June 17, 2004
Joe H. Gieck, Ed.D., PT, ATC
Professor of Sports Medicine and Athletic Training
University of Virginia
In any sport one of the primary objectives is to enjoy the activity. Avoiding injury while involved only adds to the satisfaction from your sense of accomplishment. There are many factors involved in injury prevention. All these must be considered before beginning activity. In each instance, you are in control of these factors and the role they play in injury prevention.
The first step then is to assess what the sport requires and what you bring to the table in the way of readiness for the sport. You should begin by defining what your goals are. Are they recreational or competitive in nature? While both require many of the same principles, the competitive athlete will require a more disciplined and intense approach and effort. It is much easier to remain injury free in recreational sports if you follow the same guidelines for the competitive athlete. As a competitive athlete you often have to push the limits in the physical arena which can create more risk for injury. Preparation physically and mentally can provide this cushion of physical fitness to avoid injury.
Proper rest and nutrition are necessary for optimal performance. If you are skimping on sleep and not getting an adequate diet you only hold yourself back and set yourself up for injury. Hydration is part of the nutritional balance necessary for participation. Sweat rates of elite athletes may exceed 8 - 10 quarts a day. Dehydration of as little as 2% can affect physical performance which in turn makes injury more likely.
Exercise should be that which can be comfortably tolerated. There should be a slow build up in intensity to reach peak performance. Usually an increase of about 10% per week is what is recommended to properly prepare your body for the activity and to prevent injury. Too much too soon is often the cause of overuse injury. As exercise becomes more intense it should also be pain free in that there may be some soreness but not causing musculoskeletal pain the next day. Ideally you progress the exercise in intensity but without pain or soreness.
Pain is the body's way of telling you you're doing too much and risking injury. Thus, it is important that when beginning a sport that you slowly adjust to the pace, from half to three quarter to full speed. In this manner you acclimate to the full speed of the sport. Obviously you must allow ample time to prepare for competition. However it requires time and hard work, which many are not willing to do. Just like with improper hydration, nutrition, or rest, an injury is more likely to happen.
An often overlooked area of injury prevention is a preseason screening process. Areas that should be assessed should be equipment, especially shoes, posture, strength, range of motion, proprioception, endurance, power, speed and agility. A worn or cheap pair of shoes is an example of an injury waiting to happen. Lower extremity posture in running sports should be evaluated and corrections made prior to competing. For throwing sports, have your coach assess your technique. This can spot mechanical flaws that can be corrected and reduce the chance for injury. If you have a previous injury, it should be assessed in the above areas to assure that you are ready to return to play.
You should have a strength level appropriate for your sport of choice. If the muscles and tendons cannot handle the stress loads of the sport or activity, injury is sure to occur. Strength and flexibility are the cornerstones of physical fitness. If you lack strength or adequate range of motion in your joints they are at risk of injury. A weak or tight muscle or tendon is at risk. Proprioception or balance is required in sport and a factor in the injury process if you have deficits here. For the lower extremity for example you should be able to balance easily with your eyes closed on one leg, if not then this is an area of concern and need remediation.
In beginning an exercise session you should always warm up to avoid injury. Getting the body ready for the selected activity through a series of selected exercises properly prepares you to reduce your chance of injury. Fatigue is often a cause of injury. The muscles and tendons cannot contract and relax in a sequential manner, become out of synch, reactions slow and injury is there waiting to happen in the form of a strain, sprain or fracture. When you feel fatigue coming on, it is the time for a break to allow the body its necessary recuperation.
An aerobic or endurance base is required of most all sports to prevent fatigue and injury. If you lag behind here you again put yourself at risk as well as under performing in the activity and become non competitive against those who have a good aerobic base. Ideally, you will need a physical activity that increases your pulse level to more than 120 heart beats/minute for a minimum of 20 minutes.
Anaerobic exercise is developed through power and speed training in short yet intense sessions. Power is the ability to function rapidly in your sport to attain maximal results. A good strength base is required to begin a power program. Circuit training is a good example of power training where a 30 second bout of vigorous exercise is performed followed by a 20 second rest throughout a cycle of 6 - 8 exercises. This is the system that ultimately develops you for your sport.
Speed and agility will keep you out of potentially injury producing situations. Speed may be developed by improving technique utilizing efforts with a 6 second maximum effort. Agility and coordination emphasize neuromuscular control and are the culmination of all physical fitness factors. It is the ability to react to the demands of sport. It is usually the first to suffer fatigue.
As you implement improvement of these systems you can increase muscle fiber size and bone strength, increase flexibility, decrease fat, improve cardiovascular, and respiratory fitness and help reduce the chances you will sustain injury in your activity. Those who are physically fit have an injury rate one half to those who are not fit.
The injury prone athlete exhibits negative thinking. Sport should be an enjoyable experience and one of exhilaration. Being positive about injury prevention without being too much of a risk taker will add to your pleasure of activity and help with reducing your injury risk. If the activity isn't fun find another one.
The assessment and implementation of a program to prevent injury will allow you to enjoy the benefits of the sport or activity without the consequences of pain, discomfort and frustration as a result of injury.