Prehabilitation and Preseason Conditioning

1. Prehabilitation and Preseason Conditioning Chapter 7 Sports Medicine 1

2. Rehabilitation and Prehabilitation • KEY CONCEPT • Prehabilitation decreases the chance of injury by addressing areas of concern or deficit identified before participation in a sporting event. A program can be implemented to strengthen and develop these areas, thus reducing the chance of injury during participation.

3. Rehabilitation and Prehabilitation A preventative management program with the goal of preventing injury This program addresses concerns or deficits recognized by the athlete’s family physician or other sports medicine specialist prior to sports participation.

4. Preseason Conditioning • KEY CONCEPT • Preseason conditioning allows athletes to gradually build up to a level of activity that will be expected of them on the playing field. By starting slowly, the body is allowed to adjust to the new demands; once the body has accommodated, the athlete can once again increase the demand on the body. By working incrementally to get the body adjusted, the athlete can prepare for the demands of the season.

5. Preseason Conditioning • Whenever athletes start a fitness program, or after they take an extended period of time off, their bodies need to time to adjust to the new stresses and demands.

6. Preseason Conditioning • Preseason conditioning focuses on developing the athlete in the off-season. • The conditioning program should begin six to eight weeks prior to sports participation to allow the body to gradually adapt to the demands to be placed on it. • Sports medicine physicians, certified athletic trainers, and qualified youth coaches should prescribe a preseason conditioning program and provide athletes with information on the type, frequency, intensity, and duration of training.

8. Strength Training • Strength training is a highly adaptive process whereby the body changes in response to increased training loads. • Adaptation requires a systematic application of exercise stress sufficient to stimulate muscle fatigue without injury. • If muscle is working beyond its normal limits, it adapts by becoming larger (hypertrophy). • If a muscle is worked less than normal, it becomes smaller (atrophy). • The purpose of progressive resistance exercise is to allow the body to adapt to the increased demand placed upon it.

10. Strength Training • KEY CONCEPT • Progressive resistance training allows the body to adapt to the increased demand placed upon it through training. The rate and type of strength gain is determined by four factors: 1. overload is the overwork of muscles at tensions close to their maximum; 2. specificity is the targeting of a particular muscle group alone; 3. reversibility is the characteristic of muscles that cause decreases in strength and mass with disuse;4. individual differences also account for an individual’s ability to strengthen certain muscles at a particular rate. Genetics have a strong influence on strength gain.

11. Strength Training • Overload • Muscles increase in size and strength when they are forced to contract at tensions close to maximum. • Muscles must be overloaded at a progressively increased rate. • The ideal number of repetitions is between four and eight, done in multiple sets of three or four. • Proper rest intervals between sets allows muscles to recover from exertion and prepare for the next work interval.

13. Strength Training • Specificity • Muscles adapt specifically to the nature of the work performed, an attribute known as specificity. • When muscles contract, they recruit different types of motor units to carry out the contraction. • Slow-twitch fibers are recruited for low-intensity activities such as jogging, and are relatively fatigue-resistant. • Fast-twitch fibers are used for high-speed or high-intensity activities, such as weightlifting, and fatigue more rapidly.

15. Strength Training • Specificity cont- • Increases in strength, including rehabilitation after injury or surgery, are very specific to the type of exercise, which should be as close as possible to the desired movements of the activity. • Muscle fiber type appears to play an important role in determining success in some sports, such as distance running and sprints, but not in others, such as shot-putting.

17. Strength Training • Reversibility • Muscles atrophy with disuse, immobilization, and starvation. • Slow-twitch fivers will typically atrophy faster than twitch fibers, an important factor to consider when designing a rehabilitation program after immobilization.

19. Strength Training • Individual differences • Some differences in the strength gain rate are due to the relative predominance of fast- and slow-twitch motor units in muscles. • Fiber composition is genetically determined, although a good training program can make up for genetic deficiencies.

20. Strength Training • Stretching and flexibility • Stretching, moving joints beyond their normal range, is useful for injury prevention as well as injury treatment. • Range of movement is increased due to increasing the length of the muscles, which means that limbs and joints must move further before an injury occurs. • Warming up is an essential component of stretching by increasing heart rate, blood pressure, and respiratory rate, consequently increasing oxygen and nutrient delivery to the muscles.

22. Strength Training • Stretching and flexibility cont- • Flexibility is the ability of a joint to move freely through its full range of motion. • An active person tends to be more flexible than an inactive person. • Females tend to be more flexible than males. • Older people tend to be less flexible than younger people. • Flexibility is an important as muscular strength and endurance. • To achieve flexibility in a joint, the surrounding muscles must be stretched.

23. Strength Training • Stretching and flexibility cont- • Types of Stretching • Static stretching is a gradual stretching of a muscle through the muscle’s entire range of motion, done slowly until a pulling sensation occurs. • Ballistic stretching involves a rhythmic, bouncing action, largely discounted today due to its tendency to increase the incident of injury. • Proprioceptive neuromuscular facilitation (PNF) involves a combination of contraction and relaxation of the muscles, requiring an initial isometric contraction against maximum resistance at the end of the range of motion, and is designed to be done with a qualified assistant.

24. Strength Training • KEY CONCEPT • Stretching and flexibility decrease the chances of injury. Stretching allows the athlete to actually lengthen the muscle, resulting in an increased range of motion. Therefore, joints and limbs can move further before an injury occurs.

25. Strength Training • Isometric exercise • Muscle contract, but there is no movement in the affected joints. • Muscle fibers maintain a constant length throughout the entire contraction. • Isometrics are often used for rehabilitation because the exact area of muscle weakness can be isolated, and strengthening can be administered at the proper joint angle.

27. Strength Training • Isometric exercise cont- • Blood pressure also increases rapidly, so individuals with circulatory problems and high blood pressure should avoid strenuous isometric exercise.

28. Strength Training • Dynamic (isotonic) exercise • Movement of the joint does occur during the muscle contraction. • Manual resistance training is accomplished using a training partner, somethimes called a spotter.

30. Strength Training • Dynamic (isotonic) exercise cont- • The spotter adds enough resistance to allow the lifter to fatigue the muscles, and then releases enough resistance so that the lift can be completed. • Advantages include the use of minimal equipment, the spotter can help control technique, workouts can be completed in less than 30 minutes, and training can be done anywhere. • A disadvantage is getting an inadequately trained spotter. Both the lifter and spotter should be trained so that the exercise is safe and effective.

31. Strength Training • Isokinetic exercise • Machines are used to control the speed of contraction within the range of motion. • Machines such as the Cybes and Biodex provide isokinetic results; they are generally used by physical therapists and are not readily available to the general population.

33. Strength Training • Circuit training • Six to ten strength exercises are completed, one after another until all are done. • Each exercise is performed for a specific period of time before moving on to the next exercise, with a brief rest time in between. • If more than one circuit is to be completed , the circuits will be separated by a longer rest period.

35. Strength Training • KEY CONCEPT • In isometric exercise, the muscles maintain a constant length throughout the contraction. This is a good type of exercise to target an exact area of weakness due to an injury. In isotonic or dynamic exercise, there is movement of the joint during muscle contraction. This type of exercise helps improve blood circulation, strength, and endurance. Isokinetic exercises use machines to control the speed of the contraction within a range of motion. These exercises provide muscle overload at a constant, preset speed and full range of motion.

36. Cardiorespiratory Conditioning • KEY CONCEPT • Cardiorespiratory conditioning trains the heart and other muscles to use oxygen more efficiently. This allows the athlete to perform for longer periods of time.

38. Cardiorespiratory Conditioning • Also known as aerobic or endurance training, cardiorespiratory conditioning refers to activities that put an increased demand on the lungs, heart, and other body systems. • Large muscle groups are used for activities such as walking, jogging, swimming, cross-country skiing, or cycling.

39. Cardiorespiratory Conditioning • The goal of cardiorespiratory conditioning is to train the heart and other muscles to use oxygen more efficiently, allowing the athlete to perform exercise for longer periods of time. • Results include an increase in heart size, thus lowering the resting heart rate and blood pressure. Also, oxygen transfer rates are more efficient and resting metabolism increases.

40. Cardiorespiratory Conditioning • Other benefits include reduced fatigue, improved self-confidence, improved muscle strength and tone, increased endurance, reduced stress levels, reduced body fat, and improved overall physical and mental health.

41. Special Individualized Programs • Personal trainers can assist in strength training, cardiovascular fitness, speed and endurance work, and body composition. Personal trainers should be certified and have proven knowledge and expertise. • Certified athletic trainers are allied health professionals who have a considerable knowledge of anatomy and physiology. They can be found at many high schools and most colleges and universities.