Active norfolk


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  • What sports do the coaches coach?
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  • The static pelvic position has been shown to influence the rate of ACL injury. Weak lower abdominals and poor muscular control can lead to a forward pelvic tilt. This forward pelvic tilt also allows more internal rotation than happens when the pelvis is held in neutral alignment. Strengthening the body core muscles, gluteus medius, external hip rotators, lower abdominals and obliques should increase stability and help control knee internal rotation, thus reducing ACL injury risks.Strong quadriceps and hamstrings are also crucial for ACL injury prevention. Women are considered to be more ligament-dominant in stabilising the knee joint, whereas men are more muscle-dominant. Thus, it is essential that the quadriceps are strengthened so they are capable of eccentrically controlling rapid knee joint decelerations.
  • Force production capability (peak power during vertical jump) increases throughout puberty in boys but not in girls, Ligament dominance, an inability to control knee alignment more so during frontal plane activities due to poor neuromucular control surrounding the joint, increased reliance on the ligaments to control movement and absorb force. At low knee flexion angles, early quadriceps activation or increased loads caused by strength imbalances produce an anterior pull increasing the load on the ACL Leg dominance has been linke to increase injury risk
  • We use the warm up to set our stall for the training session, a poor warm up is difficult to recover from.
  • Active norfolk

    1. 1. Injury preventionHow to make every session count
    2. 2. Neil Welch MSc ASCC• BSc Sports science and physiology• MSc Strength and conditioning• S&C coach for the the England alpine ski team• Work with athletes from multiple sports including rugby, cricket, rowing and triathlon• Founder of nw conditioning strength and conditioning consultancy• Run biomechanist at Profeet
    3. 3. Session overview• Common injuries and their mechanisms• Practical - how to screen for these injuries• Practical - injury prevention strategies• Using the whole training session
    4. 4. Learning outcomes• Learn to identify potential mechanisms of injury in athletes• Learn what to do to help prevent injury occurrence• Learn how to implement those strategies into your training sessions
    5. 5. Common injury types• Acute impact trauma - not much we can do about impacts, nature of the sport, although better strength and conditioning will mean better ability to concentrate• Pulled muscles are definitely preventable, need; – Appropriate strength through full range of motion – No bilateral imbalances – Limit agonist antagonist imbalances• Connective tissue injuries such as tendon/ligament ruptures we can have some say in reduction
    6. 6. Common injury areas• Lower leg - achilles• Shoulder injuries• Hamstring• Knee
    7. 7. Injury prevention or improved performance• Injury prevention is a conservative approach• As coaches we are looking to improve our athlete’s performance• Improved performance goes hand in hand with injury prevention• Developing strong, mobile and balanced athletes will reduce injuries
    8. 8. Achilles tendon• The connective tissue link between the calf muscles and the heel (calcaneous)• It is the strongest tendon in the human body• Stores elastic energy while running improving efficiency• Has been suggested that the limiting factor in human sprinting speed is achilles tendon strength
    9. 9. Achilles injury mechanisms• High impact forces force the tendon to dissipate force• Lack of range of motion about the ankle• Lack of strength in the muscles of the calf• Growth spurts can cause a time lag in the change of length of muscles overloading the tendon (known as Sever’s disease)
    10. 10. Achilles injury prevention• Increase the strength of the calf muscles• Ensure appropriate range of motion about the ankle• Improve shock absorption of the whole system (landing mechanics)
    11. 11. Shoulder injury mechanisms• The shoulder girdle is made up of 3 joints and is inherently instable• This makes it particularly vulnerable in an overhead position• Common injuries therefore in overhead sports e.g. tennis, cricket, javelin• Due to imbalance between internal concentric movement and external eccentric movement• Poor scapula function
    12. 12. Shoulder injury prevention• Need to be aware of whole body biomechanics and how they effect range of motion• Opening the hips improves range of motion and reduces load on the shoulder• Work on the brakes, ability to slow down the movement is important• Correct patterning of the scapula is very important
    13. 13. Hamstring injury• Most prevalent muscle strain 6-29% of all injuries• High re-injury risk of 12-31%• Recent research showing injury rates not improving – Ekstrand et al 2011 looked at injury rates for 7 consecutive seasons – 23 professional European football clubs – Unchanged competitive and training injury rates• Whatever strategies have been in place haven’t been working
    14. 14. Hamstring injury links• Lack of flexibility in hamstrings and hip flexors• Lack of gluteal activation in extending the hip• Weakness of core musculature• Weakness in the hamstrings themselves – 2.5 x bodyweight per running stride• Chronic fatigue• Previous injury• Research is mixed on the exact causes, mainly because of isolationist approaches, likely to be a mix of all these
    15. 15. The knee - ligaments • 4 ligaments in the knee • Collateral ligaments prevent lateral movement • Cruciate ligaments prevent anterior posterior movement
    16. 16. The knee - musculature• Significant musculature surrounding the joint• Imbalance can put altered load on the ligaments• Lack of strength can increase load on the ligaments
    17. 17. Causes of ACL injury• Weakness in musculature about the hips and core• Particularly vulnerable in a position of knee valgus• Knee valgus can lead to MCL strain and increase risk of ACL injury• Usually involves a rapid deceleration of the joint, therefore increased strength is a requirement• More susceptibility with females
    18. 18. Female athletes and ACL injury• More occurrence of ACL injury than males• Due to hormonal, anatomical and neuromuscular differences• Neuromuscular control deficits: strength, power or activation patterns• Ligament dominance: imbalance between ligament and neuromuscular control of knee stability• Quadriceps dominance: imbalance between quads and hamstrings• Leg dominance: imbalance from leg to leg• Trunk dominance: inability to activate core correctly
    19. 19. Knee injury prevention• Ensure adequate hamstring strength• Work on posture and pelvic alignment• Correct takeoff and landing mechanics – work on the brakes• Develop movement and force reduction and production in all 3 planes of motion
    20. 20. Screening• Allows progression to be monitored• Can show the athlete why they need to be doing the exercises/training they have been set• It can highlight those most at risk and allow the coach to target specific work to those athletes
    21. 21. Methods of screening: Hop and stop• Measures differences in force production and stability relative to height• Gives quantitative information to compare on an ongoing basis• Is quick and easy to administer• For details and reminder of protocol see athlete by design
    22. 22. Methods of screening: Tuck jumps• Again, quick and easy to administer• Feet 35cm apart, slight knee bend and jump using an arm swing bringing the knees up to parallel with the floor• On landing immediately go straight into the next jump continuing for 10 seconds• The athlete should be encouraged to land softly using a toe to midfoot rocker and keep the same footprint on landing• The athlete should be instructed to stop if they show a sharp decline in technique
    23. 23.
    24. 24. Methods of prevention• Now we have an idea of the mechanisms of injury, we can target those areas to help prevent them• You don’t have to train individual muscles unless to address a specific imbalance or rehab program• By training the correct movement it makes prevention functional and will improve performance• These movements will help long term physical preparation
    25. 25. Get stronger!• The stronger your athletes, the greater the ability to produce reduce and stabilise force• Reduction in potential for injury, prevention is better than cure• Focus on whole body strength not individual muscles• First strength gains are neuromuscular, you get better at the movements.
    26. 26. Jumping and landing• Focus on technique – Maintain correct knee alignment – Landing on forefoot rocking back to mid-foot – Keep the noise down – Brace core• Progressions: – Increase height – Change direction – Introduce rotation – Single leg
    27. 27. Activating hip abductors• To help maintain proper alignment at the knee• Exercises working against a lateral resistance during uni or bi-lateral exercises – Band squats – Split squats/lunges – Monster walks – Side lying leg raises
    28. 28. Addressing quad dominance: Hamstrings• Looking to load the Hamstrings eccentrically• Number of possible exercises to use – Good mornings – Stiff leg deadlift – Stiff leg deadlift variations
    29. 29. Calf work• Calf stretching – straight leg, bent leg and big toe raised• Calf raises – – slow eccentrics and bounces – Whilst walking• Plyometric work – ankle hops – Low load short sets of below 10 on each leg
    30. 30. Addressing leg dominance• Even out through correct bilateral technique• Use of single leg exercises – Single leg squats – Split squats – Lunges• Increase the load on the non-dominant leg
    31. 31. Core• Important to use and train core musculature in the correct way• Pelvic tilt awareness• Use of the abdominal Brace• The big 4! – Curl ups – Bird dogs – Glute bridges – Side bridges
    32. 32. Shoulder• Thoracic mobility• External rotations• Wall angels• Scapula activation
    33. 33. Athlete education• Education plays an important role, create the all round athlete• Help the athlete to understand why they’re doing what they’re doing• Get the athletes to coach each other, will embed the technique• Will give greater adherence• Encourage self awareness, the athlete should be able to feel where they are going right and wrong
    34. 34. Flexibility• Calf• Hamstring• Hip flexor• Glute• Quads• 3D stretching
    35. 35. Making every session count• Your time with your athletes is valuable, we need to make sure none of it is wasted• The warm up, it is a substantial percentage of training and contact time• Need to plan this as much as the technical components of our sessions• Include jumps, landings, lunges, squats, accelerations and decelerations• We have to do better than a run around the pitch and some stretching
    36. 36. Use your down time• Your athletes will need to rest during a session, especially if it’s high intensity• Technical sessions often lower in intensity• Possible to plan small exercise blocks into the session
    37. 37. Get creative• You can incorporate a lot of these movements into your technical drills• A jump, a lunge, a hop. These are all useable and the beginning or mid way through a drill.• Alter your start position• Alter your finish position• Alter the direction of the drill
    38. 38. Any Questions?
    39. 39. Thank you for your
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