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Reducing the Risk of Injury
#1 Rule for Injury Mitigation
• Assumption – everyone has been cleared to
start an exercise program by their primary
care provider
Warm-up Before Exercising
• raises the body’s temperature
• starts the blood flowing throughout the entire
• eases the muscles and joints into activity
How to Warm-Up
• 5 - 10 minutes at an intensity that does not tire you out
• Generic: jumping rope, jogging, jumping jacks, goosestepping, walking knee lifts, walking butt kicks
• Specific: do the activity of your exercise (e.g., walking,
jogging, biking) slowly for awhile
• Strength Training: move your joints and muscles in the same
motion of what you will be doing with weights
What About Stretching?
• Static – bend the body in such a way that there is
tension on a muscle and hold it for at least 30 seconds
• Dynamic – swing, bounce or move body parts in their
normal range of motion at a controlled speed
• Ballistic – swing, bounce or move body parts outside
their normal range of motion (NOT RECOMMENDED
• See
Do I Stretch or Warm-up First?
• Do not perform static stretching without first
warming up
• Preferably do not perform static stretching
until after exercising.
• Dynamic stretching looks a lot like warming up
• Cooling-Down looks a lot like Warming-Up.
• For 5 to 10 minutes reduce the intensity level
of your exercising before stopping.
• Now stretch
Do Not Overtrain
Do Not Overtrain
• Give your body rest between workouts
• Do not do too much, too fast during workouts.
• 10% rule: from one week to the next do not
increase speed, intensity, duration, or weight
more than 10%
Good Nutrition
Good Nutrition and Hydration
• A tired or fatigued body and mind are more
apt to have accidents or be distracted while
• Exercise converts bodily tissue into usable
energy; both fuel and water are necessary for
this process
• A combination of protein, carbohydrates, and
fat is best
Good Nutrition and Hydration – cont’d
• Eat about two hours before working out and (assuming
you are already hydrated) drink 8 to 16 ounces of water
about two hours before working out.
• Exercise that lasts less than an hour typically will not
require sports drinks to replenish electrolytes (salts).
• Some studies indicate that it is beneficial to consume
an even mix of carbohydrates and protein within two
hours of completing strength training
Listen To Your Body
• Selecting Exercises and Activities
– You know what injuries you’ve had in the past
– You know what exercises to avoid
• While Exercising
– You know when you feel a pain that is different than
your typical ache
– You can recognize that you are light-headed or
otherwise not 100%
– Modify during a routine as needed
Use Correct Gear
• Running shoe manufacturers (who are not
unbiased) suggest replacing running shoes every
300 miles
• Cotton gets wet and stays wet with sweat.
Chafing and skin irritations are more likely with
cotton exercise clothes.
• Safety – every time Nathan posts his sweaty mug
while biking, it is apparent that he is wearing a
Use Correct Form
Use Correct Form
• If you do not know how to use a particular
machine at the gym, ask a trainer
• If you do not know how to properly perform a
particular exercise, ask a trainer (or do some
careful Internet research)
• This point is important for stretching, not just
Example of Proper Form: Walking
The 8 Keys to Proper Fitness Walking
1) Stand tall, with your shoulders back, head and neck aligned with your
spine, and abs pulled in.
2) Push off with the toes of your rear foot, and land squarely on the heel of
your lead foot.
3) Roll through the entire foot, from heel strike to the ball of your foot to
the final push off with your toes, allowing your ankle to move through its
full range of motion.
4) Avoid over-striding. Increase the number of steps per minute to increase
5) Bend elbows at a right angle, and swing your arms from the shoulder,
keeping elbows close to your sides.
6) Avoid clenching hands or over-swinging your arms.
7) Minimize leaning on hills.
8) Don’t neglect stretching and strength training, especially if you
experience burning or tightness in shins or calve muscles.
Use Correct Form
Muscle Imbalance
We have opposing or
complementary muscle groups to
move our bodies in a desired way.
When one muscle contracts
(agonist) the other muscle
lengthens (antagonist). The agonist
bends a limb in a desired direction
and the antagonist returns the limb
to its original position
biceps vs. triceps
hamstrings vs. quadriceps
abs vs. erector spinae
delts vs. traps
Muscle Imbalance – cont’d
• Muscle “pairs” can be out of balance if one
cannot lengthen enough in response to the
other’s contraction or if one is significantly
stronger relative to the other. The result is poor
biomechanical movement at the joint that can
stress tendons and ligaments or harm cartilage.
• An example is that many runners have hamstrings
that are relatively weak compared to the strength
of their quadriceps and this is a common cause of
knee pain.
How to Reduce Muscle Imbalance
• Variety in Exercise
– Can help ensure all muscles are being worked
– Can help prevent injuries or soreness from repetitive
– Can help make exercising less boring
– Deliberately train both muscles of the “pair”
• Stretching
– Use static stretching to target muscles that always
seem tight
Should You Exercise When You are Sick
• The “Neck Rule” (simple to apply but not fool
– If all your symptoms occur above the neck, then it
is probably OK to exercise; but you can give your
body the extra rest.
– If any symptoms occur below the neck, then it is
better not to exercise until you get better.
Reduce Your Bodyweight
• Risk of joint and muscle pain or injury is higher
for exercisers that are obese
• Risk of stress fractures is higher for exercisers
that are obese
What If You Do Get Injured or Hurt?
• Acute injuries are sudden, sharp, traumatic injuries
that occur immediately (or within hours) and cause
pain (possibly severe pain). Most often acute injuries
result from some sort of impact or trauma such as a
fall, sprain, or collision and it's pretty obvious what
caused the injury.
• Acute injuries also cause common signs and symptoms
of injury such as pain, tenderness, redness, skin that is
warm to the touch, swelling and inflammation. If you
have swelling, you have an acute injury.
What If You Do Get Injured or Hurt? –
• Chronic injuries, on the other hand, can be
subtle and slow to develop. They sometimes
come and go, and may cause dull pain or
soreness. They are often the result of overuse,
but sometimes develop when an acute injury
is not properly treated and doesn't heal.
Most Likely Injury to Occur
• Sprain – involves ligaments that connect
bones together at joints
• Strain – involves muscles or the tendons that
connect the muscle to bones
Most Likely Injury to Occur – cont’d
• The signs of most sprains or strains are very similar:
pain and inflammation, and sometimes bruising, at the
injured area. Depending on the severity of the sprain
or strain, the pain may be mild, moderate, or severe.
• The more severe the sprain or strain, the more difficult
it is to use the affected area. If the pain and swelling do
not begin to subside within 24-72 hours, you cannot
bear weight, or if your symptoms actually get worse,
see a doctor promptly.
Caring For Sprains and Strains
The gold standard of care for sprains and strains is known as RICE therapy.
• Rest: Don’t put weight on the injured area (this includes not lifting with an
affected wrist or elbow) for 24-48 hours, to guard against aggravating the
injury further. If you physically cannot put weight on an injured knee or
ankle, see your doctor.
• Ice: Put a bag of ice on the injured area for 10 minutes at a time, and then
take it off for about 20-30 minutes over the course of the first 3 days. Ice
should not be applied directly to the skin. The cold constricts blood vessels
and slows down the inflammatory process, easing pain and swelling. Too
much time can cause injury, however, so don’t leave the bag on too long.
Caring For Sprains and Strains
• Compression: You can either wrap an injured wrist, ankle, knee or elbow
in an elastic bandage, or buy a compression sleeve at any drugstore. Like
ice, compression helps to decrease swelling.
Elevation: By placing the injured area on a pillow and elevating it above
the level of your heart, you keep fluid from collecting in the area and
decrease swelling.
• RICE therapy is particularly important during the first 24-72 hours after a
sprain or strain occurs.
When Do I Use Heat Therapy?
• Do not use heat if there is inflammation!
• Heat is for muscles — taking the edge off the
pain of whole muscle spasms and trigger
points (localized spasms, or muscle knots).
Shin Splints
• "Shinsplints" refers to medial tibial stress syndrome, an achy pain that
results when small tears occur in the muscles around your tibia (shin
bone). This makes up about 15 percent of running injuries; 10 percent of respondents poll had shinsplints in the past year.
Shinsplints are common among new runners and those returning after an
extended layoff. They're a sign that you've done too much, too quickly.
Shinsplints more likely strike runners wearing the wrong shoe or a pair with
too many miles, and those with high arches or flat feet.
When the first twinges of pain strike, back off your running to a comfortable
level for a few days to a week, then slowly up your mileage using the 10
percent rule. Bike, pool run, and swim instead, if you can.
What About Chronic Pain?
• Icing is primarily an analgesic — a pain‐reliever —
and not an actual treatment. That is, it doesn’t
“fix” anything. Use it like you use ibuprofen. It
may help to resolve chronic problems, but it’s
mostly intended to simply numb painfully
inflamed or other hurting tissues.
• For some people, they perceive that heat relieves
their chronic pain better than ice.
• Heat or Ice?? It is a personal preference.
The End
• Any Questions?
• Next Challenge !
– Choose one item from question #1 of your selfassessment and make a goal of not consuming
that item for the next two weeks
– Deliberately stretch for at least 10 minutes on at
least three different days of each of the next two
weeks (i.e., 6 days total)