This lecture covers injury prevention and athletic performance.

1. The Essentials of Performance and Prevention

2. Housekeeping
• Introductions
• Toilet breaks
• Mobile phones
• Questions

3. Overview
• Warm-up
• Recovery
• Physical conditioning
• Injury screening
• Fair-play
• Protective equipment
• Hydration and nutrition
• Environment
• Common injuries
• Injury analysis

4. Warm-up
• Essential for sport
• Injury prevention
• Preparation
• Performance
• Components:
• Aerobic activity
• Stretching
• Muscle activation
• High-intensity efforts
• Sport-specific drills

5. Warm-up – Aerobic Activity
• Why:
• Heart rate
• Body temperature
• Blood flow to muscles
• Nerve conduction
• Muscle soreness
• How:
• Jogging
• Stationary bike
• Plyometrics

6. Warm-up – Stretching
• Why:
• Increase flexibility
• Reduce injury
• Prepare the body for
end range positions
• How:
• Static
• Dynamic

7. Static vs Dynamic Stretching
• Static:
• Doesn’t reduce injury
• Impairs performance
• May reduce MTJ injuries
• Dynamic:
• Reduces potential injury
• Enhances performance
• Increases flexibility

8. Warm-up – Muscle Activation & HSR
• Key element
• Neuromuscular
activation
• Prepares the body for
sport requirements
• Mental prep
• How:
• Speed / power drills
• Skills drills
• Activation drills
• Mobility drills

9. Warm-up – Sport-Specific
• Tactical preparation
• Sport specific
• Small-sided games
• Kick, catch and throw

10. Recovery
Cool-
down
Sleep Nutrition Other

11. Recovery – Cool-down
• Aerobic exercise
• Stretching
• Static vs dynamic?

13. Recovery - Sleep
• Cognitive function
• Metabolic control
• Energy balance
• Appetite and weight
• Tissue repair
• Napping
• Factors:
• Length
• Quality
• Phase

14. Recovery - Nutrition
• Appropriately refuel
and rehydrate
• Promote muscle repair
and growth
• Boost adaptation from
training / competition
• Support immunity
• How:
• Carb-rich
• Lean proteins
• Water

15. Recovery - Other
• Foam-rolling
• Massage
• Ice baths
• Compression
• Game Ready
• Cryotherapy chambers
• Electrical stimulation

16. Recovery - Alcohol

17. Physical Conditioning
• Background
• Injury prevention
• Periodisation

18. Physical Conditioning – Background
• Why
• fitness increases injury risk irrespective of experience
• Least fit are 14x more likely to get injured than most fit
• Fatigue alters technique and muscle unit capacity

19. Physical Conditioning – IPPs
• Exercise programs designed to prevent injury
• Good evidence for injury prevention
• Ideally sport specific
• Can replace the warm up
• Examples
• FIFA11+ - football and general
• KNEE – netball
• PEP – ‘Prevent injury, Enhance Performance’ program

20. Physical Conditioning – IPPs
• Components:
• Plyometrics
• Balance
• Resistance / strength
• Agility
• Flexibility

21. Physical Conditioning - Periodisation
“Periodisation is the
process of separating the
annual or long-term
training plan into smaller
more manageable periods
or ‘cycles’ and ‘phases’”

23. Fair-play
• What – respecting the rules and opposition
• Why – enjoyable game, injury prevention
• Who – everyone

24. Protective Equipment
• Headgear doesn’t prevent concussions
• Mouthgaurds protect against dental / facial injuries
• Taping / bracing may have prophylactic effect
• Better change associated with prevention:
• Rule changes e.g. elbow to head = red card
• Hockey stick below shoulder level
• Banning the shoulder charge
• If there is a risk, ensure someone qualified can help!

25. Nutrition and Hydration
• Pre-match:
• Carbohydrates
• Glucose = fuel
• Carb loading
• 3-4 days pre-comp
• Pre-match meal
• Carbs to top up glycogen
• Timing
• 3-4 hours before play
• During exercise >90mins
• Refined carbs - sugar
• E.g. fruit, juice

26. Nutrition and Hydration
• Post-match:
• Carbohydrates
• Non-refined
• Protein rich meal
• Lean meats
• Fats
• Low fat options
• Food > supplements

27. Nutrition and Hydration
• Hydration:
• Pre-match:
• Start well hydrated
• Not overhydrated
• Post-match:
• 120-150% replacement
• Replace over 6 hours

28. Nutrition and Hydration
• Hydration:
• Thirst not a good indicator
• Urine colour – pale yellow
• Fruit & veg for hydration
• 3.7L for men
• 2.7L for women
• How:
• Water
• Sports drinks

29. Environment
• Facilities
• Surfaces
• Equipment
• Emergency procedures
• Weather

30. Environment – Facilities
• Perimeter fencing
• Vehicles/car parks
• Change rooms
• Toilet facilities
• Emergency access
• AED on site

31. Environment – Surfaces
• Level ground
• State of the pitch/court
• Firmness
• No holes/sprinklers
• Water spillage
• Adequate lighting

32. Environment – Equipment
• Well maintained
• Appropriate size
• Padded posts
• Nets secured
• Serviced

33. Environment – Emergency Procedures
• Hazards
• Monitor and report
• Qualified first-aider
• First-aid equipment
• Emergency access
• Phone
• Pre-match meeting
• Written protocols
• Medical contacts

34. Environment – Weather
• Heat stress:
• Heavy sweating
• Skin flushed, cool
• Headache / dizziness
• Weakness
• Cramps
• Rapid pulse
• Loss of consciousness
• Hypothermia:
• Weakness
• Shivering
• Pale / waxy skin
• Uncoordinated
• Confusion / agitation
• Slow, slurred speech
• Shallow breathing

35. Injury Screening
• Who’s at risk?
• Why is it necessary?
• Components
• Physical assessment
• Health questionnaire
• Lifestyle assessment
• Physical assessment
• Follow-up screening

36. Injury Screening - Who
• Every player
• Different requirements
• Sport specific
• Position specific

37. Injury Screening - Why
• Identify health risks
• Identify weaknesses
• Provide baselines
• Identify factors that
may predispose an
individual to injury
• E.g. biomechanics
• Assess rehabilitation
performance to guide
return to play
• Provide trends for
squad-based injury
prevention

42. Injury Screening – Physical Assessment
• Medical – Doctor or Physio
• Fitness – S&C Coach or Physio
• Musculoskeletal – Physiotherapist

43. Injury Screening – Musculoskeletal
• Ligaments / joints /
muscles
• Biomechanics, technique
& movement patterns
• Balance and
proprioception

45. Common Injuries
• ACL
• Hamstring strain
• Lateral ankle sprain
• Paediatric conditions

46. Common Injuries - ACL
• Ligament in the knee
• Functions:
• Prevents forward
translation of the tibia
• Provides rotational
stability of the knee

47. Common Injuries - ACL
• Causes:
• Quick deceleration
• Hyperextension
• Rotation
• Change of direction
• Contact
• Risk factors:
• High risk sports
• Female
• Anatomical variances
• Footwear – studs + astro

48. Common Injuries - ACL
• The biggest issue:
• Recurrent injury

49. Common Injuries – Hamstring Strain
• Common muscle strain
• Function:
• Knee flexor
• Hip extensor
• Mechanisms:
• High speed running
• Excessive lengthening

50. Common Injuries – Hamstring Strain
• Prognosis:
• Time to jog pain-free
• 1-2 days < 2 weeks RTP
• 3-5 days > 2 weeks RTP
• 5+ days > 4 weeks RTP
(brukner)
• Kicking mechanism
• Larger injury
• More pain

51. Common Injuries – Lateral Ankle Sprain
• Common ankle injury
• Can occur at any age
• Most are minor
• Can have long-term
consequences - CAI

52. Common Injuries – Lateral Ankle Sprain
• Mechanism:
• Rolling the ankle
• Inversion
• Landing on foot
• Uneven surfaces
• Falling over

53. Common Injuries – Lateral Ankle Sprain
• Exclude fracture
• Ottawa ankle rules
• Surgery uncommon
• Treatment:
• PEACE&LOVE
• Physio – mobilisations
• ROM, balance, strength

54. Common Injuries – Lateral Ankle Sprain
• Chronic ankle instability
• Prolonged pain
• Abnormal proprioception
• Recurrent sprains
• Prevention:
• Proper rehab
• Warm-up
• Bracing/taping

55. Paediatric Conditions
• Osgood-Schlatter:
• Knee pain in adolescents
• Growth plate inflammation
• Risk factors:
• Growth spurts
• Active kids
• Treatment:
• Pain & load management
• Strengthen / stretch

56. • Severs Disease:
• Heel pain in adolescents
• Growth plate inflammation
• Risk factors:
• Growth spurts
• Active kids
• Flat shoes
• Treatment:
• Pain management
• Load management
• Strengthen / stretch
Paediatric Conditions

57. Injury Analysis
• Trends
• Causes
• Injury data
• Solutions
• Goal
• Injury risk reduction

58. Questions