Training to Reduce Injuries
Introduction
Athletes become injured during competition and training due to many reasons. An athlete’s greatest fight against the chance of injury is to eat, sleep, and train properly. In addition, the employment of proper technique will greatly reduce the chance of injury. The genetic make up of an athlete will also play a large role in injury risk. One variable that must be considered in injuries suffered by athletes is the individuality of athletes. All athletes are different in physical and mental makeup. These characteristics are considered to be intrinsic factors. The other variable that must be considered is the extrinsic factors such as environmental factors. These are the two main variables that will determine how an athlete can be trained. An understanding of these variables by coaches can greatly reduce the chance of injury to athletes, while simultaneously improving performance.
Intrinsic factors related to injury include anthropometrics, fitness level, skeletal alignments, and previous history of injury. These factors relate to how an athlete can cope with the stresses of athletic activity. Each athlete will adapt to the stresses of sport in different ways and different time frames. It is up to the individual athlete’s tissues to adapt to the stresses placed upon them. Adaptation will depend on bone density, joint alignment, geometric make up of the tissues, fitness level, muscle strength, endurance, flexibility, nutritional habits, rest, and previous history of injury. Thus, each athlete is different and will repair from the stresses of athletics at different rates. Therefore, intrinsic factors and athlete individuality can greatly influence the risk of injury to athletes. This must be considered in designing a training program. Extrinsic factors related to injury include the training environment, coaching and training program design, practice of proper technique, daily ergonomic habits, and characteristics of the sport.
Knowing the above information strength coaches are placed in hard situations when designing team programs. In any given team, the work out imposed for the team may be too much for some athletes, just enough for others, and not enough of a training stimulus for the elite athletes on the team. The improper design of a training program can increase the risk of injury to athletes. However, when the training program is designed properly it greatly reduces the risk of injury to the athlete.
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Training and Overuse Injuries
Training must be in moderation. If there is too much training then overuse injuries develop, but if there is not enough of a training stimulus then there will be no gains in strength and power. When athletes increase there training stimulus, there is an increase stress to the tissues. This increased stress to the tissues will cause microscopic tissue damage. Once the damage occurs, the tissues begin to remodel. When the rate of tissue remodeling is greater than the rate of continued damage, then the tissue becomes stronger and the athlete may experience an increase in performance. However, when an athlete’s rate of tissue remodeling is less than the rate of continued tissue damage, then an overuse injury develops. Overuse injuries will greatly reduce the performance capabilities of the athlete. In some instances overuse injuries will stop an athlete from competing all together. Therefore, training parameters must be great enough to produce gains, but not great enough to out weigh tissue repair.
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Strength Ratios of Muscle Groups
The function of muscle is important to the efficient performance of the human body. Muscles perform three main functions: skeletal movement, maintaining postures and body positions, and joint stability. In regards to skeletal movement, muscles accelerate and decelerate joints and limb segments through ranges of motion in order to produce movement. Muscles constantly relax and contract to maintain body positions and certain postures. During movement joints must be stabilized by muscles in order to execute movements efficiently and effectively.
During athletic activity differences in muscle strength ratios can cause injuries to occur. For instance, athletes who have excessive strength of the quadriceps muscles and weak hamstring muscles can experience patellar tendonitis. The tendonitis is a result of the quadriceps pulling the tibia forward (anterior tibial translation) and the patellar tendon is forced to be stretched and translated over the edge of the tibial plateau. The hamstrings in this instance are weaker than the quadriceps and cannot stabilize the knee joint properly. The end result is anterior tibial translation on the patellar tendon. This injury mechanism can be a result of improper training (placing too much emphasis on quad strength instead of hamstring strength) or it could be a genetic predisposition to the variation in the strength ratio. Either way the training program should be geared towards balancing strength ratios in order to prevent injuries from occurring.
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Muscle Fatigue
Muscle fatigue not only causes a decrease in performance but it also causes an increase risk for injury. If muscles are not conditioned properly then they lose some of their functional capabilities. When muscles fatigue they lose there shock absorbing capacity and fatigued muscles cause an altered gait. The result is abnormal loading on the bones, joints, and ligaments. This altered stress distribution throughout the body can lead to a variety of injuries. Therefore, training should address this issue as muscle fatigue can be a precursor to injury.
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Bone Conditioning
In order to prevent injuries to bones, training programs must include exercises to strengthen bones. This can be done with the application of Wolf’s Law. Wolf’s Law states that a bone will strengthen itself along the lines of low level mechanical stress. This means that low levels (e.g. jogging, weight lifting, or punching a punching bag) of stress to the bone can make it stronger. The bone will remodel itself by taking bone away from areas of low stress and forming new bone in areas of high stress. This is done to avoid stress fractures or in some instances fractures from direct blows.
For instance, in cross country running, runners start with low mileage and gradually move up. At the onset of training runners may run 25 miles a week and slowly increase their mileage each week to avoid stress fractures. If the runners started with 50 miles a week (twice as much) they might sustain stress fractures. This is because at 50 miles per week Wolf’s law did not have time to strengthen the bones to take the stress of 50 miles a week. These are not specific numbers; they are merely numbers to make a point. Mileage will depend on the conditioning level of the athlete. You may refer to bone adaptations in the adaptations to training page.
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Neurological Training
Ligaments become sprained when joints are stretched beyond their limits. As a safety mechanism, muscles contract to stabilize joints and prevent the joint from exceeding its limit during the stresses of exercise. When a joint is stretched, so is the muscle or muscles surrounding it. The stretching of the muscles surrounding the joint causes the stretch reflex to be initiated. In turn the muscles that are stretched contract and stabilize the joint. In some athletes, there are delays in neural pathways. This can be due to a lack of training or from the genetic make up of the athlete. The longer the neural delay, the later the joint is stabilized, and the more damage occurs to the ligaments due to the lack of muscle stabilization. If athletes have reoccurring injuries such as ankle sprains they should be evaluated to see if a neural delay exist. If it does, then a training program should be implemented to decrease the neural delay time.
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Flexibility
Strength training programs should implement regular flexibility programs. Flexibility programs can reduce the amount of injuries sustained by athletes. Flexibility can improve performance, but also it can prevent injuries by allowing a greater range of motion to joints. Stretching can reduce the risk of joint sprain and muscle strain. Stretching the hamstrings can reduce the risk of low back pain, which is a common pain reported by athletes. It can also reduce muscle soreness and muscle tension. All these injuries and more can be avoided or the chance of injury can be reduced by a sound flexibility program.
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Environmental Training Conditions
Athletes should be acclimatized to the weather and trained so that they can withstand environmental stresses. The environment produces many extremes that can decrease performance and cause risk for injury to the body. One of the largest and most dangerous environmental stresses is temperature. Athletes may compete in subzero temperatures and temperatures well above 100 degrees F. These temperature extremes call on the body to dissipate or conserve heat during exercise (thermoregulation). Humidity will play a large role in an athlete’s ability to thermoregulate. Another environmental stressor is when athletes compete at elevation where the air is thin. Environmental stresses can cause injury and decrease performance. Athletes should train to cope with environmental stresses and extremes.
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Mental Training
Athletes should mentally train themselves to handle the stresses of sport. In addition, they should mentally vision themselves using proper techniques. Mental practice of proper technique will help insure the use of good techniques under stressful competitive situations. The employment of proper techniques can greatly reduce injuries.
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