A common-sense guide to minimising the risks of getting hurt
Patrick Milroy explains how an appropriate warm-up and flexibility work will help minimise injury.
A cynic would say that the way to prevent sports injury was not to play sport. Anyone playing sport is to a greater or lesser extent at risk of injury, the intensity, frequency and type of play being only some of the factors that may influence physical damage. Thus, although the ideal may be to prevent injury, the practical goal should be to minimise it. Perhaps the most basic way to reduce injury is to play according to the rules, though if the media are to be believed this presents the greatest growth area in the league table of sporting trauma. The laws of all sports were designed to ensure a level playing field but the increasing use of blatant fouls and cheating as the prizes grow larger can only contribute to the growing toll of injury. Pressure on umpires and referees comes from all directions. They are branded incompetent when the slow-motion television camera picks up a missed infringement, overzealous if they apply rules to the letter, and berated by players where decisions go against them. That money is a factor in the attitude of sportsmen cannot be denied. With some professionals retiring by the age of 30 to draw pensions it is vital for them that these are topped up in their playing years.
Newton and the strike angle
An injury may come from various directions. In contact sports, external trauma from an opponent, accidental or premeditated, causes a very high percentage. However, it is not only the intensity of the contact that produces damage but also the angle of strike, the part of the body affected, and the forces applied according to Newton's laws that determine the extent of the injury. To help minimise this, the industry of protective body wear has developed. Nevertheless, sensible protection will spare players many injuries. A man who plays games involving small hard spherical objects and fails to look after his own is risking more than leisure pursuits. The footballer that will not wear shin pads could be deemed negligent in a sport where so much lower-limb contact occurs within the rules. The list of sensible protective clothing and equipment is endless, the necessity and suitability of much of it producing a fine line, in any active sports, between flexibility and relative immobility. Successful teams and players usually have good coaches. To gain the highest professional qualifications most coaches will have undergone both generalised and sports specific training under the auspices of such bodies like the National Coaching Foundation. As their courses include anatomy, physiology, psychology, nutrition, performance and injury prevention within their modules, there should be no excuse for coaches to be unaware of the effect their training programs may have upon their athletes. Not only will intelligent coaching help to develop efficient and powerful players, but a sensible adaptation of the regime can also allow an injured player to maintain a degree of fitness while the injury heals. Further liaison with sports scientists, whose use of the slow-motion camera has revolutionised our perception of biomechanical movement, can often pinpoint the cause of an injury or even predict the one that occurs as a result of poor technique. Coaches also have pressures upon them to produce their strongest teams and may play their least injured players rather than their fittest. Playing with an injury invites problems on two fronts: first, the original injury may be reactivated, and second, the stresses induced by favouring it may place an intolerable strain on other structures which then break down.
To avoid injury, do not be injured
So, if an injury is to be prevented, the player must start with no injury. This somewhat chicken and egg situation can be minimised if adequate precautions are taken. The necessity for warm-up has often been stressed, the similar need for a cool down and the will to perform it rather less emphasised. The warm-up itself must be scientific, a five-minute jog followed by a couple of efforts merely scratches the surface. During the competition, the joints involved are liable to be used not only through their normal range of flexibility but also, often at the behest of an opponent, into angles of extension not previously contemplated. So, before a warm-up there should be a programme of movement for each joint to take it to its extremes and to lengthen muscles and tendons so that the shock of competition does not immediately tear them. Flexibility should, therefore, be built into every training programme, but a survey of the tight hamstrings of nearly every distance runner shows the futility of suggesting such exercises. An inability to comprehend that much of the lower back pain from which they suffer is related to stiff and unstretched hamstrings is accompanied by the unspoken fear that time spent in stretching equals time. However, lengthened hamstrings could allow an increase in stride length and performances to match.
Sit back and ask yourself why
The trained athlete has one other source of injury, overuse. Repeated movement and actions, especially within the one plane, can induce injury that insufficient recovery will accentuate. Unfortunately, fitness is a knife-edge, under training equals underperformance while overtraining equals overuse injury. There is no single way to prevent this, though varied training in terms of effort, intensity, terrain, environmental conditions and distance may all minimise the risk. The runner with a set 50-miles/week routine will probably suffer more from injury over a four-week period than the one who runs 35, 60, 45 and 60 miles in successive weeks, allowing time for recovery after harder and longer efforts. Objective coaching can educate, not only with regard to lower limbs, but also in the case of the racket player with tennis elbow, the swimmer with shoulder impingement pain, and so on through the endless list of overuse damage. If a single piece of advice existed for prevention of injury, much medical and paramedical staff would be out of work. However, if present trends continue the need for medical care of injured players will increase rather than decrease. That, however, does not prevent each individual from standing back from his sport and, with the help of a coach, trying to analyse why any previous injury has occurred and outlining the measures necessary to prevent any future injury.
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