| sports
injuries
One of the most frustrating aspects for any sports person is injury; worse still recurring injuries. what are the causes? If we sustain a non-contact injury when environmental conditions and previous injuries cannot be blamed, the cause is most likely poor co-ordination. We are prepared to accept this type of injury as just one of the hazards of sport due to over-training, training whilst below par or just pushing too hard. Injury is seen as just bad luck or a sort of initiation into their sport, worse still, some regard it as a trophy or a sign of commitment. The
body has a built-in fail-safe mechanism activated by the stretch reflex,
called reciprocal innervation. When a muscle is contracting it ensures
the opposing muscle releases to reduce resistance to the movement. For
example in the patellar reflex (knee jerk) the tap of the hammer
stretches the rectus femoris muscle (one of the quadriceps). The muscle
spindle within the muscle activates the reflex and the muscle contracts.
At the same time the opposing flexor muscles (hamstrings) are inhibited
so as not to interfere with the movement. The stretch reflex is instrumental in coordinating muscular activity for balance. Its function can be impeded by excessive muscular involvement, a corrupt pattern, to the extent of not allowing the release of the opposing muscle. The outcome is a tug of war between the extensor and flexor, the loser is stretched as it is in the process of contracting, resulting in a ‘pulled’ muscle. A pulled hamstring is a common symptom of this problem. (Recent studies have found the tonus of the sub-occipital muscles, at the base of the skull, have an effect on movement of the lower limbs. Why does an injury occur? What condition allows a muscle to pull or a ligament to tear? Conventional advice on injury prevention in relation to movement includes: - Avoiding poor technique Maintaining good body alignment Using correct breathing patterns To
follow this advice is harder than it first appears. Few of us are fully
aware of what constitutes good technique from a movement perspective
because our learnt pattern is a habit. These patterns may become corrupt due to poor conditioning, yet we
remain unaware of the problem until an injury occurs. Up until this
point we may have been satisfied with our technique if we have had no
indication to the contrary. Following an injury new movement patterns
are established to compensate for loss of function thus degrading the
quality of movement further. Once this stage is reached avoiding poor
technique is impossible without first improving how we move by
eradicating the suspect patterns. Trying to correct a technique will
more likely increase effort as concentrating on the task translates into
muscle tension. Imposing a style on top of a poorly aligned structure
does not improve the structure. To
maintain good body alignment an athlete first needs to have poise to
allow good body alignment! If we have poor movement patterns, and
therefore questionable ‘posture’, we will not know what good body
alignment feels like and therefore be incapable of maintaining it. If
the quality of our movement is poor, attempts to achieve correct
breathing are futile. If the structure is unbalanced, natural
functioning cannot be resumed until the structure is balanced. Conventional
advice for injury prevention falls far short of addressing the real
issue. Avoidance of injury requires a well-balanced, poised and flexible
body capable of free movement in any direction with minimal effort. To
achieve this state requires integration of the voluntary and reflex
elements of movement, something we cannot achieve by trying harder. Many
struggle to regain form after a serious injury, some take months or fail
completely. Getting back into form will be slow if we do not know
exactly what it is that needs to be recovered. Natural talent for a
sport comes from the right sort of conditioning. Good quality movement
executed in the sporting activity sets up appropriate learnt movement
patterns that reside at a subconscious level. These ‘skill patterns’
can be replaced by new poor quality actions following injury and
possibly may never be regained. The
rehabilitation period is vital. Time spent walking on crutches or with
support will change the walking pattern. Within weeks a new pattern will
overlay the existing one, a reconditioning to compensate for the injury.
Following this type of injury, we may have a different manner of walking
but remain unaware that anything is wrong. Before any progress can be
made in returning to form, we must learn how to move naturally again. If
this is not undertaken, all actions will use the new corrupt pattern as
a foundation and impact upon performance. Remedial
exercise plays an important role in the recovery process.
However, to benefit from the treatment, it is essential to first
identify the cause and then to prescribe the appropriate exercise, and
secondly to perform them correctly. Too many people do not take these
exercises seriously and fail to complete the programme due to boredom or
impatience. Those who do the exercises often do so incorrectly. An
exercise to strengthen a recovering muscle should not be done with just
the specific part in mind. For example a knee exercise should not be
performed whilst stiffening the neck or other part of the body to
achieve the position and movement required. In the process of performing
an exercise in this manner, we set up a new pattern containing
inappropriate muscular actions that may eventually lead to further
complications. Where a problem is identified before an injury occurs, corrective exercises to address it may be prescribed in order to prevent it. However, this course of action is based on the assumption that the athlete has to do something new to offset the perceived problem. It is not generally considered that the athlete may already be doing something (wrong) that is causing the problem. If this is the case, they will continue to do this ‘something wrong’ whilst performing the new exercises. If the condition that led the perceived problem is still present the effect of the exercise will be limited or consolidate the pattern further. The use of our whole body and the impact of the movement need to be considered when performing exercise. A
recent audit by The Football Association in the United Kingdom found 58%
of injuries were non-contact injuries sustained during activities such
as turning, landing, slowing down and sprinting. A small, but worrying,
amount of injuries were sustained during mundane activities away from
the game including climbing stairs, getting out of cars and even
changing channel on the television (I only hope they were not injured
using the remote control). The reasons why injuries appear to be increasing are up for debate. Issues such as diagnosis and treatment, using unfit players and the pressures of the modern game are probably factors. More research into the nature of sports injuries will no doubt have an impact on the problem. However, whilst the emphasis is placed on the symptoms, it will have limited success. If a player has lost poise through the application of excessive effort, the prevailing culture of exercise will only encourage more of the same regardless of new methods designed to strengthen the perceived weaknesses. Why do players sustain so many injuries during natural activities such as running and turning? Do existing exercises for footballers affect movement? Concentrating on individual muscle groups does not promote integrated movement. It is imperative that the whole concept is rethought before ‘new’ preventative exercise programmes are devised. Where
poor technique is considered to be a factor in the injury, an individual
cannot be said to have made a full recovery, if they have not been made
aware of what it is they are doing to cause the problem. Once the wrong
use is identified, the important step of re-education
must
come next. It is not sufficient to simply instruct the individual to
stop doing A or B. They are already unknowingly doing A or B because
habit makes it feel right. The condition that allowed the poor habit
must be addressed to bring about a full recovery. Absence of pain does
not necessarily mean the process is complete. A motorist would not tolerate the need for repeat visits to the garage with a faulty car, yet when it comes to health many seem prepared to follow the injury-treatment cycle.
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