November 7, 2023 • 49 mins
Standardized testing is commonly performed in the health and performance world to determine baselines, monitor performance, or help return an athlete to sport.
The lower extremity has received most of the attention, but the ASH Test, or Athletic Shoulder Test, popularized by Ben Ashworth, is a great option for the upper extremity.
In this episode, I talk to Ben about the ASH test and how to best use it for both rehabilitation and performance.
Save on Ben's Online Courses
Also, Ben was super gracious, and has a big discount for you on his new online courses on the testing and training of the athletic shoulder!
Full show notes: https://mikereinold.com/testing-the-athletic-shoulder-with-ben-ashworth
Want to learn more from me? I have a variety of online courses on my website!
Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
On this episode of the sportsphysical therapy podcast, I'm
joined by Ben Ashworth.
After years spending time infield sports, such as rugby and
premier league soccer.
Ben is now focusing his time onhis new venture athletic
shoulder.com.
And he's also consulting withteams and individuals to help
solve shoulder performanceproblems.
He's the inventor of the Ashtest, which is something we're
(00:23):
going to talk a lot about inthis podcast episode.
I'm really excited for it.
Welcome to the Sports PhysicalTherapy Podcast.
I'm your host, Mike Reinald fromMike Reinald.
com.
GMT20231009-170407_Recordi (00:38):
Hey, Ben, welcome to the podcast.
Thanks so much for joining me.
How's everything going?
Mike, it's going well.
Thanks.
It's been a long time since wesaw each other.
What is it?
About two weeks?
No, we, uh, we take a severalyear gap every now and then, but
then we see each other for abunch and then we'll take
another few year gap, maybehopefully less and less.
(00:59):
Exactly.
No, it was good to see you theother day.
Um, I managed to fight, managedto pin you down for, uh, for a
short time.
I know you're a busy man, so.
Yeah, no, it's, it's always fun.
I mean, we, we've met in thepast, just, you know, um, I
think it's always fun to, tokind of geek out about things
that you're really interestedin, right?
And I know you and I both have apassion for the shoulder, so I
(01:20):
thought that was, um, you know,pretty good.
So anytime I can hang out withBen is always fun.
And I, I recommend all ourlisteners.
If.
You see Ben in a conference oryou, you, you see him coming to
a seminar near you, go check himout because I think the post
course dialogue is probablygoing to be epic, right?
Something that you'll reallyenjoy, uh, hanging out with Ben.
He's, he's a great mind.
(01:41):
Is, is that a fair statement youthink Ben?
Uh, I don't like to sort of, uh,self, self promote.
It's very nice of you to saythat, so, uh, it's, it's great
to hear.
It's always nice to get feedbackfrom, from, you know, people
who, uh, know this area reallywell.
And I remember reaching out toyou.
on my own personal developmentjourney, um, about, I think it
(02:03):
was 2016, something around that.
And I just wanted to go andspend some time with people who,
uh, could add value to what I,you know, thought I knew about
shoulders, um, as I started todevelop my knowledge.
So yeah, I, I'm hopefullymaintaining a level of humility
rather than, rather thanbelieving, believing I'm a world
leading, world leading expertyet, but, uh, certainly I'm
(02:25):
trying to, I'm trying to developas we go.
So.
But, but I think that's whatmakes you great at your job
though, in all honesty, it'syour, you're going through a
personal journey and you'resharing it.
And I think to me, that's,that's always the best type of
education.
Yeah, that's, I think what thesepodcasts are for as well, isn't
it?
Sometimes you choose a podcastso you can have a good
conversation with someone.
(02:46):
Um, that's what I do with our,with our podcast too, is we
invite guests on that we want tohear from, uh, and spend some
time with.
So yeah, hopefully it's the samethe other way around.
Yeah.
Likewise.
Well, well, for my listenersthat may not be completely
familiar with your work, um,even though they, maybe they
are, and they don't even knowthey are, but why don't you
start off a little bit aboutsharing a little bit about,
(03:08):
about your journey so far, um,and what you're currently up to.
Cause I know you have, you havea great past, you know, working
in, in, you know, the soccerworld, the football world.
Um, but I, I know there's somuch more to it than that, but,
um, why don't you share witheverybody just a little bit
about your journey so far.
Yeah, I'll keep, I'll keep itbrief.
Um, it's basically a 25 year,um, physiotherapy, uh,
(03:34):
practitioner who has worked in anumber of sports.
And I started out in rugby, uh,professional rugby in about
2002.
And then I went into Olympicsports where I saw a load of
athletes from summer and wintersports.
Um, develop some understandingaround strength and
conditioning, which reallyhelped, I think, changed my
(03:56):
career, actually, gave me a bitmore breadth to my understanding
of the whole spectrum of, youknow, return to performance and
return from injury, and thenwent to Arsenal Football Club,
one of the Premier League clubsin the UK, great opportunity.
Very lucky to get that job, um,with lots of applicants and not
being from football myself.
So I then used that job, workedwith a brilliant team for six
(04:20):
years, um, at the sharp end.
Uh, had some midlife retirementand then was called to Europe to
be the director of performancefor Sparta Prague, which is a
European, uh, soccer team.
And then since finishing therelast year, which is a choice
based on coming back to family.
Uh, in London, I then started togrow my own business, so I'm
(04:43):
exclusively now working, um, assort of directing my own, my own
company, Athletic ShoulderLimited, which, uh, has, as
we'll talk further about, I'msure, um, been sort of growing
on a number of fronts over thelast year.
Yeah, that's awesome.
It's been fun to watch thiscareer too, just as I've gotten
to know you over the years andkind of see all these
(05:04):
developments and really startingto build out this athletic
shoulder company that in yourwebsite and your educational
products that you're starting tocome out with now, I think
they're going to be reallygreat, great resources for
everybody.
Um, I'm excited about it.
Um, I gotta ask though, youknow, you have a lot of past
experience in like, The fieldsport world, which I don't
necessarily think of as ashoulder type situation.
(05:26):
Oh, I guess rugby is right.
Rugby has a lot of contact and alot of, um, issues like that.
But, um, being in soccer for,for so long, um, what got you
into shoulder injuries?
Yeah, actually, I mean, that wasthis sort of funny thing.
I didn't go to Arsenal forshoulder injuries.
I went there for the money.
Let's be honest.
Um, and, uh, I, I sort of,shoulders had passed me by in
(05:51):
rugby because there was quite alot of contact collision.
And then.
Um, we, we saw a bunch ofdifferent athletes from
different sports.
I worked with a few judoplayers, a few boxers, um, and
some other like gymnastics andyou know, all, all the sort of
Olympic sports, but notspecifically shoulders.
Um, so it was only when I becamethe judo physio in 2009, as part
(06:14):
of my English Institute of Sportrole that I was.
Almost knee deep in shoulders,right?
We had 24 percent of ourinjuries, our time loss injuries
were knees and 23 percent wereshoulders.
So I suppose I could have becomea knee specialist, but those are
easy, right?
Right.
I thought, I thought I'dchallenge myself a bit and, um,
(06:35):
you know what it's like, yousort of.
Start to read, um, then you'vegot to rehab five label rehabs
at the same time, you getbetter, you make some mistakes,
you learn on the job and thenpeople start to ask you for help
in that area and that was justpart of the, the evolution of my
shoulder understanding.
And then I just kept that on.
(06:55):
I enjoyed it a lot.
I worked with some good people,setting up some early courses.
Um, people who I could gaingreat value from and I kept
conversations going outside ofthe day to day job.
I've, you know, I've always beensomeone who, who, uh, isn't a
nine to five, uh, in terms of,in terms of work.
And I engage with people, youknow, like yourself and, and
(07:18):
Eric Cressy and, uh, and KellySturrett and whoever else would,
would, would be out there thatwanted to, wanted to share
ideas.
And got speaking to teams in avery non threatening way.
So, uh, you know, people wouldcontact me about it.
I'd offer to present to them andfor a number of years, um,
developed some really goodrelationships, uh, as I started
(07:42):
to sort of build a betterunderstanding.
So I think that's, that's itreally, you know, like, over
that time, shoulders have becomemore and more of an emphasis.
And carving a niche out actuallyreally helps you in any, in any
other, you know, body part area,because if you can understand
the framework and a model aroundone area, and you can really see
(08:03):
the full spectrum, you can applythat to hamstrings, hips, knees,
ankles, whatever else you're,you're dealing with and
recognize your, Your level ofability, you know, so if I see a
complex hit now, uh, which israre, but if I did, I'd send
them on to my good friends whoare, you know, who are, who are
(08:24):
much better at that top 10percent than I am.
So, right.
No, I, I, I always think that'sa great way to, um, You know,
and when I talk to early careerprofessionals, we always talk
about making sure you're, youget really good at the basics
first, right?
Understanding the basics, but,um, there's so many benefits
from following like a strictniche and actually starting to
(08:47):
develop your competency in onearea.
Um, I, I think that's a greatpoint.
It's, it's, you're, what you'redoing is you're building out a
framework that you can usethroughout the body.
So, yeah, I mean, I think that'sa brilliant way of putting it.
So, um, you know, I appreciatethat.
You've done this because I knowfor me, when I look at the
literature and I look at some ofthe things that we do for the
(09:07):
shoulder, um, I've always feltlike we've been missing
something when it comes tofunctional testing, right?
We, um, I feel like we're reallygood at the basics with the
shoulder measuring mobility,strength, those types of things,
but, um, return to sporttesting, functional testing.
Uh, the upper extremity is justfalling behind the lower
(09:28):
extremity, right?
I think we all know that.
So, yeah.
It was really neat to see youstart focusing on this and a big
part of your career has beenbuilding some of this functional
testing and monitoring systemsfor the shoulder.
You developed the ash test,which may be the best branding
of anything I've ever seen in mylife.
By the way, I love it.
You know, Ben Ashworth with theathletic shoulder says it's just
(09:48):
perfect.
It's perfect though.
Your parents were, wereBrilliant.
Um, but you developed this Ashtest several years ago.
Why don't we start with that?
How'd you come up with the Ashtest?
What is it?
Tell, tell everybody a littlebit about it if, if they haven't
heard about it before.
Yeah, it was a, it was ajourney.
So it's a sort of, um, um, amarriage of a couple of things.
(10:09):
It's, it's the actually working,looking at lower limb injuries
and trying to, trying tominimize those in, in, in, uh, a
premier league football club,looking at hamstring isometrics,
working out how you can set up amonitoring system.
And at the same time, one ofthose conversations, as I said,
outside of Arsenal was, was withSaracen's rugby club and they,
(10:30):
they had some issues withplayers who were breaking down
in contact and return tocontact.
So that means they're reachingand trying to produce force with
long levers.
Um, and again, trying tostabilize the shoulder in space.
In a tackle, but they wereseeing players who could parcel
the normal tests, rotationalkind of cuff testing in close to
(10:54):
the body, and they would sendthem out when they pass those
when they could bench press whenthey could move a lot of weight
in the gym, but they were stillbreaking down with symptoms.
So it was this great sharp groupof people, including Daniel
Cohen, who's a force platformexpert.
Um, uh, myself.
Physio who worked in rugby allthe time, strength and
(11:17):
conditioning coach.
So there's Laura Cullock, thephysio, Paddy Hogben, the
strength coach, sitting downtrying to solve this problem.
And I literally went intoArsenal one morning, thought
this is how we test our ISOhamstrings, and then put the
plates on the floor and juststarted to push into them.
And that's how it came about.
Can we find something to help usunderstand and quantify long
(11:41):
lever stress?
across the shoulder girdle inthe same way we were using it
with great success in the lowerbody to look at posterior chain
load across the pelvis, whichwas a If you want to call it
hamstring test, so that's how itcame about.
And then the initial resultswere great.
The feedback from services wasthis is starting to pick up
stuff we're not seeing in our,in our cuff testing.
(12:02):
Okay.
And so there's a knowledge gapthat we were filling, and they
saw historical shoulder injuriesthat were showing up as weak.
They saw neck injuries that wereshowing a reduction in force,
stingers, burners, those kind oftransient issues as well.
So there was some hope for itand some confidence that we
built around the initial stage.
(12:23):
And we thought, right, becausewe're scientists, really,
underneath it all, we want tolook at the reliability.
So we published a very non sexypaper, um, back in, back in 2018
around the reliability of theASH test.
And I think that's reallyprobably what started this
introduction of this concept tomost people was probably seeing
(12:45):
that paper, right?
And, and then starting to seeyou apply it and see how you've
kind of used it over the years.
I know it's something thatwe've, we've all wanted to learn
more about.
So, um, if.
If the person listening hasn'tseen the test before and you
should, by the way, I'll putlinks to it.
I know it's an audio podcast,right?
So it's a little interesting tovisualize sometimes, but walk us
(13:07):
through it a little bit.
Tell us a little bit about whatthe test procedure is, because I
think it's easy to visualizewhen, when you describe it, but
we'll put some links into it andinto Ben's website so you can
make sure you see it, but walkus through the test procedure
and what is involved with theASH test.
Yeah, so the ash test is a, weget the, we get the player lying
(13:27):
on their front, uh, in prone andwe push down into the force
plate.
So we're pushing, if you like,into almost horizontal flexion,
horizontal adduction.
Um, but it's in three positions.
So we wanted to capture thedemands of overhead positions in
rugby.
They'll, they'll score a trywith the arm in a.
(13:49):
In a fully elevated position, soat 180 degrees, and they get
some label injuries from doingthat that are seen by some of
the surgeons in the UK.
But then you also, we alsowanted to capture some of the
more wide open field kind oftackle position.
So a Y position and a Tposition.
So 135 degrees abduction and 90degrees abduction, all again
(14:13):
pushing in an anteriordirection, because we were
interested in, can someoneproduce force?
In those wide positions toprevent their arm going into
hyper extension.
Um, and, and so based on what weknew about the isometric test.
We thought, well, this has gotsome, this has got some benefit,
potential benefit.
The test is a three secondmaximal, fast as you can go, so
(14:36):
we're attacking it as fast asyou can, and then sustaining
that contraction for threeseconds.
And we do that across all threepositions, if we're looking at
pre season screening or gettinga benchmark.
Of a group of athletes.
And then what we'll do is we'lluse utilize that either in a
return to play process, or wemight utilize it when we're
(14:57):
looking at tracking andmonitoring a player across, uh,
across the competitive season.
So you do three positions.
I think we're all familiar withI's Y's and T's very similar.
Um, we're lying face down.
So prone and pushing into theforce plates.
Um, Between the three positions,I'm kind of curious, what do you
(15:18):
tend to find?
Um, it seems like to me, from myexperience, T's and Y's
oftentimes are a little bit moresimilar, but I's tend to be a
little bit different.
Um, tell us a little bit aboutthe three positions.
Do you always do all three?
Is it, is it, are you lookingfor different things in those
three positions or do you thinkthat this is better done as a
series and that the summation ofall the information is, is
(15:40):
probably the most helpful.
Yeah, that's good.
Good insight, because I feelexactly the same.
The T's and the Y's are prettysimilar.
And the other thing, thedifference between the I and the
T and the Y in the original ASHtest protocol is that for the T
and the Y, we've got our hand,the opposite hands behind the
back.
So you can't actually use it tofix on the floor.
(16:02):
So we create this almostRotational stability issue
around, around the trunk andpelvis as one of the potential
limiting factors for pushing outin these wider T and Y
positions.
So, when I've looked at pilotcorrelations of these, the eye
tells you something different tothe Y and the T, but the Y and
the T are quite closely linkedto each other.
(16:23):
All right.
And the other reason why theeyes.
A little bit different isbecause it's more stable the
arms by the side.
So we get a max force there.
We get if if the eyes 100percent the Y will be about 85
percent and the T will be about75%.
So we see a normal kind of, ifyou like, ratio between those.
And we know if something's alittle bit off there, then it
(16:46):
could be related to either alack of range to get in an
overhead position, or it couldbe due to a, an angle specific
difference that we may pick upsomething in the Y position,
maybe through a painful arc.
We might see that the T lines upmore with a PEC major or fibers
of the PEC major, as an example,in someone who's had a previous
(17:07):
PEC injuries.
So there's still a lot to learn,and...
understand and put into context,but I think that's how we kind
of can, can utilize this.
We know based on thousands andthousands of athletes being done
over a number of differentathletes from different sports
now that it, when we revert tothe mean, we can see that
relationship bears out with I'sand Y's and T's.
(17:31):
So if you don't see thatrelationship, and that's where I
think they play well together,if you don't see that
relationship, then we know nowbecause there's there's so much
data out there that there mustbe a reason and you have to dig
a little deeper.
So, um, I think I think you saidthat well with the wise and the
tease.
I was going to ask you aboutthis about the eyes and I'm glad
(17:52):
you brought it up.
But in your experience ifsomebody has limited overhead
mobility, does that correlate tothem being able to produce less
force, or is it.
More force.
I mean, what, what have youseen?
Yeah.
So, I mean, the sort of naturalscreen for going into these high
force, high rate tests isfirstly, like, do they have
enough overhead range to get inthat position?
(18:14):
And if someone just is, youknow, thoracic kyphosis big.
Big rugby prop forward, and theyjust don't have that range of
motion.
We're not going to put them inthat position and test them.
That's just that's a given whenwe're coming back into someone
we know has that overhead rangeand this sort of getting into
that range from a mobilitystandpoint, but then you ask
them to produce force there.
(18:36):
that ability to produce force inthat kind of outer range motion,
it can be inhibited by, youknow, muscle tension.
Um, it can be inhibited by, um,a lack of, um, strength in those
positions as well.
And it can be limited by justinhibition and fear avoidance
(18:57):
being in those positions.
So that's, that's what we see.
I think that I, because it's thehighest force test, we see the
biggest deficits when it's notright.
Um, and certainly when we seesomeone who's got restricted
right shoulder mobility, freeleft shoulder mobility, we'll
probably see that bear out in aneye test in terms of their
ability to produce.
Produce peak force.
(19:17):
We see drops in force in thosepositions when they lack range.
Yeah.
That makes sense.
Um, how about symmetry?
So in normal people, normalathletes, even, uh, some that
even play, let's say unilateralsports like overhead athletes,
are you looking for symmetry?
Do you, do you find that to benormal or do you find that some
(19:37):
sort of asymmetry is acceptable?
Yeah, I think from, you know,from your experience as well as
of testing, uh, unilateralsports, I mean, where are we
going to draw the line in thesand?
Right?
We've got this, this bell shapedcurve of.
Normals and, and outliers, butit probably comes back to around
15%, something like that.
If, if someone's going 20% plusin terms of asymmetry, we start
(20:01):
to have a conversation and Ithink that's probably a good
line in the sand for people whohaven't tested overhead athletes
is, is, is a 15 percent's a goodstart point for, for a
conversation.
Um, but it will depend on theirtraining age.
You know, what they've actuallybeen doing in the gym with the
other side, are they just, arethey just throwing, are they
just playing tennis, or are theyactually doing some decent upper
(20:22):
body conditioning, and if that'sthe case, we might see less than
15%.
We might see somewhere around,you know, 10, 12%.
That's not, not a worry becausewe can look at each shoulder
kind of in isolation and say,well, relative to their body
weight.
You know, are they scoring asmuch as we'd see across a number
of athletes, male or female,depending on age in that sport.
(20:46):
And so we can use that and say,well, this gold is hitting a,
you know, a minimum standard, ifyou like, for where we believe
they need to be from a, from aforce production point of view.
And I think that's always agreat way of looking at it, too.
I know with my overheadathletes, oftentimes I want them
to be stronger on that side,right?
That's the arm that they use,um, especially with this testing
(21:09):
and the ASH protocol.
It's, to me, these are a lot ofthe acceleration forces that,
that go with velocity and someof our overhead athletic, uh,
motions that we see with our,our people in front of us each
and every day.
So for me, uh, I know forexample, like internal rotation
of the shoulder, when I look attheir strength testing, I want
it to be stronger on theirthrowing side than their non
(21:30):
throwing side.
So, you know, it's something tokeep in mind too, is you can
detect both asymmetries with aweakness, but also, you know,
for example, you might want themto be stronger on that side.
Right.
And again, anytime you can lookat a test that, that looks at
side to side differences andtrying to find just that small 1
percent to make our athletesbetter.
I think that's huge.
Right.
So, um, So, so Ben, the, thisinvolves force plates.
(21:54):
Most of us have force plates.
Oh, I shouldn't say most of ushave force plates.
A lot of people are starting toget force plates.
I'll leave it at that, right?
More people should have forceplates.
I think we can all agree.
Um, what do you do if you don'thave force plates?
What have you done?
And I know you consult with alot of different groups and
organizations.
I'm sure there's some peoplethat, that don't have access to
force plates.
What do you recommend?
(22:15):
Yeah, we've done a load ofdifferent things.
Um, and again, we try and tryand make it as scientific as
possible.
So, you know, have we have webuilt some evidence around it?
So we've got great confidence inthe evidence or we just got
great experience.
So we still got confidence init, but we need to go through a
more scientific, you know,reliability leavers.
(22:39):
Um, one of my colleagues whoworks with me, uh, Gus Morrison
published a paper on using ablood pressure cuff.
So, correlation of the bloodpressure cuff looking at
pressure out in those widerpositions and the force plates.
And there was a very goodcorrelation between those two.
We can also use a dynamometer.
(23:00):
So if you've got a dynamometer,great.
You know, use a dynamometer, putthat on the floor, make sure
it's stable.
And again, we've got verygood...
Reliability when we look at theforce plate versus the
dynamometer too.
Um, but some people don't havedynamometers or spade cuffs.
So we use dumbbells and whatwe're doing a lot more of now,
(23:21):
especially if we have a remoteclient.
So we want to be able to see howstrong you are.
So we'll get them lying on theirback in supine and we'll put a
dumbbell in their hand in a Tposition or a Y position.
And we'll look at a 10 secondhold.
And what percentage of theirbody weight can they hold in
those longer lever positions?
(23:41):
And what's their rate ofphysical exertion for that 10
second hold?
Then we start to get a reallynice gauge of, okay, where do
they sit?
Is it good, bad, or ugly?
And if they're not hitting aminimum standard, There may be
strength is a limiting factor inthose positions and then
actually the testing becomes thetraining, you know What do we
(24:02):
need to do?
Well, we need to increase yourforce production to get you up
around 10 percent of your bodyweight in in those positions
We'll do that for anterior andposterior shoulder, you know, I
test a lot of other stuff otherthan other other tests are
available Apart from the ashtest, but you know where we see
(24:22):
an anterior deficit In an ash,we'll, we'll get someone loading
out in those kind of bookendpositions, like an ISO supine
hold, uh, or even standing in adoorframe, but where we measure
it without the technology, we'llbe using a dumbbell at a
percentage of relative, uh,relative body weight.
And in your experience, thedynamometer and the force plates
(24:44):
were, uh, very similar, likeequal or close enough.
Very, very similar.
The only differences for thosepeople who are really into this
testing stuff is the height.
So if you put a force plate onthe floor, and it's 4
centimeters above the ground,and if you put a dynamo on the
ground, and it's it's 3, there'sgoing to be a slight offset.
But that will that will remainconsistent across the tests.
(25:07):
Um, and the reason why that'simportant is because, you know,
if you're coming into.
An environment of facilitytesting on the plates, but then
the player or the athletes goingoff playing tennis in another
country, and they're taking adynamo with them, maybe to use
as a monitoring tool, we justneed to be cognizant of the
slight offset there.
So, we don't start getting tooconcerned if those numbers drop
(25:29):
by 10, 15 Newtons in it.
It's a different test.
I think that's what we've got tounderstand, you're testing
different equipment, it's goingto give you different answers
and we just need to be aware ofthat.
Right.
Well, but I like the optionsthough, right?
You know, you talked about ablood pressure cuff, I mean, I
don't think you can get any morelow tech than that, right?
(25:49):
And the dumbbells I think isfantastic for that, um, for that
distance client like youmentioned.
There's doesn't even have accessor you don't even want to try to
explain to them how to use thatblood pressure cuff, right?
That must be terrible.
But, but I, I, again, anotherreason why people should at
least have a dynamometer, like ahandheld dynamometer in their
clinic, I think should be kindof, kind of one of the baselines
(26:11):
of what we do nowadays.
But, um, I, you know, I thinkit's great to see that you can
use some lower tech stuff, likethe blood pressure cuff as well.
So, um, awesome.
So.
Okay, we have our force, right?
We're looking at that position.
Tell me what metrics matter themost to you because I know
anybody that's used force platesknow that there's a ton of
(26:32):
different data points that wecan get.
Um, obviously we have, we haveforce.
Right.
But there's also the concept ofthe, the, how fast you can
produce that force or rate offorce development and so many
different ways to look at that.
What do you like to look at forthe metrics that you think tell
you the most from this testprocedure?
Yeah.
(26:52):
I mean, peak forces are givenit's very stable and it actually
gives you quite a lot of goodinformation.
Um, But for me, the rate offorce stuff is interesting.
It comes back to, uh, we've donequite a lot of work now.
Part of my PhD has been lookingat, uh, validation on, uh, and,
and reliability of rate of forcedevelopment.
(27:14):
And whilst it's never going tobe as, as, uh, reliable as peak
force.
When we compare it to othertests, like handheld testing,
and we look at the minimumdetectable change that we see
within the tests, so that we canidentify that a true change has
happened, it's very consistentacross, across things like a
counter movement jump or a, oran ISO mid thigh pull in terms
(27:38):
of the variability.
So, the measures we look atactually kind of make sense, but
the, the shorter the timeframethat you try and look at for
rate of force development.
The more variable that's goingto be.
So if you start to look at 50milliseconds after someone
starts their contraction, that'sgoing to be more variable.
(28:00):
In some people with neuralsuperpowers, they're going to be
consistent, but it's not manywho can do that.
When we start to get up to awindow around 100 milliseconds,
things start to get a bitbetter, and we can see
variability of less than 10percent, which is kind of the
gold standard.
But the longer you take, themore reliable it gets, and the
(28:23):
window we're trying to look atis around 250 milliseconds.
So 100, 150, 200 or 250.
It gets more reliable the longeryou take.
But we want to find somewherewhere we're looking at that real
aggressive attack phase and wantthose kind of markers that may
be more sensitive to pick up,um, return to performance,
(28:44):
maybe, uh, performance kind ofcorrelations like a throwing
velocity or spike velocity.
Um, and we also want to bearound the meaningful time
points for injury.
So in a blink of an eye is whenan injury happens.
So if we're starting to look at,we're starting to look at time
to peak force, which is ameasure that people often use on
handheld dynamometers.
There's 50 percent coefficientof variation in those tests,
(29:08):
because it is so inconsistent.
If you ask someone to produceforce, they'll end up producing
their peak force around 2 or 3seconds into an ISO test.
So if you ask someone to attackit, they never hit their max
force in the first 250, but whatpercentage of their max?
Can they hit there?
So, long story short, you cantell I think a lot about read a
(29:29):
lot about RFD.
If I had to put my hat on it,I'm, I'm using 100 milliseconds
rate of force development overthe first 100 milliseconds.
That's been the one where Ithink we've got that sweet spot
between something that's reallyrelevant.
to the demands of the sport andprotecting the joint and keeping
it stable against injury.
(29:51):
It's reliable enough, like howaccurate do we want to be?
It's reliable enough to give ussome consistent information and
we can use that then in returnto play or we can use that to
understand whether an athlete'spotentially under, under
fatigue.
So tell me a little bit moreabout that.
I like that.
So we have two variables,essentially, uh, peak force,
(30:13):
right?
And how fast they can producethat.
So the rate of forcedevelopment, um, how do
variations in those two metricschange what you're going to do
with people?
But when are you concerned?
Is it when somebody is weak,but, you know, fast or, or
strong, but slow, like, likewhat are the different ways that
clinically that changes yourjudgment with each person?
(30:35):
Yeah, I think the training thetraining pathways is always to
try and kind of build a biggermuscle first and then and then
access that as much of thatbigger muscle as fast as you
can.
So if someone's weak, that's thelimiting factor, you know, and I
think it's all very well goingdown the route of doing some
kind of.
(30:56):
low load, quicker, fasteractions, catches at low level,
but we really want to move theminto a place where rates of
force development is aboutforce.
You know, it's not just abouthow fast you're moving.
It's about how much force youcan produce in a, in a, in a
quick time.
So we want to move people to aplace with a high force, high
(31:18):
rates.
And the way we do that is tobuild a bigger muscle first and
then, and then allow them toaccess it.
So my training will changecompletely.
We might do some, um, you know,In terms of like developing
force in those weak, uh,athletes, we'll just do some,
you know, slower movements orISOs under higher load, we might
(31:40):
progress them from initialcapacity work to more max
strength work, but then theemphasis shifts towards a truly
ballistic intent behind theexercise.
So we can still use anisometric, but we want them to
go as fast as they can.
We're, we're tapping into neuralelements of an exercise.
You know, and that's, that'swhere I think this makes it,
(32:03):
this makes a true difference.
You know, your, your question'sinsightful because essentially
it's like, so what if we get alow rate of force, so what,
what, what do we do with it?
We got to then, if we want tomove the needle on rate of
force, we've got to perform anexercise that drives an
adaptation.
That's going to be a rate offorce exercise.
(32:25):
And that is really challenging.
It's really challenging.
I bet.
I bet.
And I see the logicalprogression to where let's say
in the injury environment forexample, where we're focused on
strength for so long in theearly middle phases of
rehabilitation approach.
But if we don't make thattransition then start to use
(32:47):
that that force that you can nowproduce at a little bit more
game speed or a little bit moremax speed, then I think you're
missing a boat in therehabilitation process as well
right?
Absolutely.
I think that it mirrors thelower body.
What we see is in rehab thatpeak force comes back much
earlier than rate of force.
That's just a natural, uh,return, uh, after injury.
(33:09):
And we also see that rate offorce suffers more.
You know, if you look at lowerlimb counterparts, like a
counter movement jump whereyou've got more time to produce
force versus a drop jump whereyou've got less time, you can
probably counter movement jumpthe same way after a big lower
body exposure.
But if you're given that shortspace of time to Do that real
(33:29):
fast, less than 2 50 millisecondground contact.
If you're fatigued, you can't doit anymore.
So that's, that's, I think,where this will go with upper
body testing.
We're just, we're just tryingto, you know, stand on the
shoulder of the lower bodyresearch and development from
ACLs and hamstrings over theyears.
And we're trying to now get to aplace where we really are able
(33:52):
to put some studies in placethat are going to capture that.
Um, rate of force developmentdeficit that I think in one
podcast episode, you used twoamazing phrases.
You said, um, stand on theshoulders of lower extremity
research, which is amazing.
And earlier you said you wereknee deep in shoulder, but it's
(34:14):
all connected, right?
Cause we know it's all connectedAs we're constantly told.
But, uh, I, I.
I, I.
These, these are the things thatI pick up on Ben.
It's, uh, that's crazy.
But, uh, uh, no, great stuff.
But, so I, I, you know, I cansee this as being super, super
valuable for contact athletes,people with instability, those
(34:36):
types of things.
Tell me a little bit about yourexperience using this
specifically with overheadathletes.
Uh, what have you seen for maybeinjury, uh, concepts and even
performance based things?
Yeah, so I think where this,where this comes into its own
is, is, as you said, right,right at the start, it's like an
end stage return to play marker.
(34:59):
So it's not designed to be athrowing test.
It's not designed to be a tennistest.
It's not designed to be aweightlifting overhead snatch
test, but because of the highdemands and the correspondence
between some of the things thatwe see in an ash test and what
we see in the high demands ofthose different sports, it
becomes a really good.
(35:21):
Long lever high force high ratetest.
So it's positioning itselftowards the back end of a return
to play process.
And that's where I think it'scoming into its own in a number
of different sports.
Um, we're seeing correlationsbetween volleyball spike and ash
(35:42):
test rate of force developmentin a wide position.
We've seen, um, that in onecohort of NCAA pitches, uh,
division, division one pitchesthrowing above eight, seven
miles an hour.
So it starts to become more,more credible.
You know, some over, some over90.
So some decent throwingathletes.
We've seen that there's a, a, achange in the ASH test.
(36:06):
Of 50 newtons per second in a Tposition from RFD perspective is
equivalent to an increase of 0.
5 miles an hour on a radar gun.
Now, these are early studieswith smaller groups, but, you
know, that's where kind ofthese, these projects and
ultimately, um, the largercohort studies can can probably
(36:26):
be built on that.
So there's definitely someinterest around, you know, the
key determinants of throwing andthe key requirements.
Of the ash test, but part of myPhD is looking into, you know,
digging a little bit deeper intothat.
I'm looking at some of themuscle activation, some of the
(36:47):
timing and firing around that.
And then really, how does thatthen all link together?
So we link.
The, the performance testing toactually the demands and tasks
that we're, we're, we're askingthe athletes to be fantastic.
I look forward to seeing that.
Um, I, I agree with you when yousay a later stage, um, test and
(37:08):
even in the overhead athlete, ifyou can produce a good amount of
force in these positions, youhave a pretty healthy shoulder.
Right.
Things are functioning well.
Things are in the rightposition.
I think that's, I think that's agreat way of putting it for
overhead athletes.
So, um, it makes sense to me tosee some correlations with
velocity, right?
Remember we said that earlier inthe podcast where I almost see
(37:31):
those as like the accelerationbased muscles.
So I think that's fantastic aswell.
Um, what have you seen With theresults of this test from just
monitoring healthy athletes overthe course of a season and maybe
that's in any sport a contactsport versus an overhead sport
But have you seen that that thethe data that you're getting
(37:53):
does it change over the courseof a season does it stay?
Consistent, is it just somethingyou see in injured players, but
what's your experience withusing this to actually monitor
people?
Yeah.
So I think it's, it's a testthat's been used in a number of
different ways around monitoringand some people might do this
once a week in, in a throwingpopulation, as an example, um,
(38:14):
some people have done it everyday, by the way, for four weeks,
I apologize to the athletes thathad to go through that process
as part, as part of my PhD.
What's interesting is, and Isuppose the summary is even in
those four weeks, yeah.
Because it's a new stimulus andthis is this is quite an
interesting thing I thinkbecause it's a new stimulus and
(38:36):
you're asking someone to do thishigh rate of force development
exercise Actually athletes getbetter at doing it.
That's training training istesting testing is training So
where we'd expect people toactually drop off maybe after
throwing, you know You knowpitching a number, you know in a
number of innings or however Wewant to do that in terms of RPE
for a session We still see thatpeople who are on an upward
(39:00):
trend will continue to improvewith repeated, uh, repeated ash
test performance in a, in adaily.
A daily environment when we useit as a monitoring tool, it's
been used really on a kind of,let's say, we take a starting
picture.
We use it on day three.
Um, some people use it on daytwo, if they believe that
(39:20):
there's, you know, someone'sgoing to go out and do something
intense on that day.
And then historically, peoplelike to do that.
We can use it to see, are theyback up to where they are
normally at 48 hours?
And if they're not, it might beused then to say, well, you're
going to go 100 percent today,or can we just.
retest you tomorrow and makesure you're back up at 100
percent of where we want youbefore you go and throw a ball
(39:43):
pen or before you go and dothose higher intensity actions.
So that's conceptual originallytaken from lower body, but now
it's been implemented in anumber of places.
And I think there's, um, youknow, some, some people have
adopted this more than others,as you know, like, is this,
there's this reluctance toprobably, um, do something new,
(40:04):
but when you're talking about aone second version of this test,
and you might do two or threereps, I think the, the load
demands compared to throwing abaseball, you know, 95 mile an
hour, um, is Um, and I thinkalso compared to a lot of the,
you know, the preparation workthat's done, which is slow
(40:27):
speed, um, you know, low load,high repetition, actually
putting in something in there.
That's in a stimulus.
That's going to protect a jointand challenge a joint is a
really useful tool to helpdevelop athletes in terms of
protection against those kind ofthrowing demands.
Fantastic.
I'm really excited to see thisPhD research that you're working
(40:51):
on come out, Ben.
I think that's going to bereally impactful for us all.
I can't wait to continue to seemore and more people that have
started to use it start toproduce some research with it.
You know that's about to come,right?
That's just how these thingstend to evolve over time.
Uh, it's going to be great tosee all the different things
that we can, uh, get out of thistesting.
So thank you for this and thankyou for joining us on the
(41:13):
podcast today to share a littlebit about this.
Um, you guys got to check itout.
Um, go to the show notes, uh, onthe website or in the podcast
and, um, Click some of thoselinks to find out a little bit
more about the Ash test and Ben,but Ben, before we let you go,
we got to do quick high five,five quick questions, five quick
answers to learn a little bitmore about you as a person.
Right.
(41:33):
I, this is kind of my favoritepart of the show, but, uh, first
question, what are you currentlyworking on for your own
professional development, yourown con ed?
And I know that's hard whenyou're going through a PhD, so
I'll give you a little credit onthis first one, but what are you
doing for your own personaldevelopment?
Well, I do like to listen.
(41:55):
I do like to listen to stuff.
If I'm not reading, if I'm noton holiday, I don't tend to have
a actual hard copy book.
Um, but the one book I bought onmy recent trip was, um, Never
Split the Difference, which isChris Voss, who was an FBI
negotiator.
And for those people who haven'tunlocked the secret power of
negotiation in, uh, you know,contract negotiation or even
(42:17):
any, any sort of.
Day to day, um, day to day, uh,challenge buying a car, whatever
it's Brilliant.
I mean, it takes you to somepretty awkward places, uh, it's,
it's not easy, but just byputting some of the stuff into
practice, incredible, the shiftsyou can get with, um, with, uh,
(42:38):
negotiation and, and the wayit's sort of sold is, is
brilliant, resonates very wellwith me.
So that's a good one.
Yeah.
I mean, isn't everything in lifea negotiation, technically.
Pretty much where it comes downto.
Yeah.
And if you've got those specialset of skills like this guy has,
um, then, uh, yeah, you, you canstart to really influence
(42:59):
people.
I would hate to be married tothat guy.
I apologize.
I don't know.
He's probably a great guy.
I apologize.
But, what is one thing thatyou've recently changed your
mind about?
Um, unfortunately this is a bittechnical, um, but it's around,
uh, Trunk assessment.
So we, we historically look at alot of these hold isometric
(43:22):
endurance tests like bearingSorensen's and side planks and,
and actually, we've kind of gotreally good at measuring peak
forces and lower body got prettygood now upper body.
But the missing link is, is thetrunk so I've been starting to
look at peak force in like amodified Palos isometric.
And, um, we're starting to seesome pretty good information
(43:44):
around that.
But I would, a call to actionfor everybody else is to just
have a look.
It's on my Instagram page, whatwe're doing, but, um, there's
more and more people inrotational sports looking at
rotational peak force testing.
I think that's going to be thenext, the next sort of big game
changer, if you like, with, withthis kind of physical profiling
and, um, strength andconditioning.
(44:06):
For sure.
And then subsequent to thatwould be rate of force
development, right?
Exactly that.
Yeah, because you can get bothisometrics are great.
So once you set up a goodposition, a good process and
you, you and I know, because wewere standing over Lenny the
other day looking at, you know,the requirements of quality
assurance to get the best data.
(44:27):
And you can always tell whensomeone has.
Thought about it, tried it,practiced it, and refined it,
like Lenny had with the, uh, isoknee extension as an example.
Um, and you can see others whojust never have because they
haven't done it, felt it, triedit, and looked at it, uh, over a
period of time.
So that's, that's what needs tohappen with the trunk, trunk
(44:48):
rotation test.
I, I agree.
I agree.
Um, what's your favorite pieceof advice that you love to give,
uh, your students or earlycareer professionals that you
mentor?
Yeah, from my own personalexperience, I got a lot of
patient mileage.
I was exposed to a huge amountof individuals, and I had the
opportunity to make Makemistakes and learn, um, in a
(45:11):
very well supported, uh, lowpressure environment.
It's also important that you geta chance to, to try things,
apply things yourself.
So not just to go along and takenotes, but actually to have a
chance to put things in place.
Um, because if you've neverproblem solved, uh, even at
lower levels, how are you goingto do it when you end up in, in,
in the elite game?
Um, so that's it.
(45:32):
Protected, but high levelexposure, volunteer.
Get yourself out there, multipledifferent sports, multiple
different environments, um, thatwill set you up, set you up well
for your future.
I love it.
What's coming up next for you,Ben?
You never know when you'retrying to grow a business, do
you, but I'm sort of going wherethe wind blows at the moment,
(45:55):
but well, a skiing holiday in 70days, not that I'm counting.
Um, and as one of the athletessaid, Oh, you must, you must be
doing well as a business ifyou're able to take a ski
holiday on December the 12th.
So that was a, that's, that's agreat thing.
Basically, developing onlinelearning and education with my
business partner there, AlexWolfe.
(46:16):
That's been going well.
We'll release a training courseearly in 2024 to complement the
level one course and the, um,and the testing course that we
just released in September.
So that's that coming up, um,and then we're going to try and
get a few more people on boardworking in London on the on the
(46:36):
rehab side as well.
Some good people.
Um, hopefully to build thebusiness nice and steadily so we
can, we can, um, deliver to, tomore people in London.
That's fantastic.
I love it.
Well, how do people learn moreabout you and the Ash Test and
Athletic Shoulder?
What's the best place to findyou?
Yeah, so I'm on, I'm on all thesocial channels, uh, LinkedIn,
just Ben Ashworth and, uh,Instagram is probably the best
(46:59):
place at the moment at AthleticShoulder.
Um, or you can go to thewebsite, uh, www.
athleticshoulder.
com.
That's awesome.
Ben, thanks so much for joiningus today and sharing your
experience with this.
That was awesome.
I'm sure everybody's going totake a lot out of this and
hopefully more and more peopleuse this Ash Test.
So please check it out if youdidn't.
(47:19):
And again, thank you, Ben, forjoining us.
Mike, an absolute pleasure.
Can't wait for the next one.
On this episode of the sportsphysical therapy podcast, I'm
joined by Ben Ashworth.
After years spending time infield sports, such as rugby and
premier league soccer.
Ben is now focusing his time onhis new venture athletic
shoulder.com.
And he's also consulting withteams and individuals to help
solve shoulder performanceproblems.
He's the inventor of the Ashtest, which is something we're
(00:23):
going to talk a lot about inthis podcast episode.
I'm really excited for it.
Welcome to the Sports PhysicalTherapy Podcast.
I'm your host, Mike Reinald fromMike Reinald.
com.
GMT20231009-170407_Recordi (00:38):
Hey, Ben, welcome to the podcast.
Thanks so much for joining me.
How's everything going?
Mike, it's going well.
Thanks.
It's been a long time since wesaw each other.
What is it?
About two weeks?
No, we, uh, we take a severalyear gap every now and then, but
then we see each other for abunch and then we'll take
another few year gap, maybehopefully less and less.
(00:59):
Exactly.
No, it was good to see you theother day.
Um, I managed to fight, managedto pin you down for, uh, for a
short time.
I know you're a busy man, so.
Yeah, no, it's, it's always fun.
I mean, we, we've met in thepast, just, you know, um, I
think it's always fun to, tokind of geek out about things
that you're really interestedin, right?
And I know you and I both have apassion for the shoulder, so I
(01:20):
thought that was, um, you know,pretty good.
So anytime I can hang out withBen is always fun.
And I, I recommend all ourlisteners.
If.
You see Ben in a conference oryou, you, you see him coming to
a seminar near you, go check himout because I think the post
course dialogue is probablygoing to be epic, right?
Something that you'll reallyenjoy, uh, hanging out with Ben.
He's, he's a great mind.
(01:41):
Is, is that a fair statement youthink Ben?
Uh, I don't like to sort of, uh,self, self promote.
It's very nice of you to saythat, so, uh, it's, it's great
to hear.
It's always nice to get feedbackfrom, from, you know, people
who, uh, know this area reallywell.
And I remember reaching out toyou.
on my own personal developmentjourney, um, about, I think it
(02:03):
was 2016, something around that.
And I just wanted to go andspend some time with people who,
uh, could add value to what I,you know, thought I knew about
shoulders, um, as I started todevelop my knowledge.
So yeah, I, I'm hopefullymaintaining a level of humility
rather than, rather thanbelieving, believing I'm a world
leading, world leading expertyet, but, uh, certainly I'm
(02:25):
trying to, I'm trying to developas we go.
So.
But, but I think that's whatmakes you great at your job
though, in all honesty, it'syour, you're going through a
personal journey and you'resharing it.
And I think to me, that's,that's always the best type of
education.
Yeah, that's, I think what thesepodcasts are for as well, isn't
it?
Sometimes you choose a podcastso you can have a good
conversation with someone.
(02:46):
Um, that's what I do with our,with our podcast too, is we
invite guests on that we want tohear from, uh, and spend some
time with.
So yeah, hopefully it's the samethe other way around.
Yeah.
Likewise.
Well, well, for my listenersthat may not be completely
familiar with your work, um,even though they, maybe they
are, and they don't even knowthey are, but why don't you
start off a little bit aboutsharing a little bit about,
(03:08):
about your journey so far, um,and what you're currently up to.
Cause I know you have, you havea great past, you know, working
in, in, you know, the soccerworld, the football world.
Um, but I, I know there's somuch more to it than that, but,
um, why don't you share witheverybody just a little bit
about your journey so far.
Yeah, I'll keep, I'll keep itbrief.
Um, it's basically a 25 year,um, physiotherapy, uh,
(03:34):
practitioner who has worked in anumber of sports.
And I started out in rugby, uh,professional rugby in about
2002.
And then I went into Olympicsports where I saw a load of
athletes from summer and wintersports.
Um, develop some understandingaround strength and
conditioning, which reallyhelped, I think, changed my
(03:56):
career, actually, gave me a bitmore breadth to my understanding
of the whole spectrum of, youknow, return to performance and
return from injury, and thenwent to Arsenal Football Club,
one of the Premier League clubsin the UK, great opportunity.
Very lucky to get that job, um,with lots of applicants and not
being from football myself.
So I then used that job, workedwith a brilliant team for six
(04:20):
years, um, at the sharp end.
Uh, had some midlife retirementand then was called to Europe to
be the director of performancefor Sparta Prague, which is a
European, uh, soccer team.
And then since finishing therelast year, which is a choice
based on coming back to family.
Uh, in London, I then started togrow my own business, so I'm
(04:43):
exclusively now working, um, assort of directing my own, my own
company, Athletic ShoulderLimited, which, uh, has, as
we'll talk further about, I'msure, um, been sort of growing
on a number of fronts over thelast year.
Yeah, that's awesome.
It's been fun to watch thiscareer too, just as I've gotten
to know you over the years andkind of see all these
(05:04):
developments and really startingto build out this athletic
shoulder company that in yourwebsite and your educational
products that you're starting tocome out with now, I think
they're going to be reallygreat, great resources for
everybody.
Um, I'm excited about it.
Um, I gotta ask though, youknow, you have a lot of past
experience in like, The fieldsport world, which I don't
necessarily think of as ashoulder type situation.
(05:26):
Oh, I guess rugby is right.
Rugby has a lot of contact and alot of, um, issues like that.
But, um, being in soccer for,for so long, um, what got you
into shoulder injuries?
Yeah, actually, I mean, that wasthis sort of funny thing.
I didn't go to Arsenal forshoulder injuries.
I went there for the money.
Let's be honest.
Um, and, uh, I, I sort of,shoulders had passed me by in
(05:51):
rugby because there was quite alot of contact collision.
And then.
Um, we, we saw a bunch ofdifferent athletes from
different sports.
I worked with a few judoplayers, a few boxers, um, and
some other like gymnastics andyou know, all, all the sort of
Olympic sports, but notspecifically shoulders.
Um, so it was only when I becamethe judo physio in 2009, as part
(06:14):
of my English Institute of Sportrole that I was.
Almost knee deep in shoulders,right?
We had 24 percent of ourinjuries, our time loss injuries
were knees and 23 percent wereshoulders.
So I suppose I could have becomea knee specialist, but those are
easy, right?
Right.
I thought, I thought I'dchallenge myself a bit and, um,
(06:35):
you know what it's like, yousort of.
Start to read, um, then you'vegot to rehab five label rehabs
at the same time, you getbetter, you make some mistakes,
you learn on the job and thenpeople start to ask you for help
in that area and that was justpart of the, the evolution of my
shoulder understanding.
And then I just kept that on.
(06:55):
I enjoyed it a lot.
I worked with some good people,setting up some early courses.
Um, people who I could gaingreat value from and I kept
conversations going outside ofthe day to day job.
I've, you know, I've always beensomeone who, who, uh, isn't a
nine to five, uh, in terms of,in terms of work.
And I engage with people, youknow, like yourself and, and
(07:18):
Eric Cressy and, uh, and KellySturrett and whoever else would,
would, would be out there thatwanted to, wanted to share
ideas.
And got speaking to teams in avery non threatening way.
So, uh, you know, people wouldcontact me about it.
I'd offer to present to them andfor a number of years, um,
developed some really goodrelationships, uh, as I started
(07:42):
to sort of build a betterunderstanding.
So I think that's, that's itreally, you know, like, over
that time, shoulders have becomemore and more of an emphasis.
And carving a niche out actuallyreally helps you in any, in any
other, you know, body part area,because if you can understand
the framework and a model aroundone area, and you can really see
(08:03):
the full spectrum, you can applythat to hamstrings, hips, knees,
ankles, whatever else you're,you're dealing with and
recognize your, Your level ofability, you know, so if I see a
complex hit now, uh, which israre, but if I did, I'd send
them on to my good friends whoare, you know, who are, who are
(08:24):
much better at that top 10percent than I am.
So, right.
No, I, I, I always think that'sa great way to, um, You know,
and when I talk to early careerprofessionals, we always talk
about making sure you're, youget really good at the basics
first, right?
Understanding the basics, but,um, there's so many benefits
from following like a strictniche and actually starting to
(08:47):
develop your competency in onearea.
Um, I, I think that's a greatpoint.
It's, it's, you're, what you'redoing is you're building out a
framework that you can usethroughout the body.
So, yeah, I mean, I think that'sa brilliant way of putting it.
So, um, you know, I appreciatethat.
You've done this because I knowfor me, when I look at the
literature and I look at some ofthe things that we do for the
(09:07):
shoulder, um, I've always feltlike we've been missing
something when it comes tofunctional testing, right?
We, um, I feel like we're reallygood at the basics with the
shoulder measuring mobility,strength, those types of things,
but, um, return to sporttesting, functional testing.
Uh, the upper extremity is justfalling behind the lower
(09:28):
extremity, right?
I think we all know that.
So, yeah.
It was really neat to see youstart focusing on this and a big
part of your career has beenbuilding some of this functional
testing and monitoring systemsfor the shoulder.
You developed the ash test,which may be the best branding
of anything I've ever seen in mylife.
By the way, I love it.
You know, Ben Ashworth with theathletic shoulder says it's just
(09:48):
perfect.
It's perfect though.
Your parents were, wereBrilliant.
Um, but you developed this Ashtest several years ago.
Why don't we start with that?
How'd you come up with the Ashtest?
What is it?
Tell, tell everybody a littlebit about it if, if they haven't
heard about it before.
Yeah, it was a, it was ajourney.
So it's a sort of, um, um, amarriage of a couple of things.
(10:09):
It's, it's the actually working,looking at lower limb injuries
and trying to, trying tominimize those in, in, in, uh, a
premier league football club,looking at hamstring isometrics,
working out how you can set up amonitoring system.
And at the same time, one ofthose conversations, as I said,
outside of Arsenal was, was withSaracen's rugby club and they,
(10:30):
they had some issues withplayers who were breaking down
in contact and return tocontact.
So that means they're reachingand trying to produce force with
long levers.
Um, and again, trying tostabilize the shoulder in space.
In a tackle, but they wereseeing players who could parcel
the normal tests, rotationalkind of cuff testing in close to
(10:54):
the body, and they would sendthem out when they pass those
when they could bench press whenthey could move a lot of weight
in the gym, but they were stillbreaking down with symptoms.
So it was this great sharp groupof people, including Daniel
Cohen, who's a force platformexpert.
Um, uh, myself.
Physio who worked in rugby allthe time, strength and
(11:17):
conditioning coach.
So there's Laura Cullock, thephysio, Paddy Hogben, the
strength coach, sitting downtrying to solve this problem.
And I literally went intoArsenal one morning, thought
this is how we test our ISOhamstrings, and then put the
plates on the floor and juststarted to push into them.
And that's how it came about.
Can we find something to help usunderstand and quantify long
(11:41):
lever stress?
across the shoulder girdle inthe same way we were using it
with great success in the lowerbody to look at posterior chain
load across the pelvis, whichwas a If you want to call it
hamstring test, so that's how itcame about.
And then the initial resultswere great.
The feedback from services wasthis is starting to pick up
stuff we're not seeing in our,in our cuff testing.
(12:02):
Okay.
And so there's a knowledge gapthat we were filling, and they
saw historical shoulder injuriesthat were showing up as weak.
They saw neck injuries that wereshowing a reduction in force,
stingers, burners, those kind oftransient issues as well.
So there was some hope for itand some confidence that we
built around the initial stage.
(12:23):
And we thought, right, becausewe're scientists, really,
underneath it all, we want tolook at the reliability.
So we published a very non sexypaper, um, back in, back in 2018
around the reliability of theASH test.
And I think that's reallyprobably what started this
introduction of this concept tomost people was probably seeing
(12:45):
that paper, right?
And, and then starting to seeyou apply it and see how you've
kind of used it over the years.
I know it's something thatwe've, we've all wanted to learn
more about.
So, um, if.
If the person listening hasn'tseen the test before and you
should, by the way, I'll putlinks to it.
I know it's an audio podcast,right?
So it's a little interesting tovisualize sometimes, but walk us
(13:07):
through it a little bit.
Tell us a little bit about whatthe test procedure is, because I
think it's easy to visualizewhen, when you describe it, but
we'll put some links into it andinto Ben's website so you can
make sure you see it, but walkus through the test procedure
and what is involved with theASH test.
Yeah, so the ash test is a, weget the, we get the player lying
(13:27):
on their front, uh, in prone andwe push down into the force
plate.
So we're pushing, if you like,into almost horizontal flexion,
horizontal adduction.
Um, but it's in three positions.
So we wanted to capture thedemands of overhead positions in
rugby.
They'll, they'll score a trywith the arm in a.
(13:49):
In a fully elevated position, soat 180 degrees, and they get
some label injuries from doingthat that are seen by some of
the surgeons in the UK.
But then you also, we alsowanted to capture some of the
more wide open field kind oftackle position.
So a Y position and a Tposition.
So 135 degrees abduction and 90degrees abduction, all again
(14:13):
pushing in an anteriordirection, because we were
interested in, can someoneproduce force?
In those wide positions toprevent their arm going into
hyper extension.
Um, and, and so based on what weknew about the isometric test.
We thought, well, this has gotsome, this has got some benefit,
potential benefit.
The test is a three secondmaximal, fast as you can go, so
(14:36):
we're attacking it as fast asyou can, and then sustaining
that contraction for threeseconds.
And we do that across all threepositions, if we're looking at
pre season screening or gettinga benchmark.
Of a group of athletes.
And then what we'll do is we'lluse utilize that either in a
return to play process, or wemight utilize it when we're
(14:57):
looking at tracking andmonitoring a player across, uh,
across the competitive season.
So you do three positions.
I think we're all familiar withI's Y's and T's very similar.
Um, we're lying face down.
So prone and pushing into theforce plates.
Um, Between the three positions,I'm kind of curious, what do you
(15:18):
tend to find?
Um, it seems like to me, from myexperience, T's and Y's
oftentimes are a little bit moresimilar, but I's tend to be a
little bit different.
Um, tell us a little bit aboutthe three positions.
Do you always do all three?
Is it, is it, are you lookingfor different things in those
three positions or do you thinkthat this is better done as a
series and that the summation ofall the information is, is
(15:40):
probably the most helpful.
Yeah, that's good.
Good insight, because I feelexactly the same.
The T's and the Y's are prettysimilar.
And the other thing, thedifference between the I and the
T and the Y in the original ASHtest protocol is that for the T
and the Y, we've got our hand,the opposite hands behind the
back.
So you can't actually use it tofix on the floor.
(16:02):
So we create this almostRotational stability issue
around, around the trunk andpelvis as one of the potential
limiting factors for pushing outin these wider T and Y
positions.
So, when I've looked at pilotcorrelations of these, the eye
tells you something different tothe Y and the T, but the Y and
the T are quite closely linkedto each other.
(16:23):
All right.
And the other reason why theeyes.
A little bit different isbecause it's more stable the
arms by the side.
So we get a max force there.
We get if if the eyes 100percent the Y will be about 85
percent and the T will be about75%.
So we see a normal kind of, ifyou like, ratio between those.
And we know if something's alittle bit off there, then it
(16:46):
could be related to either alack of range to get in an
overhead position, or it couldbe due to a, an angle specific
difference that we may pick upsomething in the Y position,
maybe through a painful arc.
We might see that the T lines upmore with a PEC major or fibers
of the PEC major, as an example,in someone who's had a previous
(17:07):
PEC injuries.
So there's still a lot to learn,and...
understand and put into context,but I think that's how we kind
of can, can utilize this.
We know based on thousands andthousands of athletes being done
over a number of differentathletes from different sports
now that it, when we revert tothe mean, we can see that
relationship bears out with I'sand Y's and T's.
(17:31):
So if you don't see thatrelationship, and that's where I
think they play well together,if you don't see that
relationship, then we know nowbecause there's there's so much
data out there that there mustbe a reason and you have to dig
a little deeper.
So, um, I think I think you saidthat well with the wise and the
tease.
I was going to ask you aboutthis about the eyes and I'm glad
(17:52):
you brought it up.
But in your experience ifsomebody has limited overhead
mobility, does that correlate tothem being able to produce less
force, or is it.
More force.
I mean, what, what have youseen?
Yeah.
So, I mean, the sort of naturalscreen for going into these high
force, high rate tests isfirstly, like, do they have
enough overhead range to get inthat position?
(18:14):
And if someone just is, youknow, thoracic kyphosis big.
Big rugby prop forward, and theyjust don't have that range of
motion.
We're not going to put them inthat position and test them.
That's just that's a given whenwe're coming back into someone
we know has that overhead rangeand this sort of getting into
that range from a mobilitystandpoint, but then you ask
them to produce force there.
(18:36):
that ability to produce force inthat kind of outer range motion,
it can be inhibited by, youknow, muscle tension.
Um, it can be inhibited by, um,a lack of, um, strength in those
positions as well.
And it can be limited by justinhibition and fear avoidance
(18:57):
being in those positions.
So that's, that's what we see.
I think that I, because it's thehighest force test, we see the
biggest deficits when it's notright.
Um, and certainly when we seesomeone who's got restricted
right shoulder mobility, freeleft shoulder mobility, we'll
probably see that bear out in aneye test in terms of their
ability to produce.
Produce peak force.
(19:17):
We see drops in force in thosepositions when they lack range.
Yeah.
That makes sense.
Um, how about symmetry?
So in normal people, normalathletes, even, uh, some that
even play, let's say unilateralsports like overhead athletes,
are you looking for symmetry?
Do you, do you find that to benormal or do you find that some
(19:37):
sort of asymmetry is acceptable?
Yeah, I think from, you know,from your experience as well as
of testing, uh, unilateralsports, I mean, where are we
going to draw the line in thesand?
Right?
We've got this, this bell shapedcurve of.
Normals and, and outliers, butit probably comes back to around
15%, something like that.
If, if someone's going 20% plusin terms of asymmetry, we start
(20:01):
to have a conversation and Ithink that's probably a good
line in the sand for people whohaven't tested overhead athletes
is, is, is a 15 percent's a goodstart point for, for a
conversation.
Um, but it will depend on theirtraining age.
You know, what they've actuallybeen doing in the gym with the
other side, are they just, arethey just throwing, are they
just playing tennis, or are theyactually doing some decent upper
(20:22):
body conditioning, and if that'sthe case, we might see less than
15%.
We might see somewhere around,you know, 10, 12%.
That's not, not a worry becausewe can look at each shoulder
kind of in isolation and say,well, relative to their body
weight.
You know, are they scoring asmuch as we'd see across a number
of athletes, male or female,depending on age in that sport.
(20:46):
And so we can use that and say,well, this gold is hitting a,
you know, a minimum standard, ifyou like, for where we believe
they need to be from a, from aforce production point of view.
And I think that's always agreat way of looking at it, too.
I know with my overheadathletes, oftentimes I want them
to be stronger on that side,right?
That's the arm that they use,um, especially with this testing
(21:09):
and the ASH protocol.
It's, to me, these are a lot ofthe acceleration forces that,
that go with velocity and someof our overhead athletic, uh,
motions that we see with our,our people in front of us each
and every day.
So for me, uh, I know forexample, like internal rotation
of the shoulder, when I look attheir strength testing, I want
it to be stronger on theirthrowing side than their non
(21:30):
throwing side.
So, you know, it's something tokeep in mind too, is you can
detect both asymmetries with aweakness, but also, you know,
for example, you might want themto be stronger on that side.
Right.
And again, anytime you can lookat a test that, that looks at
side to side differences andtrying to find just that small 1
percent to make our athletesbetter.
I think that's huge.
Right.
So, um, So, so Ben, the, thisinvolves force plates.
(21:54):
Most of us have force plates.
Oh, I shouldn't say most of ushave force plates.
A lot of people are starting toget force plates.
I'll leave it at that, right?
More people should have forceplates.
I think we can all agree.
Um, what do you do if you don'thave force plates?
What have you done?
And I know you consult with alot of different groups and
organizations.
I'm sure there's some peoplethat, that don't have access to
force plates.
What do you recommend?
(22:15):
Yeah, we've done a load ofdifferent things.
Um, and again, we try and tryand make it as scientific as
possible.
So, you know, have we have webuilt some evidence around it?
So we've got great confidence inthe evidence or we just got
great experience.
So we still got confidence init, but we need to go through a
more scientific, you know,reliability leavers.
(22:39):
Um, one of my colleagues whoworks with me, uh, Gus Morrison
published a paper on using ablood pressure cuff.
So, correlation of the bloodpressure cuff looking at
pressure out in those widerpositions and the force plates.
And there was a very goodcorrelation between those two.
We can also use a dynamometer.
(23:00):
So if you've got a dynamometer,great.
You know, use a dynamometer, putthat on the floor, make sure
it's stable.
And again, we've got verygood...
Reliability when we look at theforce plate versus the
dynamometer too.
Um, but some people don't havedynamometers or spade cuffs.
So we use dumbbells and whatwe're doing a lot more of now,
(23:21):
especially if we have a remoteclient.
So we want to be able to see howstrong you are.
So we'll get them lying on theirback in supine and we'll put a
dumbbell in their hand in a Tposition or a Y position.
And we'll look at a 10 secondhold.
And what percentage of theirbody weight can they hold in
those longer lever positions?
(23:41):
And what's their rate ofphysical exertion for that 10
second hold?
Then we start to get a reallynice gauge of, okay, where do
they sit?
Is it good, bad, or ugly?
And if they're not hitting aminimum standard, There may be
strength is a limiting factor inthose positions and then
actually the testing becomes thetraining, you know What do we
(24:02):
need to do?
Well, we need to increase yourforce production to get you up
around 10 percent of your bodyweight in in those positions
We'll do that for anterior andposterior shoulder, you know, I
test a lot of other stuff otherthan other other tests are
available Apart from the ashtest, but you know where we see
(24:22):
an anterior deficit In an ash,we'll, we'll get someone loading
out in those kind of bookendpositions, like an ISO supine
hold, uh, or even standing in adoorframe, but where we measure
it without the technology, we'llbe using a dumbbell at a
percentage of relative, uh,relative body weight.
And in your experience, thedynamometer and the force plates
(24:44):
were, uh, very similar, likeequal or close enough.
Very, very similar.
The only differences for thosepeople who are really into this
testing stuff is the height.
So if you put a force plate onthe floor, and it's 4
centimeters above the ground,and if you put a dynamo on the
ground, and it's it's 3, there'sgoing to be a slight offset.
But that will that will remainconsistent across the tests.
(25:07):
Um, and the reason why that'simportant is because, you know,
if you're coming into.
An environment of facilitytesting on the plates, but then
the player or the athletes goingoff playing tennis in another
country, and they're taking adynamo with them, maybe to use
as a monitoring tool, we justneed to be cognizant of the
slight offset there.
So, we don't start getting tooconcerned if those numbers drop
(25:29):
by 10, 15 Newtons in it.
It's a different test.
I think that's what we've got tounderstand, you're testing
different equipment, it's goingto give you different answers
and we just need to be aware ofthat.
Right.
Well, but I like the optionsthough, right?
You know, you talked about ablood pressure cuff, I mean, I
don't think you can get any morelow tech than that, right?
(25:49):
And the dumbbells I think isfantastic for that, um, for that
distance client like youmentioned.
There's doesn't even have accessor you don't even want to try to
explain to them how to use thatblood pressure cuff, right?
That must be terrible.
But, but I, I, again, anotherreason why people should at
least have a dynamometer, like ahandheld dynamometer in their
clinic, I think should be kindof, kind of one of the baselines
(26:11):
of what we do nowadays.
But, um, I, you know, I thinkit's great to see that you can
use some lower tech stuff, likethe blood pressure cuff as well.
So, um, awesome.
So.
Okay, we have our force, right?
We're looking at that position.
Tell me what metrics matter themost to you because I know
anybody that's used force platesknow that there's a ton of
(26:32):
different data points that wecan get.
Um, obviously we have, we haveforce.
Right.
But there's also the concept ofthe, the, how fast you can
produce that force or rate offorce development and so many
different ways to look at that.
What do you like to look at forthe metrics that you think tell
you the most from this testprocedure?
Yeah.
(26:52):
I mean, peak forces are givenit's very stable and it actually
gives you quite a lot of goodinformation.
Um, But for me, the rate offorce stuff is interesting.
It comes back to, uh, we've donequite a lot of work now.
Part of my PhD has been lookingat, uh, validation on, uh, and,
and reliability of rate of forcedevelopment.
(27:14):
And whilst it's never going tobe as, as, uh, reliable as peak
force.
When we compare it to othertests, like handheld testing,
and we look at the minimumdetectable change that we see
within the tests, so that we canidentify that a true change has
happened, it's very consistentacross, across things like a
counter movement jump or a, oran ISO mid thigh pull in terms
(27:38):
of the variability.
So, the measures we look atactually kind of make sense, but
the, the shorter the timeframethat you try and look at for
rate of force development.
The more variable that's goingto be.
So if you start to look at 50milliseconds after someone
starts their contraction, that'sgoing to be more variable.
(28:00):
In some people with neuralsuperpowers, they're going to be
consistent, but it's not manywho can do that.
When we start to get up to awindow around 100 milliseconds,
things start to get a bitbetter, and we can see
variability of less than 10percent, which is kind of the
gold standard.
But the longer you take, themore reliable it gets, and the
(28:23):
window we're trying to look atis around 250 milliseconds.
So 100, 150, 200 or 250.
It gets more reliable the longeryou take.
But we want to find somewherewhere we're looking at that real
aggressive attack phase and wantthose kind of markers that may
be more sensitive to pick up,um, return to performance,
(28:44):
maybe, uh, performance kind ofcorrelations like a throwing
velocity or spike velocity.
Um, and we also want to bearound the meaningful time
points for injury.
So in a blink of an eye is whenan injury happens.
So if we're starting to look at,we're starting to look at time
to peak force, which is ameasure that people often use on
handheld dynamometers.
There's 50 percent coefficientof variation in those tests,
(29:08):
because it is so inconsistent.
If you ask someone to produceforce, they'll end up producing
their peak force around 2 or 3seconds into an ISO test.
So if you ask someone to attackit, they never hit their max
force in the first 250, but whatpercentage of their max?
Can they hit there?
So, long story short, you cantell I think a lot about read a
(29:29):
lot about RFD.
If I had to put my hat on it,I'm, I'm using 100 milliseconds
rate of force development overthe first 100 milliseconds.
That's been the one where Ithink we've got that sweet spot
between something that's reallyrelevant.
to the demands of the sport andprotecting the joint and keeping
it stable against injury.
(29:51):
It's reliable enough, like howaccurate do we want to be?
It's reliable enough to give ussome consistent information and
we can use that then in returnto play or we can use that to
understand whether an athlete'spotentially under, under
fatigue.
So tell me a little bit moreabout that.
I like that.
So we have two variables,essentially, uh, peak force,
(30:13):
right?
And how fast they can producethat.
So the rate of forcedevelopment, um, how do
variations in those two metricschange what you're going to do
with people?
But when are you concerned?
Is it when somebody is weak,but, you know, fast or, or
strong, but slow, like, likewhat are the different ways that
clinically that changes yourjudgment with each person?
(30:35):
Yeah, I think the training thetraining pathways is always to
try and kind of build a biggermuscle first and then and then
access that as much of thatbigger muscle as fast as you
can.
So if someone's weak, that's thelimiting factor, you know, and I
think it's all very well goingdown the route of doing some
kind of.
(30:56):
low load, quicker, fasteractions, catches at low level,
but we really want to move theminto a place where rates of
force development is aboutforce.
You know, it's not just abouthow fast you're moving.
It's about how much force youcan produce in a, in a, in a
quick time.
So we want to move people to aplace with a high force, high
(31:18):
rates.
And the way we do that is tobuild a bigger muscle first and
then, and then allow them toaccess it.
So my training will changecompletely.
We might do some, um, you know,In terms of like developing
force in those weak, uh,athletes, we'll just do some,
you know, slower movements orISOs under higher load, we might
(31:40):
progress them from initialcapacity work to more max
strength work, but then theemphasis shifts towards a truly
ballistic intent behind theexercise.
So we can still use anisometric, but we want them to
go as fast as they can.
We're, we're tapping into neuralelements of an exercise.
You know, and that's, that'swhere I think this makes it,
(32:03):
this makes a true difference.
You know, your, your question'sinsightful because essentially
it's like, so what if we get alow rate of force, so what,
what, what do we do with it?
We got to then, if we want tomove the needle on rate of
force, we've got to perform anexercise that drives an
adaptation.
That's going to be a rate offorce exercise.
(32:25):
And that is really challenging.
It's really challenging.
I bet.
I bet.
And I see the logicalprogression to where let's say
in the injury environment forexample, where we're focused on
strength for so long in theearly middle phases of
rehabilitation approach.
But if we don't make thattransition then start to use
(32:47):
that that force that you can nowproduce at a little bit more
game speed or a little bit moremax speed, then I think you're
missing a boat in therehabilitation process as well
right?
Absolutely.
I think that it mirrors thelower body.
What we see is in rehab thatpeak force comes back much
earlier than rate of force.
That's just a natural, uh,return, uh, after injury.
(33:09):
And we also see that rate offorce suffers more.
You know, if you look at lowerlimb counterparts, like a
counter movement jump whereyou've got more time to produce
force versus a drop jump whereyou've got less time, you can
probably counter movement jumpthe same way after a big lower
body exposure.
But if you're given that shortspace of time to Do that real
(33:29):
fast, less than 2 50 millisecondground contact.
If you're fatigued, you can't doit anymore.
So that's, that's, I think,where this will go with upper
body testing.
We're just, we're just tryingto, you know, stand on the
shoulder of the lower bodyresearch and development from
ACLs and hamstrings over theyears.
And we're trying to now get to aplace where we really are able
(33:52):
to put some studies in placethat are going to capture that.
Um, rate of force developmentdeficit that I think in one
podcast episode, you used twoamazing phrases.
You said, um, stand on theshoulders of lower extremity
research, which is amazing.
And earlier you said you wereknee deep in shoulder, but it's
(34:14):
all connected, right?
Cause we know it's all connectedAs we're constantly told.
But, uh, I, I.
I, I.
These, these are the things thatI pick up on Ben.
It's, uh, that's crazy.
But, uh, uh, no, great stuff.
But, so I, I, you know, I cansee this as being super, super
valuable for contact athletes,people with instability, those
(34:36):
types of things.
Tell me a little bit about yourexperience using this
specifically with overheadathletes.
Uh, what have you seen for maybeinjury, uh, concepts and even
performance based things?
Yeah, so I think where this,where this comes into its own
is, is, as you said, right,right at the start, it's like an
end stage return to play marker.
(34:59):
So it's not designed to be athrowing test.
It's not designed to be a tennistest.
It's not designed to be aweightlifting overhead snatch
test, but because of the highdemands and the correspondence
between some of the things thatwe see in an ash test and what
we see in the high demands ofthose different sports, it
becomes a really good.
(35:21):
Long lever high force high ratetest.
So it's positioning itselftowards the back end of a return
to play process.
And that's where I think it'scoming into its own in a number
of different sports.
Um, we're seeing correlationsbetween volleyball spike and ash
(35:42):
test rate of force developmentin a wide position.
We've seen, um, that in onecohort of NCAA pitches, uh,
division, division one pitchesthrowing above eight, seven
miles an hour.
So it starts to become more,more credible.
You know, some over, some over90.
So some decent throwingathletes.
We've seen that there's a, a, achange in the ASH test.
(36:06):
Of 50 newtons per second in a Tposition from RFD perspective is
equivalent to an increase of 0.
5 miles an hour on a radar gun.
Now, these are early studieswith smaller groups, but, you
know, that's where kind ofthese, these projects and
ultimately, um, the largercohort studies can can probably
(36:26):
be built on that.
So there's definitely someinterest around, you know, the
key determinants of throwing andthe key requirements.
Of the ash test, but part of myPhD is looking into, you know,
digging a little bit deeper intothat.
I'm looking at some of themuscle activation, some of the
(36:47):
timing and firing around that.
And then really, how does thatthen all link together?
So we link.
The, the performance testing toactually the demands and tasks
that we're, we're, we're askingthe athletes to be fantastic.
I look forward to seeing that.
Um, I, I agree with you when yousay a later stage, um, test and
(37:08):
even in the overhead athlete, ifyou can produce a good amount of
force in these positions, youhave a pretty healthy shoulder.
Right.
Things are functioning well.
Things are in the rightposition.
I think that's, I think that's agreat way of putting it for
overhead athletes.
So, um, it makes sense to me tosee some correlations with
velocity, right?
Remember we said that earlier inthe podcast where I almost see
(37:31):
those as like the accelerationbased muscles.
So I think that's fantastic aswell.
Um, what have you seen With theresults of this test from just
monitoring healthy athletes overthe course of a season and maybe
that's in any sport a contactsport versus an overhead sport
But have you seen that that thethe data that you're getting
(37:53):
does it change over the courseof a season does it stay?
Consistent, is it just somethingyou see in injured players, but
what's your experience withusing this to actually monitor
people?
Yeah.
So I think it's, it's a testthat's been used in a number of
different ways around monitoringand some people might do this
once a week in, in a throwingpopulation, as an example, um,
(38:14):
some people have done it everyday, by the way, for four weeks,
I apologize to the athletes thathad to go through that process
as part, as part of my PhD.
What's interesting is, and Isuppose the summary is even in
those four weeks, yeah.
Because it's a new stimulus andthis is this is quite an
interesting thing I thinkbecause it's a new stimulus and
(38:36):
you're asking someone to do thishigh rate of force development
exercise Actually athletes getbetter at doing it.
That's training training istesting testing is training So
where we'd expect people toactually drop off maybe after
throwing, you know You knowpitching a number, you know in a
number of innings or however Wewant to do that in terms of RPE
for a session We still see thatpeople who are on an upward
(39:00):
trend will continue to improvewith repeated, uh, repeated ash
test performance in a, in adaily.
A daily environment when we useit as a monitoring tool, it's
been used really on a kind of,let's say, we take a starting
picture.
We use it on day three.
Um, some people use it on daytwo, if they believe that
(39:20):
there's, you know, someone'sgoing to go out and do something
intense on that day.
And then historically, peoplelike to do that.
We can use it to see, are theyback up to where they are
normally at 48 hours?
And if they're not, it might beused then to say, well, you're
going to go 100 percent today,or can we just.
retest you tomorrow and makesure you're back up at 100
percent of where we want youbefore you go and throw a ball
(39:43):
pen or before you go and dothose higher intensity actions.
So that's conceptual originallytaken from lower body, but now
it's been implemented in anumber of places.
And I think there's, um, youknow, some, some people have
adopted this more than others,as you know, like, is this,
there's this reluctance toprobably, um, do something new,
(40:04):
but when you're talking about aone second version of this test,
and you might do two or threereps, I think the, the load
demands compared to throwing abaseball, you know, 95 mile an
hour, um, is Um, and I thinkalso compared to a lot of the,
you know, the preparation workthat's done, which is slow
(40:27):
speed, um, you know, low load,high repetition, actually
putting in something in there.
That's in a stimulus.
That's going to protect a jointand challenge a joint is a
really useful tool to helpdevelop athletes in terms of
protection against those kind ofthrowing demands.
Fantastic.
I'm really excited to see thisPhD research that you're working
(40:51):
on come out, Ben.
I think that's going to bereally impactful for us all.
I can't wait to continue to seemore and more people that have
started to use it start toproduce some research with it.
You know that's about to come,right?
That's just how these thingstend to evolve over time.
Uh, it's going to be great tosee all the different things
that we can, uh, get out of thistesting.
So thank you for this and thankyou for joining us on the
(41:13):
podcast today to share a littlebit about this.
Um, you guys got to check itout.
Um, go to the show notes, uh, onthe website or in the podcast
and, um, Click some of thoselinks to find out a little bit
more about the Ash test and Ben,but Ben, before we let you go,
we got to do quick high five,five quick questions, five quick
answers to learn a little bitmore about you as a person.
Right.
(41:33):
I, this is kind of my favoritepart of the show, but, uh, first
question, what are you currentlyworking on for your own
professional development, yourown con ed?
And I know that's hard whenyou're going through a PhD, so
I'll give you a little credit onthis first one, but what are you
doing for your own personaldevelopment?
Well, I do like to listen.
(41:55):
I do like to listen to stuff.
If I'm not reading, if I'm noton holiday, I don't tend to have
a actual hard copy book.
Um, but the one book I bought onmy recent trip was, um, Never
Split the Difference, which isChris Voss, who was an FBI
negotiator.
And for those people who haven'tunlocked the secret power of
negotiation in, uh, you know,contract negotiation or even
(42:17):
any, any sort of.
Day to day, um, day to day, uh,challenge buying a car, whatever
it's Brilliant.
I mean, it takes you to somepretty awkward places, uh, it's,
it's not easy, but just byputting some of the stuff into
practice, incredible, the shiftsyou can get with, um, with, uh,
(42:38):
negotiation and, and the wayit's sort of sold is, is
brilliant, resonates very wellwith me.
So that's a good one.
Yeah.
I mean, isn't everything in lifea negotiation, technically.
Pretty much where it comes downto.
Yeah.
And if you've got those specialset of skills like this guy has,
um, then, uh, yeah, you, you canstart to really influence
(42:59):
people.
I would hate to be married tothat guy.
I apologize.
I don't know.
He's probably a great guy.
I apologize.
But, what is one thing thatyou've recently changed your
mind about?
Um, unfortunately this is a bittechnical, um, but it's around,
uh, Trunk assessment.
So we, we historically look at alot of these hold isometric
(43:22):
endurance tests like bearingSorensen's and side planks and,
and actually, we've kind of gotreally good at measuring peak
forces and lower body got prettygood now upper body.
But the missing link is, is thetrunk so I've been starting to
look at peak force in like amodified Palos isometric.
And, um, we're starting to seesome pretty good information
(43:44):
around that.
But I would, a call to actionfor everybody else is to just
have a look.
It's on my Instagram page, whatwe're doing, but, um, there's
more and more people inrotational sports looking at
rotational peak force testing.
I think that's going to be thenext, the next sort of big game
changer, if you like, with, withthis kind of physical profiling
and, um, strength andconditioning.
(44:06):
For sure.
And then subsequent to thatwould be rate of force
development, right?
Exactly that.
Yeah, because you can get bothisometrics are great.
So once you set up a goodposition, a good process and
you, you and I know, because wewere standing over Lenny the
other day looking at, you know,the requirements of quality
assurance to get the best data.
(44:27):
And you can always tell whensomeone has.
Thought about it, tried it,practiced it, and refined it,
like Lenny had with the, uh, isoknee extension as an example.
Um, and you can see others whojust never have because they
haven't done it, felt it, triedit, and looked at it, uh, over a
period of time.
So that's, that's what needs tohappen with the trunk, trunk
(44:48):
rotation test.
I, I agree.
I agree.
Um, what's your favorite pieceof advice that you love to give,
uh, your students or earlycareer professionals that you
mentor?
Yeah, from my own personalexperience, I got a lot of
patient mileage.
I was exposed to a huge amountof individuals, and I had the
opportunity to make Makemistakes and learn, um, in a
(45:11):
very well supported, uh, lowpressure environment.
It's also important that you geta chance to, to try things,
apply things yourself.
So not just to go along and takenotes, but actually to have a
chance to put things in place.
Um, because if you've neverproblem solved, uh, even at
lower levels, how are you goingto do it when you end up in, in,
in the elite game?
Um, so that's it.
(45:32):
Protected, but high levelexposure, volunteer.
Get yourself out there, multipledifferent sports, multiple
different environments, um, thatwill set you up, set you up well
for your future.
I love it.
What's coming up next for you,Ben?
You never know when you'retrying to grow a business, do
you, but I'm sort of going wherethe wind blows at the moment,
(45:55):
but well, a skiing holiday in 70days, not that I'm counting.
Um, and as one of the athletessaid, Oh, you must, you must be
doing well as a business ifyou're able to take a ski
holiday on December the 12th.
So that was a, that's, that's agreat thing.
Basically, developing onlinelearning and education with my
business partner there, AlexWolfe.
(46:16):
That's been going well.
We'll release a training courseearly in 2024 to complement the
level one course and the, um,and the testing course that we
just released in September.
So that's that coming up, um,and then we're going to try and
get a few more people on boardworking in London on the on the
(46:36):
rehab side as well.
Some good people.
Um, hopefully to build thebusiness nice and steadily so we
can, we can, um, deliver to, tomore people in London.
That's fantastic.
I love it.
Well, how do people learn moreabout you and the Ash Test and
Athletic Shoulder?
What's the best place to findyou?
Yeah, so I'm on, I'm on all thesocial channels, uh, LinkedIn,
just Ben Ashworth and, uh,Instagram is probably the best
(46:59):
place at the moment at AthleticShoulder.
Um, or you can go to thewebsite, uh, www.
athleticshoulder.
com.
That's awesome.
Ben, thanks so much for joiningus today and sharing your
experience with this.
That was awesome.
I'm sure everybody's going totake a lot out of this and
hopefully more and more peopleuse this Ash Test.
So please check it out if youdidn't.
(47:19):
And again, thank you, Ben, forjoining us.
Mike, an absolute pleasure.
Can't wait for the next one.
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