At Injury Active we see injuries that are caused by a range of risk factors, generally categorised into external or internal.
External risk factors are those that the athlete can control, for example being hit by another player. These risks are unpredictable and therefore difficult to prepare for.
Internal risk factors are those that the athlete can influence, for example, load management, recovery, and optimal movement.
In this blog, we will discuss how to limit internal risk factors to help you stay injury free this season.
Gradual Loading to avoid sudden injuries
A large proportion of non-contact soft tissue injuries are due to excessive and rapid increases in load. This is what we call a spike in load.
Soft tissues, such as muscles, tendons, and ligaments, have a load capacity which depends on the level of fitness of each individual. Dramatically exceeding the maximum loading capacity will increase the tissue susceptibility to injury (Gabbett, 2016).
Although at the time it may feel like you are training safely, a spike in load is likely to make you more vulnerable to injury in the long term. Consequences may not be realised until up to 3-4 weeks post-spike (Drew & Finch, 2016).
Whilst it is important to avoid overloads, undertraining must be prevented as well.
Optimally increasing the workload will encourage adaptations of the soft tissues to improve in strength, endurance and flexibility, whilst minimising the risk of developing an injury (Gabbett, 2016).
How do we find the balance between under and overloading?
It has been reported that spikes in weekly training load greater than 10-15% increase the risk of injury, (Harrison et al., 2018). Therefore, we should be increasing load gradually at no more than 10% per week. This can be measured in a variety of ways such as duration– how long you are training for, intensity– how hard you are training, frequency– how often you are training, etc. A good example from Drew & Finch (2016) was recording and reviewing the throw counts in throwing sports.
Recovery to achieve top performance
Recovery is essential for achieving top performance as it allows the body to repair itself both physically and psychologically while encouraging a gradual adaptation to physical stress.
Sleep – At least 8 hours for maximum performance
It was reported that adolescent athletes who slept on average less than 8 hours per night were 1.7 times more likely to experience an injury compared to athletes that slept for more than 8 hours (Milewski et al., 2014). Surrounding research suggests that sleep deprivation can inhibit optimal recovery processes and cause impairments in muscle glycogen repletion, muscle damage repair and cognitive and mental function (Nedelec et al., 2015). As well as increasing injury risk, lack of sleep has been found to affect performance. Reyner and Horne (2013) found that in tennis players serving accuracy was impaired by up to 53% after just one night of restricted sleep of 5 hours. Additionally, consuming caffeine prior to testing showed no beneficial effects on serving accuracy. Caffeine is not a substitute for lack of sleep!
Stretching – To avoid injuries and increase performance
Stretching is a great way to assist recovery and to address deficits in range of motion. Improving the length of muscular tissue can increase its capacity to withstand stretch before experiencing straining injuries (McHugh & Cosgrave, 2010). It has also been suggested that stretching can accelerate recovery and tissue’s return to baseline lengths faster than if no stretching was to be performed (Reuther et al., 2016).
Interested in improving your streatching routine? Check out our mobility series on youtube for some ideas on how to become more flexible.
Nutrition – Fuel your body before and after physical exercise
Adequate energy consumption before, during and after exercise is important to maximise performance and recovery. Low energy availability can cause increased risk of fatigue, injury/illness, loss of muscle mass/bone density and sub-optimal adaptations and recovery processes. It is recommended that a postexercise routine should aim to replenish fluids, electrolytes, muscle glycogen stores to encourage recovery. The building and repairing of muscles can be encouraged by protein consumption (Thomas et al., 2016).
In some cases, injury can be caused by an underlying biomechanical deficit. Sub-optimal movement can place excess stress on certain aspects of the body causing an increased injury risk.
As sports therapists, we should be looking at the body as a whole to identify the chain reactions that occur while moving. Lacking range or strength in one segment of the body can cause another to compensate putting it at higher risk of injury. For example, a foot that was not mechanically performing as well as it should cause injuries along the hip and the back.
This is why an assessment that covers the entire body can help to identify the original source causing pain and dysfunction.
Here at Injury Active, we aim to identify the weaknesses and build upon them to facilitate optimal movement patterns. Whilst doing this we believe that assessments, treatments, and rehabilitation should be individualised, specific and functional to the athlete and their sport.
Thanks for reading!
Drew, M. K. and Finch, C. F. (2016) The Relationship Between Training Load and Injury, Illness and Soreness: A Systematic and Literature Review. Sports Medicine, Jan; 46 (6); 861-883
Gabbet, T. (2016) The Training-Injury Prevention Paradox: Should Athletes be Training Smarter and Harder. British Journal of Sports Medicine, Jan; bjsports
Harrison, P. W., Johnston, R. D. and Quain, D. (2018) Literature Review: Examining the Relationship Between Training Load and Both Performance and Injury Risk in Australian Football. Journal or Australian Strength and Conditioning, 26 (2); 69-81
McHugh, M. P. and Cosgrave, C. H. (2010) To Stretch or Not to Stretch: The Role of Stretching in Injury Prevention and Performance. Scandinavian Journal of Medicine and Science in Sports, 20; 169-181
Milewski, M. D., Skaggs, D. L., Bishop, G. A. et al. (2014) Chronic Lack of Sleep is Associated with Increased Sports Injuries in Adolescent Athletes. Journal of Pediatric Orthopaedics, Mar; 34 (2); 129-133
Nedelec, M., Halson, S., Abaidia, A. et al. (2015) Stress, Sleep and Recovery in Elite Soccer: A Critical Review of the Literature. Sports Medicine, Jul; 45; 1387-1400
Reuther, K., Larsen, R., Khun, P. D. et al. (2016) Sleeper Stretch Accelerates Recovery of Glenohumeral Internal Rotation After Pitching. Journal of Shoulder and Elbow Surgery, 25; 1925-1929
Reyner, L. A. and Horne, J. A. (2013) Sleep Restriction and Serving Accuracy in Performance Tennis Players, and Effects of Caffeine. Physiology and Behaviour, Aug; 120; 93-96
Thomas, D. T., Erdman, K. A. and Burke, L. M. (2016) Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and The American College of Sports Medicine: Nutrition and Athletic Performance. Journal of the Academy of Nutrition and Dietetics, 116 (3); 501-528