Youngstown State University's Todd Burkey, breaks down the injury epidemic in sports, especially in youth sports. He provides plenty of statistics and causes of the injuries in these players. However, he gives a plan to decrease injuries, which will keep players out of the training room and on the field.

1. Connecting Rehab from the
Training Room/ Clinic to the
Weight Room
Todd Burkey AT,CSCS
Youngstown State University

2. The Injury Epidemic
• 30 million high school or younger participate in sports each
year.
• 3.5 million receive treatment for sports injuries each year.
(CDC)
• High school athletes sustain an estimated 2 million injuries per
year.
• Overuse injuries responsible for nearly half of all sport
injuries.
• Surgeons seeing 4X as many injuries vs. 5 years ago ( Dr. James
Andrews ).
• 1 of every 4 injuries are considered serious.
• 62% of injuries occur during practice.
• Sports related injuries increase severity with age.

3. Higher Level?
• Have noted more athletes entering their freshman year of
college with some injury or restriction.
• 1 of every 3 have a pre existing condition due to sports injury.
• 1 of every 4 do not finish their college career due to injury.
• Injury rates seem excessive.
• 67% of college football players reported injuries at some point
during their career.
• 36% of these injuries were to the knee.
• 80% of knee injuries required surgery.

4. The Athlete’s Knee
• ACL injuries have become commonplace (especially in
females)
• ACL Injuries as a % of all injuries:
• 1) Women’s Basketball ( 4.9% )
• 2) Women’s Gymnastics ( 4.9% )
• 3) Women’s Lacrosse ( 4.3% )
• 4) Women’s Soccer ( 3.7% )
• 5) Men’s Spring Football ( 3.5% )

5. • ACL Injury Rate per 1000 contacts:
• 1) Men’s Spring Football ( 0.33 )
• 2) Women’s Gymnastics ( 0.33 )
• 3) Women’s Soccer ( 0.28 )
• 4) Women’s Basketball ( 0.23 )
• 5) Men’s Football ( 0.18 )

7. Scary Statistics… ( 2006 )
•1,042,511 injuries per YEAR
•86,875 injuries per MONTH
•20,048 injuries per WEEK
•2,856 injuries per DAY
• 119 injuries per HOUR
• > 1 injury per MINUTE

8. Any good news?
• A careful, balanced and consistent training plan can affect risk
of injury.
• Evidence suggests that training can drastically reduce
incidence of ACL injury.
• According to ( ACSM ) 50% of overuse injuries in children are
preventable.
• Training can not only reduce risk of injury, but can also
increase performance.
•So why all the injuries?????

9. The Problem
• The American Sport Culture is not consistent.
• Medical care for athletes does not always cooperate with the
training plan.
• Differing opinions ( although diverse ) do not help the process
of preparing an athlete or safely returning them to activity.
• There needs to be a transition of care from rehabilitation in
the training room/ clinic back to the weight room.
• Try to look at it as two points in the same program.
• Consistently educate each other and the athletes you are
working with.
• Sport coaches ( especially youth ) need to be conscious of
developing proper body mechanics before sport play.

10. What to Do?
• Establish stability.
• Develop mobility.
• Develop control.
•Work on stopping before starting.
• Progress training.
• Continually revisit basic mechanics.

11. Establish Stability
• Isometric exercises.
• Posture ( Core Strength and
Endurance )
• Joint Position.
• Should probably be 1st aspect of
training or rehab.

12. Develop Mobility
• Hip mobility is lacking in most athletes.
• Thoracic mobility is also a major issue in athletes.
• Major cause of LBP is lumbar mobility combined with hip
and upper back stiffness ( McGill ).
• Hip flexor stiffness associated with hamstring injury/ re
injury ( New Zealand ).
• Most mechanical shoulder pain ( impingement ) due to
poor posture and scapular control.
• Mobility is not necessarily an issue of flexibility ( Mike
Boyle ).

13. Develop Control
• Eccentric emphasis through a range of
motion.
• Should precede speed work and emphasis
on concentric muscle action.
• Has shown effective in treating tendonitis
( Journal of Physical Therapy ).
• Most effective at submaximal load in low
volume.

14. Work on Stopping
• Deceleration emphasis.
• Focus on landing position in jumps.
• Focus on foot position, knee position, hip position when
stopping ( front and side ).
• “ Jump Training “
• Evidence suggests deceleration training has a direct
impact on risk of injury ( especially females ).
• Too often the focus is on acceleration and high speed
agilities ( contributes to bad movement mechanics )

15. Progress Training
• Continue to develop athletes in each phase.
• Stability, Mobility, and Control should be present in
nearly every phase ( prehab, training, rehab ).
• Too often these are left aside or dropped as rehab and
training advances ( detraining effect ).
• Most current model is Triphasic training ( Cal Dietz ).

16. Example training plan
• Initial 6 weeks
• Monday ( Isometric Focus ) Pause Squat, Pause
Bench, Submaximal Load
• Wednesday ( Eccentric Focus ) 5 count Back
Squat, 5 count Bench Press ( Submaximal Load )
• Friday ( Concentric Focus ) Box Squat with Bands,
Bench Press with Bands
• Daily deceleration drills as part of warm up.

20. Example rehab plan ( ankle )
• Day One ( Isometric focus ) Isometric resisted inversion,
eversion, plantar flexion, dorsiflexion
• Day Two ( Eccentric focus ) 5 count heel raises, 5 count
band resisted dorsiflexion
• Day Three ( Concentric focus ) band resisted inversion,
eversion, plantar flexion, dorsiflexion for reps
• After acute inflamatory response has ended initiate
deceleration drills on a daily basis.

21. Summary
• Injury rates have been on the rise, especially in youth
sports.
• Training is often too advanced for skill level.
• Training/ practice/ game volume is way too high.
• You can reduce the risk of injury by developing stability,
mobility and control.
• A training plan and rehab plan work best when in sync.
• Sport coaches ( especially youth ) should consider proper
instruction and movement should precede gameplay.

22. • Thanks to Doug Smith and Juniata College for the opportunity
to share and learn from this conference.
• Special thanks to Dan Wathen for the opportunity to work in
this field.
• If you have any questions please feel free to email:
teburkey@ysu.edu