Prevent Sport Injuries with Physical Therapy

Having played competitive cricket and table tennis in school, I am no stranger to sports related injuries. Some of my injuries were strains/sprains while others required surgery. Rehabilitation played a major role in helping me recover and return to my sport. But in the back of my mind, I always kept thinking “Could I have avoided it?” I had always known that in order to play I had to condition my muscles with proper strengthening and stretching exercises. But my methods were inefficient. I relied on online videos or tried to mimic my friends in the exercises they were doing. In hindsight, both modes of information gathering were amateur and may have played a role in me getting injured again and again.

My education and training in the field of therapy advanced my knowledge on the science of how our bodies work and finally I was able to find the link between playing sports and injury prevention. Does that mean everyone who loves playing sports now has to go through school again so they can learn to prevent injuries? Well while that’s an option to consider it’s not feasible. But I can certainly shed some light and give helpful information in this blog so you have some principles handy to decrease your risk of injury.

Injuries are inevitable in any sport. Some of the more common injuries we often hear about are:

• Rotator cuff injuries and tendinitis of shoulder muscles
• Labrum tear (SLAP) lesions
• Tennis Elbow and golfer’s elbow
• Muscles sprain and tear or pull (hamstring, adductor, quads, calf)
• Ligaments Sprain and tear
• Repetitive stress injuries
• Bone fractures
• Joint dislocation and subluxation
• Hip impingement syndrome and labrum tear
• Ligament injuries in the knee especially ACL, MCL and LCL
• Meniscal injuries
• Shin splints
• Runner’s knee
• Patellar tendinitis
• Ankle sprains and instability

If you play sports, recreationally or a professionally, you are susceptible to these listed and more injuries. Mechanisms for these injuries are variable. It may happen due to direct contact, i.e. getting hit directly, or due to incorrect positions/ body mechanics or overuse injuries by repeatedly straining the body in the same pattern. Then, there is also, just plain bad luck.

The prognosis of injuries depends upon their severity. It can be taken care with conservative methods which include Physical Therapy, Chiropractic, and Acupuncture, pain management and/or surgical methods.

That’s great; there is a solution to the problem. But what if we can avoid those injuries or prevent it, in the first place. Now you are probably thinking “Prevention is better then cure”.

Today we have access to all modes of information on a variety of exercises that we can do. The available information can be vague or it is detailed. We all recognize that our bodies, our level of strength and tolerance to activity are different. So an exercise that works for one person may not work for another. Everything available out there is not beneficial or needed to you. This is called “personalization”. This is the first and most basic principle for Injury Prevention. A personalized plan takes into account your current level of fitness, identifies your weakness and strengths, based on which, you then determine the type of exercises, intensity of exercises and how to progress the exercises.

Some other key factors you need to be aware of for injury prevention are:

1. Static stretching doesn’t work. Replace it with dynamic stretching.

So you did your standing calf stretch 10s hold, 10 times and now you are good to go. Now you have less chance of getting injured because “you did your stretches”. Well that is a misconception.

When our bodies are moving, our muscles are constantly in motion. A muscle does its job by alternately getting longer and shorter. So when you point your ankle to the ground the calf muscle is getting shorter, but when you point your ankle up towards your chin the calf muscle is getting longer. When we walk as our ankle moves up and down so the calf alternately gets longer and shorter.

So while you do your standing calf stretch, you are stretching it only at the end of its range, i.e. making it longer. You are not doing anything to help the muscle when it is shortened.

In contrast, during dynamic stretching, the muscle gets stretched in both on and off phase. Your body will naturally allow the short muscles to lengthen and overstretched muscles to shorten, as it finds its natural state of balance. So you get a more “functional stretch”.

Let me clarify it with an example. As you see below, pic A is a calf stretch that we are all normally used to. The exercise in the video is a dynamic stretch for the calf. In Pic A you are only stretching the muscle when its longer. In the video, you are stretching the muscle in both phases making it more beneficial for overall ankle movement.

For an exercise to be beneficial, you shoulder feel a difference in your body. You should feel more grounded, stable and note ease in movements.

2. Co-working eccentric and concentric contractions

Eccentric strengthening means muscles are lengthening under load. Concentric strengthening means muscles are shortening under load. In our usual training we mostly focus on one or the other. However, in reality during daily activities both of these actions work as an inseparable pair with opposite functions.

For Example, when you begin to jump, which direction do you move first? Majority of people will sit/squat a little before jumping to reach higher. With this movement, you are first lengthening your muscles, i.e. eccentric movement, and then with the jump you are shortening the muscle, i.e. concentric movement. So this movement is a combination of lengthening and shortening which is the reason you generate more force and successfully complete the movement.

For true Sport Injury prevention, you really have to train your muscles to work simultaneously in variety of lengths, i.e. short, long or mid range with functional exercises.

3. Single Dimensional Vs. Multi Dimensional

During Majority of exercises we focus on single dimensional training. However, we do all our activities in multi dimensional plane. So what is multi-dimensional strengthening? First let’s discuss a little about why you need it.

When a competitive soccer player stretches plays after doing calf stretch or adductors stretch for few minutes he/she has conditioned his body to move in a single dimension. During play, however, no one can predict the direction of the ball and the player ideally needs to be ready to respond in any/all direction. There is a need for speed, strength, balance and body alignment in all directions in this scenario. This can only be achieved with multi dimensional training.

Single plane exercises, like a bicep curl is beneficial for increasing muscle strength but to train your body in all directions and reduce risk for injuries you have to incorporate multi dimensional strengthening.

At Physis, after a thorough evaluation we develop a personalized treatment plan which focuses on reducing pain, developing strength, stability, control which goes a long way in prevention of future injuries as well.

Please call us for further details on 212-706-7480 or email us at info@physisrehab.com.