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Sports Injuries

Injury Prevention
Like most athletes, you undoubtedly want to reduce or eliminate your chances
of injury while participating in your sport. Injuries decrease the amount of
time you can spend in leisure activities, lower your fitness and impact
competitive performance. Sports scientists suggest that injury rates could be
reduced by 25% if athletes took appropriate preventative action.

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Track & Field

Coaches and athletes believe that males have higher injury rates than females
- male and female athletes have about the same injury rate per hour of
training.

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Among runners it is considered that training speed is the cause of injuries

(Speed Kills) but research indicates that there is no link between speed and
injury risk.

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Donotoverdoit
The amount of training you carry out plays a key role in determining your real
injury risk. Studies have shown that your best direct injury predictor may be
the amount of training you completed last month. Fatigued muscles do a poor
job of protecting their associated connective tissues, increasing the risk of
damage to bone, cartilage, tendons and ligaments. If you are a runner, the
link between training quantity and injury means that the total mileage is an
excellent indicator of your injury risk. The more miles you accrue per week,
the higher the chances of injury. One recent investigation found a marked
upswing in injury risk above 40 miles of running per week.

Thetwobestpredictorsofinjury
If you have been injured before then you are much more likely to get hurt
than an athlete who has been injury free. Regular exercises have a way of
uncovering the weak areas of the body. If you have knees that are put under
heavy stress, because of your unique biomechanics during exercises, your
knees are likely to hurt when you engage in your sport for a prolonged time.
After recovery, you re-establish your desired training load without
modification to your biomechanics then your knees are likely to be injured
again.
The second predictor of injury is probably the number of consecutive days of
training you carry out each week. Scientific studies strongly suggest that
reducing the number of consecutive days of training can lower the risk of
injury. Recovery time reduces injury rates by giving muscles and connective
tissues an opportunity to restore and repair themselves between work-outs.

Psychologicalfactors
Some studies have shown that athletes who are aggressive, tense, and
compulsive have a higher risk of injury than their relaxed peers do. Tension

may make muscles and tendons tighter, increasing the risk that they will be
harmed during workouts.

Weakmuscles

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Many injuries are caused by weak muscles which simply are not ready to
handle the specific demands of your sport. This is why people who start a
running program for the first time often do well for a few weeks but then as
they add the mileage on, suddenly develop foot or ankle problems, hamstring
soreness or perhaps lower back pain. Their bodies simply are not strong
enough to cope with the demands of the increased training load. For this
reason, it is always wise to couple resistance training with regular training.
Weak or inhibited gluteal muscles can be the cause of lower back and lower
limb injuries.

Muscleimbalance
[4]

Kemp (2000) identified that screening for muscle imbalances is the current
cutting edge of injury prevention. The rationale behind this is that there are
detectable and correctable abnormalities of muscle strength and length that
are fundamental to the development of almost all musculoskeletal pain and
dysfunction. Detection of these abnormalities and correction before injury has
occurred should be part of any injury prevention strategy. Assessment of
muscle strength and balance and regular sports massage can be beneficial in
this strategy.

MuscleStiffness
Muscle stiffness refers to the ratio between the change in muscle resistance
and the change in muscle length. Muscle stiffness is directly related to muscle
injury risk and so it is important to reduce muscle stiffness as part of a warm
up.
[5]

[6]

Research work by McNair (2000)

and Knudson (2001)
has indicated that
only dynamic stretches - slow controlled movements through the full range of
motion - decrease muscle stiffness. Static exercises did not decrease muscle
stiffness.
This suggests that dynamic stretches are the most appropriate exercises for
warming up and not static stretching exercises. Static stretches are perhaps
more appropriate for the cool down as they help to relax the muscles and
increase their range of movement. For further information see the following
articles:
How does static stretching affect an athletes performance
Dynamic versus passive stretches
Static vs. Dynamic Flexibility

TriggerPoints
A "trigger point" (TP) is a thick knot in a muscle that is palpable and tender
(even painful to the touch).
[3]

Larsen (2002)
identified that trigger points can be caused by: training
errors, inadequate preparation, worn shoes or equipment, poor biomechanics,
muscle fatigue, poor flexibility, nutritional factors (vitamin deficiency),
psychological factors (lack of sleep, stress).
Treatment of a TP (separating the fibres of the muscle knot) can be achieved
by applying direct pressure to the point for 10 to 20 seconds, gradually
releasing the pressure and repeating the process 4 of 5 times. The amount of

pressure, which will depend on the sensitivity of the TP, can be applied by
using one or both thumbs.
A number of treatments may be required but as the sensitivity (pain) of the
TP reduces it will become harder to find. If after a couple of treatments the
pain does not reduce then you should seek medical advice. Alternative
approach to treating a TP is sports massage where petrissage, friction and
effleurage techniques can be used to help breakdown the TP.
Trigger points are an early warning to a potential serious injury so checking
for TPs is very beneficial. A regular massage is well worth is as the therapists,
when conducting a massage, can check for TPs and treat them.

ProblemintheFasciachain?
Fascia is continuous uninterrupted, three-dimensional web of tissue that
extends from head to toe, from front to back, from interior to exterior and an
injury in one location may be due to a problem elsewhere in the fascia chain
e.g. low back pain may be due to tight quads - tight quads cause the hip
flexors to tighten, pulling the spine down and forwards resulting in low back
pain. So working on the quads may alleviate the low back pain.
[9]

These connected muscles make up a fascia chain and Chew (2008) explains
how his Ming Method uses the plasticity of fascia to elongate tight, contracted
areas in a fascia chain to relieve the pain they cause.

The"Q"angle
The "Q" angle is the angle between the line
of pull of the quadriceps muscles on the
knee and the line of pull of the patellar
tendon.
The "Q" angle is greater in women as the
hips are set wider apart.
A large "Q" angle may cause the kneecap to
deviate from its normal pathway on the end
of the thigh bone. This may result in a
dislocation of the kneecap if, whilst bending
it, an external force pushes the knee
inwards.

Makeitspecific
Resistance training can fortify muscles and make them less susceptible to
damage, especially if the strength building exercises involve movements that
are similar to those associated with the sport. Time should be devoted to
developing the muscle groups with strength training as appropriate to the
demands of the sport. If you are a thrower then lots of time should be spent
developing muscles at the front of the shoulder that increases the force with
which you can throw, but you must also work systematically on the muscles at
the back of the shoulder which control and stabilise the shoulder joint.

Injurypreventiontips
[1]

[2]

Tulloh (1995) and Anderson (1995)

athlete avoid injury:

identified the following tips to help an

1. Avoid training when you are tired

2. Increase your consumption of carbohydrate during periods of heavy
training
3. Increase in training should be matched with increases in resting
4. Any increase in training load should be preceded by an increase in
strengthening
5. Treat even seemingly minor injuries very carefully to prevent them
becoming a big problem
6. If you experience pain when training STOP your training session
immediately
7. Never train hard if you are stiff from the previous effort
8. Pay attention to hydration and nutrition
9. Use appropriate training surfaces
10. Check training and competition areas are clear of hazards
11. Check equipment is appropriate and safe to use
12. Introduce new activities very gradually
13. Allow lots of time for warming up and cooling off
14. Check over training and competition courses beforehand
15. Train on different surfaces, using the right footwear

16.
17.
18.
19.
20.
21.

Shower and change immediately after the cool down

Aim for maximum comfort when travelling
Stay away from infectious areas when training or competing very hard
Be extremely fussy about hygiene in hot weather
Monitor daily for signs of fatigue, if in doubt ease off.
Have regular sports massage

Coaches
The key is rapid action when the injury first appears and a lot of psychological
support to back up the remedial treatment. Educate yourself and your athletes
in the art of Cryotherapy. It is when things are not going well that the athlete
really needs their coach. It is important for the coach to have an alternative
training program to help the athlete through the injury recovery period.

OurGenesmayindicateliabilitytoinjury
Our genes control our biological systems such as muscle, cartilage and bone
formation, muscle energy production, lactic acid removal, blood and tissue
[7]
oxygenation. Research by Kambouris (2011) identified that variations in the
DNA sequence of these genes have an impact on an individual's vulnerability
to sports injury, components of fitness (endurance, speed, strength etc.) and
nutritional requirements.
[8]

Mauffulli & Merzesh (2007) found that mutations in collagen called COL5A1
led to the structure that supports the tendon being more loosely connected,
making the tendon less stable and perhaps more susceptible to injury.

References
1. TULLOH, B. (1995) Here are 10 practical guidelines that will help an
athlete avoid getting injured. Peak Performance, 55, p. 5-7
2. ANDERSON, O. (1995) How Likely are you to get hurt, and what steps
can you take to reduce the risks? Peak Performance, 55, p. 1-3
3. LARSEN, U. (2002) A trigger point in a muscle is a warning sign of a
possible serious injury. Peak Performance, 165, p. 1-6
4. KEMP, S. (2000) Why detecting muscle imbalance is an essential part of
an injury prevention strategy. Peak Performance, 128, p. 4-6
5. MCNAIR, P.J. et al. (2000) Stretching at the ankle joint: viscoelastic
responses to holds and continuous passive motion. Medicine & Science
in Sport and Exercise, 33 (3), p. 354-358
6. KNUDSON, D et al. (2001) Acute Effects of Stretching Are Not Evident in
the Kinematics of the Vertical Jump, Journal of Strength & Conditioning
Research, 15(1), p. 98-101
7. KAMBOURIS, M. (2011) Predictive genomics profiling in athletics and
sports performance. Br J Sports Med, 45 (2), lecture 27
8. MAUFFULLI, N & MERZESH, M. (2007) Genetic aspects of tendinopathy.
Journal of Science and Medicine in Sport, 11 (3), p. 243-247
9. CHEW, M. (2008) The Permanent Pain Cure. USA; McGraw Hill
Publishers

RelatedReferences
The following references provide additional information on this topic:
WITVROUW, E. et al. (2004) Stretching and injury prevention. Sports
Medicine, 34 (7), p. 443-449
HUBSCHER, M. et al. (2010) Neuromuscular training for sports injury
prevention: a systematic review. Medicine and science in sports and
exercise, 42 (3), p. 413-421

 SFRAN, M. R. et al. (1989) Warm-up and muscular injury prevention an

update. Sports Medicine, 8 (4), p. 239-249

PageReference
If you quote information from this page in your work then the reference for
this page is:
MACKENZIE, B. (1997) Injury Prevention [WWW] Available from:
https://www.brianmac.co.uk/injury.htm [Accessed 20/10/2016]

RelatedPages
The following Sports Coach pages provide additional information on this topic:

Articles on Injury Prevention

Books on Sports Injuries
Cryotherapy
Gluteal Muscles (Glutes)
Hot and Cold Contrast Baths
Muscle Balance
Muscle Cramp
Over Training
Recovery from Training
Shin Splints
Stitch

AdditionalSourcesofInformation
For further information on this topic see the following:
BEASHEL, P. and TAYLOR, J. (1996) Advanced Studies in Physical
Education and Sport. UK: Thomas Nelson and Sons Ltd.
BEASHEL, P. and TAYLOR, J. (1997) The World of Sport Examined. UK:
Thomas Nelson and Sons Ltd.
BIZLEY, K. (1994) Examining Physical Education. Oxford; Heinemann
Educational Publishers
DAVIS, B. et al. (2000) Physical Education and the Study of Sport. UK:
Harcourt Publishers Ltd.
GALLIGAN, F. et al. (2000) Advanced PE for Edexcel. Oxford;
Heinemann Educational Publishers
McARDLE, W. et al. (2000) Essentials of Exercise Physiology. 2nd ed.
Philadelphia: Lippincott Williams and Wilkins
GRISOGONO, V. (1984) Sports Injuries. UK; John Murray Publishers Ltd.
CHEW, M. (2008) The Permanent Pain Cure. London; McGraw Hill
LIDELL, L. et al. (1991) The book of Massage. Spain; Artes Graficas
Toledo
RITTER, M. and ALBOHM, A. (1987) Your Injury. USA; Cooper Publishing
Group
LINDSAY, R. et al. (1994) Treat your own Strains, Sprains and Bruises.
New Zealand; Spinal Publications Ltd.
UNGARO, A. (2002) Pilates. London; Dorling Kindersley Ltd.

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