Does your training target injury prevention?

Jun 4 / Dr. Elizabeth Salas

I often encounter teams with highly competent coaching and medical staff, who seem to be doing all the right things. They have systematic warm-ups, very thought-through training, recovery routines, therapy sessions for athletes… yet they still hit that time in the season where most athletes seem in pain or injured. I can see how a situation like this can be annoyingly frustrating.
Everyone talks about injury prevention with such familiarity, but I still wonder if they really understand what goes on behind the injury prevention process. In the occupational space, where I spent many years conducting research, there are countless methods to assess the risk of different work tasks, as well as interventions to reduce the consequent physical load on the body. We could not take any contributing factor lightly, and although we did generalize results, we did so with caution.

Recommendations were mainly guided by 2 factors:
  1. The type of injuries common to that job, and
  2. The mechanisms of injuries within the job.

At the end of the day, the most important part of this process was that every intervention was a solution fitted to the problem.

What's Different in Sports:

There is a belief that injuries in sports are highly unpredictable. The reality is that underlying fatigue (neuromuscular and/or tissue fatigue, and joint instability (from diverse sources) are often behind some of the injuries that occur as a "result of accidents" or "bad landings". In addition, the multiple demands coaches face managing teams and the pressure to achieve results often push them to adopt overgeneralized injury prevention programs.

Unfortunately, these programs don’t always target injury prevention appropriately because they are not always built considering injury mechanisms, the musculoskeletal demand specific to their sport... let alone the individual mechanical differences.

I always say that if you don’t understand the problem, you can’t create a solution. If you created a solution without understanding the problem, it would be like setting up a defense when fighting an invisible opponent: you wouldn’t see the directions of the punches nor how hard the punches would be coming to you. This is what we would call non-targeted training because the programs are not built with the purpose of preventing a specific injury, but rather to strengthen or gain other performance-specific benefits in a more general sense.

What is targeted training?

An effective injury prevention intervention must create a shield around anatomical structures at risk of injury due to the forces of specific actions associated with the sport. To accomplish this, targeted exercise training is needed.

Targeted Training refers to exercises that take into consideration
  • The injury mechanisms
  • The sports-specific musculoskeletal demands, and
  • The mechanical deficits of athletes.

This idea has been supported by previous research (Hewett & Bates; 2017), who pointed out that teams who took the time to identify athletes who were at high risk of suffering ACL injuries and intervened with targeted training were able to reduce 50% (up to 88%) of ACL injuries.

The major disadvantage about this approach is that it can be time-consuming and complex. However, more easily accessible (and practical) knowledge and the necessary tools to help facilitate the identification of these factors has great potential to help coaches and athletes identify individual risk factors. to support evidence-based training.

In the meantime, I encourage you as an athlete and/or coach to learn about the biomechanics associated with your specific sport demands and injury risks to start increasing your awareness about what movements are favorable and what movements may be injurious.

It’s important to think of this not as a quick fix, but rather as a process that will help you grow in the long run to improve your own or your athletes' performance in a safe and effective manner.
I assure you that the benefits of these strategies are not limited to athletic performance, but they go beyond to impact the athletes’ lives in the long term.

By Dr. Elizabeth Salas,
Former pro volleyball player and biomechanist. 
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