What impact can Shad Forsythe have on Arsenal’s fitness, injury management and prevention record?

Aaron Eshref looks at the new man’s qualifications and techniques.

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Boxing Day, 2013. Aaron Ramsey leaves Upton Park holding his thigh after pulling up with an injury. In retrospect there’s a strong evidence to suggest it’s the point at which Arsenal’s Premier League title challenge began to lose its way.

In 2013/14 no team lost more players to injury than the Gunners (1). Ramsey’s problem was just one of a long list of injuries that saw Arsene Wenger robbed of key men at defining moments throughout the season.

Abou Diaby’s ruptured anterior cruciate ligament of the season before was replicated by Theo Walcott, Alex Oxlade-Chamberlain sustained medial collateral ligament problem on the first day of the season, Jack Wilshere’s niggly ankle grievance continued to take its toll while the likes of Lukas Podolski, Kieran Gibbs and Mesut Ozil all knackered their hamstrings.

Unsurprisingly, the issue didn’t go unnoticed, with Arsene Wenger admitting towards the end of the season that the club were, “analysing very deeply why the injuries have happened.” He went on to say that he wanted to investigate any link between them.

On social media, supporters were quick to point the finger at Arsenal’s medical team, while so-called ‘experts’ such as Dutchman Raymond Verheijen fuelled the fire with pseudo-scientific rhetoric such as “every soft tissue injury has someone to blame” (2).

According to a paper published by Robert P. Wilder (Associate Professor of Physical Medicine and Rehabilitation at University of Virginia School of Medicine): “Approximately 50% of all sports injuries are secondary to overuse and result from repetitive microtrauma that causes local tissue damage”.

His article goes to on to explain: “Factors contributing to injuries are individual bio-mechanical abnormalities such as malalignments, muscle imbalance, inflexibility, weakness, and instability. Contributing extrinsic (avoidable) factors include poor technique, improper equipment, and improper changes in duration or frequency of activity.” (3).

Applied to Aaron Ramsey’s tendon injury, yes, he might have played too many games with too little rest and he may have been poorly managed by staff, but the factors related to strain and tear injuries are so multifactorial that to make such statements is far too simplistic.

This week, American Shad Forsythe joined Arsenal as a fitness and conditioning coach. He comes with a wealth of experience, most recently spending a decade as part of the backroom staff that helped prepare Germany for their World Cup triumph in Brazil. He’s completed a pre-medical degree, earned a Masters in Biomechanics and is a firm believer in training ‘movement and not muscles’.

What does this mean? Well it can be viewed in both a strength and conditioning context and in a medical context. In conditioning, he refers to movement training as using exercise in a movement context rather than seated static training. Plyometrics, Olympic lifts, multi plane lunges, short sharp agility training, they’re all things that can be football specific and can be recreated on the pitch by players.

In a medical context it means he’d be looking at the forces and mechanisms that cause an injury. Let’s take a look at Walcott’s ACL injury for example. Usually the ACL ruptures when three different forces are exerted on the knee.

By ‘training movement and not muscles’ players would perform movement-based exercises specifically targeting an improvement in the motor control of the knee. In simple terms the aim is to train the body to react to each force one at a time, then over time training the brain and the knee to endure all three forces at once, as might be experienced when twisting and turning on a football pitch. This is in contrast to having players routinely seated on a leg extension machine.

The train of thought is a big breakthrough in sports medicine at the highest level of football. Movement based analysis and treatment is proving increasingly popular amongst elite physiotherapists and osteopaths. The Gray Institute is a driving force behind the concepts of ‘applied functional science’ while companies such as Corkinetic are running more and more movement-based therapy and function workshops with Premier League clubs, the England national team and the British Institute of Sport (4).

Forysthe has been working with world-renowned trainer Mark Vestegen of EXOS, formally known as Athletic Performance, whose research theories are cross-disciplinary. By creating a programme that incorporates sports nutrition, physical therapy, performance training, metabolism studies and neuroscience, they hope to identify more effective and efficient means of curing athletes’ problems. It’s a refreshing evidence-based approach, rooted in the latest reseach and science. (5).

Football has for too long relied on an old-fashioned approach to sports medicine. In many cases physiotherapists and fitness coaches have been in their jobs for a long time, their respective mindsets struggling to shake off the shackles of tradition. Too often injuries have been treated with a narrow minded approach; the ankle analyzed by looking at the ankle and the shoulder by looking at the shoulder. Not enough examine ‘above and below’ or investigate how the body moves as a whole or the effect of football-specific movements on players.

Reflecting again on Wilder’s paper, he says: “Injuries are often related to biomechanical abnormalities removed from the specific injury site, requiring evaluation of the entire kinetic chain”.

The kinetic chain refers to the chain of movement that happens through the ankle, knee, hip, spine etc. Putting into practice this line of thinking will be Forsythe’s job at Arsenal, the hope being that he can combat the injuries that all too often take their toll on the club’s title ambitions.

He works at the vanguard of sports medicine and his acquisition is a credit to both Arsene Wenger and Ivan Gazidis. It’s a coup for the club that could well hold the key to more success on the pitch.

Sources

1. Arsenal in FA Premier League 2013/2014 [Internet]. Football-Lineups. [cited 2014 Jul 15]. Available from: http://www.football-lineups.com/team/Arsenal/FA_Premier_League_2013-2014/Stats/Injuries/

2. Arsene Wenger to blame for Arsenal’s injured players. Available from: ttp://www.ibtimes.co.uk/raymond-verheijen-arsene-wenger-blame-arsenals-injured-players-1440247

3. Wilder RP, Sethi S. Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints. Clin Sports Med. 2004 Jan;23(1):55–81, vi.

4. Who we work with | Cor Kinetic [Internet]. [cited 2014 Jul 15]. Available from: http://www.cor-kinetic.com/who-we-work-with/

5. EXOS [Internet]. EXOS. [cited 2014 Jul 15]. Available from: http://www.teamexos.com/