Injury prevention is the buzz phrase amongst physiotherapists and sports professionals, particularly those involved in the management of elite athletes. The physiotherapy profession in particular has moved its focus away from injury management and towards preventative strategies. These may include musclulo-skeletal screenings, devising individual programs, pre-activation work-outs in addition to carefully prescribed rehabilitation programs under the guidance of the appropriate personnel.
“BE PROACTIVE NOT REACTIVE. PREVENTION IS BETTER THAN A CURE”
One of the most important aspects of injury prevention should include a pre-activation program. This program is designed to activate certain stabilising muscles throughout the body that are important to the sport and should be performed each time before training and game scenarios. The structure of pre-activation should be similar to that of the FIFA 11 structure.
Following pre-activation, an appropriately designed warm up needs to take place. The design of the warm up needs to be specific to the demands of sport being played, it needs to have a slow graduation of intensity so that it can lead in to the training session and it should include the use of dynamic stretches (e.g. Leg swings).
On the completion of the session, an appropriate cool down is required. This is the beginning of the recovery period. It enables your body to prepare for and be at its best for the next training session. The cool down should include a gradual decrease in intensity with static stretches being performed. Education of the athlete about the tools available to them during this period is important. These extra recovery activities include the use of foam rollers, ice baths, hot/cold showers and most importantly, adequate sleep between sessions. Sleep is often underrated but it is critical time for the body to heal and repair damaged tissues. During this phase it is important that the athlete takes responsibility and shows good initiative in making the most of their time to be at their best to perform well at the next session or competition.
Studies have shown that a lack of compliance to injury management decreases the amount of playing time and leads to a higher risk of re-injury. Injuries should be reported to coaching/managing staff as soon as they occur and appropriate action should be taken. The first 24 – 48 hours are very important to commence appropriate acute management and present to a physiotherapist or sports doctor to get a thorough diagnosis. The medical personnel in charge will then take appropriate action to develop a treatment plan and a progression to a safe return to sport. The process a player follows in their recovery towards a return to sport should include a specific rehabilitation treatment program which is designed to gradually re-introduce the load required for their sport. Re-injury rates are often higher when a player is returned to sport underprepared and with poor load management.
Load management is something that is commonly not monitored especially in the younger developing athletes. Today, kids are overloading themselves both physically and mentally with the increased amounts of sport being played at local level, state level, national level and school sport. It is very important to monitor their training and playing loads and incorporate an appropriate management strategy to prevent fatigue and injury. This is especially important when a child is going through a growth period. Parents are often the first to identify this (clothing becomes too small or increased appetite) and should inform the coaching staff.
Regular drinking of fluids is essential in order to maintain sporting performance. Athletes can lose as much as 1 to 2.5 kilograms of body mass during a soccer match under normal conditions and 4 kilograms during hot and humid conditions due to sweat loss. Fluid intake of athletes is usually less than the amount that is lost during a training session or match. Athletes should not rely on being thirsty to drink fluids because by this time you are already dehydrated. A decline in body mass of 2 percent significantly affects your performance, decreases concentration, and decreases skill levels. Drinks should be cool, palatable (taste good/flavoured), and contain sodium.
Athletes need a high carbohydrate intake on a daily basis. Carbohydrates are stored in the muscles and the liver as glycogen and are the most important fuel source for energy production. Insufficient stores of carbohydrates may cause an athlete to become fatigued towards the end of a training session or match resulting in a reduction in performance and skill level. On average athletes will require between 5-8 grams of carbohydrate per kilogram of body weight each day. Therefore carbohydrate rich foods like breads, breakfast cereals, fruit, vegetables, rice, pasta, yoghurt, and low fat flavoured milk need to be the focus of meals and snacks.
“Luck favours the well prepared!
"The better prepared the luckier you get”
The last topic to injury prevention is addressing the topic of “private health insurance”. There are pros and cons to being covered by private health insurance. Private health insurance can be very costly up front, especially if you have a large family, however private health insurance allows quick access to the best available treatment, whether that be physio, sports doctors or orthopaedic surgeons. In some cases, private health insurance reduces the burden of finances in case of an emergency when medical treatment is required. Private health insurance allows early access to specialists of your choice, ensuring the right professionals can be chosen specifically to manage a particular condition. And if surgery is necessary, rather than end up on a long waiting list with a delayed recovery, the issue can be addressed quickly, shortening the time to return to sport. People with health insurance are more likely to seek early treatment for niggling problems (before they become a big problem) and undergo injury prevention programs.