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Chapter 3
Injury Prevention
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Conditioning and Injury Prevention
• Purpose – effective, physiologically appropriate
physical conditioning program:
–
Improve performance
– Minimize the risk of injury and illness
• Must understand basic principles of conditioning to
ensure a program:
– Is safe and effective
– Void of practices that could predispose the
participant to injury
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Basic Principles of Conditioning
• Specific Adaptation to Imposed Demands (SAID)
principle
• Overload principle
– Frequency: # exercise sessions per day or week
– Intensity: amount of work during an exercise
– Duration: length of a single exercise session
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Flexibility
• Total ROM at a joint that occurs pain free in each of
the planes of motion
• Combination of normal joint mechanics, mobility of
soft tissues, and muscle extensibility
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Flexibility (cont’d)
• Mechanoreceptors influence flexibility
– Muscle spindle
• Lie parallel with contractile muscle fibers
• Send sensory information to CNS
• Muscle length
• Velocity of length change
• Excite/facilitate muscle contraction
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Flexibility (cont’d)
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Flexibility (cont’d)
• Mechanoreceptors influence flexibility (cont’d)
– Golgi tendon organs (GTO)
• Lie in tendon, most at musculotendinous
junction
• Stimulated by stretch
• Send sensory information to CNS
• Muscle load and tension
• Inhibit/relax muscle contraction
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Stretching Techniques
• Ballistic
– Muscle spindle is stretched, but GTO do not fire;
muscle resists relaxation
– Momentum can lead to overstretching, tearing
• Static
– GTO override impulses from the muscle spindles
– Safer, more effective muscle stretch
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Stretching Techniques (cont’d)
• Proprioceptive neuromuscular facilitation (PNF)
– Involves stimulation of the proprioceptors
–  flexibility in one muscle group (i.e., agonist),
and simultaneously  strength in another group
(i.e., antagonist)
– Techniques
• Active inhibition
• Reciprocal inhibition
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Stretching Techniques (cont’d)
• PNF (cont’d)
– Advantages
• Early use
• Single plane or diagonal patterns
• Overload principle can be used to achieve or
maintain normal flexibility
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Muscular Strength and Endurance
• Muscular strength
– Ability of a muscle or group of muscles to
produce force in one maximal effort
• Muscular endurance
– Ability of muscle tissue to exert repetitive
tension over an extended period
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Muscular Strength and Endurance (cont’d)
• Muscular strength and endurance depends on:
– Number and size of muscle fibers
– Type of muscle fiber (slow twitch; fast twitch)
– Neuromuscular coordination
– Gender
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Static Strength vs. Dynamic Strength
• Isometric contraction
– Tension is produced by the muscle, but there is
no change in muscle length
• Concentric contraction
– Shortening; decreases joint angle
– Work to accelerate a limb
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Static Strength vs. Dynamic Strength
(cont’d)
• Eccentric contraction
– Lengthening; increases joint angle
– Work to decelerate a limb and provide shock
absorption
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Dynamic Strength
• Isotonic exercise
– Variable speed/fixed resistance
– Advantages
• Permits exercise of multiple joints
simultaneously
• Allows both eccentric & concentric
contractions
• Permits weight-bearing, CKC exercises
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Dynamic Strength (cont’d)
• Isotonic exercise (cont’d)
– Disadvantage
• When a load is applied, the muscle can only
move that load through the ROM with as much
force as the muscle provides at its weakest
point
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Dynamic Strength (cont’d)
• Isokinetic exercise
– Fixed speed/variable resistance
– Advantages
• 100% loading throughout ROM
• Pain disengages mechanism
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Dynamic Strength (cont’d)
• Isokinetic exercise (cont’d)
– Disadvantages
• As muscle fatigues, resistance decreases
• Most machines only permit concentric
contraction
• $$$$
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Strength Application Principles
• Strength gains depend primarily on the intensity of
the overload
• Endurance improvement will be determined by the
intensity and duration of exercises
– Frequency
– Intensity
– Duration
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Cardiorespiratory Endurance
• Body’s ability to sustain submaximal exercise over an
extended period
• Cardiovascular level impacts fatigue
• Detraining occurs within 1 to 2 weeks
• Generally considered the most important component of
any fitness program
• ACSM recommends
– Activity 3-5 days per week
– > 20 minutes
– Intensity of 60-90% of maximal heart rate (HRmax)
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Check for Understanding!
The fitness component that is generally considered to
be the most important is:
A. Muscular strength
B. Flexibility
C. Muscular endurance
D. Cardiovascular endurance
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Check for Understanding!
The principle of overload is achieved by manipulating
which of the following components of an exercise
program? (select all that apply)
A. Endurance
B. Duration
C. Intensity
D. Frequency
E. Specificity
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Check for Understanding!
During a ballistic stretch, which of the following are
activated?
A. Muscle spindle
B. Golgi tendon organ
C. Fast twitch fibers
D. Slow twitch fibers
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Check for Understanding!
The ability of muscle tissue to exert repetitive tension
over an extended period is termed:
A. Cardiovascular endurance
B. Muscular strength
C. Muscular endurance
D. Flexibility
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Proper Technique and Injury Prevention
• Proper technique is important with regard to:
– Efficient and effective skill performance
– The prevention of injury
• Coach is responsible to teach proper skill technique
and to continually reinforce the use of proper
technique
– The instruction and expectation of performance of
any skill needs to be age and developmentally
appropriate
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Protective Equipment and Injury
Prevention (cont’d)
• Specialized equipment can protect a participant
from accidental or routine injuries
• Coach can share or be solely responsible to ensure
that protective equipment:
– Meets minimum standards of protection
– Is in good condition, clean, properly fitted, and used
routinely
– Used as it was intended
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Principles of Protective Equipment
• Protection from forces
– High velocity–low mass: focal injury
– Low velocity–high mass: diffuse injury
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Principles of Protective Equipment
(cont’d)
• Design factors that can reduce potential injury
– Increase impact area
– Disperse impact area to another body part
– Limit the relative motion
– Add mass to the body part
– Reduce friction
– Absorb energy
– Resist the absorption of bacteria, fungi, and viruses
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Liability and Equipment Standards
• Organization’s duty to ensure the proper use of
protective equipment is usually a shared
responsibility among the athletic staff
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Liability and Equipment Standards
(cont’d)
• Some settings, coach may be legally responsible for:
– Selecting the most appropriate equipment
– Properly fitting the equipment to the individual
– Instructing the individual in proper care for the
equipment
– Warning the individual of any danger in using the
equipment inappropriately
– Supervising and monitoring the proper use of all
protective equipment
• Even if an individual provides their own
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Liability and Equipment Standards
(cont’d)
• Standards of quality agencies
– NOCSAE
• Football, baseball, softball, and lacrosse helmets
and facemasks
– Other equipment (i.e., protective eye wear, ice
hockey helmets, and facemasks)
• ASTM
• HECC
• CSA
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Liability and Equipment Standards
(cont’d)
• Athletic governing bodies
– Establish rules for the mandatory use of specific
protective equipment
– Determine rules governing special protective
equipment
– NFSHSA, NAIA, NCAA, USOC
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Protective Equipment:
Head and Face
• Football helmets
– Can reduce head injuries, but do not prevent
neck injuries due to axial loading
– Construction
• Single or double air bladder,
closed-cell padded, or
combination
• Shell – plastic or polycarbonate alloy
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Protective Equipment:
Head and Face (cont’d)
• Football helmets (cont’d)
– Effect of heat
– NOCSAE warning
– Fitting – follow manufacturer’s guidelines
– Paperwork
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Protective Equipment:
Head and Face (cont’d)
• Ice hockey helmets
– Can reduce head
injuries, but do not
prevent neck injuries
due to axial loading
– Must absorb and
disperse high-velocity,
low-mass forces
• CSA approved
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Protective Equipment:
Head and Face (cont’d)
• Batting helmets
– NOCSAE approved
– Double ear flap
design
• Other helmets
– Lacrosse
• Bicycle
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Protective Equipment:
Head and Face (cont’d)
• Face guards
– Protect and shield facial region
– Football
• Effectiveness depends on the strength of the
guard, the helmet attachments, and the fourpoint chin strap on the helmet
• Proper fit
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Protective Equipment:
Head and Face (cont’d)
• Face guards (cont’d)
– Ice hockey
• Made of clear plastic, steel wire, or combination
• HECC and ASTM standards
• Proper fit
– Lacrosse
• Made of wire mesh
• NOCSAE standards
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Protective Equipment:
Head and Face (cont’d)
• Eye wear
– Goggles
– Face shields
– Spectacles
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Protective Equipment:
Head and Face (cont’d)
• Mouth guards
– Reduce dental and oral soft tissue injuries and,
to a lesser extent, jaw fractures, cerebral
concussions, and TMJ injuries
– Proper fit
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Protective Equipment:
Throat and Neck
• Attachable throat guard
– Required for catchers in baseball and softball
• Cervical rolls and collars
– Designed to limit motion of cervical spine
– Effective in preventing burner, but properly
fitted shoulder pads are critical
– Do not decrease axial loading on the cervical
spine when the neck is flexed
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Protective Equipment:
Upper Body
• Shoulder pads
– Should protect the soft and bony tissue
structures in the shoulder, upper back, and
chest
– Construction
– Select on player position, body type, and medical
history
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Protective Equipment:
Upper Body
• Shoulder pads (cont’d)
– Types
• Cantilever: protect AC joint and distribute
forces throughout entire shoulder girdle
• Flat: provide less protection to shoulder
region, but permit more glenohumeral motion
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Protective Equipment:
Upper Body
• Elbow, forearm, wrist, and hand
– Protection from external forces
• Thorax, ribs, and abdomen
– Protection from external forces
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Protective Equipment:
Upper Body
• Lumbar/sacral
protection
– Weight training
belts; abdominal
binders
– Should support the
abdominal contents,
stabilize the trunk,
and prevent spinal
deformity or injury
during heavy lifting
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Protective Equipment:
Lower Body
• Hip and buttock region
– Protect the iliac crest, sacrum, coccyx, and
genital region
– Pads typically composed of hard polyethylene
covered with layers of Ensolite™
– Girdle with pockets can hold pads in place
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Protective Equipment:
Lower Body (cont’d)
• Thigh
– Pad: protect
quadriceps
– Neoprene sleeves:
provide
compression,
therapeutic warmth,
& support for
quadriceps or
hamstring strain
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Protective Equipment:
Lower Body (cont’d)
• Knee braces
– Prophylactic
• Protect the MCL
• Redirect lateral valgus force to points distal to the
joint
– Functional
• Provide proprioceptive feedback
• Protect ACL
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Protective Equipment:
Lower Body
• Knee braces
– Rehabilitative
• Provide immobilization at a selected angle
• Permit controlled ROM through predetermined
arcs
• Prevent accidental loading in non-weight
bearing activity
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Protective Equipment:
Lower Body (cont’d)
• Knee braces
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Protective Equipment:
Lower Body (cont’d)
• Patella braces
– Dissipate force
– Maintain patellar
alignment
– Improve patellar
tracking
• Lower leg
– Protect anterior tibia
from extension
forces
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Protective Equipment:
Lower Body (cont’d)
• Ankle braces
– Lace-up
– Semirigid orthosis
– Air bladder
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Protective Equipment:
Lower Body
• Footwear
– Selection and fit may affect injury
– Consider the sport activity and surface
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Protective Equipment:
Lower Body (cont’d)
• Foot orthotics
– Devices used in the treatment and prevention of
foot and gait abnormalities
– Three broad categories:
• Orthotics to change foot function
• Protective orthotics
• Those that combine functional control and
protection
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Check for Understanding!
Instruction of proper technique should be: (select all that
apply)
A. Based on sound physiological principles
B. Based on personal experience or anecdotal experiences
regardless of their premise
C. Should be age appropriate
D. Should be developmentally appropriate
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Check for Understanding!
The only responsibility of the coach with regard to athletic
equipment is to ensure that the equipment is approved
by the appropriate agency.
A. True
B. False
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