Chesapeake Orthopaedic and Sports Medicine Center
Information for our patients and community
Injury Prevention
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Chesapeake Orthopaedic and Sports Medicine Center
Information for our patients and community Injury Prevention
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INJURY PREVENTION and
CONDITIONING
James J.
York, M.D.
INJURY PREVENTION is:
Conditioning Aerobic Flexibility Strength Sports Specific Training Quality Coaching Conditioning: Aerobic Aerobic Conditioning = Improve "Wind" / Cardiac Conditioning Improved "Heart Stroke Volume" More blood per beat; lower resting pulse Improve Muscle Aerobic Capacity Increase Mitochondria (fuel furnaces) in muscle
Run to target heart rate:Intermittent Sprinting (Fartlek training) to improve Aerobic and Anaerobic capacity Train to the requirements of the sportRun to a pace where a conversation can be carried on Sprinting vs. running
Aerobic Conditioning"Days off" or "Light days" to decrease the risk of overuse injuriesHow often??3 x per week maintains fitness level > 3 x per week improves fitness level
Aerobic fitness should be designed into the practice A good practice moves quickly with several short rest and water breaks "Laps" are helpful but shouldn’t be the major focus of training. Issue of "laps" as disciplineFitness is your friend!! Not a punishment!! Conditioning: Flexibility Flexibility Ensure that joints can go to FULL range of motion Flexibility can be trained and improved Technique is important All of the major muscle groups
Warm-up; Stretch before training / play Cool-down; Stretch after training / play Conditioning: Flexibility Is it important in children? YES, YES, YES ESPECIALLY DURING GROWTH SPURTS Training to prevent injuries for life Especially important when coming back from strains A stretched muscle performs better; more power Conditioning: Strength Strength training Overall strength training Reduces risk of injury Improves Performance Sports Specific Strength Training Power training vs. Endurance Training Conditioning: Strength Strength training technique No more than three times per week No "back to back" days for same muscles Technique Slow, smooth action Exhale with Effort; Inhale with recovery Don’t lock joint Conditioning: Strength Strength training Power (muscle mass) training: 3 sets of pounds that cause fatigue (failure) after 8-10 reps Endurance training: 3 sets of pounds that cause fatigue (failure) after > 15 reps (much less weight) Conditioning: Strength Strength training for who? Children – when old enough to do the exercise correctly and consistently. Supervision is essential Age: 12 and up; particularly higher level performers Consider a personal trainer
Both Sexes Done properly doesn’t lead to excessive muscle mass in women Conditioning: Plyometric Rapid increases in strength Increased relative risk of injury Rapid muscle contraction after it is forcefully stretched Examples: Jumping after jumping down off of a box Repetitive jumping or skipping Incorporate into running training Conditioning: Core training Abdominals Sit-ups; "Crunches;" leg lifts Straight forward and oblique angles The Core must be strong to tie the upper and lower body together Conditioning: Balance Balance: "Propioception" Use of "Balance Boards" Should be able to stand on one leg with eyes closed for 30 seconds Use of Balance balls Conditioning: Sports Specific Throwing Catching Dexterity / Footwork Running / Sprinting Training running / sprinting technique Quality Coaching What is the coach’s training? Basic coaching training? On going training and courses? – Is the coach a "student of the game?" Coach’s understanding of child development? Child’s capacity to learn changes with age Is the coaching age-appropriate Quality Coaching Attitude Toward winning and losing Toward skill development Toward officials Toward players of varying ability Coaching boys vs. girls Making the sports experience FUN!
Overuse Injuries Accumulation of tiny injuriesOccur G R A D U A L L Y over time Start to appear about three weeks into the seasonMuscle / Tendon Ligament Bone
Overuse injuries: Examples Overuse strain (muscle / tendon)Overuse sprain (ligament of joint)Sore Shoulder; sore hamstring Shin splint Sore knee or ankle or elbow Stress fracture / Stress "reaction" of bone Painful leg (tibia) or foot (metatarsal)
Overuse: Signs & Symptoms Loss of performance The soreness that doesn’t go away after a day or two Persistent soreness with no specific injury Gradual Worsening Start to see it three weeks into training
Overuse: Treatment Reduce the length and intensity of training May need some time off Ice after training Lots of Stretching for affected muscles Orthopedic evaluation and Physical Therapy for more serious problems
Overuse: who is more at risk? Players with less conditioning Good well conditioned players – PLAYING MULTIPLE SPORTS OR IN MULTIPLE LEAGUES Multiple hard training sessions Many "back to back" practices or games
Overuse Injury Prevention Awareness Early Recognition Early Modification of Training and Treatment Planning the training appropriate to the level of the players Gradual increase in pre-season conditioning Start conditioning AT LEAST SIX WEEKS BEFORE THE SEASON
Pre Season checklist for your team members: Who has a medical problem?
Pre Practice Check Area for HazardsObstructions Broken glass Have First Aid Kit handy
Pre Game Check Area for Hazards How could an Ambulance access the area? Identify a parent with medical training Have First Aid Kit Available
HEAT INJURIES Children are more susceptible Conditions with Greatest Risklate spring transition from cooler to hot humid weather any hot humid day
HEAT INJURIES Children are more susceptible to heat injurySweat less than adults Thirst response to fluid loss may be poorer than adults Get hotter faster than adults
HEAT INJURIES Overheated players will NOT be thirsty! Thirst lags behind need for fluid Players MUST be ‘subbed’ frequently and MADE to drink on hot muggy daysuse slightly sweet drinks to encourage drinking Offer drinks on sideline to players who can’t be subbed and are ‘away from the play’ Have goalkeeper keep water nearby goal
HEAT INJURIES Heat CrampsTreatment:Sudden leg or ‘stomach’ cramps sweating profusely Easily confused with a muscle strain Rest in cool environment Passive stretching (you gently stretch the area) Drink lots of water or "sport drink"
HEAT INJURIES Heat ExhaustionLots of sweating; may be dizzy, faint or have nausea or diarrhea Skin may be gray, cold and clammy if more severe: skin may be hot and dry
HEAT INJURIES Heat Exhaustion Treatment:Immediate rest; lay down; get in shade or coolest environment possible Dampen clothes and ‘fan’ player Have player drink large amounts of water or "sport drinks" Stop activity until WELL under control
HEAT INJURIES Heat Stroke: Medical EmergencyMore severe progression of fluid loss Skin HOT & DRY; Pulse RAPID Unsteady at walking ‘Glassy’ stare Mental change: goofy; irritable; hysterical; lethargic; disoriented
HEAT INJURIES Heat Stroke: Medical Emergency Treatment:PLAYER IS AT RISK OF BRAIN DAMAGE AND DEATH! CALL 911! Get clothing off; immerse in ice cold water or cover with ice cold cloths and fan player Immediate transport to hospital
FIRST AID Bleeding:Put firm pressure on the area with the cleanest "dressing" you have available. Although you may not be able to stop the bleeding, you will definitely slow it down. Wear latex gloves for your protection
FIRST AID Splinting: elbow through fingers and knee through toes.
FIRST AID Splinting: elbow - fingers and knee - toes.
FIRST AID Splinting: shoulder / upper arm:
FIRST AID Splinting: Fingers"Buddy Tape" fingers together The "good" finger splints the injured one Have a high index of suspicion for fracture
Summary
Heat Injuries Basic First Aid
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Copyright: 2002 - 2008 Chesapeake Orthopaedics & Sports MedicineChesapeake Orthopedic & Sports Medicine Center
200 Hospital Drive
Glen Burnie, MD 21061
410-768-5555;
www.chesortho.com;
www.orthopedicdoc.net
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