1. Chapter 4 Sports-Injury Prevention

2. 2 Types of Causative Factors 1.Intrinsic Factor – * 2.Extrinsic Factor – originating from the outside

3. Causative Factors in Injury Intrinsic Factors Age * Body size * Fitness level * Skill level *

4. Risk Factors in Specific Body Areas Upper Extremity: Ligamentous laxity * Shoulder girdle weakness Lower Extremity: Tight, weak hamstrings * Joint malalignments * Study by Moskwa and Nicholas

5. Causative Factors in Injury Extrinsic Factors Equipment * Type of activity *

6. Intervention Strategies Extrinsic factors such as faulty equipment, dangerous facilities, etc. can be easily recognized and corrected. Athletes in high-risk sports MUST be educated about hazards and prevention. NCAA and NFHS have developed guidelines for medical evaluation of student/athletes.

7. Intervention NCAA Guideline 1B PPE (pre-participation physical examination) is required upon entrance into athletic program annual updated medical history unless additional medical exam is warranted based on the updated history. NFSH policy PPE required prior to first year of participation. The primary purpose of PPE: Identify preexisting injury risk factors as well as ascertain any injuries/diseases that are potentially problematic.

8. PPEs Historically known as “annual physical,” “physical exam,” and “pre-participation medical evaluation.” ***** Physical exams can identify: spina bifida occulta absence of one of paired organs * high blood pressure cardiac defects or arrhythmias * vision deficits *

9. PPEs AAP recommends PPE biannually (or when athlete enters middle/high school) with annual update including: comprehensive history, height, weight, and blood pressure. UIL recommends PPE biannually LTISD requires PPE every year Two forms of PPEs: Office-based works well when physician is familiar with athlete’s medical history * All information obtained during examination should be handled appropriately to protect athlete’s confidentiality.

10. Preseason Conditioning An essential aspect of any injury prevention program is the optimal development of physical fitness in the athlete General Conditioning: aerobic fitness, muscular strength and endurance, flexibility, nutrition, and body composition Sports-Specific Conditioning: all aspects of the sport that are unique to it

11. Conditioning Aerobic fitness Regardless of sport, all athletes benefit from improving aerobic fitness. Aerobic fitness can assist in avoiding injuries related to general fatigue Muscular strength and endurance: Muscle strength is defined as maximum amount of force that can be produced in 1 repetition (Power = Force x Velocity) Muscle power is much more important than overall strength * Increased bone density * Increased muscular endurance *

12. Muscle Strength, Power, and Endurance Training volume – * The higher the training volume in a given workout, the lower the amount of weight lifted in any given set of repetitions Training intensity – the amount of weight lifted per repetition Also, the faster the repetition is performed, the higher the intensity * Training Frequency – the number of training sessions completed in a given period of time Most strength-training programs incorporate between 3 and 5 workouts per week Moderate – to high-intensity training requires 24-48 hours for recovery *

13. Conditioning Flexibility: ROM in a given joint or combination of joints Improved flexibility has been determined to reduce the incidence of musculoskeletal injuries *

14. Conditioning Determinants of ROM: * bone structure * age * Two types of flexibility are static and dynamic flexibility. Four types of stretching are ballistic, static, PNF, and passive.

15. 4 Types of Stretching Ballistic Stretching – powerful contractions or muscles Static Stretching – holding a stretch for at least 3 seconds PNF Stretching – uses the body’s proprioceptive system to stimulate muscles to relax Passive Stretching – having someone other than the athlete move them thru ROM

16. Conditioning Nutrition and body composition: The body responds to a conditioning program more effectively when it receives proper nourishment. Coaches, parents, and athletes must take care to avoid an overemphasis on leanness.

17. Periodization Process of arranging training around specific goals and objectives. Organizes training into cyclic structure based on competitive sports seasons Manipulates exercise frequency, intensity, and duration *

18. Periodized Program Most training programs designed around a 1-year period of time (macrocycle) microcycle – 2 to 4 weeks mesocycle – several successive microcycles transition phase – 2 to 4 weeks between training seasons or microcycles (goal is to allow the athlete to recover) © BananaStock/age fotostock

19. Off-Season Programs Progress the athlete through 3 distinct phases: Hypertrophic/Endurance Phase – strengthen the connective tissue surrounding the muscle fibers and tendons attaching the muscles to bones Lower intensity with higher volumes Strength Phase – increase the strength of the involved muscle groups Higher intensity with lower volumes Power Phase – focuses on the development of higher- velocity movements Intensity is very high

20. Modification of Extrinsic Risk Factors Practice/competition environmental conditions, especially heat and humidity, must be assessed. Facilities must be designed, maintained, and frequently inspected for safety. Coaching personnel and administrators MUST monitor these factors.

21. Modification of Extrinsic Factors Indoor Facilities: Lighting * Room dimensions * Locker room and shower facilities Outdoor Facilities Safety fences * Location of dugouts * Water and sanitation facilities *

22. Protective Equipment Protective equipment plays a vital role in the prevention of injury Virtually all sports can benefit from the use of some form of safety equipment—including mouth guards