Chapter 4

Sports-Injury Prevention

Bellwork• What is the meaning of the acronym ROM?

Causative Factors in Injury

Intrinsic factorsAge Gender Body size Injury history Fitness level Muscle strength/FlexibilitySkill level Psychological state

Causative Factors in Injury

Extrinsic factors

Equipment

Environment

Type of activity

Conditioning errors

Intervention Strategies

• Extrinsic factors such as faulty equipment, dangerous facilities, etc. can be easily recognized and corrected.

• Athletes in high-risk sports MUST be educated about hazards and prevention.

• NCAA and NFHS have developed guidelines for medical evaluation of student/athletes.

InterventionNCAA Guideline 1B • PPE (pre-participation physical examination) is

required upon entrance into athletic program; thereafter, annual updated medical history unless additional medical exam is warranted based on the updated history.

NFSH policy• PPE required prior to first year of participation.The primary purpose of PPE: Identify preexisting

injury risk factors as well as ascertain any injuries/diseases that are potentially problematic.

PPEs

Historically known as “annual physical,” “physical exam,” and “pre-participation medical evaluation.”

• Primary purpose is to identify preexisting injury risk factors or preexisting injuries/diseases.

• Physical exams can identify spina bifida occulta, absence of one of paired organs, postural problems, high blood pressure, cardiac defects or arrhythmias, allergies, vision deficits, and skin infections.

PPEsAAP recommends PPE biannually (or when athlete

enters middle/high school) with annual update including: comprehensive history, height, weight, and blood pressure.

Two forms of PPEs: • Office-based works well when physician is

familiar with athlete’s medical history• Station-based screening is useful for

examining groups of athletes.All information obtained during examination should be handled appropriately to protect athlete’s confidentiality.

Preseason Conditioning

General Conditioning: aerobic fitness, muscular strength and endurance, flexibility, nutrition, and body composition

Sports-Specific Conditioning: all aspects of the sport that are unique to it

Conditioning

Aerobic fitness• Regardless of sport, all athletes benefit

from improving aerobic fitness.• It can be expressed in milliliters of oxygen

per kilogram of body weight per minute. (ml/kg/min)

• Fatigue can have detrimental effects on muscle strength, reaction time, agility and coordination.

Conditioning

Muscular strength and endurance:• Muscle power is defined as “the time rate of

performing work” Power =Force x Velocity• How do strength and endurance differ?

• Increased connective tissue strength• Increased bone density• Improved strength ratios • Increased muscular endurance• Decreased injury risk

Conditioning

Flexibility: ROM in a given joint or combination of joints• Determinants include tissue temperature,

bone structure, tissue mass, age, and gender.

• Two types of flexibility are static and dynamic flexibility.

• Four types of stretching are ballistic, static, PNF, and passive.

ConditioningNutrition and body composition:

• The body responds to a conditioning program more effectively when it receives proper nourishment.

• Coaches, parents, and athletes must take care to avoid an overemphasis on leanness.

Periodization

• Process of arranging training around specific goals and objectives.

• Organizes training into cyclic structure based on competitive sports seasons

• Manipulates exercise frequency, intensity, and duration

• Helps prevent training-induced injury

Periodized Program

Most training programs designed around a 1-year period of time (macrocycle)

• microcycle – 2 to 4 weeks• mesocycle – several

successive microcycles• transition phase – 2 to 4

weeks between training seasons or microcycles

© BananaStock/age fotostock

Modification of Extrinsic Risk Factors

• Practice/competition environmental conditions, especially heat and humidity, must be assessed.

• Facilities must be designed, maintained, and frequently inspected for safety.

• Coaching personnel and administrators MUST monitor these factors.

Modification of Extrinsic Factors

• Indoor facilities: lighting, playing surfaces, room dimensions

• Outdoor facilities: safety fences, batting

cages, location of dugouts, soccer goal

construction, water and sanitation facilities,

and EMS access routes

Protective Equipment

• Protective equipment plays a vital role in the prevention of injury

• Virtually all sports can benefit from the use of some form of safety equipment—including mouth guards