Coronavirus has shuttered all schools in the North Country of New York, and with the closing of schools comes the canceling of athletics. Thousands of student-athletes are not able to attend practice and have no games scheduled. But with re-opening of New York State on the uncertain horizon, these athletes also know that at some point next school year, they’ll be returning to classes and to practice - and many of them want to be ready for their first season back.
Adult athletes might not be in school anymore, but they’re facing the same difficulties. Marathons are postponed, pickup leagues are canceled, and there aren’t any triathlons or Ragnor races on the horizon. Even the 46’er Challenge of Adirondack fame has stopped accepting applications for completion with mountains that were climbed during the quarantine. Although their seasons might not be as tied to the academic calendar as students’, they have no less desire to be ready to get back to what they love.
But training isn’t as simple as just going in your living room and doing some YouTube videos, or going outside for a run. Athletes of all ages know that preparing themselves to be in tip-top shape for their next season is a mix of an art and a science, with things like when they start training, how much they train, and whether they take rest weeks or taper before games mattering. It can feel like a lot to try to manage, even for the most motivated athlete.
Without easy access to their usual methods of training, athletes can consider turning to their local physical therapists, especially those who specialize in sports medicine, to help them work through their pre-season routine and avoid or recover from injury. Dr. Justin Charland, PT, DPT of Pearl Physical Therapy serves the local Plattsburgh community, specializes in sports medicine, and works frequently with athletes of all ages on injury recovery, injury prevention, and optimization of performance. He graduated from the College at Brockport with his Bachelor's of Science in Exercise Physiology in 2010, then went on to earn his doctorate in physical therapy from Upstate Medical University. He subsequently went on to earn his certification in the Selective Functional Movement Assessment (SFMA) in 2013. Dr. Charland has answered some of the most challenging questions athletes have in the hopes that this will help them structure their weeks ahead and prepare for their return to their sport.
How much baseline exercise should athletes be looking to get while in quarantine on the off-season of their sport?
“It is important for athletes to stay active during this time of social isolation; however, this can also be a welcome break for overtraining,” Dr. Charland states. “There are cases where athletes are performing high level activities without proper baseline function. Giving the body some rest and returning to those foundational movements without the extra equipment can be helpful to let the body recover and improve functional strength/stability. How much exercise depends on where the athlete is physically and how close they are to the sports season, which will be discussed later. In general during this time, trying to get at least 20-30 minutes of exercise 5-7 days per week will help to maintain conditioning and prepare the body for return to sport and recreational activities while minimizing injury risk. Another factor to take into account is the type and duration of sport you participate in. Ideally, performing some type of cross training to minimize burnout and perform an activity at a sub maximal effort as compared to your sport/event is recommended.”
Many athletes have seasons that start at different times, or even pre-season training sessions that can begin weeks in advance. When should athletes start ramping up their training at home, and how can they do so safely?
“During these uncertain times, choosing exactly when to begin to ramp up training for an undetermined beginning to the season can be challenging. However, we can look at the periodization of training model to determine when you should begin training for your sport while taking into account your current fitness/performance level and when your season begins,” Dr. Charland explains. “Although this model involves 4 phases, our focus for ramping up training at home will likely place the athlete in the offseason or potentially in the preseason phase.
Phase 1, Offseason: Training usually begins with a rested athlete returning gradually to activity with low intensity and moderate volume. This usually involves 40% of both the athletes volume of activity (duration, weight lifted, repetitions of exercises) and of the intensity of activity (percentage of maximum performance). The easiest way to determine intensity is with rating of perceived exertion (how hard you feel you are working compared to maximum) or by percentage of maximum heart rate. This phase of the program generally lasts for 2-3 months and should end close to a month prior to the start of the athlete’s sports season.”
Athletes may already be familiar with rating of perceived exertion, or RPE. It’s a scale from 1-10, or sometimes 6-20, that asks the athlete to pick a number and word pair that describes how hard they’re working at the moment. On a 10 point scale, shooting for 40% would mean targeting the “moderate” area:
Athletes may also be familiar with how to calculate their percentage of maximum heart rate. Typical formulas ask for maximum heart rate to be calculated by taking 220 and subtracting the athlete’s age. Multiplying that by their target intensity - in this case, 40% - helps the athlete identify what heart rate they should try to stay around. Some critics of this technique, however, argue that this formula may underestimate heart rate for athletes, and the RPE method - or a more complicated method of calculating heart rate - are more frequently recommended if this seems to be the case. Dr. Charland continues,
“Phase 2, Preseason: Training usually begins 1-2 months prior to the athlete’s season, lasting for that same amount of time. Activity should be progressively more challenging, performing close to 70% of the maximum volume at 50-60% intensity. This phase will begin with increased interval training, strength and power to include total body activities and also allowing the athlete to focus on their weaknesses. As this phase progresses, the focus shifts to more sport specific activities to simulate activities by focusing on technique and strategy.
Phase 3: Early season: Volume decreases to close to 50% of maximum, while intensity continues to ramp up to 60-70%.
Phase 4: Competitive Phase: Volume continues to decrease as athlete tapers activity to prevent overtraining, dropping to 40% of maximum. However, intensity progresses to peak levels, reaching close to 90% during practice.”
What about athletes who might be coming off an injury - are there any particular recommendations you would have for them?
“The main recommendation for athletes that may be coming off an injury would be to listen to your body,” Dr. Charland emphasizes. “If you feel like something is more challenging on the injured side, perform an extra set or extra repetitions on that side, all while making sure the activity is performed with correct form. If there is a breakdown in form, this can lead to inflammation in the area or surrounding areas, along with potential re-injury.”
“Understanding the difference between pain and discomfort is important as well,” Dr. Charland notes. “Pain should be avoided and be assessed by a movement professional. However, discomfort such as fatigue, stretch, strain that may last for 24 hours after an activity is normal part of recovery or remodeling of soft tissue, and should be expected.”
What are some of the most important exercises upper extremity athletes can do at home to prevent injury?
“Performing targeted activities specific to your program will likely occur further into the preseason program and be directed by your coach. However, these are some basic cross training activities to perform in an off season program that will help with good global shoulder strength and mobility.
Wall angels: Standing at wall, feet about 6 inches away from wall, making contact with hips, thoracic spine and head. Placing arms back as far as you can in a “W” position with elbows and wrists in contact with wall, extend elbows overhead into “V” position as far as you can while maintaining contact points and return to starting position.
Push ups: These are a tried and true upper extremity workout, with variability in form with activity changing difficulty of performance, with progression of difficulty being performing on knees, on toes and with feet elevated. Targeting different muscle groups can be achieved with change in hand position as well, with focus on wide and narrow hand position to target chest and triceps, respectively.
Side planks: This activity is very good for shoulder strength/stability, as well as core strength. Along with the push up, this can be a versatile and progressive exercise based on positioning to challenge the athlete as they improve. Least difficult would be performing with knees bent and forearm in contact with the ground, progressing to full forearm plank with outside of feet contacting ground, to full side plank with elbow extended. Rotation can eventually be incorporated with the opposite arm to provide increased challenge to core stability during activity.
Pull ups: Although pull ups may not be feasible to most athletes at home at this time, performing this global upper body strengthening activity can be very challenging and provide a great strength base for the athlete. It also allows the athlete to work muscle groups involving a pulling motion to counteract provide challenge to muscles opposite of the push up. This exercises is also variable, performing with differing width of grips and hand positions.”
What are some of the most important exercises lower extremity athletes can do at home to prevent injury?
“Along with upper body activities, these lower body exercises are generalized and targeted for the athlete to cross train during the offseason.
Lunges: Lunging with the proper form can be a very effective exercise in building strength and control in the lower extremity. There is also variability within the lunge, performing from static position, walking lunges, lateral lunges or split squats with trail leg placed behind the athlete with the top of foot resting on a chair. If possible, performing these exercises in front of a mirror to assess form, with common compensations being knee migrating over toes, knee migrating medially (knock-knee position) or shifting weight too far forward (body should drop straight down).
Squats: Squats are a fundamental movement of the lower extremity, and performing with correct form is important. The same compensations noted with lunges above are typically seen during squatting, and therefore if applicable this exercise should be performed in front of mirror. Progressing the squat to preform single leg squat to/from chair is a good activity to determine if there is asymmetry, especially if an athlete is coming off of an injury to that leg. If more difficulty is noted on one side, performing an extra set or increased reps on that side would be beneficial.
Stepping: Using a step at home can be a good strengthening tool for the lower extremity and target each leg individually. Starting on the step and performing slow, controlled step downs while making sure the foot/knee/hip stay in line is beneficial to work on baseline strength. Another activity to perform at a step is performing explosive step ups, putting one foot up on step and trying to push up quickly while driving opposite knee up to chest. This activity is good for development of strength and power. To make exercise more challenging try to increase height of step.
Unilateral hip thrust: This activity is good for engaging one leg at at time, with focus on strengthening the gluts and providing an active stretch to the hip flexors. Start exercise with upper back resting on the front of your couch, bending one foot underneath you and the other leg straight. From this position, lift your buttocks up while engaging your abdominals. Placing additional weight over your hips can provide additional challenge for this exercise.”
Although these exercises are intentionally generalized, athletes of all ages should keep in mind that they can progress to more specific exercises and receive a more tailored program as necessary if they call Pearl Physical Therapy at (518) 563 - 7777 or click here to set up a time for either a telehealth or in-clinic evaluation with Dr. Charland.
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