So long -term advice for any coaches based on
this research is that it is absolutely shown
that this type of training is effective in terms
of helping enhance power output, which is essential
in athletes that play sport, and protective against
those athletes that are not participating in
strength training, which is often something that
we see a lot of athletes drop off of when their
sport seasons or sport buy -ins increase. Hi,
Emily. It's my pleasure to have you on Evidence
Strong Show. If you could briefly introduce yourself.
Hey, everybody. Thank you so much for having
me. My name is Emily Neff. I am the owner of
Relentless Athletics. We are a female -focused
strength and conditioning facility. We only work
with adolescent female athletes. We've been here
for 10 years. All of our girls at Relentless
play sports, and we have a heavy reliance on
Olympic weightlifting. And this is what I actually,
this population is what I base my dissertation
work on. on utilizing Olympic weightlifting really
as a novel tool for neuromuscular training to
potentially help reduce ACL injury risks. Awesome.
All right. We need some kind of backstory. How
did you arrive here? Yes, in terms of the study.
So basically, I mean, I always wanted to put
what I'd been doing here for the past 10 years
at Relentless into actual work and then to publish
it because I've seen it work year after year
after year in terms of reducing ACL. Just reducing
overall injury rates, as well as being an Olympic
weightlifter myself, understanding the brain
-body connection, how necessary that is to execute
the lifts, but then what that is doing at the
inter and intramuscular level for athletes in
general. So while working with our athletes and
just seeing their movement quality increase,
their rates of injury decrease, comparing that
to their peers who were not participating in
these types of lifts. lifts and looking at their
injury rates, I knew that this was something
that I wanted to, you know, actually put into
research because my population here is so unique
and very far few gyms have this many girls that
are this age that are performing these lifts
that we can then study and get published so that
other people can actually face off. you know,
this type of work. What is specific about this
population? We see spikes in injury in specifically
ACL injury rates occur during the pubescent period
in female athletes. And unfortunately, most studies
when we actually look at the ACL in female athletes
occurs when they're in college, just because
they're an easier population to study because
you don't need parent consent. So if we need
to understand what's going on at the physiological
level that's leading to this increased injury
risk, injury rate, we ask. absolutely need to
study this population. So because I work with
this population, this is really why I wanted
to conduct the study on them and be able to put
the results into actual practice, especially
because when you look at the research in general,
you know, there's a lot of talk now of ACL injury
rates and how that could be related to phases
of our menstrual cycle. Well, if that were the
case, why do we see an increase of these rates
occur during pubescent period and at least one
year from a female athlete? getting puberty,
50 % of her cycle is a novelatory, meaning that
she's not actually ovulating because her hormones
don't spike high enough. So if we want to focus
on female physiology, these things don't actually
add up. But what we do know is that females grow
differently than boys. Males have a neuromuscular
spurt. When they grow, they have an increase
in their not only body size, but their muscle
mass, and then their ability to actually utilize
that muscle mass because of their neuromuscular
coordination. But unfortunately for female athletes,
or females in general, they don't have the same
neuromuscular spurt. In fact, they're neuromuscular
deficit. We see an increase in body size, but
not a concurrent increase in body mass, or specifically
muscle mass. So when that occurs, females' ligaments
and tendons become loose to try to accommodate
for their growing bodies. And this may anecdotally
be what you may say is a female, sometimes after
she goes through puberty, she kind of looks like
a giraffe with her head cut off, and she's just
super lanky, doesn't know how to control her
limbs. Well, that's true, and there's a science
behind it. but we can induce an artificial neuromuscular
spurt, research shows through neuromuscular training,
particularly neuromuscular training that's going
to incorporate strength training and plyometrics.
So if we look at Olympic weightlifting, Olympic
weightlifting itself is going to introduce a
type of plyometric training as well as obviously
strength training because it introduces a progressive
overload. So if we look at Olympic weightlifting,
what a fantastic novel means of neuromuscular
training. research has demonstrated that females
become more interested in or adhere into training
when there is some type of skill -based element.
Olympic weightlifting is a skill. And unfortunately,
when we actually look at studies that look at
the prevalence of Olympic weightlifting utilized
by strength and conditioning coaches, it's at
a very low rate in females compared to males.
So this is something that we need to look at
and study and possibly introduce to female athletes
because not only does it have the potential to
reduce these injury rates, but it also has the
potential because it's skill -based for females
to more so want to adhere to training and stick
with it, which again, long -term will lead to
lower injury rates. Awesome. And there are a
plethora of additional benefits that a female
young athlete will get when they stick to training
for longer. They stay in sports, they use it
as physical activity later and, you know, pass
it down on their family members and so on. So
lots of good things happening now. Okay. This
is what you decided has to be done. Now, how
did you go about designing the study? Who did
you invite? How did you structure the study and
so on? So the protocol for Olympic weightlifting
was actually based on the protocol here that
we utilize at Relentna. So this has been a very
systemized approach to introducing Olympic weightlifting
to females. It's based off of most of the protocol
that's provided through USAID. So with that,
we also simplified this approach. Because we're
a business, we need to make sure that we have
systems that every coach can follow. So our approach
to coaching Olympic weightlifting is top, bottom,
clean only for the first month of training. Obviously,
as long as an athlete can demonstrate proficiency
in like an RDL, a front squat, all of that. But
the main goal is for an athlete to be able to
perform a hang clean while hitting three specific
movement patterns. The athlete is able to maintain
midfoot weight distribution, is able to hit vertical
extension. a distinct start and finish position
of her feet. Because this is neuromuscular training,
this needs to be based on the athlete and her
progression and learning these movements needs
to be individualized. So with that said, if an
athlete cannot hit those three protocol, she
cannot progress to below the knee in the second
phase. Instead, the athlete then moves to the
blocks because this is based out of motor learning
where we need to slightly change the movement,
but stick to the actual goal itself to actually
acquired the new motor skill so those athletes
will just move two blocks with the bar above
the knee same goal to maintain those three protocol
if the athlete is able to mean those three protocol
within that first phase she that is allowed to
progress to below the knee but is introduced
through movement chunking basically where the
athlete performs a hang clean and then a low
hang clean with the paws above the knee and now
the additional protocol or or specific movement
that this athlete is trying to achieve is a consistent
back angle from below the knee to above the knee
because these athletes are only training twice
a week the first like as i said the first four
weeks the athlete is doing just clean variation
she does a clean and a push press for day one
and just a clean for day two as we go to the
second phase the athlete will do either cleans
off the block or clean plus low hang clean based
on how she performed in phase one and then day
two will be a hang snatch same focus focusing
on midfoot weight distribution vertical extension
a distinct start and finish position of the their
feet. And this is how we went about utilizing
the Olympic weightlifting protocol as a type
of neuromuscular training. We are not coaching
athletes up to percentages. We call these, the
whole point is working them up to what we call
a threshold. So working them to a weight where
the athlete is able to maintain those three movement
patterns while hopefully hitting a slightly heavier
weight than they hit the week before, but where
technique is going to always triumph weight as
well as the speed of the bar movement. So that
threshold is basically where that athlete is
able to maintain those movements, but is slightly
challenged. And the goal is to push that threshold
each week. From there, the weightlifting protocol
itself is only going to last 30 minutes. The
remaining 30 minutes of the hour session is going
to be individualized. This is because research
on the actual strength and conditioning training
for the adolescent population is based off of,
it needs to be individualized to that athlete
based on what her motor, her movement quality
is like, as well as where her external support.
How many hours a week is she doing? So each athlete
underwent a movement assessment prior to participating
in the study. And this way, the athlete's remaining
movements, which just consisted of some type
of compound movement, such as bilateral squat,
hip hinge, vertical horizontal press, vertical
horizontal pull, nothing crazy. And some type
of unilateral or split squat type of knee dominant
movement pattern was all based on what their
scores were. And these athletes were then. either
introduced to a barbell front squat based on
their scores or just a kettlebell goblet squat.
So that's how those athletes were progressed.
Very simple linear progression. Phase one is
all about movement exposure. Phase two is about
increased volume of those same movement patterns.
These athletes were all athletes that are already
paying members of Relentless Athletics, but they
were brand new to strength training in general.
So they could not have more than a year of structured
strength training program or training. or else
they would not be eligible. All these athletes
had no significant prior injuries, meaning they
could not have been taken away from sport within
the past year, greater than 22 days due to a
type of injury, as well as, of course, having
any type of surgery, anything like that. We're
very fortunate enough that we also had a control
group. And the control group were athletes that
played on very similar sport teams to the girls
that were participating, because all the girls
that participated were individuals. They weren't
an entire team coming in because it's an individualized
training program. these individuals from the
control group all had very similar training loans,
meaning hours a week of sport, and they did not
participate in any external strength training.
program over the course of those eight weeks.
So that was really unique about this study is
that not only did we have a training focus group,
but we also had a control group that was playing
sport but not participating in this type of training
to then be able to look at the results. And what
we were looking at utilizing force plates is
we wanted to look at two things. We wanted to
look at power production, specifically through
a drop vertical jump, as well as peak landing
forces to see what happens of those two qualities
over the course of those eight weeks across both
groups. And did you test before and after? Yes.
Okay. How many participants did you have in each
group? 15 and 9 were our total at the end of
the... eight weeks that we actually were able
to analyze the results from. Awesome. And you
tested? The drop. Just the drop on the fourth
place. Fourth place. Yep. All right. The only
other thing that we did is that we also looked
at possible confounding factors. We looked at
athletes. This was just through a questionnaire
for their parents, besides asking them how many
hours a week of sport, any prior injuries, as
well as we wanted to know their menstrual cycle
status, if they started their menstrual cycle,
if it was regular or if it was irregular. Oh,
yeah. Are we ready for the results? Oh, we are
ready. Let's go. Okay. So what was most significant
was looking at the pre and post of the actual
vertical jump height in our drop jump. So our
athletes that were performing the strength training
program were able to increase by 129 .7%. Meanwhile,
the athletes in the control group, again, they
were doing the same amount of sport volume, dropped
26. So this demonstrated that this type of training,
which I got into later in the discussion, is
specifically neuroprotective. Because when we
look at previous research that demonstrates that
sport itself is going to cause fatigue and fatigue
is going to influence our ability to produce
power. And females specifically during peak height
velocity are more susceptible toward this type
of fatigue. And therefore... this type of training
could possibly be neuroprotective in the fact
that we didn't see the same drop -off. Instead,
we saw an increase. Now, when we looked at the
ground reaction forces, we actually saw that
there was no change across any group. So in control
or the training group, there was absolutely no
change, no drop -off. Everything stayed very
consistent. Athletes that came in with a higher
vertical were those athletes that also had a
lower peak landing force, regardless if they
were on a training or control group. And this
can kind of demonstrate what you would think
is that athletes that maybe are just more athletic
and more powerful, therefore demonstrate better
landing strategies. And this is just what we
are proposing. With that said, we also suggest
that perhaps because this is only an eight -week
study and we're trying to utilize Olympic weightlifting
as a type of neuromuscular training tool that
is implicit in changing our jump landing mechanics,
we probably just needed a longer duration study,
which is what other researchers suggest that
in terms of motor learning. when we take this
implicit approach, meaning we're not teaching
an athlete how to jump and land. In fact, we're
just trying to enhance movement quality implicitly
through these movement patterns. We need a longer
duration to actually see changes. So this kind
of corresponded with what we expected in the
research, but again, not what we wanted. So that
was the vertical ground reaction force versus
the change across either group. Did you look
at the height of counter movement part of the
drop jump? Did they improve after eight weeks?
Was it the same? Yes. So the training group increased
by 129 % while the control group decreased by
about 26%. Okay. Could we bring it together?
So what would be your advice from this study
for the coaches? So long -term advice for any
coaches based... on this research is that it
is absolutely shown that this type of training
is effective in terms of helping enhance power
output, which is essential in athletes that play
sport, and protective against those athletes
that are not participating in strength training,
which is often something that we see a lot of
athletes drop off of when their sport seasons
or sport buy -ins increase. So with that said,
it really comes down to education. So sport coaches
utilizing these full lifts and utilizing this...
Gilbrate's based approach is essential when it
comes to improving power output and helping decrease
any potential loss of that power output across
demanding sports schedules. Only two hours a
week is necessary to elicit these types of results
and educating parents on, although thinking or
assuming that adding more to the schedule is
actually going to be fatiguing to the athlete.
In fact, we have research that have shown otherwise.
Athletes that are actually adding this two times
a week of training that emphasizes Olympic weightlifting
actually helps your athlete perform better compared
to those that are not, have a drop in power output
demonstrating their fatigue. So having that type
of education for our parents is fundamental to
help this age group in this female athlete population
maintain this type of training, as well as when
looking... And at the dropouts, in terms of only
lost two athletes across that point of time,
it helps underscore that this type of training
is going to help captivate female athletes to
keep coming back. And that's what we need. Sounds
good. Confounding variables. We looked at irregular
menstrual cycles. There was no statistical difference,
as well as athletes that did not have their menstrual
cycle. So when we looked at those, those data
points itself didn't affect the results in either
case. Interesting. Oh, another Pandora box. Exactly.
All right. Awesome. Two short questions to finish.
The first one is, what is your favorite lift?
Oh, the snatch. Most beautiful lift in the world.
No question. And the last question is where people
can find you when they want to see what you're
doing or ask a question. Absolutely. Probably
our Instagram is the best way. So it's at relentless
underscore athletics underscore. That's the easiest
way to really get in contact with me as well
as just what we're doing here at Relentless.
All right. All the best, Emily, for your research
and your work. And thank you for today. Thank
you so much.