The Hidden Risk of Returning to Play
It’s almost spring, and that means a return to many different types of sports is upon us. People of all ages will start increasing their workouts, lifts, runs and drills in order to get ready for the coming season. But there is a hidden risk of returning to play: most spring sport injuries don’t happen during the season, they happen in the first two weeks of training. They don’t occur in the mid-season due to too much training, they are a result of the transition from winter inactivity to full athletic participation and training. When the body is asked to perform at an elite level, without proper preparation, injuries are much more likely.
At Integrated Health Solutions, we focus on functionally rehabilitative Chiropractic. This means we are extremely interested in movement patterns and maximizing human performance. We don’t want to just treat injuries after they happen, we are very interested in their prevention as well. Improper movement patterns, joint restrictions, and lack of muscle activation make some injuries inevitable, before an athlete even stepped foot on the field.
This blog is for athletes and the parents of young athletes who want to start the spring season strong, healthy, and with every competitive advantage that proactive care provides.
Today we will go over possible preseason preparation that can decrease risk of injury, signs to look for that indicate an injury is more likely, and how to focus on avoiding injury instead of relying on reactive treatment. That is the key to a healthy season.
Common Types of Injuries
Usually, the most common type of sport injuries are fairly specific to each sport. With ankle sprains being more common amongst soccer, track and lacrosse players. Shin splints and stress fractures shared among the running sports, shoulder issues usually affecting baseball, softball, and tennis players. While knee pain and lower back pain are more equal opportunity injuries. Each of these sports is harder on the respective joints that are most used in the field. The injuries usually spike the most in spring for two reasons. Basically, a deconditioning that occurs in winter, that is followed by a rapid ramp-up in activity and intensity in the spring. This 1-2 punch can be really hard on the body and especially difficult on growing bodies that may have additional muscle strain just due to rapid growth. These 2 things can lead to faulty movement patterns that can fundamentally change how an athlete accomplishes specific movements. These deviations from ideal movement are much more likely to cause injury.
Sometimes these faulty patterns stick with an athlete through many seasons and result in multiple injuries or even a repetition of the same injury over and over again. For example multiple ankle sprains on the same ankle. In this case, the cause may be the same and can keep resulting in the same effect. These deficits can be addressed to not only truly heal and rehabilitate the injury, but also to buttress the ankle against future injuries.
Preseason Preparation
The importance of good preseason preparation cannot be overstated. Muscles, joints, and even neural pathways can change and evolve depending on how much activity occurred over the winter. Increased tension in muscles, stiffness in joints, and even a decrease in activation of certain muscles can make a big difference in how you use your own body. Returning to an exercise you did last year and assuming you can do it in the same way when you’ve had significant downtime is not always a safe assumption. There is a big difference between being ‘in shape’ and having functional movements. True functional movements are what prevent injuries, especially during maximum effort. This can make the difference between a bad step on uneven ground causing an injury, or being no big deal. It can also be the difference between an average outcome and a PR.
Additionally, the ability to know where your body is in space, or proprioception, is another important factor impacting proper movement. Most athletes become quite good at this with repetitive training, but for younger athletes that are still growing, their bodies can change considerably during the off-season with growth spurts and other changes. This can lead to need to relearn how their own body moves in space a little bit. Additionally, during fast growth, coordination is sometimes affected.
What We Can Check
New patients that are seen for movement screens can be assessed for all the most common injury signs to see if they have changes to ideal movement and function that could affect the future. This would include joint restrictions and assessing to make sure the ranges of motion are where they should be. It would also include muscle activation, for example making sure that when extension is needed the gluteal muscles are extending the hip instead of having that extension come from the lower back. A solid core is essential for any type of explosive movements as that is the base that your limbs move against. These findings can greatly influence how competitive an athlete can be, in addition to predicting injury. For example, how much force can be generated by the athlete in a throw or jump, as well as speed and force transfer during kicks and throws are all affected by core stability, muscle activation, and muscle tension. Muscle relaxation is critical for explosive power. Tense muscles cannot generate the same force. So, in addition to preventing injury, we can maximize athleticism. This is why all professional teams and Olympians see professionals that assess them and keep them at the top of their game.
At-Home Strength and Activation Tips
Fortunately, a lot of this can be worked on and maintained at home with equipment such as bands, a lacrosse ball, and a foam roller. Common pitfalls that can be easily addressed at home include adding single leg balance drills to work out or play to increase ankle stability. This encourages good balance, proprioception, as well as strengthens the ankle to resist injuries such as sprains. Hips and the mid back tend to get too tight and stiff. So, exercises such as mid back extension, foam rolling, and rotational movements can maintain mid back mobility. Making sure the muscles of the hip are not tight can prevent groin injuries, quadricep tears, hamstring tears, as well as various types of pelvic and low back pain. Ensuring very strong gluteal muscles is probably the single most effective thing that can be done other than maintaining a strong core. Exercises such as clamshells, monster walks and walking lunges can help maintain good hip mobility as well as help avoid low back pain and protect the knee, especially in sports with fast direction changes such as soccer.
For shoulders, balancing the strength from the front of the shoulder and the back of the shoulder is essential. The shoulder joint does not have great stability as it maintains such a large range of motion. Protecting it can be simplified by just looking at the repetitive movements that are needed for a sport and finding an exercise that does the opposite. For example, a baseball pitcher should incorporate quite a bit of arm external rotation into their workouts since they are throwing forward repetitively. This helps keep the shoulder balanced and controls the force that they generate as they throw forward. So many sports train with strength and conditioning that too closely resembles actual play. Strength and resilience is found in true cross training.
Another great thing to remember is not to progress too quickly. This will avoid injuries related to overtraining and breakdown in tissue. Simply following the 10% rule to not increase your training volume by more than 10% from one week to the next. Training volume would include mileage, intensity, and time. This is especially important for growing athletes, as their muscles and growth plates are susceptible to injury.
How We Make a Difference
At Integrated Health Solutions, we are well-versed in the SFMA movement screens which help assess and catch the issues above. We understand how crucial diaphragmatic breathing is and how it integrates with core control. We are passionate about empowering patients to help themselves and to be able to keep doing what they love. During the exam we will assess proper movement of the spine, shoulders, hips, knees, and ankles. Elbows and wrists may be checked as well depending on the sport. This combination of functional movement screens and palpation allows us to assess for all three types of major issues: restricted joints, lack of muscle activation, and increased tension. If we find anything that is less than ideal we can address it through a combination of therapies we offer in our clinic. Dry needling is amazing at both activating tissue that is not properly turning on as well as relaxing muscle that is too tight. This is especially effective in areas that have been injured in the past. Soft tissue work such as “scraping” and myofascial release are used daily to release tension. We often show patients how to use lacrosse balls, massage guns, and foam rollers at home to maintain themselves.
Chiropractic adjustments are utilized in areas that are restricted or “stuck” in order to maintain proper mobility. muscle activation, flexibility, and joint mobility dovetail seamlessly for perfect functional movements. We also use functional rehabilitative exercises to return proper patterns, if they are not correct. The ultimate goal being to move in an ideal way without thinking about it, so you can avoid injury. And to know how to maintain that yourself! These exercises can be tailored to specific sports, so they are more relevant to each patient.
These treatment plans can be even more effective with collaboration between other professionals and coaches.
Start Strong, Stay Safe, and Have Fun!
The research is really clear that injury prevention starts before the first game, before the first whistle blow, before the first practice. Not all injuries can be prevented, but MANY can be. Bulletproofing yourself or your child’s body against the most common and easy to address issues and injuries may be as simple as an assessment with some take home exercises. Preventing injury while at the same time increasing athleticism and likelihood of a great season is a win/win!
Check out our website to see some of our incredible reviews and make an appointment to be evaluated today! Proactive care drives peak performance and encourages a happy and healthy season.
Content Provided By: Dr. Elizabeth Bouse
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