Daniel Cipriani Interview

Dan is a professor of Exercise Science at San Diego State University. I first got to know Dan about 16 years ago when he was working for Gray as a Physical Therapist. He taught for many years at University of Toledo Physical Therapy School. He was a real pioneer in Functional Therapy. Dan is a great practioner who is now really into research to find the find the why and how.

What is “functional training” from your point of view?
Functional training, as with "functional rehabilitation" is the thinking person's form of training/rehab. It involves a willingness to critically examine the physical demands, kinematics, and kinetics of a sport or activity and then create "exercise" that best represents these conditions. Human movement is so complex, and to think that we can successfully train human movement using isolated joint/muscle activities in single plane motion is a disservice to our clients/patients. I do appreciate that isolated, single joint/muscle exercise has its place, but it should only be as a small percentage of the training/rehab plan. Most human activities involve multiple joint motions, using muscles that function across multiple joints, and in many cases, involving muscles that do not even cross a particular joint but still contribute to that joint's function. Training and rehab to address this level of complexity requires a great deal of scrutiny into human movement. For instance, the hip abductor muscles (gluteus medius in particular) can abduct the femur at the hip joint, but in function, this muscle controls the frontal plane drop of the pelvis during gait, of the stance leg. It is actually controlling hip adduction. And the range of motion in which it functions is actually from 0 - 10 (or 15) degrees of hip ADDuction, not abduction. Yet, hip abduction exercises focus on the motion of hip abduction away from the midline. And consider that weakness of the hip abductors can then lead to frontal plane (and transverse plane) instability of the lumbar spine. Hence, the abductors of the hip, while not directly crossing the joints of the lower spine, actually contribute to motion and/or stability of the spine. The complexities alone of the gluteus medius insist on functional training/rehabilitation. David Nelson, an Occupational Therapist at the University of Toledo's Health Science campus believes that we need to "occupationally imbed" all activities. What he means by this is that exercises should look and feel like the activity we are training for...and if it can't look and feel like it, we should at least imagine that it looks and feels that way. Something as simple as training to shoot a jump shot might involve repetitive arm movements (elbow flexion and extension) with the athlete envisioning the jump shot, even if the actual exercise is strictly single joint and single plane.

How important is specificity?
According to scientific studies, specificity is very important to a successful training/rehab program. This is not to say that an athlete can not improve performance by performing standard, non-specific exercises. But by attending to specificity, the training program gives more bang for the buck. The studies demonstrate that we gain the way we train...this is evident whether we are talking about the speed of a movement, the range of motion of that movement, or the repetitive nature of the movement.

With the plethora of information available how do you determine what is best?
I personally emphasize information that is either research based or provides sufficient theory to justify its implementation. For instance, I remember David Tiberio, physical therapist and professor out of the University of Connecticut, theorizing that the foot and ankle can have a substantial role in knee function. At that time there was not a great deal of biomechanical research to support this theory, but Dr. Tiberio's explanation and observations made great sense. I based much of my lower extremity rehabilitation on this theory because it was based on his observations of movement and function. He provided sound, concrete observations of foot/ankle kinematics, coupled with concrete observations of knee kinematics, and joined them with a description of foot/ankle/knee movement during gait. The connections made great sense - enough to justify including foot/ankle movement in any knee rehabilitation program. And as it turned out, research later confirmed his theory. The plethora of information regarding exercise specificity is now grounded in scientific research, for the most part.

What has been the biggest innovation in training that you have seen during the course of your career? Where is the biggest room for innovation in training athletes?
The biggest innovation in training also leads to the biggest room for innovation - technology in the research setting. The biggest room for innovation is actually based on the fact that we continue to need to do research; technology in the research setting continues to improve, enabling scientists (exercise physiologists, biomechanists, etc.) to evaluate human movement and the effects of intervention/training on human movement much more effectively than say 20 years ago. While I do not question the accuracy of "old" research, I believe we can validate that research and perhaps find different outcomes with today's technology. Even something as simple as studying human muscle activity can be performed much more dynamically now, with the use of telemetry compared with fixed wire systems. It was tough to evaluate running or jumping activities when the subject was physically hard-wired to a computer...now, the athlete can run around a track, unattached to the computer, while we collect our data.

What's the biggest issue in training athletes today?
How do we keep up with all the newest approaches, the newest theories...etc. Seems like every day someone is coming up with a new or better way to train an athlete...and while I certainly value anecdotal evidence (and single case study evidence), I would like to see continued push for controlled studies that allow us to have confidence in an intervention or program. Only with controlled studies can we truly determine if one training program is sufficiently superior over others...or that perhaps no one program is superior for all. What works for one athlete may not be the best recipe for another...men and women are different from each other, adults and kids are different from each other from each other...and the only way for us to know what to study is for all those individuals involved in training and rehab to keep coming up with innovative ideas and approaches. Idea people need the researchers just as the researchers need the idea people.

What inspires you and what challenges you?
This may sound corny but I am totally inspired by the complexity of the human system - it amazes me how athletes can take these physical gifts to such heights of performance...those of us in the fields of training and rehabilitation are driven to know and understand how this system works, why this system sometimes fails us or breaks down, and how to improve the performance of this system...this is what drives me. And, as you might expect, that which inspires me also challenges me...

Daniel Cipriani, Ph.D., P.T.
Department of Exercise and Nutritional Sciences
http://www-rohan.sdsu.edu/dept/ens/ens_web/faculty/cipriani.htm