by David Potach, PT, MS, SCS, CSCS
My goal in entering the professions of physical therapy and strength and conditioning was to improve the lives of athletes and their performance in their respective sports. Most of that has taken place in the United States (treating and training in Omaha, learning and mentoring across the country). I recently had the opportunity to return to a city and country that holds a special place in my heart, Beijing, China.
Five years ago I was invited to lecture at China’s Beijing Sport University. I taught rehabilitation students the rationale for proper treatment of common soccer injuries. It was one of the coolest things I’ve done professionally and I hoped I would be able to return one day. Well, after several close calls over the years, that one day finally happened; I was invited by the Chinese Olympic Committee to return to Beijing to mentor Chinese counterparts and to treat some track athletes prior to their hosting of the World Track and Field Championships this summer. What follows is a sort of diary of that trip with activities and treatment philosophy combining to tell the story of why these trips mean so much to me personally and professionally.
Day One began in the athlete dining hall at the National Sports Training Center (NSTC). Being the non-vegetable lover I am, I stuck with mostly meats (shredded pork sliced thin–think Philly cheesesteak style–a pork meatball, chicken), seafood (shrimp), rice, dumpling, and yogurt. I did a pretty good job with chopsticks, but forced myself to use a spoon for the yogurt. It was a pretty cool opportunity to hang out and eat with China’s National basketball, tennis, gymnastics, and weightlifting teams.
[Read More About Day 1 in China in the last SPT Blog Post]
Today was a little more laid back to start, then ended with the proverbial “bang!” I woke up a little later (6 instead of 4) and decided to walk around the neighborhood in which my hotel is situated. We went to the NTSC for lunch in the athlete dining hall and I worked with some administrative “VIP’s” and more athletes, including:
- Badminton player with shoulder pain (badminton is absolutely huge in China).
- Triple jumper with knee pain; fortunately, he had a video of his jumping technique. I evaluated that and spoke to him and his coach on technique to both reduce his pain and to improve his performance.
- All “VIP’s” (five of them) had low back pain
Then we went for a celebratory dinner at Hongyuan Nanmen Shuanrou. These dinners are always an adventure. Thirteen of us sat around a table and essentially cooked our own meals in a Hot Pot. So many interesting foods (abalone, lamb, beef, greens, tofu, mushrooms, boiled peanuts). Being the picky eater I am, I stuck primarily with meats.
Days Three to Five
On Friday, I traveled to Beijing Sport University(BSU) and remained there until the end of my visit. This is where I stayed during my last trip so it was almost nostalgic coming back. BSU is just a beautiful campus with buildings dedicated to different sports and activities related to sports. BSU was founded as a way to develop coaches and sports rehab personnel to support the various teams China sponsors. For example, there are buildings dedicated to individual sports (e.g., swimming, tennis--including ping pong--and basketball) and activities (e.g., rehabilitation, strength training). Also at BSU is the second of three National Training Centers Beijing has.
NSTC (my first location) is located near the City Center and they focus primarily on basketball, badminton, ping pong, gymnastics, Olympic weightlifting, and some track and field. The second was at BSU and they have some track and field, rhythmic gymnastics, and trampolining. The third I did not go to, but that is located nearby “The (Swimming) Cube.”
While at the training center at BSU, we primarily worked with throwing athletes preparing for the upcoming Track and Field World Championships; these athletes are truly the best of the best China has…and they are treated like National treasures. The government pays for them to train either at one of these three centers or they pay for them to train with a private coach in other countries like Germany and Australia.
The throwers we worked with included several shot putters. It was just incredible watching them work and throw. They were some big athletes (up to 250 pounds for some of the females) who moved pretty gracefully for being so big. The bruising/marking on their cheeks were telltale signs of all their long hours of practice.
Some of the injuries included:
- Low back pain
- Adductor strain
- Shoulder instability
- Ankle pain
Some of the training included:
- Core training, including the Turkish Get Up
Observations and Surprises
- Communicating with athletes and the rehab staff could be a challenge, but not as bad as you might think. When lecturing, I would give four to five sentences and those would then be translated. Does that make the presentation choppy? Not really; the little breaks allowed me time to consider my next thoughts. I kind of liked it! When evaluating athletes with injuries, most did not speak good English, so there was always someone nearby who could translate for me. However, I could often discern the problem based on athlete gestures.
- Surprising to me is how little rehabilitation is performed in China. One athlete told me that she would just “do it on my own” because there is “nobody to help me” in her town. There is so much she could do but it doesn’t appear she has access to the kind of care she will need.
- Back pain is an all too common complaint. This begs the question of why. Possibilities include:
- (1) Poor core training (I didn’t see much of this)
(2) Postural habits. Look at the photo to the right. This deep squatting position is a very common way people in China rest, etc. While it likely has great benefit to other structures (like the knees), it causes a rounding of the low back and may very well lead to the common low back pain we saw.
- I learned not to tell a coach that an athlete is weak in a certain muscle (like hip abductors, etc.); the response from the coach is to add more weight, not focus on proper training. Using terms like waking up a muscle is much better.
- Similarly, trying to have an athlete rest is not conducive to continuing to be part of the program. If an athlete requests time to rest from his or her coach, a common response might be, “OK, then go home.” Meaning, you may no longer train with us, you are off the team. There’s always another athlete ready to take the place of someone who’s hurt.
- Passive treatments (both modalities and manual techniques) are the preferred rehab tools. Therapeutic exercise to fix underlying issues is not commonly used. Whenever I would instruct an athlete to perform certain exercises, they were receptive, but always asked about machines to use (like ultrasound, diathermy). The throwers always liked quick fix manual therapies that likely (certainly?) won’t result in long term gains. While the athletes were more receptive during this trip (compared to five years ago), a lot of education (of coaches, rehab staff, athletes) remains to be done.
The experience treating these high level professional and Olympic athletes will do nothing but help the athletes I work with at SPT. There’s an expectation athletes have when they are injured; while it is similar to the rest of us, competitive athletes need to know that:
- Rest--while it might be necessary on occasion--is not always the answer (try telling an Olympic shot putter or local runner to rest); there are almost always things athletes can do to continue training,
- That the person working with them understands the demands of his or her sport, both physiologically and biomechanically,
- The care they receive is based on research, expertise, and experience. There really is no substitute for it.
I appreciate the opportunity to grow professionally with these athletes and I thank you for the opportunity to share this experience with you . . . I look forward to helping SPT’s athletes like I did those in China!
by David Potach, PT, MS, SCS, CSCS