Transcript Injury Care & Prevention Presented by: Melanie Headrick

Injury Prevention &
Management of Injuries
Presented by:
Karen Craven
BSc(PT),Dip Sport (PT), CSCS
Prevention
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Through –
 Training Program Design
 Physical Conditioning
 Nutrition/Hydration
 Warm-up and Cool-down
 Stretching
 Monitoring of over-use signs and
symptoms
Training Program Design
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Appropriate type of training stimulus
Ample rest and recovery time
Specific to your sport
Specific to improve your weaknesses and
maximize your strengths.
REST…
is the most important part of
your workout.
Between workouts there
must be ample time for
recovery
Complete recovery time required following
various types of training inducing HIGH
fatigue
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Type of training
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Speed
Strength
Anaerobic lactate
Aerobic Power
Aerobic endurance
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Recovery time
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24 hrs
48-72 hrs
48 hrs
48-56 hrs
56-72 hrs
N.B. Obviously, less recovery required when fatigue is not ‘high’
Discussion required of these points!
Modified from Platonov, 1988, via Marion (1995) & Balyi, NCI-Victoria
Physical Conditioning
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Strength – gluts, hamstring/quadricep ratio,
ankle and calf, upper body
Neuromuscular coordination drills (ie SAQ
drills)
Good technique and execution
Balance and proprioception exercises
Plyometrics
Flexibility – ankle, thoracic spine
Aerobic/anaerobic conditioning
Golden Rules...
During any given training session, quality of
exercise performance is the cornerstone of
the training program.
Think of the Means of skill
performance, not the end product.
Your body needs 8 to 10 cups of fluid during the day to
stay hydrated
Fluid Intake Guidelines
Before event- drink 500 ml (2 cups) water
During the event- drink 150 to 300 ml every 15-20
minutes
for events < 1 hour WATER is good
for events > 1 hour a source of carbohydrates helps to
delay fatigue.
Choose a beverage with 4 - 8% carbohydrates
(i.e. 4-8g carbohydrates/100 ml)
After the event - consume enough fluid to replace all
losses.
1500 ml per kg of body weight lost
Hydration Status
100
90
80
Effect of
hydration status
on performance
70
60
50
40
1
2
3
4
5
6
Warm-up & Cool-down
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Increase body temperature
Increased readiness to participate
Increased efficiency of movement
Decrease in metabolic processes
Removal of Lactic Acid
Replenish Energy
Warm-up/Cool-Down
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Warm-up
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Should be Dynamic!
Cool-Down
Means slowing down (not stopping completely),
after exercise
 Continue to move around at a very low intensity for
5 to 10 minutes after a workout
 Finish with some stretching
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Stretching
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Muscles surrounding the hip, knee and ankle,
back
Daily stretching
Passive and active
Hold static stretches 30 sec. Repeat 3-5x.
Physical Activity
Muscle Fatigue
Altered Movement
Patterns
Altered Recruitment
Patterns
Altered
Proprioception
Abnormal Loading
Altered Stress Distribution
Increase in Compressive
Forces
Increase in Tensile Forces
Tissue Stress/Strain
All physiological training
is intimately dependent on
the concept of
progressive overload.
Overtraining and Overreaching
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Is an advanced expression of athletic fatigue. It
is characterized by a decline/stagnation in
performance, and is accompanied by a set of
physiological, psychological and biochemical
signs and symptoms.
Level
of
Physi
cal
prepa
redne
ss/fu
els
Training load
Next workout?
Too soon
Perfect
Supercompensation
Fatigue, decrease in normal functioning
level
Too late
Normal functioning level of the
body
Recovery of tissues and fuels
after training session
Adapted from NCCP Task #6 readings
Ref. Page 30
Workout during
supercompensation phase
Fitness gain!
Baseline fitness
Sufficient recovery =
performance gains!
Workout before
supercompensation phase
Baseline fitness
Fitness loss!
Insufficient recovery =
performance decrements!
Staging of Tendinitis/Overuse
Syndrome/Under-recovery
SYMPTOMS
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Stage I:
 Pain only after activity.
 Does not interfere with
performance.
 Often generalized tenderness.
 Disappears before next
exercise session.
Stage II:
 Minimal pain with activity.
 Does not interfere with
intensity or distance.
 Usually localized tenderness.
TREATMENT
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Modification of activity.
Assessment of training pattern.
Possibly NSAIDs
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Modification of activity.
Physical therapy; NSAIDs;
consider orthotics.
Reid, 1992
Staging of Tendinitis/Overuse
Syndrome/Under-recovery
SYMPTOMS
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Stage III:
 Pain interferes with activity.
 Usually disappears between
sessions.
 Definite local tenderness.
Stage IV:
 Pain does not disappear
between activity sessions.
 Seriously interferes with
intensity of training.
 Significant local signs of pain,
tenderness, creptitus, swelling.
TREATMENT
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Significant modification of activity.
Assess training schedule.
Physical therapy; NSAIDs;
consider orthotics.
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Usually need to temporarily
discontinue aggravating motion.
Design alternate program.
May require splinting.
Physical therapy and NSAIDs.
Reid, 1992
Staging of Tendinitis/Overuse
Syndrome/Under-recovery
SYMPTOMS
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Stage V:
 Pain interferes with sport
and activities of daily
living.
 Symptoms often chronic
or recurrent.
 Signs of tissue changes
and altered associated
muscle function.
TREATMENT
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Prolonged rest from activity.
NSAIDs plus other medical
therapies.
Consider splint or cast.
Physical therapy.
May require surgery.
Reid, 1992
Symptoms of Overtraining
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Apathy (no emotion)
Lethargy (tired all the time)
Depression
Decreased self-esteem
Emotional instability
Impaired performance
Restlessness
Irritability
Disturbed sleep
Weight loss
Loss of appetite
Increased resting heart rate
Increased vulnerability to injuries
Muscle pain/soreness
Preventing Over-training
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Set realistic and flexible training/game goals
Physical conditioning
Practice quality not quantity
Keep program flexible
Allow for rest and recovery
Relieve Stress
Nutrition and hydration
Recovery techniques (Active Rest, Relaxation,
Massage, Hot/Cold etc)
Preventing Over-training
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What to Monitor:
Morning heart rate
 Sleep
 Mood
 Appetite
 Weight
 Hydration Status
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Injury Care
Vicious Circle
Joint
Damage
Muscle
Weakness
Reflex
Inhibition
Muscle
Wasting
Immobilization
Common Signs of An Injury
 Painful
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to move or use
Swelling
Discoloration
Warm to touch
Basic Treatment of Injuries
R.I.C.E.R
REST AND RESTRICTED ACTIVITY
 ICE
 COMPRESSION
 ELEVATION
 REFER TO MEDICAL
PROFESSIONAL
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Rest
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Immobilization in anatomical
position
NWB Crutch walking
PWB Crutch walking with pain-free
heel-toe gait as tolerated
FWB with pain-free gait without
limp
Ice
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15-20 minutes per time, 5-7 times a
day (every couple of hours)
First 48 hours most important time
DON’T FREEZE!
After activity (NOT before or during
activity)
Place wet towel between skin and
ice
Compression
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Minimize swelling with a tensor
Don’t wear at night
Elevate
Keep the ankle at or above waist level at all
times when the patient is not active
 Should be continued until the swelling has
resolved
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Refer
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Refer for medical advice for injuries requiring
additional treatment
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Receive permission to return to sport from a
medical advisor
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Ensure joint is well supported on return to
sport (ie. Brace or tape)
Seek Treatment:
“The earlier the better!!”
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Sport Physiotherapy:
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Movement patterns
Alignment
Asymmetries/imbalances
Resting and active muscle tone
Flexibility and joint range of motion
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STAGES
OF
REHAB
RUNNING
PROGRESSION
RULE OF THIRDS
Magee
Therapeutic Exercise Program
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Control Inflammation (RICER)
Modify training
Rehabilitative exercises from physiotherapist
Gradual introduction of muscular strength, endurance
and power
Progressive and gradual return to sport activity
Maintain strength of opposite limb
Core stability and flexibility
Maintain cardiovascular fitness through alternative
exercise (ie swimming)
Success is...
not an accident, but rather the product of a
thoughtful and well executed plan
The End
THANK YOU!
306-934-2011
[email protected]