KIN 188 – Prevention and Care of Athletic Injuries

Components of Injury Prevention Program

Introduction

• Evaluative tools– Fitness testing procedures– Fitness testing parameters

• Exercise prescription– Strength training– Aerobic/anaerobic training– Flexibility

Fitness Testing

• Typically done in some association with PPE

• Pre- and post-season evaluations most common – little value with in-season testing

• Allow for baseline to be established (pre-season) and evaluation of progress or identification of areas to focus on (post-season)

Fitness Testing Procedures

• Muscular function– Strength, power and endurance

• Cardiovascular function

• Speed and agility

• Flexibility

• Body composition

Muscular Function

• Strength– Ability of muscle or group of muscles to overcome

resistance

• Power– Rate of performing work, requisite time element

• Endurance– Ability of muscle or group of muscles to perform

repetitive action/s

Muscular Strength

• Most common evaluative technique is using one repetition maximum (1RM) – maximal amount of resistance an individual can move one time– Must ensure that test addresses appropriate

muscle and/or muscle groups

Muscular Power

• Evaluates ability to exert maximal force in as short a period of time as possible

• Most common evaluation methods are vertical jump and standing long jump

Muscular Endurance

• Evaluated differently than strength as different energy system used

• Most common evaluative methods include push-up tests (how many in given period of time), sit-up tests, repeated squat tests

Cardiovascular Function

• Aerobic – involves ability to use oxygen in performing work– Commonly evaluated with timed run over prescribed

distance (1.5 miles is typical) or step test (number of steps in given time frame at set pace)

• Anaerobic – involves work without or with very little use of oxygen– Commonly evaluated with timed shuttle test/line drill

Speed and Agility

• Agility – ability to accelerate/decelerate and change direction under control– Often evaluated with T-test or lateral shuffle

test

• Speed – length of time required to cover distance or accomplish task– Typically evaluated with timed sprint over

prescribed distance (40 yards/100 yards)

Flexibility

• Affected by the following– Joint structure – size and shape of joint surfaces

impacts available joint ROM– Muscle size – hypertrophy can limit joint ROM via soft

tissue approximation and/or tension– Ligament/tendon composition – some individuals

have more elastin than others = more flexibility– Age – flexibility generally decreases with age– Gender – generally thought that females more flexible

than males

Flexibility

• Hamstrings are most commonly evaluated muscle group regarding flexibility– Commonly evaluated by sit and reach test

• Also can be joint or activity specific– “Wing” position for pectoralis major tightness

Body Composition

• Evaluation of amount of fat in relation to lean tissue in the body– Norms are 12%-18% for men and 14%-20% for

women– Obesity at >25% for men and >30% for women

• Evaluative methods include– Skin calipers– Body mass index– Underwater (hydrostatic) weighing– Electrical impedance

Exercise Prescription

• Muscular strength/power/endurance training– Equipment considerations

• Aerobic endurance training

• Anaerobic training

• Flexibility training

• Coaching methods and factors

Strength Training Considerations

• Essentials to any program are resistance and overload

• Resistance can take many forms – body weight, bands, machines, etc.

• Overload is key – must stress muscle beyond normal loads in order to generate response

Strength Training Considerations

• Exercise intensity

• Periodization

• Rest periods/frequency of training

Exercise Intensity

• Typically refers to percentage of 1RM and minimal intensity usually 60%-65% of 1RM

• Hypertrophy method– Goal is to increase muscular mass

• High intensity training method (HIT)– Goal is to increase or improve recruitment of

existing muscle fibers

Periodization

• Cycling of different training volumes and intensities – allows gains in all areas/different times of year

• Hypertrophy– 3-6 sets, 8-20 reps, 65%-80% 1RM

• Strength– 3-6 sets, 1-6 reps, 85%-120% 1RM

• Endurance– 1-3 sets, 10-30+ reps, 15%-60% 1RM

• Recovery– 3-6 sets, 8-20 reps, 15%-60% 1RM

Rest Periods/Training Frequency

• Rest periods depend upon training volume and intensity– Longest rest periods (3-5 minutes) for strength

exercises vs. shorter (30-60 seconds) for endurance/hypertrophy exercises

• Training frequency also depends upon training volume and intensity– Alternating days method is common– Higher loads (strength training) may require less

frequent bouts of training to minimize risk of injury

Types of Strength Training

• Isometric– Force generated in absence of joint movement– Strength gains only at specific point in ROM

• Isotonic– Moving joint through ROM against constant

resistance– Weak points in ROM (typically mid-range) so variable

tension on muscle/s• Variable resistance

– Pioneered by Nautilus to address weak points– Resistance varies through ROM but tension on

muscle/s stays constant

Types of Strength Training

• Concentric vs. eccentric training– Shortening vs. lengthening of muscle with contraction– Much greater tension in muscle with eccentric activities

• Isokinetics– Muscular activity performed at constant velocity– Very expensive, theoretically more functional

• Plyometrics– Stretch shortening cycle activities (eccentric contraction,

amoritization phase, concentric contraction)– Slide board, box jumps, weighted ball tosses

Equipment Considerations

• Free weights– Dumbbells, barbells, plates, etc.

• Strength training machines– Multi-station/”universal” machines

• Individual machines– Single muscle/movement specific

• Other equipment– Plyoballs, physioballs, Theraband/tubing

Aerobic Endurance Training

• Recommended exercise intensity of aerobic conditioning (per ACSM) is 60%-90% of maximal heart rate over a period of at least 20 minutes

• Overload principle applied to generate desired response for individual

Anaerobic Training

• Most activities are blend of aerobic and anaerobic systems

• Anaerobic training requires short, intense bouts of activity – best if can be sport specific– Sprint training (running, biking, swimming)

• Combination activities include Fartlek training and interval workouts

Flexibility Training

• Research doesn’t support increased flexibility as reducing injury risk/rate

• Passive stretching– Performed by trained personnel (ATC/PT/CPT)

• Active stretching– Individual stretches self (e.g. - standing calf stretch)

• Proprioceptive neuromuscular facilitation (PNF)– Most common is contract relax technique

• Static vs. dynamic vs. ballistic– Hold on “stretch” vs. active movements (knee lifts) vs.

“bouncing” maneuvers (typically unsafe)

Coaching Methods and Factors

• Equipment considerations

• Adherence to rules associated with activity

• Matching athletes on motor skill performance

• Control biomechanical stresses – limits overuse opportunities

• Modify demands placed on participants per circumstances (fatigue, illness, etc.)

Illness Prevention

• Adherence to OSHA guidelines for cleanliness and sanitation of facility and clinician

• Personal hygiene considerations

• Infectious disease transmission considerations