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The Myth of Mental Toughness Training: Part II

Part I discussed misapplication of physical efforts associated with military selection courses to team sport athletes and raised questions about what constitutes mental toughness and the degree to which it can be taught.  Focusing less on esoteric constructs like mental toughness and more on preparation is a practical strategy for high performers.  In sport, athletes whose execution remains steadfast despite changes in the internal or external environment are generally considered to be mentally tough.  The distinction between mental toughness and disciplined execution becomes academic when teams take collective measures to maximize preparation.  Rather than fixating on abstract qualities allegedly developed during grueling workouts, civilian organizations would be better served implementing the following training and preparatory tenets of the special operations community:

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The Myth of Mental Toughness Training: Part I

This statement is not in itself controversial but as I am limited to 140 characters on Twitter, it warrants further explanation.  To begin, this tweet was not a criticism of the strength and conditioning programs depicted in the video.  As I was adamant about in a previous post, it is unfair to judge programs based on Internet snapshots, especially when said programs don’t get to control the narrative.  The suggested narrative here is that “extreme” training gives elite collegiate football programs an edge over their competitors by cultivating mental toughness.  The popular media rarely covers the less sensational, more established training that likely comprises the bulk of these universities’ performance programs.  As is generally the case in most fields, the things that really work aren’t always conducive to driving web traffic.

Moreover, the decision to implement “mental toughness” workouts can be mandated outside of the performance staff, often by sport coaches or front office personnel.  Even if these types of workouts serve as nothing more than a brief distraction from the monotony of weight training and running, journalistic pieces like this one are not without consequences.  When impressionable parents and youth sport coaches see that (insert BCS program of choice) trains like a military special operations unit, they often demand the same thing for their 8th grade son/daughter.  It doesn’t matter that said programs might only do this kind of “training” once every few years or when the camera crews are on campus.

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Stress Inoculation and Performance

Today’s multi-part series on stress inoculation and performing under pressure begins with a guest post from Naval Special Warfare veteran and physical preparation specialist Craig Weller: Stress Inoculation Training in Tactical Strength and Conditioning.

For more thought-provoking content from Craig, check out:

​Stay tuned to learn more about what does and doesn’t constitute “mental toughness” training.

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The Façade of Patient Safety Advocacy

  • “Physical therapists shouldn’t see patients without a referral from a physician.  Your back might hurt because you have cancer.  Physical therapists don’t treat cancer.”
  • “Physical therapists shouldn’t be permitted to do dry needling.  They aren’t trained as acupuncturists.  An acupuncture needle can be dangerous in the wrong hands.”
  • “Physical therapists shouldn’t perform high velocity low amplitude thrust manipulation to the spine.  Spinal manipulation is an advanced procedure.”

Health care providers will inevitably compete for potential patients and certain interventions since the legal and practical boundaries that separate medical professions can be blurry.  The divisions that do exist are often more political than pragmatic.  The easiest way to discredit another political party is to portray it as soft on national defense and formulate a doomsday scenario whereby terrorists will rule the earth if said group assumes power.  Similarly, the best way to vilify another medical profession is to allude to all the undiagnosed malignant tumors, punctured lungs, and severed spines that would ensue if a particular group of providers expanded its scope of practice and professional autonomy.  In other words, shared interventions can be to medicine what terrorism is to politics.  The difference in medicine, however, is that the villains are professions with a weaker political lobby and lesser resources, not every potential competitor.  In medicine, we only pick the fights that we can win.  Consequently, many of the dialogues that occur between medical professions are just as mindless and futile as those that occur between politicians.  Lots of words are exchanged but nothing is actually said.

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Case Study: Femoral Acetabular Impingement

Mike is a 32-year-old male law enforcement officer presenting with chief complaint of left hip pain upon transition in and out of his work vehicle and exercises involving hip flexion like squatting (loaded and unloaded). Patient was diagnosed with left Femoral Acetabular Impingement (FAI) with bony growths and a torn hip labrum. Mike was recommended to have surgery to fix his abnormal orthopedic findings after failed attempts at out-patient physical therapy. Patient’s goals are to return to a consistent and non-painful training program for health as well as preparation for occupational demands and selection testing for a specialized law enforcement team next year.

Examination Findings

  • Toe Touch = 2 inches from toes
  • Functional Squat (feet shoulder width, knees tracking over toes) = exacerbated painful symptoms one quarter of the way into decent
  • Hip Internal Rotation = 0° bilaterally – bony end feel – exacerbated painful symptoms
  • Ober’s or “Adduction Drop” Test = (+) bilaterally – bony end feel – 2 inches from table
  • Hip Flexion = 100° bilaterally exacerbates painful symptoms

Continue reading Case Study: Femoral Acetabular Impingement