Injury prevention and management

Why is good injury management important? Welfare of the player Less time out of game Improved performance Longer career in sport

Risk Factors vs. Cause Injury correlation vs. Causation Risk factors are valid predictors of injury Impossible to fully predict when injury will occur If remove risk factor we will not necessarily rule out possibility of injury. Multi-factorial cause of injury

Risk Factors Associated With Injury Extrinsic –Direct contact –Sport-specific skills (jump,catch,twist,land,run) –Level of competition –Shoes and equipment –Surfaces –Training errors –Overtraining –Environmental factors

Risk Factors Associated With Injury Intrinsic –Movement dysfunction and muscle imbalance –Malalignment –Muscle weakness –Loss of flexibility –Poor proprioception –Intrinsic overload –Physical fitness –Age –Gender –Hydration and nutritional status –Inadequate warm-up –Previous injury e.g. ankles.*

Primary Injury Prevention Identification of risk factors –Screening –Evaluation of activities/facilities etc, Implementation of preventative strategies –Address identified risk factors; eg if you know you’re weak in an area or have previous injury then spend time on your own working on it (balance/strength etc)

Preventative Strategies Intrinsic –Specific strengthening programmes E.g. eccentric training for hamstring injuries –Balance and agility training Shown to reduce incidence of ankle and ACL injuries –Flexibility training –Improve physical fitness –Adequate nutrition and hydration –Use of taping/braces Effectively reduces re-injury of ankle sprains –Proper functional rehabilitation*

Preventative Strategies Screening Identify predisposing factors to injury Detect musculoskeletal impairments that may affect performance Identify ongoing injuries, which may or may not be receiving treatment. Players carrying injuries into a season Identify problems not responding to treatment Put into action a plan in response to these findings.

Secondary Prevention Early detection of injury. (follow up slight injuries). Seek assessment early to ensure best management. Appropriate management. Prevention of complications and severity of injury.

Acute Management Soft tissue injuries –P.R.I.C.E. Potentially life threatening injuries –First Aid Talk Observe Touch Active Movement Passive movement Skill Test –CPR (ABC) –Equipment

PRICE Protect: Protect the injured part from further damage. Don’t play on, use a sling or splint if necessary. Rest: First 72hrs are key. Body needs to direct resources to recovery after this not total rest necessarily but rest from moving or using the injured body part in a way that worsens the injury. Eg if you injure your shoulder you may be able to train on a static bike. Ice: Helps limit damage after injury so can speed time to return to play. Best practice:10min on/off x1hour. Crushed ice best. Most cold packs not great. Put oil over skin to prevent ice burn. Compression: Very important. Needs to be applied evenly. Also limits the extent of damage. Apply with ice to help cool the deeper tissues. Not overnight. Elevation: Don’t go to party and stand about all night. First 24-72hours Key. Helps decrease swelling. If Upper limb (elbow/hand) have higher than shoulder, if lower limb have higher than hip.

Training Emphasis Power is nothing without control. Focus on control and form. Don’t try to lift big but lift well. U14-16’s especially – put in a good foundation. Learn to rest well. Best performances come from fresh and rested players.

Summary Risk factors –Extrinsic –Intrinsic Injury Prevention –Identify areas of risk –Implement strategies to address these –Screening –Treatment & Rehabilitation Work on form and control Rest well