Ross Bennett - Injury Prevention and Rehabilitation in Sport

Injury Prevention and Rehabilitation in Sport

Ross Bennett

THE CROWOOD PRESS

First published in 2015 by

The Crowood Press Ltd

Ramsbury, Marlborough

Wiltshire SN8 2HR

www.crowood.com

This e-book first published in 2015

Ross Bennett 2015

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publishers.

British Library Cataloguing-in-Publication Data

A catalogue record for this book is available from the British Library.

ISBN 978 1 84797 958 2

Disclaimer

The author and publishers of this book do not accept any responsibility whatsoever for any error or omission, nor any loss, injury, damage, adverse outcome or liability suffered as a result of the use of the information contained in this book, or reliance upon it. Since some of the training exercises can be dangerous and could involve physical activities that are too strenuous for some individuals to engage in safely, it is essential that a doctor be consulted before training is undertaken.

Acknowledgements

I would like to say a huge thank-you to my wife Lucia and all my family for their continued support for my career so far. I would also like to acknowledge all lecturers and work colleagues who have contributed to my learning over the years, and have helped me mould a personal philosophy within strength and conditioning/sports science. I hope you all enjoy the book.

C ONTENTS

I t is an often neglected consideration in strength and conditioning that a well-constructed strength programme can act as a key factor in injury prevention as well as a tool for performance enhancement. Increasing the strength of key musculature and connective structures causes an increase in their integrity and robustness. This in turn enables larger acute forces or greater volume and an increasing training stimulus to be applied without a potential breakdown. Furthermore, depending on the anatomical region of strength increase, this will elicit injury prevention benefits by increasing the stability of a joint. For example, strengthening the hamstrings will directly result in increased stability of the knee joint, thus illustrating the important role the hamstrings play in stabilizing the knee (Olsen et al., 2005). Therefore, stronger hamstrings in particular will in turn reduce direct hamstring injuries such as tears, and consequently knee injuries, especially reducing injuries involved in rotation of the knee. (The importance of posterior chain strength and benefits will be explained in greater detail in a later section of this chapter.)

It may seem that this chapter is placed out of order in injury prevention programme design, as there are essential components of reducing injury that might be prescribed prior to strength training. For example, an athletes ROM (range of movement) and stability around particular joints could be a focus prior to heavier strength training, and a later chapter within this book will specifically discuss the importance of corrective exercise to the athlete. However, this chapter was selected to appear first, as I believe (particularly in the sport in which I work football) maximal strength is often neglected and misunderstood, including the benefits it can have in reducing injury rates.

Many practitioners within the field of strength and conditioning are over-cautious when applying strength training programmes to athletes, either because they are concerned for their safety, or they are worried that it might create a physiological adaptation of hypertrophy that is deemed detrimental to athletic performance. To combat this, a strength development programme is given in this chapter, which enables a modified long-term athletic development (LTAD) programme to ensure a safe and steady progression to increased strength. Guidelines are given in this chapter to create strength adaptation without necessarily causing an increase in any unwanted hypertrophy.

A progression/continuum for strength development is given below. Note that coaches and sports scientists will not always have access to athletes as young as nine, so the following steps can be applied and adapted to athletes at any age. LTAD is examined in much greater detail in (Maturing and Youth Athletes).

S TAGE 1 ( AGE 912): INTRODUCTION TO FUNDAMENTAL MOVEMENT PATTERNS

Create mobility drills that will ensure an athlete is able to generate full ROM. Body weight exercises are essential; ensure that movement occurs with no dysfunction or compensation. If you have access to players at this age group, then this stage is essential and conforms to the high flexibility and ROM an athlete has at this age (this naturally decreases as chronological age increases). The aim is to provide a wide range of exercises, to broaden an athletes skills set and to challenge them from a motor skill development point of view.

S TAGE 2 ( AGE 1314): INCREASING MOTOR CONTROL

Still prescribing a combination of bodyweight and loaded exercises, exercise prescription should be restricted to those that will be more essential for functional strength development, although variation at times is essential for psychological/physiological benefit. A list of key exercises and the benefit of each one will also be included in this section. We can now start to increase the intensity and volume a bit more, but ensure the movement is under good control. Take extra care when working with this age group: as they go through greatest peak height velocity phases (growth spurt) some athletes can experience movement issues or difficulties. This phase should also start to look at individuals who need specific ROM or stability work. Commonly, supplementary glute strength and ankle ROM training is required to enhance movement quality.

S TAGE 3 ( AGE 1516): HIGH VOLUME LOAD TIME (WORK CAPACITY STRENGTH)

After previous technical phases and motor control work, its time to increase the intensity in the gym. Based on previous experience, keeping volume relatively high post growth spurt and gradually increasing intensity seems to bridge the gap between motor control phases and general maximal strength work. Remember: if the load is higher than what the athlete is used to or has lifted before, an overload is created, which is essential for adaptation. If you are fortunate enough to be working with your athletes from a younger age, at this stage of their development there is often a natural increase in circulating hormones such as testosterone to assist further neurological gains and is thus an appropriate time to apply strength work. However, all athletes develop and mature at different times, and some may still have late growth issues as they go though PHV phases. Athletes go through their optimal strength/weight gaining phase approximately 18 months after PHV. It is therefore the responsibility of the coach and practitioner to assess the appropriate timing for the implementation of this phase.

S TAGE 4 ( AGE 17+): TRADITIONAL MAXIMAL STRENGTH PHASE

After the three previous phases, your athlete should now be technically and physically competent, and can be prescribed a well-constructed traditional periodized strength programme to maximize their strength over a period of time. A guide to recommended repetitions is given; there will also be a section on periodization later in this textbook to demonstrate the importance of volume and intensity and how it should be fluctuated.