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INJURY PREVENTION AND
TRAINING
Francis Mungai, Bsc PT
FOUNDAMENTALS OF TRAINING
The main objective of any form of physical training is to
elicit a physiological response that will permit the player
to perform at a greater level than before and protect
against injury. For any athlete attempting to undergo a
period of fitness training they must adhere to certain
principles in order to gain maximum benefits from their
training programme. This applies to all athletes, regardless
of competency and is extremely important for the injured
and deconditioned because training can be more varied
and complex in comparison to the fit athlete who is more
consistent in their training habits.
COMPETITIVE SPORT IS INHERENTLY RISKY, BUT WE CAN
SUPPORT INDIVIDUAL PLAYERS TO TAKE APPROPRIATE
PRECAUTIONS AGAINST INJURY OR RE-INJURY.
• Poor flexibility and muscle tightness are often cited as risk factors in muscle strains,
tendon injuries and re-injuries of strained muscles. The groin, hip flexors and ankle
dorsi-flexors (pointing your toe up) are often tight. Athletes should be encouraged,
therefore, not to neglect stretching these problem areas.
Laxity–loose ligaments due to either prior
injury or genetics
Muscle imbalance– e.g one leg being
stronger than the other or the quads and
hamstrings being imbalanced.
• Flexibility–people with knee injuries have flexible hamstrings
• General motor skills–knee ligaments seem to tear during landing, stopping or
cutting in an erect stance (straight knee and straight hip) and some valgus at the
knee.
• Low endurance has been cited as an injury risk. Injuries and goals are similar in that
many occur late in games.
• The game skill is also a factor in injury. Less skilled athletes suffer more injuries. Skill
work may seem dull, but we all know intuitively that the better skilled players are
usually injured less frequently.
• Foul play has been implicated in injuries as up to 50% of traumatic football injuries
were due to foul play; sometimes to the defensive player and sometimes to the
offensive player. The most skilled and most fit players are better able to avoid these
collisions.
• Boys aged 11 to 14 are at a special risk. During puberty, height increases faster than
muscle growth. The tall, weak boy gets injured more often than the shorter, less
mature or the taller more mature boy. That “in-between” period is a problem that
deserves special attention from all involved.
• Head injuries occur during head-head
contact or head-ground contact, ice or
floor, or being hit by a piece of
equipment such as a bat, lacrosse stick or
field hockey ball.
• Can change the way your brain normally
works.
• Can range from mild to severe.
• Presents itself differently for each athlete.
• Can occur during practice or competition in
ANY sport.
• Can happen even if you do not lose
consciousness.
PRINCIPLES OF EXERCISE TRAINING
• Specific adaptation to imposed demands: human body adapts
specifically to imposed demands. Given stressors on the human
system, whether biomechanical or neurological, there there will
specific adaptation to imposed demands (SAID).
• Endurance training improves cardiac output will increase when
stressed with endurance training. Muscle strength will be
improved with resistance training.
• THEREFORE: fitness can be improved by stressors (exercise) and
knowledge of how the body responds will guide exercise
prescription by physical therapists.
PRINCIPLES OF EXERCISE TRAINING
• Progressive Overload: manipulating the frequency,
intensity, and duration of a particular mode of
exercise to overload the body and stimulate an
improvement in physiological function.
PRINCIPLES OF EXERCISE TRAINING
• Specificity: adaptations to training are very specific. The
specificity of training refers to the mode or type of exercise,
the mm, the speed, the ROM and the intensity etc.
• To maximize carryover to fitness, training must be closely
matched with mode of exercise. Ex. Completing quad
exercises on a machine will not neccessarily make athlete
better at performing sit-stand transitions. Sprinters need
to train in sprinting,--not in mile long runs.
Cross training
Whilst the adaptations that occur following exercise are
greatest when the activity employed is specific to the
activity which is being trained for, it may not be possible,
either due to injury or poor fitness levels for an athlete to
mirror their sport when training. Consequently, cross
training is a mode of exercise that aids training when a
programme’s normal activities are not possible and this is
a popular mode of training for injured and deconditioned
athletes.
Despite the principle of specificity of
training, athletes may improve performance
in one mode of training by training in
another. The benefits of cross training for
the injured and deconditioned athlete allow
for the participation in training even if the
desired mode of training is not an option!
For example, cycling enables an athlete to
train aerobically even if an injury prevents
them from being able to run. They can
maintain the cardiovascular adaptations to
their training even though an injured leg
might prohibit running.
PRINCIPLES OF EXERCISE TRAINING
• Individuality: two atheletes may respond to the
same training differently based on genetics,
previous history of training, motivation, state of
fitness, etc. careful monitoring of progress and
adapting training is required to maximize
adaptations to training.
• Everyone responds to exercise training differently
even if the training performed is identical.
PRINCIPLES OF EXERCISE TRAINING
• Reversibility: A reduction in training load decreases fitness and
level of performance will decrease. In the sameway that the
molecules, tissues, organs and systems of the human body adapt
to the stimulus of training so increasing fitness, they will also
adapt to the stimulus of detraining by reverting back to their
pre-training status as the body responds to thedecreased
demands on it.
• The effects of detraining have been shown to be significant after
a couple of weeks of decreased activity. For example, after two
weeks of inactivity decreases of about 3 and 5 per cent have
been shown in muscle strength and cardiorespiratory fitness.
PRINCIPLES OF EXERCISE TRAINING
• Reversibility: A reduction in training load decreases fitness and
level of performance will decrease. In the sameway that the
molecules, tissues, organs and systems of the human body adapt
to the stimulus of training so increasing fitness, they will also
adapt to the stimulus of detraining by reverting back to their
pre-training status as the body responds to thedecreased
demands on it.
• The effects of detraining have been shown to be significant after
a couple of weeks of decreased activity. For example, after two
weeks of inactivity decreases of about 3 and 5 per cent have
been shown in muscle strength and cardiorespiratory fitness.
Overtraining
The consequence of too little recovery between training
sessions, or too many high intensity sessions performed
within a short period of time, is a concept termed
‘overtraining’.
A reduction in performance in spite of increased training
is the primary indication of overtraining. This can be a
direct consequence of muscle damage as muscles do not
recover between training bouts and therefore work in a
compromised state. The degree of muscle damage can
manifest itself as muscle soreness, earlier onset of
fatigue, muscle pain, stiffness and a higher than normal
blood lactate response.
• Adequate recovery is an integral part of a
training programme.
• Mix low, medium and high intensity work.
• Try not to perform too many high
intensity sessions back to back.
• Try to follow a high intensity session with
a low–medium session.
• Ensure an adequate CHO intake.
• Try to implement low intensity aerobic
sessions (some call this a regenerative
session) into programmes to facilitate the
recovery process.

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Injury prevention

  • 2. FOUNDAMENTALS OF TRAINING The main objective of any form of physical training is to elicit a physiological response that will permit the player to perform at a greater level than before and protect against injury. For any athlete attempting to undergo a period of fitness training they must adhere to certain principles in order to gain maximum benefits from their training programme. This applies to all athletes, regardless of competency and is extremely important for the injured and deconditioned because training can be more varied and complex in comparison to the fit athlete who is more consistent in their training habits.
  • 3. COMPETITIVE SPORT IS INHERENTLY RISKY, BUT WE CAN SUPPORT INDIVIDUAL PLAYERS TO TAKE APPROPRIATE PRECAUTIONS AGAINST INJURY OR RE-INJURY. • Poor flexibility and muscle tightness are often cited as risk factors in muscle strains, tendon injuries and re-injuries of strained muscles. The groin, hip flexors and ankle dorsi-flexors (pointing your toe up) are often tight. Athletes should be encouraged, therefore, not to neglect stretching these problem areas. Laxity–loose ligaments due to either prior injury or genetics Muscle imbalance– e.g one leg being stronger than the other or the quads and hamstrings being imbalanced.
  • 4. • Flexibility–people with knee injuries have flexible hamstrings • General motor skills–knee ligaments seem to tear during landing, stopping or cutting in an erect stance (straight knee and straight hip) and some valgus at the knee. • Low endurance has been cited as an injury risk. Injuries and goals are similar in that many occur late in games. • The game skill is also a factor in injury. Less skilled athletes suffer more injuries. Skill work may seem dull, but we all know intuitively that the better skilled players are usually injured less frequently.
  • 5. • Foul play has been implicated in injuries as up to 50% of traumatic football injuries were due to foul play; sometimes to the defensive player and sometimes to the offensive player. The most skilled and most fit players are better able to avoid these collisions. • Boys aged 11 to 14 are at a special risk. During puberty, height increases faster than muscle growth. The tall, weak boy gets injured more often than the shorter, less mature or the taller more mature boy. That “in-between” period is a problem that deserves special attention from all involved.
  • 6. • Head injuries occur during head-head contact or head-ground contact, ice or floor, or being hit by a piece of equipment such as a bat, lacrosse stick or field hockey ball. • Can change the way your brain normally works. • Can range from mild to severe. • Presents itself differently for each athlete. • Can occur during practice or competition in ANY sport. • Can happen even if you do not lose consciousness.
  • 7. PRINCIPLES OF EXERCISE TRAINING • Specific adaptation to imposed demands: human body adapts specifically to imposed demands. Given stressors on the human system, whether biomechanical or neurological, there there will specific adaptation to imposed demands (SAID). • Endurance training improves cardiac output will increase when stressed with endurance training. Muscle strength will be improved with resistance training. • THEREFORE: fitness can be improved by stressors (exercise) and knowledge of how the body responds will guide exercise prescription by physical therapists.
  • 8. PRINCIPLES OF EXERCISE TRAINING • Progressive Overload: manipulating the frequency, intensity, and duration of a particular mode of exercise to overload the body and stimulate an improvement in physiological function.
  • 9. PRINCIPLES OF EXERCISE TRAINING • Specificity: adaptations to training are very specific. The specificity of training refers to the mode or type of exercise, the mm, the speed, the ROM and the intensity etc. • To maximize carryover to fitness, training must be closely matched with mode of exercise. Ex. Completing quad exercises on a machine will not neccessarily make athlete better at performing sit-stand transitions. Sprinters need to train in sprinting,--not in mile long runs.
  • 10. Cross training Whilst the adaptations that occur following exercise are greatest when the activity employed is specific to the activity which is being trained for, it may not be possible, either due to injury or poor fitness levels for an athlete to mirror their sport when training. Consequently, cross training is a mode of exercise that aids training when a programme’s normal activities are not possible and this is a popular mode of training for injured and deconditioned athletes.
  • 11. Despite the principle of specificity of training, athletes may improve performance in one mode of training by training in another. The benefits of cross training for the injured and deconditioned athlete allow for the participation in training even if the desired mode of training is not an option! For example, cycling enables an athlete to train aerobically even if an injury prevents them from being able to run. They can maintain the cardiovascular adaptations to their training even though an injured leg might prohibit running.
  • 12. PRINCIPLES OF EXERCISE TRAINING • Individuality: two atheletes may respond to the same training differently based on genetics, previous history of training, motivation, state of fitness, etc. careful monitoring of progress and adapting training is required to maximize adaptations to training. • Everyone responds to exercise training differently even if the training performed is identical.
  • 13. PRINCIPLES OF EXERCISE TRAINING • Reversibility: A reduction in training load decreases fitness and level of performance will decrease. In the sameway that the molecules, tissues, organs and systems of the human body adapt to the stimulus of training so increasing fitness, they will also adapt to the stimulus of detraining by reverting back to their pre-training status as the body responds to thedecreased demands on it. • The effects of detraining have been shown to be significant after a couple of weeks of decreased activity. For example, after two weeks of inactivity decreases of about 3 and 5 per cent have been shown in muscle strength and cardiorespiratory fitness.
  • 14. PRINCIPLES OF EXERCISE TRAINING • Reversibility: A reduction in training load decreases fitness and level of performance will decrease. In the sameway that the molecules, tissues, organs and systems of the human body adapt to the stimulus of training so increasing fitness, they will also adapt to the stimulus of detraining by reverting back to their pre-training status as the body responds to thedecreased demands on it. • The effects of detraining have been shown to be significant after a couple of weeks of decreased activity. For example, after two weeks of inactivity decreases of about 3 and 5 per cent have been shown in muscle strength and cardiorespiratory fitness.
  • 15. Overtraining The consequence of too little recovery between training sessions, or too many high intensity sessions performed within a short period of time, is a concept termed ‘overtraining’. A reduction in performance in spite of increased training is the primary indication of overtraining. This can be a direct consequence of muscle damage as muscles do not recover between training bouts and therefore work in a compromised state. The degree of muscle damage can manifest itself as muscle soreness, earlier onset of fatigue, muscle pain, stiffness and a higher than normal blood lactate response.
  • 16. • Adequate recovery is an integral part of a training programme. • Mix low, medium and high intensity work. • Try not to perform too many high intensity sessions back to back. • Try to follow a high intensity session with a low–medium session. • Ensure an adequate CHO intake. • Try to implement low intensity aerobic sessions (some call this a regenerative session) into programmes to facilitate the recovery process.