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Six Ways To Prevent Sports Injuries

Get warm, co-ordinated, relaxed, smart and mobilized!

800 words, updated Sep 9th, 2014
by Paul Ingraham, Vancouver, Canadabio
I am a science writer, the Assistant Editor of ScienceBasedMedicine.org, and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I’ve written hundreds of articles and several books, and I’m known for sassy, skeptical, referenced analysis and a huge bibliography. I am a runner and ultimate player, and live in beautiful downtown Vancouver, Canada. • full bioabout SaveYourself.ca

Weekend warriors and a lot of amateur athletes tend to believe that injury prevention is pretty much all about having a stretching regimen, and they are usually feeling guilty about not doing it enough. If I had a buck for every time I’ve heard someone say, just before a game of ultimate, “I should really do some stretching” … well, heck, I could afford to play ultimate for a living.

Lucky for them, they aren’t really missing anything important. As established elsewhere, stretching doesn’t really work for the things people think it does, and it is particularly useless at preventing injury.1 Here are five ways to prevent injury that are a much better use of your time …

Warm up

The best known was to prevent injury is to warm up.23 Prepare for any intense activity by doing a similar activity less intensely. In other words, start slow! To warm up your tissues, you need metabolic activity: the heat causes physical changes in connective tissues that make them more pliable. Many more complex benefits arise from the stimulus of mild physiological stress. Mobilizations (discussed below) are an excellent warmup method, but really it’s just a matter of starting intense activities slowly.

Conversely, don’t overdo it. I’ve seen sports teams crimmage for an hour before game time. I think that’s crazy: players go into competition not only warmed up but worn out. In competition, you can’t afford to give up any resources, and you only have so much juice in a day — no matter how fit you are. Athletes get hurt far more when they are tired than when they’re fresh.

Speaking of being tired…

Get your zzzleep

As just mentioned, tiredness is a major driver of injury. And sleep deprivation is an almost universally underestimated problem, as well as a factor in pain.4 People who actually do get enough sleep are extremely rare, and of course actual insomnia is a common problem. Insomnia treatment is not as hard as people think, and it’s a great indirect injury prevention tip, something that is definitely relevant to performance and injury risk — but has nothing to do with what you’re doing before, during, or after workouts.

Cultivate coordination

Many traumatic injuries are probably caused by a lack of coordination — an inability to sense and respond to traumatic forces. Developing coordination takes diligent practice at complex tasks. But you can make some progress simply challenging yourself with a wide variety of activity and sensations, and coordination can be improved.5 Again, mobilizations are your friend.

Chill out, man

Adaptability prevents injury, and rigidity is the opposite of adaptability. Relaxation is more psychological than golf. To purge rigidity from your system, you will have to go on journey of self-exploration: most tension is emotional and protective. You won’t be able to relax and be “comfortable in your own skin” until you know yourself better. Meanwhile, you’ll get more injury prevention mileage.

Play smart, not hard

Many injuries are caused by excessive and mis-directed effort! That might seem like a bit of a no brainer, but people need to learn this. I certainly did. It is one of the great lessons of martial arts.

I remember the day I learned this lesson in ultimate, watching an older woman play. She seemed unlikely to be competitive — she was simply too old, and a little overweight. In fact, it turned out that she was the best player on the field that day, entirely because she was clever. I particularly remember how little she ran. Although there were certainly bursts of intensity, her effort was precise and savvy, and time and again she got the better of other players with only a fraction of the sweat.

Mobilize

Mobilizations are rhythmical movements that gradually expand your comfortable range of motion, providing your tissues with a variety of stimuli and stresses. The basic philosophy of mobilization is “use it or lose it.” It is a specific method of warming up that also cultivates coordination and relaxation. A link to more information is listed below.

And don’t waste your time stretching! As far as I know, stretching does not have any general injury prevention benefit.

About Paul Ingraham

I am a science writer, former massage therapist, and assistant editor of Science-Based Medicine. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook and Google, but mostly Twitter.

Notes

  1. Stretching just doesn’t have the effects that most people hope it does. Plentiful recent stretching research has shown that it doesn’t warm you up, prevent soreness or injury, enhance peformance, or physically change muscles. Although it can boost flexibility, the value of this is unclear, and no other measurable and significant benefit to stretching has ever been proven. Regardless of efficacy, stretching is inefficient, “proper” technique is controversial at best, and many key muscles are actually biomechanically impossible to stretch — like most of the quadriceps group (which runners never believe without diagrams). If there’s any hope for stretching, it might be a therapeutic effect on muscle “knots” (myofascial trigger points), but even that theory is full of problems. See Quite a Stretch: Stretching science shows that a stretching habit isn’t doing much of what people hope. BACK TO TEXT
  2. Soligard et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. British Medical Journal. 2008. PubMed #19066253.

    Research has shown for years now that good ol’ stretching doesn’t really prevent athletic injuries. So what does? Warmups that “improve strength, awareness, and neuromuscular control” might just do the trick. Practicing coordination and control, basically (see Panics et al). In 2008, Norwegian researchers compared injuries in over a thousand female footballers who participated in such a warmup for a season, to another several hundred who didn’t. Athletes who warmed up had fewer traumatic injuries and fewer overuse injuries. Moreover, the injuries they did have were less severe. Static stretching was not part of the warmup, but “active” stretching was (i.e. Mobilize!).

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  3. Soligard et al. Compliance with a comprehensive warm-up programme to prevent injuries in youth football. British Journal of Sports Medicine. 2010. PubMed #20551159.

    Researchers found that injury rates were significantly lower in soccer (football) teams that diligently performed warmup exercises (“The 11+”, a warmup program recommended by FIFA, which notably does not include stretching). On the one hand, there was not much difference between a little warming up (low participation) and a bit more warming up (average participation). But players and teams that did an especially good job of warming up (“twice as many injury prevention sessions”) got solid results: “the risk of overall and acute injuries was reduced by more than a third among players with high compliance compared with players with intermediate compliance.” That extra enthusiasm went a long way!

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  4. Almost everyone needs to take sleep deprivation more seriously. We are used to thinking of insomnia as a symptom, but it can also be hazardous in itself in many ways. Chronic pain is probably aggravated by insomnia or even mild but chronic sleep deprivation. For more information, see Insomnia Until it Hurts: The role of sleep deprivation in muscle pain and other kinds of chronic pain. BACK TO TEXT
  5. Panics et al. Effect of proprioception training on knee joint position sense in female team handball players. British Journal of Sports Medicine. 2008.

    A general warmup with an emphasis on coordination has been shown to reduce athletic injury rates significantly (see Soligard, for instance). Perhaps it is the neuromuscular or proprioceptive training component of this that causes the effect. A 2008 experiment compared athletes’ with and without this kind of training. Those who did it had a greatly improved sense of joint position. In other words, they really knew where their joints were! “This may explain the effect of neuromuscular training in reducing the injury rate,” the authors concluded.

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