Letter of Response from Vert Mooney M.D. of San Diego Spine Center - Nationally renown as one of the foremost Spine Specialists in the U.S.

Letter of Response from Dr. Nicholas A. DiNubile - Nationally renown as the former Special Advisor to the President's Council on Physical Fitness and Sports


THE DEATH OF SPORTS MEDICINE
A Response to Explosive Exercise
Roger Schwab

If the concept of explosive exercise and its supposed benefits have been "peer-reviewed" and supported by any bona fide study, justification of the entire scope of exercise science must be seriously questioned. Explosive exercise and the "considerable evidence" of benefits as cited by the authors are far outweighed by common sense. Injuries in exercise are for the most part caused when force exceeds the structural integrity of the involved musculo-skeletal system. Since the limit of this breaking strength is an unknown until exceeded, thus too late and producing injury, it is common sense to utilize exercise with the minimum force necessary to stimulate the desired result.

It took nearly three quarters of the Current Comment on explosive exercise before the authors finally and inevitably surrendered to the ultimate truth, suggesting an exercise program, which has a rate of injury, associated with it. This conclusion renders their position paper worse than worthless; a dangerous self-serving opinion, which should never have, weaved its way into the web of the American College of Sports Medicine. Conley and Stone find the need to explain to the reader that "injuries from strength training including explosive exercise, are rare with rates of occurrence and severity far lower than many sports...adequate safety measures and quality instruction should always be enforced." In this opinion, the above is an admission of the obvious, a before you try it warning that what is being touted here is potentially dangerous to anyone and everyone who does try it, athlete or non-athlete. Common sense dictates that exercise programs designed to build strength should seek to reduce, if not eliminate, injuries. If you have ever witnessed an injury in an Olympic lift, it is almost always instantly obvious, painful to look at and severe. And we're not talking novice here, but experienced world class Olympic lifter. Conley and Stone do not mention that proper exercise, exercise which can and should be performed by everyone, should strengthen the muscles, connective tissues, and bones, and never damage the skeleton. The authors entice the reader to ignore this common sense: If force exceeds structural integrity, injury must occur. And in almost every corner of the athletic arena, from the head-on collision we call football, the battle under the boards in basketball, to the ultimate check in hockey, serious injuries are produced by the high levels of impact force imposed on the musculo-skeletal system of the athlete. (Exceptions being over use sports related injuries brought on in part by athletes perpetually fatigued by training programs stressing high volumes of work which fail to allow overall system recovery. Also, disuse atrophy especially of the neck and lower back brought on by failure to include specific cervical and lumbar exercise. And by the way, do the authors suggest explosive exercises for the neck and lower back? If so, the paper further deteriorates to utter insanity.) To suggest that fast, ballistic or plyometric movement under load in the weight room will produce faster athletes, sufficiently and safely strengthening them in order to optimally compete on the field or play is simply dangerous advice. Fast movements under load will more likely produce injured athletes. It is not fast movements that make you faster, it is stronger muscles. It makes far more sense for any athlete (or non-athlete) to strengthen his or her major muscular structures in the safest way possible, which most definitely are not high, speed, high impact force "speed-strength" exercises. Working major muscular structures intensely throughout the greatest possible range of motion with controlled, smooth movement for a series of 10 plus repetitions will stimulate strength increases for anyone in a safe manner. Build strength safely in the weight room. Practice skill specifically on the athletic field. Though we cannot alter the forces on the playing field, we can certainly improve structural integrity safely through lower force, higher intensity training to withstand these forces. Even if explosive training somehow "appears to increase a wide range of athletic performance", which it almost certainly does not, the potential orthopedic cost would be far greater than the improvement in functional ability.

Can one really believe that athletes should be performing jump squats with a barbell loaded on the cervical spine? Power cleans? Squat snatches? All of these exercises, according to Conley and Stone, should be taught properly to prevent injury (which in itself is incongruous, since explosive exercise produces rather than prevents injuries.) Those who by into this thinking usually have a background in Olympic lifting and its inherent dangers, the root of the problem.

Why the intensity and strong opinions of this rebuttal? Perhaps it is my background as both an Olympic lifter and power lifter. I practiced both during a four year Collegiate career at Pennsylvania State University from 1964 through 1967, setting school records in both activities including a successful 365 pound bench press at 180 1/4 pounds bodyweight with a two second pause at the chest and without the use of a "bench pressing" shirt or any other aids. Squatting was performed in competition with 400 plus pounds. These squats were not partial squats as is the norm today when squats are performed. Rather, these were full squats (competitions dictated lifts below parallel). I also successfully competed in the Olympic "quick lifts"; personal bests including a 240-pound snatch and a clean and jerk of 305 pounds. Not national caliber lifts, but very competitive at the college level in 1964-1967. However, X-rays performed due to nagging neck and lower back pain revealed disc herniations at C3-C7, osteoplytes at every level, a reversal of my lordic curve and narrowing of my vertebral canal (spinal Stenosis) at C7. My lumbar spine showed similar disc disease at L4-5 L5-S1. Major degenerative change at 24 years old! Strong reasons to take a serious look at exercise protocol.

And what did I learn from this? Well, for starters, maybe the spine was not meant to support 400 pounds or that "throwing" a barbell overhead from a pre-stretched position will greatly compromise muscles and connective tissues as will "catching" this barbell on the way down. The cause of my problems was not the barbell; it was my misuse of the tool, a misuse that is at the heart of explosive exercise.

Remember, trainees get older and joint stress accumulates silently. The exercise sins of athletes in their twenties, may not surface until their thirties, forties and even later. When they start falling apart later in life, athletes (and non-athletes) may not realize that their problems were produced by misguided priorities and training principles practiced at an earlier age, injuries that never had to happen if safety in exercise was never compromised.

Conley and Stone are right that athletes and not-athletes can realize their potential utilizing the exact same training program - however, not the training program that these "scientists" advocate.

My advice is that anyone who has ever considered utilizing progressive resistance exercise as a stimulus to improving functional ability and/or performance in sports should carefully read the July 1999 Current Comment from the American College of Sports Medicine. Read it again and then proceed in your own workouts to do precisely the opposite.

"Explosive exercise" is the antithesis of sports medicine, leading to short term nagging injuries and long-term chronic disasters. It cannot be part of a well-rounded training program.

If the American College of Sports Medicine ever achieved any dignity, that moment in time is now gone. And with it dies "Sports Medicine", the catchy phrase once recognized and trusted as the prescription for a safe, sensible medically oriented approach to the field of exercise, a field now adrift in myth and confusion.

The benefits??? Of explosive exercise have now been told - told officially on the letterhead of the American College of Sports Medicine. Shame on you.