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Tuesday, 19 February 2013

more on Performance Therapy - or - how I managed to piss almost everybody off...




"You are what you do. If you do boring, stupid, monotonous work, chances are you’ll end up boring, stupid, and monotonous." 
- Bob Black: The Abolition of Work and Other Essays


I posted a longer blog a few hours ago.
I didn’t like it...it was far too long, and it didn’t really flow.
So I killed it.

Instead, we have the following, and a second part (which is actually a third part - as this follows along from my last post on Performance Therapy) will come along in the next few days.


Here’s my little story...

Very early on in my career, I had the great fortune of spending quite a bit of time in Austin, Texas with Dan Pfaff and his superstar group of post-graduate track and field athletes, including eventual Canadian Olympic gold medalists Donovan Bailey, Glenroy Gilbert and Bruny Surin, and Major Championship medallists Obadele Thompson, Kareem Streete Thompson, Mark Boswell and others.  It was pretty much a Grand Prix ad infinitum - especially during the spring of 1996 in the lead-up to the Atlanta Games, as each day welcomed the arrival of an ever-expanding crowd of on-lookers.  Cameras, reporters, University students, professors, other coaches, other athletes...we all supplemented the circus - heck, even a young Governor Bush made the odd appearance!

It was right around this time that a new therapeutic technique was being ‘experimented’ with.  ART® (Active Release Technique) was officially developed by chiropractor Dr Michael Leahy, but from my understanding/memory, it was the work of Dr Mark Lindsay and Dan Pfaff on that track in central Texas where its acute application to elite sport was first refined. Mentored by legendary track coach Tom Tellez (coach to Carl Lewis, Mike Marsh, Joe Deloach, Floyd Heard, and hundreds of other world-class athletes), Dan very early in his career understood the importance of good therapy - his is an holistic philosophy in the truest sense of the word - and he believed in integrating the therapeutic input into the training process. He likened the elite athlete to a racing car: you wouldn’t send an F1 Ferrari out onto the track without thoroughly checking through its systems, and making any necessary adjustments.  Modification of the car doesn’t end when it drives onto the track: in fact, it’s during qualifying that most of the important work is done.  ‘Parc fermé’  begins when the car first leaves the garage, and ends only when the race begins.  It’s the same in sport - our best work is done when the athlete is out on the track or field - moving - not when he is sat in the garage - on the treatment table.  In ART, Dan had found a technique that promised immediate tissue changes, and with the brilliance of Dr Lindsay set about developing what we now know as ‘track-side’ (or ‘performance’) therapy.  

My apprenticeship involved not only attaching myself to Dan’s hip, but also observing Dr Lindsay as he and Dan prepared Donovan for training.  Often, pre-session therapy would take an hour or more, with additional inputs throughout the session. An overly-sensitive-demanding (and supremely talented) athlete, an analytical-perfectionist coach, and a gifted-detailed therapist - all experimenting with a new(ish) technique - provided the perfect environment to drive the creative process. 
...as well as a fertile and fruitful training ground for a young coach from Canada 
(it was also this unique environment - and the lessons learnt within it - that served as the stick that continued to stir the pot year upon year as I matured as a coach...but more on that a little later...)

Dan, with US high-jumper Amy Acuff

Creativity in all areas emerges from the conscious blending of dissimilar subjects. Creative ideas are most frequently new combinations of old ideas; creative thinkers simply look at these old ideas with ‘new eyes’ - examining all the variables, and being open to the unexpected...exposing themselves to the envelope of serendipity. For example, Leonardo da Vinci believed that the first way of looking at a particular problem was too biased to his normal way of thinking; thus, he reconstructed it in order to see it in many different ways. He would continue this process - moving from one perspective to another - until he gained maximum understanding of its essence.

Michael Michalko, in his excellent book, Creative Thinkering, calls this multiplicity of perspectives; it allows us to bring forth a new creative consciousness and expand the possibilities. It is what enabled Einstein to formulate his theory of relativity, which is in essence a description of the interaction between different perspectives. His genius lay in finding a perspective that no one else had taken (Michalko). 
“Imagination is more important than knowledge” - Einstein

It is clear that the more we know, the greater our chance of arriving at compelling combinations. It is also important to understand that this knowledge should extend further than one’s own subject - reaching out into other subjects will lead to a more enlightened understanding - a deeper appreciation.  Most who have risen to eminence in arts, literature or sciences have frequently possessed considerable knowledge of subjects outside their own sphere of activity, as we ‘fill in the gaps’ between these different connections 


It is this ‘dynamic interconnectedness’ that was the greatest lesson I learned from Dan Pfaff.  In our attempts to understand, we too often separate everything into parts, but we cannot effectively analyze a system in terms of its constituent parts. This is reductionist. The body is not reductionist. The body is a complex, dynamical system of interdependence. 

We know this.  in fact, we’ve known this for over a century...

Almost one hundred and fifty years ago, Friedrich Engels accurately describes the state of the physical sciences today: “...at the time Engels wrote his Dialectics of Nature, the physical sciences seemed to have rejected the mechanistic world view and drawn closer to the idea of an historical development of nature. Engels mentions three fundamental discoveries: energy and the laws governing its qualitative transformations, the cell as the basic constituent of life, and Darwin’s discovery of the evolution of species. In view of these great discoveries, Engels came to the conclusion that the mechanistic world view was dead." (Prigonine & Stengers). 
...and in 1903, Henri Poincare stated that -
“...small differences in the initial conditions produce very great ones in the final phenomena. A small error in the former will produce an enormous error in the latter. Prediction becomes impossible. Unless these initial changes could be defined and measured, the outcome or deviation caused by these ripples could never be predicted...”. 
This realization led to Edward Lorenz's fascination with the mathematics of complex systems and the beginning of the scientific revolution known as chaos theory: as a small random change is introduced into a system, it causes a ripple effect that can overwhelm and change the long term behavior of the system (that Lorenz termed the “Butterfly Effect”). 
Engels, Poincare, Lorenz, and others, endorsed a complexity view, and it seemed a new world was to open up - one where people thought in terms of processes rather than structures, relationships rather than components, and interconnections rather than separation.
So what happened?

Over 100 years after Engels first signed the death warrant to the mechanistic world-view.  Over 100 years after Poincare first identified the folly in system prediction. 
Over 40 years since Lorenz furthered this understanding.
...we are still clinging to a ‘separatist’ mind-set. Still compartmentalizing systems into smaller and smaller parts.  Still hanging on to our linear and reductionist views.

me, with UK sprinter Marlon Devonish

But...
How can we begin to express deep understanding of how the body moves without having an appreciation of how it falters?  How can we begin to express deep understanding of how the body adapts without having an appreciation of disorder? How can we begin to express deep understanding of sprint mechanics without having an appreciation for mechanical dysfunction? It goes on and on...it is all connected:

“Perhaps the most impressive (example) is that carbon, hydrogen, oxygen, nitrogen, sulfur, phosphorus, iron, and a few other elements, mixed in just the right way, yield life.

...life has emergent properties not present in or predictable from these constituent parts. There is a kind of awesome synergy between the parts...for the last few centuries the Cartesian project in science has been to break matter down into ever smaller bits in the pursuit of understanding. And this works to some extent. We can understand matter by breaking it down to atoms, then protons and electrons and neutrons, then quarks, then gluons, and so on. We can understand organisms by breaking them down into organs, then tissues, then cells, then organelles, then proteins, then DNA, and so on. Putting things back together in order to understand them is harder and typically comes later in the development of a scientist or of science. Think of the difficulties in understanding how all the cells in our bodies work together, as compared with the study of the cells themselves. Whole new fields of neuroscience and systems biology and network science are arising to accomplish just this. And these fields are arising just now, after centuries of stomping on castles in order to figure them out.
- Nicholas A. Christakis


Spending those springs and summers in Austin taught me that I needed to be more than just a coach.  I needed to dig deeper, by moving side-ways.  In order for me to gain a greater understanding of the athlete and how he adapts, Dan told me I needed to be familiar with so much more than sprinting.  He encouraged me to study pedagogy, biomechanics, neurophysiology, anatomy, biology, nutrition, endocrinology, psychology, philosophy, and yes...therapy. 

And it was this that has repeatedly landed me in hot water with ‘real’ therapists, sports doctors, NGBs, Sports/Training Centers, building managers, CEOs, and sport administrators (I don’t have enough fingers and toes for the numbers of these folk that I have pissed off)

My journey down the road towards deeper understanding of elite sport has seen far too many brick walls.  Far too many times, I have been blocked, told to turn around, to ‘stick to what I know’...to leave the therapy to the therapists...the nutrition to the nutritionists...the psychology to the psychologists...

My early appreciation of the integrated nature of sport became both a blessing and a curse.  The lessons I learned from Dan have paved a way for a deeper appreciation and understanding of what coaching is all about.  But it also led to a career-full of getting my knuckles rapped at every turn.  And the subsequent ‘banging of head to wall’, as I grew more and more frustrated at the apparent ignorance of much of the traditional separatist sports system.

In the next post, I will delve a little more into the creative process, into expertise, and how I learned to ‘just get along’...


“to be quite liked by two requires you to be actively hated by ten and mildly irritate twenty” 
- Alain de Botton



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30 comments:

  1. I wrote a really long post and then erase it. I think your post is really great. The real question is why do people stay in their box. I think because the lack of curiosity. If you're involve in any human endeavour, questions arised that goes beyond your comprehension. If you're curious you feel that this is unacceptable. A lot of people are not curious enough. People that are curious and have a burning desire for knowledge will seek answers and solutions to their problems.

    The only true difficulty when you adopt this approach is to find a good mentor.



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  2. Hey Stu! Good stuff! The box is comfortable, I am encased - therefore(?) I am safe....

    I like the way you think. Is it easy to do things the way you do them? Comfortable is boring, is losing, is stagnant.....

    Keep up the posts, I will finally get posting again at some point, you motivate me.

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    1. is it supposed to be easy?
      ...'the box is safe' - I like that...I might steal it!

      looking forward to you posting again!

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    2. Comfortable is boring. I like that one. Even evolving in the same area for a long time is boring. What's thrilling is to make links and connections between different fields and see patterns. The subfields classifications is totally man made and arbitrary. Bottom line ->Feynman's principle : take the world from a different point of you.

      PS : Poincaré, Stengers Prigogine. Good reading Stuart. I had Stengers has a Sciences philosophy teacher and one of my best friend was Ilya's graduate student. Poincaré is one of my favorite character in the history of sciences : a true mathematical genius, wise and funny in a sense.

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  3. Sorry for spoiling your post but he was very deep, so it took time to digest but finally, here is my long post :

    There is 2 issues in your post

    1) reductionism,
    2) hyperspecialisation

    1)
    Concerning Poincaré, the mechanistic approach... I think citing Engels is a bad example. At his time we didn't know what we now know and the reductionist approach was as it best at Engels time. It really started with Maxwell, when he discovered that optics, electricity and magnetism was the same thing and this approach had been so successful during the 20th century. The popularity of the reductionist approach was due to his succes. Moreover reductionism is in a sense a generalistic approach. We try to unify things using fewer and fewer principles. Like Alain Connes said : we condense information. The goal of any reductionist is to get the whole pictures using few principle.
    Scientists know that you cannot use quantum mechanics to describe neurobiology or even the cell. It is out of reach. That's why we still have neurobiologist, biologist, physiologist, doctors. I think there is a misunderstanding of what scientist is thinking or believing. Most scientist believe that everything is governed by the law of fundamental physics and that in principle you could describe everything from it. But at the same time they know that we cannot explain the cell using quantum mechanics cause it is practically impossible.

    The reductionist approach may fail but still it is not a apprach that one should discarded. It has been useful and efficient 100 years after Engels. So why not use it again as long as it is useful. Moreover there is a gap between macroscopic physics and microscopic physics and using a reductionist approach to link the two is a noble and useful endeavour that may give cues to non reductionist science like biology or even chemistry. I think what really matters is the scientific methods and not human pscyhology. Scientific methods is : obsevation->model->comparison and measurable falsifiable predictions. Nature doesn't care about scientists being reductionist.

    2)
    The separatist mindset was a necessity. At Poincaré's time it was still possible for someone to be an expert in many many fields. But as science evolved it became impossible to be a generalist anymore. So fields started to separate and became more and more precise and specialised.

    Now you're right, there is a real issue nowdays as field became way too much separate. Even in Physics let say there are some subfields known by maybe a couple of hundreds of people in the world. But the issue is a social one. This separatism was forced by our limited mind and exacerbated by our sociology I would say. It would be to long to enter into the details though.

    On the other hand there is still people (very smart) who are specialists in many different fields and seems to know everything, Pierre-Gilles deGènes was one of those, Mumford, Simons, Weinberg,...

    In this situation, I think the good approach is the one you described in your post about learning. In my opinion it's really a very good, wise and deep description of what people should do. I totally recognized myself in your 4 steps process.

    Sorry for being so long.

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    1. thanks for your comments Fabien....I will require a few more coffees in my system before I feel intelligent enough to respond!

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    2. I really can't disagree with anything you have said here, Fabien!
      All good points...my citing of Engels was just to point out that he had declared the mechanistic approach dead over 100 years ago, yet here we are probably more mechanistic-reductionist than ever....it was not to argue its merits of lack thereof...your examples of some of the necessities/justifications of reductionism are well-accepted.

      We just seem to be in an ever-increasing spiral of 'deeper is better' vertical thinking, and forgetting to pause and to step back, look at, and gain a better understanding of how it all connects...

      "The real thinker sees the connections, grasps the essence of the life force operating in every individual instance. Why should any individual stop at poetry, or find art unrelated to science, or narrow his or her intellectual interests? The mind was designed to connect things, like a loom that knits together all of the threads of a fabric. If life exists as an organic whole and cannot be separated into parts without losing a sense of the whole, then thinking should make itself equal to the whole".
      - Robert Greene, Mastery

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    3. I think we agree on almost everything. My point was just that you can be a generalist in your interests yet being reductionist in your approach with more or less success. The vertical thinking that you mention is quite true to some extent in science, but believe me really deep scientist has a profound and holostici view. I remember a discussion with a famous mathematician or physicist where he said that most mathematician or physicist that try to be biologist usually fails because they try to do it like a physicist or a mathematician yet systems in biology are far more complex than in physics or mathematics. I think that the main point is that you need many tools and not just a hammer and I think that what your post is all about : be whatever is the most efficient.

      Concerning the connections : that's the essence of science, seeing commonalities between things, trying to grasp the essence and actually that's reductionism. Reductionism is just an extreme view : everything is linked by a common denominator. There maybe one but in practice it is not a useful concept but a very useful approach. The only trap is not to be an extremist. If you like those kind of topics I strongly recommand you Feynman and more recently Alain Connes or Cédric Villani. Though it's in French. Anyway I'm really off topic but it's still funny to share views on unrelated topics.

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    4. wish I could speak/read French....have read quite a bit of Feynman's (non-technical) work, though....very entertaining and interesting writer.

      generally, I feel we need to shift our aim of increasing our ability to predict, control and manipulate to that of improving our ability to make the complex dynamics and relationships more intelligible...I don't pretend to have the answers, but I find it a fascinating subject

      thanks for your wise comments Fabien...

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  4. Here’s my take on this subject Stu 2 parts. I fundamentally believe in the concept of proactive treatment, and as you describe, performance therapy. This is how I practice as an AT and S+C coach all the time. The concept of the athlete being analogized as an F1 vehicle is very poignant as the reality is that every time an athlete trains or plays they put a tremendous amount of stress on the tissues of their body and those tissues and systems need to be regularly assessed and therapeutically supported.
    There are two fundamental discords with the concept of the F1 analogy though, and they are not trivial by any means. The first is that the human body has the capacity to adapt, so unlike a car which can not replace the damaged rubber on its tires between sessions, the human body as we all know has huge capability to re-built itself and maintain itself. The second discord is the psyche of the athlete. As we know human beings have different psychological profiles, some who are healthy and understand the value of support, therapy, and help, and can place it as a realistic component of their preparation system. But then there are some that lend themselves to addictive tendencies, as well as some who revel in being enabled and it is these athletes with whom the concept of performance therapy can become as negative as it is positive.
    Athletes who become dependant on performance therapy to prepare and succeed are hamstrung by this dependence. All of us as practitioners have egos and to a lesser and greater degree, we often feed off of the perceived “need” that athlete feels around our services or support. We must be the advocates of self-support, and independence in our athletes, not dependence. It is a very fine line that we dance appropriately providing the required physical maintenance work that an athlete should have, or providing the support and athlete “needs” as in “neediness”.
    So the question becomes, how much time and effort in the garage is required or necessary for the athlete to be capable of producing its best performance, but at the same time providing them with the capacity to be self reliant and independent.

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    1. Very interesting view. So you're an advocate to teach a kind of self-therapy emergency kit for athletes? How do implement that?

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    2. Thanks for your comments Scotty. We are on the same page on both of your ‘discords’, though I don’t believe either to be a big enough reason to discount both its effectiveness, and, in many cases, necessity in optimizing the training and competition process. Like any input, it requires careful consideration as to its timing, the interaction with the main session proper, and its effect on the overall load. But far too many throw the baby out with the bath water. At its essence, I see performance therapy as a part of the warm-up sequence that - like all other parts of the warm-up - will require more or less time and energy depending upon the situation (i.e. the athlete’s physical state, the details of the session, who is available for treatment, what ‘self-treatment’ options do you have, etc.).

      I guess the F1 metaphor works to a point, but I agree to its limitations: your point in regards to self-organization/self-adaptation is well-taken. In my extremely simplistic view, the ‘body’ - in its allostatic state - has two choices - negative adaptation, and positive adaptation. If we can help ‘point’ the body in the ‘right’ direction by making a few key inputs, then I struggle to see an issue...

      Sometimes, as part of the training process, we want the ‘system’ to experience times of over-reaching - in effect ‘negative adaptation’ - but I don’t think we ever want mechanics to fall too far outside of the athlete’s typical manner of movement. So if our input can help keep them within this bandwidth, why not intervene?

      As for ‘dependancy’, I have two thoughts. Firstly, I see ‘dependency’ as a general trait: no athlete will ever become ‘dependent’ upon this unless the general trait exists within them. Some athletes need things to cling to. Others don’t (not to say it cannot be improved upon). If it’s not ‘performance therapy’, they'll find something else. Secondly, I agree 100% with what you said vis a vis ‘practitioner egos’. In fact, in Part I of the post, I addressed it:

      “Performance Therapy is not:
      Created to make the athlete ‘dependent’ on the treatment.  Often, therapists and coaches can use such an opportunity to ‘validate’ their reasons for being at the track; not comfortable with the sometime necessity of passivity, they allow their egos to inform their process. Instead, performance therapy is used to hold the athlete more accountable.  With daily intervention, the coach-therapist has constant information about the athlete’s tissue, and can better recommend ‘homework’ (such as stretching, foam and ball rolling, hydro-therapy, etc.) so the athlete can begin to take more responsibility in their preparedness.  The goal of performance therapy is to reduce the amount of time needed on the treatment table - not to increase it.”

      Again - appreciate your thoughts Scotty...you’re right though - a very ‘provocative’ topic.

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    3. Absolutely, though I wouldn't call it an emergency kit, more of a preventative measures program. When we work with an athlete we should make them aware of what healthy and productive movement "feels" like so that they can identify when they are not functioning at 100%. Just as the driver in the F1 car can tell the mechanics when something isn't right, and in many instances can dial this down the the actual problem. Further there is much they can do themselves with various self therapies such as forms for self massage like foam and ball rolling, forms of active stretching, nutritional programming and supplementation, etc. that can help them personally manage their own bodies. This translates into how they warm up, cool down, and recover from each training and competition session. The more they become aware of their bodies, the more they can identify moments to seek support, and moments to self manage, and they become better advocates for themselves over time.

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    4. You're right prevention is key. Every coach and athlete should have some form of preventative tools. Just having the ability to feel that something is not optimal in some joint or muscle is already very helpful.

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  5. The second issue that has come in discussion up is should S+C professionals treat athletes. With regard to this element there are several important factors to consider.
    First of all, lets differentiate between athletes not suffering from pathology, and athletes suffering from some sort of pathology, pain usually being our guide in this domain. Those who are not suffering from pathology may still present with dysfunction and mechanical imbalance which we feel may be preventing them from higher performance, or may be setting the athlete up for injury in the future. In this type of scenario the fact that a coach may have acquired therapeutic skill sets throughout his/her growth and development as a professional lends itself their implication in regular maintenance work and support of an overall program of performance.
    However, the problem becomes when athletes are suffering from pathology, or the inherent dysfunctions that have been observed and treated and are not resolving.
    The primary reason for the discourse often seen between treating coaches and therapists can lie in the concept of and desire to “box” out or “boxing” in, and this is often ego driven and turf oriented. But it also resides in a deeper more understandable and practical issue, the issue of responsibility. As professional domain is defined by level of responsibility and this is why as you move further up the food chain of such responsibility the cost of your liability insurance increases. Thus the reason for the often seen discourse between therapists and physicians which at times can be as strong as the one seen between performance coaches and therapists. I spend a lot of money every year for the right to practice therapeutic techniques as well as building and delivering performance training programs, of which both policies have very clear delineations of what I can, and can’t do.
    The key issue in the delivery of therapeutic skill sets is the underlying cause of the issue you wish to treat. Therapists spend a long time learning and practicing the art of history taking, differential assessment systems, and understanding how to recognize underlying pathology. I can’t tell you how many times I’ve attended courses on skill sets capacity and never once has anyone taught the attendees how to recognize or assess underlying pathology. Skills are often taught in an assess and effect approach, and this works just fine when the practitioner taking the course is a therapist because he/she has already been taught how to approach the process of “clearing” for other potential sources of the problem. When the source of the problem ends up being something far graver than musculoskeletal dysfunction, and the athlete ends up suffering grave consequences, who’s fault does it become? Thus the issue of responsibility being at the forefront of the discourse.
    The counter argument to this is that if we provide therapeutic support and the athlete feels better, isn’t this a positive thing? It certainly is a great thing, but what happens if they don’t feel better? What happens when they feel worse, and that happens? As a therapist and performance coach I can tell you there have many times in my career when I made the wrong call and an athlete felt worse after a working session, and the fact that I could depend on my knowledge as a therapist to fall back upon for change of direction, or deductive assessment of my mistake was a huge factor in what happened next.

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  6. Finally, whenever you learn adjunct therapeutic skills (and that’s what they are, skills, just like learning to use a hammer or a saw in carpentry), you go through a process. I’ve gone through this process many times in my career: you acquire the skills, and you put them into practice, much of the time when unnecessary in order to learn to use them (just like the hammer analogy we’ve all heard, much of what you see looks like it might be a nail). Your “clear” understanding of those skills at initiation becomes cloudier as you get further away from the original source. You revisit the source, you re-affirm your skill acquisition, you fine-tune your use, and you practice the appropriate use of that skill mixed with other skills you’ve learned. You do this over and over again until you acquire expertise, and this takes a long time and a lot of client sessions. Not only do you learn to not use the hammer only when working with nails, but you also learn which hammer is best used with which nail, and when it's a screw, and screwdriver might be a better solution. This process repeats itself over an over again with the process of learning new skills and as analogized, all the tools in the tool box. It can be a very slippery slope if the practitioner learns one skill and does not clearly understand when its use is inappropriate or ineffective, but makes the athlete “feel” good. Feeling good is not the purpose, the purpose is to fix the problem and move forward.
    Though there are no simple answers the questions you have presented, there are some clear central principles that should underpin the solution.

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    1. so - referring to Lorne’s example (http://athleticconditioningcenter.blogspot.ca/2013/02/my-experience-with-performance-therapy.html), with what amount of certainty, experience, and training would it be allowable for the S&C coach (or for that matter, the team/technical or personal coach - as in the athlete’s sprint coach) to step in?

      Very difficult questions...not sure they lend themselves to simple answers. You have definitely added to the depth of the discussion Scotty - it’s appreciated!

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    2. The situation that Lorne describes is really more about relationships, trust, and respect than it is about domain. At the end of the day there needs to be a working relationship where the capabilities of all parties are on the table and people understand what one another is capable of. I haven't enough historical context to truly comment on this example, and wouldn't want to assume anything.

      That being said, when there is pathology, the ultimate responsibility rests in the hands of the medical lead and as such, they need to know what the athlete is doing, because if it goes wrong, they will be called on the carpet to explain why the million dollar player isn't playing.

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    3. I think the ultimate responsibility lies with the coach - even with pathology. The coach (in concert with the athlete) alway has the choice of whether or not he/she will take the advice of the medical team. The S&C coach is a different story, and I think this is where some of the ambiguity exists....as the S&C coach is part of the support team -and by definition is required to be 'supportive of the team', he cannot be seen to exist outside of what should be a fairly structured hierarchy...he's the S&C coach, and quite rightly should not be doing 'therapy'.

      The lines become blurred though (as Lorne points out in the caption to one of his pictures on his blog) as to what constitutes 'therapy'....perhaps it's as simple as a 'pathology or not' yes or no....or maybe it is much deeper. The same challenges exist within the entirety of the support team...e.g. for years, S&C coaches have been providing nutritional and supplemental advice - but perhaps because of a closer communicative bond between S&C and nutritionists, this hasn't proved to be as much of a potential issue....

      just some random thoughts that I will attempt to expand on in my next post...

      thanks again for your thoughts Scotty....

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    4. FInally had time to join the discussion (had some work to do). Reading all the above i think i have really nothing to add on this. Great replies by Scott.

      Well maybe there is one thing, i talked about with my Dutch colleque Erwin the previous weekend. We believe and see that performace therapy or track side therapy allows movement to happen with the result of better technical development in contradiction to more cognitive technical development approaches. It feels like we have found "an other entry" to the motor cortex of the brain where more fluid and clean movement is made and above a movement that is not much influenced by stress/pressure.

      What are your experiences with this?

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    5. Stu, agree with the coach/athlete approach and ultimately the athlete is the advocate for their own body. The dynamics of performance therapy are complicated as there are a myriad of circumstances and scenarios to discuss. The situation which Lorne describes, inside a real team environment where there are very clear lines of communication and hierarchy lends itself to the clearest path in that the lead medical practitioner needs to know what's going on. When dealing with classically individual athletes, even framed within a team environment, then things get more complicated. As per Roog's comments, there is a lot to be gained by providing "therapy" track side or in the gym in order to improve movement strategies, increase freedom of movement, and support exercise selection and training programming. The existence of pathology is not so much the issue as the use of the therapy to "treat" pathology, versus the use of therapy to augment or assist training effects. If your intent is to "treat", then you should have some form of medical qualification. If the intent is to support training effect, then it becomes an available option for delivery by a coach. This can be a slippery slope though as what constitutes real expertise in these adjunct skill sets. It can get very grey and murky out there!

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    6. that's it pretty much in a nutshell...well said, Scotty!

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    7. Rogier...you bring up an excellent point - namely, it's all connected! Our input affects both feed-forward and feed-back processes. The body's allostatic nature and dynamic self-organisational properties makes prediction of adaptation a rough estimate at best...
      the more information we have, the better prediction we can make...thus, the importance of 'hands-on' work from the coach...

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  7. Coming off topic to the current discussion. Mr. McMillian at the moment I have an interest in learning sports massage. In order to provide to learn to be good at what I want to do, what advice would you give to a complete novice?
    Please give as much as advice as you can provide!

    I'm eventually thinking of taking the ITEC Certificate in Sports Massage Therapy Level 4. I know that might not mean alot to you since you probably know alot more than most people who took that course!

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    1. to be honest, I am really not familiar with the different qualifications in sport massage or therapy. My best advice would be to 1) get educated (do your research - find the best scenario you can that fits your individual situation), 2) find a mentor - someone you can shadow/apprentice under, and 3) get stuck in - find people to practice on...your friends, family, etc...there is no substitute for experience - the more bodies you work on, the better you will become...

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  8. This comment has been removed by the author.

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  9. Great Post Stu. And as an athlete that received that "track side therapy" I can attest to it's success. Even the slightest "sticky hip" can set off a whole training session, but that therapy on the spot is beneficial and turns useless into useful.
    Besides, unless a chiro, massage, sport therapist, et al want to be readily available at all times, there needs to be some freedom put into the hands of the coach that is constantly present and committed.
    Thankfully, most athletes can act as the band-aids to your bruised knuckles.

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    1. thanks Lisa...

      I guess the 'freedom' often comes from what role the coach plays...it has usually been a pretty easy call for me, because I have been the coach...for the S&C coach, I think it's a different story. Like Scotty says, working within the framework of the team, and within the understanding of the medical set-up is important...

      I will expand on this in Part III...stay tuned

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