BlazeSports Institute for Applied Science CDSS Level I Curriculum

1. BlazeSports Institute for Applied Science CDSS Level I Curriculum

2. Injury Prevention for Athletes with Physical Disabilities

3. We would like to thank the following people for their contributions to the content of this presentation: Ben Johnson, EdD, CDSS Professor and Chair Dept. of Physical Education and Exercise Science Brooklyn College City University of New York Jackie McParlane, DO, FACOEP Director - Emergency Medicine Residency Program Botsford Hospital Farmington Hills, MI

4. Objectives This session will provide basic sport science insights into how injuries occur in sport and physical activity and their prevention through proper planning and training and conditioning programs. The goal is to provide the participant with an understanding of how acute and chronic injuries occur and ultimately can be reduced or even eliminated through sound planning and training.

5. Objectives The session participant will identify the areas of specialization under the sports medicine umbrella and learn the important components of the coach’s role in the absence of a Certified Athletic Trainer (ATC). The session participant will learn about the relationship of stress and strain on musculoskeletal tissues and how each relates to both acute and chronic injuries. The session participant will learn about the components of fitness and the principles of training and conditioning. The session participant will learn to identify specific aspects of disability sport and physical activities that may contribute to injury. 

6. Sports Medicine The American College of Sports Medicine (ACSM) defines sports medicine as multidisciplinary, including the physiological, biomechanical, psychological, and pathological phenomena associated with exercise and sport.

7. What is Your Role? Sports Medicine Team Performance Enhancement Injury Care & Management Coaching Physical Education Sport Psychology Personal Fitness Training Strength & Conditioning Sports Nutrition Exercise Physiology Biomechanics Athletic Training Sports Physical Therapy Physician Physicians Assistant Sports Massage Therapy Sports Dentistry Osteopathic Medicine Orthotists/Prosthetists Sports Chiropractic

8. The Coach • Understand the role and responsibility of each person on the sports medicine team • Know the state laws surrounding the ability to function as a health care provider • Certified in CPR and First Aid • Directly responsible for injury prevention by ensuring athletes have the proper level of fitness to participate • Must engage in professional development

9. The Coach When there is no Certified Athletic Trainer • Ensure the competitive environment (field of play) is as safe as possible • Educate parents and athletes about inherent risks related to participation • Ensure proper training and conditioning of athlete • Monitor environmental conditions to ensure safe participation • Selecting, properly fitting and maintaining equipment including protective equipment • Explain importance of proper nutrition and hydration

10. Training and Conditioning Improper conditioning is one of the major causes of sports injuries!!

11. Training and Conditioning A FATIGUED athlete is more prone to injury!!

12. Training and Conditioning SAID Principle • S pecific • A daptations to • I mposed • D emands

13. Training and Conditioning Components of Physical Fitness • Cardiorespiratory Fitness • Flexibility • Muscular Fitness

14. Training and Conditioning Components of Physical Fitness • Cardiorespiratory (Energy) Fitness • Aerobic • Anaerobic

15. Training and Conditioning Components of Physical Fitness • Cardiorespiratory Fitness • Interval Training

16. Training and Conditioning Components of Physical Fitness • Flexibility • Static (passive) • Dynamic (active)

17. Training and Conditioning Components of Physical Fitness • Factors that Affect Flexibility • Anatomical • Joint structure, age, gender • Limited training affect • Training • Activity level, resistance training, stretching exercises

18. Loading or ForceTensionCompressionShearBendingTorsionDeformationChange in shape/lengthElastic limits of bone, tendons, ligaments and cartilageFailure point of tissue Training and Conditioning Components of Physical Fitness Stress and Strain on Tissue

19. Serious injury of tissue begins Force / Load Micro-injury of tissue begins with frequent repetition in this range Complete Failure of Tissue Plastic Region Elastic Region Normal range for most people Length/Deformation of Tissue

20. Training and Conditioning Components of Physical Fitness • Stretching Techniques • Passive • Static • Active • Ballistic • Dynamic • Combined • Proprioceptive Neuromuscular Facilitation (PNF)

21. Training and Conditioning Components of Physical Fitness • Static Stretching • Most common method • Excellent for increasing ROM • Appropriate for all athletes • Safest method of stretching due to slow, controlled movements • 30 second hold • 3-4 repetitions

22. Training and Conditioning Components of Physical Fitness • Ballistic Stretching • Bouncing movements • Stretch not held • Invokes stretch reflex • Higher potential for injury • NOT recommended for increasing flexibility • Different from plyometric training • Performed within existing ROM

23. Training and Conditioning Components of Physical Fitness • Dynamic Stretching • Functional, sport-specific movements • NO bouncing • Ideal during warm-up • Incorporate multiple joints • Maintain body temp • Time efficient • Not as effective for ROM increase as static or PNF stretching

24. Training and Conditioning Components of Physical Fitness • PNF Stretching • First used in neuromuscular rehabilitation • Relax muscle with increased tone or activity • Can be ore effective than static stretching • Usually requires a partner • Three Types • Hold-Relax • Contract-Relax • Hold-Relax with Agonist Contraction

25. Training and Conditioning Components of Physical Fitness • Muscular Fitness • Flexibility • Strength • Power • Endurance

26. Training and Conditioning Components of Physical Fitness ForceMotion Motion Energy Energy Injury Potential

27. Training and Conditioning Components of Physical Fitness • Strength • The maximal force a muscle group can generate at a specified velocity • Velocity (v) = change in position • change in time • v = displacement • time

28. Training and Conditioning Components of Physical Fitness • Strength • The maximal force a muscle group can generate at a specified velocity • Force (F) = mass x acceleration • acceleration (a) = change in velocity • change in time

29. Training and Conditioning Components of Physical Fitness F = m (v / t) Maximize or Minimize Force??? Force =   Mass =   Change in Velocity =   Time =  

30. Training and Conditioning Components of Physical Fitness • Power • The ability to generate force rapidly • Power = Work / time

31. Training and Conditioning Components of Physical Fitness • Endurance • The ability to perform repetitive muscular contractions against some resistance

32. Training and Conditioning Components of Physical Fitness • Muscle Balance • Train anterior and posterior muscles uniformly

33. Training and Conditioning Components of Physical Fitness • Muscle Balance

34. Training and Conditioning Principles of Conditioning • Warm-up/cooldown • Motivation • Overload • Consistency • Progression • Intensity • Specificity • Individuality • Stress • Safety

35. Training and Conditioning Principles of Conditioning • Warm-up 15-20 min. • General • Increase heart rate, blood flow, body temp., respiration rate, perspiration and decrease joint viscosity • Stretching • Static Vs Dynamic • Specific (technical skill)

36. Training and Conditioning Principles of Conditioning • Cooldown 5-15 min. • Brings heart rate back to baseline • Prevents blood from pooling in lower extremities • Stretching helps relax muscles, maintain ROM

37. Training and Conditioning Principles of Conditioning • Motivation • Vary the training program to keep it fresh • Utilize proper goal setting to maintain motivation • Overload • Gradually increase the imposed demands to realize continual results • Maintain muscle balance

38. Training and Conditioning Principles of Conditioning • Consistency • Training and conditioning must take place 2-3 times per week to realize change • Progression • Gradually increase the intensity of the program • Intensity • Increase intensity rather than quantity/duration

39. Training and Conditioning Principles of Conditioning • Specificity • Develop the program to address specific fitness goals • Begin with general fitness, then move to sport-specific • Aerobic, anaerobic, power, speed, endurance, flexibility, etc. • Individuality • Adjust the training program to meet the needs and progression of the individual athlete

40. Training and Conditioning Principles of Conditioning • Stress • If you are engaged in a program that meets multiple times per week, understand that the athlete has other stressful aspects to their life and may need time away from training • Safety • Environment • Education

41. Periodization Principles of Conditioning • Individualized • Organizes training and conditioning into cycles • Timely peak performance • Helps reduce injury • Helps avoid overtraining

42. Periodization Principles of Conditioning

43. Age Considerations Principles of Conditioning • Youth • Ensure emotional and cognitive maturity to follow directions • Focus on muscular strength and endurance, flexibility, and cardiorespiratory endurance • Limit heavy loads and moderate progression

44. Age Considerations Principles of Conditioning • Older Adults • Consider pre-existing health conditions • Aerobic and resistance training beneficial • Begin with low-intensity and low-volume in untrained participants • Moderate progression

45. Injury Concerns By Impairment/Disability Athletes who use Sport Chairs Athletes with Amputations Athletes with Cerebral Palsy Athletes with Visual Impairment

46. Athletes Who use Sport Chairs Most common injuries are strains & muscular injuries of upper extremities Overuse Injuries Fractures of hands from falls & collisions Overdevelopment of anterior muscles, weakness of posterior muscles

47. Autonomic disreflexia Can be life threatening! • Conditions, below the level of injury, that may lead to autonomic hyperreflexia include: • Full Bladder • Constipation or a full bowel • Pain • Infection • Skin breakdown • Ingrown toenail • Sudden temperature changes in the surrounding environment • Symptoms may include: • High blood pressure • Low heart rate • Anxiety or agitation • Severe pounding headache • Sweating above the level of the injury • Nasal stuffiness

48. Autonomic disreflexia Can be life threatening! • Treatment • Sit athlete up/dangle legs down • Removal of Stimuli • Catheterization • Loosen tight clothes • Anti-hypertensive medication • Complications • Seizures • pulmonary edema • myocardial infarction • cerebral hemorrhage

49. Athletes with amputation Risk for skin irritation or breakdown. Use appropriate padding and friction eliminating material

50. Athletes with Cerebral Palsy Seizures relatively common in this population Increase in lactic acid production => muscle fatigue Wheelchair users have higher upper extremity strains, sprains, overuse Ambulatory athletes have more knee injuries Be aware of the role spasticity plays Crashes