12/18/2018
Zach Koba, MS, CSCS
Injury Prevention: What is it?
Most of my current and former clients have the same goal- to be able to perform activity without pain. Overall, to summarize injury prevention in its simplest form, prevention is nothing more than systematically progressing your bodies tissue tolerances gradually to be able to perform the exercise or sport specific functions of your choosing with the least chance of injury. Clinically this may mean that we are working on your “tissue tolerance” to activity while a strength and conditioning coach may refer to the same concept as periodization of a training program.
Let's think about this from a strength and conditioning standpoint. Many of my clients come to me after the insult or injury has already happened. Whenever I evaluate a new client everything starts with an assessment. If we don't assess, we guess. What coaches mean by this is if we do not have an understanding of your past exercise history, abilities, previous injuries, or movement patterns it is impossible to know what you body will respond to best or needs to perform lifting movements and sport specific movements optimally.
Why is this important? For starters movement patterns and compensations often begin long before pain arises and tissue starts sending out pain signals or warning signs. Something as simple as knee stiffness or joint pain after a workout is often the first warning. As movement professionals we know (or should) that the biggest predictor of future injury is previous injury and, to myself and many others in the field, movement patterns and functional capacity (combination of strength, endurance, and mobility) can be a large predictor of future injury potential regardless of an athletes current physical performance. I have seen athletes performing at very high levels who have very poor movement and by “cleaning up” their movement quality performance increases exponentially in a very short period of time as we have “unlocked” potential and the bodies natural capacity through improved movement quality.
Cyclical Balance for Injury Prevention:
First Injury Prevention Starts with Balance- With all of my athletes the biggest factor we promote is balance. No… I'm not talking about standing on one leg or walking a tightrope. I’m focusing on the athlete who can bench 300 pounds but is unable to perform 5 pull ups or complete 10 “perfect” push ups. "But coach, I weigh 250 pounds, pull ups are hard." Yes, they are, but you bench three times per week religiously and performed pull up variations one time last month. This lack of balance is a red flag (or should be) and signals a strength imbalance within the body. In the lower body it is not uncommon for me to come across athletes who can squat several hundred pounds but have limited abilities to perform body weight motions pertaining to the posterior chain such as a simple hamstring curl. When these movement patterns and imbalances are identified injury prevention programs can be as simple as incorporating or balancing strength deficits at individual joints.
Second Stick To Movement Quality- Mobility and balance are key, and often overlooked components of any strength and conditioning or Injury Prevention program. That previously mentioned athlete who can squat 550 and bench 300 pounds in the weight room may have trouble balancing on a single leg or may be unable to change direction in a reasonable amount of time particularly when in an open environment where the movement is unplanned (think on the playing field such as chasing an offensive player). In addition, while tissue stiffness is advantageous for certain positions such as with an offensive lineman in football, it should not be so extreme as to considerably limit normal joint motion such as being able to flex the knee or be unable to rotate the shoulder overhead or behind the back as the body needs this for overall movement feedback and awareness of joint position to prevent injuries. When we find athletes with obvious movement or mobility deficits we unload the weights, work on these deficits through full range, get them to a normalized range of motion and then reload the movement pattern. In more cases than not we see a period of considerable performance improvement whether it be weight room numbers or pain free activity tolerances.
Third Know Your Why- When speaking with coaches or athletes the first question I ask them is “why do you do this [insert any exercise or conditioning activity]? Is it a tradition that has been passed down since the beginning of time or is it a specific, well defined, activity that is helping you or your athletes achieve a goal. If the entire team performs the same workout, why? Does you point guard, soccer forward, and defensive back have the same physical demands as your goalie, basketball center, or offensive lineman? As athletes progress to higher levels of sporting participation and subsequent training they gradually become more and more in tune with the “whys”. The best athletes I have worked with have a very good understanding of human performance and particularly recovery strategies that help them get back to training sessions sooner and closer to 100% recovered. At the end of the day every athlete I have worked with on an individual basis gives me considerable effort- athletes are motivated to perform at a high level. What separates the good athletes from great ones is their ability and understanding of recovery and the “whys”.
Finally Keep It Simple- There are numerous well researched injury prevention programs readily available with an internet search for dozens of sports. Individual sport coaches and movement professionals, particularly at the high school level, can easily incorporate these routines into the warm up phase of their teams preparatory movements and reap the benefits of healthier and well balanced athletes while reducing the rates and severity of injuries. When in doubt contact a qualified movement professional to help you or your team assess each individual athlete and point you in the best direction. The investment is worth it.
In the second part of this series we will begin to focus on reducing knee injuries for athletes.
