FUNCTIONAL TRAINING AND REHAB Wayne Strube PT, DPT

DISCLAIMER

The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, Department of Defense or the U.S. Government.

WHAT IS FUNCTIONAL TRAINING?

A classification of exercise which involves training the body for activities performed in daily life.

There’s a big gap

END: Endurance STR: Strength PWR: Power SPD: Speed AGI: Agility FLX: Flexibility NER: Nerve DUR: Durability HAN: Hand-Eye Coordination ANA: Analytic Aptitude

GENERAL COMPONENTS

Strength

Endurance Mobility

Strength

Endurance Mobility

Strength - the ability to overcome resistance Endurance - the ability to sustain activity Mobility - the quality of movement Current Method Functional

WHAT IS FUNCTIONAL PERFORMANCE TRAINING

Targets components of the specific athlete Targets the neuromuscular system

Trains movements (muscle groups and the nervous system), not just muscles

Includes challenges to improve multiple components of fitness: dynamic and static balance, coordination, strength, endurance, proprioception, agility, speed, power, etc.

KINETIC CHAIN/LINKING

Kinetic Linking For optimal movement the body must act as a

kinetic chain where energy and force are transferred successfully and safely from one body part/joint to another.

You don’t want weak links anywhere in the chain.

CORE STRENGTHENING “PILLAR”

Foundational Movements Stable Base Center Axis

Shoulders Trunk Hips

CORE/PILLAR

Every warm up begins with core Exercises used to initiate/activate the stabilizing muscles

of the shoulders, trunk, and hips

Keep a stable base from which to move Creates more efficient movement patterns

PERFORMANCE PYRAMID

Functional Movement Represents the foundation: mobility and stability

The ability to move through foundational patterns Squat, Lunge, SLS, etc

Functional Performance Represents gross performance and efficiency of

movement Strength, speed, power, quickness, endurance, etc

Functional Skill Represents specific skill, ability to perform a given

activity or complete a task Running while catching, hitting, shooting, advanced skills

Cook, 2010

FUNCTIONAL MOVEMENT SCREEN

• Deep Squat, Hurdle Step, Rotary Stability, Stability Push-up, Active Straight Leg Raise, In-Line Lunge, and shoulder Mobility

• Each movement is scored 0-3 according to specific criteria

• Composite score of <14 predicts injury

(Kiesel et al, 2007; Kiesel, Butler, and Pilsky, 2009; Kiesel, Pilsy, and Butler, In Press; Chorba, Chorba, Bouillon, Overmyer, and Landis, 2010; Minick et al, 2010)

Y-BALANCE TEST

Predictor of Injury Assesses balance, coordination and stability

Composite reach distance <94% of the limb length were 6.5x more likely to have a lower extremity injury

Anterior reach distance difference >4cm = 2.5x more likely to sustain a lower extremity injury

(Kiesel et al, 2007; Kiesel, Butler, and Pilsky, 2009; Kiesel, Pilsy, and Butler, In Press; Chorba, Chorba, Bouillon, Overmyer, and Landis, 2010; Minick et al, 2010)

MAIN POINTS

The Performance Pyramid is built the foundation foundation of mobility and stability

You are only as strong as your weakest link Assessing and correcting impairments is the key to

injury prevention and enhancing performance Recover and regeneration are vital to helping you

achieve your goals Majority of injuries lend themselves to rapid

rehabilitation and reconditioning

TRAINING INJURED SOLDIERS

With out proper form integrated into the patients neuromuscular development there will be a lack of safe function

“Compensations” When a stabilizing muscle is inactive or weak therefore

the stress is shifted to another part of the body Mid foot strike running

Core strength Hip Strength Proper knee, hip and ankle alignment

WEEKLY TRAINING FOR RETURNING TO DUTY

Linear Day Lateral Day Acceleration Day Strike/Interval Day Functional Day

LINEAR DAY

Block 1 Fwd Band Walks Hurdle Plank Split Lunge Lunge Fwd Lunge Rev Hip Mob over/under Hip Swings 2-way

Block 2 Ladder Fwd Ladder Diagonal Towel Runs Short/Long Hill Runs Up/Down

Block 3

Pose Belt Run Overhead Run Sand Bag Run Hills Video Analysis

LATERAL DAY

Warm Up Lateral Band Walks Lateral Hurdles Forward Lunge Reverse Slides Lateral Slides Hip Swings

Core Lateral Palof Squat Lateral Palof Split Squat Palof Tall Kneel Snake Squat Form with Arm

movements

Ladder Lateral Drills 1 Box Full Lader Ladder Diagonals S Drill 1 Each Way Cone Cut 45 Degree L&R

Cut Drills Lateral Airex CAT CAT Trainer T-Drills

Movement Skill Tree Runs for time Beep Test Stair Runs

ACCELERATION DAY

Warm up Lateral Band Walks Sprint Band Walks

Mid-foot/Hip Ext Sprint Hurdles Fwd Lunge Rev Lunge

Core Prone Plank

4, 3, 2 Point Side Plank

Knees, Ankles, Leg Lift Bridge

Double Leg, Marching ASLR Arm Action Tempo

Jog to Sprint

Sprint Drills Leg Recovery (pony drills) Wall Drive Quick Step Drills Straight Leg Shuffle Push-Up Start Fall Start Jump Back Start Airex to Hurdle Runs CAT Thigh Runs

Sprint Power Sled Pull or Treadmill Push Stair Runs Bullet Belt

STRIKE/INTERVAL DAY

Total Body Burpees Front/Back Squat Thrust

Lower Body Pushing Air Squats Lunges

Fwd, Lat, Backward Step-ups

Fwd, Lat Lower Body Pulling

Glute-ham raise Val-slide curls Scissor Hip Extension Band Leg Curls

Upper Body Push Push-ups

Norm, Close, Wide, Plyo Hand Stand TRX

Upper Body Pulling Pull-ups Chin-ups Clapping Kipping TRX Row

STRIKE/INTERVAL DAY CONT.

Tire Exercises Flips Flips with jump Sledge Hammer Hits Burpee jump Burpee Varriations

Pushing/Dragging Sled Pushes Sled Pulls (upper body) Sled Drags Varriations

Tabata Drills: Work 20 Seconds Rest 10 Seconds

Intervals can be of any variation:

FUNCTIONAL DAY

Hiking Ruck Marching Power Park Fitness

Mud Run American Ninja Warrior

Paint Ball