Prevention of injuries in Sports.

1. Prevention of Sports Injuries
Dr. Usha (PT)
Assistant Professor
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2. INTRODUCTION
 To minimize activity-related injury, that is, to improve the
benefit: risk ratio associated with physical activity and sport.
 Sports injury prevention can be characterized as being
1. Primary
2. Secondary
3. Tertiary
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3.  Primary prevention include health promotion and injury
prevention (e.g. ankle braces being worn by an entire team, even
those without previous ankle sprain)
 Secondary prevention can be defined as early diagnosis and
intervention to limit the development of disability or reduce the
risk of reinjury. (e.g. early RICE treatment of an ankle sprain)
 Tertiary prevention is the focus on rehabilitation to reduce
and/or correct an existing disability attributed to an underlying
disease. (e.g. in the case of a patient who has had an ankle sprain,
this would refer to wobble board exercises and graduated return to
sport after the initial treatment for the sprain.
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4. Warm-up
Stretching
Taping and bracing
Protective equipment
Suitable equipment
Appropriate surfaces
• Appropriate training
• Adequate recovery
• Psychology
• Nutrition.
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5. 1. The magnitude of the problem must be identified and
described in terms of the incidence and severity of sports
injuries.
2. The risk factors and injury mechanisms that play a part in
causing sports injuries must be identified.
3. To introduce measures that are likely to reduce the future
risk and/or severity of sports injuries
4. The effect of the measures must be evaluated by repeating
the first step.
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7. 1. Considers the internal risk factors— factors that may
predispose to or protect the athlete from injury. This
includes athlete characteristics, factors such as age,
maturation, gender, body composition and fitness level. One
factor that consistently has been documented to be a
significant predictor is previous injury—almost regardless
of the injury type studied. Internal factors such as these
interact to predispose to or protect from injury.
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8.  Internal risk factors can be modifiable and non-modifiable
1. Modifiable risk factors may be targeted by specific
training methods.
2. Non-modifiable factors (such as gender) can be used to
target intervention measures to those athletes who are at an
increased risk.
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10.  The second group of risk factors is the external factors the
athletes are cold weather, or inappropriate footwear. exposed
to, for example, floor friction in indoor team sports, snow
conditions in alpine skiing, a slippery surface (running track),
very
 Exposure to such external risk factors may interact with the
internal factors to make the athlete more or less susceptible
to injury. When intrinsic and extrinsic risk factors act
simultaneously, the athlete is at far greater risk of injury than
when risk factors are present in isolation.
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11.  The final link in the chain of events is the inciting event,
which is usually referred to as the injury mechanism—what
we see when watching an injury situation.
 Again, it may be helpful to use a comprehensive model to
describe the inciting event, which accounts for the events
leading to the injury situation (playing situation, player and
opponent behavior), as well as includes a description of whole
body and joint biomechanics at the time of injury.
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12.  For clinicians, this model can be used to identify potential
causes of injury.
 The key questions to ask are:
Who is at increased risk? Why?
How do injuries typically occur?
 When caring for a defined group of athletes, such as a soccer
team or an alpine skiing team, this can be done using a
systematic risk management approach.
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13.  Individual risk factors (and protective factors) can be mapped
during the pre-season physical examination (e.g. history of
previous injury, malalignment) or tested as part of the team’s
fitness testing program (e.g. strength, flexibility, neuromuscular
control).
 Then it is possible to do a risk analysis to document the parts of
the season when athletes are at the greatest risk of sustaining
injuries as a result of the training or competitive programs.
 E.g. of situations in which risk increases are when athletes switch
from one training surface to another (e.g. from grass to gravel) or
to new types of training (e.g. at the start of a strength training
period).
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14.  Analysis is an important basis for planning preventive
measures, particularly for the purpose of avoiding overuse
injuries.
 The analysis is based on the idea that the risk of injuries is
greater during transitional periods and that each stage has
certain characteristics that may increase risk. The risk profile
usually varies from sport to sport.
 Healthcare personnel responsible for teams or training
groups should do this type of analysis in collaboration with
the coaches and athletes and create a plan for relevant
preventive measures based on the risk analysis.
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15. WARM-UP
 Warm-up prepares the body for exercise. The type of exercise
to be performed determines the type of warm-up.
 The most effective warm-up consists of both general and
specific exercises.
 General exercises may include jogging, general stretching and
resistance exercises.
 Specific exercises include stretches and movements that are
appropriate for the particular activity about to be undertaken.
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16. Possible benefits of warm-up prior to
physical activity
 Increased blood flow to muscles
 Increased oxyhemoglobin breakdown, with
 Increased oxygen delivery to muscles
 Increased circulation leading to decreased vascular resistance
 Increased release of oxygen from myoglobin
 Enhanced cellular metabolism
 Reduced muscle viscosity leading to smoother muscle
contraction and increased mechanical efficiency
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17.  Increased speed of nerve impulses
 Increased sensitivity of nerve receptors
 Decreased activity of alpha fibers and sensitivity of muscles to
stretch
 Decreased number of injuries due to increased range of motion
 Decreased stiffness of connective tissue leading to decreased
likelihood of tears
 Increased cardiovascular response to sudden strenuous exercise
 Increased relaxation and concentration.
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18.  In team sports there can be a group regimen with a built-in period
of ‘free warm-up’. One guideline for the intensity of the warm-up is
to produce some mild sweating without fatigue. The effect of a
warmup lasts approximately 30 minutes, so it is important not to
warm up too early.
 The structured warm-up programs designed to prevent injuries
can reduce injury risk by 50% or more. However, it is not known
whether it is the physiological effects of the warm-up program as
described above which confer the effect on injury risk, or whether
the reduced risk results from training effects on strength,
neuromuscular control, technique or other factors.
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19. STRETCHING
The ability to move a joint smoothly throughout a full
range of movement is considered an important
component of good health.
There is a hereditary component to general flexibility,
and specific joints or muscles may become stiff as a
result of injury, overactivity or inactivity.
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20.  Athletes commonly perform three different types of stretching
exercises—static, ballistic and proprioceptive neuromuscular facilitation
(PNF).
Static stretching
 The stretch position is assumed slowly and gently and held for 30–60
seconds. The athlete should not experience any discomfort in the
stretched muscle.
 As the position is held, tension from the stretch becomes strong enough
to initiate the inverse myotatic stretch reflex with subsequent muscle
relaxation.
 The muscle can then be stretched a little further, again without
discomfort. This increased stretch should also be held for approximately
30 seconds, then relaxed.
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21.  If, during either stage of the stretch, there is a feeling of
tension or pain, overstretching is occurring and this may
cause injury.
 The athlete should ease off to a more comfortable position. Of
the different types of stretches, static stretch produces the
least amount of tension and is probably the safest method of
increasing flexibility.
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22. Ballistic stretching
 In a ballistic stretch, the muscle is stretched to near its limit,
then stretched further with a bouncing movement. The
disadvantage of this stretch is that the quick bouncing causes
a strong reflex muscle contraction.
 Stretching a muscle against this increased tension heightens
the chances of injury. Therefore, this technique is not
commonly used.
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23. Ballistic stretching may be used, however, by athletes
in the latter stages of a stretching program. It should
be preceded by an adequate warm-up and slow static
stretching.
It is used particularly in gymnastics, ballet and dance
where maximal range of motion is advantageous.
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24. Proprioceptive neuromuscular facilitation stretching
 PNF stretching is performed by alternating contraction and relaxation of
both agonist and antagonist muscles. that muscle relaxation is increased
both after agonist contraction and antagonist muscle contraction.
 There are a number of different PNF stretching techniques (Fig. 6.4).
PNF stretching may produce greater flexibility gains than other
stretching techniques.
 Its major disadvantage is that there is a tendency to overstretch. PNF
stretches should ideally be performed with a partner who is aware of
the potential dangers of the technique. PNF stretching is based on the
observations
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25. Principles of stretching
 The basic principles of stretching are:
 Warm-up prior to stretching
 Stretch before and after exercise
 Stretch gently and slowly
 Stretch to the point of tension but never pain.
 A general stretching program involving stretches of the major muscle
groups.
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33. TAPING AND BRACING
 Taping (or strapping) and bracing are used to restrict
undesired, potentially harmful motion and allow desired
motion. There are two main indications for the use of tape and
braces:
1. Prevention—taping is used as a preventive measure in high-
risk activities, for example, basketball players’ ankles
2. Rehabilitation—taping is used as a protective mechanism
during the healing and rehabilitation phases.
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34. Although taping and bracing are used in the injury
management of conditions in numerous joints, they
have not been proven to be effective for primary
injury prevention in the shoulder, elbow, knee and
spinal joints.
However, there is good evidence to suggest that
bracing may prevent re-injuries in athletes with a
history of a previous ankle sprain.
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35. Taping
 There are many different tapes and bandages available for use by
athletes. However, when the purpose is to restrict undesired
motion, only adhesive, non-stretch (rigid) tape is appropriate.
 Elastic tape is inappropriate for restricting motion. Good tape
should be adhesive, strong, non-irritant and easily torn by the
therapist.
 Tape is ideally applied over joints where skin sliding can be limited
to one direction. The joints most suitable for taping are the ankle,
wrist, finger, acromioclavicular joint and the first
metatarsophalangeal joint.
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36. 36

37.  As well as providing mechanical support, tape may enhance
proprioception. Guidelines for tape application are:
1. Preparation
2. Application
3. Removal
4. Complications
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38. PREPARATION
 The athlete and the therapist should be in a comfortable
position for tape application.
 Tailor the taping to the needs of the individual and the sport
being played. It is important to provide support but not
restrict essential movement.
 Injured ligaments should be held in a shortened position
during taping. Ligaments that have not previously been
injured should be held in neutral position.
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39.  Shave body hair, preferably at least 8 hours prior to tape
application to avoid skin irritation.
 Clean skin, remove grease and sweat.
 Apply an adhesive skin spray prior to taping, especially if
sweating is likely to reduce the adhesiveness of the tape.
 Use an underwrap if a skin allergy exists.
 Care should be taken with the use of non-stretch tape around
swollen joints.
 Use tape of appropriate width.
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40. 40
Pre wrap or Underwrap

41. APPLICATION
 Use anchors proximally and distally, as tape adheres better to itself
than to skin.
 Unroll the tape before laying it upon the skin to ensure correct
tension.
 Apply even pressure.
 Overlap the previous tape by one-half to ensure strength and even
application.
 Smooth out all folds and creases to prevent blisters and
lacerations.
 If discomfort is present after tape application, adjust the tape.
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Anchors

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44. REMOVAL
Remove tape carefully with the use of tape cutters or
tape scissors.
Hold the skin and pull the tape slowly in opposite
direction.
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45. COMPLICATIONS
 Complications of tape application include reduced circulation
from tight taping, skin irritation due to mechanical or allergic
phenomena, and decreased effectiveness of tape with time.
 Tape provides substantial material support but, as with any
material, does have a threshold where it fails. It may be
necessary to reapply tape at a suitable break during the
athletic activity, for example, at half-time.
 Tape application requires practise to perfect technique.
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46. BRACING
 Bracing has several advantages over taping. An athlete can put
a brace on by himself or herself and although the initial cost of
a brace may be high, a good quality, strong brace will last a
considerable time and may prove to be cheaper than repeated
taping.
 Bracing also has a number of disadvantages. These include
possible slipping of the brace during use, the weight of the
brace, problems with exact sizing and the risk of the brace
wearing out at an inopportune moment. Sometimes it may be
necessary for braces to be custom-made.
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47.  A number of different types of braces are available. Heat-retaining
sleeves are commonly used in the treatment of many chronic
inflammatory conditions These sleeves are commonly made out of
neoprene.
 The neoprene support offers increased warmth and comfort over
the affected area and may improve proprioception but provides
little or no mechanical support. The sleeves are available for most
joints and muscles.
 Increased mechanical support can be gained by the use of harder
material or the addition of straps or laces. Certain braces are used
only to restrict movement, such as a hinged knee brace
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Neoprene brace for knee

49. Braces can be custom-made by molding thermoplastic
material over the affected part.
Such splints are commonly used in the hand and
wrist, particularly over the first carpometacarpal joint
after a Bennett’s fracture or at the first
metacarpophalangeal joint after a hyperextension
sprain or ulnar collateral ligament sprain.
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51. PROTECTIVE EQUIPMENT
Protective equipment has been designed to shield
various parts of the body against injury without
interfering with sporting activity. Protective
equipment can also be used on return to activity after
injury in situations where direct contact may
aggravate the injury.
Helmets are mandatory in certain sports such as
motor racing, motor cycling, cycling, ice hockey, horse
riding and American football.
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53.  In other sports the use of helmets is not universally accepted,
such as in rugby football and skateboarding. The role of
helmets, and face shields in protection against head injuries.
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54.  Other protective equipment commonly worn includes: mouth
guards in most collision sports; shoulder pads in American
and rugby football; chest, forearm and groin protectors in ice
hockey; knee pads when playing on artificial surfaces or while
rollerblading; wrist guards in rollerblading and
snowboarding; and shin pads in soccer and hockey.
 It is important that protective equipment fits correctly.
Protective equipment may provide a psychological benefit by
increasing a player’s confidence.
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55. SUITABLE EQUIPMENT
Running shoes, football boots, ski boots and tennis
racquets are important elements that contribute to, or
prevent, sports injuries.
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56. RUNNING SHOES
 The sports clinician must be able to assess foot type and
advise athletes on the type of shoe most suited to their needs.
The optimum shoe for a runner is one that matches the
runner’s specific mechanical features. Several features of
shoes may affect foot function. The first part of the shoe to be
considered is the heel counter, the upper rear part of the shoe.
 The heel counter should be made of rigid, firm plastic to assist
in rear foot stability.
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57. Parts of shoe
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58. Forefoot flexibility must be adequate to allow easy
motion of the foot flexing at toe-off .
With a rigid sole, the calf muscles may need to
perform extra work in order to plantarflex the foot
during propulsion. A shoe with a lack of flexibility in
the forefoot may help the individual with
metatarsalgia.
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59.  The midsole of the shoe is probably the most important
feature. Midsoles are usually made of EVA, which is light and a
good shock absorber. The midsole houses the more complex
shock-absorbing materials such as gel pads and air bladders.
The most important feature of the midsole is its density
(durometer).
 It should be appropriately firm or soft depending on the
mechanics and weight of the individual. Midsoles that are too
soft permit excessive mobility, whereas firmer ones allow a
more stable platform and often extended wear.
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60. Runners requiring control of excessive motion should
use a midsole of dual density that is harder on the
medial aspect of the foot. Runners requiring extra
shock absorption should choose a shoe with a soft
midsole that still provides lateral stability.
Maximum impact forces vary little in magnitude
between soft and hard midsoles but the maximal
forces occur at a later stage in the soft shoes.
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61.  Midsoles that are flared promote rapid and excessive
pronation of the foot and should be avoided. This negative
aspect of lateral flaring outweighs the advantage of decreased
impact forces. Last construction refers to the method used to
join the upper of the shoe to the midsole.
 Shoes are generally slip lasted where the upper is sewn
together and glued directly to the sole. This promotes shoe
flexibility but may reduce stability. Stroebel lasting is a
technique whereby canvas or foam is perimeter stitched to
the base of the upper and then glued to the midsole.
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62.  This lasting technique became popular when manufacturers
replaced the fiber boards with rigid plates lodged directly in the
midsole to increase torsional rigidity.
 Last construction, once the primary feature in footwear design, is
now seen as a prime factor influencing the fit of a shoe but it has
little influence on mechanics and foot function. There is no
evidence to support the commonly held view that the shape of a
shoe influences foot function.
 There is a range of last shapes available in today’s shoe market. It
is important that the athlete is fitted by a professional and is
comfortable with the ‘feel’ of the running shoes before they are
purchased. Note that footwear brands differ in their construction.62

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65. RUNNING SPIKES
Poorly designed running spikes may contribute to foot
and lower limb injuries but there is a dearth of
published literature in this field. The majority of
running spikes are designed so that the spike plate is
plantar grade in relation to the heel.
When running on a flat surface the heel lift is
negligible and, thus, the heel is lower than the
forefoot, which we call ‘negative heel’. This
phenomenon is the opposite of a heel ‘raise’, as used in
the treatment of Achilles’ problems.
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66. 66
Running Spikes

67. When running in spikes, the athlete strikes the ground
on the forefoot and midfoot with the heel off the
ground. The heel does not usually make contact with
the ground while running at or near top speed.
However, at lesser speeds, as the body weight moves
over the foot, the foot lowers to the ground with little
stability due to the negative heel.
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68.  The calf muscles may be subject to greater eccentric load due
to the negative heel lift as the tibia is required to dorsiflex
over the foot through a greater range. In addition, the small
heel provides little stability for the eccentric lowering of the
heel by the calf muscles.
 These factors may predispose to the development of Achilles
tendinopathy and shin pain in runners, as well as increasing
the amount of compensatory pronation and midtarsal joint
dorsiflexion. Running spikes may be modified to provide more
stability by increasing the heel lift and balancing the shoe.
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70. FOOTBALL BOOTS
 Football boots require all the features of a good running shoe
in addition to features that will allow kicking and rapid
changes of direction, particularly on soft surfaces.
 The construction of many types of football boots provides
inadequate support for the lower limb.
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72. The ideal football boot should be of adequate foot
depth in the upper, have a rigid heel counter, have
sufficient forefoot flexibility, have a wide sole, be
slightly curved in shape and the ‘stops’ or cleats
should be placed to allow adequate forefoot flexibility.
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74. SKI BOOTS
Generally, ski boots are stiffer. However, a stiff ski boot
does not allow adequate compensatory movement at
the midtarsal and subtalar joint and places additional
stress on the bones and joints of the lower limb.
More advanced skiers require stiff boots. Ski boots
should be individually fitted and boots are available
that allow individual molding to the shape of the
skier’s foot.
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Ski boots

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77.  During skiing, control is maintained by pronating the foot to
edge the downhill ski into the slope. Skiers who have certain
biomechanical abnormalities (e.g. forefoot varus, rear foot
varus) already have their foot fully pronated in a flat position
in the boot.
 This forces the skier to internally rotate the lower limb and
adopt a valgus knee position to maintain edge control. This
may lead to inefficient skiing, fatigue and medial knee pain.
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78. Excessive foot pronation may be corrected with an
orthosis placed in the ski boot to restore the foot to a
neutral position.
As the degree of correction possible with orthoses is
limited by boot fit, additional control is sometimes
required by the use of canting or wedging of the
underside of the boot.
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79. Most equipment-related skiing injuries occur when
the ski acts as a lever to turn or twist the lower leg,
and many can be prevented with appropriate binding
release.
Beginners are particularly at risk as they have
relatively tighter bindings and boots and bindings of
lower quality than the intermediate level skier.
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80. TENNIS RACQUETS
 In tennis, the impact between ball and racquet produces a
significant amount of force, and how much force reaches the
tennis player’s arm depends on how hard the player swings,
the speed of the incoming ball, where on the racquet face the
ball is struck, the qualities of the racquet, the string tension
and the stroke mechanics.
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81. Each racquet has an area where the initial shock is at a
minimum—the center of percussion or ‘sweet spot’.
When the ball is hit in the sweet spot, the shot feels
good.
If the ball is not hit in the sweet spot, there is
increased shock transmitted to the hand, wrist and
elbow.
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83.  The major factor in the etiology of tennis-related elbow
pain is incorrect stroking technique, especially the
backhand drive. However, the characteristics of the
racquet may also contribute.
 The older style wooden racquets were heavy and flexible,
both of which reduced shock on impact.
 The modern wide-body racquets are lighter and stiffer in
order to generate increased power but these racquets do
not absorb the shock of impact as well as wooden
racquets.
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85. There are a number of ways of altering the tennis racquet to
reduce the shock at impact and lessen the force transmitted to
the player’s arm:
• Lower string tension
• Increase flexibility of the racquet
• Increase the size of the racquet head
• Increase the weight (add lead tape to head and handle)
• Increase the grip size
• Grip higher on the handle of the racquet. 85

86.  The tennis player should choose the largest comfortable grip
size. A larger grip size prevents the player gripping the
racquet too tightly.
 Players should also be encouraged to loosen their grip on the
racquet. It is only necessary to squeeze firmly on the grip
during the acceleration phase of the stroke.
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88. APPROPRIATE SURFACES
 The surface on which sportspeople play is under the spotlight
as it may be a major contributor to injury risk through
excessive shoe–surface traction.
 This possibility was proposed as a mechanism for anterior
cruciate ligament (ACL) rupture in European handball as early
as 1990, and has later been examined in a large,
epidemiological study where the ACL injury rate was
compared between two different floor types—wooden floors
(parquet, generally having lower friction) and artificial floors
(generally having higher friction).
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89.  These results indicated that the risk of ACL injury among
female team handball players is higher on high-friction
artificial floors than on wooden floors. However, other factors
also have a significant role in shoe–surface friction, principally
shoe type and floor maintenance.
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90.  The perennial rye grass is associated with lower shoe–surface
traction than Kentucky blue grass or bermuda grass because
it creates less thatch.
 The studies suggest that rye grass generally offers a safer
surface with respect to ACL injuries for football than some
other grasses.
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92.  To prevent all possible injuries, it is important to consider playing
surface hardness because of its association with overuse injuries
such as stress fractures, shin pain and tendinopathy.
 A hard surface such as concrete generates greater force through
the musculoskeletal system than a forgiving surface such as grass.
 Sporting activities can generate extremely high loads that may, or
may not, be modulated by the surface. Maximal impact forces
during walking have been shown to approach twice body weight,
during running three to four times and during jumping five to 12
times
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93. APPROPRIATE TRAINING
 It is essential for sports clinicians to understand the different
elements of training and their possible relationship to injury.
This familiarity facilitates clinicians obtaining a full training
history from an injured athlete or learning about the longer
term training strategy from a coach.
 This makes it possible to determine where training error
occurred and to take active steps to prevent this recurring.
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94. PRINCIPLES OF TRAINING
 ‘Training’ is the pursuit of activity that will ultimately lead to
an increase in performance in a given sport. A number of
general principles of training apply to all sports:
• Periodization
• Specificity
• Overload
• Individuality
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95. PERIODIZATION
Three distinct phases:
1. Conditioning (preparation)- emphasizes developing aerobic
and anaerobic fitness, strength and power. The athlete is
‘training tired’ and if required to compete would probably
perform poorly.
2. Pre-competition (transitional)- emphasis switches from
pure conditioning to technique work.
3. Competition- emphasis is on competitive performance while
maintaining basic conditioning
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96.  In many sports, for example, basketball, football and hockey, a
four to six month competition season is usual. In some
instances, an athlete is required to undertake two periods of
competition in the one year.
 In other instances, the competition period may last as long as
eight to 10 months and conditioning work must extend into
the competitive season. However, the same principles of
training apply. The athlete should aim for a peak performance
at a predetermined time in a competitive season, such as a
specific championship or final.
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97.  To ensure complete recovery from the physical and mental
stress of competition, adequate time should be allowed
between the end of one season and the start of the next. This
period may last four to six weeks.
 In the intermediate time frame, it is important to introduce
easy weeks into the training program; these give the athlete
time to recover and diminish the risk of injury.
 During these easy weeks, the volume and intensity of training
may be decreased and the opportunity may be taken to test
the athlete’s progress in the form of a time trial, mini
competition or practise match. The optimal spacing of these
easy weeks is probably every third or fourth week. 97

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99. OVERLOAD
 Overload is a variable that athletes and coaches manipulate to
allow the athlete to perform work at a greater intensity or to
perform a greater volume of work at a given intensity, or to
decrease recovery time between eff orts of a given volume and
intensity.
Overload principles include the following:
• Apply stress to the body over and above that which is
normally encountered.
• If increased stress is not excessive and adequate adaptation
time is allowed, the work capacity of the athlete will be
increased (‘supercompensation’). 99

100.  Allow adequate recovery time to produce a training effect.
 Increase training load by changing the volume (quantity or duration) or
the intensity (quality) of training.
 Only increase volume or intensity at any particular time (increases in
volume should precede increases in intensity).
 Progress new training activities slowly so as not to cause injury to
muscle groups and joints unaccustomed to that activity.
 Titrate overload to maximally improve performance without incurring
injury (this is an art!).
 Monitor the athlete closely for signs of decreased performance or
overtraining
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101. SPECIFICITY
 Specificity refers to the principle of directing training to
performance in the athlete’s given sport. It is important,
therefore, to identify the most important components of
fitness for each particular sport and tailor the athlete’s
training towards improving these particular components.
 There is no advantage for a power athlete in doing large
amounts of endurance training, nor for an endurance athlete
to spend considerable time on strength training. Some sports,
for example, football, require both strength and endurance
training.
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102. INDIVIDUALITY
 As individual differences between athletes are great, training
must be tailored to the individual’s needs. Individuals differ in
their tolerance of particular training loads, response to
specific training stimuli, speed of recovery, psychological
make-up, nutritional intake and lifestyle habits.
 Individual responses to training are influenced by previous
training history, age, current state of fitness and genetic make-
up.
102

103. TRAINING METHODS
 Endurance or aerobic training,
 Anaerobic training,
 Strength and power training,
 Flexibility training,
 Speed and agility training,
 Specific skill training and
 Cross-training.
103

104. AEROBIC TRAINING
 Aerobic training is performed to increase aerobic capacity or
fitness. The aerobic capacity of an individual is the ability to
utilize the body’s glycogen stores via the aerobic metabolic
pathway.
 An individual’s aerobic capacity is measured by the maximum
oxygen consumption, better known as the Vo2max—the
maximum amount of oxygen an individual is able to utilize in
one minute per kilogram of body weight
104

105.  This can be measured in the laboratory by exercising the
individual to exhaustion and directly measuring the amount
of oxygen consumed and carbon dioxide produced. (Accurate
method)
 The “predicted Vo2max” (simpler, but less exact method) is
estimated by measuring the heart rate at a specific workload
and commonly performed in health and fitness centers.
105

106.  Alternatively, the rating of perceived exertion (RPE) can also
be measured at a series of submaximal workloads so that the
maximal workload predicted to occur at a maximal RPE of 20
units can be estimated.
 Although the athlete is unable to monitor oxygen
consumption directly during training he or she can monitor
heart rate or RPE or both, which correlates well with oxygen
consumption during submaximal activity. Thus, heart rate or
RPE can be used to monitor the intensity of aerobic training.
106

107.  In muscle, aerobic activity increases mitochondrial number
and activity, glycogen storage, ability to use free fatty acids
and vascularity. Cardiovascular effects include decreased
heart rate and blood pressure with increased cardiac stroke
volume and improved endothelial function.
107

108. 108

109. ANAEROBIC TRAINING
Anaerobic exercise utilizes the anaerobic (oxygen
independent, i.e. without the need for oxygen)
metabolism of glucose to produce energy. This
pathway utilizes ATP as its energy substrate and, as a
result, produces less energy per molecule of glucose
utilized than does aerobic exercise.
Anaerobic training improves the capacity to maintain
a high rate of power production for short durations of
exercise at very high intensities.
109

110.  This requires that muscle recruitment and muscle contractile
function be better maintained after training so that the onset
of fatigue is developed.
 This may result, in part, from the increased efficiency of the
body’s anaerobic metabolism while also improving its
tolerance of lactic acidosis. The level of discomfort
experienced in training correlates well with measured serum
lactate concentrations.
110

111.  The most efficient method of increasing anaerobic fitness is to
undertake a form of intermittent exercise or interval training.
Interval training involves a number of bouts of exercise that
are separated by periods of rest or recovery.
 The principle of such training is to achieve a level of lactic
acidosis with one individual eff ort and then allow the body to
recover from its effects before embarking on another bout of
exercise. There is scope for enormous variation in the
intensity and duration of the exercise bouts and the duration
of the recovery period.
111

112. STRENGTH AND POWER TRAINING
 Muscular strength is the amount of force that may be exerted
by an individual in a single maximum muscular contraction.
 Power is the maximum amount of work an individual can
perform in a given unit of time.
 Muscular strength may be increased by utilizing one of three
different resistance training techniques.
1. Isotonic strength training- Concentric & Eccentric muscle
contraction or combined movement
2. Isokinetic strength training
3. Isometric strength training
112

113. ISOTONIC STRENGTH TRAINING
 Resistance can be provided by free weights, rubber bands,
pulleys, weight machines or the individual’s own body weight.
 Examples include the bench press, the dumbbell curl, the
power squat and the calf raise.
113

114. The advantages of isotonic weight training over isometric
and isokinetic techniques include:
 Tend to be more functional, natural movements
 Athlete can observe the work being done as the weight is
lifted
 May be performed over a full range of movement or,
alternatively, over a specific limited range of movements
 Athlete/coach can measure the amount of weight lifted and
the number of repetitions performed.
114

115. The potential dangers of isotonic weight training include:
 Athletes require adequate supervision in the gymnasium
 Athlete should never attempt to lift a maximal weight without
a ‘spotter’—an assistant who is able to help the athlete if
problems arise
 Isotonic machines such as the universal or nautilus machines
may provide a safe alternative to free weights but these
machines limit the range of motion and are unable to provide
truly constant resistance through the lift .
115

116.  Isotonic exercises in which the body weight of the individual
is used as resistance are also safer than free weights and are
often more convenient to perform.
 Exercises such as sit-ups, push-ups and chin-ups can be done
almost anywhere and require no supervision.
 However, it is difficult to increase the resistance of the
exercise and the only way to increase the eff ort is to increase
the number of repetitions performed.
116

117. ISOKINETIC AND ISOMETRIC STRENGTH
TRAINING
 Because of the need for specialized equipment, the use of
isokinetic training by athletes is usually limited to
rehabilitation from injury.
 Isometric training is usually discouraged because it develops
strength in a very small range of motion but it is used in
rehabilitation after injury where range of motion may be
restricted.
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118. OLYMPIC-TYPE WEIGHTLIFTING
 Often used as part of a strength training program.
 Involves the lifting of a weight from the floor to a position above the ground
 The Olympic-type lift s are the power clean, snatch, and clean and jerk
118

119. 119

120.  These lift s exercise a greater number of muscle groups than
conventional weightlifting, exercising them both
concentrically and eccentrically.
 The potential for injury is high and athletes must learn correct
lifting techniques before attempting large weights.
 It is advisable to wear a weight belt to prevent back injuries.
Because of the explosive nature of the lift , Olympic-type
lifting is an excellent means for improving power as well as
strength.
120

121. PLYOMETRIC TRAINING
 Use the natural elastic recoil elements of human muscle and
the neurological stretch reflex to produce a stronger, faster
muscle response.
 A form of resistance training that combines a rapid eccentric
muscle contraction followed by a rapid concentric contraction
to produce a fast forceful movement.
 It must be performed in conjunction with a resistance training
program as athletes need to have minimum basic strength
levels before commencing plyometrics.
121

122.  E.g. of plyometric activities: hopping and bounding drills, jumps over hurdles
and depth jumps
122

123.  Great potential for injury (because of explosive nature of
plyometrics)
 Delayed onset muscle soreness (DOMS) may occur following
these ex.
 Plyometric training should only be performed one to two
times per week and when the athlete is fresh. The surface
must be firm, but forgiving, such as sprung basketball floors.
Injury risk is minimized if the athlete warms up and warms
down correctly and the volume of work is built up gradually.
When technique begins to deteriorate, the exercise should be
stopped. 123

124. SPEED TRAINING
 Running speed, a largely inherited ability, is an important
component of many sports. Athletes can, however, develop
speed by improving muscular power and strength, thus
increasing stride length and cadence, as well as by improving
technique, which increases the efficiency of ground coverage.
 Therefore, running speed can be increased by undertaking
resistance and power training as well as by performing
running drills. These drills may include ‘high knees’, ‘heel to
buttock’ and ‘overspeed’ work, for example, downhill running.
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125. AGILITY TRAINING
 Agility and rapid reflexes are also inherited characteristics.
However, like speed, they can be improved somewhat by
training and, thus, are included in training programs of all
sports. There is an increasing emphasis on agility training for
exercise prescription among seniors to prevent falls.
 Examples of specific agility exercises include the classic
military stepping exercises and figure of eight running. These
exercises should be sport-specific whenever possible.
125

126. SPECIFIC SKILL TRAINING
 Sports have specific skills that require training in order to
achieve a high level of efficiency. A proportion of training time
must be devoted to developing these specific skills, preferably
with the aid of a coach.
 Often, skill training requires the repetition of explosive
movements and, therefore, has a high risk of injury. To
prevent injury, a proportion of skill training should be done at
an intensity level below normal competition conditions.
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127. CROSS-TRAINING
 To prevent injury it may be beneficial to reduce the amount of
weight-bearing exercise. Cross-training enables the athlete to
maintain aerobic fitness while reducing stress on weight-
bearing joints, muscles and tendons.
 In athletes with a chronic condition such as articular cartilage
damage to a weight-bearing joint, cross training may be used
to reduce the impact load while maintaining adequate
training volume. Similarly, in a patient returning to sport from
an overuse injury, such as a stress fracture, cross-training can
reduce the risk of recurrence.
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128.  Runners may wish to introduce one to two sessions per week
of activities such as cycling, swimming or water running.
These alternative work-outs can mirror the athlete’s usual
training session (e.g. interval training, aerobic or anaerobic
training).
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129. PSYCHOLOGY AND INJURY
PREVENTION
 Excessive psychological arousal can not only impair sporting
performance but is also likely to increase the risk of injury.
Overarousal is associated with impairment of natural
technique, which players describe as a ‘loss of rhythm’. Loss of
concentration can also predispose to injury by giving the
athlete less time to react to cues.
 This is clearly a risk in contact and collision sports but can
also cause injury in noncontact sports.
129

130.  For example, an overaroused tennis player who does not react
optimally to an opponent’s serve will then be forced to return from
a biomechanically poor position, which increases stress on certain
muscle groups.
 Underarousal can also predispose to injury. For example, if a player
has been relegated to a lower level of competition, he or she may
not warm up as diligently as normal. Furthermore, visual cues may
not cause as rapid a response as when truly focused. This may lead
to injury in a body contact sport or technical errors that can lead to
falls in a sport such as gymnastics.
130

131. NUTRITION AND INJURY
PREVENTION
 Inadequate nutrition may increase the risk of injury due to its
effect on recovery. Inadequate glycogen repletion causes a
reliance on fat and protein stores and this may result in
increased protein breakdown, which, in turn, may lead to soft
tissue injury.
 There are several mechanisms by which inadequate dietary
protein intake may lead to muscle injury. Intense training
causes skeletal muscle breakdown, which can be exacerbated
by inadequate dietary protein.
131

132.  Inadequate hydration may compromise blood flow to working
muscle, which may increase susceptibility to injury. Hydration
is thought to influence the amount and composition of joint
fluid, which helps to nourish articular cartilage.
 Calcium is the major mineral component of bone but
inadequate dietary intake does not appear to be directly
associated with bony injury, such as stress fracture. Because
of the role of micronutrients in bone and/or muscle
metabolism, deficiencies in nutrients such as potassium, iron,
zinc, magnesium, chromium, copper and various vitamins
may increase susceptibility to injury.
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133. Maintaining low weight and low body fat is important
in many sports and confers an advantage in sports
such as running and gymnastics. In sports such as
rowing and wrestling, weight limits are set.
Athletes may have rapid, large fluctuations in weight
immediately prior to competition, which is associated
with significant losses of lean body tissue and water.
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134. 134
Thank You