Then respond back to the 8 responses below

Subject:BiologyPrice: Bought3

Share With

Then respond back to the 8 responses below. (100-200 words)

1. Present the pros and cons for muscle fiber typing of children to "guide" them into sports to increase their likelihood of future success.

 

2. From a neuromuscular perspective, discuss the validity of the adage, "Perfect practice makes for perfect performance.

 

3. Explain how knowledge of neuromuscular exercise physiology can help enhance an athlete's:

- Strength and Power

- Sports Skill Performance

 

Response 1: Matt Winn:

Performance differences among individuals with equal amounts of time practicing the volleyball spike are:

 -Individual differences in muscle fiber type distribution. Although men, women and children have about the same amount of slow twitch fibers in their upper and lower extremities (~45-55%), distribution of those fibers can vary greatly between individuals. (McArdle, 2014)

 -Individual differences in muscle fiber-motor unit ratios. "Some motor units contain up to 1000 or more muscle fibers, whereas motor units of the larynx, fingers, or eyeball contain relatively few."(McArdle, 2014). This ratio likely has a large contribution to the variation in sport skill performance.

 -Individual differences in fatigue resistance. This can be at the CNS level or at the muscle fiber level. Examples are: reduced neurotransmitters/neuromodulators, reduced glycogen content, lack of oxygen, increased lactate, etc. (McArdle, 2014)

 -Type of training plays a significant role in neuromuscular adaptations. Depending on the necessary performance adaptation, a proper training protocol can create optimal performance outcomes. Complex training programs which incorporate plyometrics with heavy resistance training has been shown to improve performance over heavy resistance training alone (Li, 2019)

 

Response 2: Jacob Schmitz

 

The volleyball spike is a dynamic movement that requires the whole kinetic chain working together in synchronicity, if one of the links of the chain are compromised then the performance may also be effected no matter how small of a degree. Neuromuscular factors play a major role in this function, in the case of a volleyball spike, joint centration of the shoulder and core stability are crucial. The volleyball spike is dynamic, not a static movement, joint centration provides a more functional joint as it is located in a position of mechanical advantage; this allows optimal transfer load and forces through the body with minimal stress on passive structures and compromising positions (Frank, Kobesova, & Kolar, 2013).  In addition to this, proper diaphragmatic breathing and core bracing is the fundamental building block for dynamic movements such as a volleyball spike. Addressing the neuromuscular aspect, the dual bracing and respiration function of the of the diaphragm activates cortical as well as subcortical brain to aid in the feed forward mechanism of proper integrated spinal stabilization.  Frank, Kobesova, and Kolar (2013) state that “corrective stabilization strategies should always be the foundational tenet of any training program.

 

 

 

Response 3: Alice Cardona

 

The volleyball spike is definitely a skill. I’m an ex-volleyball played I played for 12 years until my senior year in college and learning the spike was the hardest technique to master. There are a lot of factors that affects the mechanics of the spike for example the running phase, arm and feet position, the direction of the shoulders, the timing and the pace. In conclusion the skill relies on the person’s neuromuscular coordination. If we break down the volleyball spike skill we were to analyze a volleyball spike we start with the a) starting position, (b) the approach, (c) jump, (d) arm strike, and (d) the famous follow-through.  Some of the neuromuscular components that help explain the performance differences in the volleyball spike among individuals are the perceptual or proprioception component, physical components, body control, precision, multi-limb coordination, rate control, aim, explosive strength, trunk strength during flexion, and the dynamic flexibility their all underlying neuromuscular and motor abilities required to perform the volleyball spike (Kessel, 2015).

 

 

Response 4: Chad Rawdon

So many things can cause shoulder pain, acute or repetitive use injuries have different levels within them. Find better ways to treat injuries without surgery is a benefit to all.  Things to consider when choosing a treatment path are age of person, severity of the injury, activity level of the injured person, and available recovery time. What I found most interesting with this article was in the treatment section for rotator cuff tears where a prospective multi center study published in 2013 by the MOON shoulder group of 452 patients treated with a standardized physical therapy program for atraumatic full-thickness rotator cuff tears revealed a 75% satisfaction rate in patients after 2 years of follow-up. (Pogorzelski et al. 2018)The fact that there was a 75% satisfaction rate blew me away. I had to look up what a full-thickness tear was to make sure I remember what it was correctly because 75% seem high for a complete tear without surgery.  With full thickness tears the entire tendon has separated or torn from the bone. (Luks,H 2017) Not all full thickness tears need surgery but I for one would most likely opt for surgery just for peace of mind and I would feel like it would not get gradually worse without me knowing it. Also, pain is a very subjective thing, so with any study that relies on a subject to report if things are better or worse is always difficult for me to buy into the results. Some people aren’t very active or seldom lift their arms over their head during they typical day while others work above their head or have regular impact on their shoulders which would skew the results. For me a broad study should be broken down into age and daily activity to get a better read on whether or not surgery or non-surgical methods would be better.

 

Response 5: Kendra Clamors

  With working in a physical therapy clinic, I think the most common shoulder injury we treat are rotator cuff tears. We try our best to help those patients who have torn their rotators cuffs without having to look into getting surgery for it, but that’s not always the case. According to the article, “Although symptomatic rotator cuff tears are common and affect between 4% and 32% of the general population, the most appropriate therapy is still debatable. While there is agreement that traumatic rotator cuff tears should be treated operatively, the treatment choice for atraumatic rotator cuff tears remains unclear,” (Pogorzelski et al., 2018). With physical therapy being a treatment option there are certain protocols that the therapists have to follow. Physical therapy included daily postural and stretching exercising as well as strengthening of the rotator cuff three times a week. If needed, patients were seen by a physical therapist, especially for manual mobilization of the glenohumeral joint (Pogorzelski et al., 2018). The part of the article that I found interesting was about how there really is no evidence that a torn tendon actually heals without surgical re-fixation. This includes the progression from an initially reparable tear to an irreparable tear, as well as inferior postoperative outcomes of chronic tears compared with acutely fixed tears. If treated nonoperatively, a combination of activity modification, stretching and strengthening of the periscapular muscles and the deltoid should be performed. MRI of a known rotator cuff tear can be performed on patients who want to progress with surgical refixation of the tear and those who wish to monitor tear progression to consider surgery at some future time point (Pogorzelski et al.,2018). I personally like working with patients that have this type of injury. Getting to see their progression from when they first come into therapy to when they leave is an awesome feeling. I know therapy doesn’t always help everyone out, but we at least try to make daily tasks a little easier and as pain free as we can for them.

 

Response 6: Scott Walker

For the second article, I have been very lucky not to have any kind of sports related shoulder injury. In fact, I have not had a shoulder related injury at work either. I really do not have any insight into the first two possible responses. I have not thought about non-contact sports and shoulder injuries before though. “Shoulder injuries can also occur in non-contact sports, such as golf, tennis, swimming and weightlifting. Although shoulder injuries may be more common in contact sports, the injury may have a larger impact on the performance of individuals playing non-contact sports. For example, golfers require very precise maneuvers of their dominant shoulder to swing a golf club with accuracy” (Leung, 2016). I took the oppourtunity to look at the role of the shoulder in golf and the golf swings. The shoulder joint plays an important role in the golf swing whereby not only the muscles around the glenohumeral joint but also the scapula stabilizing muscles are extremely important for an effective golf swing. Golf is strictly not considered to be an overhead sport; however, the extreme peak positions of the golf swing involve placing the shoulder joint in maximum abduction and adduction positions which can provoke impingement, lesions of the pulley system or even a special form of posterior shoulder instability” (Liem, Gosheger, Schmidt, 2014). So what can golfers do to help prevent shoulder injuries and stay healthy? One key thing is to look at the entire body motion of a golf swing, and look at how the body is working together in order to produce a desired result. One sporting website suggests that one of the top reasons for shoulder injury is poor lower body/core and function (p2sportscare, N.D.). In addition to last’s week’s discussion and response, having poor or underdeveloped core muscles and a poor swing can lead to shoulder problems for golfers. I would recommend a full body workout for all golfers, not just upper body extremities.

 

Response 7: Josh Young

As someone who has had to have surgery for an injury and who knows how grueling and time consuming the recovery can be, I am an advocate of nonoperative treatment when possible. Some injuries do require surgery (certain fractures, complete tears), but surgery does not have to be presented as the only option for treatment. Since my undergrad courses, I have had a particular interest in the glenohumeral (GH) joint itself and the stability aspect of the shoulder, so the section of the article about anterior shoulder instability stood out to me. I found it interesting that patients younger than 30 who underwent nonoperative treatment had such a high re-dislocation occurrence (Pogorzelski, Fritz, Godin, Imhoff, & Millett, 2018). I would have thought that the reinjury rate was much lower for patients of that age group. I have never treated a patient that presented with anterior shoulder instability, but I have seen multiple people who present with anteriorly rolled shoulders, where increasing stability is the main goal of the rehab plan. I start by strengthening the posterior shoulder muscles: traps, lats, external rotators, rhomboids, and rear deltoids. From there I progress to strengthening the serratus anterior muscle to really stabilize the shoulder blade. In many cases of anteriorly rolled shoulders that I see, scapular winging is also an issue. Since GH movement is directly influenced by scapulohumeral rhythm, the scapula has to be stable to optimize GH stability. Another part of this section of the article was whether to immobilize in internal or external rotation. I’ve always assumed that the shoulder should be immobilized in a neutral position, or at least as close to neutral as possible. My shoulders don’t have any problems but being put into external rotation for too long can become uncomfortable, so I can see why that would be an uncomfortable position for someone who just had a traumatic injury to their shoulder. As the article pointed out, that could have a negative influence on patient compliance (Pogorzelski et al., 2018). I’ve had to alter some patients’ at-home rehab plan because they simply won’t comply to what I want them to do. My logic is to structure the recovery plan in a way that makes sense for patients and is relatively easy for them to do. Otherwise, they aren’t going to do it and they won’t recover properly.

 

Response 8: Lauren Haggett

Before reading this article I knew about examination tests such as an MRI, X-ray, ultrasound, and range of motion, but it was interesting to learn how the BLISS testing works. Positive biceps tendon testing could indicate issues in the labrum. An increase in shoulder pain during labral testing indicates a labral tear. Pain and numbness can indicate an impingement injury, such as “rotator cuff tendinopathy, rotator cuff calcification, bony spurs under the acromion, and subacromial bursal pathology” (Leung, 2016). Positive scarf testing or palpations can indicate an acromioclavicular joint injury. Instability and dislocations can be indicated by a positive stability test such as apprehension or jerk test. The article also mentioned that many times there may be more than one shoulder problem happening simultaneously (Leung, 2016). I think this a really important factor for beginner physical therapists/doctors to consider. It is easy to treat identify and treat an issue that is easily recognizable; however, if multiple issues are occurring simultaneously, it may become more difficult for inexperienced clinicians to identify the issues. It is also important for patients to understand this idea as well, because they may go though a treatment process and still be experiencing pain and complications caused by another pathology. When more than one injury occurs, it may require treatments that deviate from the traditional treatment process if only one injury is occurring. I thought that it was also interesting to learn how treatment options, whether non-surgical or surgical, are determined for injuries such as rotator cuff disorders, shoulder instabilities and dislocations, clavicle fractures, acromioclavicular injuries, and biceps tendinopathy. For many of these injuries non-surgical options are available, yet non-surgical options are not always the best option for every patient. Treatment approaches may be determined by age, activity level, and injury degree. I thought it was also helpful to understand when a patient should be referred to a specialist for additional care.