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Chapter 4: Preventing Injuries Through Fitness Training. Reduce Injury Prepare the Athlete. Athletic Trainers and Strength and Conditioning Coaches. Cooperative relationship that serves to condition athletes in an effort to minimize injury and maximize performance

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athletic trainers and strength and conditioning coaches
Athletic Trainers and Strength and Conditioning Coaches
  • Cooperative relationship that serves to condition athletes in an effort to minimize injury and maximize performance
  • Knowledge of flexibility, strength, and cardiorespiratory endurance is necessary
  • Many strength coaches are certified through the National Strength and Conditioning Association
Athletic trainer may be called upon to review programs/make suggestions
    • Take into consideration components of particular sport and injury prevention
  • Rehabilitation of injuries is the responsibility of the athletic trainer
  • Different settings (professional, college, high school) will require differing levels of supervision by the ATC
principles of conditioning and training


Overload and SAID principle






Relaxation/Minimize Stress


Principles of Conditioning and Training
warm up
  • Precaution against unnecessary musculoskeletal injury and soreness
  • May enhance certain aspects of performance
  • Prepares body physiologically for physical work
  • Stimulates cardiorespiratory system, enhancing circulation and blood flow to muscles
  • Increases metabolic processes, core temperature, and muscle elasticity
  • Activities which bring a general warming to the body(break a sweat)
  • Not related to sport


  • Specific to sport
  • Stretching, jogging, running, throwing, catching

Should last 10-15 minutes resulting in effects that will last 45 minutes

cool down
  • Essential component of workout
  • Bring body back to resting state
  • 5-10 minutes in duration
  • Often ignored
  • Decreased muscle soreness following training if time used to stretch after workout
improving and maintaining flexibility
Improving and Maintaining Flexibility
  • Ability to move a joint(s) smoothly through a full range of motion (ROM)
  • Good flexibility is essential for successful physical performance
Decreased ROM results in:
    • Decreased performance capabilities
    • Uncoordinated/awkward movements
    • Predisposes athlete to injury
  • Recommended by athletic trainers to prevent injury
factors that limit flexibility
Factors That Limit Flexibility
  • Bony structures
  • Tissue approximation
  • Excessive fat
  • Muscle and tendon lengths
  • Connective tissue
  • Scarring and contractures
  • Skin
  • Neural tissue tightness
range of motion rom
Active range of motion

Dynamic flexibility

Ability to move a joint with little resistance

Passive range of motion

Static flexibility

Motion of joint to end points without muscle contraction

Range of Motion(ROM)
range of motion
Range of Motion
  • Must be able to move through unrestricted range
  • Must have elasticity for additional stretch encountered during activity
agonist vs antagonist muscles
Agonist vs. Antagonist Muscles
  • Joints are capable of multiple movements
  • Agonist
    • Muscle producing movement
    • Quadriceps contract to produce knee extension
  • Antagonist
    • Muscle undergoing stretch during movement
    • Hamstrings will stretch during knee extension
  • Agonist and antagonist work together to produce smooth coordinated movements
stretching techniques
Stretching Techniques


  • Bouncing movement in which repetitive contractions of agonist work to stretch antagonist muscle
  • Spindles tighten instead of relax
  • Possible soreness due to repeated eccentric contractions of antagonist
  • Also referred to as dynamic stretching
  • May more closely mimic muscle activity during sport
Static stretching
  • Passively stretching
  • 6-8 second hold
  • Go to point of pain and back off and hold for 30 seconds (3 to 4 times)
  • Controlled, less chance of injury
  • Not dynamic
Proprioceptive Neuromuscular Facilitation Techniques
    • Used by physical therapists for neuromuscular paralysis
    • Slow-reversal-hold-relax
    • Contract-relax
    • Hold-relax
    • Best technique to improve flexibility
    • Autogenic inhibition (push = tension)
    • Reciprocal inhibition (pull = relax)
Stretching Neural Structures
    • Must differentiate between musculotendinous tightness and neural tension
  • Stretching Fascia
    • Fascia can limit motion (pain, injury, inflammation)
    • Can be performed manually or using foam roller
neurophysiological basis of stretching
Neurophysiological Basis of Stretching

Stretch Reflex

  • Muscle is placed on stretch(muscle spindle)
  • Muscle spindles fire relaying information to spinal cord
  • Spinal cord relays message to golgi tendon and increases tension
  • After 6 seconds golgi tendon organ (GTO) relays signal for muscle tension to decrease
  • Prevents injury - protective mechanism
With static stretching golgi tendons are able to override impulses from muscle spindle following initial reflex resistance
  • Allows muscle to remain stretched without injury
  • Using PNF = benefit greatly from these principles
    • With slow-reversal hold technique, maximal contraction of muscle stimulates GTO reflex relaxation before stretch applied
    • Relaxation of antagonist during contraction = autogenic inhibition
During relaxation phase, antagonist is placed under stretch but assisted by agonist contraction to pull further
  • Contraction elicits additional relaxation of antagonist (protect against injury)
  • Referred to as reciprocal inhibition
the pilates method
The Pilates Method
  • Conditioning program that improves muscle control, flexibility, coordination, strength and tone
  • Enhances body awareness, improves body alignment and breathing, increases movement efficiency
  • Designed to stretch and strengthen muscles through a sequence of carefully performed movements
Utilizes specific breathing pattern for each exercise
  • Goal
    • Develop a healthy self image through posture, coordination and flexibility
  • Generally begins with one-on-one session in order to assess client’s physical condition
  • Classes in a studio are also available
    • Very popular in health clubs and gyms
  • Based on philosophy that illness is related to poor mental attitude, posture and diet
  • Reduce stress through mental and physical approaches
  • Used to unite mind and body
  • Involves various postures and breathing exercises
    • Designed to increase mobility and flexibility
flexibility vs strength
Flexibility vs. Strength
  • Co-exist
  • Believed that muscle bound = zero flexibility?
  • Strength training will provide individual with ability to develop dynamic flexibility through full range of motion
  • Develop more powerful and coordinated movements
measuring range of motion
Measuring Range of Motion
  • Various devices have been designed to accommodate joint sizes and complexities of movement
  • Goniometer most widely used device
    • Protractor (degrees) that utilizes alignment of two arms parallel to longitudinal axis of two segments involved in motion
  • Relatively accurate tool for measurement
muscle strength power and endurance
Muscle Strength, Power, and Endurance
  • Strength: ability to generate force against resistance
  • Power: is the relationship between strength and time
  • Muscular endurance: repetitive muscular contractions (increase strength = increase endurance
muscle contractions
Muscle Contractions
  • Isometric contraction
    • No length change occurs during contraction
    • Pro: quick, effective, cheap, good for rehab
    • Con: only works at one point in ROM
  • Isotonic contraction
    • Concentric- shortening of muscle with contraction in an effort to overcome more resistance
    • Eccentric - lengthening of muscle with contraction because load is greater than force being produced
    • Both are considered dynamic movements
fast twitch vs slow twitch
Fast Twitch vs. Slow Twitch
  • Fibers within a particular motor unit display distinct metabolic and contractile capability

Slow twitch (Type I):

    • Fatigue resistant
    • Time necessary to produce force is greater
    • Long duration, aerobic type activities
    • Generally major constituent of postural muscles
Fast twitch (Type II)
  • Fatigue
  • Anaerobic in nature
  • High force in short amount of time
  • Produce powerful movements
  • A vs. B

Individual make-up

  • Muscles contain both types of fibers
  • Muscle functioning impacts ratios (postural vs. powerful movement)
  • Genetically determined

Metabolic capabilities can change in response to training

physiological and biomechanical factors that determine levels of muscular strength
Physiological and Biomechanical Factors that Determine Levels of Muscular Strength
  • Hypertrophy vs. Atrophy
  • Size of muscle: function of diameter and number of fibers
  • Neuromuscular efficiency
  • Biomechanical factors
  • Overtraining (psychologically, physiologically)
  • Reversibility
explanation for muscle hypertrophy
Explanation for Muscle Hypertrophy
  • Three theories of muscle hypertrophy:
    • Increase in number of fibers
    • Infusion of blood - transient hypertrophy
    • Increase in protein myofilament number and size
      • PROVEN
Improved Neuromuscular Efficiency
    • Early gains minus hypertrophy
    • Enhanced efficiency due to enhanced neural function
  • Other enhancements due to training
    • Increased non-contractile tissue strength, bone mineral content, aerobic/anaerobic enzymes, enhanced oxygen uptake
techniques of resistance training
Techniques of Resistance Training
  • Progressive resistance exercise
  • Overload principle must be applied
  • Must work muscle at increasingly higher intensities to enhance strength over time
  • If intensity of training does not increase, but training continues, muscle strength will be sustained
overload principle
Overload Principle
  • Activity must be increased and upgraded constantly in order to gain a higher response from the body
  • Work at or near maximum capacity
  • Applicable to conditioning and training
Isometric Exercises
    • Contraction where muscle length remains unchanged
    • Muscle contraction that lasts 10 seconds and should be perform 5-10 times/daily
    • Pro: quick, effective, cheap, good for rehabilitation
    • Con: only works at one point in ROM, produces spiking of blood pressure due to Valsalva maneuver
progressive resistance exercises isotonic training
Progressive Resistance Exercises (Isotonic training)
  • Shortening/lengthening
  • Concentric vs. Eccentric
  • Various types of equipment can be utilized
    • (Free weights, machine weight)
  • Spotter is necessary for free weight training to prevent injury, motivate partner and instruct on technique
Concentric and eccentric training should be incorporated for greatest strength improvement
  • Concentric phase of lift should last 1-2 seconds, eccentric phase 2-4 seconds
  • Variations exist between free and machine weight lifting
    • Motion restrictions, levels of muscular control required, amount of weight that can be lifted
Terminology associated with weight training
    • Repetitions
    • Repetition maximum
    • One repetition maximum
    • Set
    • Intensity
    • Recovery period
    • Frequency
When training should be able to perform 3 sets of 6-8 repetitions
  • Increases should occur in increments of 10%
  • 1 RM can be utilized measure maximum amount of weight that can be lifted - must be very careful
  • Training of a particular muscle group should occur 3-4 times per week (not on successive days)
muscular endurance vs strength
Muscular Endurance vs. Strength
  • Training for endurance enhances strength and vice versa
  • Training for strength should involve lower repetitions at heavier weight
  • Training for endurance requires lower weight at 12-15 repetitions
  • Persons that possess greater strength also tend to exhibit greater muscular endurance
isokinetic training
Isokinetic Training
  • Muscle contraction at a constant velocity
  • Maximal and constant resistance throughout the full range of motion
  • Maximal effort = Maximal strength gains
  • Disadvantages
    • Cost
    • Need for maximal effort/motivation
  • Rehabilitation
circuit training
Circuit Training
  • Combination of exercise stations
  • 8 - 12 stations, 3 times through
  • Design for different training goals
    • Flexibility
    • Calisthenics
    • Aerobic exercise
calisthenic strengthening exercises
Calisthenic Strengthening Exercises
  • Free exercise
  • Isotonic training
  • Gravity’s involvement determines level of intensity
  • Full range of motion, may incorporate holding phase
  • Pull-ups, push-ups, back extensions, leg extensions
plyometric exercise
Plyometric Exercise
  • Rapid stretch, eccentric contraction followed by a rapid concentric contraction to create a forceful explosive movement
  • Rate of stretch vs. magnitude
  • Jumps, bounds, medicine ball throws
  • Very technical training - skills must be learned with appropriate technique
training for the female athlete
Training for the Female Athlete
  • Critical for female athlete
  • Significant hypertrophy is related to testosterone present within body
  • Remarkable gains are experienced initially due to enhanced nervous system and muscle interaction (efficiency-not muscle bulk)
  • Following initial gains, plateau occurs, with females
Males tend to continue to increase strength with training
  • Critical difference is the ratio of strength to body fat
    • Females have reduced strength to body weight ratio due to higher percentage of body fat
    • Ratio can be enhanced through weight training and decrease in body fat percentage/increased lean weight
strength training in adolescents
Strength Training in Adolescents
  • If properly supervised young athletes can improve strength, power, endurance, balance and proprioception
  • Develop a positive body image
  • Results in improved sports performance while preventing injuries
Strength gains can occur without significant muscle hypertrophy
  • Close supervision and instruction is critical
  • Progression = based on physical maturity
  • Utilize calisthenic exercises and body weight as resistance
cardiorespiratory endurance
Cardiorespiratory Endurance
  • Perform whole body activities for extended period of time
  • Performance vs. fatigue vs. injury
  • System’s four components
    • Heart
    • Lungs
    • Blood vessels
    • Blood
  • Improvements in endurance are the results of improvements in these 4 components
Aerobic capacity = VO2max
  • Increases in intensity require higher levels of oxygen consumption
  • Inherit certain range of maximum aerobic capacity
  • More active = higher capacity
  • Average value = 45-60 ml O2/min/kg
  • Three factors impact capacity
    • External respiration
    • Ventilatory process
    • Gas transportation (most limiting factor)
impact on heart
Impact on Heart
  • Main pumping mechanism
  • Increase exercise = increased oxygen requirement=increase heart pumping
  • Heart must gradually adapt to imposed demands but will reach steady state after 2-3 minutes of training
  • Heart able to adapt through increases in heart rate and stroke volume which will enhance overall cardiac output
A training effect results with regard to cardiac output.
  • Over the course of training, at a given intensity, stroke volume increases while heart rate is reduced
  • Cardiac functioning becomes more efficient (hypertrophy of heart occurs)

Cardiac Output = Increased Stroke Volume x Decreased Heart Rate

energy systems
Energy Systems
  • Various sports entail different energy demands
  • Long distance running and swimming vs. sprinting and jumping
  • ATP: Immediate Energy Source
    • ATP produced from glucose breakdown
    • Glucose from blood or glycogen (muscle or liver) broken down to glucose converted to ATP
    • Fat becomes utilized when glycogen stores depleted
Aerobic versus Anaerobic Metabolism
    • Both generate ATP
    • Initial ATP production from glucose occurs in muscle (without oxygen = anaerobic)
    • Transition to glucose and fat oxidation (requiring oxygen = aerobic) to continue activity
    • Generally both systems occur to a degree simultaneously
    • Type of ATP production relative to intensity
      • Short burst (high intensity) = anaerobic
      • Long duration (sustained intensity) = aerobic
types of training for cardiorespiratory endurance
Types of Training for Cardiorespiratory Endurance
  • Level of improvement will be determined by initial levels
  • Continuous
    • Mode (type of exercise) - must be aerobic in nature
    • Frequency (at least 3 times/week)
    • Duration (at least 20 minutes)
    • Intensity (must elevate heart rate to 70% of maximum)
Interval training
    • Intermittent activities involving periods of intense work and active recovery
    • Must occur at 60-80% of maximal heart rate
    • Allows for higher intensity training at short intervals over an extended period of time
    • Most anaerobic sports require short burst which can be mimicked through interval training
Fartlek training
    • Cross-country running that originated in Sweden
    • Speed play
    • Similar to interval training in the fact activity occurs over a specific period of time but pace and speed are not specified
    • Consists of varied terrain which incorporates varying degrees of hills
    • Dynamic form of training
    • Must elevate heart rate to minimal levels to be effective
    • Popular form of training in off-season
Equipment for Endurance Training
    • Cost can vary from $2- $60,000
    • Jump rope to treadmill and computers
  • Fitness Assessments
    • Provides coaching and athletic training personnel with information relative to fitness and preparedness
    • Pre-testing and post-testing format should be utilized
    • Can assess all facets of training and conditioning with established tests and protocols
periodization in training and conditioning
Periodization in Training and Conditioning
  • Traditional seasons no longer exist for serious athletes
  • Periodization
    • Achieve peak performance
    • Decrease injuries and overtraining
    • Program that spans various seasons
    • Modify program relative to athlete’s needs
  • Complete training cycle
  • Seasonal approach based on preseason, in-season, and off-season
  • Changes in intensity, volume, specificity of training occur in order to achieve peak levels of fitness for competition
  • Broken into mesocycles (lasting weeks or months)
  • Transition period:
    • Follows last competition (early off-season)
    • Unstructured (escape rigors of training)
  • Preparatory period:
    • Off-season
    • Hypertropy/endurance phase (Low intensity with high volume)
      • Allows for development of endurance base
      • Lasts several weeks to 2 months
    • Strength Phase
    • Power Phase (High intensity/ pre-season)
Preparatory period (continued)
    • Strength Phase
      • Intensity and volume increase to moderate levels
    • Power Phase (High intensity/ pre-season)
      • Volume is decreased to allow adequate recovery
  • Competition period:
    • May last a week or several months for seasonal sports
    • High intensity, low volume, skill training sessions
    • May incorporate microcycles (1-7 days)
      • Designed to ensure peak on days of competition
cross training
Cross Training
  • Training for a sport with substitutions of alternative activities (carryover value)
  • Useful in transition and preparatory periods
  • Variety to training regimen
  • Should be discontinued prior to preseason as it is not sport-specific