Friday, November 4, 2011

Scare Tactics

Squat lifts likely cause of stress fractures in young athletes, study finds

This is unfortunate garbage in so many ways. Lets break this down a bit (words from the article are in italics, my words below)...

The squat lift, an exercise that has long been a standard training technique for athletes, puts inordinate stress on the spine and likely is the cause of chronic stress fractures in young athletes.

That’s the conclusion of a study presented Wednesday at the North American Spine Society annual meeting.

Puts stress on the spine? Sure so do a lot of things, sedents. "Likely" the cause?

Even when young athletes have textbook form in doing squats, they are risking a hard-to-heal stress fracture of the posterior lumbar spine structure known as the pars interarticularis.

Textbook form? Who's judging? Fear mongering.

“These are high-risk lifts whether you’re a child or an adult,” said lead author John McClellan, a pediatric and adult spine surgeon at the Nebraska Spine Center in Omaha. “For years, coaches have blamed spinal fractures on kids’ poor weightlifting techniques, so we wanted to put that theory to the test.”

Absolutely they are high-risk lifts. How do you push the envelope without pushing the envelope. That's why I have the position I have as a strength and conditioning coach, to help push the envelope and make sure things are done right. The study did not test that theory, sorry.

To do that, McClellan and his co-researchers enlisted 20 male athletes in their 20s, taking X-rays of them in various positions, including normal standing as well as doing front and back squats. They used a bar and weights totaling 95 pounds.

95 pounds... that's a nice warm-up weight.

The exercises were done under the guidance of a physical therapist.

Uhhh.... that's a problem.

The most alarming finding was a change in the slope of the sacrum during a back squat, when the bar was across the upper back.

OMG! That is NOT alarming. That's what happens in a back squat.

The average sacral slope increased from 41 degrees in normal standing to 68 degrees while doing back squat and 58 degrees while doing a front squat, when the bar was across the clavicles.

The researchers concluded that squats significantly increase the slope of sacrum and the alignment of the spine, resulting in a “horizontalization” of the sacrum.

“I agree with him,” said Raj Rao, an orthopedic surgeon who practices at Froedtert Hospital in Wauwatosa. “It fits and is consistent with the established literature.”

Thank you for that information!

Rao, a professor of orthopedic surgery and neurosurgery at the Medical College of Wisconsin, would not go so far as to say squats should not be done at all, but athletes, especially younger ones, need to be cautious, he said.

Ok, we are getting a little more logical now. That's why my 2 and 5 year old use a plastic toy broom. (No! They don't do this daily, just once in a while for shits and giggles, geez! Their workouts mostly consist of playing outside.)

Doctors said doing a similar type of exercise without weight is much less likely to cause pars stress fractures.

Of course it does... thanks for more logic. But less weight also does less for making physiological change... hey, it's physio-LOGICAL!

Rao said some people may be more predisposed to problems with the pars. Once a stress fracture occurs, he said, it can be very hard to heal.

However, changing attitudes of coaches and trainers is difficult, said Michael Reed, a physical therapist who specializes in the spine.

Contrary to popular belief, my goal is NOT to injure anybody. Change my attitude to what? Using less effective means? Well people, then stop buying tickets for the games, and ranting and raving over great sport performances or the lack thereof. Let's just give a trophy to everyone.

Has it ever occurred to anyone that progressively overloading the training to high levels IS injury prevention? It doesn't happen by progressive underload. Come to grips with reality, sport is high velocity, high force. No exposure = no preparedness.

Part of the problem is the exercise is effective at strengthening muscles.

Damn right. And it's not a problem.

“The problem is, it can be very risky,” said Reed, who practices at the Hospital for Special Surgery Spine and Sport in Jupiter, Fla. “Even the best form will not protect you.”

More fear mongering. Tell me something that isn't risky that has high reward? C'mon tell me?!

Reed said he doubts many parents know how risky squats are. He said they probably rely on coaches and trainers who don’t fully understand the risks.

... and also therapists and chiros who just don't understand. (Hey Jazzy Jeff and The Fresh Prince, can you remix that one for me?)

Reed said squats also pose risk for older adults, but the biggest concern is in people who are skeletally immature.

Older adults? Who cares?! (just kidding)

Indeed, squats are a part of training for many high school sports, added McClellan. Many kids start doing the exercises by age 13.

In a well controlled and coached environment with the usual progression, good for them!

He said he has seen more than 500 kids with pars fractures and often they remember hurting themselves doing squats.

Spewing numbers... so this is science huh? The kids SELF-REPORTING that they OFTEN remember hurting themselves doing squats??? So how does this relate to the first statement: “For years, coaches have blamed spinal fractures on kids’ poor weightlifting techniques, so we wanted to put that theory to the test.”? So 500+ kids were with great coaches, using great technique?

Invariably, coaches will blame the injury on bad form, he said. Now there is evidence that even good form puts the spine at risk, he said.

Darn, now what am I going to blame their squatting injuries on? Because everyone is getting hurt squatting right? Uh... wait a minute... what squatting injuries???

Once a pars fracture occurs, the chance of it healing is as low as 2%, he added.

Many of those people eventually will develop degenerative disc problems and a lifetime of low back pain, he said.

I get it... but enough with the scare tactics.
I can't believe I wasted my time on a stupid journalistic report of the pseudoscientific claims of this vendetta study. But... there comes a time when myself or my fellow coaches have to stop putting up with this BS, and outlandish claimss are being made against the things we are doing to help the athletes (I've discussed this issue at length in previous blog posts). And if research is needed, we (coaches) can come up with the necessary paper. The problem is that there's this particular type of "study" to deal with and gets too much media attention... which is why we need more logic.

All this no doubt adds to the resurfacing of the whole bilateral vs. unilateral lower body training debate. There really shouldn't be much debate as both have their positives and negatives and touch on different aspects of physical development. The problem occurs when an absolute stance is taken on one over the other. Instead of stating 'this is what has worked well for us in this particular situation', we have attempts at meme proliferation specifically for monetary purposes (or just one-sided, illogical arguments).

Debates and arguments are excellent for this particular profession where the holy grail has not been found (and never will be), and Carl Valle has been probing the waters for real treasure. I can't say enough good things about the questions he raises and points he makes and, emotions aside, the challenges he presents are important for consumer reporting.

I highly suggest reading Carl's recent blog posts.

Stone Cold and Boyleling Over

Secret Hip Flexor Strengthening Exercise!

Bilateral Exercise- Rise from the Grave

Dangers of the RFESS- Breaking down the Back Breaker!

One argument that comes up with the single-leg lifts vs. double leg is that so and so has had less training injury when removing the squat for another exercise. In my limited experience and that of many other good coaches, I/we have not had any problems with the squat (maybe my kids aren't reporting it, haha!). Maybe better coaching is occurring because a better understanding of movement. If I lost my passion for teaching a good squat, then sure... maybe we'd have more squatting injuries. I have seen injuries (back and other) with single-leg lifts, but if they are coached well, they are good options in a program along with squats. Keep the doors open... Squatting isn't the only thing, or the end all be all in the methods I use, it's just that few are out to bastardize sprinting, jumping, or light weights.
Let's be rational and argue. Argument is good. Bring a little emotion too (we really can't separate the right and the left brain, sorry); it fuels creativity and enthusiasm. Forget about the money and let's do it for the evolution of training science and theory. We don't have to all agree, and there doesn't have to be, nor will there always be a right answer. It will better us all.
Sorry if I offended anyone. If I am wrong or you disagree, please call me out.