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 3Injury 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

  • 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

  • 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)

  • 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’d)


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

  • 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)

  • 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’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

    • 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 depends on:

    • Number and size of muscle fibers

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

    • Neuromuscular coordination

    • Gender


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)

  • Eccentric contraction

    • Lengthening; increases joint angle

    • Work to decelerate a limb and provide shock absorption


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)

  • 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’d)

  • Isokinetic exercise

    • Fixed speed/variable resistance

    • Advantages

      • 100% loading throughout ROM

      • Pain disengages mechanism


Dynamic Strength (cont’d)

  • Isokinetic exercise (cont’d)

    • Disadvantages

      • As muscle fatigues, resistance decreases

      • Most machines only permit concentric contraction

      • $$$$


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

  • 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!

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

  • Muscular strength

  • Flexibility

  • Muscular endurance

  • Cardiovascular endurance


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 Understanding!

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

  • Muscle spindle

  • Golgi tendon organ

  • Fast twitch fibers

  • Slow twitch fibers


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 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)

  • 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

  • Protection from forces

    • High velocity–low mass: focal injury

    • Low velocity–high mass: diffuse injury


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

  • 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)

  • 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’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’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

  • 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)

  • Football helmets (cont’d)

    • Effect of heat

    • NOCSAE warning

    • Fitting – follow manufacturer’s guidelines

    • Paperwork


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’d)

  • Batting helmets

    • NOCSAE approved

    • Double ear flap design

  • Other helmets

    • Lacrosse

  • Bicycle


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’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’d)

  • Eye wear

    • Goggles

    • Face shields

    • Spectacles


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

  • 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

  • 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 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 Body

  • Elbow, forearm, wrist, and hand

    • Protection from external forces

  • Thorax, ribs, and abdomen

    • Protection from external forces


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

  • 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)

  • Thigh

    • Pad: protect quadriceps

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


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 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’d)

  • Knee braces


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’d)

  • Ankle braces

    • Lace-up

    • Semirigid orthosis

    • Air bladder


Protective Equipment:Lower Body

  • Footwear

    • Selection and fit may affect injury

    • Consider the sport activity and surface


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 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 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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