You get pseudo-order when you seek order; you only get a measure of order and control when you embrace randomness”. Nasim Taleb
A group of essays concerning the epidemic of injuries in American sport; especially of the lower extremity; have established a cause and effect connection between susceptibility to injury and the incongruous amalgamation of strength and conditioning coaches, academics, athletic trainers, physical therapists, doctors, exercise charlatans, made for sale training methods, systems, and so forth.
To make such a claim; to lay blame at the doorstep so many educated people; for the damage they are directly and indirectly responsible; it is necessary to make a case as to how the misguided beliefs and practices of all these professionals are linked.
A number of commonly accepted beliefs emanate from ‘facts’ found in academic publications; and/or textbooks and likewise certifications of such knowledge sold by professional organizations. These organizations certify expertise through the sale of knowledge; while at the same time providing the certified coaches and trainers who take their courses convenient access to exercise equipment vendors who pay fees to attend their national conferences, i.e., a contradictory conflict of interest.That is to say, these organizations promote the sale their certification knowledge along with equipment developed and sold by vendors with little or no experience in the field.
At the risk of being overly simplistic; in most respects, many of the frequently occurring lower extremity injuries such as Achilles rupture, plantar fascia tear, high ankle sprain, inversion sprain, ACL tear and related knee injuries, foot injuries: Jones, Lisfranc, pedal foot fracture, tibial plateau fracture; have many precipitating circumstances in common, i.e., a consilience of induction links the circumstances which confirms the theory as to the root cause and reasons for the epidemic of injuries.
Biomechanical Factors of Injury Susceptibility
/ excessive dynamic resistance to bending, running, cutting about the athletic field;
The first place to look for dynamic resistance in lower extremities is the all too common practice of treating the shins as if they were tree stumps: rigid, vertical links tightly bound at the ankle joints (base) by tight ligaments and tendons; and, in many sports bound with tape and/or bracing and/or shoes taped to ankles to further stiffen the base. When an athlete endeavors to flex lower extremities in running, leaning to one side in cutting, change of direction or even flexing to fall; shins like tree stumps are not very cooperative when it comes to bending knees, hips and ankles.
Chronic application of exercises performed within arbitrarily determined restricted ranges of movement, taping, bracing of ankle joints and so forth reinforce the metaphor shins are treated like tree stumps. For instance, susceptibility to ankle injuries in the USA can be linked to the perception in academic, coaching, therapeutic circles shins should be tree stumps – rigid; in isolation from the rest of the body; should remain close to vertical, nearly immobile, restricted to minimal if any tilting in sport activities (See figure 1).
Figure 1. The practice of teaching athletes to stiffen ankle joints by bending in squatting and other exercises with vertical shins and/or keeping knees from traveling forward in front of toes, i.e., artificial override of a million years of evolution; emanates from the perception ankles function as tree stumps. This circumstance is without question one of the root causes of the lower extremity injury epidemic in American dynamic sports.
/ the affect of exercise protocols on muscles’ composition of intra – muscular connective tissue;
“The force recorded in slow movements is essentially indistinguishable from that recorded under isometric conditions”, Zaporozhanov, V.A., 1988
A negative outcome of the chronic application of static exercises: isometrics; deliberate slow tempo performance of strength exercise; induced slow movement from heavy resistance exercises or multiple repetitions to fatigue, or, to point of failure; is the possibility of developing significant – intra – muscular connective tissue in the affected muscles. Laying down of an excess of intra – muscular connective tissue reduces the elasticity of the muscle (Gudz, 1975); which in its turn, would tend to increase resistance to passive stretching of the affected muscles.
Such a superfluous ‘internal resistance’ to passive stretching of an athlete’s muscles resulting from chronic static strength training is a morphological factor. The possibility the laying down of this extra connective tissue elevates susceptibility to injury in dynamic sports; is a relatively unknown in the western literature. Little or no consideration is accorded this possibility when coaches, trainers and therapist apply the aforementioned static training techniques. The fact that this an “unknown unknown” factor and/or it is just simply ignored within the fitness for sale community. Were it otherwise, training techniques such as high intensity training (H.I.T.); one set to failure or resistance applied to resistance exercises would have long since fallen out of favor (see figure 2).
Figure 2: Coach adds to the resistance of the machine exercise forcing a set to failure. Adding resistance to already resistance exercise machine is a misguided effort at increasing effectiveness by slowing the movement to a virtual isometric or to an equivalent slow grind.
A perfect example of a negative muscle morphology; a consequence of chronic application of static exercises; is the well known inability of athletes from static sports (powerlifting/bodybuilding) to switch successfully to dynamic sports such as Olympic weightlifting; where the ability to rapidly switch direction and display suppleness in multiple joints instantaneously are requisite skills. A negative outcome for other dynamic sports can be traced to exercise protocols such as the one depicted in figure; when the athletes trained in this manner suffer serious lower extremity injury running, cutting and other dynamic maneuvers about the court or field.
Many injuries occur in the pre – season in sports such as football and basketball when the athletes return to the practice field after months in the weight room practicing static exercises; exercises to fatigue and so forth. It is hard to deny the culprit is the prolonged exposure to ‘safe unsafe’ environs of the gym in the lead up to the practice field. Research confirms practical experiences in dynamic sports of a negative muscle morphology from chronic application of isometric conditions:
“….prolonged application of static loading, causing a large reaction of intra – muscular connective tissue is unjustified for those types of sports associated with quick dynamic muscular work.” Gudz, P.Z., 1975
/ exercise techniques based on misrepresentations outside of logic ( MOL)
A flaw in logic, completely lacking common sense; is the rather widespread practice of teaching athletes to perform exercises with specific patterns of muscle involvement; especially contracting or tightening certain muscles or groups to support spine or prevent injury. A prime example of a misrepresentation outside of logic (MOL); is the mantra emanating from the so – called ‘core training devotees’; that one should strive to maintain a ‘tight core’.
It is not possible to perform exercises, especially complex coordination exercises while maintaining a ‘tight core’. There are over 600 muscles in human body, focus of attention on one muscle, or group in the presence of performing dynamic sport exercises; is neither practical nor possible (Latash, Zatsiorsky, 2016):
“The central nervous system definitely does not program in detail displacement of effectors, joint rotations, muscle forces, joint torques and muscle activation patterns. This is clearly impossible given the dependence of all these variables on the current external conditions, which are never 100% predictable.” M.L. Latash, V.M., Zatsiorsky, Biomechanics of Motor Control, 2016
Furthermore, ‘core training’ is a pass around commodity; made – up pseudo – science for sale. A misrepresentation outside of logic (MOL) is the centerpiece of the ‘core training’ narrative; the idea one should ‘tighten’ core muscles to perform strength exercises. This is coupled with the false claim the ‘tight core’ will help injury proof the athlete; especially the spine. A simple, yet poignant reason the ‘tight core’ idea is nonsense; is the likewise groundless assumption consciously activating specific abdominal muscles to perform straining can in any way replace nature’s many millennia evolved ‘reactiveness’ of the human body:
“What is proposed here is to impose an abnormal, non-functional pattern of control to overcome a functional organization of the neuro-muscular system to injury: a protective control strategy that is as old as human evolution.” Lederman, 2007
Another ‘core’ (MOL) is the idea that weak abdominal muscles translate into back problems; strengthening of core muscles will supposedly prevent back injury if the strength of the muscles are balanced. Although, no tangible evidence is forthcoming for a ‘balance of strength’, whatever that might be, between abdominal/core muscles and back muscles; there are plenty of examples in sport where back strength rises disproportionately to abdominal; with no ill effects.
For instance, elite weightlifters can have the following strength ratios between abdominal and back muscles: trunk (ilio – femoral and lumbar joints) 4.3:1 with no injury susceptibility traced to ratio of strength. The same strength ratio idea is true for quadriceps to hamstring ratio of elite weightlifters; a ratio of thigh muscles (knee joint) 4.3:1 is normal and likewise not considered a detriment.
The prevailing idea that arbitrarily determined strength ratios between antagonistic muscle groups is a potential injury prophylactic is categorically proven false by the large injury rate in American sport where these ideas have been floating around for decades. Furthermore, various training methods which profess to achieve a balance of muscle strength have been in place to mitigate susceptibility to injury; likewise for decades; in absence of concrete proof of their effectiveness:
“Core stability exercises are no more effective than, and will not prevent injury more than, any other forms of exercise. Core stability exercises are no better than other forms of exercise in reducing chronic lower back pain. Any therapeutic influence is related to the exercise effects rather than CS issues.” Lederman, E., 2007
On the contrary, because of, or in spite of these mitigations, the rate of injury continues to rise (see Charniga, 2022, “Why? So many flies keep dropping in the NFL’s barbecue”, www.sportivnypress.com)
/ negative affects of limiting range of motion in strength exercises on dynamic resistance;
Figure 3. On left, simple strength exercise performed with artificially restricted range of motion in knee, hip and especially ankle joints; falsely assumed to be safer for athletes in dynamic sports. On right, example of selection criteria for beginning weightlifting training in Bulgaria with a simple test of multi – joint mobility in youthful athlete.
Proof positive there is a direct link between the proliferation of ‘safe’ exercise techniques and the injury epidemic in American sport (see Charniga, www.sportivnypress.com) is the fact arbitrary restricted/controlled range of movement exercises predominate. Yet actual sport science; based on considerable practical experience, with mountains of empirical evidence has produced the following protocol for injury prophylactic exercise technique:
“It is important to perform resistance exercises through the whole range of a joint’s movement. The joints should fully flex and completely straighten.” A. I. Falameyev, 1986
The athletes depicted in figure 3 performing half – bends with dumbbells illustrate an exercise protocol for a senescential preparation of football players. The athletes are learning to perform simple, low coordination tasks, requiring minimal coordination/equilibrium skills; with weighted resistance: ‘tree stump training’. A positive transfer to dynamic sport activities is a highly unlikely outcome. On the other hand a selection criterion of youthful athletes for weightlifting training depicted on the right in figure 3, is part of selection process for weightlifting training. The idea of such a test is to find those with the ability for simultaneous display of flexibility in multiple joints, muscles, tendons, ligaments; a prerequisite for the skills, especially equilibrium; inherent to the dynamics of weightlifting sport.
The qualities connected with a rapid, multi – joint, complex flexibility; form a skill-set highly transferable to dynamic sport; whereas the transfer potential of ‘tree stump training’ to dynamic sport, is sorely lacking. Hence, a lack of these qualities is connected with susceptibility to injury:
“This so – called “flexibility reserve” (it is more precise to say the “extensibility reserve”) allows one to reduce the stretching resistance of the muscles within a given amplitude of movement to the minimum; consequently, the exercise is executed without superfluous tension, i.e., more economically. Furthermore, an extensibility reserve is a safeguard against injury.” R. Moroz, 1980
The concept of an athlete’s “flexibility reserve” (Moroz, 1980) means a positive outcome can be anticipated for the development and maintenance of this ‘extra’ suppleness; serving as an injury prophylactic; by reducing the “stretching resistance of the muscles”. Whereas, the senectitude training, as depicted in the figure; will tend to raise the stretching resistance of the muscles; while at the same time enhancing injury susceptibility.
/ safe movement patterns deemed unsafe;
Most exercise techniques prescribed for injury prophylactic such as movement of knees in line with feet in squatting, performing squats to about parallel by sitting back so shins do not tilt, are arbitrary; instead of preparing an athlete for the unexpected; raise the risk the unexpected, will result in injury.
Athletes moving about the field or court in dynamic sports are constantly encountering unexpected perturbations; uncharacteristic of artificially restricted, simple, pre – programmed, weight room, athletic training and physical therapy room exercises. It is during these encounters on the athletic field or court where the co – activation reactions, especially to the unanticipated, where one can expect increased stiffness of the muscles and joints involved. Consequently, cutting, rapid change of direction, which do not involve simple pre – programmed motions can become unsafe from learning the ‘safe’ joint, tendon and muscle stiffening exercises and techniques.
Figure 4. Super elite female weightlifter exhibits of movement of lower extremities straining to stand from a clean. Academic tunnel vision suggests shifting of the knee joints outside a linear alignment with the foot is a defect; a sigh of weakness. However, the large muscle mass of the woman’s calves demonstrates other muscles are involved in straightening lower extremities from squat. Furthermore, the fact this movement is reactive; it is in all probability; an individualized mechanical efficiency. Charniga photos.
/ affect of exercises restricting normal activation patterns of multiple muscle groups on dynamic activities;
A good example of a worthless and potentially hazardous exercise machine to be found in most any athletic training, rehabilitation, weight room and so forth, is the seated leg extension. It is used extensively for testing as well as training the quadriceps and hamstring group of muscles. This particular exercise machine is notoriously unsuitable for either testing or training athletes for the athletic field or court.
No one uses their the thigh muscles in this manner in dynamic sports. The effect of strength training is angle specific. In the example shown in the figure; strengthening or measuring quadriceps strength with this machine exercise is carried out with immobile ankle, i.e., with the foot in a fixed position. This means synergist muscles which can participate in knee extension such as shank muscles are excluded; which does not happen in running, jumping and so forth.
Figure 5. Example of a potentially hazardous; nonetheless extensively utilized clinical/training testing machine to evaluate strength as well as an exercise protocol to strengthen leg muscles; with super elite collegiate basketball player. Since leaving college for the NBA the then 18 year old athlete (pictured):
“….has tried to keep a low profile on social media while rehabbing a fractured right foot that has kept him out the entire 2021-22 season.
“In three seasons, Williamson has played just 85 career games, including 24 as a rookie when he missed the first 13 weeks of the season because of a torn meniscus in his right knee. Williamson’s original timeline for that injury was 6-8 weeks.” https://www.espn.com/nba/story/_/id/33574775/new-orleans-pelicans-zion-williamson-posts-dunk-video-amid-ongoing-rehab-foot
Testing/training while seated with testing and exercise machines of this type has no applicability to natural conditions in sport. The actual strength and power potential of the muscles which straighten lower extremities; as measured by this machine are inaccurate; because many participating muscles are excluded by the limitations of the machine. Furthermore, the transfer of strength from training muscles in one position in this instance, seated; will not transfer fully postures such as standing; even if the synergist muscles the machine does not measure were somehow activated.
Figure 6. Extension of lower extremities in dynamic sports is totally different from testing and the exercise conditions of machines. Contrast knee and hip extension with raised heels to the simplistic muscle isolation exercise protocols of figure 5. Athletes in dynamic sports are typically standing with raised heels; which is connected with heavy use of foot and shank musculature, tendons and ligaments. Charniga photo
Training quadriceps muscles seated; in isolation of foot and shank muscles which are active in the vertical postures of running, jumping and so forth; can be a potential root cause of the lower extremity injury epidemic (see figure 5). Athletes are strengthening while training/learning to use muscles in isolation, outside a normal complex coordination structure typical of dynamic sports. In effect, the trainee can be learning to fight his/her own muscles instead of coordinating the relative participation of all the muscles of the leg spring.
/ M.L. Latash, M.L., Zatsiorsky, V. M., Biomechanics of Motor Control, 2016
/ Lederman, E., “The Myth of Core stability”, CPDO Online Journal (2007), June, p1-17. www.cpdo.net
/ Charniga, A., “Hamstring injury in sport”, www.sportivnypress.com
/ Charniga, A., “Why Safe is Unsafe”, www.sportivnypress.com
/ Charniga, A., “Nine straps”, www.sportivnypress.com
/ Charniga, A., “Muscles of the Shank, Movement of the Shin & Susceptibility to Lower Extremity Injury”, www.sportivnypress.com
/ Charniga, A., “Shouldn’t Female Weightlifters b Injury Prone?”, www.sportivnypress.com
/ Charniga, A., “A Stability Instability Convexity”, www.sportivnypress.com
/Gudz, P.Z., “Morphological alterations of muscular connective tissue as a result of static and dynamic training”, Papers from the First All – Soviet Conference on Sport Morphology Moscow, The All- Soviet Scientific Research Institute of Physical Culture, 31-33:1975. Translated by Andrew Charniga
/ Latash, M.L., Zatsiorsky, V. M., Biomechanics of Motor Control, 2016
/ Lederman, E., “The Myth of Core stability”, CPDO Online Journal (2007), June, p1-17. www.cpdo.net
/ Gree, T. “Pausing at the precipice”, https://Scholars-stage.org