Prevention of Injuries
If you’ve been involved in sports or physical activities for a long time, you’ve almost certainly sustained an injury of some sort, such as a sprained ankle, tendinitis, aching knees, or even worse, torn cartilage or a fractured bone.
Injuries vary in nature and severity, with some resulting in little time off and others requiring months of recovery or even the end of a career. The million-dollar question, regardless of the sort of damage, is “Can we prevent injuries and, if so, how?” It’s a good question, and I believe the solution is simpler than most people believe.
Understanding some of the causes is necessary before we can prevent damage. Acute and chronic injuries are the most common types of injuries. Acute injuries are usually severe in nature, such as a hit to the side of the knee or a bike tumble. Because the causes of acute injuries are often beyond our control, they are difficult to prevent.
Chronic injuries, on the other hand, often have no evident cause, proceed slowly, and have ambiguous or “mild” symptoms. These nonspecific and seemingly insignificant symptoms, if not addressed promptly, might develop into an injury that necessitates forced time away from your sport or activity, or even surgery.
Chronic injuries, despite not always being obvious, do have a cause, and the majority of them are preventable. Chronic injuries are sometimes caused by “overuse” and manifest as recurrent stress or just “doing too much too fast.” Repetitive stress is defined as repeatedly executing the same activities without sufficient strength, endurance, or rest. “Too much, too soon” refers to the frequency, volume, and intensity of a certain exercise or training program, and is also known as “training errors.” The bottom line is that when the stress of an activity or exercise exceeds the tissue’s physiologic tolerance, micro-trauma, inflammation, and pain often ensue.
Inadequate preparation or training habits, ill-fitting equipment, improper technique, and insufficient recovery time are all factors that can be controlled. And here is the key: within our training program and activities, we have the capacity to regulate and adjust variables that can avoid most, if not all, chronic injuries.
Chronic injuries, however, can be difficult to cure, regardless of how preventable they are. Because the causes can be obscure and multi-faceted, the treating doctor must frequently function as a detective. Is it part of the training curriculum, and if so, which part? Is it a combination of frequency, volume, and intensity, or all three? Is it bad footwear, a bad bike fit, bad technique, or bad body mechanics? Is the recovery time proportional to the training load? When trying to figure out what’s causing the problem and devising a treatment and preventative strategy, all variables must be taken into account.
In light of the foregoing, injury prevention principles can be divided into four categories, which I refer to as the PETR Principles: preparation, equipment, technique, and recovery.
A conditioning program that includes a proper warm-up, mobility, strength, endurance, and balance training is referred to as preparation.
Using the appropriate activity-specific equipment, such as adequate footwear for jogging or hiking, bike fit for cycling, racquet fit for racquet sports, and golf club fit, among other things.
When it comes to training and performing, technique refers to proper form and body mechanics.
Within a training program, recovery includes enough rest so that the body may replenish, adapt, and get stronger.
Preparation
Preparation is the cornerstone of injury avoidance. Simply said, the purpose of preparation is to raise the body’s physiological tolerance to the point where the mechanical demands of any given sport or activity do not cause harm. The greater the tolerance for stress, the better equipped the body is.
Preparation usually entails a goal-oriented conditioning program that includes proper warm-up, mobility, progressive strength training, endurance, and balancing exercises. The program can be generic or customized to an activity or sport, depending on the goals.
A “periodized” training plan, which is a science-based training strategy that divides training into stages or cycles and advances from broad to specific, is one such method. These cycles adjust the frequency, volume, and intensity of individual workouts to best prepare you for the next phase while still allowing for enough recovery.
Warm up your body.
Warming up is used to get the body ready for action and to encourage efficient movement patterns. Muscles, connective tissue, and joints that are restricted develop compensations inside and between our moving parts, resulting in dysfunctional and inefficient movement patterns that can contribute to inflammation, pain, and injury. Our muscles, connective tissue, and joints will be less stressed if our movement patterns are more efficient. Warming up properly enhances mobility, tunes the neuromuscular system, optimizes force generation (aka strength and power), coordination, and reinforces activity-specific movement patterns.
Warming up techniques vary, but most incorporate both dynamic mobility exercises and static “hold and release” stretches. Although there are numerous theories and explanations for both, when applied and done correctly, each approach can effectively enhance the other and achieve ideal mobility and movement efficiency. Distinct activities have different movement requirements, but a full warm up appropriate to an activity should be a component of every athlete’s regimen for maximum preparation and performance, as well as injury avoidance.
Other advantages of mobility and flexibility
During activity, it aids in the maintenance of technique and posture.
Helps the central nervous system to recover.
Improves blood flow to the muscles, allowing them to be nourished and waste byproducts to be removed.
Reduces the production of scar tissue as a result of immobility and injury.
Relaxes the body.
Strength
Strength improves the body’s ability to absorb and disperse the stress of activity and sport, making it more resistant to injury. Strength training promotes joint and spine stability by increasing muscle, tendon, ligament, connective tissue, and bone strength. We are only as powerful as our weakest connection in the end. It’s a cliche, but it’s true. Strength promotes total movement efficiency while also contributing to power, endurance, coordination, and balance. You don’t have to be a “athlete” or participate in sports to reap the benefits of improved strength.
By adapting to progressive resistance or overload, our muscles, tendons, connective tissue, and bones become stronger and more resistant to damage. The process by which the body develops its tolerance level to exercise or other physical demands as long as enough recovery is provided is known as adaptation. To ensure the most effective adaptation, strength training should include progressive loading.
Machines, cables, dumbbells, barbells, medicine balls, elastic bands and cords, and even body weight can be used for strength training. Single muscle groups or numerous muscle groups can be isolated in exercises that replicate specific movements. The latter are typically referred to as “functional” workouts because they contain motions that occur in real life and sport, and they frequently require the body, rather than a machine, to provide leverage and balance for the movement.
The benefits and drawbacks of a given strength training strategy will be determined by your goals, strengths and weaknesses, and the “phase” you are in, whether general or specific. Keep in mind that the majority of real-life activities and sports take place with our feet on the ground and our bodies providing the movement’s leverage.
Strength training has other advantages.
Improved ability to maintain good posture and form while participating in sports like swimming, cycling, or running.
Improves coordination by increasing movement pattern intensity, timing, and sequence.
Can aid in the reduction of muscle group strength imbalances.
If you are harmed, you will have a shorter time to recover.
Increased self-assurance. Greater performance equals improved strength, and better performance equals more confidence. Because confidence creates achievement, it should not be disregarded.
Endurance
Endurance has several shapes, involves a variety of physiological systems, and is unique to each sport. Endurance refers to the body’s ability to endure tiredness for the sake of damage prevention. Fatigue can cause a variety of errors or compensatory behaviors, including a loss of strength, technique, coordination, balance, and timing. Fatigue makes it difficult to move efficiently and puts the body at risk of damage. Endurance helps sustain appropriate performance levels and reduces the risk of injury by delaying the onset of weariness.
It’s important to note that exhaustion isn’t always a terrible thing. Fatigue is a normal byproduct of conditioning, and when combined with adequate recovery procedures, it increases the adaption response, which leads to increased strength in exhausted tissues.
Equipment
Most people think of equipment as a way to protect themselves from serious injury, such as a football helmet or shin guards. However, equipment, and its right fit, has a part in decreasing stress and enhancing movement efficiency, and it must be taken into account when it comes to injury prevention. This is especially true for activities like cycling and running that involve repetitive stress.
Bike fitness is an excellent example. Cycling is a type of exercise that involves repeatedly moving the legs over a wide range of motion against resistance while sitting in a fixed seat leaning forward. If not properly fitted, this posture provides a certain geometry between the body and the bike, which can inflict undue stress on the knees, hips, and back. This geometry, on the other hand, can be tuned to produce the least amount of stress while optimizing force production when properly fitted.
In order to improve fit and biomechanics, a professional bike fitter may take 20 or more measurements, including but not limited to seat height, fore and aft seat alignment, stem, frame, crank, and cleat alignment. Bike fitting is both a talent and an art, and getting the right fit can make a big difference in terms of maximizing comfort and efficiency while reducing stress and the risk of overuse injury for riders of all levels.
Other considerations include suitable running, court, and field sports footwear; golf club shaft stiffness, weight, grip, and even length; and tennis racket grip size and string tension, to mention a few. Not only should equipment and fit be addressed to prevent injury, but also to improve performance.
Technique
There are numerous tactics for swimming 100 meters, running a 10k, hitting a backhand, jumping over a hurdle, or hitting a golf ball, but some are more efficient and successful than others. Technique refers to a movement pattern that is required to do an activity or sport as efficiently and successfully as possible. In general, the better the technique, the less the stress, the lower the chance of damage, and the better the outcome.
Running cadence is an example. Simply put, cadence refers to the number of steps made in a given amount of time, usually one minute. Runners who run at a higher cadence (180 steps per minute) are more efficient and generate fewer impact forces than those who run at a lower cadence (160 steps per minute). Lower cadence runners tend to over-stride, causing more impact stress on the legs, hips, and back to absorb and distribute, perhaps leading to overuse injury.
By shortening the stride, a higher cadence prevents overstriding and promotes a foot strike that is closer to the body’s center of mass (COM). Each foot strike’s “braking effect,” or “loading rate,” is reduced as a result. The foot functions as a “brake,” or resistance, that must be overcome in order for the body to go forward and over the foot. The stronger the resistance, the more out in front of our COM the foot falls; the closer the foot falls to the COM, the smaller the braking impact.
Please keep in mind that 180 steps per minute is merely a guideline, and what is “ideal” for one individual may not be “optimal” for another. Some runners may be more efficient at 170 steps per minute, while others may be more effective at 182 steps per minute or more. With any action or sport, proper technique can be learnt and must be factored into the injury prevention equation.
Although technique is vital in athletic performance, form and posture in general exercise, such as strength training and daily activities, cannot be disregarded or undervalued in the injury prevention equation. During strength training, the neck, back (think spine), and shoulders, as well as all of their related components like spinal discs, ligaments, and muscles, are especially sensitive to damage. Proper posture encourages the most efficient movement patterns while reducing stress. The framework of our bodies, the skeleton, and the muscles that control movement, are designed to perform best when properly aligned.
Posture is certainly deserving of its own essay, and I’ll update and link to a previous article I authored at a later date. Until then, when lifting or bending forward, hinge at the hips rather than the spine, keep your shoulders back, and try to maintain the three spinal curves while simultaneously working your core muscles. This reduces needless stress on spinal structures including intervertebral discs and ligaments while also improving muscular performance.
Last but not least, the core is much more than just the abdominal muscles. Consider a girdle, or broad band of muscles, that wraps around our trunk and connects to the pelvic and shoulder girdle. Learn how to engage these muscles while keeping the three curves indicated above in mind, and train accordingly. A strong core offers a solid basis for the extremities to move on, allowing for more efficient energy transfer.
Recovery
As previously stated, preparation is a critical component in accelerating the adaption process and increasing the body’s tolerance to stress and damage. However, adaptation will not be possible unless enough recovery is included. Rest is necessary for the body to recover its energy stores, mend itself, and gain strength. Many people find it surprising that the body strengthens during rest intervals rather than during workouts. The key to developing stronger, faster, and reaping the rewards of preparation is recovery.
Depending on the intensity of an activity or exercise, rest and recuperation can take many various forms. The more severe the workout, the longer it will take to recuperate. Complete rest, such as sleep or days off, or “relative rest,” such as an easy training day, are examples of recovery. However, without appropriate rest, sleep, or healing time, the body becomes weary and more prone to injury.
Coaching
I’d be remiss if I didn’t address the advantages of coaching when it comes to injury prevention. Few of us have the knowledge or expertise to design training programs that are tailored to each person’s specific requirements and objectives. Coaching is important not only for achieving a great outcome, but also for avoiding damage.
Conclusion
Acute and chronic injuries occur when the body is not prepared for the demands placed on it: the stress of an activity or exercise exceeds the tissue’s physiologic tolerance, resulting in an accumulation of micro-trauma, inflammation, and pain. Most acute injuries are difficult to control, but the majority of chronic and overuse injuries can be avoided with a little thinking and effort. Most, if not all, chronic injuries can be avoided by controlling and manipulating the factors within our training programs and activities.
Following the PETR Principles strengthens the body’s resistance to stress and eliminates chance and luck from training. Preparation prepares the body, while correct equipment and technique decreases stress and boosts productivity. Recovery helps the body to adapt to and grow stronger in the face of increasing stress. Whether you’re a weekend warrior, a recreational or competitive athlete, appropriate preparation, equipment, technique, and rehabilitation are essential for avoiding nagging injuries and, worse, time away from an activity or sport you like. If you have the opportunity, coaching can be an important element of your overall injury prevention strategy.