How to get back to sport without getting injured

The focus is now on non-contact soft tissue injuries – those that do not occur after hitting another player or a surface –because these are generally more avoidable. After all, you have a lot less control over contact injuries. Soft tissue injuries – collectively ligaments, tendons, muscles and cartilage – can, in some sports such as football, account for more than three-quarters of ACL injuries.

This means that, in most cases, an ACL tear, Achilles, hamstring, or ankle sprain is not the result of one athlete hitting another, but rather the result of a quick cut, awkward jump or landing, overloading the force of a tissue. . Usually the athlete has done it hundreds or even thousands of times.

On their own, ligaments like the ACL are not strong enough to withstand the forces of a hard cut or a big jump. This is where muscles and other secondary support structures come in, literally holding the knee up with precisely sequenced contractions that, when things are working well, give athletes the ability to move and play safely. But, when coordination is disrupted, balance is fragile, or muscles are deconditioned, ligaments or tendons are exposed to forces that can ultimately tear tissue.

Lessons learned from the lockout

In one frequently referenced research article, Tim Hewett, an ACL injury expert, analyzed football players returning to the field after the 2011 NFL lockout. Although players had plenty of “rest” after the previous season – the result of ‘A four-month lockout of NFL facilities – there was a 500 percent increase in Achilles tendon ruptures during the abridged preseason. With limited access to team medical staff, facilities and the typical 14-week structured preseason training schedule, players had only 17 days to prepare for preseason games. The result was not pretty.

The reason, Hewett theorized, was that the lack of off-season conditioning and season preparation left soft tissue structures vulnerable, leaving players vulnerable to injury.

In a more recent document, to be published soon to study, with measurements taken before and during the end of the Covid-19 pandemic, Hewett and others looked at performance and injury risk markers in 483 NFL players over four seasons. After the prolonged layoff from training and participation due to the Covid-19 lockdown, athleticism and explosiveness declined – including the rate of strength development and peak strength development -, which led the researchers to suggest a higher risk of soft tissue damage.

“What the study we did with NFL football players clearly showed was that when you did tests measuring whole body power, athleticism and explosiveness dropped after a rest. linked to a pandemic. Which correlated with an increased risk of injury, especially in the lower body, ”Hewett said.

Performance decreases, risk of injury increases

For parents and young athletes, the implications of this research are worrying. It’s not just about being a little short of breath after being away for months, wasted training time could mean young people are more prone to serious and life-changing injuries early in their careers. athletic.

Hewett is also concerned about the risk to all athletes, not just those who play on Sunday. “It seems very likely to me where we are now that we’re going to have some trouble ahead. It’s worrying. The positives of injury prevention work: that good neuromotor training is good for injury prevention and performance, ”Hewett said. “When you don’t have that training, when you decrease it, it all goes in the opposite direction. This is what we have seen in NFL players and it is what we fear to see in young recreational athletes.

Pandya has already started to see these pandemic-related effects in evaluations of young athletes. “In my clinic, I have seen simple tests, one-leg balance and one-leg squat, change quite dramatically in my athletes. Twelve to eighteen months ago, 90 percent of children playing sports passed the tests, ”Pandya said. “Out of 10 children I tested today, eight fall doing a single squat. These are kids who want to get back to competitive football and can’t even stand on one leg for 10 seconds. Pretty striking about the basics we took for granted – balance, stability, strength, and flexibility – have gone downhill completely over the past year or so. I say to the kids, “If you can’t keep one leg balanced in the clinic, what will happen in the 75th minute of a football game when you try to cut?”

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