Injury Prevention & Management of Injuries

Presented by:Karen Craven

BSc(PT),Dip Sport (PT), CSCS

Prevention Through –

Training Program DesignPhysical ConditioningNutrition/HydrationWarm-up and Cool-downStretchingMonitoring of over-use signs and symptoms

Training Program Design

Appropriate type of training stimulus Ample rest and recovery time Specific to your sport Specific to improve your weaknesses

and maximize your strengths.

REST… is the most important part of your workout.

Between workouts there must be ample

time for recovery

Complete recovery time required following various types of training

inducing HIGH fatigue

Type of training Speed Strength Anaerobic

lactate Aerobic Power Aerobic

endurance

Recovery time 24 hrs 48-72 hrs 48 hrs 48-56 hrs 56-72 hrs

N.B. Obviously, less recovery required when fatigue is not ‘high’Discussion required of these points!

Modified from Platonov, 1988, via Marion (1995) & Balyi, NCI-Victoria

Physical Conditioning

Strength – gluts, hamstring/quadricep ratio, ankle and calf, upper body

Neuromuscular coordination drills (ie SAQ drills)

Good technique and execution Balance and proprioception

exercises Plyometrics Flexibility – ankle, thoracic spine Aerobic/anaerobic conditioning

Golden Rules...

During any given training session, quality of exercise performance

is the cornerstone of the training program.

Think of the Means of skill performance, not the end

product.

Your body needs 8 to 10 cups of fluid during the day to stay hydrated

Fluid Intake Guidelines

Before event- drink 500 ml (2 cups) waterDuring the event- drink 150 to 300 ml

every 15-20 minutes for events < 1 hour WATER is good

for events > 1 hour a source of carbohydrates helps to delay fatigue.

Choose a beverage with 4 - 8% carbohydrates

(i.e. 4-8g carbohydrates/100 ml)After the event - consume enough fluid to

replace all losses. 1500 ml per kg of body weight lost

Hydration Status

40

50

60

70

80

90

100

1 2 3 4 5 6

Effect ofhydration statuson performance

Warm-up & Cool-down

Increase body temperature Increased readiness to participate Increased efficiency of movement

Decrease in metabolic processes Removal of Lactic Acid Replenish Energy

Warm-up/Cool-Down

Warm-up Should be Dynamic!

Cool-Down Means slowing down (not stopping

completely), after exercise Continue to move around at a very low

intensity for 5 to 10 minutes after a workout

Finish with some stretching

Stretching

Muscles surrounding the hip, knee and ankle, back

Daily stretching Passive and active Hold static stretches 30 sec. Repeat

3-5x.

  Physical Activity  

  Muscle Fatigue  

Altered Movement Patterns

  Altered Recruitment Patterns

  Altered Proprioception

  Abnormal Loading  

  Altered Stress Distribution  

Increase in Compressive Forces

  Increase in Tensile Forces

  Tissue Stress/Strain  

All physiological training is intimately dependent on

the concept of progressive overload.

Overtraining and Overreaching

Is an advanced expression of athletic fatigue. It is characterized by a decline/stagnation in performance, and is accompanied by a set of physiological, psychological and biochemical signs and symptoms.

Training load

Supercompensation Normal functioning level of the body

Recovery of tissues and fuels after training sessionFatigue, decrease in normal

functioning level

Adapted from NCCP Task #6 readings

PerfectToo soon Too late

Next workout?

Level of Physical preparedness/fuels

Ref. Page 30

Baseline fitness

Fitness gain!

Workout during supercompensation phase

Sufficient recovery = performance gains!

Baseline fitness

Fitness loss!

Workout before supercompensation phase

Insufficient recovery = performance decrements!

Staging of Tendinitis/Overuse

Syndrome/Under-recoverySYMPTOMS Stage I:

Pain only after activity. Does not interfere with

performance. Often generalized

tenderness. Disappears before next

exercise session.

Stage II: Minimal pain with

activity. Does not interfere with

intensity or distance. Usually localized

tenderness.

TREATMENT

Modification of activity.Assessment of training pattern.Possibly NSAIDs

Modification of activity.Physical therapy; NSAIDs; consider orthotics.

Reid, 1992

Staging of Tendinitis/Overuse

Syndrome/Under-recoverySYMPTOMS Stage III:

Pain interferes with activity. Usually disappears between sessions. Definite local tenderness.

Stage IV: Pain does not disappear between activity sessions. Seriously interferes with intensity of training. Significant local signs of pain, tenderness, creptitus,

swelling.

TREATMENT Significant modification of activity.

Assess training schedule.Physical therapy; NSAIDs; consider orthotics.

Usually need to temporarily discontinue aggravating motion.Design alternate program.May require splinting.Physical therapy and NSAIDs.

Reid, 1992

Staging of Tendinitis/Overuse

Syndrome/Under-recoverySYMPTOMS Stage V:

Pain interferes with sport and activities of daily living.

Symptoms often chronic or recurrent. Signs of tissue changes and altered

associated muscle function.

TREATMENT

Prolonged rest from activity.NSAIDs plus other medical therapies.Consider splint or cast.Physical therapy.May require surgery.

Reid, 1992

Symptoms of Overtraining

Apathy (no emotion) Lethargy (tired all the time) Depression Decreased self-esteem Emotional instability Impaired performance Restlessness Irritability Disturbed sleep Weight loss Loss of appetite Increased resting heart rate Increased vulnerability to injuries Muscle pain/soreness

Preventing Over-training Set realistic and flexible

training/game goals Physical conditioning Practice quality not quantity Keep program flexible Allow for rest and recovery Relieve Stress Nutrition and hydration Recovery techniques (Active Rest,

Relaxation, Massage, Hot/Cold etc)

Preventing Over-training

What to Monitor: Morning heart rate Sleep Mood Appetite Weight Hydration Status

Injury Care

Vicious Circle

JointDamage

ReflexInhibition

MuscleWasting

MuscleWeakness

Immobilization

Common Signs of An Injury

Painful to move or use Swelling Discoloration Warm to touch

Basic Treatment of Injuries

R.I.C.E.R REST AND RESTRICTED

ACTIVITY ICE COMPRESSION ELEVATION REFER TO MEDICAL

PROFESSIONAL

Rest Immobilization in

anatomical position NWB Crutch walking PWB Crutch walking with

pain-free heel-toe gait as tolerated

FWB with pain-free gait without limp

Ice

15-20 minutes per time, 5-7 times a day (every couple of hours)

First 48 hours most important time

DON’T FREEZE! After activity (NOT before

or during activity) Place wet towel between

skin and ice

Compression

Minimize swelling with a tensor Don’t wear at night

Elevate

Keep the ankle at or above waist level at all times when the patient is not active

Should be continued until the swelling has resolved

Refer

Refer for medical advice for injuries requiring additional treatment

Receive permission to return to sport from a medical advisor

Ensure joint is well supported on return to sport (ie. Brace or tape)

Seek Treatment:“The earlier the better!!”

Sport Physiotherapy: - Movement patterns- Alignment- Asymmetries/imbalances- Resting and active muscle tone- Flexibility and joint range of motion

STAGESOFREHAB

RUNNINGPROGRESSION

RULE OF THIRDS

Magee

Therapeutic Exercise Program

Control Inflammation (RICER) Modify training Rehabilitative exercises from

physiotherapist Gradual introduction of muscular

strength, endurance and power Progressive and gradual return to sport

activity Maintain strength of opposite limb Core stability and flexibility Maintain cardiovascular fitness through

alternative exercise (ie swimming)

Success is...not an accident, but rather the product of a

thoughtful and well executed plan

The End

THANK YOU!

306-934-2011craven.sports@sasktel.net