What advice should youth coaches tell athletes that are returning from sports injuries?
The best advice on return to play or activity is to make sure that you are 100% fit to actually return. This doesn’t mean that you are free from injury or pain and discomfort, but you are at a level at least commensurate with levels prior to the injury.
We often make the mistake, for example, of comparing girth measurements on injured and non-injured limbs as a measure of readiness. This is not sufficient. We then often compare the relative strength of the two limbs. But if you are involved in a power or endurance sport you must compare the relative power or endurance.
When to return to activity?
The other piece of advice particularly applies to return to play after soft tissue sports injuries. Firstly if your injury is chronic i.e. you have had it for a long time and it is persistently there, you must continue to do pre-hab (injury prevention) as part of your everyday training regime, e.g a chronic Achilles tendon pain needs to be continually pre-habbed with eccentric calf and tendon exercises once it is pain-free.
Secondly, research suggests that if a muscle has been torn e.g. a hamstring tear, then you have up to a 75% great chance of tearing it again. Consequently, pre-hab and re-hab hamstring strengthening, (proximally, distally, and in the belly of the muscle) should be regularly carried out as part of normal training e.g Nordic hamstring and straight legged dead lift are 2 good examples.
How can a coach determine whether this is due to program design?
If a coach notices that his or her athletes are getting a lot of ‘knocks and small niggles’ during training, would this just be normal, or could there be other factors at work?
It is interesting here to research many of the studies on ‘Over-training’. They did prove that not enough recovery or training to hard and/or too long can lead to this syndrome. It wasn’t until Dr Richard Budgett (Great Britain Olympic Team Head of Medicine) put forward a more feasible explanation. So he replaced ‘Over training Syndrome’ with “Under performance Syndrome’ and the pieces of the jigsaw started to fall into place.
Dr Budgett explained that there were many factors, not just poor training modality that led to athletes under performing. These included poor diet, lack of sleep, drugs, alcohol, poor relationships, general stress, family problems etc etc.
Improving Athlete Health and Reducing Sports Injuries: Lessons from The Wallabies
Athletes should not be suffering sports injuries or be sick all the time. In 1998, when I started in The Wallabies we were averaging 5 colds (UR Infections and chest infections) per year. Dr John Best and I got together and looked at the possible reasons. The average for a normal Australian (non-athlete) was about 3 per year.
We found that some players were not sleeping satisfactorily. The training levels were probably too heavy for some players (up from what they were used to). Also, some players were not getting adequate nutrition for the training demands. So firstly, we set about improving sleep habits. Which sound easy but was fairly complicated, and Dr Best started monitoring this closely.
Secondly, we began close H.R. analysis of all training sessions. Whether easy, moderate or hard and looked closely at recovery rates. We also made players take specific days off and encouraged active recovery. Thirdly, we began cooking classes/advice. Besty’s wife came in and talked at length (she was a medical doctors as well) on relationships and how to overcome problems. Finally, we offered multivitamins/mineral supplements and brown anti-oxidants. It seemed to work.
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