Put simply- the idea behind PRP is to use higher concentrations of and athletes blood platelets to promote faster injury healing.

PRP preparations contain a concentration of 3-5 more platelets and growth factors (up to 25 times that in normal blood). The rich concentration is achieved by collecting the individual athletes blood samples and using a variety of filters and centrifugation, the production of platelet rich solution is derived. about 24-48 hours after the original extraction, the platelet rich solution is injected back in the injured site based upon a variety physician recommendations.  At this stage of treatment- it is important to note- that physician opinions vary as the the amount of injections- the type and locations of treatment, as no formalized recommendations yet exist. A costly process- injections can run the gamut- from $500- $2000 per shot.

PRP injections are also best performed under ultrasound guidance.  In order to maximize the effect of the treatment, PRP should be directly injected into the injured area, and specifically- the damaged site.  If the athlete is experiencing a tendon injury- some physicians may make several holes in an injured tendon to facilitate n increased inflammatory response, which further promotes healing. Following the injection- the athlete remains inactive for a period of 24-48 hours before phase one of rehabilitation begins.

PRP is increasing in clinical practice and trends are emerging.  Tendinopathies and acute muscle injuries form the most common use of PRP therapy, with ligamentous and other soft tissue conditions following.  It is important to know that no long term- high quality studies of PRP treatment have been performed, however- anecdotal results for muscular tissue injuries have been good.

When an athlete asks a strength coach “would PRP be a good option here?” the answer is simple:

“I don’t know… thats something you’ll need to address with both the athletic trainer and the team doctor”.

PRP- a medical treatment is no different than any other phase of medicine- and while the knowledge of the process is important for you to  understand, the position you take a a strength coach is important to your entire profession, organization, and the athlete themselves.

After all- you dont want the team nutritionist or massage therapist prescribing exercise- do you?

PRP appears to be emerging in professional sports as a treatment option.  Consult your teams medical staff and inform them of an athletes discussion surrounding PRP. Know what the effect of PRP is- if any- on your phase of the athlete rehabilitation process- at a time when load is being introduced- and exercise options surround an athletes return to play- try to understand the effect that PRP will have on initial strength- strength progression – movement facilitation and energy system manipulation.  While the “side effects” known are minimal- stay attuned to the research and share your own findings with your medical team.

WHY?

Strength Coaches (and any coach prescribing a exercise to adapt a purpose) should have an answer that makes sense , and an answers that has immediate  and direct connection to:

(a) Your individual goals,
(b)  Your sport, (not always as obvious as it seems)
(c) Your time of season, and
(d) YOU as the individual athlete.

If the answer proposed doesn’t accompany all four of these responses-question further and seek an “edit” on the exercise for these targets.

I see too many athletes and strength coaches caught up in Fads.  I cringe now when I see Lebron James – plank position – pulling a weighted rope on Nike’s latest Basketball Commercials (sans NBA).  I can almost guarantee I’ll see this exercise now in Spring Training – and likely a strength coach who will be prescribing it.

WHY?

I asked this when I saw the exercise- immediately thought of James- using isometric core strength defending space under the rim- pulling his arm back (shoulder flexion and elbow extension) against his opponent and thought- “makes sense”.  It’s a low risk exercise-high transfer to the sport- right maybe for James as an individual (I can’t accurately answer that question) and when the season will start?  Who Knows… overall-from a general perspective  I see this as a “transferable” exercise for basketball.  Highly photographic exercise for nikes purpose- who knows if James even does this (although he looked highly adept at the process)

For baseball? No.

The only transfer this may have is in those once annual bench clearing brawls that look more like a group dance with a push- pull- hold – and wasted energy.

WHY?  

Athletes: Ask this consistently- Coaches: be ready for the question  and be responsible enough to have the right answers- if not- you’re guessing- and your athlete deserves better.

WHY?- its the question that helps the industry- the coach and the athlete- evolve.

Well said Nan.. still rings true today.  All the coaches in the world can tell you its good to lift- good to workout- stay in shape- and we have great facilities at the stadium…road gyms. You name it.  If the athlete isn’t driven by the desire for success-what do you do?  I know a number of coaches and execs who’ll say “It’s the strength coaches job to make them want to do it…Some even hold the strength coach accountable.  In this situation however…it’s easy to define accountability… were each accountable for our own attitudes and behaviors.

In fact…the only two things in life we control- are our attitudes and our behaviors.

On the field- our game is measured- and measured and re-measured..by behaviors.

Every behavior is a  moment of truth in baseball.  I’ll give you an example:

In a playoff situation- game on the line- a ground-ball hit to the backhand of the shortstop and a swift runner- how confident are you that your athlete can make the out?

Many players that perform well in these situations are called “clutch” performers… they “rise to the occasion” according to the play by play announcer.

Little does the announcer know-it’s likely the opposite.

These athletes don’t “rise to the occasion”… in fact.. they dont let the occasion “rise”.  They focus on the Task- NOT the outcome.

A great example is the 2 x 4 piece of wood.  If i put it on the ground– and ask you to walk across it – from one side to the other- no problem – piece of cake- one foot in front of the other- done.

Now- lets put that 2 x 4 200 feet in the air between two buildings.  Same approach?

No.. now you are thinking about the possible outcomes (like falling to your death) and the task isn’t as easy – is it?  The task didn’t change- your perception of the value of the outcome- did.  Clutch performers-focus on tasks- and have an ability to either remove the outcome from their minds, or at least not place that thought over the concentration of the task required.

Tasks that are physical require strength- agility -neuromuscular coordination- power- energy.. I can go on and on.  Just the ground ball example above has about 20 different physiological aspects knitted together that determine the mechanical or task success.

It makes sense then, that developing these elements away from the moment of truth to ensure success would be innate… but it’s not.

Somewhere along the way- a high school coach- parent- even a professional coach “poisoned” exercise.

I still see it today …” He’s late?  Make him run laps!”

Great.  Now running is a negative.  It’s punishment.

In baseball- mandating lifts are the same way.  If the motivation is extrinsic- the compliance is short lived.  I’ve often thought- what if I said to the hitting coach..“He’s late?  Give him 5 extra rounds of BP… (you see where Im going…)

I’ve had some of the highest (shudder on the term…) “Compliance” in lifts in pro baseball in the last 6 years when measured against other levels of the organization.  I’ve been able to do this because I’ll figure out a driver- an innate desire that I can tie to the task of conditioning.  One (nameless) Major League LHP I worked with two years ago- was so anti conditioning- when the VP of Player development found out he was spending 75 minutes a day training with me- he said- “how did you do it”.

The answer… I got to know him.  I “cared enough” to know what he likes (it wasn’t baseball- baseball itself was work!).  Behind the baseball veil for this player was a deep desire to be in the music industry.  A few short stories at starbucks on how cool it would be to own your own studio.. and how much money it would take to do it right- with no experience- getting a loan will be tough- but wait!  There’s about 8 million dollars hanging off your left shoulder… if we do this right- and stay focused on YOUR goal… you’ll succeed in the moments of truth- and then… you win.  Ironically- so to does the team- the organization… and last of all, the strength coach.

Strength coach.. its a loose title.  Deep down- you’ll see that the good ones understand psychology- and care about the people around them to find the ember that burns- and if you’re good enough at your job- you’ll breath a little air onto that ember and have “burning desire”.  Get enough burning desires- you’ve got “compliance”.

Psychology leads physiology.  No doubt.  And Nan, if you can get the horse to see that same water in a different light… sometimes the thirst develops.

Strength Coaches have long looked at “periodization” models for the process of planning peak performance.  Periodization models are necessary, and should be built around peak performance times  (over the course of a baseball year) and also around the philosophy of how to “build an athlete”.

As an NASM (National Academy of Sports) practitioner and recently, a curriculum advisory board member, I prefer the “under utilized” (in baseball)  Optimal Performance Training  (OPT) model. This begins with stabilization of the athletes frame.  In this case- we need to initially off-set the imbalances that baseball creates.

Once complete- we move into strengthening the skeletal system. The focus here is on joint integrity – ensuring the ratio of strength- from front to back and each side of each joint segment, has the strength to sustain work.

The next Phase of training is the power sequence- depending on the seasonal length for the athlete- this begins late december- early January and runs all the way to spring training.

The focus now is the analysis and understanding of high speed movements in joint compressive and distraction profiles , that TRANSFER to the field of play.  No transfer- No deal. Transfer meaning: support for the baseball movement- including force production- force reduction- muscular power endurance (not an oxy-moron) and metabolic recovery.

It’s a system that has worked for me for 6 years A system and methodology that optimizes the athlete for peak performance, and during a 162 game season- reduces the opportunity for soft tissue injury.

When a better system or method is exposed- I’ll use it.  As mentioned in the prior post on Kaizen- Staying open minded- and each season looking for new ways to impart science upon the athlete is the key.

The old adage “No Pain – No Gain” may be better presented as “No Brain No Gain”.  Be smarter in your training approach- the yield?

Your athlete evolution.

Strength Coaches- what are we doing?  Sports Specificity has been a grossly overused term, massively “misinterpreted” by many in the field of Strength and Conditioning.  When reviewing many organizational programs- I see in-season lifts- cardiovascular training schedules and programming that is anti-baseball.  With most programs rooted in a football science, many organizational programs MAY contribute to poor performance of the the athlete.

When was the last time you completed an audit of your teams strength and conditioning program?  All good systems- employ a series of checks and balances.  In Japanese culture the definition of Kaizen is “improvement” and particularly, “Continuous Improvement”- slow, incremental… but constant.

Here’s a look at some of things we condition- to affect:  Throwing Velocity… Pitcher Endurance….Running Speed (not top speed- but acceleration and curvilinear speed- why we still run the 60 is beyond me)… Swing Speed (Power)…Lateral Agility…and overall- Injury Reduction.  How do we do it – how do we affect it constantly?

Throwing Velocity- Deceleration- through defined and individual specific load vectors
Pitcher Endurance- Metabolic Training for improved Oxygen utilization
Running Speed- Starting speed (30) and acceleration through 60 feet of a base path on MAX Velocity Days
Swing Power- Ground Force- Core rotational Training featuring emphasis on thoracic mobilization
Lateral Agility-  Do you even know the amount of lateral movements your players by position make day in- day out?  Whats the volume? Ensure the volume is appropriate for every cone drill!
Injury Reduction: This is where Specificity plays a key role.  How do you have a program that is supposed to reduce injury- IF you dont know the imbalances of the individual athlete?  Single Leg Squats (SLS) and Overhead Squat (OHS) assessments are important at multiple times throughout the course of a season.. not just pre and post season.  in a one-sided sport- imbalances will be building by overall volume and it’s important to stay in touch with these.

The next question is WHEN do we do it? Periodization is critical to success- in an annual- seasonal- weekly- home stand – road trip and single day adjustments.  Each year- good coaches need to evaluate their athletes- and their programs.  Their should be learning continuously- adaption and change- and re-evaluation. Scientific - Measurable- yet Open Ended for constant improvement.  It’s the Kaizen of strength and conditioning.

Three quick assessments first introduced at the IMG academy for tennis players include an interlocking hands behind the head test (arm), a 180 degree jump test, (leg) and the extended arm with hands forming a circle and visually focusing on a distant object, closing eyes independently to assess object movement and eye dominance.

There are many assessment s in the area of leg dominance as indicated by Spry, C. Zebas and Visser in their 1990 Study “WHAT IS LEG DOMINANCE?” (University of Kansas Lawrence, Kansas, USA), and likely as many arm and eye assessments.  FOllowing accurate diagnostics for your athlete and your situation (ten assessments or a simple three) the Strength Conditioning and Performance Coach acquires knowledge that can be shared with skills coaches.

Astros Hitting Coordinator Ty Van Burkleo is a literal “repository” of hitting information. Following assessment of dominant limbs in instructional league prospects, it started to become evident that such dominance was having an effect on advancing a critical skill specific to hitting, Hip Rotation.  The next step- to create training drills specifically to reduce the impeding dominance of leg, hand or eye, and watch the results.

Immediately – players “see the ball better”, “feel more balanced”, felt as if they had more “Power” when returning to hitting after the introduction of neural pattern distortion drills.  While subjective in analysis- this provides valuable ground for discussion and further analysis for skill based sports such as baseball.

Once the swing begins, the musculoskeletal system kicks in and this is where we see success and often, failure.
Power production is simple Physics in hitting.
Most good hitting coaches teach players to hit down through the front leg- providing an axis for the body to rotate against. Hips rotate- shoulders and hands follow to provide an “elastic” contraction that produces bat speed.  The faster the bat- the harder the ball is hit- the harder the ball is hit- the greater the opportunity for success, and the greater measurable value a player has in the game today.
From the Strength and Conditioning Performance support- it’s important to understand the physics of the swing- and we can see the muscular dynamics needed to optimize player performance.

The front leg must be stable…but how?  Flexion of the hip girdle and maintenance of the rotational position is a function of glute (medius) and piriformis strength.  Rotation is a function of the ability to sequence the muscular action through the core, and may account for up to 80% of the bat velocity created.

Stabilization drills and sequencing drills are extremely valuable to hitters, and these “transfer” to game success more closely than anything else.

Scientific Method is a step-by-step approach consisting of (1) identifying and defining a problem, (2) accumulating relevant data, (3) formulating a tentative hypothesis, (4) conducting experiments to test the hypothesis, (5) interpreting the results objectively, and – in the case of problem solving (6) repeating the steps until an acceptable solution is found.

In fitness- exercises are often developed without attention to the result. Gym Science- as it is oft referred was developed with a focus on a muscles origin – insertion- and contracting of that muscle in isolation to produce a hypertrophic result. There is little regard for overall movement considerations, and this knowledge is what separates strength and conditioning coaches from trainers, yet not all strength and conditioning coaches employ scientific method in exercise evaluation.

The simple performance of a core exercise does not in fact mean it will add value to the core of an athlete.

As we focus on baseball, we need to understand the desired skill performance physical demands and work backwards to determine the (a) implement load- (b) it’s vector and (c) the correct muscular recruitment sequence that yields the optimal motion within the constructs of the athlete and the environment of the sport.

Is it time to apply scientific method to evaluate exercise? It’s time we offered greater respect to our athletes when prescribing exercises to affect their outcome. Correct application will evoke an evolution of the athlete and the evolution of a sport.

“Well- push ups are great exercises for baseball players!”  This (Insert name here) is the best exercise for a baseball player!”

Really?  Whats the science there?  And when you say “great” or “best” when, for whom, and with what goal in mind?

It’s time we get back to the science of exercise science….