Daniel S. Lorenz

Is There Evidence to Support a Forefoot Strike Pattern in Barefoot Runners? A Review

Context: Barefoot running is a trend among running enthusiasts that is the subject of much controversy. At this time, benefits appear to be more speculative and anecdotal than evidence based. Additionally, the risk of injuries is not well established. Evidence acquisition: A PubMed search was undertaken for articles published in English from 1980 to 2011. Additional references were accrued from reference lists of research articles. Results: While minimal data exist that definitively support barefoot running, there are data lending support to the argument that runners should use a forefoot strike pattern in lieu of a heel strike pattern to reduce ground reaction forces, ground contact time, and step length. Conclusions: Whether there is a positive or negative effect on injury has yet to be determined. Unquestionably, more research is needed before definitive conclusions can be drawn.

Periodization: Current Review and Suggested Implementation for Athletic Rehabilitation

Background: Clinicians are constantly faced with the challenge of designing training programs for injured and noninjured athletes that maximize healing and optimize performance. Periodization is a concept of systematic progression—that is, resistance training programs that follow predictable patterns of change in training variables. The strength training literature is abundant with studies comparing periodization schemes on uninjured, trained, and untrained athletes. The rehabilitation literature, however, is scarce with information about how to optimally design resistance training programs based on periodization principles for injured athletes. The purpose of this review is to discuss relevant training variables and methods of periodization, as well as periodization program outcomes. A secondary purpose is to provide an anecdotal framework regarding implementation of periodization principles into rehabilitation programs. Evidence Acquisition: A Medline search from 1979 to 2009 was implemented with the keywords periodization, strength training, rehabilitation, endurance, power, hypertrophy, and resistance training with the Boolean term AND in all possible combinations in the English language. Each author also undertook independent hand searching of article references used in this review. Results: Based on the studies researched, periodized strength training regimens demonstrate improved outcomes as compared to nonperiodized programs. Conclusions: Despite the evidence in the strength training literature supporting periodization programs, there is a considerable lack of data in the rehabilitation literature about program design and successful implementation of periodization into rehabilitation programs.BACKGROUND Clinicians are constantly faced with the challenge of designing training programs for injured and noninjured athletes that maximize healing and optimize performance. Periodization is a concept of systematic progression-that is, resistance training programs that follow predictable patterns of change in training variables. The strength training literature is abundant with studies comparing periodization schemes on uninjured, trained, and untrained athletes. The rehabilitation literature, however, is scarce with information about how to optimally design resistance training programs based on periodization principles for injured athletes. The purpose of this review is to discuss relevant training variables and methods of periodization, as well as periodization program outcomes. A secondary purpose is to provide an anecdotal framework regarding implementation of periodization principles into rehabilitation programs. EVIDENCE ACQUISITION A Medline search from 1979 to 2009 was implemented with the keywords periodization, strength training, rehabilitation, endurance, power, hypertrophy, and resistance training with the Boolean term AND in all possible combinations in the English language. Each author also undertook independent hand searching of article references used in this review. RESULTS Based on the studies researched, periodized strength training regimens demonstrate improved outcomes as compared to nonperiodized programs. CONCLUSIONS Despite the evidence in the strength training literature supporting periodization programs, there is a considerable lack of data in the rehabilitation literature about program design and successful implementation of periodization into rehabilitation programs.

What Performance Characteristics Determine Elite Versus Nonelite Athletes in the Same Sport

Context: There are significant data comparing elite and nonelite athletes in anaerobic field and court sports as well as endurance sports. This review delineates specific performance characteristics in the elite athlete and may help guide rehabilitation. Evidence Acquisition: A Medline search from April 1982 to April 2012 was undertaken for articles written in English. Additional references were accrued from reference lists of research articles. Results: In the anaerobic athlete, maximal power production was consistently correlated to elite performance. Elite performance in the endurance athlete is more ambiguous, however, and appears to be related to the dependent variable investigated in each individual study. Conclusion: In anaerobic field and court sport athletes, maximal power output is most predictive of elite performance. In the endurance athlete, however, it is not as clear. Elite endurance athletes consistently test higher than nonelite athletes in running economy, anaerobic threshold, and VO2max.

Performance Enhancement in the Terminal Phases of Rehabilitation

Context: There is a dearth of literature on the performance enhancement in the recovering athlete in the terminal phases of rehabilitation. There are established training methods that target strength, power, speed, endurance, and metabolic capacity that all lead to performance enhancement. Evidence Acquisition: A PubMed search from 1980 to 2010 was undertaken for articles in English. Additional references were accrued from reference lists of research articles. Results: Multiple options are available to improve strength, power, speed, endurance, and metabolic capacity during rehabilitation. Conclusion: Sports clinicians have several components to address in the rehabilitation of a recovering athlete in addition to performance enhancement. Sports clinicians should focus their efforts on increasing power, a product of maximum force and speed of performance.