Chapter 4: Preventing Injuries Through Fitness Training

1. Chapter 4: Preventing Injuries Through Fitness Training

2. Reduce InjuryPrepare the Athlete

3. 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

4. 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

6. Warm-up/Cool-down Motivation Overload and SAID principle Consistency/routine Progression Intensity Specificity Individuality Relaxation/Minimize Stress Safety Principles of Conditioning and Training

7. 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

8. General • Activities which bring a general warming to the body(break a sweat) • Not related to sport Specific • Specific to sport • Stretching, jogging, running, throwing, catching Should last 10-15 minutes resulting in effects that will last 45 minutes

9. 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

10. 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

11. Decreased ROM results in: • Decreased performance capabilities • Uncoordinated/awkward movements • Predisposes athlete to injury • Recommended by athletic trainers to prevent injury

12. Factors That Limit Flexibility • Bony structures • Tissue approximation • Excessive fat • Muscle and tendon lengths • Connective tissue • Scarring and contractures • Skin • Neural tissue tightness

13. 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)

14. Range of Motion • Must be able to move through unrestricted range • Must have elasticity for additional stretch encountered during activity

15. 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

16. Stretching Techniques Ballistic • 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

17. 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

18. 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)

19. 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

20. 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

22. 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

23. 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

24. 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

25. 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

26. Yoga • 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

27. 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

28. 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

30. Flexibility, Muscular Strength, Endurance, and Power

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. 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

42. 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

43. Terminology associated with weight training • Repetitions • Repetition maximum • One repetition maximum • Set • Intensity • Recovery period • Frequency

44. 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)

45. 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

46. 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

48. Circuit Training • Combination of exercise stations • 8 - 12 stations, 3 times through • Design for different training goals • Flexibility • Calisthenics • Aerobic exercise

49. 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

50. 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