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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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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
  • 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 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
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 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