WWW.concussionpreventionprotocol.com

By Ralph Cornwell, Jr., Ph.D. (abd)

To protect athletes from concussions and other head injuries, strength coaches should focus on strengthening the neck and trapezius muscles. In fact, the author argues that neck strengthening should be a training priority.

In a tradition that dates back centuries, physicians take the Hippocratic Oath before they practice medicine. In the original interpretation of the oath, a doctor would swear to “prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.”

This code of moral conduct offers up valuable lessons to strength coaches and athletic trainers who work with the “patient” in their world: the athlete. Strength coaches are charged primarily with the duty of preparing athletes for the rigors of their chosen sport. Referring back to the Hippocratic Oath, one could argue that increasing the performance of an athlete should become the second priority for strength coaches because a great athlete standing injured on the sidelines does no one any good.

Instead, the top priority for strength coaches should be a training regimen targeted first at protecting their athletes from harm as they tune them for competition. If strength coaches look first to protect their athletes from potential harm and prepare properly and diligently the most vulnerable region of athletes’ bodies, one could argue that the number of serious sports injuries could be reduced or minimized.

And what is the most vulnerable region of the body that, if traumatized, could lead to a serious, possibly life-threatening injury? Without question, it is the neck region (cervical spine).

The neck supports the head, which encases the hierarchy of human beings’ functions, the brain. The trapezius–either of the two large muscles that run from the base of the back of the skull to the middle of the back–makes it possible for persons to raise their heads and shoulders. In essence, these muscles act as the foundation and support the driving force at the top of the body–back to the brain. If the foundation is strong, then the head is better supported and the brain better protected.

Given the critical role these muscles play, one would think the neck and trapezius would be at the top of strength coaches’ regimens for their athletes. But in a recent survey I distributed as part of my dissertation, over 200 college and university strength coaches were asked about their neck/trapezius training regimens, and their answers revealed this muscle region has a lower training priority than others. Survey questions ranged from “does your weight room have a four-way neck machine,” and “do you do any direct stimulation to strengthen the neck,” to simply “how important is training the neck in your program?”

The lack of emphasis on training this area may be explained by the fact that many coaches are simply unaware of the importance of training the neck and the trapezius muscles, which the neck relies on to dissipate forces. If strength coaches knew of the vital role the neck plays in sports performance, as well as the importance of increasing neck strength, then these results may have been very different.

Muscle regions other than the neck/trapezius area were emphasized in most strength-training programs. Does the following sound familiar when examining many of the nation’s strength training programs? Athletes use the bench press for the upper body; squats and leg presses for the lower body; and some abdominal and lower back work. This is a complete regimen, as many would suggest, if the strength coach’s only priority is the performance of the athlete rather than protection of that individual.

However, by training the neck and trapezius muscles, strength coaches can enhance protection and performance of their athletes. A stronger neck increases the strength of an athlete, who then functions as a complete working unit. For example, consider that the trapezius muscles run from the base of the back of the skull all the way to thoracic vertebrae 12. Overlooking such a critical and major muscle group certainly does not enhance an athlete’s overall performance.

To minimize head injuries, let’s revisit the neck/trapezius area and see how these muscles play a critical role. Neck muscles act as springs and shock absorbers; bigger, stronger necks can better absorb with less deformation. Recalling the laws of physics, consider the neck as a cylinder. The larger the circumference of the cylinder, the more load it can support without buckling.

As training the neck area increases strength there, the soft tissue thickens and the neck becomes stiffer. Using physics again to explain the necessity for stiffness, view the neck as a coiled spring. The thicker the coils of the spring, the greater the stiffness ratio. A smaller, less stiff spring is easier to compress from an axial-loading standpoint. A stiffer spring–or stronger neck–deflects greater frontal or side impact forces.

All variables being equal, if a given cylinder increases its diameter by two inches–say from six inches to eight inches–the deformation decreases 43 percent. Common sense, simple logic, or even strong speculation suggests that a bigger, stronger neck would give an athlete a better chance of avoiding serious injury when absorbing impact forces during collisions.

And female athletes should not avoid training the neck area, just because many think they will get a “fat neck” from such conditioning. Biologically, females do not achieve the hypertrophy that males do, but they can benefit greatly from the strength gained in this region of the body.

Training the neck area in four directions–flexion, extension, and left and right lateral flexion–followed by a shoulder shrug exercise offers the most effective direct stimulus to this region of the body. Neck machines are great devices to help with this training, but if strength coaches cannot afford these machines, they should educate themselves on the protocol of manual neck resistance, along with a barbell or dumbbell shrug.

Relating back to the original premise, if strength coaches truly believe their first priority is to protect the athlete and prevent injury, and that the neck and cervical spine are at risk during competition, why would they not train this region of athletes’ bodies religiously? If strength coaches train all the agonist and antagonist muscle groups but neglect the neck and trapezius area, are they truly preparing their athletes effectively for the rigors of their sport? Well-informed strength and conditioning professionals would see the logic in this premise and would want to help their athletes in any way they could.

Strength coaches need to find 30 minutes twice a week to train the neck and trapezius area. With effective time management and efficiencies, any strength and conditioning program could meet this objective. In setting up a strength training facility, would it not make sense also that for every station, say, for squatting, there would also be a station for protecting the brain and turning the head?

As these questions tumble forth, again the Hippocratic Oath comes back into play–”to prescribe regimens for the good of my patients.” Maybe the essence of that document created long ago can have relevance in more ways than one to strength coaches everywhere today.

Acknowledgments
I would like to thank Dan Riley for all of his help and wisdom over the years. I would like to thank Mike Gittleson for his guidance with this article and the completion of my Doctoral Degree. Also, special thanks to Chris Potter Mechanical/Structural Engineer for his help and insight. Lastly, I would like to thank Tyler Hobson for the use of a great neck machine that will allow me to finish my research.

Ralph Cornwell is a Ph.D. candidate in health promotion/human performance at Virginia Polytechnic Institute and State University, with additional course work in sports psychology. A Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association. An honors society member, he currently is conducting a case study on neck injuries and the prevention of or leasing of concussive forces. He has more than 17 years experience as a strength and conditioning coach, consultant and lecturer. Having derived his training philosophy from Dan Riley while with the Washington Redskins, Cornwell has worked with high-school, collegiate and professional athletes–including those in the National Football League, Major League Baseball and Major League Soccer–as well as women’s soccer and lacrosse players, NFL Europe athletes, European and Russian basketball players, and several international players from Africa and Australia. He has been the head strength and conditioning coach at Radford University, the University of North Carolina at Greensboro, and North Carolina Agricultural and Technical State University, and assistant coach at the United States Military Academy at West Point. Cornwell points to the fact that he never had an injury in a weight room where he was the head coach. At age 45, he still trains as hard as any of his athletes.

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Remember to Visit concussionpreventionprotocol.com

Mark Asanovich presents a thought provoking education in the art and science of strength training.

Spend the day with Mark and become a better educated and better informed Health Care Provider. From Athletic Trainer to Strength Coach and all other health care professions in between. You will benefit from this lecture, I give you my personal guarantee on this one. You will have an expanded knowledge base when you leave this seminar .

The Who, What, When, Where, and Why of Exercise and How to Prescribe and Administer it Successfully

Prudent, Productive, Practical and Purposeful Strength and Conditioning Principles

Please select a date and location:  ALEXANDRIA – June 5  FREDERICK - June 6 BALTIMORE - June 7
HARRISBURG - Ju12  WILKES-BARRE - June 13  PHILADELPHIA – June 14

Dates & Locations
ALEXANDRIA – June 5, 2012
Hampton Inn Alexandria-Old Town South
5821 Richmond Hwy, Alexandria, VA 22303 703-329-1400
FREDERICK – June 6, 2012
Hampton Inn
5311 Buckeystown Pk, Frederick, MD 21704 301-698-2500   

BALTIMORE – June 7, 2012
Hilton Garden Inn Baltimore/White Marsh
5015 Campbell Blvd, Baltimore, MD 21236 410-427-0600

HARRISBURG – June 12, 2012
Radisson Penn Harris Hotel and Convention Center
1150 Camp Hill Bypass, Camp Hill, PA 17011 717-763-7117

WILKES-BARRE – June 13, 2012
Hilton Garden Inn
2424 Highland Park Blvd, Wilkes-Barre, PA 18702 570-820-8595

PHILADELPHIA – June 14, 2012
Four Points by Sheraton
4101 A Island Ave, Philadelphia, PA 19153 215-492-0400

NFL Strength Coach, Educator, Innovator in The Strength Training Profession. Mark is clearly one of the few that warrants the title “One of the Best In OUR Profession.”

Don’t miss the educational opportunity!!!

Todd Toriscelli enters his 15th season with the Buccaneers in 2011 and second as director of sports medicine and performance after serving as head athletic trainer for 13 seasons. He has been a part of four division championships during his tenure as well as the Buccaneer’s first Super Bowl title, a 48-21 victory over Oakland in Super Bowl XXXVII.

Todd viewed our Concussion Prevention DVD and had this to say:

Being proactive in the prevention of concussions is without question the main priority of coaches and medical personnel who are associated with contact sports. In addition to protective  equipment, neck strength has to be a priority, especially in youth sports. The process of gaining functional neck strength is not complicated but must be done properly. This DVD does a great job of not only stating the need for proper training of the head and neck but is a great teaching tool for a very effective functional head and neck program that is not equipment dependent. I highly recommend this program to be used at all levels of contact sports.

Toriscelli coordinates the team’s daily medical coverage including all performance parameters such as physical development and nutrition. Toriscelli and his staff have conducted research projects on dehydration and exercise in the heat in conjunction with scientists from the Gatorade Sports Science Institute, and he recently co-authored an article in the International Journal of Sports Medicine. He has also published several other articles and lectured on topics related to sports medicine. Most recently, Toriscelli was named to the NFL Health and Safety Panel in May of 2011.

Mark and I appreciate Todd Toriscelli taking the time to watch the Concussion Prevention Protocol and stating his opinion.  The NFL and their awareness of the ONLY Evidence Based Head and Neck Strength Training Protocol is very important to the lowering of forces and reducing the incident of concussions.

Sports have become so competitive from Pee Wee League to the Professional level.  Really what sport is not considered a contact sport? Soccer, Basketball, wrestling, lacrosse, field hockey, ice hockey, football, rugby, even cheer leading has one of the highest concussion rates. Our hope is that more and more leagues and organizations come to the realization that TRAINING THE MUSCLES OF THE HEAD AND NECK ARE PRIORITY ONE.

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COACHES EVERYWHERE KNOW HOW MUCH THEIR ATHLETES BENCH PRESS OR SQUAT.

ATHLETIC TRAINERS ARE AWARE OF MUSCLE IMBALANCES , INJURIES  OR THE PREDISPOSITIONS OF THEIR ATHLETES.

Coaches and trainers record all types of data about all sorts of things.  Treatment given to particular athlete or in the case of a coach, maybe he has measurement of all the athletes vertical jumps.

Anterior Cruciate Ligament tears are common, but a major injury in athletics.  There are timelines for recovery, how strong the musculature around your knee should be as you progress through therapy administered by the ATC.

No competent athletic trainer would release an athlete to return to competition unless he was sure the athlete was ready.  The trainer, team physician, and the strength coach collaborate on how to best get an athlete back to playing their sport, but not until the athlete has regained full range of movement, propericetion, baseline strength levels etc.

The trainer needs best effort numbers from the strength coach to judge how far the athlete has progressed. There is a need to know how close to 100 percent  the  strength level of the muscular of the injured area, in this case being the knee, before the returns to play.  The strength coach has numbers on squats, knee extension, for quadriceps strength, leg curl and RDLs for hamstring strength. Now they know how close the athlete is to regaining full strength in the musculature of the injured area. This way you have baseline measurements, solid number of where the athlete was strength wise before the injury and now after the rehab.

Lets examine another common but serious injury, Concussions.

Concussion Management is a Good thing.  The Concussion Management Protocol  allows the athlete to rest, sometimes sleeping in a dark  room for hours a day until symptoms subside.  What happens to the athletes strength level as their muscles atrophy while they rest? More importantly, what happens to the muscles of the head and neck. Those same muscles that were not strong enough to ward off the initial Concussion, are now even weaker because of the inactivity.

Now, we need numbers. Solid Numbers about previous Head and Neck Muscular Strength. What was the circumference of the athlete’s neck prior to the Concussion? How much have those muscles atrophied? Do strength coaches have numbers on baseline strength of the muscles of the Head and Neck? If they have baseline numbers on the quadriceps surely they will have numbers on the muscles that protect the Athlete’s Brain.

Sadly, I know of  only one Division I University that documents all those vital numbers and has a data base of information at their disposal. Colgate University does an outstanding job of knowing those Numbers.

How can a team physician, strength coach and athletic trainers make an informed decision about Return to Play without All the pertinent information?

Do parents want their sons and daughters to Return to Play with a weaker body and a much weaker neck?  We know muscles atrophy very fast, and if athletes are restricted from activity for longer and longer periods of time, then the muscles are even weaker when they return to competition.

Before an athlete can Return to Play, there are several tests. There are No tests given by professionals for head and neck musculature strength.

Would the Team Doctor give approval to an athlete to return to play from ACL surgery  with weak quadriceps or hamstring muscles? Why would we put a helmet on the head of an athlete with a weak neck? Should an athlete be allowed to “head” a soccer ball with a weak neck?

What can be done to ensure that our athletes are Properly Protected?

1. Implement a comprehensive Head and Neck Training Program.

2. Strength  coaches need to keep accurate and up- to- date records of head and neck musculature. Have current circumference measurements of male athlete’s necks.

3. Athletic Trainers and Strength Coaches need to share information of athlete’s  strength levels, including the muscles of the head and neck.

4. Make this information available to Physicians so that an informed decision can be made about when an athlete can safely return to play.

“To prevent” literally means “to keep something from happening”

In the World of Sports Medicine Prevention s is defined as  “prevention” all interventions that occur before the initial onset of disorder.

When addressing The Concussion Epidemic ,WE must use the later term. In a ever chancing fast paced sports arena one could never expect to stop something from happening. Simply being in the wrong place at the wrong time can spell disaster

As Professionals in the field of Preventative Sports Medicine, I know we all have read, or participated in protocols to Prevent Anterior Cruciate Ligament(ACL) Tears. There are literally 100s of protocols to protect the knee joint and particularly the ACL from tearing.

As Professionals we all know despite our best efforts our athletes will tear their ACLs. But that does not mean we ignore the ACL and just let things happen without at least putting forth our best efforts to prepare the athlete for competition, with the hope that our efforts as professionals have given the athlete a fair chance at not tearing the ACL.

AS professionals, why do we treat concussions completely different?   We all know that concussions cannot be prevented, just as ACL tears cannot be prevented.  WE prepare athletes for the contact and forces related to ACL tears.  Wouldn’t it then be logical to assume that if prevention protocols that
strengthen muscles around a joint that reduces tears of a repairable ligament;
are at least equal, if not the same sense of urgency for the prevention of cervical
spine injury and traumatic brain pathologies ••• to a joint that may not be                        
repairable???

Instead, the prevention of cervical spine injury and traumatic brain injury
has focused on better recognition, better education, better legislation, better
execution and better innovation.

Strengthening of the head, neck and surrounding cervical structures ••• is
the ONLY organic contingency within our control to prepare individuals to
withstand potentially injurious forces.

THERE IS SIMPLY NO GOOD
REASON FOR NOT TRAINING THE MUSCLES SURROUNDING THE CERVICAL
SPINE. PERIOD!

So, if we cannot Prevent Concussions, as professionals we can certainly reduce or lower the forces that can cause damage. We know subconcussive forces over time my be even more dangerous then the big ” kills shots” we see on ESPN. Subconcussive forces go undetected and over days, weeks, months and years of small strikes to the head have a cumulative and damaging effect to the athlete’s brain. One researcher coined the term death by a thousand cuts to illustrate the devastating affects of low G-force hits to the head over  time. If properly training the muscles of the head and neck can “raise the bar” on the number of subconcussive hits it takes before you become cognitively impaired, that is a victory in and of it’s self.

It is imperative that health care practitioners take a ~PROACTIVE approach rather than
a REACTIVE approach in their prevention strategies. Current attempts at
“prevention” primarily involve management of the injury after the damage already
has been done.

EVERY contingency must be
painstakingly explored, considered and engaged- EVERY SINGLE ONE! Therefore,
the prudent thing, no •••the RIGHT thing to do is to PREPARE individuals •••just in
case the other preventative measures fail.

There are several means by which Concussions  can be prevented.

1) If all organized activities  were prohibited, Concussions could be Prevented.

2) Federal Legislation outlawing all Sports participation at all levels, Pee Wee to PROFESSIONAL  ATHLETES we would Prevent Concussions.

3) Stopping individuals from operating  all motor vehicles, thus eliminating motor vehicle collisions, Would Prevent Concussions.

4) Banning water, snow skiing , sky diving and even running too Fast,Would Prevent Concussions.

Equestrian Sports would definitely  have to go if we  are going to Prevent Concussion.

WE WILL NEVER PREVENT CONCUSSIONS.

BUT that does Not mean we do nothing about the Concussion Epidemic. Coaches need to Protect Their Athletes by reducing and minimizing the risk of   sustaining a concussion.

Countless ACL prevention programs have been researched, developed
and implemented with a high degree of urgency to curb the incidence of these
injuries. Wouldn’t it then be logical to assume that if prevention protocols that
strengthen muscles around a joint that reduces tears of a repairable ligament;
are at least equal, if not the same sense of urgency for the reduction of cervical
spine injury and traumatic brain pathologies ••• to a joint that may not be
repairable???

WE WILL NEVER PREVENT CONCUSSIONS!

DOES THAT MEAN WE DO NOTHING?

No, we must prepare our athletes for the contact of their Sport. Through a Concussion Reduction Protocol that lowers forces associated with concussions and minimizes the effects of concussive and subconcussive forces.

Strengthening of the head and neck  musculature and the surrounding cervical structures ••• is
the ONL Y organic contingency within our control to prepare individuals to
withstand potentially injurious forces.

Coaches, athletic trainers, physical therapists, strength coaches and parents obtain the skills to Protect The Athlete.   Learn how You can Protect your Athlete.    Go to ConcussionPreventionProtocol.com

Mission Statement

To disseminate evidence-based neck strengthening protocols and principles to health care practitioners, coaches, parents and the general public to prevent the prevalence and severity of cervical neck injury and mild traumatic brain injury/concussions in a manner that is prudent, productive, practical & purposeful.

We wrestled with this problem for the last two days. If you remember the movie Jerry McGuire, he wanted fewer clients,which did result in less money, but better personal attention for his clients. Similarly, We want more DVDS in the hands of coaches, athletic trainers, strength coaches, even parents.

We had an epiphany. Lower the price to 59.95 for as long as we can.More DVDs distributed. We want to  remove any excuse  not to buy the DVD and Manual Package because of budget restrictions. Mark and I want to ensure everyone has the knowledge to Protect Their Athletes.

Right NOW Football players around the country at all levels are preparing for a Collision Sport. Are their coaches prepared to train them? From a Conscientious or Liability stand point, there should be  a sense of urgency for coaches to obtain the skill set to PREPARE and PROTECT their Athletes.

This is not just about Football. All athletes need to Properly train the muscles of Head and Neck. All athletes need to protect and prepare the musculature that surrounds the cervical spine.

So what about the proactive people that have already purchased our DVD?  We wanted to be fair to them because they bought our product because they wanted to be on the cutting edge of Preparing Athletes for the Rigors of their Sport. When we begin certifying Head and Neck Training Specialist starting in March, anyone who has purchased the DVD Prior to our price reduction will receive a 25.00 dollars credit towards the price of the certification.

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When you chose to be a coach YOU were immediately Charged

with the  Responsibitily of keeping them safe and

preparing them for competition.  We give you the tools to take care

Of  THE HEAD AND NECK.

Finally, The Concussion Prevention Protocol DVD IS Here!

Concussions have become a National Epidemic.  Millions  of dollars have been spent to fund studies over the last 15 years.The research continues but the number of concussions in Athletics INCREASE Each YEAR. Something proactive needed to be done. Through our research and input from some of the greatest minds in strength and conditioning we have created the Protocol to

Protect  Your Athletes.

This Your opportunity to purchase the ONLY Evidence based CONCUSSION PREVENTION PROTOCOL DVD.

PRIORITY ONE

          The most important goal of the strength & conditioning professional is to PRUDENTLY PREPARE the individual for the rigors of the task at hand. As such, given the catastrophic consequences of a cervical spine and traumatic brain injury, the strengthening of the neck and surrounding muscular structures of the cervical spine MUST be considered PRIORITY ONE in the prescription and design  of exercise routines.

The Educational DVD and Instructional Manual will give you the knowledge and expertise to Properly strength train the musculature of the head and neck and surrounding muscle groups.

“All athletes exposed to “head impacts” (collisions, head trauma) should place the highest priority on strengthening the musculature of the neck and trapezius. Reliable and evidenced based information has been unavailable until now. Coaches, athletes, and especially parents can rely upon this manual (DVD) for the most comprehensive information available on neck development. I can without any reservation recommend this DVD for the safest and most effective methods to strengthen the neck and trapezius.”

Dan Riley                                                                                                                                                                             

Three Time Super Bowl Champion Strength Coach for the Washington Redskins

27 Year NFL Strength Coach (Washington Redskins & Houston Texans)

9 Year Collegiate Strength Coach United States Military Academy & Penn State

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Go to http://www.concussionpreventionprotocol.com , optimumfitnesssonline.com or coachaprotraining.com

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