NECK STRENGTHENING PROGRAM

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1 NECK STRENGTHENING PROGRAM The Orthopedic Specialty Hospital (TOSH) is one of the country's premier facilities for orthopedic surgical care, physical therapy, sport specific rehabilitation, sports training, and nutritional counseling. TOSH is the official Sports Medicine and Sports Training provider to Utah Youth Soccer Association (UYSA), and the State Select/Utah Olympic Development Program (ODP). Through the TOSH Soccer Program, we have created a neck and upper thoracic strengthening program designed to strengthen the muscles surrounding and supporting the head. Although there is conflicting research in the area of sports related concussions and traumatic brain injuries, several research studies support the integration of neck strengthening program in youth sports as an injury prevention tool. By strengthening a player s neck and upper thoracic muscles, it improves their ability to control their head after a contact situation. Sports related concussion happen during contact situations. These concussive contact situations may be two players hitting one another during a challenge for a ball, or it could be a player falling to the ground and hitting their head on the field. Many youth soccer players lack the neck strength to prevent their head from hitting the ground after contact with another player. The force of head hitting the ground may be the actual cause of the head injury, but the injury could have potentially been avoided if the head to ground contact was prevented. This neck strengthening program was designed as a tool and guideline for youth soccer coaches to utilize with their players during training sessions. We have provided 2 different types of exercise programs for convenience. The first program is an isometric strengthening program, and the second is a concentriceccentric strengthening program. Details for each program are listed below on pages 3 and 4.

2 Types of Sports Related Concussions (T.B.I.) There are 2 types of head injuries: 1- Coup Injury: occurs on the same side of the brain in which impact or contact was made (i.e. stationary head hit with moving object player hit by another player) 2- Contrecoup Injury: occurs on the opposite side of the brain in which impact or contact was made (i.e. whiplash type of injuries, when the moving head hits a stationary object player falling and hitting head on the ground). - Coup and contrecoup injuries can occur individually or together. - When a moving object impacts the stationary head, coup injuries are typical, while contrecoup injuries are produced when the moving head strikes a stationary object (see image below). The idea behind incorporating a neck and upper thoracic strengthening program is to improve the strength and control of a players head. Essentially increasing the neck strength will: 1. May help players prevent a coup type of head injury by increasing overall control of their head, and potentially decreasing or preventing an initial contact. 2. May help players prevent a contrecoup type of head injury by decreasing the excessive amount of head movement (whiplash) after the body has been contacted by an object.

3 ISOMETRIC NECK STRENGTHENING EXERCISES Isometric Exercises (no equipment needed) 4 Way Isometrics: Isometric (static) strengthening requires a contraction of the muscles fibers, but the fibers do not lengthen or shorten (i.e. pushing against an immovable object). Isometrics are great because they are easy to do and do not require any equipment. The negative aspect is they tend to strengthen the muscle(s) in one position, as opposed to the full range of motion (i.e. weighted bicep curl held at 90 with no movement). Isometric Neck Exercise Lateral Flexion: Place your palm against the side of your head (temple). Pushing hard, provide equal pressure between the hand and the head. Do not allow the head to move, and be sure to breathe regularly. Hold 10 seconds, rest, and Repeat 3-5 times for each side. Forward Flexion: Place the palms of the hands on the top of the forehead. Pushing hard, provide equal pressure between the hand and the head. Do not allow the head to move, and be sure to breathe regularly. Hold 10 seconds, rest, and Repeat 3-5 times. Extension: Clasp hands behind the head. Pushing hard, provide equal pressure between the hand and the head. Do not allow the head to move, and be sure to breathe regularly. Hold 10 seconds, rest, and Repeat 3-5 times.

4 Concentric & Eccentric Exercises (equipment needed) Concentric & Eccentric: Concentric & Eccentric (dynamic) strengthening requires a contraction of the muscles fibers where the fibers are lengthening and shortening. A good example of this is lifting weights (i.e. bicep curl, as the weight is curled up the muscles fibers are shortening (concentric), and as the weight is lowered down the muscle fibers are lengthening (eccentric), both provide different strengthening benefits). Concentric and Eccentric strengthening is very effective, but it does require equipment (resistance tubing). Concentric & Eccentric Exercises Shoulder Shrugs: Standing on the resistance band with good posture, and holding resistance bands with arms at sides, shrug shoulders up towards ears. When shoulders are up, roll shoulders back and squeeze shoulder blades together and return back to the starting position. Repeat 3 sets of 15 reps Scapular Retractions: Have a partner hold the resitance band, or connect the band to an object (i.e. wrap band around goal post) holding the restistance band, keep elbows straight and focus on pinching shoulder blades together. Squeeze shoulder blades back and down. Repeat 3 sets of 15 reps.

5 Lateral Shoulder Raises: Standing on the resistance band with good posture, and holding resistance bands with arms at sides, keep your elbows straight and raise arms to side while going only slightly higher than your shoulders. Slowly lower back down to the starting position. Repeat 3 sets of 15 reps. Front Shoulder Raises: Standing on the resistance band with good posture, and holding resistance bands with arms at sides, keep your elbows straight and raise arms forward while going only slightly higher than your shoulders. Slowly lower back down to the starting position. Repeat 3 sets of 15 reps.

6 Overhead Shoulder Press: Standing on the resistance band with good posture, and holding resistance bands with arms at a 90 angle, press hands above your head while straightening arms. Slowly lower back down to the starting position. Repeat 3 sets of 15 reps Upright Rows: Standing on the resistance band with good posture. Cross the resistance bands and rest arms in front of your hips. Lift both hands towards your chin but stop when hands and elbows are at shoulder height. Slowly lower back down to the starting position. Repeat 3 sets of 15 reps

7 Horizontal Abduction: Holding resistance band in hands, stand with good posture and raise arms to shoulder height. Open arms apart from each other while squeezing shoulder blades together. Extend hands backwards until the resistance bands make contact with your chest, but do not extend back past the shoulders. Repeat 3 sets of 15 reps. Push-Ups: Starting in a plank position, hands shoulder width apart, and keeping body as straight as possible, contract the core muscles while slowly lowering the body to the ground. Touch chest to the ground and push back up. Do not let hips drop, and maintain straight body position. Repeat 3 sets of 15 reps. (If unable to complete a push-up with good posture, modify by doing them from the knees). For questions/comments/concerns please contact: Dustin Bybee, ATC TOSH Soccer Program Coordinator (801) Cell (801) Office Our experience ON the field makes our experience IN the field that much more valuable.

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