When the Prevention is the Cause

According the coach Tony Dungy the most important ability an athlete can possess is availability. To be healthy and ready to play gives you a chance to be in the game and compete. Everyday I read the sports page or watch the sports news I am reminded of Dungy’s words when I see the number of athletes who are unavailable to play because of injury. I find it ironic that as our knowledge of training has grown and with the increased emphasis on sport science that injuries have actually increased not decreased. I see more time devoted to “injury prevention” routines, sometimes to exclusion of actual training. Some of these programs are quite elaborate and sciencey in their appearance and the rationale behind them. So then where is the disconnect occurring?

One conclusion that I have come to is that many of the so-called prevention programs and exercises actually are cause of the injuries they are designed to prevent. In an attempt to prevent injury people have designed routines that put stress on the muscle group or area of the body that is susceptible to injury. Often that area or muscle is isolated and worked extra, sometime in multiple sessions in a day. This simply adds stress to stress. The athlete is still expected to practice and play, but certain areas are being fatigued so that when that area is stressed no matter how strong or flexible it has been made in a sterile environment it will be injured.

The other factor is that injury prevention programs are being done to exclusion of the actual physical training needded to prepare for the demands of the sport and the position. I saw an ATC take a player through a prevention program it was all done at about half of game speed. The movements’ were off and on a BOSU ball. This was all done because this player did not achieve an acceptable score on a movement screen. He was not allowed to work with the teams S&C coach but he was expected to practice and play in the games. What’s wrong with this picture? Needless to say he did not make it through the season. This is not an exception, it is becoming the norm. If you knew nothing about training or rehabilitation just common sense would cause you to question this approach.

As an example lets look at one of the most common injuries, hamstring pulls. One of the most popular strengthening/prevention exercises is the so-called Nordic or Russian hamstring curl. This is an example of the prevention being the cause. This exercise puts undue stress on the distal hamstring. If you revisit the function of the hamstring in sprinting, it acts as a decelerator of the lower leg and at stance and through toe off as an extensor of the hip. With this in mind you would eliminate the Nordic hamstring exercise, the various bridging exercises done on physio balls and the sacred Russian ham/glute exercise. They all create neural confusion. They teach the hamstring to work different and in some ways opposite of the way they must function in sprinting. Instead do lunge & reaches in multiple planes, step-ups both on a low and high box. Oh by the way don’t forget to sprint, if the only time you sprint all out is in a game or match you are significantly increasing the odds of injury. Sprint all out in practice, it doesn’t have to be much, just enough to keep the system tuned up. Also run curves and angles as a prevention measure. The hamstrings are stressed more on curves and coming off the curve so practice the skill.

As a rule of thumb thoroughly study the sport and position demands and know the qualities of the individual athlete. Then design a comprehensive training program that address the sport demands and takes into account the individual athletes strength’s and weaknesses as well as how the play the game. Injury prevention should be transparent. It should be included in the athletes training and addressed though proper exercise selection, good training design and thorough coaching.
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Vern Gambetta

Director at Gambetta Sports Training Systems

Vern is the Director of Gambetta Sports Training Systems. He has been the a conditioning coach for several MLS teams as well as the conditioning consultant to the US Men's World Cup Soccer team. Vern is the former Director of Conditioning for the Chicago White Sox and New York Mets. He has lectured and conducted clinics in Canada, Japan, Australia and Europe and has authored six books and over one hundred articles related to coaching and sport performance in a variety of sports. He has a BA in teaching with a coaching minor and an MA in Education with an emphasis in physical education from Stanford University.