injuries

Avoiding Pre-season Injury

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pre-season injuries

If you want avoid pre-season training injuries – start to plan your pre-season program now! This is good advice if you are between seasons or starting a sport again after a period of not playing. It is also good for trainers / coaches to consider when running a pre-season fitness program for a team.

A few months off regular exercise and training after winter sports is routine and often good for the body. But when pre-season training starts is when our physio clinic starts to fill up with athletes with strains. Here’s a guide to reduce your risk of injury during the next pre-season and regular season.

It starts with understanding injury risk and how we measure it. Why do some people get injured more than others? Can anything be done?

There are a lot of different reasons involved in why an injury may occur and there is no single test that provides an overall level of injury risk. Most professional sporting clubs use a complex battery of preseason testing, but it requires a huge amount of resources, and the chances are your local club doesn’t have that.

Recently a very simple, easy to understand and freely available risk indicator has been researched: The ratio of an athlete’s current exercise load compared to their historical exercise load (current week vs previous four weeks). This has been shown to predict injury risk in Cricket fast bowlers, Australian Rules football players and Rugby League football players. In order to get this ratio, you have to measure exercise load. In professional sport, players will often train with GPS and accelerometers to measure exercise load over the season – large fluctuations in load = higher risk of injury. When those devices aren’t available we have to go back to more simple measures.

Start recording in a diary the type (cardio, speed/sprint, power, strength etc) of exercise you do each day and some indicator of quantity (i.e. distance ran or the total time spent training). Then you need a measure of the intensity of the session which is usually relative to 100% as hard as you could go. If the session varies then record what you think is the average intensity and the amount of time spent at the maximum intensity. The goal of your workload diary is to allow you to plan your workload volume and intensity each week relative to the previous ones to make it a gradual transition during pre-season conditioning. This will avoid large spikes in workload and reduce your injury risk.

So when you get active again make sure you plan what you will do one week to the next and avoid spikes. But if do you get an injury we will be there to get you back on track.

If you want to read more on this see the articles below:

* Hulin BT, Gabbett TJ, Blanch P, et al. Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers. Br J Sports Med 2014;48: 708–12.

* Hulin BT, Gabbett TJ, Lawson DW, et al. The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br J Sports Med 2016;50:231–6.

* Murray, N. B., Gabbett, T. J., Townshend, A. D., Hulin, B. T. and McLellan, C. P. (2017), Individual and combined effects of acute and chronic running loads on injury risk in elite Australian footballers. Scand J Med Sci Sports, 27: 990–998. doi:10.1111/sms.12719

Running biomechanics and muscle strength

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Running physiotherapy injury

 

Biomechanics refers to how we are built and how we move. Some of us have legs that bow out (varus alignment) and others have knock knees (valgus alignment) which relates to the shape of our bone structure. It is a combination of our bony structure and how well our muscles work that can increase the likelihood of injury with running. This blog is looking at key areas of muscle weakness that alter our biomechanics and lead to injury. Your bony structure can’t be changed but improving your strength in the right areas can be achieved within 6 weeks of an exercise program that is designed for you. Assessing the biomechanics of the body combined with a basic understanding of your running style is important if you are serious about running.

A biomechanical physiotherapy assessment considers whether you have sufficient strength and mobility in the right places for running. The muscles in the back of the leg (calf, hamstring and gluteal) are important to maintain strength for running. Weakness in these muscles often leads to pain and injury in runners.

  • Calf muscle and Achilles tendon strength – it is important to understand that both muscles and tendons can respond to the loads we put on them. A simple test and exercise for the calf and achilles is the calf raise. If you can’t do a repeated full height single leg calf raise of more than 6 reps than you probably don’t have enough strength. I encourage people to get to 15 reps and be able to repeat 3 sets as a baseline but there isn’t a magic number here because it also depends on your running style. If you are about to change your style and get further forwards on the forefoot then check your calf and achilles strength first to minimise the chance of getting achilles tendon problems.

calf raise

  • Hamstring strength is essential for fast running but a base level of strength is also important for your park runners to 10km distances. Clearly the most functional way to strengthen the hamstrings for running is to gradually increase the distance and intensity of your running sessions. If you can’t do a hamstring bridge exercise or it takes considerable effort then you need to get stronger. Caution with doing this exercise – if it causes back pain then stop and discuss with one of our physio’s.

hamstring bridge

  • Gluteal (buttock muscle) strength allows for a stable pelvis during running. If you don’t have adequate gluteal strength it puts extra load on the knees, hips and lower back. Unless you have had a biomechanical physio assessment you probably don’t know if your glut’s are working well enough. A glute bridge is similar to a hamstring bridge but the knees are bent at approximately 90°. By bending the knees it makes it harder to use the hamstrings to lift the bottom and thus challenges the gluteal muscles more. Again if you have back pain stop and get some advice.

glute bridge

  • A squat is another good exercise to get the glute muscles working for runners but it needs to be done correctly. Keeping the back straight and bending at both the knees and hips gets the gluteal muscles working. Once you have been taught to do a squat correctly the challenge is a single leg squat with letting the knee drop in valgus collapse.

Squat exercise

Hope you have enjoyed reading about good strength exercises for runners. Thanks to Pete for his stick figure art which has been enjoyed by his clients for many years.