Giants Win! – The Power of Teamwork

Tags

collaboration, giants, goals, leadership, san francisco, team dynamics, team work

Giants Fan

Wow! What do I do with my time now?  The San Francisco Giants did the unthinkable.  Nobody thought they would win the NDLS yet the World Series.  But they pulled it off and stunned the US.  A friend of mine told me last night that the World Series had the lowest television viewing in 30 years.  Why?  Because the underdog took it?  I have a theory why the Giants were able to persevere and do the “unthinkable”.  The power of teamwork.  When Pablo had a slump at mid season, late season, and post season, somebody stepped it up.  When Torres was out for his appendectomy, Rowand stepped up.  Even though Rowand is the second highest paid Giant, he sat out and let his “hot” teammates do the work.  When Cody Ross (Sorry Doc) got cold, Renteria stepped it up and earned himself MVP.

The underacknowledged component of the Giants team is the coaching and Medical Staff.  These people all get world series rings too… and are well deserved.  The Team MD (Dr. Ken Akizuki) helped keep Uribe in the game with a torn biceps.  The head coach Bruce Boche is responsible for putting together an amazing mid-season roster (Cody Ross, Pat Burrell, and bringing up Buster Posey / Madison Baumgartner).  These pick ups were not sole ideas of Manager Boche.  The ideas were contributed by all coaching staff and even players.  Talk about teamwork.

The following are characteristics of teams according to Larson and LaFasto in their book titled Teamwork: What Must Go Right/What Can Go Wrong.

1. The team must have a clear goal. – Obviously this was to win the World Series.  Some may say that it was also to beat the Padres.
2. The team must have a results-driven structure. – Boche’s ideas on coaching and not being afraid to bench high paying players.
3. The team must have competent team members. The Giants had veteran players Huff, Renteria, Torres, and  Huff who were hungry enough to win combined with new talent Posey and Baumgartner who are destined to make history.  In the education setting this can be take to mean that the problem given to the team should be one that the members can tackle given their level of knowledge.
4. The team must have unified commitment. Despite the obvious variances of backgrounds (southern boys and latino boys all living in liberal San Francisco) the team had a commitment.  This doesn’t mean that team members must agree on everything. It means that all individuals must be directing their efforts towards the goal. If an individual’s efforts is going purely towards personal goals, then the team will confront this and resolve the problem.
5. The team must have a collaborative climate. It is a climate of trust produced by honest, open, consistent and respectful behavior. With this climate teams perform well…without it, they fail.  With Aubrey Huff’s rally thong and locker room leadership, the team was destined to victory despite any mild slumps he had during the final 2 months of the season.  Tim Lincecum and Brian Wilson’s unique qualities combined with the team cultural differences melded into a climate of acceptance through team members slumps.
6. The team must have high standards that are understood by all. Team members must know what is expected of them individually and collectively.  Rowand and Zito (the two highest paying salaries on the Giants) sat the bench when push came to shove because that is what was going to get them the World Series title.
7. The team must receive external support and encouragement. Encouragement and praise works just as well in motivating teams as it does with individuals.  Giants fans!
8. The team must have principled leadership. Teams usually need someone to lead the effort. Team members must know that the team leader has the position because they have good leadership skills and are working for the good of the team. Huff and Posey definitely stepped it up to lead the team and keep them positive.  Manager Boche maintained a good relationship with the team despite making some hard decisions to bench some players when needed.  The team members will be less supportive if they feel that the team leader is putting him/herself above the team, achieving personal recognition or otherwise benefiting from the position.  This is obviously not the case with the Giants.
   

   Huff and Burrell - team mates

So, how does this apply to life?  In my life, it applies tremendously with work.  If the Physical Therapist does not communicate with the patient, doctor, front desk, personal trainer, performance specialist, then the drive to success to achieve goals is a waste of time.  We must have a clear goal, working relationship, external support, experience, and leadership in order to help someone recover from an injury and return to desired activities (sports).  The one thing that was not mentioned in Larson and LaFastos list is FUN.  The team must have fun.  I believe that is if you do not know your team well enough to be Facebook friends or chat about personal life without apprehensiveness, you will be less successful.  After all, exercise and sport was meant to be fun.  This is one of the reasons why I entered Physical Therapy and Sports Medicine as a profession.

Aubrey Huff’s locker room antics carried the Giants through the late season.  The rally thong made light of the pressure of succeeding in the late season.  Sure there were probably a lot of jokes about Huff’s rally thong, but it worked.  And the hideous “Fear the Beard” of Brian Wilson and Sergio Romo showed that the team did not care about appearance.  The common goal and superstitions increased their team dynamics and confidence to kill the opponent pitching staff throughout the late season.

When I look back and remember the GREAT teams I was part of, it all makes sense.  I remember the 92-96 Mitchell, SD  Kernels. We were volleyball and basketball champs multiple years in a row in each sport.  Why?  Because we are ongoing team mates…the majority of the varsity basketball players were also on the volleyball team.  We also had a legacy to perform well.  Coach Gary Munsen had a history of wins.   With years of state championship wins, a town of fans behind you, a lot of talent, and most importantly teamwork, we were destined to win.  Again the underacknowledged contribution to these wins was the athletic training department – they kept us injury free and were huge component to the locker room antics leading us to success.

So, why do we not succeed in our lives now?  We don’t have the passion, drive, and teamwork that many people have in athletics.  This should be obvious in corporate and clinical settings.  Have more fun, foster teamwork, and you will see results.  Is your practitioner hoarding you?  This might be a sign that he/she is not a team player.  If they want what is best for you, they will refer you to the person that will help you most.  Does your employer foster teamwork outside of workplace settings?  This might be the missing link in your happiness in your profession.  Be the “Giant” today and initiate the team dynamics.  Start by wearing the red rally thong.

References:

http://www.ndt-ed.org/TeachingResources/ClassroomTips/Teamwork.htm

Climbing Injuries

Tags

bouldering, Climbing techniques, injury prevention, knee injuries, physical therapy, Rock Climbing, shoulder injuries, sport climbing

Rock Climbing has become a passion of mine since I joined Mission Cliffs in San Francisco 4 years ago.  Although I do not do any outdoor climbing, bouldering has become a primary source of exercise for me. When consistently hitting the wall I see immediate strength and body composition changes.  As a Physical Therapist I have a unique perspective on the training effect and injuries occurring due to trauma and more importantly, overuse.  Although many varieties of climbing exist (bouldering, soloing, sport climbing with belay, competition climbing, and alpine) we will be referring primarily to sport climbing (short belay) and bouldering because these styles are used indoors at gyms.

The Sport and related Injuries

Rock Climbing is becoming increasingly popular among not adrenaline type fitness seekers.  It was known more as an extreme sport, but as more gyms are incorporating climbing walls the sport has grown to 9 million participants each year.  With the surge in interest among non skilled climbers comes increased risk of injury.  The most common injuries in rock climbing are caused by falls and include fractures, sprains, and strains that occur in the lower extremities.  Ankle sprains make up the majority of acute injuries in climbers.  Overuse injuries were reported at 44%, 19% at more than one site in a study published in the British Journal of Sports Medicine.

I am more interested in overuse component because as a physical therapist I have seen an increasing number (or shoulder and knee injuries) in this population.  Hand and wrist iuries are by far the most common overuse injuries, but is not my expertise so I will be focusing on shoulder and knee injuries I have seen in climbers.  This sport requires power strength, endurance strength, flexibility, technique, patience, and TECHNIQUE.  Those who lack technique or are untrained (poor core and shoulder stability or flexibility deficits) are at risk for overuse injury.  At the same time, many seasoned climbers are solely die-hard climbers.  Just as any other sport, climbing requires cross training and balance maintenance through flexibility and strength training.  Climbers develop shortened latissimus dorsi, increased kyphosis and “climbers neck (forward head posture)” which can lead to Upper Crossed Syndrome.  Other injuries include elbow, wrist and hand tendonopathies, and Spinal Pain (which is beyond the scope in this blog).  In addition to overuse, some of the skilled techniques used in climbing can also be problematic.

Problematic Skills

1)  Edging – Refers to placing the leg in external rotation (frog leg position) with the majority of the load through the big toe.  At same time incorporating a lift in the heel will provide additional foot stability for ascending and creating power more securely.  If there is not enough hip mobility/ stability or calf/foot stability the knee can become the fulcrum point leading to sprains, strains or imbalances.

Edging Technique

2)  Stemming –  Refers to using counterforce to support yourself between two spots.  This requires flexibility at the hip and shoulder and joint stability to facilitate extremity stability on the wall when there is minimal  holds available in a corner or between two rocks.  Lack of either can lead to shoulder, hip, or knee injuries.

Stemming Technique

3) Manteling and downpressure –  Refers to the downward pressure through your arms to create counter force or to match your feet to your hands to get higher.  Both of these techniques require a downward pressure and depression of the scapula (serratus activation).  Lack of shoulder or core stability  or enough flexibility may lead to shoulder injuries.

Mantel Technique

4) Straight armed resting, lieback, or “using bone, not muscle” – Refers to locking out your elbows and using counter force with the feet while leaning away from the wall.  Although this technique saves energy and allows you to rest, much of the rest may be going through the shoulder capsular stabilizing structures

Injury Trends seen in Physical Therapy

1) Shoulder Impingement – This is probably the most common overuse injury I see in climbers and is also the most treatable and preventable.  Once the rotator cuff or bicipital tendon become injured or painful, the best thing to do is “active rest.”  As stated before, many avid climbers do not train their imbalances with cross training and will usually get away with it.  With shoulder impingement, rest from climbing is imperative.  In addition, get in the wight room to strengthen the rotator cuff and scapular stabilizers for improved balance around the shoulder.  If posture is the problem, then get on the foam roller and do your corrective exercises to align the tissues around the glenohumeral and scapulothoracic joints (shoulder and shoulder blade).

2) Shoulder Labral damage – Unfortunately this injury is becoming more common and if too severe cannot be treated without surgery.  There are several ways the labrum (the connective tissue surrounding the socket of the shoulder that provides stability) is injured depending on the location of the lesion.  SLAP (Superior Labrum Anterior to Posterior), Bankart, or Hill Sachs Lesion involve different pathologies in the capsule of the shoulder.  SLAP tears may occur from overuse of the bicep tendon (common with pulling movements) or from putting the shoulder in awkward reaching back positions used in stemming.  Bankart and Hill Sachs lesions are usually seen in hypermobility or dislocations which may occur during manteling/down pressure or during falls.

3)  “Lateral and posterior knee pain” – I have seen a myriad of injuries at the knee presenting as IT band Syndrome, hamstring tendonitis or ligamentous instability.  Many of the patients believe the injuries are related to other activities (no trauma during climbing).  However I believe the hip rotation movements seen with toe in and out holds eventually leads to microtrauma in any of the structures mentioned above.  Many people do not know that there are actually three joints at the knee (Patellafemoral, Tibiofemoral and the overlooked proximal Tibiofibula joint).  When technique gets sloppy or there are flexibility deficits at the hip, the proximal tib-fib joint may be repetitively strained and lead to instability.    This combined with excessive calf work required for the heel up technique (mentioned above) leads to dysfunction, cysts, or joint changes.  The same mechanism of injury can also lead to meniscus tears.

The Patellafemoral, Tibiofemoral and Proximial Tibiofemoral Joints

Treatment = Prevention

1. Warm up and Stretch: This may involve several minutes on the bike or dynamic sub maximal movements to heat the muscles.  Many climbers will start with easy routes.  Because these emphasize using the already dominant muscles it is not optimal for waking up the muscles that control balance in the joints.  For warm up and stretching I recommend doing yoga (sun salutations) or lunge matrices with arm movements to loosen up the whole body.  Here is a video of the Gary Gray common lunge matrix.

2. Work on your Imbalances: If your hamstrings or hips are tight, stretch them.  If your lats or pecs are tight, stretch them.  Again this can all be accomplished by doing regular yoga.  Every climber should be doing preventative shoulder stability and core/hip stability exercises.  This doesn’t mean doing more climbing to strengthen your body.  It means finding the exercises that isolate the weaknesses (usually the rotator cuff, middle/lower traps and deep hip rotators).  If you are not sure what your imbalances are, find a trainer or physical therapist.

3. Rest between climbs: I recommend climbing no more than every other day in order to prevent injury resulting from fatigue.  It is best to do your imbalance correction exercises on the days you do not climb which will ultimately enhance your performance and prevent injury.

4. Off Season: Just as you should rest your body between work outs, you should take 1-3 months off every year for recovery.  Every other sport requires an off season in order to allow the body to recover…so does climbing.  This is all part of periodization and strength training professionals have this down to a science.  It works not only for injury prevention, but will also enhance your performance in the long run.

5.  Power Training:  If you do not currently have an injury such as the one described above, power training may be necessary.  For beginner or advanced climbers who are looking to advance their performance this may be the missing link in training.

6. Improve your technique – practice, practice and practice.  Take beginner and intermediate courses. Work out with experienced climbers.  This is by far the most important component of prevention.

Other Options

Unfortunately if prevention does not keep these common injuries from occurring, Rest and Rehab is a necessity.  From Experience, overuse injuries can be frustrating with sports requiring the amount of power used in Rock Climbing.  Many shoulder and knee injuries may ultimately require surgery if not treated conservatively early into the pathology.

Thanks to one of my loyal patients encouraging me to climb, I was hooked.  It is my hopes that the sport continues to grow safely.  The benefits to recreational and fitness climbing are numerous if you train correctly.  Check out the links below for more information on Rock Climbing injuries and fitness.

http://www.rock-climbing-for-life.com/climbing-injury.html

http://abcnews.go.com/Health/story?id=8165004&page=1

http://www.bodyresults.com/s2climbing-flexibility.asp

http://www.climbinginjuries.com/page/shoulders

http://orthoinfo.aaos.org/topic.cfm?topic=A00015

http://www.hyperstrike.com/Rock-Climbing-Workout-Article-105.aspx

Me Gusta Espanol

Tags

Latin music, Medical Mission, physical therapy, Spanish language

Each post tends to start the same way.  How can we manage our time with incorporating necessary duties AND learning into our schedules.  Well, learning a foreign language for many is a daunting task.  We have work, exercise, and social activities on our agendas.  How the heck do you find time to learn a new language?  Because I love the language of Espanol, we will use it as an example.

To begin, you need a base of knowledge of that language including knowing 1-3 verb tenses (past, present, and commanding – you begin to pick up others the more you learn and study).  If  starting from scratch the best way to get that base knowledge is by taking a community college class for 1-2 semesters.  It keeps you on track with your progression and forced to study for tests.  Once the verb tenses and basic vocabulary is ingrained, maintenance is key for continuing to advance your fluency.  Just like any skill, if you don’t practice, you will lose it.  I am not fluent in Spanish by any means but I love the ongoing effort to continue learning in a way that does not require a lot of extra time.

Below are the most helpful ways that I continue working on my Spanish vocabulary:

1)  Podcasts

I went from having a beginners knowledge of Spanish Vocab to intermediate just by listening to Spanish Pod every morning while I was walking the dog.  The key to finding a good podcast is length.  If you want to integrate it into a day that has no minutes to spare, It must be short.  I began with SpanishPod – a daily podcast I found on I Tunes that has multiple levels of difficulty and incorporates real daily conversations into your learning.  It was funny, so I was hooked.  That went well, until they started charging for intermediate and advanced lessons.  There are many other podcasts available on I Tunes to help you get going.

2)  Listen to Latin Music

This has been most successful for improving my listening skills.  I listen to Salsa, Bachata, Reggaeton, Merengue, and Pop latin music.  The sound is very similar to English hip/hop and Reggae (two of my favorites styles) meshing to give a nice Caribbean beat.  Of course, the vocabulary of most Latin music is about love, fighting, and dancing so it is not the broadest of vocabulary to study.   Reggaeton is very similar to English hip hop – fighting, gangs, and derogatory to women but it has a great beat and you can usually pick up the verses after listening a few times.  One of my favorite podcasts that plays this style of music is  www.corrientelatina.com.  The website also has videos, music, and information on entertainment.

For a complete run down of Latin styles and artists visit about.com

3)  Travel to Spanish-speaking countries on your vacation

Immersion is the easiest way to be forced into speaking Spanish for a long period.  Mexico, Central America and South America all have affordable options for vacations.  Some places I really enjoyed were Cabo San Lucas  (Mexico) and Ecuador.   I am leaving for a two-week trip to Costa Rica soon so should come back with improved Spanish!

4)  Practice with your friends and co-workers as much as possible

In California 1/3 people knows more than beginners level Spanish.  I work with people from Honduras, Guatemala and Mexico.  Practicing daily will help maintain your vocabulary.  Have a “Palabra del dia” (word of the day)  to incorporate into your daily conversations with co-workers.  Before you know it you will have 365 more Spanish words and phrases to your vocabulary.

5)  Community College classes

As I said above, taking Spanish I and II are essential stepping-stones to getting a base knowledge.  The other option is listening to Rosetta Stone or other learning series.  In my experience, it is easy to fall off the wagon with the listening CDs and they are minimally interactive.  They are also more expensive ($200-600) than taking a 70$ community college class.

6)  Get our of your comfort zone and just use it

Use it when you are talking to people in your community, your spouse, and friends.  They may appreciate the review as well and it will allow you to review your vocabulary daily as I said above.  Even if you have a horrible accent, Spanish-speaking people usually like to help you out and appreciate that you are trying.  Talk to the clerks at stores, ordering food, and anyone you come into contact with that speaks Spanish.

7)  Work in a department where you are forced to use it

I love what I do for work and have found that the best way to incorporate studying Spanish is to use it while at work.  I don’t have many Spanish-speaking patients in the outpatient clinic I work at, but I float into the inpatient hospital in the Mission district, where there are many Spanish-speaking patients.  If necessary I use an interpreter, but I usually do well enough.  A lot of my Spanish vocabulary consists of body parts, pain, direction giving so I am fairly good in the medical realm, but I couldn’t last a minute in a conversation about politics.  If you don’t and opportunity to work in a place like this, find a place to volunteer (Good Will, soup kitchen or a church).

8)  Medical Missions or other missionary work

This is the fastest way at improving Spanish vocabulary because you are thrown into an environment where you are communicating constantly with patients and community that you are attempting to improve in a short period of time.  Missions are a lot of work but are very rewarding.  I have the privilege of traveling to Ecuador with Operation Rainbow for 3 years and look forward to it every time.  It is unpaid and I donate a whole week of paid time off for the chance to help Ecuadorians improve their health care systems and quality of life.  While there I am essentially giving Physical Therapy as I do every day in the US, however I am speaking Spanish the entire time.  We have interpreters present if I get stuck but by the end of the week can usually hold a clean conversation in Spanish.

Operation Rainbow mainly goes to Central and South America (Latin America countries) with teams of Doctors, Nurses, Physical Therapists and interpreters but NOW they have a team in Haiti.  In the earthquake relief effort, Operation Rainbow would be an excellent organization to give to.

Thanks for following my Blog!  I will be in Central America for several weeks then at Combined Sections Meeting so I will not have a post in February.  Topics in the works for March are:

Climbers Shoulder

Exercise and Depression

Social Media Time Management

The Evolution of the Golf Belt Buckle

MUCHAS GRACIAS!