Sport Injury & Rehabilitation

A sport injury is usually considered to be a case of bad luck and is probably the most frustrating experience for any athlete. Only one thing is worse and that's a recurring condition. But how much is it down to bad luck? Is your rehabilition exercise program causing more damage? Could you be the root cause of your problem? Is A Sport Injury Down To Bad Luck Or Bad Form? If you suffer a non-contact sport injury when environmental conditions and previous injuries cannot be blamed, the cause is most likely poor co-ordination. You are probably prepared to accept this as just one of the hazards of sport. A sport injury is seen as just bad luck or a sort of initiation into sport, worse still, some may even regard it as a trophy or a sign of commitment. Why do non-contact sport injuries happen? What condition allows a muscle to pull or a ligament to tear? Conventional advice on injury prevention in relation to movement includes: - Avoiding poor technique Maintaining good body alignment Using correct breathing patterns To follow this advice is harder than it first appears. Few of us are fully aware of what really constitutes good technique from a movement perspective because our learnt pattern is a habit. These patterns may become suspect due to poor conditioning, yet we remain unaware of the problem until an injury occurs. Up until this point we may have been satisfied with our technique if we have had no indication to the contrary. Following an injury new movement patterns are established to compensate for loss of function thus degrading the quality of movement further. Once this stage is reached avoiding poor technique is impossible without first improving how we move by eradicating the suspect patterns. Trying to correct a technique will more likely increase effort as concentrating on the task translates into muscle tension. Imposing a style on top of a poorly aligned structure does not improve the structure. To maintain good body alignment an athlete first needs to have poise to allow good body alignment! If we have poor movement patterns, and therefore questionable ‘posture’, we will not know what good body alignment feels like and therefore be incapable of maintaining it. If the quality of our movement is poor, attempts to achieve correct breathing are futile. If the structure is unbalanced, natural functioning cannot be resumed until the structure is balanced. Conventional advice for sport injury prevention falls far short of addressing the real issue. Avoidance of injury requires a well-balanced, poised and flexible body capable of free movement in any direction with minimal effort. To achieve this state requires integration of the voluntary and reflex elements of movement, something we cannot achieve by trying harder. Many struggle to regain form after a serious sport injury and lengthy rehab period, some take months or fail completely. Getting back into form will be slow if we do not know exactly what it is that needs to be recovered. Natural talent for a sport comes from the right sort of conditioning. Good quality movement executed in the sporting activity sets up appropriate learnt movement patterns that reside at a subconscious level. These ‘skill patterns’ can be replaced by new poor quality actions following sport injury and possibly may never be regained. Rehabilition: Time To Assess The rehabilitation period is vital. Time spent walking on crutches or with support will change the walking pattern. Within weeks a new pattern will overlay the existing one, a reconditioning to compensate for the injury. Following this type of injury, we may have a different manner of walking but remain unaware that anything is wrong. Before any progress can be made in returning to form, we must learn how to move naturally again. If this is not undertaken, all actions including core strengthening techniques and corrective exercise will use the new corrupt pattern as a foundation and impact upon performance. Remedial exercise plays an important role in the recovery process. However, to benefit from the treatment, it is essential to first identify the cause and then to prescribe the appropriate exercise, and secondly to perform them correctly. Too many people do not take these exercises seriously and fail to complete the programme due to boredom or impatience. Those who do the exercises often do so incorrectly. An exercise to strengthen a recovering muscle should not be done with just the specific part in mind. For example a knee exercise should not be performed whilst stiffening the neck or other part of the body to achieve the position and movement required. In the process of performing an exercise in this manner, we set up a new pattern containing inappropriate muscular actions that may eventually lead to further complication. Where a problem is identified before a sport injury occurs, corrective exercises to address it are prescribed in order to prevent it. However, this course of action is based on the assumption that the athlete has to do something new to offset the perceived problem. It is not generally considered that the athlete may already be doing something (wrong) that is causing the problem. If this is the case, they will continue to do this ‘something wrong’ whilst performing the new exercises. If the condition that led the perceived problem is still present the effect of the exercise will be limited or consolidate the pattern further. The use of our whole body and the impact of the movement need to be considered when performing exercise. A recent audit by The Football Association in the United Kingdom found 58% of injuries were non-contact injuries sustained during activities such as turning, landing, slowing down and sprinting. A small, but worrying, amount of injuries were sustained during mundane activities away from the game including climbing stairs, getting out of cars and even changing channel on the television (I only hope they were not injured using the remote control). The reasons why injuries appear to be increasing are up for debate. Issues such as diagnosis and treatment, using unfit players and the pressures of the modern game are probably factors. More research into the nature of sport injury will no doubt have an impact on the problem. However, whilst the emphasis is placed on corrective exercise for the symptoms, it will have limited success. If a player has lost poise through the application of excessive effort, the prevailing culture of exercise will only encourage more of the same regardless of new methods designed to strengthen the perceived weaknesses. Why do players sustain so many injuries during natural activities such as running and turning? Do existing exercises for improving fitness and sport injury rehab ultimately affect movement? Concentrating on individual muscle groups does not promote integrated movement. It is imperative that the whole concept is rethought before ‘new’ preventative exercise programmes are devised for sport injury sufferers. Where poor technique is considered to be a factor in the injury, an individual cannot be said to have made a full recovery, if they have not been made aware of what it is they are doing to cause the problem. Once the wrong use is identified, the important step of re-education must come next. It is not sufficient to simply instruct the individual to stop doing A or B. They are already unknowingly doing A or B because habit makes it feel right. The condition that allowed the poor habit must be addressed to bring about a full recovery. Absence of pain does not necessarily mean the process is complete.

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