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Are We Too Preoccupied With Rare Large Injuries?

Over the past 10 years we have seen a  climb in the rate of sports’  injuries, especially ones that require surgery. 

In the U.S., approximately 30 million children participate in organized sports each year.  Just because playing sports is fun doesn’t mean there isn’t potential for injury.  According to the Centers for Disease Control (CDC), more than 2.6 million children 0 – 19-years-old are treated in the emergency department each year for sports-related injuries. There are between 250,000 and 300,000 ACL injuries per year, and they're almost exclusively happening to athletes. (http://lbpost.com/life/health/2000004217-concussions-and-acl-injuries-a-duo-that-is-on-the-rise-in-youth-sports )

Image result for acl injury Image result for acl injury

While these numbers seem high, they actually represent 1%  of the youth athlete population that may tear their ACL.  The question arises:   Are the numbers to the point that our training programs need to strictly address the prevention of these specific injuries? 

Data from a brief case study  over the past 2 months at the Sports Performance Center illustrates a different scenario.  Out of 30 athletes, five  had some type of soft tissue injury.  These injuries either prevented them outright from doing their training program, or decreased their ability to perform at 100%.  Roughly 15% of our athletes are walking in the door with some sort of painful dysfunction.

Instead of focusing on the 1%, why not  focus on the much higher number of athletes that will develop a chronic injury that prevents them from training hard and can become a precursor to a larger injury?  Frequently, coaches and parents inquire about specific injury prevention strategies  when it might be smarter to look at the bigger picture.                                                                           

When we look at injuries, Mike Boyle said it best, “you either have a traumatic event (concussion) or overuse issues”.  These overuse issues are easily preventable or managed.  One of my athletes has intermittent left medial knee pain.  When she moves too much, the inside of her knee hurts.  Initially we screened for potential causes of pain. Nothing hurt, but she did have limitations in left ankle mobility and motor control of her right hip.  We removed a lot of the jumping and cutting that originally caused her knee pain to flare, and added in exercises that addressed her ankle and hip limitations.  As a result, in just one month, she is experiencing no pain with training, and her pain after 2hr goalie sessions has decreased to “barely noticeable”.     

 

The statistics cited by Mark Hyman in his book Until It Hurts: America’s Obsession with Youth Sports and How It Harms Our Kids, are sobering indeed: “Every year more than 3.5 million children under 15 require medical treatment for sports injuries, nearly half of which are the result of simple overuse.”   (http://www.nytimes.com/2010/05/25/health/25brod.html)                                                                                                                              

Here is the best part.  SMART TRAINING = TRAUMATIC INJURY PREVENTION.  The take home message here is that soft tissue/overuse injuries far exceed the number of traumatic injuries that most people are scared of.  In addition, they are huge contributors to traumatic events.  External force, a fatigued state where muscles can’t keep up with demand and poor mechanics that put a joint in a compromised position are the three main factors in acute injury.  Smart training that addresses mechanics, strength and recovery, and workload management of practices, training and games, have far greater impact on overall injury prevention than simply a few targeted exercises.

Other great resources

http://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/sports_injury_statistics_90,P02787/

http://www.apta.org/APTAMedia/Handouts/PT2013/youngathletes_McNeff_1.pdf

 

 

 

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Sleep Part 2

   recovery
   

We already touched on how important sleep is, and what a drastic effect it has on keeping your cognitive function optimal.  Remember our buckets?  Movement, nutrition, recovery and mindset.  These buckets do not act in isolation.  In other words, a lack of optimal attention in one bucket can affect the functioning of another bucket.  Let's look at how Mindset can affect Recovery.

I like to do at least 1-3 visualization sessions with athletes at the end of a training cycle because it is a great way to initiate the recovery process after some heavy lifts, and it also allows time to shed light on one's current state. We will lie on a bench or floor and go through some guided relaxation techniques and follow up with some visual cues to help plant a seed for success.

One thing that is readily apparent are the athletes who can shut down/sleep well and those that can't. When I first ask the athletes to check in with how their bodies feel, and go through some "contract and relax" techniques to become aware of tissues, I see who is able to focus and who has a harder time narrowing their attention. The idea of the practice is to feel what full contraction is like and then completely relax, rather than staying in a state of constant tension. This interrupts the cycle of signaling from the brain and hopefully allows for the athlete to fall into a state of low muscle neural tone. With the athletes that have a harder time slowing down, usually their hands are moving around and their facial features are twitching. This occurs even if the cue they just heard is to check in with how their legs are feeling. 

Typically they never reach a state of relaxation, and when asked if they have trouble falling asleep or staying asleep the answer is usually "yes". I have only been wrong once so far out of about 40 athletes, so I wont say its 100% accurate, but its highly correlated. This type of athlete typically goes to bed around 11-1am and wakes up at 6-7am. This would seem like enough sleep if we are shooting for 6-8hr, but what is really important is that he is in bed, but not asleep because his mind is running. Or he falls asleep, but wakes up in the middle of the night and can't get back to sleep. His mind is running systems all day/night, which even though it isn't physical stress, it definitely is mental strain. The consequence is a lower quality of sleep.  Lower quality of sleep=lower quality of recovery.

This is where your mindset bucket is having a detrimental effect on your recovery bucket. What sometimes stinks is that same mindset might make you a beast in your training, but also crushes your ability to recover from it. Everything is always a balancing act.

Here is what I usually suggest for our athletes to try at least once.

headspace

They offer a free trial that you can use as often as you like.

Till next week!

Coach Tom

 train
 
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Sleep Part 1

cat

 
 remember  
   

Over the years we have seen more information come out about sleep and its importance. When we are going to embark on a new goal: getting stronger, losing body fat, improving our 40yd time or just starting a new habit it's important that we pay attention to the major buckets that have the most impact on these outcomes.

In my opinion there are really only 4 buckets. Movement, nutrition, recovery and mindset. Sleep fills up most of your recovery bucket.

As you'll see in Chad Waterbury's post it is highly correlated to motor learning. So trying to pick up or improve an athletic movement can be hindered or enhanced based on how much sleep you are getting.

Check it out here.

Chad's article

Part 2 will be next week.

Have a great week!

Coach Tom

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