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  1. Integrative Approaches to Optimum Performance Geoff Lecovin M.S., D.C., N.D., L.Ac., CSCS

  2. Geoff Lecovin, DC, ND, L.Ac, CSCS In private practice for over 18 years Chiropractor (1990) Naturopathic Physician and Acupuncturist (1994) Certified Strength & Conditioning Specialist (NSCA, 2005) Corrective Exercise Specialist (NASM, 2006) Performance Enhancement Specialist (NASM, 2006)

  3. Integrative Components of Optimum Performance Psychological Biochemical Structural

  4. Psychological(visualization and Intention) *When you visualize yourself performing an activity, you are in turn physiologically creating neural patterns in your brain, just as if you had physically performed the action. *These patterns are similar to small tracks engraved in the brain cells from physically rehearsing an activity *Mental imagery is intended to train our minds and create the neural patterns in our brain to teach our neuromusculoskeletal system to do exactly what we want it to do. *Ultimately, an athlete can enhance their performance physically by simply mentally practicing the activity. * The more emotion and intention, the more effective the results

  5. Effects of Visualization on the Free-throw Performance of Basketball Players."University of Chicago • Athletes were tested to determine their free-throw proficiency and then randomly assigned to one of three experimental groups. • The first went to the gym every day for one hour and practiced throwing free throws. • The second group also went to the gym, but instead of physically practicing, they lay down and simply visualized themselves successfully shooting. • The third group did nothing • At the end of 30 days, the three groups were re-tested • The players who hadn't practiced at all showed no improvement in performance; and many exhibited a drop. Those who had physically practiced one hour each day showed a performance increase of 24 percent. • The visualization group, by merely imagining themselves successfully shooting free throws, improved 23 percent

  6. Stress and the Mind-Body Connection Repressed Conscious or Unconscious Emotions Abnormal Autonomic Activity (Sympathetic) Reduced Local Circulation of Blood Mild Oxygen Deprivation Muscle Pain Nerve pain/Numbness/Tingling/Weakness Tendon Pain DECREASED PERFORMANCE

  7. Biochemical • Diet • Supplementation

  8. A Balanced Approach to Diet Focus on fueling the body with nutrients that provide energy for exercise rather than on calorie restriction. Optimize nutrients Shift balance of omega-3:omega-6 fats Change carbohydrate sources to fruits and vegetables Incorporate lean protein sources with every meal and snack All calories are not created equal

  9. The Healthy Plate Starch Non-starchy veggies Protein Corn Peas Potatoes Pumpkin Squash Sweet potatoes Whole grains Yams Asparagus Broccoli Cabbage Carrots DGLV Green beans Peppers Tomatoes Beans & lentils Beef (grassfed) Cottage cheese Eggs Fish Nuts & nut butters Poultry & pork (lean) Tempeh & tofu

  10. The Power of Color RED (anthocyanins, lycopenes)- strawberries, cranberries, raspberries, cherries, grapes, beets, peppers, water melon, pomegranates, apples, onions, pink grapefruit ORANGE-YELLOW (beta carotene, lutein, zeaxanthin)- carrots, sweet potatoes, yellow potatoes, orange, mangoes, cantaloupe, pumpkin, squash, apricots, corn, banana, turmeric, ginger GREEN (beta carotene, lutein)- spinach, chard, kale, avocado, asparagus, artichokes, broccoli. Brussels sprouts, cabbage, green tea BLUE-PURPLE (anthocyanins)- blueberries, blackberries, grapes, red wine, eggplant WHITE- garlic, onion, cauliflower BLACK/BROWN- Coffee, dark chocolate, nuts The Color Code. James A. Joseph, Ph.D., Daniel A. Nadeau, M.D., Anne Underwood

  11. General Macronutrient Guidelines CHO- 40-55% PRO- 25-30% (1-2 g/kg body weight) FAT- 25-30% *Base macronutrient intake upon type of exercise/sport, goals, mood and energy level

  12. Fats Eat more: monounsaturated & omega 3s -avocado, olive, fish, flax, walnuts, wild game, DGLV Limit: saturated fat - beef, butter, cheese, egg yolks Avoid/eliminate: trans fat - margarine, partially hydrogenated oils *Eating healthy fats is essential for weight loss, general health, fitness and a fat-burning metabolism

  13. Omega 3:Omega 6 Omega 3= fish, flaxseed, walnuts, canola, DGLV, grassfed beef Omega 6= soybean oil, safflower oil, corn oil, other polyunsaturated vegetable and seed oils *Imbalances between omega 3:omega 6 increases inflammation, thereby increasing risk for inflammatory diseases such as CHD, stroke, autoimmune problems, eczema, RA, etc.

  14. What About Carbs? Glycemic Index (GI) = measures the rise in blood sugar triggered by a specific number of carbohydrates of that food. The higher the number, the greater the blood sugar response. Glycemic Load (GL) = indicates how much of a carbohydrate is in a serving of a particular food. *Choosing foods with a low GL is beneficial for weight loss and overall health

  15. The Influence of Hormones When you eat, what you eat and how you exercise affects which hormones are released

  16. The Influence of Hormones Catabolic- glucagon, epinephrine, norepinephrine, cortisol Anabolic- testosterone, growth hormone, IGF-1, insulin

  17. How food intake affects hormonal response Insulin (lipogenic and anabolic): Lowers blood sugar, raises triglycerides and shuttles AAs and other nutrients into muscles Glucagon (lipolytic and catabolic): Raises blood sugar and breaks down fat and protein for energy CHO triggers insulin Protein triggers glucagon Fat is neutral

  18. Nutrient Timing Critical for: Immune function Recovery and repair Reducing body fat Increasing/maintaining energy Nutrient Timing: The Future of Sports Nutrition by John Ivy & Robert Portman Basic Health Publications (February 20, 2004)

  19. Energy Phase Carbohydrate/protein supplement 30 minutes before working out:1. Maintains immune function 2. Stops rise in cortisol 3. Sets stage for faster post-workout recovery 4. Spares muscle glycogen and protein 5. Minimizes muscle damage e.g. 20 g high glycemic CHO, 5-6 g whey protein, electrolyte/vitamin formula (C, E, Na, K, Mg)

  20. Anabolic Phase CHO/Protein within 45 minutes after exercising to optimize insulin response and repair muscle 1. Shifts metabolism from catabolic to anabolic state 2. Speeds up elimination of waste by increasing muscle blood flow 3. Replenishes glycogen stores 4. Initiates tissue repair and reduces muscle damage 5. Bolsters immune system and sets stage for muscle growth

  21. Growth Phase The 18-24 hr period after exercise during which the majority of muscle and strength gains occur. 1. Consume CHO/PRO 2 hr after exercise 2. Eat high protein diet and high protein/low glycemic CHO snacks (depending upon goals e.g. body building, weight gain/loss etc.)

  22. Ergogenic Aids Creatine—take 3 to 6 grams daily (for higher intensity events and body building) Whey protein- consume pre and post workout Physique athletes have a higher protein:carb ratio than performance athletes Caffeine— 5 mg caffeine per kg of body weight(drip=65-100 mg/cup; 2 oz espresso= about 100mg). Ingest caffeine about 3 - 4 hours before the competition. Caffeine mobilizes fat stores and encourages working muscles to use fat as a fuel. This delays the depletion of muscle glycogen and allows for a prolongation of exercise. Also lowers RPE. Glutamine— several grams post-workout during times of very intense training Vitamins—take a multivitamin (with iron for menstruating females) daily Sports drinks/Carbohydrate gels— see next slides EFA's—eat fish 2 to 3 times per week or take 2 to 4 grams of EPA and DHA daily BCAA (Leucine, Isoleucine , Valine) Quercetin- 250-500 mg 15 minutes before meals three times per day CoQ10- 300mg daily Green/black Tea- 2-8 cups daily Fresh fruit and vegetables (Phytochemicals) Water

  23. Sport Drinks • Best for- endurance athletes who exercise for more than an hour at a time • What to look for- 6-9% CHO (divide grams of CHO per serving by the milliliters of drink per serving and multiply by 100) • >9%- GI distress • <5%- not enough to fuel muscles • Home made- mix 9 tsp sugar, 1/8 tsp salt and the juice of 1 lemon. • Dose- Take 5-12 ounces every 15-20 minutes

  24. Carbohydrate Gels • Best for- endurance athletes who exercise for more than an hour at a time • What to look for- 70-100 calories and 17-25, CHO. • Dose- 1-2 gels per hour (30-60g CHO). Take with 8 oz water to enhance digestion • Good food sources- Honey sticks (1 tsp/25 calories). Take 2-3 sticks per ½ hour

  25. Structure • Identify musculoskeletal dysfunction • Treatment (e.g. trigger point acupuncture, soft tissue release, joint manipulation • Optimizing the kinetic chain through corrective exercise • Exercise- core, strength & hypertrophy, power

  26. Kinetic Chain

  27. 5 Kinetic Chain Checkpoints • Feet- Straight ahead with neutral ankle position • Knees- straight ahead in line with 2nd and 3rd toes • Hips- neutral spine and abdominal drawn in • Shoulders- in line with center of hip joint • Head- center of ear in line with center of shoulder

  28. Optimum Alignment • Alignment of the musculoskeletal system allowing posture to be balanced with center of gravity • Ability of the neuromuscular system to perform functional tasks with the least amount of energy and stress on the kinetic chain

  29. Ideal Posture • Optimum muscle length-tension relationships at which a muscles are capable of developing maximal tension

  30. Muscle Imbalance

  31. Dysfunction • Altered reciprocalinhibition- a tight muscle causes decreased neural drive to its functional antagonist • Synergistis dominance- compensation of synergistic muscles in order to maintain force production • Myofascial dysfunction (trigger points) • Arthrokinematic dysfunction- joint dysfunction affecting the surrounding muscles • Faulty movement patterns

  32. Dysfunction Leads to • Altered neuromuscular control • Tissue fatigue • Injury and impaired performance

  33. Causes of Muscle Imbalances • Postural stress • Pattern overload • Repetitive movement • Lack of core stability • Lack of neuromuscular efficiency

  34. PATTERNS OF DYSFUNCTION • When a chain reaction evolves in which some muscles shorten and others weaken, in predictable patterns of imbalance (Janda) • Upper crossed syndrome • Lower crossed syndrome

  35. Cumulative Injury Cycle

  36. STRUCTURAL CAUSES OF PAIN • Trigger Points • Muscle shortening • Altered joint mechanics • Abherant motion • Pathology

  37. MYOFASCIAL TRIGGER POINTS 1.Small circumscribed hyperirritable foci in muscles and fascia 2. Begins with a muscle strain 3. Site of sensitized nerves, increased metabolism and reduced circulation

  38. TRIGGER POINT SYMPTOMS 1. Local or referred pain 2. Pain with muscle contraction 3. Muscle stiffness and restricted joint motion 4. Muscle weakness 5. Paresthesia and numbness 6. Proprioceptive disturbance 7. Autonomic dysfunction

  39. Trigger Points Can Compromise • Flexability • Balance • Strength • Power • Speed • Agility

  40. PERPETUATING FACTORS • Mechanical Stresses • Nutritional/Dietary factors • Metabolic and Endocrine Inadequacies • Psychological factors • Chronic Infection • Other (allergy, sleep, improper breathing, dehydration, smoking, caffeine, medications, visceral disease)

  41. TREATMENT 1. Release muscle shortening and deactivate trigger points- trigger point acupuncture, soft tissue and joint manipulation 2. Corrective exercise 3. Prevention- core, strength, power exercises 4. Diet/Nutrition 5. Lifestyle modification

  42. “DRY NEEDLING”(Intramuscular Stimulation) Insertion of an Acupuncture needle according to neuroanatomical concepts

  43. THE EFFECTS OF DRY NEEDLING • Strengthen Tendons & Ligaments by inducing local inflammatory reactions (PDGF, Fibroblasts, collagen) • Stimulates stretch sensitive GTO & Muscle Spindles • Mechanical disruption • Treat Overactive Motor Points • Provides Blood & Growth Factors which can disrupt microscars • Alters Neural Control via neurotransmitters, endorphins and inhibitory mechanisms • Stimulates Reflex Mechanisms e.g. spinal, sympathetic and circulatory

  44. SOFT TISSUE RELEASE TECHNIQUE (Taws) • Specific contact is made on the muscle • Traction is applied to the tissue in order to trap the lesion • The muscle is moved either actively or passively through the line of injury • The stretch is held for 1-2 seconds • Repetitions are done in different positions and planes of motion (8-10 times)

  45. EFFECTS OF SOFT TISSUE RELEASE 1. STR stretches and softens scar tissue/adhesions 2. Pain input messages to limbic system are reprogrammed 3. Muscle length, flexability and memory are regained

  46. Adjunctive Therapy • Hydrotherapy- hot, cold and contrast • Kinesiotaping • Supplements: Bromelain, C/Bioflavonoids, Cal/Mag, DMSO, Glucosamine, MSM, Fish oil, Biofreeze • Exercise

  47. OPT Exercise Model (NASM)