Tales From The Trenches: Directional Bias Programming with Sam Leslie

Directional Bias Programming

By Sam Leslie
November 27, 2017

I’m an unashamed fan of technology for measuring performance, so PUSH bands have become a big part of my work with athletes at MyPhysio Evolution clinic. The instantaneous verification of what I see, combined with the assistance it gives to an athlete’s motivation when used repeatedly for testing progress make it a great little tool for any training or clinic environment. My particular area of research is a concept called Direction Bias, and you can find more detailed information on this topic in a previous article I have written here.

In a nutshell it boils down to a few key concepts:

  1. The body has a preferred way of moving that it finds most efficient, which results in an improved quality of movement and improved power development, called Direction Bias or Direction Preference.
     
  2. Direction Bias/Preference (DB) is brought about by either:
    • an underlying pathology (whether it be symptomatic or asymptomatic);
    • developmental reasons, which can be assessed quite easily with repeated movement testing in a "Direction Bias Assessment".
       
  3. If the athlete is loaded in either in a position or movement direction AGAINST their bias, they will inevitably:
    • lose form;
    • find the exercise harder than it should be; and/or
    • develop symptoms.

These effects will yield less than satisfactory training outcomes. The research I have been doing over the last few years and the testing I do on my athletes support these theorems.

I love the phrase "athlete specific before sports specific" because it encapsulates and explains the reasoning behind the sometimes unusual exercise selections that make up the programming I do. Therefore, the programs I design attempt to train the athlete in a position of comfort or "preference", which strengthens the neuromuscular system in a position AWAY from where pathology may influence movement patterning.

The more robust an athlete becomes across all planes of movement while being kept AWAY from the positions of aggravation, the more their tolerance to that aggravating position improves over time.

Why do I use PUSH?

I get extremely frustrated at therapists and coaches not testing their interventions immediately and expecting that the next week or even 3-4 weeks later that the athlete has optimised their performance improvements. I like to use PUSH to immediately assess the effect of each exercise on a performance measure. I believe that if you can select exercises that deliver immediate positive acute changes, it is more likely that with time these will yield an engrained positive training effect, which of course can be assessed through a more formal testing approach that you can’t do in a weight room.

Case Example – Madii Himbury Mogul Skier

Figure 1: Madii Himbury performing a Back full somersault.

Figure 1: Madii Himbury performing a Back full somersault.

Figure 2: Baseline Repeated Hop Metrics from PUSH iOS App

Figure 2: Baseline Repeated Hop Metrics from PUSH iOS App

This case example is @ausmsa mogul skier and @ausolympicteam hopeful @madiihimbury (Figure 1). In this example we used the RSI Stiffness Test on the PUSH App as our objective measure (Figure 2).

I prefer to use a single leg repeated hop measure in those that are athletically competent to perform the task correctly. As it is part of the standard 3 stage battery of tests used in assessing an athlete’s direction bias plus gives good visual, tactile and biometric feedback to both coach and athlete on performance. In this case baseline average Power over 6 jumps was 1711W.

All of the exercises assessed were posterior chain dominant “extension bias” exercises as Madii was assessed to have an “extension bias”. In short this means that with repeated ‘extension’ movements her movement quality and symptoms improved. All exercise repetitions were 6-8 reps with an RPE of 6-7/10. All measurements were taken 90 secs after the last rep and there was a further 90 secs before the next exercise was commenced.

The first exercise we assessed was loaded rebound depth jump which demonstrated a small (6%) improvement over baseline. Not bad but not that exciting either. Let’s move onto the next exercise.

Figure 3: (Left) Depth Jump Rebounds;  (Right) Corresponding Repeated Hop Results from PUSH iOS App

Figure 3: (Left) Depth Jump Rebounds; 
(Right) Corresponding Repeated Hop Results from PUSH iOS App

Next were Hip Thrusters, a “go to” exercise for those Extension #directionbias athletes and the results increased 17% above baseline. This would receive a tick and inclusion in my programming for this athlete.

Figure 4: (Left) Hip thrusters; (Right) Corresponding Repeated Hop Results from PUSH iOS App

Figure 4: (Left) Hip thrusters; (Right) Corresponding Repeated Hop Results from PUSH iOS App

Next we assessed the Deadlift, which though an Extension "hinge" exercise loads her from a position of relative flexion, making part of the exercise act as "flexion biased" and wow, a 20% loss in power 😔. So we avoid that in her programming, but can we tinker with it to make it beneficial? We’ll find out later…

Figure 5: (Left) Deadlift; (Right) Corresponding Repeated Hop Metrics from PUSH iOS App

Figure 5: (Left) Deadlift; (Right) Corresponding Repeated Hop Metrics from PUSH iOS App

After this drop we try a Nordic lowering exercise (very Extension biased exercise) and boom, her power returns with a PR of 2057W - all within 5 minutess!

Figure 6: (Left) Nordics; (Right) Corresponding Repeated Hop Metrics from PUSH iOS App

Figure 6: (Left) Nordics; (Right) Corresponding Repeated Hop Metrics from PUSH iOS App

As promised we try the Deadlift again but use the Hex bar to raise the torso compared to traditional DL, (i.e., increase the relative lumbar extension) and we haven’t lost near as much power (1948W compared to 1600W). There is still a loss from the last exercise (Nordics), but it is still greater than baseline. So do we include it in the program or not?

Figure 7: (Left) Hex Bar Deadlift; (Right) Corresponding Repeated Hop Metrics from PUSH iOS App  

Figure 7: (Left) Hex Bar Deadlift; (Right) Corresponding Repeated Hop Metrics from PUSH iOS App
 

Well we repeated the exercise but this time put the Hex Bar plates up on a 15cm weight stack so that the initial loading was not done in as much hip/pelvic flexion compared to the previous exercise. And the result? 28% above baseline after 6 weighted sets including 7 x 6 repeated sets of hopping in about 30 minutes - certainly no fatigue effect being demonstrated there.

Figure 8: Resulting Metrics for Elevated Hex Bar Deadlift.

Figure 8: Resulting Metrics for Elevated Hex Bar Deadlift.

Clinical Reasoning

Mogul skiing involves maintaining a position of deep hip flexion whilst negotiating massive flexion forces from hitting each mogul, as well as absorbing the flexion force of landing after two aerial jump within each run. The PUSH band can give us some information on how Madii’s neuromuscular system reacts to repeated flexion loading. The closest exercise we used here was the traditional Deadlift and this left us with a 20% loss in power! Hinting at the likelihood of performance degradation on the slopes with a program that focuses on a “sports specific” deep flexion approach.

However, by focusing on exercises that generate an acute positive performance effect in her programming we hope to create a more robust athlete so that when she is placed under those massive flexion loads in training/competition her neuromuscular system is more robust to handle it. Ie. Train her away from deep flexion but train her to be able to absorb forces that would push her there.

There is still far more research to be done on this, and this is of course just a case study, but “Direction Bias programming” is demonstrating some wonderful rehabilitation and performance effects. The use of PUSH bands allows immediate assessment of the effectiveness of an exercise in a clinical setting that is well within the budget of the private clinician.

About the Author

Sam Leslie has been practicing for over 20 years and working with elite sport for the past 15 years. His experience extends from AFL to cycling to soccer to athletics. Sam is the Director of Medical Services for Nitro Athletics and Head Sports Physiotherapist for Athletics Victoria and Rogue Performance. He has been Head Physio for the Australian team at the past three World Universiade Games, worked with the Chinese Athletic team leading up to the 2017 World Championships in London, and lectures on the APA Sports Physiotherapy course program and DMA Clinical Pilates courses. He serves as a Strength Training Consultant to many of Australia’s best coaches and personally to over 20 of Australia’s best athletes.

His practice, MyPhysio Evolution, is regarded as one of the most progressive practices in the world, nurturing the concept that weak links in a kinetic chain, when corrected, not only reduce injury risk but lead to performance benefits. This is the basis of his current research at the University of Melbourne, introducing the concept of Direction Biased Resistance Training.

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