On this episode of the #AskMikeReinold show we talk about building injury prevention programs. Sure, these are usually just solid training programs, but there are ways to make them even better at injury prevention. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.
#AskMikeReinold Episode 232: How to Build Injury Prevention Programs
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Show Notes
Transcript
Student:
Okay, so Tyler from New York asks, how do you build injury prevention programs? Are injury prevention programs, for the most part, just good sound training?
Mike Reinold:
Great question, Tyler. I like that one a lot. A lot of people say that. I’m probably one of those people in that camp that I’ve probably said that at some point in my life, too, that a good injury prevention program’s the same as a good training program, which is the same as a performance enhancement program. They’re all just good training. So I kind of liked that concept. I know others like Mike Boyle and Gray Cook and even Mark [inaudible 00:01:46] and stuff, I’ve definitely kind of heard repeat some of those concepts as well. So yeah, I mean, I think we approach it that way at Champion. I’d love to kind of get some other thoughts. Maybe start off even with Dewy for a sec here and just kind of talk about what’s the difference maybe … Dewy, maybe we start with this. What’s the difference between just a training program and an injury training program? Is there a difference and do you do anything differently?
Diwesh Poudyal:
Yeah, I think to start, I would say that overall concept of a good strength and conditioning program being a good injury prevention program does hold true. Now, there is a couple other things that we probably should add to that a little bit so that we’re not overgeneralizing. We do have to look at the demands of the sport and say, all right, what do they get a lot of and what are the specific demands that we do have to get the athletes ready for?
Mike Reinold:
I like that.
Diwesh Poudyal:
So let’s use a runner as an example. So a runner wants to do distance running. We got to get their endurance really high. We’ve got to get some level of power so that they can be a little bit more efficient when it comes to their top end work. But then we have to say, all right, they get a ton of repetitive motion. They get repetitive stress on these joints. How do we give them specific movements or a little bit more isolated, targeted work for specific muscle groups that keeps them healthy in the long run? So an easy example there would be give them a little bit more heavy [inaudible 00:03:12] strengthening work. Maybe give them some plyo work, some vertical power work, and get them ready to go and build a better, more efficient [inaudible 00:03:22].
Mike Reinold:
I like that. And I like the concept of really focusing on the demands of the sport. So two things I’d say. The demand of the sport, and then secondarily, I’d probably even add what are the common injuries in the sport that we’re talking about to prevent that injury? What are the most common injuries you see? So that way you can almost reverse hack it. So, if your sport tends to get hamstring strains, you’re probably going to do more things to get that more resilient in your program here. So I like the way you phrase it. It starts with a good training program. But I actually think if it’s just a good training program, it’s probably not as good as it could be. So who else has some thoughts? I’d like to hear Dave’s thoughts maybe on the whole concept of maybe, sometimes it’s not a magical exercise, but maybe an injury prevention program is just working on building capacity. And then I know maybe Dan might have some stuff too. So I don’t know. Dan, you want to start it off maybe?
Dan Pope:
Yeah. Sorry. I’m foaming at the mouth about this.
Mike Reinold:
[crosstalk 00:04:24]. Yeah, nice. We can’t tell because you have a mask on, so we can’t see the foam.
Dan Pope:
Yeah, it could be COVID. I’m just kidding. I don’t think it is.
Mike Reinold:
Not funny. Not funny. It’s not. It’s rabies though.
Dan Pope:
Yeah, it could be rabies. It could be rabies. Well, I’m in the fitness world, so it’s a little funky because the training programs for my athletes, they don’t do a sport beyond kind of working out in the gym. So it’s a little bit different. And I think because of that, the fitness world could be a little bit better in terms of creating an injury prevention program. And I think you said it right on the head there. We have to figure out exactly how these injuries are happening before we start trying to apply this blanket injury prevention plan, which doesn’t really address any of the real reasons why people get hurt.
Dan Pope:
So first and foremost, you’ve got to figure out your sport and where those injuries are occurring. So, if you start thinking about … I had an athlete the other day who had a pec rupture. And if you start looking through the medical literature, it’s supposed to be very uncommon. I’ll tell you what. If you are a power lifting athlete, and if you’ve worked at power lifting, pec strain and pec rupture is actually quite common. Same thing goes for the bicep. So we need to make sure that we’re creating an injury prevention plan that’s very specific to the reasons why people get hurt. It could also be an overuse issue, it could be a loading issue, it could be that we don’t have mobility in the right areas. Something like Olympic weightlifting.
Dan Pope:
I know people love to poo-poo flexibility as it’s something that can prevent injuries. And maybe in a field sport athlete it might not be the best intervention to reduce the likelihood of getting, let’s say, a hamstring strain injury, but if you don’t have the right mobility to perform an Olympic lift, you might have terrible pain in, let’s say, your wrist, elbow, shoulder, because you can’t get into a front rack, you can’t get overhead fully. So in my population, since there’s a lot of Olympic weightlifting, I need to do quite a bit of mobility work to reduce the likelihood of getting injured. So I guess I’m not adding a ton more than what you had already said. I’m just expanding upon it and just making sure that when people are trying to create a prevention plan, there’s some real thought towards how people get hurt first and starting to address those issues, as opposed to blanketly trying to make someone more balanced, or do more rowing and pulling. There are all these ideas of pop up into the fitness world that are supposed to prevent injuries magically, but they’re not addressing the actual way that people get hurt in the gym.
Mike Reinold:
I liked that too. And I think we’re all saying that that concept is pretty dang close, but if that’s all you believe in, it’s not enough. You have to understand the specific demands and injuries of the sport. So Dave, I’d just love to hear your thoughts because I know you’ve put some thoughts on capacity. And sometimes we don’t get hurt because of something that happens, but maybe it’s either under or over capacity preparation, almost to a point. So how would capacity go into an injury prevention program?
Dave Tilley:
Yeah, it’s interesting and it’s also, unfortunately, a really a big elephant in the room topic in our profession because everybody here who’s a provider in medical or not come with parents or coaches or internet gurus. They want the one best exercise for low back pain. They want the three best stretches to help with your knee pain. It’s not that simple. This is such a complicated, multifaceted issue. And honestly, most of the time it comes down to a harder conversation about workloads and are you following a good program? Do you have really good, basic technique? Do you work on the basics every single day? Do you have patience to go through multiple adaptation cycles over months and years, not weeks and days? People want a quick, instant fix.
Dave Tilley:
And so yeah, maybe mobility or strength or control issues, maybe there’s something you can pick up. But 95% of the time, it’s going to be a much bigger problem with the workload issue in their culture. And I think unfortunately, a lot of times people are just pushing too hard too soon with younger athletes and they want to show off for a scholarship or a showcase or something like that. And that’s a workload problem. You’re trying to ramp up super aggressively for something that maybe is not a super relevant goal for your long-term performance. And I think I’m having more of those harder conversations around periodization and long-term athletic development and planning a good workload over a year and saying, okay, well what’s your biggest competition? When can we ramp up to that? How are we going to ramp up to that? How many weeks, how many months are we going to go into that?
Dave Tilley:
And I think unfortunately, that’s a way harder for someone to be patient and to go slow and do the proper steps. And so they don’t want to do that. And it’s really hard because, again, in an instant gratification world, they want to just always be ready to go 100%. And so, people want those fancy exercises and they want that quick solution, three stretches for knee pain or this best exercise for back pain, and I don’t think we’re doing anybody a service when we try to go that route.
Mike Reinold:
I like that. Yeah. So I mean, again, if you just think injury prevention programs are a functional training program, then I think you missed the boat on that. What Dave kind of said, maybe you don’t ramp them up enough, so you’re not preparing them enough for their competitive season. Maybe you ramp them up too much, or maybe you ramp them up too fast. And I think that’s the other thing, is the pace of getting them to their capacity.
Lenny Macrina:
I think it’s also a cultural thing too. If you look at some of the sports that are out there, baseball is pretty well accepted now that you have to strength train at some capacity in-season and out of season. And then we were talking about, in a previous episode, about rowing. Rowers don’t really train. They train by rowing. They don’t necessarily come in and want to have a program for an off-season because there really isn’t an off-season. Same in gymnastics. Gymnastics, basically, you don’t train because you’re going to get too bulky. You’re going to lose your flexibility. But baseball is, no, let’s train, and almost to the point, training almost too much, I feel. We have kids coming in that are looking jacked. Dude, pump the brakes a little.
Mike Reinold:
Lenny just broke the internet. Lenny just broke the internet.
Lenny Macrina:
Exactly.
Dave Tilley:
[crosstalk 00:09:52]. It took me six years to get there.
Lenny Macrina:
Yeah, absolutely. And you’re trying in gymnastics and Lisa’s trying in rowing, or crew. And I think there’s a cultural thing too, that is being addressed as well throughout the different sports.
Mike Reinold:
Awesome. So good stuff. So bunch of things that go into it. I wish it was as simple as just a good training program. That’s your foundation. That’s probably 80% of it though. But then there’s some more specific things you can do on top to be even better. And you know what? That’s how you set yourself apart, Tyler. That’s the big part of that, is that you can set yourself apart by being that person there. Lisa, did you have something brief?
Lisa Russell:
May I add one little thing?
Mike Reinold:
Yeah, sure.
Lisa Russell:
I was going to say, at least within the rowing world, one thing that I’ve really noticed holds people back is a lot of times when coaches do develop some sort of strength program or some sort of injury prevention type stuff, it’s blanketed for the entire team. And so I feel like, keeping in mind obviously every athlete’s an individual and everybody moves differently and needs different things, that that can go a long way. And so again, not having the magical exercise or even just the set of injury prevention, we give this to everybody. I think being aware of people’s variability and what individuals need goes a long way too.
Mike Reinold:
That makes sense too. Everybody may have a different thing that they need. So maybe they’re tight somewhere, weak somewhere, something somewhere. I think that’s a really good point, so I’m glad you added that here. We didn’t even really talk about that. It’s your individual deficiencies and things. So, perfect. So, awesome. So, great question. Thanks, Tyler. We will keep going with these questions if you keep asking. So head to MikeReinold.com, click on that podcast link, and you could fill out the form to ask us more questions. Not answer us more questions. It’s not jeopardy. That would be interesting. We should do that one episode.
Dave Tilley:
300th episode?
Mike Reinold:
300. We’re getting there. Awesome. Thanks so much. See you on the next episode.
