The following is part of a transcript of the Dr. Jay Show from 1560 The Game in Houston, TX. Participating in the discussion are Dr. J. Michael Bennett, a Board Certified Orthopedic Surgeon and Sports Medicine Doctor with offices in Houston, near the Houston Galleria, and Sugar Land, near First Colony Mall; Danny Arnold, Director of Plex Sports Medicine, Physical Training and Therapy; and Bob Lewis of 1650 The Game. If you have an orthopedic or sports medicine issue, please call our office at 281-633-8600 to schedule an appointment. Click this link to go to the previous section of the transcript, which discusses potential problems with physical therapy and this link to move to the first section of this Dr. Jay Show transcript.
Here’s the transcript:
DR. BENNETT — So we’re moving on. I mentioned before sports specific training and performance and this is the big buzzword out there. Everybody’s a “sports facility,” everybody’s “sports specific,” everybody’s “sports training.” The only reason for this is because we’ve got active populations and the hospitals have realized that, the physicians have realized that, the therapists have realized that, so there’s so much buzz around that topic. So it’s even more important that you do your due diligence and go out there and research that facility, your physician and your therapist, look into their backgrounds, and don’t believe the hype. You’ve got to ask some questions, talk to your friends and family and determine what do they know about this person and what kind of results have they gotten? We have Danny on here from Plex and we’ve talked about Plex and sports performance.
What I like about Plex personally is they put an emphasis on something a lot of places don’t do. Once I finish with a patient in regards to their therapy protocol, which takes them anywhere from four to six months to go through, around five months or so depending on the type of injury – maybe an ACL or a rotator cuff, or depending upon that particular person and what their sport is – there’s a gap I don’t like, just throwing my patients out into the wild, telling them, “Hey, man, you’re good. Go and play your sport.”
A lot of times these muscles may look great and the patient may have a great range of motion, but those fast twitch muscles, the neuromuscular portion of their rehabilitation training, is still not fully adapted back to their pre-injury level. You teach your muscles to fire in appropriate positions when you land or when you jump or when you’re playing basketball and you learn how to land appropriately. When you injure yourself you’re starting from square one. You tear your ACL, your muscles go, you get surgery, you’re immobilized and your muscles are completely weak – those muscles have forgotten how to fire appropriately.
So you start with your motion, you start with your muscle firing, you get your strength back relatively, but you’re still not firing those muscles appropriately to go out there and play basketball again. That’s why sports specific training is key when it comes to rehabilitation and a return to sports, especially a return to sports at pre-injury levels. Even with throwers and pitchers, same thing.
Danny does a very good job with that over at Plex, they do a sports specific training where they put a lot of emphasis on the neuromuscular training, on what’s called plyometrics – I think this is a key portion of rehab – and Danny I want you to give us some information about what exactly you do over there at Plex and what your philosophy is.
DANNY ARNOLD – It goes hand in hand with the therapy or the rehabilitation or the training aspect that you have to consider the person’s lifestyle and that means that you customize things according to that individual. It’s very hard to customize things if you’re doing it in a group setting. At Plex we try to customize it so everything is totally different. When it comes down to the sports training, it’s the same thing too. Sometimes sports training is done in group settings and you’re going to get some advantages with that, but not as much as you could from a customized, individualized sports specific training. And that means you consider the person’s history, you consider the person’s weaknesses, basically measurements of such things like a long stride versus a small stride, which indicates you have to train them differently. When it comes down to their past experience with training, they might not be at an advanced stage where you can allow them to do certain types of training so customization has to become a priority when it comes to training. That’s a huge thing when it comes down to choosing a facility, asking how are you going to customize this and what experience or expertise do you have in order to be able to include something that’s just specifically for me.
So the point is to do something beneficial for that individual, not just for a whole group in general. Now, one thing you mentioned is plyometrics, which to a lot of people means bounding and jumping, basically rapid movement especially with change of direction. That is very important because this is not a myth, this is not an opinion, you have two types of muscle fibers: you have fast twitch muscle fibers and you have slow twitch muscle fibers. When we’re doing the traditional resistance training, meaning like the machines or the things that most people do in gyms, that usually works out the slow twitch muscle fibers. We have to also work out the fast twitch muscles to also prevent injuries and to also aid with stabilization and so because of that we need to do some exercises like the plyometrics, which plays a big role in injury prevention. But when it comes to activities that are fast and explosive, there is also a higher risk of developing an injury so you have to choose the right individuals and the right facilities to do that type of activity.
Plyometrics is a key to doing sports specific training because obviously every sport nowadays is explosive, is fast, and to think that you can come and train one particular way, in a slow fashion, and then on the field or the court you are going to be able to switch gears, is ludicrous. It’s like assuming all you do all week is study English and then on Saturday you’re going to take a mathematical test and you’re going to do really well.
BENNETT – Yeah, Danny, I agree and I wanted to pipe in that when you’re talking about the explosive movements that there are actually a number of studies out there, particularly in the American Journal of Sports Medicine, that actually show that plyometrics, neuromuscular training, makes a big difference particularly in female basketball players because that’s where we see the highest incidence of ACL injuries because of, number one, their hyperlaxity, their loose joints, and number two, because of the landing strategies that they employ. A lot of these basketball players are landing with their legs stiff and then they actually contort and twist them a little bit easier and if they aren’t firing muscles quickly to stabilize their knee or bend their knee, that can make a difference in regards to recovery and injury prevention.
BOB LEWIS – Are plyometrics actually a preventive strategy and a rehab strategy?
BENNETT – This is actually where group therapy can come into play. You have sports specific training, like we mentioned, and I see that as primarily after surgery to get you back to the pre-game level. There’s also sports performance, and I see that more as an injury prevention type of thing where we need to get those muscles firing appropriately and basically correct your wrongs if you’ve got bad habits and you’re say not landing correctly. So plyometrics employs a lot of the sports specific training theories but it also applies it to a patient that’s not injured.
If you have questions about the information discussed here, please call our office at 281-633-8600. We have two offices serving patients in the metro Houston area — one in Richmond, TX, and the other in Sugar Land, TX.
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