New Directions for Training and Rehabilitation for Sports: Where We Are, Where We Are Going, And How To Stay Ahead Of The Curve

As always, a summary is included at the end of the article.


Many athletes have knee pain, and are referred to a knee doctor.  This specialist has likely spent years on end learning all about the knee, problems it can have and how to correct these problems.  One recent revelation in both sports medicine and strength training is that fixing the knee by focusing only on the muscles across it (quads and hamstrings) doesn’t really seem to work!  During a squat or a running movement, the knee will only move in a direction that the hip joint and ankle joint allow it to – meaning that if you experience knee pain, it’s probably not your knee’s fault, and a doctor ignorant of what is going on above and below the knee can only help so much.  Looking at the above picture, if you put a healthy knee in those positions, you will be in pain.  A doctor or coach only looking at the affected area can treat symptoms, but if those symptoms are caused by something else, relief from those symptoms will be short lived.  The same trend can be seen in treatment of shoulder injuries, by looking at movement of the thoracic spine.  Where the spine is not strong or mobile, the shoulder will take more of the force.  Prehabilitation by strength coaches and rehabilitation by physical therapists and athletic trainers takes this into account.  We are headed in the right direction!

So what’s missing?  A look at a few fields of research relevant to athletes, where they are, and where they are going.

#1)  Food Combining – we are at a point where we have studied what to eat quite a bit.  While as an industry, we are by no means at a level of mastery about what is the best food to eat, American science has almost completely ignored the way that different foods interact within the body when they are eaten together, and what types of foods should be eaten at what time of day, and how the preparation of food influences not only the amount of vitamins and nutrients in a laboratory.  More importantly, the preparation and combination of food influences how the food is absorbed into the body.  Ask a sick person: nutrients don’t just go into your body and magically make you stronger, they must be absorbed!  With digestion in mind, the Ukrainians, Russians, Chinese and several other countries’ athletic coaches have strong opinions on when to eat what, what goes together, even when to drink water* (spoiler alert: they think we’re doing it all wrong).

#2)  Fascia – The current assumptions that any western coach, orthopedic doctor, trainer or therapist uses is based off of Da Vinci’s belief that the structure within us (bones, muscles) can be explained by the structures that we have built (bridges, etc.)  We say that the quadriceps contract, and act upon the patella tendon to straighten the knee, much like a pulley system.  This understanding of the human body is finally being called into question.  And for good reason:  If it explained the way we worked, modern sports medicine would be a whole lot more effective than it is!  The contracting and lengthening (concentric/eccentric contracting) of a muscle does not explain how we walk, or we would be exhausted every time we went grocery shopping.  We rely on the elastic nature of the fascia to hold our body together* – that’s how Shaolin monks can hold their fighting stances for hours on end – the stances that their grandmasters decided upon were carefully selected based on an understanding of the body’s tensegrity, rendering something that looks as inefficient for fighting as a horse stance an extremely stable combat stance.  An understanding of fascia helps one to understand that literally every part of your body is involved in every movement that you do – if you’ve ever broken your arm, you will notice that your whole body is sore as you walk around in a sling, because a small change in the way you carry one area of the body has an effect on every other part of the system.


An interesting thing to note is that Chinese fighters are taught to use Qi to hold their poses – Qi flows along the Chinese Meridians, which line up almost perfectly with the Anatomy Trains along which fascia run that Thomas Myers and other researchers have called attention to in recent decades.

If you need further proof that this is useful, here is a picture of World Athletics Center (a track & field training center responsible for many Olympians, American and international) athletes using fascial stretching:

WAC stretch

#3) Putting it all together – If you’ve read up on fascia already, you know that nutrition and hydration (NOT the same thing as how much water you drink – diet and lifestyle have a huge effect on how much body your body needs/uses/how efficiently it uses water – but that’s for another post) have a HUGE effect on the quality of the body’s tissues.  Fascia, muscles, tendons, ligaments, even bones act differently when you give them different building blocks.  Certain nutritional deficiencies can show up as tight muscles – for example, a deficiency in magnesium causes athletes to “feel” tight, and are often found stretching like their lives depend on it even if they have normal or above average range of motion.  Certain foods, supplements and herbs can change recovery times from injury, and actually aid in the elasticity (speed, jumping ability implicated here) of parts of your body.*

Connecting something like the amount of stress an athlete is under and how that will necessarily have an effect on the way that athlete recovers from workouts is very difficult, but necessary.  Did you know that cortisol (the hormone released by chronic stress) actually blocks calcium’s absorption in your gut?  I’m sure I’m not the only athlete whose injury woes coincided with other major life stresses!!

Also, did you know that the mineral content and quality of your diet in general affect how your body will react to stress?  I never realized how calmly I could sit in traffic until I had completely overhauled my diet.


-The symptom (i.e. an injured knee) is not necessarily the cause (i.e. the knee pain is caused by a dysfunctional hip)

-One must look at the whole system!

-“Specialists,” doctors or coaches that only specialize in one area of the body or in one skill, will often misunderstand a problem due to their narrow lens

-How we absorb the nutrients of food is more important than the nutrients of food as tested in a laboratory*

-The nutritional benefits we will gain from a food can be exponentially enhanced or completely diminished based on what we eat it with*

-When we eat also matters*

-Looking at the human body as if it were a series of isolated cables and pulleys has proved incorrect

-The “stuff” that holds us together is elastic, and this needs to be accounted for in any working model of the human body, especially for athletes

-Anatomy Trains, or patterns of fascial recruitment in the body, match up with traditional Chinese Meridians.  Shaolin Monks have used knowledge of these meridians for thousands of years to pull off jaw-dropping feats of athleticism

-Although manual therapy and stretching can help improve the quality of this fascia, nutrition and hydration play huge roles as well

-Nutrition, lifestyle, training, mental health, social lives…Everything is interconnected!

-The mineral content and quality of your diet affect how your body will react to stress

-Cortisol (the hormone released by chronic stress) actually blocks calcium’s absorption in your gut

*Future post alert!

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