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Safety First – Stronger Necks = Fewer Injuries
by: Ryan Cidzik Strength and Conditioning Coach, Columbia University
© January 2013
7

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Neck testing and training methods for football are critical ways to reduce injuries. Even though research studies have shown that increases in neck strength decrease the chance of a head injury, there is no national standard for neck testing in collision sports. At the University of Memphis, we developed an innovative program to test, monitor, and strengthen the neck that has decreased our concussions and missed playing time 50% in one year. This past season at Columbia University, we decreased concussions 59% from the previous year. Our system addresses four main areas of concern: 1-Is the athlete insufficient in neck strength? 2-Is the athlete insufficient in neck size? 3-Is the athlete insufficient in neck range of motion? 4-Are we training the neck year-round to address both individual and team deficiencies? We believe that our innovative system gives our athletes the best protection possible when it comes to fighting concussions. HEAD INJURIES AND A STRONG NECK Concussions occur because of linear and/or rotational acceleration-deceleration of the head, as well as axial compression to the cervical spine, which damages brain tissue. Hits to the facemask increase the chance of a concussion due to the rotational acceleration with these types of hits. Concussive hits can cause a buildup of toxic tau protein within the brain, which damages the neural fibers that connect brain tissue. Since the brain is the most complex organ in the human body and is incapable of regeneration, protecting it is critical. A 2007 Neurosurgery study proved that having a stronger neck reduces your risk of a concussion because, with an increase in neck strength and stiffness you decrease the amount of head acceleration following a hit. Not only will strengthening your neck muscles decrease your risk of a neck injury, but it will also likely decrease rehabilitation time in the event of an injury. As strength coaches, we cannot control football technique, injury history, or anticipating a hit. We can, however, control how strong our athletes’ necks are, how big our athletes’ necks are, how much range of motion (ROM) they have, and how our athletes train. RISK FACTORS FOR A CONCUSSION #1: INSUFFICIENT NECK STRENGTH My main area of concern when looking at all of the neck strength tests that have been done, was that all have been done in a research or rehab setting. What I did was take all of the principles supported by science and research and come up with a method to safely, effectively, and reliably test neck strength in a weight room setting. Ten things should be present when testing neck strength: 1. 2. 3. Warm-up properly. Test isometrically. Test static strength endurance.

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if not more. 8. After a thorough level of training has been established. When performing manual work. For hypertrophy work. Whatever training methods you chose to use with your athletes. while any muscle group can be trained several days per week. weighted resistance.. and low intensive workloads. and combo methods. Airex pads. the cervical muscles need different forms of activation and stimulation just like anything else. Once you have tested all of your players. The upper trap. it is suggested that coaches do all manual work on their athletes until all athletes thoroughly understand how to perform it on each other. RISK FACTORS FOR A CONSUSSION #2: INSUFFICIENT NECK SIZE Besides neck strength. and neck circumference. If an athlete’s neck circumference is not proportionate to the length of his neck and/or the size of his head. It is suggested that a Rate of Perceived Exertion (RPE) scale is used on all exercises. and ranges of motion in our neck strength program. 9. methods. the intensity cannot be high every day. If an athlete is below the minimal clinical standards for ROM. Use a firm fixation system. especially on high or medium RPE days. rank them. 10. If they have only been doing neck strengthening exercises with one day per week. which is also very important for dissipating forces. We use three RPEs in our neck training program: high RPE (9 on a scale of 10). there must be a balance between high. the Journal of Biomechanical Engineering. What your athletes can handle in training is dependent on their current level of work capacity. meticulous and serious thought-process as any other muscle group. tempos. why is the neck any different? While predominantly slow twitch muscles. therefore increasing the chance of a neck injury. Test forward flexion. and low RPE (3 on a scale of 10). stability balls. For strength work. extra re-lengthening (stretching) work is needed.American Football Monthly . don’t expect to jump into a four day-a-week program without getting someone hurt.The Magazine For Football Coaches http://www. he/she compromises the ability to move out of the way of the path of the torso during impact loading. So. Always be very critical of 2 of 5 1/18/2013 3:48 PM . If an athlete is insufficient in neck strength. should be trained 1-2 days per week.com/Subaccess/articles. NECK STRENGTHENING METHODS We utilize a variety of exercises. bands. Load the chin and forehead. While most of our training involves manual eccentric-based work. and rotations should be done at least one-two days per week. Articles in Spine.. the Journal of Manipulative and Physiological Therapeutics have suggested the importance of these measures in regards to head injury risks. 4. and that is the case all year long. we use various resistances including manual work. other objective tests that can expose potential concussion risks to athletes are neck length. extra hypertrophy (size) work is needed.php?article. This is important because. Don’t use complex instruments. For recovery purposes. RISK FACTORS FOR A CONCUSSSION #3: INSUFFICIENT NECK RANGE OF MOTION An article in the Journal of Athletic Training showed that if an athlete has decreased cervical spine ROM. We approach neck programming and training with the same. Be sure various stretching and re-lengthening methods are included in your year-round neck program. in which we utilize a variety of methods suggested by manual therapists. If you wanted to increase your strength in the back squat. would you do the exact same workout every day? No. medium RPE (6 on a scale of 10). More often than not. we train the neck 3-4 days per week. 6. first get with the medical staff and find out if the athlete has a current or past injury. hence increasing the chance of an injury. RISK FACTORS FOR A CONCUSSION #4: INSUFFICIENT NECK TRAINING Too many coaches put very little thought into actually training the neck. Second. Keep the chin tucked. heavier resistance using 6 reps or 15-20 seconds of work per set is ideal. Test in a neutral head position. 7.americanfootballmonthly. A proper warm-up is always required. A stiff or sore athlete cannot properly absorb force. coaches just tell their athletes to go do one or two sets of 10 reps on the 4-way neck machine. a medium resistance using 12 reps or 40 seconds of work is ideal for each set. medium. The neck should be trained in 10 different patterns. neck machines. extra neck strength work is needed. 5. head circumference. it is very important that they are not losing ROM due to training or competition. Use enough weight to be safe and effective.

• Upper trap work is done two days per week. • Extra work is needed for those with a lower strength and/or circumference score. Friday is a low RPE day). • Train the neck four days per week. Tuesday is a low RPE day.com/Subaccess/articles. • Re-teach the athlete proper form. neck circumference. and ROM are tested before Spring ball starts. • Upper trap work is done two days per week. Thursday is a high RPE day. Early Off-Season (February) • Train the neck four days per week.. head circumference. and Friday is a medium RPE day). 3 of 5 1/18/2013 3:48 PM .The Magazine For Football Coaches http://www. Tuesday is a low RPE day. • Upper trap work is done one day per week. • Upper trap work is done one day per week. • Begin to physically prepare the athlete’s neck for the physical demands of Spring ball. • ROM is tested as needed with athletes. • Decrease volume to accommodate for the increased stress of practice. • Begin introducing Perturbations which: . Spring Ball (March-April) • Train the neck three days per week.Improves reaction time. • Neck strength. • Train the neck 3 days per week. (Monday is a high RPE day.americanfootballmonthly. neck circumference. Friday is a low/medium RPE day). . and ROM are tested at the start of January. Thursday is a high/medium RPE day.Enhances proprioceptor signals to the muscles. • Your higher RPE day should not be placed the day of (or day before) the practice with the most contact. • Make sure to re-lengthen the muscles post-workout and practice. increase work capacity and begin re-educating the neck muscles.Decreases risk of injury.. June) • Neck strength and neck circumference are tested at the start of June.php?article. Summer – Phase I (May. • Continue to increase work capacity. (Monday is a high RPE day. • Progress the difficulty of exercises throughout the month. (Monday is a high RPE day. Our yearly collegiate neck strengthening and testing progression is as follows: Early Off-Season (January) • Neck strength. .American Football Monthly . neck length. Wednesday is a low RPE day.

you have a much greater chance to have significantly reduced the forces the brain will see. If you see the blow coming and you have a very strong neck and contract the neck muscles. He has been a strength coach in the NFL with both the Cleveland Browns and New York Jets. we can help minimize head injury risks by addressing those issues. Robert Cantu.. usually proprioceptive in nature. Summer – Phase II (June.americanfootballmonthly. including perturbations one-two days per week. • Measure neck circumference every four weeks. • Day two is a high RPE day but with a lower volume than the summer to accommodate for the stresses of the season. • Day three is a medium RPE day. In addition to eight years of college coaching experience – most recently at the University of Memphis – he was the Strength and Conditioning Coordinator for NFL Europe for four years.The Magazine For Football Coaches http://www. Friday is a low/medium RPE day). and ROM are tested at the end of July.com/Subaccess/articles. or training. • Continue more advanced methods of training. • Perturbations should be done one day per week. and make adjustments to the training program if a significant amount of hypertrophy has been lost. In-Season (August – December) • Train the neck three days per week.American Football Monthly . • Extra work is still needed for those with a lower strength and/or circumference score. • Begin more advanced methods of training. • ROM is tested as needed. July) • Train the neck four days per week (Monday is a high RPE day.. • Upper trap work is done one day per week. While we cannot truly prevent all injuries from occurring. • Upper trap work is done one day per week. Pre-Season Camp (August) • Train the neck two-three days per week. • Neck circuits are used to reformulate capacity. ROM. • Most of the neck work is either a medium or lower RPE with full range of motion. • Neck strength.” p About the Author: Ryan Cidzik is the Director of Strength and Conditioning at Columbia University. who just received a $1 million grant from the NFL to study brain injuries said. neck circumference. we need to do our part in providing our athletes with the best protection possible.php?article. • Upper trap work is done two days per week. Dr. If we can determine if an athlete is insufficient in neck strength. • Day one is a low RPE day with focus on full range of motion. • Make sure to re-lengthen the muscles post-workout and post-practice. Tuesday is a low RPE day. 4 of 5 1/18/2013 3:48 PM . Thursday is a high RPE day. “It’s just straight physics. size. • Do not introduce any new exercises in-season.

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