Just Some Brief Thoughts About Recent Events

By Mike Stone, William Hornsby, Mike Ramsey, Dan Wathen, Brian Johnston, Meg Stone

Center of Excellence for Sport Science and Coach Education

As most of you are aware the University Iowa American football program has recently had problems stemming from the hospitalization of 13 members of the team (apparently mostly freshmen and sophomores).

This phenomena created the usual pursuit (especially be the media) for someone to blame. No doubt there are a number of coaches and medical personnel who will receive their share (fair or not). No doubt these personnel are searching for answers, and I am sure they are mulling over their own decisions about training that might have led to this event. Undoubtedly, without any prompting, although they will receive plenty, alterations will be made in initiation of training for the future.

However, while the fire is still hot, we will take a few moments of the reader’s time to give our own opinions as to where blame lies:

There is no particular order here – however we would argue that a major portion of the blame lies with the NCAA and other governing bodies for these reasons:

1. Over the past 30-40 years the number of training days allotted has steadily decreased – concomitantly the number of competition days has steadily increased; for example collegiate baseball now plays 56 games in 13 weeks. This was suppose to obviate poor decisions by coaches as to “training all the time” Instead it has allowed many (not all) athletes, to take considerable amounts of time off during the summer, at Christmas, spring break, fall break, thanksgiving, etc. - during this break time they eat more and train less (often not at all) ; they come back to practice/training fatter and out of shape for that sport.

The various rules put in place to limit training time are often not appreciated for their negative effects --- Often, soon after the break there is a competition, for example(s): collegiate volleyball competitions may occur two weeks after athletes return from summer break – thus the coach is faced with trying to get their athletes into “shape” in two weeks, which is not possible or logical – yet their job often depends upon winning each game. In collegiate track and field, training begins in September, and a great deal of effort is expended by athletes and coaches for “preparation” stage training and usually one indoor meet before Christmas break – so, much of the conditioning (not to mention event practice) is lost through de-conditioning across 3-4 weeks of break – then the athlete returns to school for a competition (and often travel) held the first week-end of their return. Obviously, the coach(s) is faced with how to deal with a de-conditioned (to various degrees) athlete in a very short amount of time.

2. NCAA and Athletic departments and academics all must share some of the blame for poor coaches educational programs.

One analogy that seems reasonable is that in many ways being a coach is a like being a medical doctor. A medical doctor must go to medical school, obtain a scientific background so that they can better practice the art of medicine. Logically, it makes sense that a good coach would go to school, obtain a science background and so that they could better practice the art of coaching.

Interestingly, most people in the USA would not send their children (or themselves) to a MD that did not attend (and become certified) medical school. Yet, we consistently do this and allow it to be done with coaches.

One might argue that coaching, especially strength and conditioning, coaching is in a similar state to that of medical education before the advent of the Flexner report of 1910 (Carnegie Foundation Bulletin Number Four). When Flexner compiled his report, many USA and Canadian medical schools were "proprietary", essentially small trade schools owned by one or more doctors, unaffiliated with a college or university, and awarded a degree or certification to primarily to make a profit. A degree was typically awarded after only two years of study. Laboratory work and dissection were not necessarily required. Many of the instructors were local doctors teaching part-time, whose own training left something to be desired. The regulation of the medical profession by state government was minimal or nonexistent. “Physicians” varied substantially in their scientific understanding of medicine, human physiology or pharmacology. There is no evidence that the majority of 1910 Americans were aware of the situation or were dissatisfied with this situation. As a result congress, state and local governments enacted legislation altering medical education. The consequences of this report include some very positive (but some negative) results.

A physician must receive at least six, and preferably eight, years of post-secondary formal instruction, in a university setting;

• Medical training adheres closely to the scientific method and is thoroughly grounded in human physiology and biochemistry. Medical research adheres fully to the protocols of scientific research


• Average physician quality has increased significantly;


• No medical school can be created without the permission of the state government. Likewise, the size of existing medical schools is subject to state regulation;


• Each state branch of the American Medical Association has oversight over the conventional medical schools located within the state;


• Medicine in the USA and Canada becomes a highly paid and well-respected profession;

However:

• A number of medical schools were closed or most were reorganized. The number of medical school graduates sharply declined, and the resulting reduction in the supply of doctors makes the availability and affordability of medical care problematic.


• The Report also led to the closure of the type of medical schools that trained doctors willing to charge their patients less. Moreover, before the Report, high quality doctors varied their fees according to what they believed their patients could afford, a practice known as price discrimination. The extent of price discrimination in American medicine declined in the aftermath of the Report;


• Reuben Kessel (1958) argued that the Flexner Report in effect began the cartelization of the American medical profession, a cartelization enforced by the American Medical Association and backed by the police power of each American state. This de facto cartel restricted the supply of physicians, and raised the incomes of the remaining practitioners.

It can be argued that athletic trainers went through a similar process in the 1950’s – resulting in the NATA and certification. Think about this in terms of today’s coaches, particularly S and C coaches – hopefully we can move toward better education, perhaps certification and greater respect from other professionals.

Consider the following - at present:

· The NCAA has no real educational standards for coaches, particularly as it concerns the strength coaches

· Athletic departments have no real standards for coaches including S &C coach, nor do athletic departments strongly promote coaches education

· Most academic (college and University) related programs, leading to a degree, are based on participation not performance and are generally devoid of classes dealing with the training process, use of monitoring programs, appropriate strength and conditioning practices or how to interface with sport science/sport medicine.

3. Sports Science – hardly any in the USA – there are many Exercise Science/Wellness programs in the USA, there are a few exercise scientists that have done some exercise science with teams from time to time, there are few real sport scientists in the USA (See: What is Sport Science? – www.sportscienceed.com).

4. Sport Medicine – while the sport medicine group has done well at becoming a true profession and performs an invaluable service to sport – one must question some of the practices employed:

1. because of the professional nature of sport medicine (e.g. medical doctors and NATA certified staff) the sport medicine staff are able to “overrule “coaches on training/practice procedures – while this may have many beneficial effects – it is not always in the athletes’ best interest. This assumes that the sport medical staff has a good knowledge of training practices and the training process, which is usually not the case for example:

a. although dying out – the erroneous idea that squats are bad for your knees

b. blaming the weight room for everything – for example – a hand injury becomes a total ban on lifting weights

c. adding in rehabilitation exercises without telling the S and C coach – which alters the “prescription” for training, increases injury potential and may interfere with training adaptation (i.e. adding in endurance activities to strength-power athletes’ training)

d. assuming that the sport coaches and particularly the S and C coach are poorly educated and trained – while this is often true it is not universal (e.g. – not recognizing that the S and C coach may have a reasonable level of education knowledge and experience dealing more directly with the training process)

the above is by no means always the case – however, in observing and discussing issues with AT’s and coaches over the years these problems (a – d) do appear to be commonly encountered.

5. Some of the blame must ride on the shoulders of strength and conditioning who have allowed their profession to be taken over by the sports coach or the sports medicine department. We would argue this stems from:

a. the S and C coach may indeed be poorly educated. This may be partially related to # 2 above. The university based coaches program they received a degree form may not have contained the necessary ingredients to give them a sound education.

b. Many (perhaps most) coaches do not have a degree in physical education, exercise physiology, sport science or anything related. Indeed, they strongly believe that they can learn on the job through “paying their dues” and simply gaining experience. While experience is necessary – it cannot take the place of a sound science background – see number one above.

c. Even for those coaches, especially for S and C coaches, the current environment in sport is that the head coach has the final word on everything (except participating with severe injury). Indeed the S and c coach is looked upon as a service provider rather than a professional. For example: the head coach (or an assistant) makes poor decisions dealing with training of athletes that likely will increase injury or overtraining potential – the strength coach recognizes this but is powerless to alter the course of events.

The S and C coach must bear some responsibility for allowing this to happen. In some cases the s and c coach is well educated, has served their dues, and does in fact understand the training process, better than other coaches and better than the sport medicine staff – they understand the potential consequences of allowing the poor training practice to precede –but it still takes place, often with poor outcomes.

An interesting dilemma, the S and C coach knows better, by allowing the poor training practice to proceed they are sanctioning the activity – however, if they speak up they rarely are heard, not taken seriously by the coaching staff or the Athletic Department and often get blamed for the poor outcome??

Hopefully, the reader will think about what has been presented in this short paper.




Information on the Flexnor Report was modified from Wikipedia and Medicinenet.com