Art of Prevention
Our mission is to decrease the prevalence of preventable injuries and athletes therein optimizing performance by decreasing the time that our athletes spend benched due to injury. We are going to distill information and practices from experts in the field of injury prevention. High level coaches and top performing athletes. We believe this information should be accessible to everyone so that we can reduce the rates of preventable injuries.
Art of Prevention
Bridging the Gap: Enhancing Performance While Reducing Injury Risk in Gymnasts with Dr. Kayla Keck DC
In this episode I sat down with Dr. Kayla Keck DC and discussed all things gymnastics. We spoke about a range of topics from injury prevention to performance and bridging the gap between the two.
Dr. Keck helped us elucidate some of the differences in how normal soreness versus the sharp twangs of injury may present and feel amongst young gymnasts. These signs are always important to look out for as we try to notice and address small injuries before they become larger and more intense ones.
Load management and a progressive return to sport with proper loading was a major theme of the episode. We discussed how more traditional models of physical therapy and chiropractic care can miss the mark on addressing the root cause of an athletes pain. In many instances simply applying treatments to address pain do not solve the true reason why the pain is there, and does not adequately prepare the athlete to return to gymnastics.
We will certainly be having Dr. Kayla back for a part 2. If you are in the Dallas/Mckinney area or would like to reach out to her via instagram the links are below!
Website:
Instagram:
@drkaylakeck
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Welcome to the Art of Prevention podcast, where we take the best evidence, experience and practices and we synthesize that information to help you reduce your risk of injury. Today I'm speaking with Dr Kayla Keck, who is the owner of Perfect 10 Rehab and Performance. Today, the topic is gymnasts how do we keep gymnasts performing at a high level while also reducing their risk of injury? So, kayla, thank you so much for coming on to the podcast today and letting me interview you and pick your brain for a little bit of time. How about you tell us a little bit more about Hi?
Speaker 2:Nick, thanks for having me Super excited to be here. You talked on what I am and what I do a little bit, but I was a gymnast growing up from the St Louis area. I started gymnastics at a very young age. I was four and dove right in competitively, was a gymnast until about the age of 14, 15. And then I transferred over to cheerleading, where I cheered at the University of Missouri after that, but basically got to where I am.
Speaker 2:I was injured a lot as a gymnast and back then I know it wasn't that long ago I would get injured. I would go to the orthopedic doctor and they would tell me to rest, or they would put me in a boot or a sling or something to rest. Whatever was hurting for four to six weeks and then they would say you're good to go, and then I would go back into gymnastics. Either that was still hurting or I would hurt something else very soon after, and it was just this repetitive cycle. And so it was.
Speaker 2:At that point I realized like there's a huge missing piece here. Um, in you know our world, we call it that kind of like the bridge from rehab to performance. Um, but to be honest, I wasn't getting the rehab at all. And when I was getting the rehab it was this very like cookie cutter range of motion. Here's a piece of paper, finish it, come see me when you're done, sit on the bike for 20 minutes, whatever.
Speaker 2:Um, and I realized later on, you know, um, that wasn't super helpful. Um, and there's this huge gap in the gymnastics population, and getting them back to performance and not only to performance, but safe performance, um, without the risk of injury, so really that like risk reduction was missing. So as I went through chiro school, I knew that that was the population I wanted to focus on, and I felt like it was just my calling to just kind of give back to the population that I was a part of for so long with the knowledge I have now. So I'm truly passionate about this group of people. I love them dearly and I really feel, like you know, I have now. So, um, I'm truly passionate about this group of people. Um, I love them dearly and I really feel, like you know, I have something to give them and I get super excited over this stuff. So thanks for having me.
Speaker 1:Awesome and I'm I've. We've got a couple of topics that we were discussing beforehand that we really want to dive into. Um, and I love that you talked about that, that gap, you know, because that's something that we don't really appreciate so much. Like if we talk about something seemingly innocuous like the ankle sprain, which happens a ton in gymnasts right 23,000 ankle sprains happen every single day in the United States. And if you're somebody who's just a hobby jogger or just you know, walking around on the sidewalks and your ankle melts over a curb, then it may not be the worst thing in the world to just kind of do that rest, ice compression, elevation, the rice protocol, and then if your normal activity is just walking, then it's not that tough to get back to walking.
Speaker 1:But when you're dealing with a very active population like you and I deal with, if we just do that rice protocol and then we go back to ultra running or we go back to rock climbing and bouldering or, in your population specifically, go back to the extremely dynamic floor routines or jumping onto the balance beam or all these other just amazing feats of physical activity, without the proper rehabilitation and true strengthening, bridging that gap, like you said, that's when we can run into more chronic issues.
Speaker 1:So I'd love to hear a little bit about this, maybe a concept of the spectrum of injury and something that people can look out for, because we have those acute injuries, like that ankle sprain, but we also have, like these small aches and pains that start to build up over time and can lead to compensations, and also these overuse and chronic injuries and in my opinion, in my experience also can predispose one to more catastrophic type of injuries, where there is something that is like the straw that broke the camel's back and then we tear something or do something that you and I can't fix and then it's like now you actually need to see the ortho. Can you tell us about some of the small aches and pains that you see consistently that, if not treated appropriately and we don't bridge that gap appropriately, can lead to those more nefarious manifestations?
Speaker 2:Yeah, absolutely, and this is a multifaceted question and I have a million things swirling in my head, but the biggest thing that jumps out is low back pain, and this is just an absolute epidemic in gymnasts. And I don't have all the right answers, and we're, you know, continually searching for all of the right answers, but this is the biggest thing that I see that presents itself in these smaller aches and pains, until it's just not, until it's this massive blowout and it's like, ok, well, now we do have to do the rest. We do have to do, you know, complete shutdown of everything, because we've completely ignored it. And you'll see that a lot in gymnasts, right, for a number of reasons, they brush things under the rug. They're, you know, these extremely tough individuals that are putting themselves, you know, under extreme amounts of pressure and load, and so they'll brush things under the rug. They'll, you know, brush it off as soreness. I started a new skill or whatever, and I'm just sore from this, right. And then what happens a lot of times is I'll get them when we're kind of progressed. Maybe we've been dealing with this little bit of low back pain for six months, right, and just for so long they're like it's fine, it's fine, it's fine, whatever. Maybe it was only hurting during the skill and then it's sort of progressing to now like we're waking up with pain, going to bed with pain, um.
Speaker 2:So I think, uh, recognition of injury versus soreness early on is super, super important. And this is something I talked to all of my gymnasts and their parents about is how can we distinguish between an injury and something just being sore? Um, and again, this is kind of like when you have somebody give you a pain scale. It's like it's hard to know exactly what the gymnast is feeling in that moment. But there are a few things that I ask you know. One is like is it a mechanical type of pain, right? Is it only hurting when you do something, or is it like this agonizing sharp pain that you're having at all times, right? So I think timing of pain is super important in gymnast. And then the other thing is like soreness is really never sharp, right? So if we're experiencing some type of sharpness, we're probably past that soreness level and we need to you know further, investigate, um.
Speaker 2:The other thing that I'm finding is, um, one many people don't know about you and I, right, we sort of are I don't want to call us new, but like we're this sort of, they're just chiropractors, you know they should they're not our first go to. We go to the you know ortho first, whatever. So what I see a lot of is is they've gone to the ortho first. The ortho has then put them out, maybe, you know, in the beginning stages when they probably should have been loaded and, like you know, worked on some tissue tolerance in the beginning. So we've rested, maybe for X amount of weeks or whatever.
Speaker 2:They go back into the gym and realize it's still there and then I happen to be the next person they find right, or maybe they did, you know they went to the ortho and then they went through like the hospital, physical therapy, whatever. And what I find there is, you know we say the word like rehab. Purgatory happens where it's like, okay, we rested, went to some type of physical therapy, did some type of rehab. We go back but like it might be a little bit better, but it's not healed right, like we're still experiencing it and it's frustrating because we just did, however, amount of weeks of rest, rehab, all the things.
Speaker 2:And what I'm finding the most in that little path is whatever they did in rehab was not comparable to what they're doing in the gym. And so I like to have relationships with the coaches, with the doctors who they're seeing too, because I try to emphasize, like you said, somebody who sprains their ankle and their goal is to get back to walking, their rehab process is going to look extremely different than somebody whose goal is to get back to all four events, right. And so trying to communicate that with the orthos like hey, they need more than just a dead bug, right, they need more than just, you know, some band work, right, like they need to be challenged, because if they're not being challenged, nothing is changing, right, and I say that a lot Like if we are not challenging you here in the office, it's not changing anything outside of the office. And so I think what happens most times is we do get stuck in that bridge. Right, we're trying, like okay, we had the rehab, we're feeling better, but then like we're not quite ready for the performance part, right. So it's this piece in the middle that I see a lot where it's like it feels a little bit better, I go back to gym, it's still bad, right.
Speaker 2:So really finding I think the progressive loading process for a gymnast is different, obviously, than any other athlete, because the statistic is like when they're doing a floor routine, they're coming down at 19 times their body weight right. So we can't think that, like doing a calf raise is going to prepare them for 19 times their body weight right. There's just in a lot of ways, like in a lot of different parts of your body are affected by the 19 times your body weight right. Your every single joint in your body your ankles, your low back, like all of these things are affected by that, and so we can't be, we can't truly believe that you know, three sets of 10 heel raises is going to translate into being prepared for that.
Speaker 1:Yeah, with no added weight or anything like that, but luckily they did some stretching beforehand so they'll be ready to go Right. Obviously that's a little bit of sarcasm. I talk to runners and we're talking about every foot strike is seven to eight times body weight going through the ankle. But then you get to gymnastics and the numbers are just a crazy higher, you know, and that's because you're using springboards, you're using different implements and it's just such a fascinating world that I'm personally just starting to learn more and more about, which is one of the reasons that I brought you on so many different things to unpack, with all the things that you just talked about, from low back pain to the types of forces, to the types of rehabilitation for these athletes.
Speaker 1:Why is low back pain such a nefarious problem? And let's say, I'm a parent of a 13-year-old gymnast and they're coming in. They've had some back pain for a little bit of time and we tried the six weeks of rest and things like that and things just didn't seem to get better. What are your recommendations or what are the things to look out for? Like, hey, this is an injury, it's not just soreness. So you mentioned that sharp pain. Are there any specific things with specific implements that you're like, oh yeah, when they a lot of my gymnasts with back pain and and um, you know, I don't necessarily want to fear monger, but what are some of the things that that low back pain that we brush under the rug can lead to? Some of the more catastrophic type things where it's like, oh, now we have to shut you down because of you have a par stress fracture or you have a disc herniation, et cetera.
Speaker 2:Right, um, yeah, I mean, you hit the nail on the head there. Um, we don't want to fear monger, but the thing that is the overarching like we don't want this to happen would be the pars fracture in the gymnast right, and we're seeing it a lot and we're seeing it in younger athletes, right. The biggest thing is just body positioning of those athletes, right, they spend so much of their time in that extended arched position that I mean it first presents itself as like a nice little facet syndrome, right, and then but inevitably I'm not getting them at that just like nice little easy to treat facet syndrome, we're getting them at the oh, is this a pars fracture? Right, like, do we have to worry about something a little bit more sinister here? But the thing is, with a facet syndrome you know it's an overuse injury at the beginning, right, it's like we, we've, we've gone into this position, we've, we're, maybe we are increasing our number of skills or we're going up a level, we started new skills, whatever it might be. This is when we see this the most right. Um, we start to just get into that overuse injury area, um, but then they push through it, and then that's when we become at risk for those facets. I mean, um, pars, fractures and things like that.
Speaker 2:I do see, um, low back pain is is such a fascinating thing because, like anything else, excuse me there's just so many different pathologies and and just different things. Right, and, and I think the biggest thing to remember in a gymnast always is that N equals one, truly like, every single gymnast is different than the next, right, um, what I'm finding a lot, uh one, is their lumbar spines just do not move into flexion at all, right, so we're like sort of sort of stuck in that like excessive lumbar lordosis, and then they're also jamming it further into the lumbar lordosis, over and over and over and over again, right, what I do see this leads to is then, if we have some type of fall or movement that's quick and they're not prepared for it and they do jam themselves into flexion, we can also get those like disky pathology symptoms, those types of things too. But then we run into this thing where it's like, okay, they did this fall into flexion, have a textbook disc herniation, disc pathology, but we can't treat them the same way as as another person who might have had the same thing. We can't treat them the same as me who bent down to pick up a kettlebell and, you know, had some type of pop in my back and whatever. Right, our go-to there is to extend them. Right, a disc loves extension, but then you translate this into a gymnast and it's like they hate extension. So, with that being said, like you can't just take this gymnast into extension, right, um. So you have to, you have to get creative, you have to find that directional preference still, but it's harder because they don't like either direction.
Speaker 2:Right, a gymnast with that situation is like sort of stuck in this holy cow. We just need to stabilize, right, um, but we're we're seeing a lot of it is they just have no control over the lumbar spine. Um, into flexion. It's just like stuck in this lumbar lumbar lordosis. And then what we're also finding if you go above the lumbar spine is we're super kyphotic. Right Shoulders, upper back, are leaning forward. That limits our movement into flexion of the shoulders, a whole bunch of other things. So then we're dumping into the low back even more. Right, we can't extend through anything else. We're not flexing through the shoulders properly. Maybe our hips aren't extending. Well, we're dumping into the low back every single time.
Speaker 2:So there's just so many things to look at, and I've done a talk a couple of times about different areas of the body that we need to look at if a gymnast is presenting with low back pain, because if you're just looking at the low back, you're missing something, you know, and I think that is a huge gap. It's like these gymnasts go to a doctor, to whoever, and they're treating the low back, which is great. Obviously, that's where the pain is and we we need to treat the low back. But why did they have the low back pain in the first place? Right, are they able to extend well through their hips? Are they moving well through the thoracic spine? Is their shoulder moving well, right? It's like all of these little things that aren't little, right? It's like when they're moving like they are, we have to be sure that everything is moving like it should, so that the low back pain or the low back just isn't taking every single force over and over again.
Speaker 1:Yeah, that was such a wonderful explanation of back pain and all the different causes of it, and so, just for some of the people that may be listening and aren't quite as clinically oriented, the facets in that facet syndrome that we're talking about, those are just some of the really small demands that we place on gymnasts, because it is very much an aesthetic type sport where you have to do things a certain way, whether that's great for your back or if it's just okay or not so wonderful. And oftentimes it's that repeated motion, over and over and over again. So it's not necessarily the movement that's the issue, but the number of times that you do that movement, and so that extension is bending backwards, flexion is bending forwards, and when they're asked to extend so many times throughout the course of the training session, the training week, the training month, the training years, that's when we can lead to those overuse injuries and left unchecked it can then progress to something like the stress fracture, which is similar to something like a breaking of a bone, but not quite to the same extent. And in a stress fracture type scenario where somebody more likely or more commonly will have that night pain or pain first thing in the morning, things like that. If that's also left unchecked because we have these really really tough individuals that really want to perform well and love gymnastics, want to do well for their parents, etc. It can actually progress to that full-blown fracture and then we can get structural changes in the low back slash lumbar spine, can get structural changes in the low back slash lumbar spine. So, wow, you just did such a great job of explaining all of those things so well.
Speaker 1:And I think also the thing that you talked about as far as like the N equals one or like every person's an individual. That's one of the really big separators between like you and I versus like the general, like big box PT or going to just a traditional chiropractic office. Not to say that anything is wrong with those, they certainly have their purpose in their place, but when you go there you're more likely to get the general low back protocol. You know the packet of exercises that is kind of famous you know, with just like the dead bug and the bird dog, which are great exercises when used appropriately. But if somebody can't move their hips appropriately, then the back is going to take up all the slack there and if they have excessive rounding in their shoulders and their upper back then in order to get into those postural positions that are necessary for the grading system and doing well in the sport, then again it's going to put more stress on the low back, just like what you just so eloquently talked about.
Speaker 1:One of the things that you've been introducing with a lot of your athletes is not just treating the pain because you know, to be honest, like if we look at ourselves and what we do, like it's like it'd be, you'd be better off if you just want pain relief, to take some Advil or go and get an injection which, for multiple reasons, isn't the best thing for the long-term health and performance. What are some of the things that you're doing to bridge that gap? Like, let's say, somebody does come in and you're like okay, so we've gotten you out of pain. But you and I both know getting back to performance it's not over once you're just out of pain and this is one of the fall off points for a lot of people. They go oh, my kid's not complaining of this pain anymore, so we're just going to go right back to gymnastics.
Speaker 1:But you and I both know there are still those deficits, whether it be a deficit in the motion or control at the hip or above, in the mid back, that need to be addressed in order for that athlete to have long term high performance and health. So can you speak on some of the things that you look out for? And then it's like, hey, once we get you out of pain, that's when phase two happens and that's that bridging the gap stage. What does phase two look like for a lot of your, your patients specifically?
Speaker 2:Yeah, so that is what, like pretty much what I focus on in here. I always separate it into buckets and I've tried to find these different systems that I can like communicate well to the athlete, the coaches, the parents, everybody, so that we're all on the same page. Um, and I separate them into buckets. So bucket one is like passive care. You're maybe it's an acute injury and we're, you know, trying to increase range of motion of the ankle, we're trying to control swelling, we're doing all those things that, like they need help with right, like they do need my help with right. That's bucket one. Then we moved on to bucket two. This is more of our, like, corrective exercise and we're really talking about an acute injury here, right, so you know, if it's an ankle sprain, okay, our range of motion is back to where we need it to be, swelling is managed, we're walking without any limp, without any pain, all these things. Okay, we need to start some corrective exercises of some sort, right, once we're we're and this is where we lose a lot of people right, we're out of pain, we're doing things 95%, you know, of what we did before. We're not worried about instability of whatever. Um, but it's really bucket three that we have to put more emphasis on right, and this goes for any injury. But that.
Speaker 2:Bucket three is progressive loading. Right, that is load management, increasing the load of whatever they're doing to get them more well-prepared to go back into gymnastics full force. Right, I'll mention this a lot. But, like, bucket two is full of like ankle cars and we need to be doing maybe this is our heel race phase, right, we do have to do those things, and I'm not saying I never do a heel race, but what I'm saying is that heel raise is not preparing them for what they need to be doing in the gym, right? So that third bucket, our load management bucket, progressive loading bucket is where we lift weights. Right, we introduce higher loads so that when they go back into gymnastics they're better prepared for this 19 times their body weight when they land.
Speaker 2:Right, we, we again just can't think that, like, if we're out of pain, that equals good, right, um, and so we stress this a lot. Like I'm, of course and I caught myself saying this a lot I'll say I don't care about the pain. That's not true. But I'm not worried about the pain, right, the pain is there because we hurt ourselves. But what we need to be really worried about is the function right. So that's when we're looking up and below the chain of whatever's going on.
Speaker 2:Right, if it's the low back, this is where we start to load up. We need to be looking at loading into the hips. We need to be loading into the shoulders. We need to be doing all these things so that, when we go back and we have to use everything, we're actually prepared and we've like, managed the load up to the point of, okay, now we're ready to go. Right, we can't just like, okay, the range of motion is back, their pain is, you know, mostly under control. They can just go.
Speaker 2:So this is where I think our job is the most important to explain this to them. Like, we have to be introducing load that is equal to or greater than the load that they're going to be experiencing in the gym, and that's where we're missing every single time. Right, and I'd be lying if I said I didn't lose a lot of athletes here. Right, it's time, it's money, it's all these things, but like, truly, the bucket three, the progressive loading bucket, the introduction to managing that is so, so, so important, but we're having a hard time getting there right, but then what happens? That's where we get in that rehab purgatory. So we've done that.
Speaker 2:Okay, maybe it's an ankle sprain. We've done bucket one, we've done bucket two. They're feeling great, so they go off. You know, hey, I'm good, I don't need to come see you again. We will inevitably see see them again, maybe for an ankle again or maybe for something else, but it's because we, we let them fly a little too soon, right, and I always tell them it's not that I don't want you doing anything right now, but like, this is where I see a lot of this, where maybe they went, you know, mainstream ortho, whatever they get released, what does that mean? Like we have no idea. We don't have guidelines, right For many things of whatever released means right, and even if you do look at some of the guidelines, they don't.
Speaker 1:Air quotes released.
Speaker 2:Right, it doesn't translate into whatever a gymnast is doing, right. And so that's the biggest question I get from parents and a gymnast is like, hey, I'm released, what can I do, you know? And so that's when we have to work backwards and it's like, well, what do you want to get to and how do we get there safely? Because, like, just releasing you is so dangerous, right? So you mean to say, okay, we've done the bare minimum, right, even if you know you've been doing some like. You know, a lot of times gymnasts will say, well, I'm, you know, I've just been doing basics or whatever, I'm trying to rest, whatever, but that's still like a 10 times increase when they go from just doing basics into like whatever they're trying to do. If they just completely go, you know, chains off, we're going, and so really trying to find that ladder of progressive loading.
Speaker 2:Is is where you and I come in and where we thrive and where we need to communicate better to our parents, coaches, gymnasts that, like this is, this is the land we want to live in, right? And I love when I get an athlete who's just like they come in and the parents are like we just really want to, you know, better prepare ourselves for injury. You know, risk management, all those things. Cause I'm like, yes, this is where we are, we can take it from the bottom up. We look at how they're moving, what's missing, and we can go from there and it truly does help out, right, like even if something that we've, dr Natalie and I, have been saying in here and you, I think, called it risk reduction, which I love, we call it like injury management or preparation, right, we don't necessarily prevent every injury that comes our way, and we'd be silly to just say that whatever we're doing is completely preventing injuries, because sometimes things just happen, right, exactly.
Speaker 1:Yes, but what does?
Speaker 2:happen is if we are correctly loading, if we're correctly managing our body and all the ways, not just like our point of pain, if we're making sure our hips and everything are moving well. When an injury does come along, it's quicker, right. We have better prepared for that moment to happen and we'll get out of it quicker.
Speaker 1:Yes, I totally agree, and it is funny, like, with the name of the podcast being Art of Prevention. People love to bring up the fact that you cannot prevent every single injury. It's like, yeah, I totally understand that. But if you think about it from a kind of backwards scenario, we could create programming that causes injuries right, and no one would argue with that, right. So it's like, well, there's obviously a middle ground here where we can have the programming and things necessary and things in place to reduce the risk of injury, and that balancing act between enhancing performance while also not enhancing risk of injury is where we try to find ourselves, and that's where coordination with the coaches comes into play.
Speaker 1:Load management when they go back into the gym. So like, if you're dealing with somebody that has an ankle injury, it's like, hey, like going and getting on the trampoline or the springboard not the best idea. It's like not the time to work on your most intense floor routine. You might need to be doing things into the foam pit for a while, and that's where you take that N of one and you go. These are your modifications for right now.
Speaker 1:This is what I don't want you to do, this is what you're safe to do and I'm going to talk to your coach and tell them to keep an eye on you because it's not the coach's fault. The coach is working on performance enhancement. But they may have I don't know 10, 15, 20 kids in a class and they don't have the time to spend the entire hour, or however long that class is, with your individual child and we can tell the coach, give them the rundown like hey, keep an eye on this athlete for these specific things, and I don't want them to do X, Y and Z, because we are going to be working on those and I'm going to do the best possible job of improving their capacity so that you don't have to worry about it as much.
Speaker 2:Yes, a hundred percent.
Speaker 1:You also mentioned strength training, which before before the conversation, you're like oh yeah, nick, we're talking about strength training, right? And I was like, yeah, of course. Uh, cause it's so funny, you caught me off guard with that Cause that's something I talk about all the time with my running athletes and all the people that just don't want to strength train, um, and then you talked about the implementation of that with your gymnast and I was like duh, light bulb moment, like we need to be doing strength training and that slow heavy training. In my opinion, like, oftentimes, the, the preventative things are the things that they're not getting.
Speaker 1:So gymnasts, it's like ballistic, dynamic, very powerful athletes and incredible athletes, but what they don't get are some of those slow heavy movements to prepare some of those tissues as a foundation for those dynamic things. So what does some of the strength training look like for some of your athletes and where do you find, like, best implementation? Um, cause I know these athletes are busy and they're they've got a ton of training on the books already. How do you implement strength training, like um. And then also, if I could get a little commentary on, like, maybe, age groups that it's appropriate to start, um, maybe we could talk about some of the myths surrounding strength training too, cause I think there I bet those abound for sure.
Speaker 2:There's a lot yes, um, yeah, um again lots of things to say on this topic, and I mentioned to you before what I'm currently doing is by no means perfect, but I think you know, as more research comes out about strength training and the importance of strength training, I'm learning, and I'm learning by experience and I'm learning by doing, and what I found is definitely doing is better than not doing. But the biggest thing is I've said this a lot and I truly, like my life revolves around load management and what I find a lot of. And when I first started really working with the gymnasts, I'm like, well, we need to strength train, we need to do all these things. But, like the issue becomes these gymnasts my high level gymnasts are already in the gym like 30 hours a week, right. And so when their parents ask me, like, well, what is the best thing we can do for recovery, I'm like go home and eat and take a nap, right. Like that's truly like get a good night's sleep, eat a good meal, like those are the things we need to be focusing on, right. So I do have to be careful and, like you know, at what point is it just too much, right, at what point is it like this strength training is doing more harm than good, right? And so I also mentioned there are different hours of the week happening at different times of year and there's an in-season, there's an off-season, but honestly, in gymnastics it's always in-season, right? Like there's an in in season where they're competing, and then there's an is is really look at their training schedule and is it actually going to benefit them to be implementing some type of strength training, right?
Speaker 2:Um, and I will say, in the summertime we do have a little outlet to to become available here, but I really don't want these girls training more than 30 hours a week. Like, that's just silly to me for them to have 30 hours a week of some type of training and then me put an hour on top of that of strength training, right? It just doesn't really. It doesn't really make sense. Um, what I do find is that when we do have somebody coming from an injury and their load is way less in the gym, this is the prime time to be like let's hit it, right, because we do have that access to. They have a little bit more rest going on so we can load them a little bit more, right?
Speaker 2:But I also think from a preventative space. We need to start prioritizing that type of movement, right? How do we expect our bodies to be under this type of load if, you know, in the gym and I'm not racking on you know conditioning at all, the gymnastics conditioning is some of the best in the world as far as, like, sports specificity goes, like they are truly training specifically. But like we have to do something different, right? Like just how a runner needs to do more than run, like a gymnast needs to be do more, you know doing way more than just their conditioning.
Speaker 2:And so I think finding things that complement the conditioning that they're doing already well, is the important piece, right? So, and this doesn't mean that they have to and you know, I think parents get a little scared. They're like I don't want my girls, you know, underneath a huge barbell and stuff, like you don't have to do that, right, like that's not what all strength training looks like. And and that's what I love to do is like, how do we make our strength training match what they're doing in the gym, or at least compliment what they're doing in the gym? Well, you know and I've had this conversation with a lot of people before when you know we talk about sports specificity and making things sports specific, like some things aren't meant to be sports specific right Like a squat, doesn't need to look different for a gymnast than it does to a runner.
Speaker 2:Right, when we're squatting, we're purposefully doing that for the sake of loading. Right Like a gymnast needs the same type of strength, right Like composition, that a runner does right. And so it's like we get sometimes too far into the weeds and the nitty gritty of like this isn't sports specific enough, Like that's okay, you know, like the point of cross training and the point of load management and that kind of thing is like your movements can look different and that's okay and that's good.
Speaker 1:Yeah, and then at the end of the day, it's like we're not just dealing with a gymnast here, we're dealing with a person.
Speaker 2:Right.
Speaker 1:You know, it's like they may have a life outside of gymnastics one day, and it might be good to prepare them for that as well.
Speaker 2:Absolutely.
Speaker 1:Gosh. Well, I know that you've got to run here pretty soon.
Speaker 2:Maybe we'll do a part two of this.
Speaker 2:I don't want to leave without talking about the importance of core stability. I didn't get a chance to dive in, oh my God. Yes, but I think that that is the number one missed thing in gymnastics is focusing on core stability rather than core strength. Right, and what we'll hear over and over again from the coaches, from the parents, is like well, she's ripped, she has a six pack and I'm like cool, that's awesome.
Speaker 2:But like, are we able to use our core the way that it was designed to be used, right? Like, are we able to manage the loads and transfer loads? Well, because we're using our core right. And what we're finding in research and in experience is that, like, the more we can focus on that, the job of the core and using the stability job of the core, it truly will reduce the risk of injury. Right, and that's a missing piece. But the other missing piece of that is like a dead bug isn't enough, right? We can't just do a dead bug and expect that that's going to just like miraculously make them this extremely stable, injury proof, individual right. It has to be specific to the athlete. Um, you know, each one can be different, but we have to be actually loading up the core and stabilizing the core in more than just the dead bug.
Speaker 1:Amazing. Wow, I know that you've got to run, so I think we need to get part two on the books right now, because I have so many different things that I want to ask you about.
Speaker 2:We can absolutely do part two.
Speaker 1:So I will let you get to the rest of your day. Thank you so much. If people have questions or want to email you or want to find you, if they're in the Dallas area, how should they find you?
Speaker 2:Yeah, on Instagram I am Dr Kayla Keck, so just dr Kayla Keck, and then my email is the same dr Kayla Keck at gmailcom.
Speaker 1:Amazing. Well, thank you so much and I will be in touch so we can get get part two on the books and rolling Thank you, thank you.
Speaker 1:I hope that you enjoyed this episode of the Art of Prevention podcast. If you did enjoy and or benefit from some of the information in this podcast, please be sure to like, subscribe and share this podcast, or please give us a five-star review on any platform that you find podcasts. One thing to note that this podcast is for education and entertainment purposes only. No doctor patient is formed and if you are having any difficulty, pain, discomfort, etc. With any of the movements or ideas described within this podcast, please seek the help of a qualified and board-certified medical professional, such as your medical doctor or a sports chiropractor, physical therapist, etc.