First things first, always see a medical professional if you are in pain or worried about a specific injury or ailment (injuries are complex). This article is designed to get you thinking about what measures you can take to reduce the risk of training injuries.
Unfortunately, it is unlikely that we will eradicate injuries, especially when aiming for the highest level of performance. However, there is a lot we can do to reduce the risk of injuries.
For me, there are two significant factors:
- Technique: How you perform an exercise.
- Load Management: How much and how hard.
I have listed technique first because it is usually the first thing that comes to mind when it comes to injury prevention during exercise, and we should, of course, aim to perform movements with optimal form. However, load management is, by far, the most important factor.
I get between 100-200 people in my gym each day (a mix of athletes and the general public), and more often than not, when someone approaches me with a niggle or injury, my first thought isn’t, “I bet your lifting or running technique was off.” Instead, it is along the lines of, “I bet you have done too much or gone too hard.”
Of course, this isn’t always the case. For example, when it comes to running, footwear and running mechanics play a role. But 8 out of 10 times, I find their programming has involved a sudden spike in frequency, volume, and/or intensity – we don’t want sudden spikes!
At the end of the day, if you keep getting niggles and injuries, then the likelihood is your structures don’t have the strength to accommodate the stress. An individual who can deadlift over 400kg can pretty much pick up a 50kg barbell however they like (with good or bad technique), whether it be with a bent back, leaning to one side, with one arm, or while standing on one leg. Yes, being bent and twisted and having uneven loading on the spine may increase the risk of injury, but their tissues have the strength to tolerate it.
If you use a position that is biomechanically efficient and spreads the load across all of the working muscles (some more than others), it will reduce the risk of any one structure being loaded beyond its capacity and therefore, reduce the risk of injury. It will also maximize performance because a biomechanically efficient position + more muscle recruitment = more weight lifted.
Top 10 Tips:
- Stay away from sudden spikes in frequency, volume, and/or intensity.
- Know your body and your HOTSPOTS (the areas you have identified as potential problem areas for you – we are all built differently and have lived different lives).
- Understand that pain is a signal that is trying to tell you something.
- Be prepared to make adaptations. Yes, sometimes we must dig deep, but we must also understand the difference between acceptable levels of discomfort, and pain warning us to stop or risk longer-term issues.
- If an exercise causes you issues, try regressing the movement by reducing the load or range of motion – if a squat with a 20kg barbell feels fine, but a squat with a 100kg barbell doesn’t, maybe the movement isn’t the issue, but the load is? Always consider load tolerance (how much weight your tissues can handle).
- Aim to progress up to a decent level of frequency. For example, to prevent sprint injuries, we should sprint often.
- Running is stressful, so program it wisely – it is not just about what distance you can run or the weight you can lift; it is about what your tissues can recover effectively from (tissue tolerance).
- When it comes to strength training, play the long game.
- Don’t program off how fit or strong you USED to be – nobody cares how much you used to bench press.
- Aim to stimulate, not annihilate – again, play the long game!
The TAB Method:
Now we have looked at many tips and snippets of advice I give to my clients and athletes to prevent injuries; let’s look at a methodology I designed for when someone comes to me and wants to work around a niggle or injury.
Note: At this point, it is established the individual in question has no underlying issue that would result in contraindications to the exercises they are doing. Fundamentally, they need to get their tissues working.
- Take away aggravators: Initially, get rid of the things that make the injury feel worse during exercise, hours after and the next day (if you keep picking a scab, it will never heal).
- Add in exercises that feel good (these can be totally unrelated to the area): Load the tissues, increase circulation and promote healing. Also, include mobility work to reduce excessive tension.
- Build resilience to the aggravators: Injury prevention 101 is “build the strength to accommodate the stress.” Once initial healing has taken place, we need to progressively build resilience in the tissues.
Once you start using the TAB Method, you will see how it can be implemented way before overuse injuries take hold (repetitive strain injuries – RSIs). For example, you notice the five sets of five pull-ups you are doing three times a week are starting to aggravate your right elbow. Therefore, you take them out of the next couple of sessions and add in the wrist roller exercise to develop strength in both the wrist flexors and extensor muscles. From there, you perform inverted rows for a couple of sessions before returning to the full pull-up movement pain-free.
Training rarely has to cease; it just has to change a little.
On top of the TAB Method, I have also got what I call the IIR Protocol, which is a 3-step process to getting muscles and tendons back to full health.
The IIR Protocol:
IIR stands for Isometric, Isotonic and Reactive, and these three terms denote key development stages when rehabbing a muscle back to full health.
We will often start with Isometrics, which refers to a muscle contraction with no length change. These exercises are easy to facilitate, have an extremely low risk of injury, yet allow the individual to produce a high amount of force – I will often have my clients/athletes perform 3×40 second holds of an isometric contraction.
There are two forms of isometric contraction training techniques:
- Yielding: Simply holding a position, for example, holding yourself at the top of a single-leg calf raise while standing on a step.
- Overcoming: Pushing into an immovable object, for example, leaning forward and placing your hands on a wall to your front, performing a calf raise and holding a position maximally by pushing with your hands.
Out of the two forms of isometric training, overcoming is by far the best as it allows you to produce incredible amounts of force and hold it for prologued periods to maximize the work on both the muscles and tendons.
Note: These drills are not just for rehab. They are also a great way to maintain tissue health and build upon muscle strength, endurance and tissue resilience.
Following a phase of performing lots of isometric contractions, we progress to isotonic contractions, where there is a change of muscle length.
There are two types of isotonic contractions:
- Eccentric: When the muscle is lengthening.
- Concentric: When the muscle is shortening.
The eccentric phase is much stronger than the concentric phase and working controlled/slow eccentric actions is often the next step following building strength with isometrics.
I usually split the isotonic phase down into two sub-phases:
- Tempo: Concentrating on slower contractions and lifting speeds – specifically slow eccentrics.
- RFD (Rate of Force Development): Concentrating on faster contractions and lifting speed – specifically fast concentric.
Although we often start with lots of eccentric work, it should be noted that eccentric contractions cause more DOMS than isometric and concentric contractions, with concentric contractions causing the least.
DOMS: Delayed Onset Muscle Soreness – the soreness you feel 24-72 hours after exercise.
Just as with injury prevention, the key to preventing DOMS is a progressive program (no sudden spikes in any of the variables) and then the implementation of high frequency – if you perform an activity regularly, you are unlikely to get very sore, but take a week or two off and the DOMS will come back with a vengeance.
The final phase of the IIR Protocol is what I refer to as the Reactive Phase, and this refers to explosive and powerful movements.
Reactive/elastic strength refers to your ability to quickly and forcefully transition between the eccentric and concentric phases, and this is developed with jumps and throws – Plyometric and Ballistic training.
Note: All plyometric exercises are ballistic exercises, but not all ballistic exercises are plyometric exercises – I differentiate the two depending on their aim (it’s just my semantics).
When our focus is to maximize the force and speed at which we can transition from the eccentric to the concentric phase and utilize the elastic properties of the muscle and the stretch reflex (an unconscious contraction in response to a stretch in the muscle), we call it Plyometric Training.
Plyometric training, which is commonly referred to as “jump training,” is key for increasing reactive strength and building resilient and powerful muscles and tendons – remember, tendons are like springs and we should train them like a spring.
Note: The mechanism of a muscle lengthening and shortening (utilizing the stretch reflex) is referred to as the Stretch-Shortening Cycle (SSC).
When our primary aim is the continued acceleration through the concentric phase (which all jumps do), with or without a prior eccentric phase, we call it Ballistic Training. For example, a concentric-only medicine ball throw is a ballistic training exercise that does not capitalize on the benefits of the stretch-shortening cycle (stretch reflex) and therefore, I do NOT class it as plyometric.
This phase of the protocol is by far the most underutilized, and this is one of the main reasons people reinjure themselves, and here’s an example of why this happens:
A rugby player sprints for the ball, and their right hamstrings “pop” (they have strained their hamstrings); following this injury, they proceed to perform lots of slow and controlled rehab exercises in the gym to load the hamstrings and get them back to pain-free movement.
From there, after a few weeks of specific exercise and a cessation of gameplay and sprints, etc. The athlete’s hamstrings are feeling good and they are ready to get back on the pitch. However, on the first game back, they sprint for the ball and their hamstrings “pop” again!
Basically, what has happened is the player has got back to pain-free movement and what would be considered by most to be a fully recovered hamstring using a combination of rest and likely the first two phases of the IIR Protocol. However, they haven’t then progressively worked their hamstrings back up to a level of conditioning where they can tolerate the high stressors of sprinting and kicking, etc.
It is NO use only performing controlled movements in a training setting, if the setting you are going into involves incredibly explosive, powerful and often erratic movements.
Well, this article started quite simple, and then got a little heavy on the training terminology to say the least. Therefore, if you have any questions at all, don’t hesitate to drop me an email to [email protected]