Proprioception, Proprioception, Core Strength, and Core Strength, and

Plyometrics For Plyometrics For The Injured AthleteThe Injured Athlete

Grady J. Hardeman, M.Ed., LAT, ATC, CSCSGrady J. Hardeman, M.Ed., LAT, ATC, CSCS

Cabarrus County Schools Cabarrus County Schools

Cabarrus County Sports Medicine Cabarrus County Sports Medicine SymposiumSymposium

January 20January 20thth, 2007, 2007

ObjectivesObjectives1.1. Define Core Strength, Proprioception, Define Core Strength, Proprioception,

and discuss how they relate to and discuss how they relate to Plyometrics.Plyometrics.

2.2. Review the basic muscle physiology of Review the basic muscle physiology of plyometrics.plyometrics.

3.3. Discuss the factors to consider when Discuss the factors to consider when implementing plyometrics into the implementing plyometrics into the rehabilitation program. rehabilitation program.

4.4. Understand how plyometrics can benefit Understand how plyometrics can benefit the injured athletethe injured athlete

5.5. Provide Sample Plyometric Exercises for Provide Sample Plyometric Exercises for the Upper and Lower extremities, and the Upper and Lower extremities, and the Trunk.the Trunk.

What is The Core???What is The Core???

• Where the bodies Where the bodies center of gravity center of gravity is located, and is located, and all movement is all movement is initiatedinitiated– AnatomyAnatomy::

•Hip, Back, and Hip, Back, and Abdominal Abdominal musculaturemusculature

ProprioceptionProprioception

• Knowing where the body is in space.Knowing where the body is in space.• Also known as Kinesthetic Awareness Also known as Kinesthetic Awareness

or Sense.or Sense.• Becomes impaired after injury, and Becomes impaired after injury, and

needs to be re-trained in order for the needs to be re-trained in order for the athlete to return to activity safely.athlete to return to activity safely.

• Required for plyometric and other Required for plyometric and other closed-chain rehabilitation activities.closed-chain rehabilitation activities.

Proprioception ExercisesProprioception Exercises

PlyometricsPlyometrics

• It is not always the It is not always the strongest strongest OROR the the quickest athlete that quickest athlete that prevails. It is usually the prevails. It is usually the one who is the strongest one who is the strongest ANDAND the quickest. the quickest.

• Plyometric exercise Plyometric exercise enhances both strength enhances both strength and speed.and speed.

• Speed + Strength = Speed + Strength = POWERPOWER

Muscle Physiology Muscle Physiology ReviewReview

• Muscle SpindleMuscle Spindle: A specialized : A specialized proprioceptor that is sensitive to both proprioceptor that is sensitive to both muscle length and the rate at which the muscle length and the rate at which the muscle lengthens.muscle lengthens.

• This structure is what is responsible for This structure is what is responsible for the stretch reflex.the stretch reflex.

• This reflex is important in the This reflex is important in the development of good kinesthetic sense, development of good kinesthetic sense, and is also responsible for the increased and is also responsible for the increased force production during the stretch force production during the stretch shortening cycle (Plyometric).shortening cycle (Plyometric).

Muscle SpindleMuscle Spindle

Diagram taken from The Essentials of Strength Training and Conditioning 2nd Ed. Pg. 19: Fig. 2.2

Stretch Shortening CycleStretch Shortening Cycle

• Three PhasesThree Phases

1.1. Eccentric or Pre-loading phaseEccentric or Pre-loading phase Muscle lengthens as it contracts.Muscle lengthens as it contracts.

2.2. Isometric or Amortization phaseIsometric or Amortization phase Muscle length does not change.Muscle length does not change.

3.3. Concentric or Explosive PhaseConcentric or Explosive Phase Muscle shortens as it contracts.Muscle shortens as it contracts.

How Does It WorkHow Does It Work• During the eccentric phase elastic During the eccentric phase elastic

energy is stored within the muscle. It is energy is stored within the muscle. It is released during the concentric phase released during the concentric phase and provides a more forceful and provides a more forceful contraction.contraction.

• The muscle spindle is activated during The muscle spindle is activated during the stretch (eccentric phase), and sends the stretch (eccentric phase), and sends a signal to the spinal cord which a signal to the spinal cord which activates the agonist muscle to contract. activates the agonist muscle to contract. This is known as the “stretch reflex”.This is known as the “stretch reflex”.

Benefits To The Injured Benefits To The Injured AthleteAthlete

• Aids in the restoration of the Aids in the restoration of the “Neuromuscular Control” that is lost “Neuromuscular Control” that is lost due to injury.due to injury.– The athlete is more capable of The athlete is more capable of

subconsciously reacting to subconsciously reacting to unanticipated joint loads during unanticipated joint loads during activity.activity.

• Enhances mental preparation for Enhances mental preparation for return to sport.return to sport.– Restores confidenceRestores confidence

• Enhances muscle force production.Enhances muscle force production.

Factors To Consider When Factors To Consider When Implementing Plyometrics Implementing Plyometrics

Into A Rehabilitation Into A Rehabilitation Program.Program.• Three Important Questions?Three Important Questions?

– What was the injury?What was the injury?– Where is the athlete in the healing/rehab. Where is the athlete in the healing/rehab.

process?process?– What is the athletes history with plyometric What is the athletes history with plyometric

exercises?exercises?

• ProgressionProgression• VolumeVolume• FrequencyFrequency• SpecificitySpecificity

Progression To Progression To PlyometricsPlyometrics

• There must be a There must be a solid foundation solid foundation of core strength of core strength and and proprioception proprioception prior to prior to initiating initiating plyometric plyometric activities.activities.

Plyometrics

Core Strength Proprioception

ProgressionProgression

Strengthen the “Core” first.Strengthen the “Core” first.Learn how to land (Proprioception)Learn how to land (Proprioception)

May begin the process in the pool to decrease May begin the process in the pool to decrease the stress applied to the lower extremities.the stress applied to the lower extremities.

Start slow and then increase intensity and Start slow and then increase intensity and speed when necessary.speed when necessary.

Move from bilateral to unilateral.Move from bilateral to unilateral.Progress from stable to unstable surfaces Progress from stable to unstable surfaces

when appropriate.when appropriate.

VolumeVolume

• Measured by foot contacts.Measured by foot contacts.– Per exercisePer exercise– Per sessionPer session

• Dependant upon the intensity of the Dependant upon the intensity of the exercise.exercise.

• The higher the intensity, the lower the The higher the intensity, the lower the volume.volume.

• Example:Example:– The Jump Rope Exercise may have more foot The Jump Rope Exercise may have more foot

contacts than the Box Jump Exercise.contacts than the Box Jump Exercise.

FrequencyFrequency

• There should only There should only be 1-2 exercise be 1-2 exercise sessions per week.sessions per week.

• There should be There should be 48 – 72 hours in-48 – 72 hours in-between training between training sessions.sessions.

• Expect Delayed Expect Delayed Onset Muscle Onset Muscle Soreness (DOMS)Soreness (DOMS)

MoMonn

TueTuess

WeWedd

ThurThurss

FriFri

xx xx

xx

xx xx

SpecificitySpecificity

•When possible When possible try to make the try to make the exercise mimic exercise mimic the movements the movements of the athletes of the athletes sport.sport.

Make It SafeMake It Safe• Warm-up properly prior to plyometric exercise.Warm-up properly prior to plyometric exercise.• Make sure that the exercise area is free from Make sure that the exercise area is free from

clutter.clutter.• Work on the appropriate surface.Work on the appropriate surface.

– Rubberized flooring, gymnastic floor, soft dry Rubberized flooring, gymnastic floor, soft dry grass.grass.

• Use plyometrics at the beginning of the Use plyometrics at the beginning of the rehabilitation session.rehabilitation session.

• Monitor the athlete for fatigue.Monitor the athlete for fatigue.• Focus on Focus on QualityQuality of exercise not quantity. of exercise not quantity.• Give the athlete appropriate feedback.Give the athlete appropriate feedback.

Upper ExtremityUpper Extremity• Push-up → Plyometric Push-upPush-up → Plyometric Push-up• Medicine Ball ExercisesMedicine Ball Exercises• High-speed tubing exercises High-speed tubing exercises

that incorporate an eccentric that incorporate an eccentric contraction.contraction.

Eccentric Phase of the Plyometric Push-Up

Concentric Phase of the High-Speed Tubing Exercise

Lower ExtremityLower Extremity

• Jumps in PlaceJumps in Place•Multiple JumpsMultiple Jumps•Standing JumpsStanding Jumps•Box JumpsBox Jumps

Diagram taken from NBA Power Conditioning Page 136 Rim Jumps

(Chu, ATT, Plyometrics in Sports Injury Rehabilitation, May, 1999)

TrunkTrunk• Rotational Twist with Medicine BallRotational Twist with Medicine Ball

– StandingStanding– Sitting on Physio-ball or FloorSitting on Physio-ball or Floor

• Sit-up with medicine ball tossSit-up with medicine ball toss• Bilateral Straight Leg RaiseBilateral Straight Leg Raise

Eccentric Phase of the Rotational Trunk Twist

Concentric Phase of the Rotational Trunk

Twist

Eccentric Phase of the Rotational Trunk Twist

ConclusionConclusion• Prior to performing plyometric Prior to performing plyometric

exercises the athlete should have a exercises the athlete should have a good foundation of core strength and good foundation of core strength and proprioception.proprioception.

• Plyometric exercise, when performed Plyometric exercise, when performed correctly, can be a great tool during correctly, can be a great tool during the rehabilitation process.the rehabilitation process.

• Plyometric exercise used in conjunction Plyometric exercise used in conjunction with other forms of strength training with other forms of strength training provides a greater benefit than provides a greater benefit than plyometric exercises used alone.plyometric exercises used alone.

ReferencesReferences• Luttgens, Kathryn, Deutsch, Helga, and Hamilton, Nancy. 1992. Luttgens, Kathryn, Deutsch, Helga, and Hamilton, Nancy. 1992.

Kinesiology –Scientific Kinesiology –Scientific Basis of Human MotionBasis of Human Motion, 8, 8thth Ed. Madison, Ed. Madison, Wisconsin: Brown & Benchmark..Wisconsin: Brown & Benchmark..

• Chu, Donald. 1998. Chu, Donald. 1998. Jumping Into PlyometricsJumping Into Plyometrics, 2, 2ndnd Ed. Champaign, Illinois: Ed. Champaign, Illinois: Human Human Kinetics.Kinetics.

• Chu, Donald. 1999. Plyometrics in Sports Injury Rehabilitation and Chu, Donald. 1999. Plyometrics in Sports Injury Rehabilitation and Training. Training. Athletic Athletic Therapy Today. Therapy Today. Vol.4, Num. 3. Pages 7-11.Vol.4, Num. 3. Pages 7-11.

• Harris, R.T., and Dudley, Gary. 2000. Harris, R.T., and Dudley, Gary. 2000. Essentials of Strength Training and Essentials of Strength Training and ConditioningConditioning, 2, 2ndnd Ed. Champaign, Illinois, Human Kinetics.Ed. Champaign, Illinois, Human Kinetics.

• Riewald, Scott. 2003. Energy Storage in Muscle. Riewald, Scott. 2003. Energy Storage in Muscle. NSCA’s Performance NSCA’s Performance Training Journal. Training Journal. Vol. 2 , Num.2 Pages 8-9.Vol. 2 , Num.2 Pages 8-9.

• Kutz, Matthew R. 2003. Theoretical and Practical Issues for Plyometric Kutz, Matthew R. 2003. Theoretical and Practical Issues for Plyometric Training. Training. NSCA’s Performance Training Journal. NSCA’s Performance Training Journal. Vol. 2, Num. 2. Vol. 2, Num. 2. Pages 10-12.Pages 10-12.

• Swanik, Buz C, Swanik, Kathleen A. 1999. Plyometrics in Rehabilitating the Swanik, Buz C, Swanik, Kathleen A. 1999. Plyometrics in Rehabilitating the Lower Lower Extremity. Extremity. Athletic Therapy Today. Athletic Therapy Today. Vol. 4, Num. 3 Pages 16-22,Vol. 4, Num. 3 Pages 16-22,

• Handzel, Tracey M. 2003. Core Training For Improved Performance. Handzel, Tracey M. 2003. Core Training For Improved Performance. NSCA’s NSCA’s Performance Training Journal.Performance Training Journal. Vol. 2, Num. 6. Pages 26-30. Vol. 2, Num. 6. Pages 26-30.

Thank YouThank You

Living well is the best Living well is the best revengerevenge

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