family Medicine Physician.  Rebecca began managing athlete concussions in 2010 when she became one of the first ImPACT certified physicians in Nebraska. 

She has continued to assist concussion patients in private practice and more recently at Methodist Physicians Clinic in Omaha, Nebraska. 

Her concussion patients now extend beyond athletes to include all age groups, as is consistent with family medicine, and varying degrees of head injury from acute concussions to post-concussion syndrome. Rebecca continues to be active in Concussion Focus and concussion education in the Omaha community.  Her goal in treating concussion patients is to understand where they are in their recovery,  help them through with the resources we have available and return them to their fullest quality of life after these most unfortunate head bumps.

Ah, sleep!  It is oh so important when you are recovering from a concussion, but what do you do when the injured brain does not want to sleep? 

Sleep habits become more essential post-concussion.  Scheduling regular sleep, wake times, and sticking to them helps. Here are a few tips you can implement to help manage sleep after a concussion. 

Managing a Concussion: Sleeping Tips

Aim for 7-9 hours of sleep per night. Minimize screen usage such as phones, computers, TVs, and reducing exposure to brighter lights before bed will help.

Try relaxing activities, meditation, stretching or reading if tolerated can be helpful before bed.  A short nap can be okay during the day, but if it starts to impair your ability to fall asleep, you may want to limit the duration of the daytime resting or eliminate it all together.  Physical activity is helpful during the day if you can tolerate some, but physical activity just before bedtime can make you more alert.  Decreasing or eliminating caffeine helps as well. 

And what if these tactics still do not work?

Sometimes an over the counter sleep aid like melatonin starting at a dose of 1 mg – 3 mg can be helpful to drift off to sleep easier. If headaches are a bother as well, Tylenol or Ibuprofen, at an appropriate dose for your age, prior to sleep may help.  You may also want to talk with your physician about medications that can diminish headaches as well as assist in sleep. 

Overall it is perfectly reasonable to start examining and modifying sleep habits. It may take some discipline and patience as you try a few nights with your new sleep routine. This course has no side effects and could lead to fewer concussion symptoms. If the concussion, however, has caused more difficult to manage sleep cycles, do not hesitate to seek help.

Sweet dreams!

Guest Blog Author: Rebecca Lancaster, MD


The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)


Our Collaboration with Concussion Focus

What is ConcussionFocus? Concussion Focus is a collaborative group of healthcare professionals in the Omaha and surrounding area that decided to come together to provide a team approach to concussion management. 

Representing the areas of family medicine, pediatrics, neurology, athletic training, physical therapy, and other disciplines allow each professional to offer expertise in their field while communications with each other to best serve the patient’s needs.

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What Everybody Ought to Know About: Concussion Protocol Evolution

Around 2004, while the head athletic trainer at a Class A high school in Lincoln, NE, I had the good fortune of being part of a research study that was looking at the use of a computerized tool for assessing concussion. The name of the program was ANAM and it assessed things similar to what we know today as ImPact.  In watching football players take this test after sustaining a concussion and comparing it to their baseline, I started to notice something that made me sick to my stomach.

Kids were not recovering in the 7 day window which we used at the time as the standard for clearing them to play again after concussion.

Especially freshmen and sophomores.

Concussions Early 2000’s.

Dr. Lori Terryberry-Spohr, a phenomenal practitioner and researcher at Madonna Rehabilitation Hospital, was instrumental in helping me understand what this program was finding and why it was starting to concern me.   I was noticing athletes were still symptomatic even after returning to play.  They were struggling with quick and accurate decisions – which is something essential to playing sports effectively and safely.  I was starting to question how I was handling concussions and wondered if we needed to start doing things a little differently.  The other athletic trainers in my school district were wondering the same thing. 

I was starting to question how I was handling concussions and wondered if we needed to start doing things a little differently.  The other athletic trainers in my school district were wondering the same thing. 

 

At the same time, the national landscape was changing drastically in regards to managing concussions and in a very short amount of time we are where we are today.  No longer do we rate concussions in severity and no longer do we use a variety of grading scales that vary from liberal to conservative. You either have one or not.  Terms like bell rung, dingers, and stuns are not used any longer.

Concussions Today

All sorts of technology exists to aid athletic trainers and other sports medicine practitioners with concussion management.  There are state laws in place with the hope of protecting young athletes from continuing play after sustaining a concussion Nebraska LB 923.  Most importantly, we have much better approaches to return to play and now return to learn.

The more interesting point is all of this new information has streamed, really flooded, into mainstream media and the households of America.  Yet I still have to endure the verbal lashing from a parent when I explain why their athlete can’t finish the game and will probably be out for a minimum of 2 weeks. I still have to drum like the Energizer bunny advocating on behalf of the kid whose parents refuse to associate the decline in school with the concussion their athlete sustained months earlier.  I still have to read doctor’s notes clearing kids a day later.  

Yes, I said doctor.

I still have to drum like the Energizer bunny advocating on behalf of the kid whose parents refuse to associate the decline in school with the concussion their athlete sustained months earlier.

 

The good news is the greater majority of athletes, parents, and practitioners get it now and this has led to some really great multidisciplinary approaches to helping athletes recover from concussion.  A great example is the team of providers in Omaha that participate in Concussion Focus.  My colleague Josiah Parker leads that team.  He has immersed himself in knowledge and practice techniques to provide post-concussion physical therapy and for the small percentage of cases that don’t resolve normally he can make all the difference in the world for their recovery.

Obviously I did the best I could back then based on the information we had at hand.  I also feel extremely grateful the kids I sent back out did okay.  Today, though, I know so much more and am appreciative for all of the resources that exist for kids in relation to concussions.

Written By: Danielle Kleber, ATC Director of Marketing & Operations

Question:  Do you know which sport has the second highest incidence of concussion (next to football)?

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How To: Crush Your Goals – Even When You Have No Motivation

Making changes is really tough.  Human nature often seems to get the best of us, no matter how hard we try to instill a new habit or focus in on a goal.

Some of us struggle more than others and some people have an easier time with it. (I think the latter are where performance coaches come from). Either way, it might be good to start with a basic concept about motivation.

We are motivated in two ways – intrinsically and extrinsically.  Intrinsic motivators are things that come from within like the desire to do your best, the ability to stay dialed into a goal, or the pleasure you get from doing a good job.

Extrinisic motivators are things outside of you that push you towards an action.  

For example, a free t-shirt upon joining, a contest with a big prize at the end, a reward your coach gives you for making it to your 20th session.  

The key to staying locked in on a goal or making sustainable changes to a behavior is to get yourself to a place where you rely on intrinsic motivation.

Or, at least, that is what they teach you in school when you study exercise science. You’re taught to design fitness programs or corporate wellness programs with lots of extrinsic reward up front with a goal to move people to intrinsic motivators to stay at it all by themselves.

I am sitting in an airport right now watching people and I don’t think this model is working.

How about we figure out what motivates each person? It is not the same for each of us – I can assure you that! How about we help empower people to become self-aware to know what works for them and then make sure we embed that into their programs?  

Now we’re getting somewhere!

Obviously this is just my opinion, but I watch our coaches work with our members on a personal level like this everyday and see it gets results.  I know digging in and learning about the person and what motivates them or keeps them accountable is an important part of serving the client.

I also know that most people need some form of ongoing extrinsic motivating factors surrounding them.  Sure, there are those few that are self-disciplined or motivated at a higher level.  However, the majority of us need constant focus on a reward or goal.  

I believe it is time people start demanding more out of the training experience and this is simply not possible with the big box gym set-up with the cheap monthly membership.  

Is semi-private training an investment?  Yes, absolutely it is.  

Is it worth it?  Well, is what you’re doing now working?

Question:  Consider your personal behaviors… what truly motivates you?

Written By: Danielle Kleber, ATC Director of Marketing & Operations

Do you Experience Back Pain After Working Out?

5 Things I Did to Reduce My Own Post-Exercise Back Pain

I don’t know about you but I love those workouts when you finish and you think to yourself, “Yep, I crushed it!” But for me, then the inevitable would happen. Later that night or the next morning I would feel my back start to tighten and before long that low-grade nagging pain would return in my lower back. 

When I was younger the pain would stick around for maybe a day. However, as I got older the pain would start to last for three or four days up to even a week.

The tipping point for me personally was about eight years ago when I herniated my L5/S1 disc. Once I recovered from that injury, I decided it was time to start being more proactive toward my nagging low back pain. Here are five things I began incorporating into my workouts on a regular basis.

I started incorporating these five things in my workouts on a regular basis and I am happy to say my back pain has significantly reduced and my recovery between workouts is back to where it was 15 years ago. 

My Top 5 Go-To’s:

1. Thoracic spine rotations

Why it works: Having a mobile and flexibile thoracic spine (upper back) is pivotal to low back health. If our upper back is tight, forces will transfer down into the low back which may overload the small joints of the back causing soreness and pain. 

Performing this exercise:

Lay on your side with your upper leg bent to 90 degrees at the hip and knee and propped up on a foam roller.  The hand of your down arm should rest across your top knee.

With your top arm, reach back toward the ground trying to get your shoulder blade to rest on the floor.  

Make sure your top knee does not lift off the roller.  Hold for 5 seconds and repeat 10 times each direction.


2. Hip figure 4 stretch

Why it works: Hip tightness, especially in the back of the hip, is without a doubt the most common restriction we see in people with low back pain. Like the upper back, if your hips are tight and don’t move well, the force from the lift gets moved up into your low back. This stretch is designed to target that specific area. 

Performing this exercise:

Starting on your hands and knees, bring one leg in front and across the other like you were folding your legs.

From there, sit back letting your other leg side straight which will stretch your other hip.  

Hold for 15 seconds and repeat 5 times.


3. Elevated toe touches

Why it works: For lifts like squats and deadlifts, you need an appropriate amount of calf and hamstring flexibility so that when you’re at the bottom of your lift your pelvis and spine can be positioned correctly. This exercise is one that I also like to use to determine if someone is ready to do those activities. If you cannot touch your toes in this position, we are not starting those lifts. 

Performing this exercise:

Start with placing the balls of your feet up on a couple inch block (25lb plates or books work well).  With your legs straight, slowly reach down and touch your toes.  

If you can not touch your toes, go as far as you can then slightly bend your knees to achieve the desired distance.  

Breathing out while reaching down can also give you a little more reach as well. Hold for 5 seconds and repeat 10 times.


4. Lateral band walks

Why it works: Unlike the first three exercises that were focusing mostly on flexibility and mobility, this exercise is specifically designed to get the most important muscle in your body prepared and ready for lifting. Your glutes are the cornerstone of having a solid foundation and platform to lift from. The more awake and ready they are for exercise, the less tension force will be taken through your low back muscles to lift yourself back into an upright position. 

Performing this exercise:

With a lateral band around your ankles, get into an athletic, ready position. Slowly step out to the side then slowly bring your trail leg back into the starting position.  

Do not let your trail foot drag on the ground. Repeat for 2 sets of 15 steps each direction. 

If you need a lateral band, click here:


5. Switch to front squat over back squat

Why it works: Squatting is an exercise that has huge benefits. Increasing your heart rate, elevating your muscle building hormones and developing strength in multiple muscle groups are all key benefits of squatting. However, the back squat is not for everyone’s body.

If you lack flexibility in certain areas or foundational strength, then loading a back squat will increase stress to the joints in your lower back. When the load is switched to the front, your body naturally becomes more upright and positions your spine in a way that does not excessively load your vertebral joints. 

Performing this exercise:

Begin standing tall with feet hip width, pointing forward and a barbell resting across the shoulders.  Hands can either hold the barbell in a cross face position or a clean grip position.  Squat down until the thighs are parallel with the floor, pause and then return to the original position.

Remember, your chest should maintain a relative tallness and your heels should remain in contact with the ground.


Nagging lower back pain after working out cannot just affect your ability to perform your next workout. If left unaddressed, that nagging pain could turn into something more severe.

If you are like I was, give these 5 things a try for a good month and see if you aren’t feeling better!

If after a month you are still having pain after your workouts, give us a call and let’s figure out what else needs to be done to get you feeling better!

Written By: Travis Manners, PT, SCS, CSCS, President and Founder 

How To: Perform Your Best All Season Long – Benefits 2 & 3

The importance of off season training is no secret to athletes and sport coaches, but some don’t fully understand the importance of in season training. Training during an athletes in season provides valuable time to maintain off season gains, reduce the risk of in season injury and aid in faster recovery from practices and games. 

In our previous blog, How To: Perform Your Best All Season Long – Benefit 1 Trenton ClausenMike Servais and Gus Thiel discussed the 1st benefit of training while in season – maintaining off season gains.

Today, we will dive into the 2nd and 3rd benefits of training while in season and why it is paramount to continue to train during this time.

Athletes train hard in the off season to ensure they are at their best by the time the season rolls around, but once their season arrives they suddenly stop training as their schedules fill up with games and practices.

As the season wears on they might start to notice that their bodies become more sore with each game and their nagging aches and pains just won’t go away.

Why is it that? With all the work put in during the off season they should feel great all season, right? Unfortunately, it does not work that way. The 2nd benefit of training while in season is to aid in reducing the athlete’s chance of sustaining an injury. 

Benefit 2)

Injury prevention is another key factor that we work on in our in season training programs. We must continue maintaining our strength to prevent soft tissue injuries. We can do this through strength training and active recovery methods such as self-myofascial release (i.e. foam rolling), stretching, icing, and rest.

If we are able to maintain our strength and tissue quality during the season we will fend off injuries that can be prevented and keep us on the field of play.

“Athletes that work to maintain their strength, muscle tissue quality and joint health during the season are less susceptible to injuries because their body is more prepared to handle the stresses of the season.”

– Mike Servais

Benefit 3)

The final benefit from training in season is the ability to recover faster from games and practices. Over the course of a long season, athlete’s bodies take a beating. But fear not! A proper in-season program will not make an athlete feel worse!

In fact, getting back in the gym will allow athletes to address this issue by performing soft-tissue work (using a foam roller, lacrosse ball, etc.) to restore muscle tissue quality.

Maintaining tissue quality is vital for joint mobility (ability for a joint to move) and stability (ability to control joint position).

“Always remember that training in season doesn’t mean that your workout program should be put on the back burner. Be smart about your in season programs and your body will thank you later!” – Gus Thiel 

 

Here at Athletes’ Training Center, we want our athletes to be at their best once the season starts. However, it takes discipline and dedication to maintain peak performance throughout the year. We will make sure you feel your best come game time!

Tip: Interested in our in season programs?
Ask about our maintenance memberships or our Free Trial Sessions!

Written By Performance Coaches:

Trenton Clausen – MA, CSCS, USAW-L2SP, Director of Sports Performance
Mike Servais – CSCS, USAW-L1, Performance Coach
Gus Thiel BS, FMS-L1SP, Performance Coach 

No-Nonsense Solution for Sticking to Healthy Habits

Have you ever found yourself trying to start a healthy habit such as taking a multi-vitamin each morning, but find yourself forgetting the vitamin on the counter at home after a few unsuccessful attempts? Or have you ever told yourself that you needed to drink more water and lose sight of this habit after just a few days? Well, do I have an idea for you…habit stacking!

If you haven’t heard of this idea please continue reading and even if you have you just might learn another trick or two today. Now, let’s think back to when you were a little kid.

I bet your parents continually had to remind you to brush your teeth. I remember my parents doing this every time I woke up or went to bed. At the time I didn’t think much of it, and I bet I even found these “reminders” somewhat annoying. 

I obviously didn’t form the habit of brushing my teeth right away. But still to this day I brush my teeth right when I wake up and right before I lie down for the night. Why do I still continue to do this? Why did all of those “constant reminders” from my parents eventually pay off? 

The answer is habit stacking.

I learned that habit not because I know it should be done twice a day but because I stacked the habit of brushing my teeth with a habit I already had indebted into my life, waking up and before going to bed.

You see, I stacked this habit of brushing my teeth with another easy habit already established in my daily routine until it became a true habit. This is no different when starting a new habit such as drinking enough water throughout the day or getting some healthy exercise habits each day.

Think about an everyday habit you already have created, how about that cup of coffee you drink every morning. Try having a glass of water and your multi-vitamin at the same time you sit down with that cup of coffee.

Before you know it that glass of water and multi-vitamin will be another one of your everyday habits. Or, maybe before you turn on that favorite television show every Monday night, complete 3 sets of 30 second front planks.

If you can take your already established habits and stack healthy ones with them you can conquer anything. Take some time to write down your already established habits and then write another habit you would like to stack with them.

You might be surprised by how easy these new habits are to create with the help of some already easy ones in your life.

Written By: Trent Clausen, MA, CSCS, USAW-L2SP Director of Sports Performance

Jump-start Your Athletic Ability: 3 Effortless Tips

I am constantly getting questions from high school athletes about which supplements they should be buying or taking to improve their performance and recovery.

Now, this may seem like a complicated question requiring an endlessly long answer full of micro and macro nutrient breakdowns, but in reality it’s a simple as asking those athletes a few questions.

Today, we will dive into 3 effortless tips athletes can do to jump-start their athletic ability.  

Tip #1 Eat a quality breakfast

This one is vital! I am constantly talking to athletes who tell me they cannot gain weight or are continuously losing weight while in season. I immediately ask them about their breakfast every morning.

Most of the time I get one of two answers.

Response #1 “I don’t have time for breakfast in the morning.”
Response #2 “I ate a pop tart, does that count?”

Response #1 leads me into my “how important sleep is” spiel. We will dive into this in a bit. With response #2 I usually respond with a giant eye roll and a large exhale. In what world is a pop tart considered a meal?

Especially a meal that will support and sustain a growing athlete through a long and stressful school day, a practice or a game. 

I don’t expect a gourmet breakfast every morning, but I do expect an athlete to get up 10 minutes earlier than they are accustomed to in order to prepare some food. Making sure your body is fueled with quality calories is the first step to high level sport performance!

Breakfast Suggestions:

  • 3-4 full eggs
  • Steamed rice or toast
  • Deli meat, ground beef or turkey
  • 1 piece of fruit

Tip #2 Sleep 7-8 hours a night

I cannot stress this point enough, high school athletes need to sleep. While asleep the body regulates hormones, repairs cells, and controls stress. The “Journal of Physiology and Behavior” published a study showing the benefits extra sleep on serving performance in tennis players, giving credibility to the fact that sleep improves performance.

Most of the time, high school athletes are very busy with school, sports and social activities. With such busy schedules, sleep is usually the first thing on the chopping block. Don’t let it be!

Suggestions:

  • Get in a pre-sleep routine
  • Keep bedtime as consistent as possible (weekdays AND weekends)
  • Sleep in the DARK (no TV, phone, tablet)

Tip #3 Hydrate

Hydration is often taken for granted when discussing athletic performance. It seems simple, right? Drink water. But, it is often neglected and can have a negative effect on practice and game performance.

The ACSM describes water as “the most essential component of the human body”. Water transports nutrients, eliminates waste products, regulates body temperature, maintains blood circulation and pressure, lubricates joints and body tissue as well as facilitate digestion.

Long bouts of exercise I.E. practices or games can result in up to a 2% loss of body weight due to fluid loss. That means it is possible for a 150 pound athlete to lose up to 3 pounds of “water weight” during a sporting event or workout.

Dehydration can cause premature muscle fatigue, coordination loss, a decrease in energy and a loss of athletic performance. They need to be drinking before, during and after their session. An easy rule of thumb for athletes to follow is to drink 20-24 ounces of water for every pound loss during activity.

Suggestions:

  • Drink a large (16-20oz) glass of water first thing in the morning
  • Carry a water bottle with you during the school day
  • Continue to drink water or Gatorade DURING your workout, practice or game

Not all sports performance enhancers come in a plastic tub or bottle! These easy tips and reminders will go a long way in ensuring your body is ready for the demands of your toughest workout or game!

Written By: Joe Servais – MA, CSCS, Performance Coach 

Sources: 

Schwartz, J., & Simon, R. D. (2015). Sleep extension improves serving accuracy: A study with college varsity tennis players. Physiology & behavior, 151, 541-544.

Sawka, M. N., Burke, L. M., Eichner, E. R., Maughan, R. J., Montain, S. J., & Stachenfeld, N. S. (2007). Exercise and fluid replacement. American College of Sports Medicine position stand. Med Sci Sports Exerc, 39, 377-390.

 

Jennie A., Collegiate Track & Field Athlete

Athletes’ Training Center has worked to specialize workouts to fit my athletic needs. The strength coaches have a one on one personal connection to fix minor details that have had a major impact on my athletic performance.