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Chapter 4
Sports-Injury Prevention
2 Types of Causative Factors
1. Intrinsic Factor – *
2. Extrinsic Factor – originating from the
outside
Causative Factors in Injury
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Intrinsic Factors
Age
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Body size
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Fitness level
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Skill level
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Risk Factors in Specific Body Areas
• Upper Extremity:
• Ligamentous laxity
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• Shoulder girdle weakness
• Lower Extremity:
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Tight, weak hamstrings
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Joint malalignments
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Study by Moskwa and
Nicholas
Causative Factors in Injury
Extrinsic Factors
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Equipment
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Type of activity
*
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.
Intervention
NCAA Guideline 1B
• PPE (pre-participation physical examination) is
required upon entrance into athletic program
• 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.”
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• Physical exams can identify:
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spina bifida occulta
absence of one of paired organs
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high blood pressure
cardiac defects or arrhythmias
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vision deficits
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PPEs
• AAP recommends PPE biannually (or when athlete enters
middle/high school) with annual update including:
comprehensive history, height, weight, and blood pressure.
• UIL recommends PPE biannually
• LTISD requires PPE every year
Two forms of PPEs:
• Office-based works well when physician is familiar
with athlete’s medical history
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All information obtained during examination should be handled
appropriately to protect athlete’s confidentiality.
Preseason Conditioning
An essential aspect of any injury
prevention program is the optimal
development of physical fitness in the
athlete
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.
• Aerobic fitness can assist in avoiding
injuries related to general fatigue
Muscular strength and endurance:
• Muscle strength is defined as maximum
amount of force that can be produced in 1
repetition (Power = Force x Velocity)
• Muscle power is much more important
than overall strength
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• Increased bone density
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• Increased muscular endurance
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Muscle Strength, Power, and Endurance
• Training volume – *
• The higher the training volume in a given workout, the lower the
amount of weight lifted in any given set of repetitions
• Training intensity – the amount of weight lifted per repetition
• Also, the faster the repetition is performed, the higher the intensity
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• Training Frequency – the number of training sessions completed in a
given period of time
• Most strength-training programs incorporate between 3 and 5
workouts per week
• Moderate – to high-intensity training requires 24-48 hours for
recovery
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Conditioning
• Flexibility: ROM in a given joint
or combination of joints
• Improved flexibility has been
determined to reduce the
incidence of musculoskeletal
injuries
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Conditioning
Determinants of ROM:
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bone structure
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age
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Two types of flexibility are
static and dynamic flexibility.
• Four types of stretching are
ballistic, static, PNF, and
passive.
4 Types of Stretching
• Ballistic Stretching – powerful
contractions or muscles
• Static Stretching – holding a
stretch for at least 3 seconds
• PNF Stretching – uses the
body’s proprioceptive system
to stimulate muscles to relax
• Passive Stretching – having
someone other than the
athlete move them thru ROM
Conditioning
Nutrition 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
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Periodized Program
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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 (goal
is to allow the athlete to
recover)
Off-Season Programs
• Progress the athlete through 3 distinct phases:
• Hypertrophic/Endurance Phase – strengthen the connective
tissue surrounding the muscle fibers and tendons attaching
the muscles to bones
• Lower intensity with higher volumes
• Strength Phase – increase the strength of the involved
muscle groups
• Higher intensity with lower volumes
• Power Phase – focuses on the development of highervelocity movements
• Intensity is very high
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
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• Room dimensions
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• Locker room and shower
facilities
Outdoor Facilities
• Safety fences
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• Location of dugouts
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• Water and sanitation
facilities
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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