AFTER THE SIREN: Rehabilitative Pilates for AFL players

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1 AFTER THE SIREN: Rehabilitative Pilates for AFL players Stevie Peers February 20th Bardon/Brisbane, Australia

2 Abstract There s no doubting that AFL players are amongst some of the fittest athletes in the world. They re disciplined, dedicated and trained by the best in the business. Taking only 3 weeks off a year, the life of a professional AFL player is not all fun and games; their strict training and eating plans would test anyone s endurance levels and can be incredibly demanding on their bodies. On the field, an AFL player is susceptible to a number of injuries, from a hamstring tear to a lost tooth, so their training regime needs to be dynamic enough to prepare their bodies for any harmful situation they could come up against. These days, more and more AFL clubs are introducing Pilates to their weekly training plans as a way to treat and prevent injuries. 2

3 Table of contents ABSTRACT... 2 TABLE OF CONTENTS... 3 ANATOMICAL DESCRIPTION: GROIN STRAIN... 4 MY CLIENT... 6 ABOUT... 6 W EEKLY EXERCISE REGIME... 6 INJURIES AND LIMITATIONS... 7 REHAB TREATMENTS... 7 PILATES CONDITIONING PROGRAM... 8 PILATES SESSION/EXERCISES... 8 DESIRED RESULTS CONCLUSION BIBLIOGRAPHY W EBSITES BOOKS

4 Anatomical description: Groin Strain A groin strain is a muscular tear or rupture to any one of your groin muscles; usually one of the hip adductor muscle group. The adductors consist of five muscles: adductor brevis, longus, magnus, pectineus and gracilis. Any of these groin muscles can be strained but the most common is adductor longus. The symptoms of Groin Strain include: Groin pain and tenderness Muscles spasm or tightness of your groin muscles Pain on stretch of your groin muscles Groin pain with groin muscle contraction Groin Pain is a common injury in AFL players. This is due to the requirements of the sport that produce high loads across the pelvis from repeated kicking, cutting, quick changes of direction and pivoting. Excessive training volumes including high kicking and cutting loads, inadequate recovery and rapid changes in training intensity and duration can all cause overload and groin pathology. 4

5 Early identification and management of the signs and symptoms of groin pain is essential to decrease the severity and duration of the symptoms. Common warning signs from the player developing groin pathology include a loss of kicking distance and penetration and reduced speed and agility. Treatment often includes a combination of soft tissue therapy, muscle strengthening and most importantly, activity modification. A period of relative rest from aggravating activities (such as limiting duration and intensity of training, and reducing kicking and agility drills) may be enough to control symptoms in the early stages, although an increased period of unloading and slow return to running and football training may be required in more severe cases. A rehabilitation period of 3-6 months is not uncommon in advanced cases of longstanding groin pain. Once players return to the field, individual training volumes need to be monitored and managed for the remainder of the season to prevent recurrence. Continued strengthening and flexibility programs also need to be continued to improve strength and flexibility deficits and prevent further episodes of groin pain. 5

6 About My Client Chris Dickson is a 32-year-old minor league AFL player. He trains twice a week for 2 hours and plays a full 2 hour game each weekend. Chris plays in a number of positions on rotation; Centre Half Back, Ruck and Full Forward. These are all high contact, therefore high impact positions. Chris works in Sales where he spends a lot of time sat down at a computer. The juxtaposition of a job that keeps him, for the most part, very stationary where there is a risk of faulty posture, such as; rounding shoulders, rotation for an extended amount of time, neck misalignment and forward head motion, compared to a hobby that requires him to be extremely mobile and move his body into confronting positions at a moments notice, can be a dangerous combination without the necessary conditioning, stretching, training and body awareness. Weekly exercise regime Chris s typical weekly exercise regime consists of; 3-4 x 45-minute bike rides, 2 x 45-minute weight lifting sessions, 1 x 1-hour Pilates session, 2 x 2-hour football-training sessions (Skills based training and cardio endurance training) 1 x 2-hour Football game 6

7 Injuries and limitations Groin strain Shortened and tight calf muscles Heel spurs Weak and tight hip flexors Left leg longer than the right Forward head Hip misalignment Hyperlordosis Shortened Pectorals Rehab treatments Regular acupuncture, targeting the groin, calf and ankles/feet, Realignment, focusing on creating symmetry in his legs and hips, Strength building and stretching exercises. Deep tissue sports massages.

8 Pilates conditioning program Pilates session/exercises I give Chris a fundamental warm up because the double leg stretch, single leg stretch and criss-cross in the Intermediate warm up tend to aggravate his groin before his body is fully warm. Fundamental Warm Up Mat Pelvic Curl Using a ball between the knees to keep the inner thighs engaged and prevent deviations Fundamental Warm Up Mat Spine Twist Supine Using a ball between the knees to keep the inner thighs engaged and prevent deviations Fundamental Warm Up Mat Chest Lift Using a ball between the knees to keep the inner thighs engaged and prevent deviations Fundamental Warm Up Mat Chest Lift with rotation Using a ball between the knees to keep the inner thighs engaged and prevent deviations I start Chris with foot work on the reformer because this is where he receives the most support. He doesn t have the strength to sit high out of his hips on the chair and maintain a stable core, and he doesn t have the flexibility to have his legs elevated on the Caddy without his tailbone lifting. Fundamental Foot Work Reformer Parallel heels Fundamental Foot Work Reformer Parallel heels Ball between the toes and sometimes between the knees also as Chris s feet tends to roll out. Ball between the heels and sometimes between the knees also as Chris s feet tends to roll out. Fundamental Foot Work Reformer V Position toes Fundamental Foot Work Reformer Open V heels Fundamental Foot Work Reformer Open V toes Fundamental Foot Work Reformer Calf raises Nice and slowly, really concentrating on the stretch as Chris has incredibly tight calf muscles. Ball between the heels to prevent roll out. Fundamental Foot Work Reformer Prances 8

9 Fundamental Foot Work Reformer Single leg heel Fundamental Foot Work Reformer Single leg toes Being careful with the leg in table as this can sometimes aggravate the groin Being careful with the leg in table as this can sometimes aggravate the groin I like doing the short box series for Chris s abdominal work because having his legs elevated and/or in table top for too long can place too much pressure on his groin. Round back and flat back in the short box series provides the stretch across the front of the hips that he requires as well as an opening through the back where he is very stiff, while the tilt and twist give his spine the flexion and rotation he really needs to improve his game while playing football. Intermediate Abdominal Work Reformer Round Back Intermediate Abdominal Work Reformer Flat Back I keep Chris s hands behind his head in the flat back because he doesn t yet have enough control to keep his ribs from flaring when his arms are above his head. Intermediate Abdominal Work Reformer Tilt Intermediate Abdominal Work Reformer Twist I keep Chris on the reformer for hip work because at the moment he doesn t have enough control through his hips for the caddy. On the reformer, I can easily adjust the resistance with each exercise to allow the groin to gain strength and stretch out while keeping the flow of the session going. Fundamental Hip Work Reformer Frog Fundamental Hip Work Reformer Circles down I would have the resistance light to medium for frog so that Chris can maintain control, keeping his ankles squeezing together. I would take the resistance up to medium for circles so that he has something to push into while lengthening out of his hips Fundamental Hip Work Reformer Circles up Fundamental Hip Work Reformer Openings I would keep the resistance medium for openings so that the springs can pull him into a deep inner thigh stretch on the out motion. 9

10 I put Chris on the Cadillac for spinal articulation because while the monkey gives his spine a great stretch and mobility, it also works his hamstrings and calves, which are very tight. Fundamental Spinal Articulation Cadillac Monkey Original As a result of years of playing football without stretching properly, and years of being slumped over a computer, Chris is very tight in his whole body, so I like to spend a reasonable amount of time with his stretches to really open him up. Fundamental Stretches Step Barrel Shoulder Stretch Lying Side Fundamental Stretches Reformer Standing Lunge I love this exercise for Chris because it gives him a great release through his shoulders and pectorals, which have become shortened from his posture at work. This is a challenging but very necessary stretch for Chris, he struggles to keep his pelvis square due to the tightness in his hip flexors, for this reason I keep the resistance very light. Going from standing lunge to scooter flows really well and the knee stretch group is great for Chris as he learns to work from his core to control his hip extensors. Fundamental FBI F/I Reformer Scooter Fundamental FBI F/I Reformer Round Back Finding and maintaining this round back position in this exercise is difficult for Chris because the tightness in his groin tends to pull him forward. A lot of tactile feedback is required for precision during this exercise. Fundamental FBI F/I Reformer Flat Back 10

11 Chris already has a very strong upper body, so when we are working the arms I am more concerned about creating more motion through the shoulders than building more strength. For this reason I like to use either the Cadillac for the arms standing series, or the Ped-a-Pul. I like the proprioceptive feedback that can be gained from standing with the spine against the ped-a-pul to lengthen from the top of the head down to the tailbone, whereas I like the deep core engagement that comes from the arms standing series. Fundamental Arm Work Ped-a-pul Extension Chris s shoulders tend to hike up during this exercise so I have to be sure to watch him carefully from every angle. Fundamental Arm Work Ped-a-pul Adduction Fundamental Arm Work Ped-a-pul Circles Up At all times during this series I am conscious of Chris lengthening his spine and reaching his legs long out of his hips. Fundamental Arm Work Ped-a-pul Circles Down Fundamental Arm Work Ped-a-pul Triceps Chris is limited when it comes to the leg work because a lot of it irritates his groin. Squats make his groin jam up because he doesn t have enough stability in his joints, while the inflexibility in the backs of his legs mean that he can t land well in the jumping and causes him pain. For this reason I put Chris on the wunda chair; the hip opener gives a great stretch to the hips extensors as he controls the pedal down and up. Fundamental Leg Work Wunda Chair Hamstring Curl Intermediate Leg Work Wunda Chair Hip Opener Using the wunda chair to perform the side stretch is excellent for Chris, his whole body is so open and stretched out with his leg reaching out nice and long and his spine reaching in the opposite direction. Using a lot of tactile feedback and assistance, the whole side of his body gets great relief from the exercise. Fundamental Lateral Flexion/Rotation Wunda Chair Side Stretch 11

12 Chris has very limited back extension and can often find it uncomfortable so I am cautious with the exercises I give him. While swan basic on the wunda chair is the fundamental exercise for back extension, I am more inclined to have him do swan on floor. The reason for this is that due to the stiffness through his back, he struggles to lift himself into back extension for swan basic, whereas swan on floor gives him more awareness of where he is and where he needs to go. It also gives his one final shoulder stretch. Intermediate Back Extension Wunda Chair Swan on Floor Desired results This program was designed primarily to give Chris the stretch that he so desperately requires. Regular practice using this model has already seen a great improvement in Chris s posture, and it will be interesting to see how it affects his game when AFL season starts back. I would expect the following things to happen based on continued practice of this program: Neck Sitting back over the spine instead of reaching forward Pectorals Opened up, no more rounded shoulders resulting in a more upright stance. Shoulders More motion and stability. Hip Flexors Longer, stronger and more stable resulting in a more neutral pelvis and no more hyperlordosis Hamstrings Stretched out, possibly even a more equal length through both legs. Calves Longer tendons, creating less pressure on the heels (spurs) and feet 12

13 Conclusion Chris has been suffering from a lot of pain predominantly in his groin, though he does get very sore shoulders and feet regularly. This affects his everyday life considerably, as his stiffness makes it difficult for him to move around fluidly. This is worst in the mornings but has been known to last all day and sometimes even multiple days. Chris s concerns are that his AFL career will have to end sooner than he would like and that in later life he will develop arthritis and be in constant and chronic pain. With regular Pilates practice, I hope to keep Chris on the field for a couple more years with a body that has been conditioned to the knocks, bumps and falls that occur in the game and that recovers faster. Mostly I hope to improve his body so that his future self can live free from pain, active and healthy for as long as possible.

14 Bibliography Websites Groin Strain PhysioWorks, 2015 How to treat common injuries in the AFL Game day, 2015 Books Pilates Anatomy Karen Clippenger & Rael Isacowitz, USA, Human Kinetics, 2011 Pilates 2 nd Edition Rael Isacowitz, USA, Human Kinetics, 2014 Wunda Chair Movement Analysis Workbook Body Arts and Science International, Costa Mesa, California, 2012 BASI Reformer Movement Analysis Workbook Body Arts and Science International, Costa Mesa, California, 2012 BASI Cadillac Movement Analysis Workbook Body Arts and Science International, Costa Mesa, California, 2012 BASI Auxiliary Movement Analysis Workbook Body Arts and Science International, Costa Mesa, California, 2014 BASI Mat Movement Analysis Workbook Body Arts and Science International, Costa Mesa, California, 2012 Study Guide Comprehensive Course Body Arts and Science International, Costa Mesa, California, 2013