Integrative Approaches
to Optimum
Performance
Geoff Lecovin M.S., D.C., N.D., L.Ac., CSCS
Geoff Lecovin, DC, ND, L.Ac, CSCS
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In private practice for over 18 years
Chiropractor (1990)
Naturopathic Physician and Acupuncturist
(1994)
Certified Strength & Conditioning Specialist
(NSCA, 2005)
Corrective Exercise Specialist (NASM, 2006)
Performance Enhancement Specialist (NASM,
2006)
Integrative Components of
Optimum Performance
Psychological
Biochemical
Structural
Psychological
(visualization and Intention)
*When you visualize yourself performing an activity, you are in turn physiologically
creating neural patterns in your brain, just as if you had physically performed the
action.
*These patterns are similar to small tracks engraved in the brain cells from physically
rehearsing an activity
*Mental imagery is intended to train our minds and create the neural patterns in our
brain to teach our neuromusculoskeletal system to do exactly what we want it to do.
*Ultimately, an athlete can enhance their performance physically by simply mentally
practicing the activity.
* The more emotion and intention, the more effective the results
Effects of Visualization on the Free-throw Performance of Basketball Players."
University of Chicago
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Athletes were tested to determine their free-throw proficiency and then
randomly assigned to one of three experimental groups.
The first went to the gym every day for one hour and practiced throwing free
throws.
The second group also went to the gym, but instead of physically practicing,
they lay down and simply visualized themselves successfully shooting.
The third group did nothing
At the end of 30 days, the three groups were re-tested
The players who hadn't practiced at all showed no improvement in
performance; and many exhibited a drop. Those who had physically practiced
one hour each day showed a performance increase of 24 percent.
The visualization group, by merely imagining themselves successfully shooting
free throws, improved 23 percent
Stress and the Mind-Body Connection
Repressed Conscious or Unconscious Emotions
Abnormal Autonomic Activity (Sympathetic)
Reduced Local Circulation of Blood
Mild Oxygen Deprivation
Muscle Pain
Nerve pain/Numbness/Tingling/Weakness
Tendon Pain
DECREASED PERFORMANCE
Biochemical
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Diet
Supplementation
A Balanced Approach to Diet
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Focus on fueling the body with nutrients that provide
energy for exercise rather than on calorie restriction.
Optimize nutrients
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Shift balance of omega-3:omega-6 fats
Change carbohydrate sources to fruits and vegetables
Incorporate lean protein sources with every meal and snack
All calories are not created equal
The Healthy Plate
Asparagus
Broccoli
Cabbage
Carrots
DGLV
Green beans
Peppers
Tomatoes
Starch
Non-starchy
veggies
Protein
Corn
Peas
Potatoes
Pumpkin
Squash
Sweet potatoes
Whole grains
Yams
Beans & lentils
Beef (grassfed)
Cottage cheese
Eggs
Fish
Nuts & nut butters
Poultry & pork
(lean)
Tempeh & tofu
The Power of Color
RED (anthocyanins, lycopenes)- strawberries, cranberries, raspberries, cherries, grapes,
beets, peppers, water melon, pomegranates, apples, onions, pink grapefruit
ORANGE-YELLOW (beta carotene, lutein, zeaxanthin)- carrots, sweet potatoes, yellow
potatoes, orange, mangoes, cantaloupe, pumpkin, squash, apricots, corn, banana,
turmeric, ginger
GREEN (beta carotene, lutein)- spinach, chard, kale, avocado, asparagus, artichokes,
broccoli. Brussels sprouts, cabbage, green tea
BLUE-PURPLE (anthocyanins)- blueberries, blackberries, grapes, red wine, eggplant
WHITE- garlic, onion, cauliflower
BLACK/BROWN- Coffee, dark chocolate, nuts
The Color Code. James A. Joseph, Ph.D., Daniel A. Nadeau, M.D., Anne Underwood
General Macronutrient Guidelines
CHO- 40-55%
PRO- 25-30% (1-2 g/kg body weight)
FAT- 25-30%
*Base macronutrient intake upon type of
exercise/sport, goals, mood and energy level
Fats
Eat more: monounsaturated & omega 3s
-avocado, olive, fish, flax, walnuts, wild game,
DGLV
Limit: saturated fat
- beef, butter, cheese, egg yolks
Avoid/eliminate: trans fat
- margarine, partially hydrogenated oils
*Eating healthy fats is essential for weight loss, general health,
fitness and a fat-burning metabolism
Omega 3:Omega 6
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Omega 3= fish, flaxseed, walnuts, canola, DGLV,
grassfed beef
Omega 6= soybean oil, safflower oil, corn oil, other
polyunsaturated vegetable and seed oils
*Imbalances between omega 3:omega 6 increases
inflammation, thereby increasing risk for inflammatory
diseases such as CHD, stroke, autoimmune problems,
eczema, RA, etc.
What About Carbs?
Glycemic Index (GI) = measures the rise in blood sugar
triggered by a specific number of carbohydrates of that
food. The higher the number, the greater the blood
sugar response.
Glycemic Load (GL) = indicates how much of a
carbohydrate is in a serving of a particular food.
*Choosing foods with a low GL is beneficial for weight
loss and overall health
The Influence of Hormones
When you eat, what you eat and how you exercise
affects which hormones are released
The Influence of Hormones
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Catabolic- glucagon, epinephrine,
norepinephrine, cortisol
Anabolic- testosterone, growth hormone,
IGF-1, insulin
How food intake affects hormonal
response
Insulin (lipogenic and anabolic): Lowers blood sugar,
raises triglycerides and shuttles AAs and other nutrients
into muscles
Glucagon (lipolytic and catabolic): Raises blood sugar
and breaks down fat and protein for energy
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CHO triggers insulin
Protein triggers glucagon
Fat is neutral
Nutrient Timing
Critical for:
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Immune function
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Recovery and repair
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Reducing body fat
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Increasing/maintaining energy
Nutrient Timing: The Future of Sports Nutrition by John Ivy & Robert
Portman
Basic Health Publications (February 20, 2004)
Energy Phase
Carbohydrate/protein supplement 30 minutes before
working out:
1. Maintains immune function
2. Stops rise in cortisol
3. Sets stage for faster post-workout recovery
4. Spares muscle glycogen and protein
5. Minimizes muscle damage
e.g. 20 g high glycemic CHO, 5-6 g whey protein,
electrolyte/vitamin formula (C, E, Na, K, Mg)
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Anabolic Phase
CHO/Protein within 45 minutes after exercising to
optimize insulin response and repair muscle
1. Shifts metabolism from catabolic to anabolic state
2. Speeds up elimination of waste by increasing muscle
blood flow
3. Replenishes glycogen stores
4. Initiates tissue repair and reduces muscle damage
5. Bolsters immune system and sets stage for muscle
growth
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Growth Phase
The 18-24 hr period after exercise during which
the majority of muscle and strength gains occur.
1. Consume CHO/PRO 2 hr after exercise
2. Eat high protein diet and high protein/low
glycemic CHO snacks (depending upon goals
e.g. body building, weight gain/loss etc.)
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Ergogenic Aids
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Creatine—take 3 to 6 grams daily (for higher intensity events and body building)
Whey protein- consume pre and post workout
Physique athletes have a higher protein:carb ratio than performance athletes
Caffeine— 5 mg caffeine per kg of body weight (drip=65-100 mg/cup; 2 oz espresso=
about 100mg). Ingest caffeine about 3 - 4 hours before the competition. Caffeine
mobilizes fat stores and encourages working muscles to use fat as a fuel. This delays the
depletion of muscle glycogen and allows for a prolongation of exercise. Also lowers RPE.
Glutamine— several grams post-workout during times of very intense training
Vitamins—take a multivitamin (with iron for menstruating females) daily
Sports drinks/Carbohydrate gels— see next slides
EFA's—eat fish 2 to 3 times per week or take 2 to 4 grams of EPA and DHA daily
BCAA (Leucine, Isoleucine , Valine)
Quercetin- 250-500 mg 15 minutes before meals three times per day
CoQ10- 300mg daily
Green/black Tea- 2-8 cups daily
Fresh fruit and vegetables (Phytochemicals)
Water
Sport Drinks
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Best for- endurance athletes who exercise for more
than an hour at a time
What to look for- 6-9% CHO (divide grams of CHO
per serving by the milliliters of drink per serving and
multiply by 100)
>9%- GI distress
<5%- not enough to fuel muscles
Home made- mix 9 tsp sugar, 1/8 tsp salt and the juice
of 1 lemon.
Dose- Take 5-12 ounces every 15-20 minutes
Carbohydrate Gels
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Best for- endurance athletes who exercise for
more than an hour at a time
What to look for- 70-100 calories and 17-25,
CHO.
Dose- 1-2 gels per hour (30-60g CHO). Take
with 8 oz water to enhance digestion
Good food sources- Honey sticks (1 tsp/25
calories). Take 2-3 sticks per ½ hour
Structure
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Identify musculoskeletal dysfunction
Treatment (e.g. trigger point acupuncture, soft
tissue release, joint manipulation
Optimizing the kinetic chain through corrective
exercise
Exercise- core, strength & hypertrophy, power
Kinetic Chain
Kinetic Chain
Muscular
Articular
Neural
5 Kinetic Chain Checkpoints
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Feet- Straight ahead with neutral ankle
position
Knees- straight ahead in line with 2nd and 3rd
toes
Hips- neutral spine and abdominal drawn in
Shoulders- in line with center of hip joint
Head- center of ear in line with center of
shoulder
Optimum Alignment
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Alignment of the musculoskeletal system
allowing posture to be balanced with center of
gravity
Ability of the neuromuscular system to perform
functional tasks with the least amount of energy
and stress on the kinetic chain
Ideal Posture
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Optimum muscle length-tension relationships at
which a muscles are capable of developing
maximal tension
Muscle Imbalance
Muscle Imbalance
Altered Reciprocol inhibition
(Altered length-tension )
Synergistic Dominance
(Altered force-couple)
Arthrokinetic Dysfunction
(Altered Joint function)
Dysfunction
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Altered reciprocal inhibition- a tight muscle causes
decreased neural drive to its functional antagonist
Synergistis dominance- compensation of synergistic
muscles in order to maintain force production
Myofascial dysfunction (trigger points)
Arthrokinematic dysfunction- joint dysfunction
affecting the surrounding muscles
Faulty movement patterns
Dysfunction Leads to
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Altered neuromuscular control
Tissue fatigue
Injury and impaired performance
Causes of Muscle Imbalances
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Postural stress
Pattern overload
Repetitive movement
Lack of core stability
Lack of neuromuscular efficiency
PATTERNS OF DYSFUNCTION
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When a chain reaction evolves in which some
muscles shorten and others weaken, in
predictable patterns of imbalance (Janda)
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Upper crossed syndrome
Lower crossed syndrome
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Cumulative Injury Cycle
Tissue Trauma
Muscle Imbalance
Inflammation
Altered Neuromuscular Control
Muscle Spasm - Adhesions/Trigger points
STRUCTURAL CAUSES OF
PAIN
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Trigger Points
Muscle shortening
Altered joint mechanics
Abherant motion
Pathology
MYOFASCIAL TRIGGER
POINTS
1.Small circumscribed hyperirritable foci in
muscles and fascia
2. Begins with a muscle strain
3. Site of sensitized nerves, increased metabolism
and reduced circulation
TRIGGER POINT SYMPTOMS
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Local or referred pain
Pain with muscle contraction
Muscle stiffness and restricted joint motion
Muscle weakness
Paresthesia and numbness
Proprioceptive disturbance
Autonomic dysfunction
Trigger Points Can Compromise
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Flexability
Balance
Strength
Power
Speed
Agility
PERPETUATING FACTORS
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Mechanical Stresses
Nutritional/Dietary factors
Metabolic and Endocrine Inadequacies
Psychological factors
Chronic Infection
Other (allergy, sleep, improper breathing,
dehydration, smoking, caffeine, medications,
visceral disease)
TREATMENT
1. Release muscle shortening and deactivate trigger pointstrigger point acupuncture, soft tissue and joint
manipulation
2. Corrective exercise
3. Prevention- core, strength, power exercises
4. Diet/Nutrition
5. Lifestyle modification
“DRY NEEDLING”
(Intramuscular Stimulation)
Insertion of an Acupuncture needle according to
neuroanatomical concepts
THE EFFECTS OF DRY
NEEDLING
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Strengthen Tendons & Ligaments by inducing local
inflammatory reactions (PDGF, Fibroblasts, collagen)
Stimulates stretch sensitive GTO & Muscle Spindles
Mechanical disruption
Treat Overactive Motor Points
Provides Blood & Growth Factors which can disrupt
microscars
Alters Neural Control via neurotransmitters,
endorphins and inhibitory mechanisms
Stimulates Reflex Mechanisms e.g. spinal, sympathetic
and circulatory
SOFT TISSUE RELEASE
TECHNIQUE (Taws)
1. Specific contact is made on the muscle
2. Traction is applied to the tissue in
order to trap the lesion
3. The muscle is moved either actively or
passively through the line of injury
4. The stretch is held for 1-2 seconds
5. Repetitions are done in different
positions and planes of motion (8-10
times)
EFFECTS OF SOFT TISSUE
RELEASE
1. STR stretches and softens scar tissue/adhesions
2. Pain input messages to limbic system are
reprogrammed
3. Muscle length, flexability and memory are
regained
Adjunctive Therapy
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Hydrotherapy- hot, cold and contrast
Kinesiotaping
Supplements: Bromelain, C/Bioflavonoids,
Cal/Mag, DMSO, Glucosamine, MSM, Fish oil,
Biofreeze
Exercise
OPT Exercise Model (NASM)
Functional Exercise
(NASM)
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Multiplanar (sagittal, transverse, frontal)
Involves acceleration, deceleration and
stabilization
Multiple speeds
Varying body positions
Optimum alignment
Integrative Exercise
(NASM)
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Kinetic chain Assessment
Flexibilty
Core stabilization
Balance
Speed and agility
Resistance
Power
Cardiorespiratory
Supportive nutrition
Recovery and regeneration
Periodization
Planned changes in training programs to
facilitate steady improvements by manipulating
volume and intensity
Five Stages:
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Anatomical adaptation- general conditioning
Hypertrophy
Strength
Maximal strength/power
Skill
Anabolic Hormones and Exercise
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Growth Hormone
Testosterone
IGF-1
Insulin
Hormonally Intelligent Exercise
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Short rest- 30 sec or less
Multiple sets- 4 plus
6-12 repetitions
Intensity 65% or more
Large muscle groups (compound exercises- squat,
deadlift, lunge, push, pull, twist)
keep blood sugar levels balanced with pre/post
nutrition
Anaerobic (EPOC- excess post exercise oxygen
consumption)
Stabilisation
(NASM)
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Correct imbalances that could lead to injury or
correct injuries that prevent exercise or cause
dysfunction
Corrective Exercise Protocol
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Inhibit
Lengthen
Activate
Integrate
Stretching Continuum
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Static (autogenic inhibition)- passively taking a
muscle to a point of tension for 20 seconds
Active (reciprocal inhibition)- using agonists and
synergists to dynamically move the joint into a range
of motion. Typically 10 reps of 2 seconds
Dynamic- uses the force production of a muscle and
the body’s momentum to take a joint through full
available range of motion. Used as pre-activity warmup
Strength and Conditioning Journal: Vol. 24, No. 6, pp. 33–37.
Should Static Stretching Be Used During a Warm-Up for Strength and Power
Activities?
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The objective of stretching in a warm-up is to achieve a shortterm increase in the ROM at a joint or to induce muscle
relaxation and therefore decrease the stiffness of the muscletendon system
Substantial evidence is now available to state that static stretching
can impair strength and power performance
Instead, rehearsal of the skill about to be performed, at gradually
increasing intensities, culminating in some efforts that are equal
to or greater than the expected competition intensity. This type
of dynamic warm-up serves to activate or recruit the specific
muscle fibers and neural pathways required to achieve optimum
neuromuscular performance
Summary
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Balanced diet with “power” foods and
phytonutrients
Full-body workouts 2-3x/week, including core,
flexibility, strength and power
High intensity interval training 2x/week
Low-intensity activities 1-2x/week
Don’t stress the small stuff
Get adequate sleep