Injury management in heavy training or preparation phases Ian Scarborough M. Sports Physiotherapy...

Injury management in Injury management in heavy training or heavy training or

preparation phasespreparation phasesIan ScarboroughIan Scarborough

M. Sports PhysiotherapyM. Sports Physiotherapy

Wakefield Sports ClinicWakefield Sports Clinic

Ian Scarborough M. Sports Physiotherapy CopyrightIan Scarborough M. Sports Physiotherapy Copyright 2007 2007

Basic Training TheoryBasic Training Theory

The body needs to be physically The body needs to be physically overloaded to improve fitnessoverloaded to improve fitness

Athletes need to give their body rest to Athletes need to give their body rest to recover from the physical workload to get recover from the physical workload to get the most out of training the most out of training

Improvements in fitness occur after Improvements in fitness occur after training (with rest and recovery)training (with rest and recovery)


Load ManagementLoad Management

Identify the load place upon an athleteIdentify the load place upon an athlete Game demandsGame demands Training and Competition frequency/durationTraining and Competition frequency/duration Extraneous demands (family, study, sports)Extraneous demands (family, study, sports)

Identify the available downtime for the athleteIdentify the available downtime for the athlete

Coordinate loading and unloading to best allow Coordinate loading and unloading to best allow for training gains, recovery and injury for training gains, recovery and injury management management


Heavy phaseHeavy phase

May vary depending upon training levelMay vary depending upon training levelElite level – national teamsElite level – national teamsElite level – SASI / AVL and state teamsElite level – SASI / AVL and state teamsDevelopment level – SASI / School teamsDevelopment level – SASI / School teams

Period of time where emphasis is upon Period of time where emphasis is upon considerable workload with minimal rest considerable workload with minimal rest lasting 4-6 weekslasting 4-6 weeks


Preparatory phasePreparatory phase

Period of time preceding competition Period of time preceding competition where emphasis is upon replicating where emphasis is upon replicating competitive expectationscompetitive expectations

Duration is usually 2-4 weeksDuration is usually 2-4 weeks

Training content is mainly high match Training content is mainly high match replication drills with minimal skills focusreplication drills with minimal skills focus


Demands of VolleyballDemands of Volleyball

Per GamePer Game SpikingSpiking

Heavy: 60 spikesHeavy: 60 spikes Moderate: 40 spikesModerate: 40 spikes Light: 20 spikesLight: 20 spikes

JumpingJumping Heavy: 150 jumpsHeavy: 150 jumps Moderate: 100 jumpsModerate: 100 jumps Light: 50 jumpsLight: 50 jumps

Training load – 280Training load – 280 Competition – 360Competition – 360

Training load – 800Training load – 800 Competition - 900Competition - 900

Blocks, serves, spikesBlocks, serves, spikes


OverloadOverload

Requirements of the body to sustain these Requirements of the body to sustain these demandsdemandsTissue damageTissue damage

Adaptation of tissuesAdaptation of tissues

Fatigue: physical and emotional Fatigue: physical and emotional


Overuse InjuriesOveruse Injuries

Early signs and symptomsEarly signs and symptomsComplaints of skill related sorenessComplaints of skill related sorenessSoreness lasting an hour post trainingSoreness lasting an hour post trainingRubbing the affected areaRubbing the affected areaTrying to stretch out sore spotsTrying to stretch out sore spotsReduction in skill performanceReduction in skill performanceFrustration with skill outcomesFrustration with skill outcomes


Injury PreventionInjury Prevention

Ensure fitness and coordination Ensure fitness and coordination Required for training drills and competitionRequired for training drills and competition

Recognize training loadsRecognize training loadsEnsure limitations on number of skill Ensure limitations on number of skill

repetitions per trainingrepetitions per training

Ensure recovery time between training Ensure recovery time between training sessionssessions


Recognize Training LoadsRecognize Training Loads

Number of trainings per weekNumber of trainings per weekNumber of games per weekNumber of games per week

Number of spikes/jump per training/gameNumber of spikes/jump per training/gameNumber of weight or jump trainingsNumber of weight or jump trainings

Number of social gamesNumber of social gamesNumber of other sports (training / games)Number of other sports (training / games)


Find Time for RecoveryFind Time for RecoveryTraining Plan over week; month; year Training Plan over week; month; year Include Include

Training days/sessions (incl weights)Training days/sessions (incl weights)Study sessions (incl homework)Study sessions (incl homework)Work sessionsWork sessionsCompetition days / weeksCompetition days / weeksFamily commitmentsFamily commitments

Plan for looking after self (recovery)Plan for looking after self (recovery)


Training Plan / DiaryTraining Plan / Diary

DayDay MonMon TuesTues WedWed ThTh FriFri SatSat SunSun

AmAm SchoolSchool SchoolSchool SchoolSchoolCricket Cricket or or NetballNetball

StateState

DDDD SchoolSchool SchoolSchoolReserve Reserve or State or State LeagueLeague

PmPm SASISASI ClubClub StateState SASISASI


DilemmaDilemma

4 different volleyball coaches4 different volleyball coachesAll want their athlete to train full capacityAll want their athlete to train full capacityDifficulty communicating between coachesDifficulty communicating between coachesDiffering heavy phases and competition datesDiffering heavy phases and competition dates

1 Athlete1 AthleteKeen to play / practice as much as possibleKeen to play / practice as much as possibleFear of exclusion if not involved 100%Fear of exclusion if not involved 100%Young, fit and invincible!Young, fit and invincible!


StrategyStrategyPrioritize trainings for competitionsPrioritize trainings for competitions

Taper other trainings to allow recovery for Taper other trainings to allow recovery for priority trainingpriority training

Vary athlete’s demands at repeated Vary athlete’s demands at repeated training sessionstraining sessions

Injury ManagementInjury Management


Rehabilitating injuriesRehabilitating injuries

AcuteAcute Rest from all activityRest from all activity RICERRICER Maintain muscle Maintain muscle

activity and joint ROMactivity and joint ROM Graduated return to Graduated return to

fitness and loadingfitness and loading Graduated return to Graduated return to

volleyballvolleyball

OveruseOveruse Relative restRelative rest ICEICE Technique analysisTechnique analysis Maintain skill and Maintain skill and

fitnessfitness Graduated return to Graduated return to

aggravating activityaggravating activity Identify overload and Identify overload and

adaptadapt


Return to fitnessReturn to fitness

Cross training to maintain aerobic fitnessCross training to maintain aerobic fitnesscycling, rowing, swimmingcycling, rowing, swimming

Weight training to maintain strengthWeight training to maintain strengthBody weight exercisesBody weight exercisesOverload for non injured partsOverload for non injured parts

Agility to maintain court speedAgility to maintain court speed


Return to sportReturn to sport

Skills retrainingSkills retrainingUninfluenced by injury at 50-75%Uninfluenced by injury at 50-75% Influenced by injury at 25-50%Influenced by injury at 25-50%

Develop movement controlDevelop movement control Improve ability to make positionImprove ability to make position

Controlled environmentControlled environmentDelay competitive training until 100%Delay competitive training until 100%

Progress intensity if pain free during the Progress intensity if pain free during the session as well as the next daysession as well as the next day


Return to competitionReturn to competition

Graduated inclusion into game Graduated inclusion into game

Ensure player manages injury on the Ensure player manages injury on the benchbench

May require rest from game to facilitate May require rest from game to facilitate inclusion in future competitioninclusion in future competition


Injury ManagementInjury Management

Doctor, Physio, Trainer, Other health Doctor, Physio, Trainer, Other health professionalsprofessionalsEnsure communication (verbal or written)Ensure communication (verbal or written) Identify limitations and capabilitiesIdentify limitations and capabilities

Facilitate rehabilitation at and between Facilitate rehabilitation at and between trainings or competitionstrainings or competitions

Incorporate injured athlete into trainingIncorporate injured athlete into training


At trainingAt trainingEnsure good warm up (sweating)Ensure good warm up (sweating)Allocate time for athletes to attend to Allocate time for athletes to attend to

rehab exercisesrehab exercisesDuring warm upDuring warm upDuring aggravating activity or break in playDuring aggravating activity or break in play

Have ICE or Contrast baths availableHave ICE or Contrast baths availableEnsure time allocated for warm down and Ensure time allocated for warm down and

stretchingstretchingEnsure athletes have snacks and hydrateEnsure athletes have snacks and hydrate


Between trainingsBetween trainings

Reinforce application to rehab activitiesReinforce application to rehab activities

Identify suitable recovery strategiesIdentify suitable recovery strategies

Communicate with other coaches and Communicate with other coaches and parents about load expectations for athleteparents about load expectations for athlete

Communicate with athlete about progressCommunicate with athlete about progress


ConclusionConclusion

• Self management requires self monitoring of training and competition loads

• Athlete-sports health team needs to manage these loads to incorporate injury rehabilitation

• This is difficult to achieve if the coach isn’t on board!

• Communicate

Injury management in heavy training or preparation phases Ian Scarborough M. Sports Physiotherapy...

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