Injury prevention should be prioritised. The term ‘Injury prevention’ is difficult. No 100% guarantees can ever be made about keeping injury free. Especially in sport where there is likely to be external stressors on the body, or contact sports (which is most!).
However, taking due diligence to prepare an athlete best for the stresses and strains of their sport is not only sensible, but it’s a key responsibility of the coaching and therapy staff within the elite sport world.
Serious injuries or lack of serious injuries can make or break a players career. As a Physiotherapist heading up the Sports Injury Clinic in the NHS for a few years, I’ve seen the mental and physical toll that a serious injury can have on a player.
You don’t have to search far to find articles on professional players who are open about their struggles with injury – often reporting the psychological impact is far greater than the physical. Some players are never quite the same when returning from injury. I’m sure the psychology of these situations has a big part to play too. Imagine being 100% committed to a tackle after you’ve been laid off for 9 months following ACL injury and surgical repair.
So avoiding injury is key!
I do think coaches are catching up with elite sports, but there is still a lot of work to be done. I am forever sending my patients/athletes warm up routines and injury management programmes because they admit they aren’t doing anything right now.
The non-negotiables at any level should be:
A dynamic warm-up for sport:
This should replicate the movements and demands of the sport about to be played. Running Drills of increasing intensity and complexity and with similar movement patterns to that of the sport an athlete is about to play.
For example, if we are talking about football, running drills should start with straight line movements, and then progress to start, stop, circling, side to side, forwards and backwards movements
Then the progression to strength Drills
Then finally finishing the warm up with explosive plyometric movements like bounding, strides, and finally plant & cuts at 80% speed (side step type movements are quite strenuous at speed)
Monitor and maintain ankle range of motion regularly.
In elite sport, they monitor and maintain ankle range of motion daily if necessary. This is because how important the ankle joint is to the rest of the lower limb function. In an interview with Jack Haines, 1st team Physiotherapist at Wasps, he described the potential functional deficits to lower limb function as ‘massive’ when talking about loss of ankle range of motion.
It’s simple to record knee to wall scores and athletes should be encouraged to warm-up with ankle mobility drills
The key evidence around ankle range of motion is:
Reduced ankle dorsiflexion increases the chance of ACL knee injury.
WAHLSTEDT, C. AND RASMUSSEN-BARR, E., 2014
Anterior cruciate ligament injury and ankle dorsiflexion.
Knee Surgery, Sports Traumatology, Arthroscopy, 23(11), pp.3202-3207.
Decreased dorsiflexion is associated with increased risk of patella tendon injury.
MALLIARAS,P., COOK, J. AND KENT, P., 2006
Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players.
Journal of Science and Medicine in Sport, 9(4), pp.304-309.
Full Text here
Reduced dorsiflexion increases hamstring injury risk, one of the most common injuries in Australian football.
GABBE, B., BENNELL, K., FINCH, C., WAJSWELNER, H. AND ORCHARD, J., 2003
Predictors of hamstring injury in elite Australian football.
Journal of Science and Medicine in Sport, 6(4), p.87.
Full text here
Fast bowlers have a greater injury risk when they have reduced dorsiflexion.
DENNIS, R. J., FINCH, C. F., MCINTOSH, A. S. AND ELLIOTT, B. C., 2008
Use of field-based tests to identify risk factors for injury to fast bowlers in cricket.
British Journal of Sports Medicine, 42(6), pp.477-482.
Full text here
A-FLEX brings elite level ankle warm ups to athletes of all levels! Check it out!
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