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SPEED Clinic Helps Athletes Prevent Injury, Improve Performance

The UVA SPEED (Speed, Power, Endurance, Education and Development) Clinic is a world-class program for runners and golfers that combines modern technology with practical experience in sports to optimize athletic performance and heal and prevent injury.

The SPEED Clinic offers advanced technology for biomechanical analysis for athletes of all levels, from weekend warriors and 5K enthusiasts to Olympic competitors.

Learn more about the services offered from Max Prokopy, a UVA exercise physiologist.

Learn more about the UVA SPEED Clinic 
SPEED Clinic Helps Athletes Prevent Injury, Improve Performance
Featured Speaker:
Max Prokopy
Max Prokopy is an exercise physiologist and director of the SPEED Clinic at UVA.
Transcription:

Melanie Cole (Host): The UVA SPEED Clinic is a world class program for runners and golfers that combines modern technology with practical experience in sports to optimize athletic performance, heal and prevent injury. My guest today is Max Prokopy. He's an exercise physiologist and the Director of the SPEED Clinic at UVA Health System. Welcome to the show, Max. Tell us what is the SPEED Clinic and what does it stand for?

Max Prokopy (Guest): Hi, Melanie. Thanks for having me on and I appreciate you getting my last name correct. It's a tough one to pronounce. The SPEED Clinic here at University of Virginia is an acronym. It stands for strength, power, endurance, education, and development.

Melanie: And, what does it do? What do you do at the SPEED clinic?

Max: Over the years we've done many things. We started out as a research laboratory. We had one of the first, what's called a “force instrumented” to treadmill which basically allows people to see exactly what's happening in walking and running in terms of the forces that are occurring throughout the body. That allowed us to do a lot of research on let's say, for example, footwear, like do high heels really change how you walk? Or, even sports performance such as, if you go out for a bike ride, does that change how you run right after you take a bike ride? So, those would be a couple of examples. We're now going to transition our services and it's something that's a little more custom, individual oriented. In other words, an individual athlete comes to try and optimize their performance or, more than likely, to try to figure out why they might be getting hurt.

Melanie: So, what type of patients do you see there?

Max: We see a tremendous variety. We've seen people anywhere from 11-84 years old, primarily runners and golfers, and we see some occasional speed walkers, baseball players and we're developing some stuff from lacrosse and tennis as well.

Melanie: So, how do assessments, Max, at the SPEED Clinic differ from seeing like a physician or physical therapist?

Max: I think number one, you get a lot of time with us. So, a typical assessment lasts about two and a half to three hours, which, in the modern Western healthcare industry, is pretty hard to get time with a medical professional for that amount of time. So, what that means in that amount of time, we're not just having somebody sit around and check their emails for the entire time. We're digging through every little possible facet of what may be going on, and that's all relative to their individual goals. Some people come to us with the goal of qualifying for the Boston Marathon or breaking 80 in golf. Other people want to find out why their right knee hurts that's been hurting them for years and they can't get to the bottom of what to do about it. And then, finally, we can actually work with therapists or physicians in other parts of the country or region to kind of help them; help guide their therapeutic processes. In other words, using our data and our technology to help them understand what the next steps are for the athlete. In the end, what we end up seeing are actually a lot of frustrated athletes. And then, occasionally, we see some really smart ones that say, “I don't have any particular issues. I just want to get a little faster, a little better, “ or, “I run my first marathon and can you help me make sure that I'm doing this kind of thing correctly?” So, those are the people we really like to see. They're thinking ahead.

Melanie: You touched on it a little bit but what type of equipment and technology does the clinic use to help identify, analyze and correct issues that impact these patients?

Max: We have 12 infrared cameras. They can shoot anywhere up to 2000 frames a second and with that, what we do is, essentially, we create a 3-D animation of what's happening in an athlete. And then, more importantly, we can see what happens at every joint in their body that we care to measure. So, if there’s something going on during a motion--walking, running, biking, golfing--we're going to be able to figure out what that motion is and then we can also figure out through some pretty fancy tricks of engineering, we can figure out what kind of forces are happening at their joints.

Melanie: So, what are some of the most common problems for runners and golfers? As you're studying these biomechanics of these athletes, what are you seeing most commonly for runners and golfers?

Max: Well, the most common symptoms in runners, would be knee pain, plantar fasciitis, IT Band syndrome, and then a lot of times what would go sort of unnoticed by them, but I sort of prod and get through it. In runners, we see actually a lot of back pain. They just don't really think that they have it or they don't think it's running related. In golfers the most common complaints injury wise would be back pain, wrist pain and elbow pain.

Melanie: That certainly is so common among golfers. So, when you're working with them, Max, what are some adjustments that you can make to improve their athletic performance with golfers? Are you teaching them better swing techniques, not hitting the ground? What are you teaching them?

Max: First w kind of show them, again, based on their individual goals, how are they moving their bodies, and what's contributing to some of their either complaints or what's holding them back from their goals. And then, coming up with a series of strategies, it could be exercises; it could be drills. It could be just simple technique ideas that will help them kind of break through those barriers. So, the number one thing that we'll look at, especially with runners is their posture. That's probably the most underrated aspect of what a runner needs to be able to do is maintain their posture for a significant period of time. That helps them control the forces better across joints. So, if you think about it, let's take a runner's knee pain, for example, or runner's knee. That's simply a case of overuse. The knee is either taking on too much stress or it's moving too much in a direction that the joint and the joint tissues don't like. So, our job, then, is to help them distribute those forces better across other joints so the knee takes less of a load.

Melanie: So then, let's talk about some other things that you do for them if they have pain relief, if they do have injuries. Do you help them work through that? And, also mental coaching because so much of athletics, especially running and golfing, really takes a large amount of mental concentration. So how do you help them there?

Max: That's a great question. So, I do delve a little bit into pain research. I don't do the research myself. I just read about it. But, pain is clearly a central nervous system, meaning the brain and spinal cord complication, and people can absolutely get trapped in a cycle of pain. In other words, they can either engage in avoidance behaviors or they can get themselves in sort of a defeated cycle. Even your most motivated and seemingly positive people can get themselves trapped in a cycle where they don't think their knee is never going to hurt again. Breaking through that is really important. That's where the data really help. We can just clearly show them that, “This is why your knee is bothering you. It's not like some other crazy thing. You didn't drop out of the airplane,” or some other this kind of stuff. This is exactly what's going on and why, and here's what we're going to do about it. So, we have to show them a path forward that doesn't involve pain or discouragement.

Melanie: And, what about the mental coaching?

Max: Well, the first thing is to help somebody understand that they can make an effective change through fairly simple habits, right? So, if we go back to posture, which I said was really key to running healthy. Posture is simply the accumulation of our daily habits. So, if we sit in a certain kind of chair all day or we repeat a motion at a factory all day, our posture is going to be reflected in that. So, effecting change in those areas will, then, lead to some of the things that we're looking for there. So that's, for a lot of people, a big wake up call. I very rarely have to say much more than that to sort of help them mentally, so to speak.

Melanie: Is there any nutrition advice going on as athletes are trying to increase their athletic performance and optimize it?

Max: We do some consultation there in that sense. Many people come to us with their complaints, their issues or their goals that are so much more immediate that in a session, we will rarely get all the way down to some nutritional fine tuning. But, certainly we do talk, primarily in the case of the people we would see in pain, we certainly do talk about anti-inflammatory strategies through diet.

Melanie: So, wrap it up for us, Max, about the UVA SPEED Clinic--speed, power, endurance, education and development--at UVA and why you want listeners to come there to optimize their athletic performance.

Max: We don't rely on a range of other people’s opinions or this person did x, y and z and so, you should do x, y and z. We rely on taking a lot of time and a fine tooth comb to figuring out exactly what works for you and we have a technology to back that up and, frankly, have the experience and testimonials to back that up. In other words, somebody is coming for their own interests and we do a remarkable job of figuring out exactly what they need specific to their own anatomical needs. So, I'll give you an example. We had a runner come just the other day who ran with the toes pointed together, kind of pigeon-toed and he had 4-5 coaches that were trying to get him out of that type of positioning. After a few tests, we came to the conclusion that that's actually the best way for that person to run. That person never had injuries, they came to us, they were like they want to get faster. All the coaches want them to not run pigeon-toed and I said, “Bud, you should run a little bit pigeon-toed. I'm sorry but that's going to be the fastest way for you to run.” So, this is the kind of story that we can produce in the sense that we are going to take a look at the individual standing in front of us and not worry about, necessarily, generalities.

Melanie: Thank you so much for being with us today, Max. For more information on the UVA SPEED Clinic, you can go to www.uvahealth.com. That's www.uvahealth.com. You're listening to UVA Health Systems Radio. This is Melanie Cole. Thanks so much for listening.