5 Ways To Reduce Injury: Part 1

When it comes to injury prediction and prevention, there is no magic bullet. Despite the influx of technology and tracking, there are still prevalent injuries that we continue to see. It isn't uncommon to see athletes, particularly youth down and out for weeks and even seasons. The simple yet inconvenient truth is we’re never going to be able to accurately predict all injuries, much less prevent them. That being said, over the course of working with a range of athletes, I have a few simple guidelines for physical preparation and training protocols that are important and help to reduce injury rates. These tips don’t just apply to those of sport, but various training levels as well.

1. The Importance Of Symmetry

I’m a big believer in basing a program around staple bilateral movements such as squats, deadlifts, and Olympic variations, as they provide an excellent opportunity to develop strength and power through numerous joints and muscles, linking the feet to the shoulders. And yet if athletes do these alone, they can still develop or possess imbalances. We know that one of the biggest predictors of future injury is previous injury (and of course, severity is important as well). Any injury to a joint, muscle, ligament, tendon, or motion segment naturally makes us overcompensate on the other side, while de-emphasizing the injured one as a self-protection mechanism.

When performing bilateral movements, it’s possible for the side that hasn’t been hurt to compensate for the one that has, and the outcome – performing a squat, say – feels fine for the athlete and looks good to me, the coach. But then one day the athlete is running sprints in training and tweaks a hamstring. Or maybe they go down for the count in a game with a groin pull. This isn’t just an acute event, but the result of allowing bilateral movements to hide the asymmetry and combination of overcompensation and under-emphasis that has developed after they recovered insufficiently from injury. As almost every athlete has been or will be hurt at some time, we need to add in more unilateral movements to our training. These can shine a light on an asymmetry, restriction, or compensatory pattern, allowing us to then address it through mobility work, single-side strengthening, etc.

So for example...a player who previously injured his left shoulder might do fine with a barbell bench press, at least until he doesn’t one day. But by switching him to dumbbell bench press, we see that he’s shaky on that injured side, even with a lightweight. Well, now we’ve identified an instability or weakness and can start remedying it.

Personally, I tore my Achilles on my left leg, which has affected my entire left side and made me favor the right. So I know I need to be doing step-ups and other unilateral leg work to maintain strength on that weaker side, while also doing more proprioception and mobility on it…this never stops!

2. Beware Of Variety For Variety's Sake

As coaches, we often fear our athletes are going to get bored or, worse still, burned out by doing the same old routine in the gym time after time. So we start mixing things up. It’s fine if these are purposeful variations with a clear rationale. However, if we start giving in to the temptation, or even athletes’ requests, to follow the latest fad or trends, we can soon run into trouble. This applies to exercise selection as well and loading/sequencing patterns. For example, maybe isometric work is popular in one moment; a few months later, coaches have moved on and now emphasize eccentric training. While every session does not and should not need to be identical, we should avoid programming variety for variety’s sake.

Every time an athlete has to learn a new movement, there’s a change in neural and mechanical stress and an unknown “load” as it is unfamiliar. If you are in a sport, you may only have one session a week to improve or maintain lower body strength at a high level. If we compromise the intensity of the session each week by changing the exercise, we go nowhere fast. Unfamiliar exercises require an element of learning the movement and how to sequence and load it, which can impact fatigue and produce increased muscle soreness (DOMS). This lack of familiarity reduces the intensity we can push and can create an unwanted risk of injury. On the flip-side, the old adage “familiarity builds intensity” is very true. When your athletes are performing exercises they’ve mastered, they instinctively know when to push and when to back off, how to identify and self-correct errors, and what a “good” or “bad” session feels like.

The same is true of aerobic work. If you have your athletes do a 5K or 10K run weekly, they’re going to become adept at pacing themselves well to finish it, understanding their cadence, and fine-tuning their form. They won’t achieve such competence if you keep switching up the distance just for the heck of it.

To be continued! Check-in next week for the other 3 ways to reduce injury!