Can sporting injuries be prevented?
As long as we have sport there will always be injuries, but the number of injuries can be reduced by being sensible in approach. I believe that prevention can be divided into several areas.
Factors of prevention
- Paternity (genetics)
These four Ps of prevention are the special rules of helping prevent sporting injuries.
Preparation is essential in any sporting area. Without match fitness, any extra stress pulls on other faculties of the body. Sporting endeavours relies on a good training regime.
- Cardiovascular fitness develops with training, so that the person can concentrate on the game itself and not be struggling.
- Muscular fitness requires that the muscles have are appropriately stretched both prior and post-game and have enough strength to endure the activity.
- Coordination involves regular practice, with the development of neuromuscular ability.
Without these factors, extra stresses fall on individual joints to take up the slack at times of undue stress.
The older a patient becomes, the more important these factors are. Muscles tighten, cardiovascular fitness drops off and balance and reflexes are not as good as when the patient is younger. These factors are extremely important following an injury. Returning to sport following too short a period of rehabilitation will pre-dispose the patient to a second injury.
Whilst the ubiquitous nature of sporting events means that we all see players regularly returning to games after very short periods of rehabilitation, these are highly trained athletes of a professional nature who spend their whole day training, and in many situations the doctor and athlete may take a balanced risk for the sake of a once in a life time opportunity, such as playing in a grand final. For most people, we do not recommend returning earlier than necessary to sport to try to prevent further injuries.
In all sports the athlete can be protected by simple measures (common sense approach) such as the use of mouth guards, shin guards, appropriate strapping during the sporting endeavour and in many cases, such as skiing or sailing, helmets are recommended.
Participation can be defined by the level of sporting activities undertaken. All doctors would encourage a healthy lifestyle which involves undertaking regular exercise. Whilst enjoyment obtained from sport is extremely high, in many cases sport can be undertaken to excess. Most patients who suffer sporting injuries have been exposed to, or still involve the use of a “personal trainer”. While most trainers are aware of the importance of a balanced approach to training based upon the patient’s ability, age and expectations, some training regimes can be extremely excessive.
Training and utilising what is thought to be army-style techniques can be dangerous. In reality, these techniques are not considered to be used by the army as they are inappropriate and too dangerous. Examples include the use of dragging truck tyres around a sporting field with a rope tied to the torso, excessive lunges or jumps with weights on their back. Whilst these techniques are seen to encourage excessive force to build up the musculature, one must be aware that the muscles are only a small link in the biomechanical chain which also involves bones and joints. As a person’s age increases, their joints degenerate and wear out. Any forces placed through those muscles are also transmitted via that same muscle through the joint to the ground and wears out the joint extremely quickly.
Such activities can be particularly harmful to a patient, causing premature degeneration and may result in pain and arthritis. It also leads to weakness in the muscles, secondary to muscle inhibition (painful response leads to the muscle’s weakening and inability to work).
Therefore, the level of participation needs to be tempered in a sensible fashion. Whilst such activities may be recommended in certain sporting training regimes, for the vast majority of people, excessive training can do more harm than good, and can even possibly lead to heart and lung problems.
It is ironic that the patients who are hyper flexible are also the people who are the most likely to suffer from recurrent dislocations of the joints resulting in the requirement for surgery, and the development of early arthritis. The same applies to most injuries in that families are prone to develop the same injuries.
A patient’s level of flexibility can be determined by the family history, such as if the family had regular joint dislocations or anterior cruciate (knee ligament) ruptures. The patient’s ability to hyper extend their fingers, thumbs, wrists and elbows also demonstrates ligament laxity.
I like to divide the patients into two groups:
- “Stiffies” refers to those without ligament laxity
- These patients have stiffness and are more likely to develop back pain, osteitis pubis and tear hamstrings or sustain muscle tears.
- In these patients it is vitally important in their preparation to undertake a stretching regime to try to regain range of motion in all joints as much as possible, so as to take the stress off the ligaments and muscles.
- “Looseys” refers to those who do have joint laxity.
- These patients, as opposed to the stiff ones above, are more likely to dislocate shoulders, rupture anterior cruciate ligaments, dislocate fingers etc.
- In these patients, joint stretching prior to training is probably not so important as muscular toning. A good pilates regime to build up the patient’s core is even more useful in these latter groups.
In both groups of patients, an individualised training program is recommended, incorporating physiotherapists or involving a general practitioner/sports doctor.
Whilst sporting injuries cannot completely be prevented, the number of injuries can be minimalized by following these simple principles which we would highly endorse. If an injury does happen, it requires a holistic approach to prevent it recurring or resulting in new injuries. It is important to have a surgeon involved in the care who sees the patient in a holistic fashion and provides quality care.
At Glenelg Orthopaedics you can be reassured that our motto is to provide quality orthopaedic care and a holistic approach.