Prevention of Sports Injuries
Prof. Himanshu G. Dave
Department of Physical Education, S.C.A. Patel Arts College, Sadhli, Dist. Vadodara, State-Gujarat
PRINCIPLES OF INJURY PREVENTION:
A) physical conditioning:
Physical conditioning is a key principle of injury prevention. Appropriate conditioning programs decrease the risk and severity of an injury as well as help prevent re-injury. Maximizing the chance for safe athletic performance requires adequate muscular strength, balance, power, endurance, neuro-muscular co-ordination, joint flexibility, cardiovascular endurance, good body composition as well as maintained segmentation of body posture. Improving specific components of fitness and conditioning reduces the risk of injury.
For e.g. Strengthening the muscle of a joint helps reduce injuries to the area. Regular exercises can significantly increase the strength of the ligaments surrounding the knee or other joints of the body so as to prevent the joint injuries. Muscle development provides increased strength that helps to stabilize joints and improve movement skills which is an important factor for avoiding an injury.
The SAID principle (Specific Adaptation to Imposed Demands) states that, “If the body is placed under stress of varying intensities and durations, it attempts to overcome the stress by adapting specifically to the imposed demands.” For e.g. Muscles around a joint can be developed and conditioned to provide optimal stabilization of the joint. Likewise, when a muscle primarily produces motion of a joint, proper conditioning can prevent the muscle from undergoing an unwanted movement. The demands of a specific athletic event must be a progressive stress applied in that athlete's training.
Other components of strength conditioning which contribute to injury prevention are the ability of the muscle to contract or exert force at an accelerated speed, and muscular endurance, which allows the athlete to maintain an appropriate strength level over a period of time
Proprioceptive or kinesthetic sense through balance training enhances motor control, which is needed to reduce the risk of injury or re-injury during practice or competition. When injury to a joint or musculo-tendinous structure occurs, somato-sensory information is altered which adversely affects the motor control. Hence, rehabilitation should emphasize restoring the athlete’s balance strategies. This will also decreases the risk of recurrent injury. The balance training task must be specific to the type of balance strategies required by the athlete’s event.
3) Flexibility :
Effective performance requires a full range of motion and adequate joint flexibility to decrease athlete’s susceptibility to injury. Normal muscular length-tension and adequate extensibility upon stretch helps in protecting the body from injury. The athlete’s entire body is able to work more effectively and safely after a period of warm-up, stretching and skill-drills that are related to the athlete’s event. The warm up period before practice or competition increases the body tissue temperature. Temperature has a significant influence on the mechanical behavior of connective tissue under tensile stretch. Higher temperature at low loads produces the greatest elongation with the least damage of connective tissue. Increased connective tissue temperature also increases extensibility. Optimal stretching occurs only when voluntary and reflex muscle resistance is eliminated. Ballistic stretching is not a favorable method because as the muscles stretch rapidly the intrafusal muscle spindles may be activated, causing a reflex protective muscle contraction. Forceful ballistic stretching can also cause micro trauma of muscle fibers.
Cardiovascular endurance is also a factor in injury prevention. The cardiovascular and respiratory systems must be adequately conditioned to delay the onset of fatigue. A fatigued athlete becomes vulnerable to injury when the nervous and muscular systems are unable to respond adequately to an injury producing situation.
B) Appropriate training methods:
Ensuring proper, efficient mechanics requires practice and effective coaching, including a systematic series of specific, repetitive and progressive exercises and drills. Faulty mechanics must be corrected and good fundamentals ingrained. Exercises should include strength, relaxation and flexibility specifically geared to the demands made on the body2.
C) Rest and Recovery:
Adequate sleep is important for general good mental and physical health, and becomes critical for recovery after intensive work-outs. Chronic overexertion and fatigue can make the athlete susceptible to injury.
D) Muscle soreness:
Muscular over-exertion may present as muscle soreness, muscle stiffness and muscle spasm. According to the ‘Muscle Spasm Hypothesis’ of muscle soreness, ischemia to the muscles releases pain substances from the muscle fibers and stimulate the pain receptors resulting into the muscle pain. Stretching the muscles helps reduce the spasms and associated pain. According to the ‘Tissue damage hypothesis”, micro-tears occur and pain/soreness results from the nerve endings being stimulated by muscle tissue swelling. Proper massage may aid in reducing tissue edema and decreasing accompanying muscle spasm. Ice application or other forms of cryotherapy, and pool training, may facilitate the body’s healing response. Appropriate rest will allow microscopic damage of the tissue to heal3.
E) Appropriate equipment:
Shoes are the most critical piece of a track and field athlete’s equipment and should be individually and carefully selected. Proper fitting shoes can mean the difference between a low and a high risk of injury for track and field competitors. Training in improperly fitted shoes can result in chronic abnormal pressures to the foot and cause injuries or structural deformities. Every member of the sports team (coach, official, sports medicine persons and athletes) must be aware of any hazardous field situation where the field events practices and competitions take place, and take action to assure the higher level of safety.
F) Psychological Factors:
Athletes need to be psychologically prepared for practices and competition in order to reduce the risk of injury. In understanding the stress-injury relationship, “Nideffer” (1983) points out that muscle tension increases in response to stress. Increased tension in the antagonistic and agonistic muscle groups result in reduced flexibility and less of motor coordination. Increased muscular tension also slows reaction time, which reduces athlete’s ability to respond. Mental as well as physical fatigue can contribute to injury occurrence. The role of attention focus and muscular tension can be a major problem. Fear or worry about a second injury can cause stress and increased muscular tension4.
G) Training In Extreme Condition:
Coach and athlete should take into account the temperature and humidity during training and the need to acclimatize after travel to a different, extreme climate or altitude. Extreme heat and humidity, cold and altitude can adversely affect performance in many events. To avoid dehydration and the fatigue that can occur from inadequate fluid replenishment, athletes must drink extra water, juices and the other drinks. Athletes should learn to drink before they feel thirsty. By the time an individual is aware of thirst, they have lost 1% of their body weight; by 2% he is already dehydrated and may have reduced his or her work capacity by 10-15%. Assuring adequate water, juices and sports drinks, helps to keep the percipients energized, focused and better able to concentrate. The health and safety of the athlete must be the number one priority in any practice or competition situation. In unsafe climatic conditions, training should be curtailed, and practice or competition times must be re-scheduled to allow the safest environment for all participants5.
How to prevent sports injuries
Following are some general rules for injury prevention no matter what sports you play. While it is impossible to prevent every injury, research suggests that rate of injury could be reduced by 20 to 25% if coaches, sports scientists and athletes took appropriate preventative action, including6:
a. Be in a proper physical and mental condition: Keep in mind the weakened warrior has a high rate of injury. One should adequately train as per the requirement of the game, general as well as specifically. It is a mistake to expect the sports itself to get you into shape. Many injuries can be prevented by following a regular condition program of exercises designed specifically as per the demand of sports for training as well as for competition based on the level of the competition. And one should take into account the mental condition of the athlete also.
b. Know and abide by the rules of sports: The rules are designed, in part, to keep things safe. This is extremely important for anyone who participates in contact sports. Rules of conduct, including illegal blocks and tackles are enforced to keep athlete healthy. Know them and follow them.
c. Wear appropriate protective gears and equipment: Protective gears and equipments are not for sissies. The protective equipments that fit you will can save you during training and competition. Never train yourself during training except proper equipment and never play in a competition without your safety gears.
d. Rest: Athlete with high consecutive days of training has more injuries. Many athlete think the more they train, the better they will perform. This is a misconception. Rest is a critical component of proper training program. Rest can make you stronger and prevent injuries of overuse, fatigue and poor judgment.
e. Always warm up before training: Warm muscles and joints are less susceptible to injuries. The proper warm up is essential for injury prevention. Make sure your warm up suits to your sports. You may simply start your sports slowly or practice specific stretching or mental rehearsal depending upon your activity.
f. Avoid playing when fatigue or in pain: Pain indicates a problem. You need to pay attention to warning signs which your body provides. Research provides us with helpful clues about the cause of sports injuries. There are two factors that out weight the rest when it comes to predicting a sport injury. They are:
- Having a history of injury: Previous injuries to muscles or joints tend to develop into chronic problem areas for many athletes. It is extremely important to warm up and stretch previously injured parts.
- A high number of consecutive days of training: Recovery days reduce injury rates by giving muscles and connective tissue an appropriate to repair between training sessions.
Injury prevention tips :
· Avoid training when you are tired.
· Increase your consumption of carbohydrate during the period of heavy training.
· Increase in training should be matched with the increase in resting.
· Any increase in training load should be preceded by an increase in strengthening.
· Treat even minor injuries very carefully to prevent them becoming a big problem.
· If you experience pain when training STOP training sessions immediately.
· Pay attention to hydration and nutrition.
· Use appropriate training surface.
· Check equipment is appropriate and safe to use.
· Introduce new activities very gradually.
· Aim for maximum comfort when traveling.
· Be extremely careful about hygiene.
· Monitor daily the signs of fatigue. If in doubt ease-off.
· Have regular sports massage.
As a coach :
The key is rapid action when the injury first appears and a lot of psychological support is required to back up the remedial treatment. Educate yourself and your athlete in the art to learn different basic therapy. 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.
· Coaches should have the appropriate basic knowledge of coaching.
· Coaching activities must be appropriate to the age and ability of the participant.
· Skill should be taught in a progressive manner with readiness (strength, flexibility, understanding of requirements etc.) Constantly monitored.
· Program should be balanced, providing a variety of content over a period of classes. They should include adequate physical conditioning and the range of movement experiences.
· Conditioning programs should focus on the major muscle groups for strength as well as the smaller muscle groups for optimum joint stability.
· All sessions should include adequate warm up and cool down sessions7.
Hence, it is very much clear by the above discussion that we cannot stop injuries completely from the games and sports, but we can minimize the rate of injury by proper knowledge and awareness. We can minimize the rate of injury by the help of sports sciences and awareness to the athletes.
Meaning of difficult words and definations.
Trauma: Any physical damage to the body caused by an accident or an emotional wound or shock often having long lasting effect.
Catastrophic: Extremely harmful, bringing physical ruin e.g. catastrophic illness.
Growth plates : The thin layer of cartilage between the epiphysis and shaft of a long bone.
Cardiovascular Endurance : Body’s ability to continue exertion while getting energy from the aerobic system used to supply the body with energy.
Propriocepative/kinesthetic sense : It is the sense of the relative position of neighboring parts of the body and strength of effort being employed in moment.
Connective tissue : Tissue of meso dermal origin consisting of e.g. collagen fibro basts and fatty cells supporting organs and fills spaces between them and forms tendons and ligaments.
Tensile stretch : A measure of the ability of a material to with stand a longitudinal stress, expressed as the greatest stress that the material can stand without breaking.
Ballistic Stretching : Is a form of passive stretching of dynamic stretching in a bouncing motion. Ballistic stretches force the limb into an extended range of motion when the muscle has not relaxed enough to enter it. This stretching has been found to the hazardous to the body8.
Micro Trauma : Is the general term given to small injuries. It can include the micro tearing of muscle fibers, the sheath around the muscle and the connective tissue. It can also include stress to the tendons.
Ingrained : Deeply rooted/ firmly fixed or held.
Muscle Spasam : A painful and involuntary muscle contraction.
Muscle Soreness : Is the pain and stiffness felt in muscles, several hours to days after unaccustomed or strenuous exercise. The soreness is felt must strongly 24 to 72 hours after the exercise. It is caused by eccentric exercise.
1. Prentice, W. Arnhem’s Principles of Athletic Training (12th Edition).
2. Prentice, W. Arnhem’s Principles of Athletic Training (12th Edition).
3. Lamb, D.R. Phychology of exercises, Responses and Adaptations (2nd Edition)
4. Kerr, G.A. and Minden, H. (1988) Psychological factors factors to the occurrence of athletic injuries, journal of sports and exercise Psychology, 10,167-113.
5. Clerk, N fluids, Dehydration and Thirst Quenchers. Sports Nutrition Sports Medicine System.
6. Jones, B.H. Bovee, M.W. and Cowan, D.N. (1993) Intrinsic risk factors for exercise related injuries among male and female.
7. Meeusen, R. and Borms, J. (1992) Gymnastics injuries, Sports medicine 13 (5) : 337-356
8. Nideffer, R.M.The injured athlete : Psychological factors in treatment.