Injuries

Previous Class Activities

The previous class involved various exercises such as push-ups, jump squats, and a plank as a tiebreaker in a competition. It was described as a fun and engaging activity.

Upcoming Schedule

  • The class will cover injuries today.

  • On Wednesday, the topic will be facility layout and risk considerations.

  • Friday will be a wrap-up session; attendance is required to submit programs.

  • The program submission requires a hard copy (printed) and an electronic copy (emailed).

  • The professor aims to grade and return the programs before the final exam.

Alex Ter's Presentation Follow-Up

Alex Ter from IST CrossFit addressed only a few of the questions sent to him. He will create a recording to answer the remaining questions, which will then be shared with the students.

Injuries: An Overview

As exercise physiologists, diagnosing and treating injuries falls outside their scope of practice. However, exercise physiologists play a role in injury prevention and management under their supervision. Some may pursue further education to become physical therapists or athletic trainers, professions that heavily deal with injury management.

Risk of Injury

Injury risk cannot be eliminated from physical activity, sport, exercise, or recreation. The goal is to minimize the risk as much as possible. Injury is an inherent risk that must always be considered.

Statistics of Exercise-Related Injuries

  • Between 2007 and 2017, reported exercise and equipment-related injuries more than doubled. This is likely an underestimate due to unreported injuries.

  • An article on Brightspace estimates nearly a million weight training-related injuries requiring emergency department visits in 2007. However, many more injuries go unreported.

  • The approach is to consider the risk-to-benefit ratio. Minimizing risks is a crucial role for exercise professionals.

Types of Injuries

Injuries range from minor inconveniences like torn calluses to life-threatening events:

  • Calluses and minor skin tears.

  • Muscle tears.

  • Shin splints.

  • Tendonitis/Tendinopathy.

  • Ligament tears.

  • Blunt force trauma.

  • Fatalities during exercise (rare but possible).

Identifying Risk of Injury

  • History of Previous Injury: Important to know past injuries, as they can influence exercise prescription. Repeated questioning might be necessary to gather complete information.

  • Association with Certain Activities: Some activities have known injury risks, such as ACL injuries in female athletes involved in jumping and cutting sports (5-9 times higher risk). Repetitive movements can lead to repetitive stress injuries like shin splints.

  • Injury-Prone Individuals: Some individuals may be more prone to injuries due to clumsiness, coordination issues, or personality traits like recklessness.

  • Current Status: Emotional or psychological stress can impact physical resilience. Strength coaches often reduce training intensity during stressful periods like final exams.

Prehabilitation

Prehabilitation involves proactive strategies to prevent injuries before they occur. Bracing, taping, and weight belts can be used preventatively, though scientific evidence supporting the effectiveness of weight belts is limited.

Prevention and Personality

Avoid unnecessary risks during exercise. An example was given of squatting 135 pounds on a stability ball, leading to injury when the ball slipped out. The story illustrated the importance of avoiding reckless activities.

Spontaneous Injuries

Some injuries appear to occur spontaneously, but often there are underlying factors that were not recognized beforehand.

Common Ingredients for Musculoskeletal Injuries

  • Technique: Poor technique is a major contributor to injuries. Fatigue can impair technique.

  • Inflexibility: Limited flexibility can lead to suboptimal lifting techniques.

  • Miseducation: Lack of knowledge about proper form and movement patterns.

  • Anatomy: Individual anatomical variations influence how exercises can be performed.

  • Muscle Weakness: Can lead to improper form.

The Dilemma of Bad Technique in Elite Athletes

The question arises whether to correct bad technique in elite athletes who have achieved high levels of performance despite it. Making changes could potentially disrupt their performance or increase their risk of injury due to compensatory adaptations developed over time.

Stress-Strain Failure Relationship

Excessive overload can cause the weakest link to fail, resulting in injury. Chronic overuse, combined with insufficient recovery, increases this risk. Ignoring warning signs and pushing through pain can also lead to injuries.

Freak Injuries

These are rare, unpredictable events with catastrophic consequences. Examples include:

  • A CrossFit competitor (Kevin Ogar) who was paralyzed during a workout.

  • A U.S. senator who lost an eye due to an elastic band snapping.

  • A baseball player who lost an eye when a training apparatus detached from the wall.

Injury Types: Acute vs. Chronic

  • Acute Injuries: Occur suddenly (macro trauma).

  • Chronic Injuries: Develop gradually over time (micro trauma).

Acute Injuries: Strains

  • Strains involve muscles and tendons (ST), while sprains involve ligaments (SP).

  • Strains are graded based on severity: Grade 1 (minor), Grade 2 (partial), and Grade 3 (complete).

Grade 1 (First Degree)

The most minor tear, with strong muscular activity but pain upon contraction

Grade 2 (Second Degree)

Partial tear with disrupted tissue, weakness, and pain upon contraction.

Grade 3 (Third Degree)

Complete tear with no force production.

Muscle tears often occur at the muscular-tendinous junction or where the tendon attaches to the bone. Complete tears typically require surgery for full recovery.

Examples of muscular injuries and bruising: pec tears, tricep tears, hamstring injuries, Achilles tears.

Macho Man Randy Savage

An anecdote about Macho Man Randy Savage, who had a torn tricep from wrestling that was never surgically repaired, leading to muscle atrophy. When asked about if he tore his tricep, he mentioned that he tore it years ago and it atrophied as a result. Following the injury, anytime he hit a pose he always hits his left because his arm never fully recovered.

Blunt Force Trauma

Example: Dropping weight plates on feet, emphasizing the importance of closed-toe shoes in the gym.

Herniated Disc

  • Involves the rupture of the nucleus pulposus through the annulus fibrosis.

  • Flexion (bending forward) can exacerbate the condition, pushing the disc material outward.

  • The herniated material can compress nerves, leading to symptoms like sciatica.

Dislocation vs Subluxation

Partial displacement of joint surfaces or complete displacement.

Chronic Injuries

  • Tendinitis/Tendinopathy: Inflammation or pathology of a tendon.

  • Tennis Elbow: Repetitive stress injury from swinging a tennis racket.

  • Jumper's Knee: Overuse injury from repetitive jumping.

  • Skeletal Micro Damage: Microfractures leading to stress fractures.

  • Medial Tibial Stress Syndrome: Shin splints caused by repetitive running.

Common Ingredients Leading to Chronic Injuries

  • Program Design: High volume, insufficient recovery.

  • Training Surface: Impact on shin splints (e.g., road vs. grass).

  • Foot Strike Pattern: Biomechanics and technique.

  • Decreased Flexibility: Affects skeletal alignment and biomechanics.

Intervertebral Disc Bulging

Similar to a herniated disc, but the disc hasn't fully ruptured and can still compress nerves.

Non-Specific Low Back Pain

A diagnosis where back pain is acknowledged but the cause is unknown, making treatment challenging.