Physio - Injury prevention

Burke Sports Injury and Rehabilitation Clinic
Prospect, Athenry
Hi, all here the second edition of Physio Info, I hope you found the article on hamstring injuries informative. Today, we are going to deal with injury prevention.
Injury Prevention is a topic much discussed in health and Sport Injury and Rehabilitation circles. As well as considering the pain and suffering for the injured patients, it is a vital to attempts to decrease health costs and insurance premiums, improve sporting performance and increase participation in healthy activity. It is never likely to be completely successful, for as long as people play sport, lift things, sit too long or drive cars (plus all other daily activities) there will be injuries. 
Sports injuries are injuries that occur in athletic activities. In many cases, these injuries are due to overuse or acute trauma of a part of the body when participating in a certain activity. Unfortunately acute trauma invariably cannot be avoided especially in team sports.
Guidelines to minimise risk of injury
Warm-Up forms an essential component of any exercise.  A warm up should focus on the muscles to be used during the exercise and is determined by the type of exercise or activity that you plan on doing.  A warm-up for a round of golf for example should focus on warming up of the upper limbs and back, whereas a runner will need to focus on the legs.  A warm-up should consist of gentle aerobic exercise of main muscle groups to be used during activities, gentle stretching and gradual increasing of the heart rate.
A good specific warm-up leads to fewer injuries due to: 
  1. Increased blood flow to muscles
  2. Increased joint range of motion
  3. Improved muscle flexibility
  4. Improved circulation
In the past, GAA teams in particular were often guilty of foregoing a warm-up and go straight into kicking footballs over the bar from 35-40 yards – a sure recipe for quad and hip flexor tears. Whereas, now most trainers are aware of the importance of warm-ups. Similarly, golfers often arrive to the 1st tee directly from the car and go straight into a full swing, increasing the likelihood of wrist, shoulder and lower back injuries.
Stretching/Muscle flexibility is an important factor in injury prevention.  Injury occurs in muscle and connective tissue which is forced beyond its natural limit resulting in muscular strain. By engaging in stretching we hope to lengthen muscles and connective tissue making them more flexible and adaptable to stresses at their end of range, thereby reducing the likelihood of injury.
In general the following rules apply with regard to stretching:
  1. Make sure you’re warm before stretching
  2. Hold stretches for 30-60 seconds
  3. Repeat, stretching further the second time
  4. Stretch to point of tension not pain
  5. Stretch before and after exercise
Appropriate Training Beware of the impact of over training on increasing injury likelihood.  Training programmes should be individually tailored with adequate rest periods and cross training.  The general principles of training state that the body needs to be put under stress in order to produce a training effect and to benefit from the work-out.  However continuous high intensity bouts of exercise without appropriate periodisation and rest days will lead to an increased likelihood of overuse injuries.
Overuse injuries are particularly common in runners who participate in high volumes of a single type of training.  This can commonly lead to lower limb overuse injuries.  Adequate periodisation, and cross training is crucial in prevention of such injuries.  There may be a case for the introduction of a weight training or pool session instead of one of the longer runs perhaps once a week.
Equipment Always use appropriate equipment for the job. Ill fitting cycling helmets, poor work-station set-up, tools that aren’t strong enough, using runners for long distance running are all things that contribute to people ending up injured and contacting Burke Sports Injury and Rehabilitation Clinic (086) 8365687
Workload Don’t load your body past its capacity to cope. Lifting overloaded wheelbarrows, running 10 km without training, typing for hours without a break can stress the body beyond its limits. Build up loads gradually allowing the body to adapt before applying more stress.  
Body Mechanics Make sure your body is in appropriate shape to do what you ask of it. Tight and weak muscles, joint stiffness, flat feet, poor posture, poor cardiovascular fitness limits your ability to perform tasks and can lead to injury. 
Intensity Trying to keep up with others, who can perform the task at a higher level than you, can lead to overload. Running with someone at their faster pace, trying to play at the level you could twenty years ago, helping to lift piece of furniture with your husband, typing faster than you can usually manage can push yourself into injury
Recovery Working constantly until the job is done, doing the painting or washing ALL the windows over the long weekend, going to the gym every day of the week fails to create the conditions in which the body can have time to strengthen. 
Get a proper training programme and Injury Education allowing you to have a more objective approach to what you are doing and can avoid many of the pitfalls described above. 
Injury prevention is not a sure thing. Despite the best plans, care and training programs people will still suffer injuries.  
Following the injury prevention basics will only minimise the risk.  
If you are injured, seek advice and treatment as soon as possible by calling Burke Sports Injury and Rehabilitation Clinic.
Overuse Injuries

Overuse injuries often build up slowly and can be categorised according to their severity: 

a) Pre painful stage: the actual injury to the tissue involved (whether it be muscle, tendon or bone), occurs before the onset of pain. At this stage the area may be tender to touch, but the athlete experiences no pain during activity. 
b) Grade 1: the athlete is aware of pain after activity. This will usually fade before the next training session. 
c) Grade 2: pain is experienced at the beginning of a training session. It usually diminishes through the session but the athlete is again aware of pain after completing the session.   
d) Grade 3: at this stage there is pain before, during and after training. The athletes’ performance is reduced by the pain. 

Treating overuse injuries 

  1. Ice - acts to decrease the inflammation and soreness. It should be used for 10-20 minutes over the affected areas.  
  2. Heat - is useful in relaxing muscles and as a method of temporary pain relief after the initial 24 hours. Alternating heat and ice may have a role in more chronic conditions. 
  3. Anti-inflammatory - Tablets and Gels should be taken under supervision and should only form part of an overall treatment programme. 
  4. Compression and Elevation - Is useful where an injury involves swelling, particularly in the early stages. Elevation means that the injured part should be held above the level of the heart. 
  1. Rest - You must not continue doing sessions that cause pain.  This will only continue the process of injury and lengthen the time for recovery. 
  2. Identify the cause of the injury- Involves assessing your training habits and programme looking for areas that may be causing the problem.  
  3. Rectify the cause of the injury - Either self treatment or if you require the services of a Sport Rehabilitator, make sure they understand your sport, thoroughly examine you and discuss your problems fully, and give you a home programme and discuss how you should modify your training.  
  4. Seek treatment at an early stage - The duration and severity of your injury will be significantly reduced if you introduce remedial action as soon as possible. You cannot train through an overuse injury. It will only get worse. Seek a Sports Rehabilitator for treatment. 
  5. Maintain fitness by alternative means - Training in other sports that do not affect your pain, Activities such as water walking/running may allow you to maintain your cardiovascular fitness. Hydrotherapy is vitally important at this stage
In conclusion you must learn to listen to your body. Remember that "no pain, no gain" does not apply here. The 10 percent rule is very helpful in determining how to take things to the "next level." In general, you should not increase your training program or activity more than 10 percent per week. This allows your body adequate time for recovery and response. This rule also applies to increasing pace or mileage for walkers and runners, as well as to the amount of weight added in strength training programs.
Always remember to warm up and cool down properly before and after activity. Incorporating strength training, increasing flexibility, and improving core stability will also help minimise overuse injuries.
Seek the advice of a Sports Rehabilitation specialist when beginning an exercise program or sport to prevent chronic or recurrent problems. Your program can also be modified to maintain overall fitness levels in a safe manner while you recover from your injury. You should return to play only when clearance is granted by a health care professional.
Hope you have great injury free week and if you have any further queries please do not hesitate to contact me

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