Applied Sports Science newsletter – November 2, 2016

Everyone has limiters—whether known or hidden—in his or her body: muscles that aren’t developed or aren’t firing; asymmetrical movement; restricted mobility; or impaired coordination and balance. One of the keys to success in triathlon is pushing limits and learning from failures instead of avoiding them.

Identifying and exposing these limits in an athlete’s body is the beginning of this process. Enter the physical therapist. Why a PT? They have the perfect skill set to identify these limiters and create a program to address them. A PT studies anatomy, physiology, neurological function, musculoskeletal function and biomechanics. A PT graduates with a Doctor of Physical Therapy degree that emphasizes critical thinking and evidence-based care. Physical therapy assessments are like solving a puzzle; they focus on the causes of injury, not just the diagnosis. This is the reason assessments are useful even when no injury is apparent: PTs help predict future injuries by identifying limiters within the athlete’s body.

It’s safe to say VO2 Max is all the rage in wearable tech. It’s been a focus of high-end sports watches for a while, but now it’s going mainstream on the latest fitness trackers.

Fitbit has chosen it as the basis for its “Cardio Fitness” score on the Fitbit Charge 2, and what was once a metric for elite athletes is fast becoming a figure that weekend park runners are being conditioned to obsess over.

But what exactly is VO2 Max? How useful is it as a measure of overall fitness and, most importantly, can you trust a fitness tracker or smartwatch to give you an accurate reading?

Athletes use a variety of postexercise recovery techniques with the belief that they are effective at enhancing return to competition and training. Common modalities include massage, cold water immersion, compression, electrical stimulation, vibration therapy and a combination of one or more of these strategies. Other approaches include diet and hydration protocols, active recovery and sleep. Despite their popularity, the evidence for the effectiveness of most of these modalities is rather limited, although recent efforts are advancing their science which should help in the recommendation of optimal indications and protocols.

The scientific literature on postexercise massage has accelerated in the last decade. A number of clinical and animal studies have addressed biological plausibility. Clinical studies have investigated the long-held claims that massage mediates leucocyte migration and attenuates the inflammatory response to exercise, as well as decreases pain, muscle tone and hyperactivity.

Kentucky is one of the best teams in the country. They have the No. 1 recruiting class in the country, they’re highly-ranked in every preseason poll, and they’re one of the favorites to win the National Championship in betting odds. They’ve got a good chance at getting their ninth title, thanks to guys like Isaiah Briscoe, De’Aaron Fox, Malik Monk and Bam Adebayo. However, one guy that many people don’t think of when looking at Kentucky’s biggest factors is Rob Harris, the strength and conditioning coach.

When most people think of Red Rocks Amphitheatre 15 miles west of Denver, they think of a live music venue that has almost no equal for sheer scenic beauty.

When Gary Harris and a handful of his NBA teammates on the Denver Nuggets think about Red Rocks, they think about an outdoor gym.

Perched at 6,450 feet above sea level, Red Rocks turns out to be a pretty amazing place for offseason altitude training.

… There are three strategies represented here. The first, pioneered by the Stanford social psychology professor Carol Dweck and illustrated by the initial example, aims to change students’ mind-sets by showing them that their intelligence can grow through deliberate work. I’ve written about Dr. Dweck’s theories as applied to college students, but they are just as successful with students in middle school.

The second uses constructive critical feedback to instill trust in minority adolescents, a demonstrably powerful way to advance their social and intellectual development.

The third intervention — and in some ways, the most powerful — invites students to acknowledge their self-worth, combating the corrosive effects of racial stereotypes, by having them focus on a self-affirming value.

Footwear comfort is essential and pressure distribution on the foot was shown as a relevant objective measurement to assess it. However, asperities on the foot sides, especially the metatarsals and the instep, make its evaluation difficult with available equipment. Thus, a sock equipped with textile pressure sensors was designed. Results from the mechanical tests showed a high linearity of the sensor response under incremental loadings and allowed to determine the regression equation to convert voltage values into pressure measurements. The sensor response was also highly repeatable and the creep under constant loading was low. Pressure measurements on human feet associated with a perception questionnaire exhibited that significant relationships existed between pressure and comfort perceived on the first, the third and the fifth metatarsals and top of the instep.

Practitioner Summary: A sock equipped with textile sensors was validated for measuring the pressure on the foot top, medial and lateral sides to evaluate footwear comfort. This device may be relevant to help individuals with low sensitivity, such as children, elderly or neuropathic, to choose the shoes that fit the best.

A new cell phone app specializing in sports injury detection captured 99 percent more physical and mental health symptoms for college athletes than traditional sports medicine surveillance, according to new research released at the American Public Health Association’s 2016 Annual Meeting and Expo in Denver.

Occlusion boundary detection and figure/ground assignment are among the fundamental challenges for the real world visual pattern recognition applications, such as 3D spatial understanding, robotic navigation and object search. We attack these challenges by extracting an intermediate-level image/video representation, namely, Common-Fate Fragments. A Common-Fate Fragment is composed of both over-segmented region and edge fragments. Physically, it exists as a coupled edge-region fragment bound with dynamic information. Common-Fate Fragment candidates are generated by an integrated line-region growing process, which does not require complete object segmentation or closed object boundary extraction. To identify Common-Fate Fragments from these extracted candidates, we introduce a back-projection verification scheme that can circumvent the notoriously difficult task of direct motion estimation on boundaries. This allows occlusion detection and figure/ground labeling to be jointly conducted within a simple but effective hypothesize-and-test framework. We test the proposed method on YouTube Motion Boundaries (YMB) data set and two benchmark data sets: the CMU and Berkeley motion data sets. Even though the idea of the proposed method is simple and transparent, promising experimental results are observed.

Athletes want to get the most out of themselves physically without further risking injury. IMeasureU is aiming to help by creating a tool that can precisely manage training and game loads for athletes.

Thor Besier, a world-renowned bio-mechanist and co-founder of IMeasureU wanted something that would allow him to get lab-quality metrics, but in the field. The tool that he and Mark Finch (founder and CTO) created is a small, lightweight sensor that can measure acceleration and angular direction in three dimensions.

While the sensor can be used for a variety of sports, researchers at New Zealand-based IMU have initially decided to focus on the sport of basketball.

Background: Anterior cruciate ligament (ACL) injuries are common in the National Football League (NFL). Limited literature exists regarding return to play (RTP) and the factors affecting RTP after ACL reconstruction in NFL players.

Purpose/Hypothesis: To determine RTP rates after ACL reconstruction in NFL players and to ascertain which variables affect RTP in these players. We hypothesized that RTP in this population will be less than in the general population and similar to the limited studies published previously.

Study Design: Case-control study; Level of evidence, 3.

Methods: A total of 92 NFL athletes who sustained ACL injuries requiring ACL reconstruction from 2013 to 2015 were retrospectively studied to determine rate of RTP and the variables affecting RTP.

Results: Sixty-two percent (57/92) of NFL athletes returned to NFL game play prior to the end of the 2015-2016 postseason. ACL injuries were noted in 10 different player positions, with 81.5% of all injuries as isolated ACL injuries (75/92) and 18.5% with concomitant knee injuries. A significant difference in ability to RTP was found for players who sustained in-season injuries compared with those who sustained off-season/preseason injuries (P = .02). No significant differences in RTP were found for players who played less than 4 years in the NFL compared with those who played longer. The mean draft round of players who returned was 3.96, with the odds ratio favoring RTP at 4.44 (P = .003) for players drafted in the first 3 rounds of the NFL draft compared with those drafted in the fourth round or later. No significant differences were found with regard to playing surface, laterality, concomitant injury, previous ipsilateral or contralateral ACL reconstruction, final outcome of the game, or contact compared with noncontact injuries.

Conclusion: The RTP rates we reported after ACL reconstruction in NFL players are similar to prior studies; however, running backs and wide receivers had lower rates of RTP than previously reported. As previously published, quarterbacks were found to have high RTP rates. Most ACL injuries take place during the preseason or early regular season. Early selection in the NFL draft was a strong predictor of ability to RTP.

Background: Orthopaedic clinics have acquired a multitude of health professionals to improve clinic efficiency. More recently, athletic trainers (ATs) have been utilized to improve clinical efficiency and patient care because of their extensive background in musculoskeletal injuries and anatomy. Improved clinical efficiency allows for increased patient visits, potentially enhancing patient access and downstream revenue via relative value units (RVUs).

Hypothesis: The addition of an AT into a sports medicine physician’s clinic will increase total patient throughput and overall RVU production.

Study Design: Retrospective analysis.

Level of Evidence: Level 4.

Methods: Patients seen by each of the 2 primary care sports medicine physicians at St Luke’s Sports Medicine for a 2-year period were retrospectively evaluated. The initial clinic model included the physician and a medical assistant; during the second year of analysis an AT was added to the clinic staffing model. Two-tailed t tests were used to determine significant differences in patient volume between the 2 periods of data collection.

Results: Through the implementation of an AT, patient throughput increased by 0.7 patients per hour over 2 half-day clinics, a 25% increase (P < 0.01). Physician B patient visits increased by 21%, or 3.8 patients per 6.5-hour clinic day (P < 0.01). Additionally, RVU production increased by 3.23 per half-day and 4.3 per full day for physicians A and B, respectively.

Conclusion: Clinical efficiency was improved with the addition of an AT. Total physician RVUs improved, thereby raising the potential revenue of both the physician and health care institution. Employing ATs in a sports medicine clinic may improve clinical productivity and financial stability, thereby validating the incorporation of ATs into the established clinical model.

Clinical Relevance: Limited research exists measuring patient throughput with an AT in a sports medicine clinic. This study investigates patient throughput and the subsequent increase in work-based RVUs.

Mike Krzyzewski’s name is synonymous with basketball greatness. His list of accomplishments could fill a novel and he’s the winningest coach in college basketball history. The guy knows a thing or two about coaching.

Imagine for a moment what it would be like to shadow Krzyzewski for a few days, to be able to see him at work and learn his processes. How would your workflow change if you spent some time with one of college basketball’s top minds?

Meet Kevin Cullen, the guy whose job is to do exactly that. Duke’s director of information technology and a valued member of Krzyzewki’s USA Basketball staff since 2008, Cullen recently visited Hudl and allowed us to pick his brain on the Blue Devils’ in-season schedule and how they utilize video. Come take a peek behind the curtain of one of the giants of college basketball.

Liverpool remain a work in progress but it’s coming together promisingly. During Jürgen Klopp’s first campaign at Anfield the players adapted quickly to his high-energy, heavy-pressing system and regularly disrupted the opposition’s passing but they only sporadically formulated quick, incisive attacking moves themselves.

This season things have improved significantly. The pressing is still impressively efficient and remains an extremely useful way of creating chances but Liverpool’s passing interplay makes them a more complete attacking force. Their 69 shots on target this season is the most in the Premier League.

The most impressive aspect of their 4-2 victory over Crystal Palace on Saturday evening was the manner in which they filled space dynamically. This side feature various forwards who drift around – Philippe Coutinho, Adam Lallana, Sadio Mané – and with multiple players varying position there is a danger it will become congested in the centre, where they all prefer to play. That was never a problem at Selhurst Park with team-mates making a reverse run whenever a player drifted out of his natural zone.