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Injury Prevention

Like most athletes, you undoubtedly want to reduce or eliminate your chances of injury while participating in your sport. Injuries decrease the time you can spend on leisure activities, lower your fitness and impact competitive performance. Sports scientists suggest that injury rates could be reduced by 25% if athletes took appropriate preventative action.

Common Misconceptions

Coaches and athletes believe that males have higher injury rates than females - male and female athletes have about the same injury rate per hour of training.

Among runners, it is considered that training speed is the cause of injuries (Speed Kills), but research indicates no link between speed and injury risk.

Do not overdo it

The amount of training you carry out plays a crucial role in determining your real injury risk. Studies have shown that your best direct injury predictor may be the amount of exercise you completed last month. Fatigued muscles do poorly protect their associated connective tissues, increasing the risk of damage to bone, cartilage, tendons and ligaments. If you are a runner, the link between training quantity and injury means that the total mileage indicates your injury risk. The more miles you accrue per week, the higher the chances of injury. One recent investigation found a marked upswing in injury risk above 40 miles of running per week.

The two best predictors of injury

If you have been injured before, you are much more likely to get hurt than an injury-free athlete. Regular exercises have a way of uncovering the weak areas of the body. If you have knees put under heavy stress, your knees are likely to hurt when you engage in your sport for a prolonged time because of your unique biomechanics during exercises. After recovery, you re-establish your desired training load.

The second predictor of injury is the number of consecutive days of training you carry out each week. Scientific studies strongly suggest that reducing the number of successive training days can lower injury risk. Recovery time reduces injury rates by allowing muscles and connective tissues an opportunity to restore and repair themselves between workouts.

Psychological factors

Some studies have shown that aggressive, tense, and compulsive athletes have a higher risk of injury than their relaxed peers. Tension may make muscles and tendons tighter, increasing the chance that they will be harmed during workouts.

Weak muscles

Many injuries are caused by weak muscles that are not ready to handle the specific demands of your sport. Weak or inhibited gluteal muscles can cause lower back and lower limb injuries. People who start a running program for the first time do well for a few weeks but then suddenly develop foot or ankle problems, hamstring soreness or lower back pain as they increase the mileage. Their bodies are not strong enough to cope with the demands of the increased training load. For this reason, it is always wise to couple resistance training with regular training.

Muscle imbalance

Kemp (2000)[4] identified that screening for muscle imbalances is the current cutting edge of injury prevention. The rationale behind this is that there are detectable and correctable abnormalities of muscle strength and length that are fundamental to the development of almost all musculoskeletal pain and dysfunction. Detection of these abnormalities and correction before an injury has occurred should be part of any injury prevention strategy. This strategy can benefit the asessment of muscle strength and balance and regular sports massage.

Muscle Stiffness

Muscle stiffness refers to the ratio between the change in muscle resistance and the change in muscle length. Muscle stiffness is directly related to muscle injury risk, so it is essential to reduce muscle stiffness as part of a warm-up.

Research work by McNair (2000)[5] and Knudson (2001)[6] has indicated that only dynamic stretches - slow controlled movements through the full range of motion - decrease muscle stiffness. Static exercises did not reduce muscle stiffness.

This suggests that dynamic stretches are the most appropriate exercises for warming up and not static stretching exercises. Static stretches are perhaps more suitable for the cool down as they help relax the muscles and increase their range of movement. For further information, see the following articles:

Trigger Points

A "trigger point" (TP) is a thick knot in a muscle that is palpable and tender (even painful to the touch).

Larsen (2002)[3] identified that trigger points can be caused by training errors, inadequate preparation, worn shoes or equipment, poor biomechanics, muscle fatigue, poor flexibility, nutritional factors (vitamin deficiency), and psychological factors (lack of sleep, stress).

Treatment of a TP (separating the fibres of the muscle knot) can be achieved by applying direct pressure to the point for 10 to 20 seconds, gradually releasing the tension and repeating the process 4 or 5 times. The amount of pressure, which will depend on the sensitivity of the TP, can be applied by using one or both thumbs.

Several treatments may be required, but as the TP's sensitivity (pain) reduces, it will become harder to find. If, after a couple of treatments, the pain does not subside, you should seek medical advice. An alternative approach to treating a TP is sports massage, where petrissage, friction, and effleurage techniques can help break down the TP.

Trigger points are an early warning of a potentially severe injury, so checking for TPs is very beneficial. A regular massage is well worth it as the therapists when conducting a massage, can check for TPs and treat them.

A problem in the Fascia chain?

Fascia is a continuous, uninterrupted, three-dimensional web of tissue that extends from head to toe, from front to back, from interior to exterior, and an injury in one location may be due to a problem elsewhere in the fascia chain, e.g. low back pain may be due to tight quads. In essence, tight quads cause the hip flexors to tighten, pulling the spine down and forwards, resulting in low back pain. So, working on the quads may alleviate low back pain.

These connected muscles make up a fascia chain. Chew (2008)[9] explains how his Ming Method uses fascia's plasticity to elongate tight, contracted areas in a fascia chain to relieve the pain they cause.

The "Q" angle

The "Q" angle is the angle between the line of pull of the quadriceps muscles on the knee and the line of pull of the patellar tendon.

The "Q" angle is higher in women as the hips are set wider apart.

A large "Q" angle may cause the kneecap to deviate from its normal pathway on the end of the thigh bone. This may result in a dislocation of the kneecap if, while bending it, an external force pushes the knee inwards.

 Q angle

Make it specific

Resistance training can fortify muscles and make them less susceptible to damage, especially if the strength-building exercises involve movements similar to those associated with the sport. Time should be devoted to developing muscle groups with strength training appropriate to the sport's demands. If you are a thrower, time should be spent developing muscles at the front of the shoulder that increases the force you can throw. Still, you must also work systematically on the muscles at the shoulder's back, which control and stabilise the shoulder joint.

Injury prevention tips

Tulloh (1995)[1] and Anderson (1995)[2] identified the following tips to help an athlete avoid injury:

  1. Avoid training when you are tired
  2. Increase your consumption of carbohydrates during periods of heavy training
  3. Increase in training should be matched with increases in resting
  4. An increase in strengthening should precede any increase in training load
  5. Treat even seemingly minor injuries very carefully to prevent them from becoming a big problem
  6. If you experience pain when training STOP your training session immediately
  7. Never train hard if you are stiff from the previous effort
  8. Pay attention to hydration and nutrition
  9. Use appropriate training surfaces
  10. Check training and competition areas are clear of hazards
  11. Check equipment is appropriate and safe to use
  12. Introduce new activities very gradually
  13. Allow lots of time for warming up and cooling off
  14. Check over training and competition courses beforehand
  15. Train on different surfaces, using the right footwear
  16. Shower and change immediately after the cooldown
  17. Aim for maximum comfort when travelling
  18. Stay away from infectious areas when training or competing very hard
  19. Be extremely fussy about hygiene in hot weather
  20. Monitor daily for signs of fatigue, if in doubt ease off.
  21. Have a regular sports massage

Coaches

Educate yourself and your athletes in the art of Cryotherapy. When things are not going well, the athlete needs their coach. The coach needs to have an alternative training program to help the athlete through the injury recovery period. The key is rapid action when the injury first appears and a lot of psychological support to back up the remedial treatment.

Our Genes may indicate liability for injury

Our genes control our biological systems such as muscle, cartilage and bone formation, muscle energy production, lactic acid removal, blood and tissue oxygenation. Research by Kambouris (2011)[7] identified that variations in the DNA sequence of these genes have an impact on an individual's vulnerability to a sports injury, components of fitness (endurance, speed, strength etc.) and nutritional requirements.

Mauffulli & Merzesh (2007)[8] found that mutations in collagen called COL5A1 led to the structure supporting the tendon being more loosely connected, making the tendon less stable and perhaps more susceptible to injury.

References

  1. TULLOH, B. (1995) Here are 10 practical guidelines that will help an athlete avoid getting injured. Peak Performance, 55, p. 5-7
  2. ANDERSON, O. (1995) How Likely are you to get hurt, and what steps can you take to reduce the risks? Peak Performance, 55, p. 1-3
  3. LARSEN, U. (2002) A trigger point in a muscle is a warning sign of a possible serious injury. Peak Performance, 165, p. 1-6
  4. KEMP, S. (2000) Why detecting muscle imbalance is an essential part of an injury prevention strategy. Peak Performance, 128, p. 4-6
  5. MCNAIR, P.J. et al. (2000) Stretching at the ankle joint: viscoelastic responses to holds and continuous passive motion. Medicine & Science in Sport and Exercise, 33 (3), p. 354-358
  6. KNUDSON, D et al. (2001) Acute Effects of Stretching Are Not Evident in the Kinematics of the Vertical Jump, Journal of Strength & Conditioning Research, 15(1), p. 98-101
  7. KAMBOURIS, M. (2011) Predictive genomics profiling in athletics and sports performance. Br J Sports Med, 45 (2), lecture 27
  8. MAUFFULLI, N & MERZESH, M. (2007) Genetic aspects of tendinopathy. Journal of Science and Medicine in Sport, 11 (3), p. 243-247
  9. CHEW, M. (2008) The Permanent Pain Cure. USA; McGraw Hill Publishers

Page Reference

If you quote information from this page in your work, then the reference for this page is:

  • MACKENZIE, B. (1997) Injury Prevention [WWW] Available from: https://www.brianmac.co.uk/injury.htm [Accessed