For a competing athlete, injuries are inevitable. Managing injury risk will be central to the athlete successes and long-term career. Dr Tojborn Soligard (Sports Medicine Scientist, IOC) and Dr Richard Budgett (Medical and Scientific Director, IOC), provided important information on injury risk and ways in which athletes can manage these risks.
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The protection of the athletes’ health should be a main priority for the athletes themselves and their entourage.
Despite suffering less from non-communicable diseases such as coronary heart disease, obesity, hypertension, diabetes so on, athletes are exposed to a dramatically higher risk of injuries and illnesses following their sports participation, mostly muscular skeletal injuries or concussions.
Injuries are often split into two main categories:
Acute injuries on the one hand, usually occur as the result of a single, traumatic event such as muscle strains, ligament sprains and bone fractures.
Overuse injuries on the other hand are subtle, and occur over time with a gradual onset. Common examples include Achilles tendinopathies, shin splints, jumper knee, tennis elbow and so on.
When talking about prevention though, we’re talking about identifying factors that put athletes at risk and then about trying to change these factors, to reduce the risk in the athlete. For example, if muscle weakness is identified as a risk factor, the appropriate preventive measure can be a strengthening programme.
Independently of the importance of winning it’s really important that we understand and consider what injuries are, what might place athletes at risk, and most importantly, how to prevent these injuries from happening.
There are a number of risk factors that we know are prevelant in sport for injury:
– Prior injury: for example if the athlete injured the hamstring in the past, he/she is at an increased risk of getting that hamstring injury later
– Age or exposure: the number of training sessions and the number of competitive periods an athlete had over his/her lifetime
– Neuromuscular fatigue, sleep deprivation: an athlete is more likely to get an injury at the latter stages of competition or at the latter stages of a match due to fatigue
-Muscle weakness: not just global muscle weakness but also asymmetries in muscle strength (such as left side versus right side, front versus back) and symmetry in range of motion; how much hip rotation, how much ankle dorsiflexion the athlete has
-Dehydration. Inadequate fluids and electrolyte balances, create an increased risk of soft tissue damage
-Poor variation in training loads and training intensities: If the athlete does the same high volumes, without any planned rest, without any planned fluctuation in the training speeds, the training intensity, the training volume, there is risk of soft tissue injuries or over-training syndrome.
Injury prevention requires a multi-factorial emphasis.
The reality is stretching can be a very good thing for athletes but we cannot expect that continually doing stretching without strengthening through range of motion is going to work. In fact we know that it probably increases injury risk.
So what are some simple strategies that can be employed to reduce injury risk?
A lot of it gets down to planning
– Ensure that there’s variation in the intensity, the volume and the speed, within a day, within a week, and within a training block.
-Avoid sudden spikes in a training load (going from doing not much for a couple of weeks and then suddenly going back into a full training load)
-Periodise gradually so we don’t get athletes coming in straight after a break and going straight into a high-speed session.
– Adequate rehabilitate prior injuries
-Keep markers on physical abilities. Following an injury, make sure that athletes return to those healthy pre-injury levels before we put them back into competition.
-Rehabilitation is not complete until the athlete is not only competent, but also confident, so that they can get back into training and not be worried about the injury itself.
-Priorize Warm-ups, as they have the aim of increasing the core body temperature and preparing the mind to train, as are really important to increase soft tissue compliance.
-Increasing the hamstring length and the trunk range of motion are really important, so if the athlete suddenly has to bend down and pick up a ball, he/she already experienced that range of motion as they went into it in training.
-Avoid a prolonged period of static stretching, holding a stretch for 30 seconds or a minute just before an explosive activity. That is a risk factor for increasing muscle injuries. Instead do gentle, ballistic movement stretches as opposed to a static hold stretch. When it comes to the warm-up, start gently and then we gradually increase the tempo until hitting full training speed.
-Use the warm-up to do the athlete´s individual correctives such as increasing the hip range of motion or activating the glutes, or the shoulder rotator cuff. That’s a perfect time to be able to do it before going into technical training.
-Improve strength on both sides of the athlete’s body; front and back, left and right. Strength work allows to cut a third of the injury rates.
-Get fit. One of the biggest predictors of concussion is a poor running score
We know we can’t prevent every injury but if we take note of these measures, we’ll be able to significantly reduce the risk profile for the injuries that we can prevent.