Chapter 3 injury prevention
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Chapter 3 Injury Prevention. Conditioning and Injury Prevention. Purpose – effective, physiologically appropriate physical conditioning program: Improve performance Minimize the risk of injury and illness Must understand basic principles of conditioning to ensure a program:

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Chapter 3 Injury Prevention

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Chapter 3 injury prevention

Chapter 3Injury Prevention


Conditioning and injury prevention

Conditioning and Injury Prevention

  • Purpose – effective, physiologically appropriate physical conditioning program:

    • Improve performance

    • Minimize the risk of injury and illness

  • Must understand basic principles of conditioning to ensure a program:

    • Is safe and effective

    • Void of practices that could predispose the participant to injury


Basic principles of conditioning

Basic Principles of Conditioning

  • Specific Adaptation to Imposed Demands (SAID) principle

  • Overload principle

    • Frequency: # exercise sessions per day or week

    • Intensity: amount of work during an exercise

    • Duration: length of a single exercise session


Flexibility

Flexibility

  • Total ROM at a joint that occurs pain free in each of the planes of motion

  • Combination of normal joint mechanics, mobility of soft tissues, and muscle extensibility


Flexibility cont d

Flexibility (cont’d)

  • Mechanoreceptors influence flexibility

    • Muscle spindle

      • Lie parallel with contractile muscle fibers

      • Send sensory information to CNS

        • Muscle length

        • Velocity of length change

      • Excite/facilitate muscle contraction


Flexibility cont d1

Flexibility (cont’d)


Flexibility cont d2

Flexibility (cont’d)

  • Mechanoreceptors influence flexibility (cont’d)

    • Golgi tendon organs (GTO)

      • Lie in tendon, most at musculotendinous junction

      • Stimulated by stretch

      • Send sensory information to CNS

        • Muscle load and tension

      • Inhibit/relax muscle contraction


Stretching techniques

Stretching Techniques

  • Ballistic

    • Muscle spindle is stretched, but GTO do not fire; muscle resists relaxation

    • Momentum can lead to overstretching, tearing

  • Static

    • GTO override impulses from the muscle spindles

    • Safer, more effective muscle stretch


Stretching techniques cont d

Stretching Techniques (cont’d)

  • Proprioceptive neuromuscular facilitation (PNF)

    • Involves stimulation of the proprioceptors

    •  flexibility in one muscle group (i.e., agonist), and simultaneously  strength in another group (i.e., antagonist)

    • Techniques

      • Active inhibition

      • Reciprocal inhibition


Stretching techniques cont d1

Stretching Techniques (cont’d)

  • PNF (cont’d)

    • Advantages

      • Early use

      • Single plane or diagonal patterns

  • Overload principle can be used to achieve or maintain normal flexibility


Muscular strength and endurance

Muscular Strength and Endurance

  • Muscular strength

    • Ability of a muscle or group of muscles to produce force in one maximal effort

  • Muscular endurance

    • Ability of muscle tissue to exert repetitive tension over an extended period


Muscular strength and endurance cont d

Muscular Strength and Endurance (cont’d)

  • Muscular strength and endurance depends on:

    • Number and size of muscle fibers

    • Type of muscle fiber (slow twitch; fast twitch)

    • Neuromuscular coordination

    • Gender


Static strength vs dynamic strength

Static Strength vs. Dynamic Strength

  • Isometric contraction

    • Tension is produced by the muscle, but there is no change in muscle length

  • Concentric contraction

    • Shortening; decreases joint angle

    • Work to accelerate a limb


Static strength vs dynamic strength cont d

Static Strength vs. Dynamic Strength (cont’d)

  • Eccentric contraction

    • Lengthening; increases joint angle

    • Work to decelerate a limb and provide shock absorption


Dynamic strength

Dynamic Strength

  • Isotonic exercise

    • Variable speed/fixed resistance

    • Advantages

      • Permits exercise of multiple joints simultaneously

      • Allows both eccentric & concentric contractions

      • Permits weight-bearing, CKC exercises


Dynamic strength cont d

Dynamic Strength (cont’d)

  • Isotonic exercise (cont’d)

    • Disadvantage

      • When a load is applied, the muscle can only move that load through the ROM with as much force as the muscle provides at its weakest point


Dynamic strength cont d1

Dynamic Strength (cont’d)

  • Isokinetic exercise

    • Fixed speed/variable resistance

    • Advantages

      • 100% loading throughout ROM

      • Pain disengages mechanism


Dynamic strength cont d2

Dynamic Strength (cont’d)

  • Isokinetic exercise (cont’d)

    • Disadvantages

      • As muscle fatigues, resistance decreases

      • Most machines only permit concentric contraction

      • $$$$


Strength application principles

Strength Application Principles

  • Strength gains depend primarily on the intensity of the overload

  • Endurance improvement will be determined by the intensity and duration of exercises

    • Frequency

    • Intensity

    • Duration


Cardiorespiratory endurance

Cardiorespiratory Endurance

  • Body’s ability to sustain submaximal exercise over an extended period

  • Cardiovascular level impacts fatigue

  • Detraining occurs within 1 to 2 weeks

  • Generally considered the most important component of any fitness program

  • ACSM recommends

    • Activity 3-5 days per week

    • > 20 minutes

    • Intensity of 60-90% of maximal heart rate (HRmax)


Check for understanding

Check for Understanding!

The fitness component that is generally considered to be the most important is:

  • Muscular strength

  • Flexibility

  • Muscular endurance

  • Cardiovascular endurance


Check for understanding1

Check for Understanding!

The principle of overload is achieved by manipulating which of the following components of an exercise program? (select all that apply)

  • Endurance

  • Duration

  • Intensity

  • Frequency

  • Specificity


Check for understanding2

Check for Understanding!

During a ballistic stretch, which of the following are activated?

  • Muscle spindle

  • Golgi tendon organ

  • Fast twitch fibers

  • Slow twitch fibers


Check for understanding3

Check for Understanding!

The ability of muscle tissue to exert repetitive tension over an extended period is termed:

  • Cardiovascular endurance

  • Muscular strength

  • Muscular endurance

  • Flexibility


Proper technique and injury prevention

Proper Technique and Injury Prevention

  • Proper technique is important with regard to:

    • Efficient and effective skill performance

    • The prevention of injury

  • Coach is responsible to teach proper skill technique and to continually reinforce the use of proper technique

    • The instruction and expectation of performance of any skill needs to be age and developmentally appropriate


Protective equipment and injury prevention cont d

Protective Equipment and Injury Prevention (cont’d)

  • Specialized equipment can protect a participant from accidental or routine injuries

  • Coach can share or be solely responsible to ensure that protective equipment:

    • Meets minimum standards of protection

    • Is in good condition, clean, properly fitted, and used routinely

    • Used as it was intended


Principles of protective equipment

Principles of Protective Equipment

  • Protection from forces

    • High velocity–low mass: focal injury

    • Low velocity–high mass: diffuse injury


Principles of protective equipment cont d

Principles of Protective Equipment (cont’d)

  • Design factors that can reduce potential injury

    • Increase impact area

    • Disperse impact area to another body part

    • Limit the relative motion

    • Add mass to the body part

    • Reduce friction

    • Absorb energy

    • Resist the absorption of bacteria, fungi, and viruses


Liability and equipment standards

Liability and Equipment Standards

  • Organization’s duty to ensure the proper use of protective equipment is usually a shared responsibility among the athletic staff


Liability and equipment standards cont d

Liability and Equipment Standards (cont’d)

  • Some settings, coach may be legally responsible for:

    • Selecting the most appropriate equipment

    • Properly fitting the equipment to the individual

    • Instructing the individual in proper care for the equipment

    • Warning the individual of any danger in using the equipment inappropriately

    • Supervising and monitoring the proper use of all protective equipment

      • Even if an individual provides their own


Liability and equipment standards cont d1

Liability and Equipment Standards (cont’d)

  • Standards of quality agencies

    • NOCSAE

      • Football, baseball, softball, and lacrosse helmets and facemasks

    • Other equipment (i.e., protective eye wear, ice hockey helmets, and facemasks)

      • ASTM

      • HECC

      • CSA


Liability and equipment standards cont d2

Liability and Equipment Standards (cont’d)

  • Athletic governing bodies

    • Establish rules for the mandatory use of specific protective equipment

    • Determine rules governing special protective equipment

    • NFSHSA, NAIA, NCAA, USOC


Protective equipment head and face

Protective Equipment: Head and Face

  • Football helmets

    • Can reduce head injuries, but do not prevent neck injuries due to axial loading

    • Construction

      • Single or double air bladder, closed-cell padded, or combination

      • Shell – plastic or polycarbonate alloy


Protective equipment head and face cont d

Protective Equipment:Head and Face (cont’d)

  • Football helmets (cont’d)

    • Effect of heat

    • NOCSAE warning

    • Fitting – follow manufacturer’s guidelines

    • Paperwork


Protective equipment head and face cont d1

Protective Equipment:Head and Face (cont’d)

  • Ice hockey helmets

    • Can reduce head injuries, but do not prevent neck injuries due to axial loading

    • Must absorb and disperse high-velocity, low-mass forces

  • CSA approved


Protective equipment head and face cont d2

Protective Equipment:Head and Face (cont’d)

  • Batting helmets

    • NOCSAE approved

    • Double ear flap design

  • Other helmets

    • Lacrosse

  • Bicycle


Protective equipment head and face cont d3

Protective Equipment:Head and Face (cont’d)

  • Face guards

    • Protect and shield facial region

    • Football

      • Effectiveness depends on the strength of the guard, the helmet attachments, and the four-point chin strap on the helmet

      • Proper fit


Protective equipment head and face cont d4

Protective Equipment:Head and Face (cont’d)

  • Face guards (cont’d)

    • Ice hockey

      • Made of clear plastic, steel wire, or combination

      • HECC and ASTM standards

      • Proper fit

    • Lacrosse

      • Made of wire mesh

      • NOCSAE standards


Protective equipment head and face cont d5

Protective Equipment:Head and Face (cont’d)

  • Eye wear

    • Goggles

    • Face shields

    • Spectacles


Protective equipment head and face cont d6

Protective Equipment:Head and Face (cont’d)

  • Mouth guards

    • Reduce dental and oral soft tissue injuries and, to a lesser extent, jaw fractures, cerebral concussions, and TMJ injuries

    • Proper fit


Protective equipment throat and neck

Protective Equipment:Throat and Neck

  • Attachable throat guard

    • Required for catchers in baseball and softball

  • Cervical rolls and collars

    • Designed to limit motion of cervical spine

    • Effective in preventing burner, but properly fitted shoulder pads are critical

    • Do not decrease axial loading on the cervical spine when the neck is flexed


Protective equipment upper body

Protective Equipment:Upper Body

  • Shoulder pads

    • Should protect the soft and bony tissue structures in the shoulder, upper back, and chest

    • Construction

    • Select on player position, body type, and medical history


Protective equipment upper body1

Protective Equipment:Upper Body

  • Shoulder pads (cont’d)

    • Types

      • Cantilever: protect AC joint and distribute forces throughout entire shoulder girdle

      • Flat: provide less protection to shoulder region, but permit more glenohumeral motion


Protective equipment upper body2

Protective Equipment:Upper Body

  • Elbow, forearm, wrist, and hand

    • Protection from external forces

  • Thorax, ribs, and abdomen

    • Protection from external forces


Protective equipment upper body3

Protective Equipment:Upper Body

  • Lumbar/sacral protection

    • Weight training belts; abdominal binders

    • Should support the abdominal contents, stabilize the trunk, and prevent spinal deformity or injury during heavy lifting


Protective equipment lower body

Protective Equipment:Lower Body

  • Hip and buttock region

    • Protect the iliac crest, sacrum, coccyx, and genital region

    • Pads typically composed of hard polyethylene covered with layers of Ensolite™

    • Girdle with pockets can hold pads in place


Protective equipment lower body cont d

Protective Equipment:Lower Body (cont’d)

  • Thigh

    • Pad: protect quadriceps

    • Neoprene sleeves: provide compression, therapeutic warmth, & support for quadriceps or hamstring strain


Protective equipment lower body cont d1

Protective Equipment:Lower Body (cont’d)

  • Knee braces

    • Prophylactic

      • Protect the MCL

      • Redirect lateral valgus force to points distal to the joint

    • Functional

      • Provide proprioceptive feedback

      • Protect ACL


Protective equipment lower body1

Protective Equipment:Lower Body

  • Knee braces

    • Rehabilitative

      • Provide immobilization at a selected angle

      • Permit controlled ROM through predetermined arcs

      • Prevent accidental loading in non-weight bearing activity


Protective equipment lower body cont d2

Protective Equipment:Lower Body (cont’d)

  • Knee braces


Protective equipment lower body cont d3

Protective Equipment:Lower Body (cont’d)

  • Patella braces

    • Dissipate force

    • Maintain patellar alignment

    • Improve patellar tracking

  • Lower leg

    • Protect anterior tibia from extension forces


Protective equipment lower body cont d4

Protective Equipment:Lower Body (cont’d)

  • Ankle braces

    • Lace-up

    • Semirigid orthosis

    • Air bladder


Protective equipment lower body2

Protective Equipment:Lower Body

  • Footwear

    • Selection and fit may affect injury

    • Consider the sport activity and surface


Protective equipment lower body cont d5

Protective Equipment:Lower Body (cont’d)

  • Foot orthotics

    • Devices used in the treatment and prevention of foot and gait abnormalities

    • Three broad categories:

      • Orthotics to change foot function

      • Protective orthotics

      • Those that combine functional control and protection


Check for understanding4

Check for Understanding!

Instruction of proper technique should be: (select all that apply)

  • Based on sound physiological principles

  • Based on personal experience or anecdotal experiences regardless of their premise

  • Should be age appropriate

  • Should be developmentally appropriate


Check for understanding5

Check for Understanding!

The only responsibility of the coach with regard to athletic equipment is to ensure that the equipment is approved by the appropriate agency.

  • True

  • False


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