Strength Training for Injury Reduction in Athletes: The Evidence

Strength Training for Injury Reduction in Athletes: The Evidence

The British Journal of Sports Medicine recently published a review of the evidence for Strength Training as a strategy to reduce injuries in Athletes- and the results are impressive! For those that tend to just read the first few lines of an article, take this away. If you are an athlete, or you coach athletes, strength training should be a priority in your programming if you want to reduce injury risk. For the rest of you, please read on.

This article was by Lauresen, Andersen and Andersen (2018). Below is a summary:

The Interventions

  • 6 studies were included, totaling 7738 participants aged between 12-40 y.o.
  • The average intervention duration was 21.39 weeks.
  • Average volume of training was 80 reps per week.
  • Average intensity was 8.39 RM (these means the maximum number of repetitions that can be performed for a given exercise).

The Outcomes

  • Strength Training reduced sports injuries by 66% with a 95% confidence interval of 52% (combined results from 4 of the 6 studies).
  • A 10% increase in strength training volume resulted in reduced injury risk of 4%.
  • No injuries occurred as a result of the strength training throughout the interventions.
  • Strength training was both safe and effective for adolescents as well as adult athletes.

Why? The Mechanisms

The authors can only speculate as to why strength training helped protect athletes from injury, but their proposed mechanisms to explain its effectiveness are:

  • Preconditioning- effectively toughening up the muscles/tendons so they can deal with greater loads.
  • Variation of loading across the body so that parts of the body that are not stressed by the sport take more of the load in the gym.
  • Improved coordination and technique in the gym crossing over to movements in sports.

The Recommendations

The authors concluded with the following recommendations for strength training, and I advise that if you choose to trust an Exercise Professional to help you or your athletes commence a strength training program that they can demonstrate an understanding and adherence to these principles.

  • Commence with a familiarisation period so that the athletes can develop the confidence and capability to perform the exercises correctly.
  • Ensure the athlete is supervised in the gym so that exercises can be completed well and loads are monitored accurately.
  • Loads are individualised to the athletes capability and are altered appropriately over a training cycle.
  • Exercises are varied across the year of training.

I would add in that it is also important that the strength training program is correctly synchronised with the training and competition schedules, so the Exercise Professional must be in regular communication with the athlete’s coach. For example, during an athletes off-season they can focus on improving function and technique; during pre-season switch to muscle building; and within season aim to build/maintain strength and power. The Exercise Physiologists at iNform have extensive experience managing the strength training programs of athletes across many sports. If you would like to speak to one of our EPs about the services we offer athletes, please contact us!

About the Author

Lauersen, J. B., Andersen, T. E., & Andersen, L. B. (2018). Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. Br J Sports Med, bjsports-2018.

Injury Risk Factors for Elite Junior Tennis Players: What you need to know

Injury Risk Factors for Elite Junior Tennis Players: What you need to know

Recently the Journal of Sports Sciences published a Systematic Review detailing the factors associated with injury in Elite Junior Tennis players. It is important that coaches and parents of such athletes are aware of the findings (Oosterhoof et al, 2018).

Risk Factors for Lower Back Injury

Previous Lower Back Injury:

Previous injury is often a good predictor of future injury. Why? That is not clear, but one reason may be that rehabilitation of injuries is often not done to the level that it needs to. Rehab is often done adequately to get a player back on the court, but functional deficiencies can remain. This can predispose the athlete to recurrence, or to injury of another part of the body due to compensation. Elite Junior Tennis players should undertake their rehabilitation under the guidance of a Physiotherapist and Exercise Physiologist that are experienced in this field.

Training Loads > 6hrs p/wk:

Elite Junior Tennis players will be training and playing at least this amount. So how do we mitigate against this as a risk factor? For one, the athlete needs to have a good recovery repertoire and be diligent with it. A recovery program should be personalised for the athlete, but some common features of an athlete recovery plan are; adequate sleep; good diet, hydration and nutritional support (protein especially); massage; stretching and cold-water immersion. Secondly, Functional Resistance training can help build strength in muscles and tendons, mobility in joints, stability in movement, balance and spatial awareness. If your child, or an athlete under your guidance does not have a recovery plan, and/or is not undertaking a quality, personalised functional strength program I would speak to a qualified and experienced Exercise Physiologist to help them build one.

Risk Factor for Upper Extremity Injury

Fewer Years of Playing Experience

The authors do not specify what it meant by ‘fewer years of experience’ so we can only speculate. But generally speaking, when a young person starts at a new sport, their body is going to be exposed to forces that they may not be conditioned to deal with. I recommend that young people new to tennis undertake an overall movement capacity assessment, such as the ‘Movement Screen’ (Movement Screen ). This will identify any functional limitations that can be corrected through a functional strength training program. We use the Movement Screen with all of our young athletes at iNform.

Risk Factor for Lower Extremity Injury

Stretching

Interestingly, in the studies included in the aforementioned review players that regularly stretched the muscles of the lower body had an increased risk of injury than those that didn’t. This is counterintuitive for most, as stretching is supposed to be good for us, right? Stretching can be useful for increasing the mobility of a restricted joint. However stretching can also acutely reduce our muscles responsiveness and power. So there are pros and cons to stretching for athletes. If an athlete is going to be prescribed stretches, they should be recommended only for areas that display movement restriction (and have shown a positive response to stretching) and should be timed so that performance is not impacted negatively. The Exercise Physiologists at iNform can easily identify whether a young tennis player would benefit from stretching, and recommend when is best to do it.

Summary

Whilst there are injury risks associated with playing Elite Level Tennis at the junior level, they can be mitigated by taking an intelligent and strategic approach to the young athletes programming. The Exercise Physiologists at iNform have extensive experience helping Elite Young Tennis players stay strong and healthy and on the court.

About the Author

  1. Jacobien H.F. Oosterhoff, Vincent Gouttebarge, Maarten Moen, J. Bart Staal, Gino M.M.J. Kerkhoffs, Johannes L. Tol & Babette M. Pluim (2018) Risk factors for musculoskeletal injuries in elite junior tennis players: a systematic review, Journal of Sports Sciences, DOI: 10.1080/02640414.2018.1485620

 

My 5 Favourite Types of Running (and where I do them in South Australia)

My 5 Favourite Types of Running (and where I do them in South Australia)

My Father-in-law absolutely loves wine. As long as it is a big, smooth Barossa Shiraz. I on the other hand like a bit of diversity- a cold, crisp Riesling on a hot summer’s day; a big brooding Cabernet on a cold wintry night; a Pinot, well, there are a lot of contexts where Pinot is appealing! It is much the same with running for me. Some people like to do the same 5km Park Run every week. Great! I however like to run in lot’s of different ways and contexts. So here are my top 5 types of run and where I enjoy doing them the most.

5: Flat Road Running

A long, straight, flat stretch of tarmac in front of me. Feet tapping away with the consistency of a metronome. Breathing in an easy rhythm- every 3rd foot strike. Mind clear,  basically meditating. Km’s ticking away without really noticing. This is running relaxation.

Where I do it: The Riverland; Yorke Peninsula (Around Port Broughton or Ardrossan).

4: Sprinting

From a crouched starting point, then accelerating up to top speed. Driving the knees forward, ripping the elbows back. Completely releasing the brakes. I am sure it feels more impressive than it looks, but in my mind I am flying. The lungs start to bite which is the cue to take the foot off the the accelerator. My legs gradually wind down. I let myself recover, then go again.

Where I do it: Balhannah Footy Oval; Amy Gillett Bikeway

3: Uphill

Yes I am serious, I love running uphill. As I approach the incline my mindset shifts. This hill will be like a big meal- just take your time with it and take it one mouthful at a time. I lean forward, focus on pulling my knees through, and get into a nice easy rhythm. I imagine the little engine that could; chug-chugging it’s way up the winding track. The revs are oscillating close to, but always under the red-line until the crest is spotted, then comes an acceleration. Relief as the gradient plateaus.

Where I do it: The (Old) South Eastern Freeway; ‘The Guts’ Track at Fox Creek.

2: Trails

I love narrow, rocky trails. If there is a steep drop-off on one side, excellent. Creek crossing, boulder hopping, ducking under low branches. It can be more like an obstacle course than a run. Agility and power are required to negotiate what the trails offers. One minute I am scampering up tight switch backs; next I am weaving down the other side like a slalom skier. This is an extreme sport!

Where I do it: Sturt Gorge; Morialta

1: Beach Running

This is running stripped (almost!) completely back. Barefoot, wearing just shorts and a hat. Along the shore line, the waves are the soundtrack. Always on a hot day. When the heat gets a bit much the hat gets chucked to one side and in the ocean I go. The first beach run of the summer results in blistered feet and sore calves- but both toughen up pretty quick. For me beach running is heaven.

Where I do it: Normanville to Carrickalinga; Aldinga Beach

I hope to see you out at one of my favourite spots!

About the Author

Never too old for play-time – Mountain biking as playtime for adults

Never too old for play-time – Mountain biking as playtime for adults

The fours lads were ready to ride. Their backpacks were stuffed with water and sugary snacks. Their bikes were good to go. They planned to head off into the distance, but they didn’t know exactly where. What they did know is that they’d end up muddy, sweaty, hungry and ready for dinner.

This could be written about my 10 year-old self. Heading off for adventures with my tribe of little buddies from my street. Or it could be written about me last Friday, heading off for a Mountain bike ride with mates after a solid day’s work.

Mountain biking as playtime for adults

I adore Mountain Bike riding, and I am sure it is mostly because of its reminiscence to my childhood. For me, and the guys I ride with, Mountain Bike riding is not about competing, or personal records, or elevating my status on Strava. It is about adventure. It is about letting go of all of our adult roles and responsibilities for a few hours and becoming kids again. Getting muddy and soaked by rain when out on a forest trail is an ageless, timeless experience.

I am about to become a Father. We want to establish consistent routines and boundaries for our child so that they can grow up knowing we will be consistent, reliable and fair. I will also need to do a little bit of growing up, but I am excited to begin growing into my new role as Father.

But I also hope to keep reserving time for me to be child like.  I want to keep having adventures, heading off into the distance and coming back muddy, sweaty and hungry, even if it is only for an hour or two every fortnight.  We encourage active play for our children as we know it helps development of many important physical traits like agility, strength, aerobic fitness, and balance. We also know it promotes creativity, memory, decision-making and teamwork. As an adult, should I not also value these traits? As an Exercise Physiologist, of course I do. And I want to set an example for my child to spend time playing throughout their entire life also.

About the Author

How can strength training help your walking? 

How can strength training help your walking? 

Walking is easy right?

We learn to do it from around the first birthday mark and continue to work on it through our younger years until it becomes an action that we really think very little about. In this time we are building a base level of strength and function. When we want to go somewhere we just get up and our legs somehow get us from point A to point B. For the most part this serves us well and we can deal with the stresses placed on the body.

What happens when we choose to get out and be a little more adventurous?

Walking hills = Increased demand + increased need for strength

Let’s look at a popular local walk – Waterfall Gully up to My Lofty summit. The walk itself is fairly short, 2km to the top and a total of 475 metres of elevation gain.

Now let’s hypothesise that you weigh 65 kilos and are carrying a couple of litres of water, a snack and a camera. You need a camera to capture the waterfalls, abundant wildlife or the children/grandchildren running ahead. So you’ll have maybe a total of an extra five kilos (maybe 20 kilos if the grandchild gets tired and you have to carry them). So now you have 70 kilograms or more and you’re asking your body to haul you 475 meters into the sky, whilst covering 2 km of distance.  

That’s a fairly big increase in stress that the body now has to deal with. What should you do now? Read on.        

Add some strength training sessions to your week

Our bodies adapt to the stresses we place upon it and they do this quite efficiently. If you add increased load a few times per week (strength training) our bodies will adapt to these stresses and will become stronger and more able to cope with higher levels of stress. This results in a few things:-

  1. You will have a lower risk of injury
  2. A higher enjoyment rate during your walks
  3. You may even be able to keep up with the little ones.

Additionally, you also have the ability to test yourself more in some longer or more challenging walks. All in all, you will be more resilient and capable than before.

If you are unsure how to build strength, seek advice

Strength training can be beneficial to your health and well-being in many ways, if done incorrectly it can also potentially cause injury. If you are not experienced in strength training I would strongly advise you to seek professional advice and ensure you are both doing exercises correctly and that you have exercises prescribed that suit your specific needs.

From 0-to-1000km: Mobility for cyclists to keep you riding longer!

From 0-to-1000km: Mobility for cyclists to keep you riding longer!

Road cyclist fatigued!

Road cyclist fatigued!

Wow, I can’t believe its only 4 weeks until we leave for Melbourne to start our 1000km bike ride back to Adelaide for the Leukaemia Foundation’s RideasOne! It’s been a little while since my last post on the series – sorry! But I promise I’ve been on the bike!

 

In fact, since we last chatted,  I have fallen in love with road riding. For a trail addict (running and mountain biking), I never thought I would put that in writing! But the growing sense of strength climbing up hills, the speed of a light and responsive bike flying down hills, and the camaraderie and great chats of group rides has been something that gets me out of bed in the early mornings with a smile on my face!!

 

Dealing with Fatigue

By now the kilometres on the bike are starting to really build, due both to a few months of riding, and the ‘pressure’ of time getting shorter and shorter ahead of us! So one thing I’m aware of personally, and I think also for my riding companions is that this is the time when little niggles may start to appear; in the form of tight muscles or joints, and perhaps little aches and pains as our bodies compensate for the increasing demands by tightening up.

 

So this is the time that looking after our muscles and joints becomes paramount to make sure that we get to the starting line healthy!! This ideally involves a warm up before we ride as well as a cool down, and even some other sessions of mobility and flexibility work during the week. The one negative thing about road cycling is the amount of time that is spent in a pretty fixed and flexed position. It is not unusual  to spend 3-5hrs o the bike, especially during the weekend rides, and most of this is spent in repeated hip flexion with a flexed trunk and arms fixed to the handlebars… so there isn’t a lot of extension or rotation going on!! So ideally these warm up and cool down sessions focus on stretching and ‘mobilising’ a lot of these joints that are ‘stuck’ in very short ranges of motion for kilometres on end.

 

Warm ups are important

I know that for most riders a warm up entails nothing more than pulling on the lycra, pumping up the tires and perhaps taking it easy for the first few Ks of riding; and cool downs revolve around checking out our stats on strava! I also know that anything else for a warm up is a hard ask, as most rides need to start very early in the morning, so consider spending even 5minutes preparing the body for the fun work ahead, and focus more on the post ride mobility sessions – your body will love you for it!!

 

This will be particularly important for those of us doing a multi-day event such as the 7-day Ride-as-One from Melbourne to Adelaide, to ensure we give ourselves every chance to keep our bodies in good form as fatigue sets in!

 

An optimal mobility session should improve performance and reduce our risk of injury, while only taking 10-15 minutes to complete.

Ideal Mobility for Cyclists Routine

There’s a well established process for achieving best results during one of these sessions:

  1. Ideally one should start with  some self ‘releasing’ (think about the type of ‘soft tissue’/massage type of treatment that a therapist  would do to you). This is referred to as Self-Myofascial Release (SMR). Any time you use a foam roller or some sort of ball on tight muscle tissue, you are performing some form of Self-Myofascial Release (SMR). SMR is suggested to improve mobility at joint segments and the flexibility of specific muscle tissue.
  2. Once we have reduced the stiffness of specific muscle tissues through effective SMR, it is time to move onto stretching. These stretches are going to be short and to the point! with the intent to increase the length of short and stiff muscle tissue. By increasing the length of these specific tissues, we can increase the flexibility of that tissue AND increase the range of movement we have at the joints in which that tissue acts on.

 

The reason we want to keep these stretches short (~10-20 seconds) is twofold. Firstly, we want to reduce our total mobility time to something efficient and sustainable. Additionally, in our experience, short and strong stretches where we try and focus on ‘teasing out’ the muscle tissue are extremely effective.

 

The key areas we are going to focus on are:

  1. Hips – including hip flexors at the front and glutes posteriorly
  2. Quads and hamstrings
  3. Thoracic/rib cage region

 

Spend 10-15mins after your rides going through the program described in the PDF below and let me know if it helps! 

iNform Cycling Mobility and Self Massage Program

 

If you would like more specific advice for your needs, don’t hesitate to contact us!