sports injury prevention part 1

8/6/2019 Sports Injury Prevention Part 1

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Advanced Physiotherapy and InjuryPrevention

Part 1. Overview of 8 point plan - tonight

Part 2. Strapping

Part 3. Periodisation - The Science of Training Part 4. Warmup


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Prevention/Performance

Rest

Ice Compression

Elevation

Diagnosis


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0

10

20

30

40

50

60

Preinjury Postinjury

games/season


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0

1

2

3

4

5

6

7

8

Pre-injury 1 Year Post injury


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Up to 2 years may be needed to regain normal

quadriceps muscle performance following ACL

reconstruction.

Frequent non-return to peak performance (20

50%)


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0

2

4

6

8

10

12

14

16

18

pre injury post injury



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Advanced Physiotherapy and InjuryPrevention (c)


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Previous Hamstring Injury 30 % will re-injure within the season


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General health

Medical history

Medical conditions,allergies

Previous injuries

Drug use

Health

Questionaire



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Social

Environmental

Alcohol/cigarettes

Living arrangements

Diet

General

History

Medical conditions

Previous injuries

Drug use

Health

Questionaire

Lifestyle

Questionaire



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Medical

Fitness

Musculoskeletal

Social

Environmental

Alcohol/cigarettes

Living arrangements

Diet

General

History

Medical conditions

Previous injuries

Drug use

Health

Questionaire

Lifestyle

Questionaire

Physical

Assessment



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Mid-year

After injury

Musculoskeletal

Fitness

Medical

Social

Environmental

Alcohol/cigarettes

Living arrangements

Diet

General

History

Medical conditions

Previous injuries

Drug use

Health

Questionaire

Lifestyle

Questionaire

FollowupPhysical

Assessment


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For example

ACL injuries are more prevalent in those withpoor strength of their hip external rotators

ACL injuries are more prevalent in those withpoor balance

Patellofemoral pain is more prevalent in thosewith weak hip external rotators, flat feet, weakquadriceps (VMO)

Shoulder impingement syndrome is morecommon in those with poor thoracic extension



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Ligaments/joints/muscles

Biomechanics technique and movement

patterns

Balance and Proprioception



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Weaker connective tissue

Greater injury risk.



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Biomechanics/Technique



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Efficiency

Injuries

Performance.



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Throwing and kicking

Catching

Hitting

Swimming.


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Observation

Physical Assessment

Video Analysis

Force Plate Analysis.



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It is really hard to see things without slow

motion but

If something looks odd it probably is

And needs professional assessment.



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0

0.2

0.4

0.6

0.8

1

1.2

1.4

Before Program After Program



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Pre Activity Warm-up.

Aerobic exercise.

Stretching.

Sport-specific

exercises.

Post Activity Cool-down

Aerobic exercise.

Stretching.

Recovery



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ACTIVITY PHYSIOLOGICAL

EFFECT

EFFECT ON

PERFORMANCE

EFFECT ON

INJURY

PREVENTION

Issues


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EFFECT

EFFECT ON

PERFORMANCE

EFFECT ON

INJURY

PREVENTION

Issues

- Aerobic Activity Increases heart rate,

core temperature,

nerve conduction

Can increase or impair

performance

depending on theamount done, rest

intervals following

Reduces muscle

soreness

Optimal not

established, variable

for different levels offitness, different

sports


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EFFECT

EFFECT ON

PERFORMANCE

EFFECT ON

INJURY

PREVENTION

Issues


core temperature,

nerve conduction


performance


intervals following

Reduces muscle

soreness

Optimal not



sports

- Static Stretching Increases compliance

of muscle tendon unit

Reduces Performance

unless followed by

other activity

Nil


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EFFECT

EFFECT ON

PERFORMANCE

EFFECT ON INJURY

PREVENTIONIssues


core temperature,

nerve conduction


performance

depending on the

amount done, restintervals following

Reduces muscle

soreness

Optimal not established,

variable for different

levels of fitness, different

sports



Reduces Performance

unless followed by

other activity

nil

- Sport Specific

Exercises

Neuromuscular

activation,

concentration

Likely increase Certain targeted

programs very effective

Needs to be specifically

targeted at sport/level

ACTIVITY PHYSIOLOGICAL EFFECT ON EFFECT ON


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EFFECT

EFFECT ON

PERFORMANCE

EFFECT ON

INJURY

PREVENTION

Issues


core temperature,

nerve conduction


performance


intervals following

Reduces muscle

soreness

Optimal not



sports



Reduces Performance

unless followed by

other activity

nil

- Sport Specific

Exercises

Neuromuscular

activation,

concentration


programs very

effective

Needs to be

specifically targeted at

sport/level

COOL-DOWN AND

RECOVERY

ACTIVITY PHYSIOLOGICAL EFFECT ON EFFECT ON I


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EFFECT

EFFECT ON

PERFORMANCE

EFFECT ON

INJURY

PREVENTION

Issues


core temperature,

nerve conduction


performance


intervals following

Reduces muscle

soreness

Optimal not



sports



Reduces Performance

unless followed by

other activity

nil

- Sport Specific

Exercises

Neuromuscular

activation,

concentration


programs very

effective

Needs to be


sport/level

COOL-DOWN AND

RECOVERY

Aerobic Exercise Nil No proven effect



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EFFECT

EFFECT ON

PERFORMANCE

EFFECT ON

INJURY

PREVENTION

Issues


core temperature,

nerve conduction


performance


intervals following

Reduces muscle

soreness

Optimal not



sports



Reduces Performance

unless followed by

other activity

nil

- Sport Specific

Exercises

Neuromuscular

activation,

concentration


programs very

effective

Needs to be


sport/level

COOL-DOWN AND

RECOVERY

Aerobic Exercise Nil No proven effect

Stretching Increases compliance


Nil No proven effect


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Advanced Physiotherapy and Injury

Prevention


EFFECT

EFFECT ON

PERFORMANCE

EFFECT ON

INJURY

PREVENTION

Issues


core temperature,

nerve conduction


performance

depending on the

amount done, rest

intervals following

Reduces muscle

soreness

Optimal not


for different levels of

fitness, different

sports



Reduces Performance

unless followed by

other activity

nil

- Sport Specific

Exercises

Neuromuscular

activation,

concentration


programs very

effective

Needs to be


sport/level

COOL-DOWN AND

RECOVERY

Aerobic Exercise Sustains heart rate,

core temperature,


Stretching Increases compliance



Massage Reduced inflammation Nil Reduced musclesoreness

Not strong evidence,expensive

Cold water immersion Reduced inflammation Some evidence May reduce muscle

soreness

What temperature for

how long,


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Dynamic Stretching

Dynamic stretching consists of functional

exercises which use sports specific movement

patterns to prepare the body for activity


Prevention


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Static vs Dynamic Stretching

STATIC STRETCHING DYNAMIC STRETCHING

EFFECT ON PERFORMANCE NEGATIVE POSITIVE

EFFECT ON INJURY RATES UNCLEAR MAY INCREASE

OR DECREASE

UNCLEAR MAY DECREASE


Prevention


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Prevention

Static stretching will probably reduce performance unless itis followed by dynamic activity

Any form of stretching has very little relevance to sportwhere excessive muscle length is not required

Static stretching will probably not prevent a muscle strain

Static stretching is still valuable at other times if done in asports specific way as many sports still require extremeranges of motion

Dynamic stretching has potential to increase performance

and to reduce injury rates however must be done when theathlete is warm and needs to be sports specific


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Prevention

Performing a properly structured

professionally designed warmup and

competing will do the following

Reduce injury ratePerformance


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Prevention


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PEP PROGRAM (74 81% reduction in ACL Injury Rates) Developed due to incidence of female ACL injuries (2-8x

men)

Developed by Santa Monica Orthopaedic and Sport MedicineResearch Foundation.

Designed to replace the traditional 20 minute soccer warmup

Emphasis on soft landing and deep knee and hip flexion

Optimally the program should be performed at least 2-3 timesper week during the season


Prevention


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These programs are excellent but only cover

knee injuries

We know how to prevent many other running

injuries

So ..... Integrating what we know from these

programs with what we know from running

biomechanics will result in


Prevention


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Prevention

A world class sports warm-up routine for

sports requiring speed, agility and quickness

designed to improve performance and reduce

injury, that INTEGRATES INTOYOUR CURRENT TRAINING

PROGRAM


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Reduced fitness increases injury risk

irrespective of experience in the sport

Least fit are 14X more likely to get injured

than most fit (Pope et al 2000)


Prevention


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BMI= kg/m2

Normal 18-25

Above or below

doubles the injury risk


Prevention


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Prevention

Periodisation

Genetics

Injury

Correct technique

Exercise selection

Rest

Psychological


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This allows for a more effective manipulation

of training variables, with the goal of

optimizing the athletes physiological and

psychological state of preparedness for themain competitions of the year while avoiding

injury or the over-trained state. (Dolcetti 2000, adoptedfrom Bompa, 1983)


Prevention


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Prevention


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Fair play means respecting the opposition, the officialsand the rules, staying calm no matter what happens,and maintaining your dignity whether or not you are

winning. Some rules are designed and enforced to reduce or

remove the risk of injury. For example, hockey playersarent allowed to raise their sticks above shoulder

level, spear tackling in rugby is illegal, and physicalcontact in non-contact sports is penalised.

This is the responsibility of coaches, player and officials


Prevention


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Bracing and taping. Bracing and taping can

provide some protection against injury to

joints.

Bracing vs Taping.


Prevention


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Footware. Players wearing shoes with air cells

in the heel were 4.3 times more likely to injure

an ankle than those wearing shoes without air

cells Br J Sports Med 2001;35:103-108


Prevention


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Prevention

Should contain four to eight percent

carbohydrate and 0.5-0.7g/litre sodium (ACC

website).

Needed for sports > 1 hour


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Prevention

Helps us to indentify injury trends

Helps us to identify causes

Allows us to provide solutions


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Prevention

Allows us to identify problem areas

Leads to better solutions


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Facilities Perimeter fencing

Vehicles and spectators

Clean and hygenic

Surfaces

Level ground

Hardness No holes, sprinkler

Water spills on floor

Adequate lighting

Equipment

Well maintained

Appropriate size

Padded posts

Nets secured


Prevention


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Make sure you have a system of monitoring and reporting bothpotential and current hazards. Make individuals responsible forchecking areas or equipment regularly.

Emergency procedures

Ensure:

a qualified first-aider is always at training and competition a first aid kit is always available and is well sign-posted

emergency access is always clear, and that coaches know thedirections to the nearest Accident and Emergency (A&E) clinic

a phone is always available, to contact emergency services.

Note:Ensure that any visiting teams know the emergency procedures atyour venue.


Prevention


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REST

ICE

COMPRESSION

ELEVATION

D


Prevention


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Diagnose as quickly as possible

Dont figure it out for yourself

Dont expect google to help

Dont ignore small niggles


Prevention


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All the above applies to children but

Children are not just small adults


Prevention


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Growth Plate Injuries

Severs Syndrome

Osgood Schlatters Syndrome


Prevention


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Have now Explanations of common injury

Are producing or uploading

Performance enhancement and injury preventionblog

Screening questionaires

Sports trainers kit

Uploaded screening information

Video of Advanced Warmup

sports injury prevention part 1

Documents