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Mitigation for Injuries

In this video, we discuss the two categories of injuries. We explain how they happen, and which we have any control over. Since that’s only one of them, we delve into mitigation strategies to help prevent injury.

Chapters:
00:00 Introduction
01:17 Catastrophic Injury
02:57 Overuse Injury
06:07 Recovery and Sleep
08:40 Mobility and Tissue Preparation
14:40 Conclusion

Transcript:

Welcome back to the Fitness Edda. I am your host Erik Castiglione, owner, and head coach of Viking Athletics. And this week we’re going to be talking about injury mitigation.

It is impossible to truly prevent injury. So, we want to talk about steps that we can take in order to mitigate it. Anyone that claims they can prevent injury is selling you a bill of goods. There are things we can do to mitigate risk and mitigate severity, but there’s nothing that we can do to prevent it 100%

So, what we’re going to be covering today – this should be a shorter topic hopefully, I won’t keep you here for a half hour, should be closer to the 10-15 minute mark, if that – we’re going to be covering the two different types, or categories rather, of injuries. We have catastrophic injuries, and overuse. It’s a pretty quick distinction. We’ll get into that.

And then we’ll talk about specific mitigation strategies. Specifically, recovery, mobility, and tissue preparation. We’ll get into these are terms that kind of get thrown around a lot. Especially mobility and recovery. We’ll talk about what we mean specifically for them.

So, there are two types of injuries really. There’re catastrophic injuries, and there are overuse injuries. Catastrophic injuries are when something just goes terribly wrong. It’s something outside of your control. It’s not controllable. This could mean that you have a car accident, and you know, you end up breaking a bone, or you get banged up. Maybe you slip on the ice and fall and break something. It’s winter – stuff like that.

Or you could just have a really, really bad day of weightlifting and something just goes terribly wrong. Like, you end up passing out with a bar on your shoulders and spraining your wrist. Again, no amount of preparation is really going to help with that. It was a freak accident. I choked myself out and fell over backwards with 300 pounds on my shoulders. So luckily for me, I only sprained my wrist. Had I banged my head I could have had a concussion or something like that.

If you have a football player that takes a bad hit and ends up with a concussion – these are the kinds of catastrophic injuries that we’re talking about. There’s not a whole lot that you can do to mitigate that, so we don’t even want to delve into that.

When people again are talking about injury prevention, usually what we’re talking about – we don’t need to see that again it’ll live forever in USA weightlifting history – what we’re talking about to prevent injury are overuse injuries.

So, these are the “okay, I’ve been running too much and now I have Achilles pain,” or, “my shoulder is bothering me from doing all those kipping pull-ups.” In order to understand this, they come from overuse, it’s pretty simple. Too much volume. Volume is a word that gets thrown around when we talk about training. You know, you’re doing too much. We’re not talking about total volume necessarily in this case, we’re talking about too much for a particular body part. If I overload a particular body part, I end up with tissue irritation or failure.

If I end up overloading the small tissues in my shoulders and my rotator cuff – there’s four muscles in the rotator cuff – SLAP tear is a common one when we talk about kipping pull ups. I’m doing too much load, and too much volume, and my shoulder gives out. I have done too much work, and I was not able to handle it, so my body gives out. We see that a lot when we have lifters that end up getting hurt, when we have runners that end up with knee pain, or ankle pain, or any kind of joint pain from high volume of running. And that is the type of injury that we can work to mitigate.

I’m not going to get into rehab, which is well beyond my scope of practice as a coach. That would be the realm of physical therapy. If you do find yourself in need of one, come see Dr. Raf Ozdemirer. We have him on site – he runs Dynamic Performance PT, and he does a lot of work for us in our gym at Viking Athletics. He’s great – he focuses on sports performance and how to keep you doing what you want to be doing as you’re working through and around injuries.

Back to the overuse injury – we are talking also here about exposure to a new more unfamiliar range of motion. Familiar would mean that you have repeated exposure to it. Unfamiliar would mean you’ve only been into it a couple of times. A lot of times, we see people roll an ankle. You are turning

your foot to such a degree that you are exposing the soft tissue of the ankle to a range of motion that you probably don’t train a whole lot, and it causes pain. In severe cases it can lead to a sprain or strain or, God forbid, a break. Whereas, if you were familiar with that range of motion, and you trained it a fair amount and loaded it, it would no longer be new and unfamiliar, and your tissue would be prepared for that.

That brings us into mitigation strategies. I just hinted at one by talking about that, we’ll get to that next. The first one is recovery. If you think about it, it’s kind of obvious. If I get injuries from overusing certain muscles, how do I avoid overusing them? Number one – my training needs to be smart. I need to have an appropriate training volume for me, but I also need to make sure that I’m recovering. And the best recovery tool out there to this day is still sleep.

You can talk about contrast showers, you can talk about cold plunges, we can talk about soft tissue work, we can talk about massages, nothing beats sleep. In fact, it is the only so called injury prevention strategy out there. Figure 10 right here – I took this from a course that I took, and I’ve seen numerous other graphs that are very similar – your chance of injury increases with lack of sleep. We can see here – 6 hours of sleep you are 75% more likely to get injured. If you are getting 9 hours of sleep it’s less than 20%.

I’ve seen other statistics – I think the number thrown around was a 170% likely increase in injury for people that are sleeping less than 6 hours a night or something like that. The bottom line is, if I’m not allowing my tissues to recover, what was within the realm of possibility, and the realm of manageable volume for me has now, the goalposts have moved. If I’m not recovered what was good for me is no longer good for me. So hopefully that part is obvious. Get enough sleep. Your tissues will recover, and you are better able not only to adapt to your training but to handle the same amount and a little bit more volume.

Another piece of this is eating enough protein and calories. We want to make sure we are getting enough calories in general to fuel our exercise and to allow our bodies to repair themselves. Protein is instrumental in that. It is used for repair, preferably also in the presence of carbohydrates. For muscle growth and muscle synthesis usually you need  both, but primarily it would be the protein. And we want to make sure we are getting enough calories to fuel exercise. If you are starving yourself and working out, you are at greater risk of injury. That would be the second piece.

Moving on. The next mitigation strategy – I hinted at it when we were talking about rolling your ankle – is mobility. Mobility is a term that was popularized in the CrossFit world by Dr. Kelly Starrett. He’s written numerous books on it, Becoming a Supple Leopard, Deskbound, Built to Move, Ready to Run, he’s got a whole series of them. His definition of mobility is all encompassing. Basically, anything that you’re doing to improve performance, be it soft tissue work, stretching, dynamic motion, he lumps all that under the mobility umbrella. We’re talking specifically about range of motion here, and more importantly strength and stability within that range of motion.

The more that you’re able to expose yourself to different ranges of motion and to build strength in those ranges of motion, the more robust you’re going to be and the more likely you are to shake it off if you are forced into those ranges of motion. So again, using the example of rolling an ankle. If I routinely turn my feet to the outside, and, there’s a guy named Ido Portal who was famous for this – essentially walking around on the knife edge of your feet, and even squatting and loading that up. You are now building that range of motion, you are strengthening the tissues to work through that range of motion, and it is no longer new or unfamiliar.

You can do that with just about anything. If you’re worried about knee pain, you know when we teach the squat, we are always telling people to sit back. There is another guy on the internet, “Knees Over Toes Guy,” who is a big advocate for heels elevated squats. It loads up the quads, it forces the knees to go out over your toes you can do lunges there too, and again the common thought was if we squat that way, and we only squat that way, and we ignore our hamstrings in favor of our quads, we are going to get hurt. We are going to put too much stress on the knee joint.

But if I’m getting enough posterior chain work through the rest of my training, and I’m building strength there simultaneously while I work on my knees over my toes, and I build my range of motion that way, I am now balanced. And I have now increased what we call a functional range of motion. Again, the more I can expose myself to various positions, and I can strengthen myself through those positions – if something happens and you are forced into it, you’ve been there before It’s not new, and you are more likely to shake it off.

The third mitigation strategy is tissue preparation. Again, mobility is a part of that. But what it means specifically here is your ability to handle impact. So, it’s slightly different. We are not talking about your ability to move through space, we are talking about your ability to absorb force. So, this is a little bit different.

This is where plyometric work comes in. And for runners in particular, they get injured most of the time because they handle a lot of impact. Every step that runners take is impact on their body. And if they have not adequately prepared their tissues to handle that, you run into Achilles pain. You run into shin splints, you run into knee pain, hip pain, all of that.

So, we can mitigate that by improving our body’s ability to absorb force. We do that through plyometrics. There are various ways to implement this. Whether it is high force plyometrics where I’m going for, call it a depth jump – I’m dropping off of a box and using the rebound to jump onto another box. That is a quick turnaround. We’re really working on the stretch reflex there. That type of plyometric work is great for power. It’s good to include some of that.

And then you also want to include what would call plyometric endurance. Whether I have little hurdles that I’m jumping over for a minute at a time, or even, the simplest one would be just jumping rope. If I am jumping rope and doing a ton of singles in place for minute after minute, I am going to build up my body’s ability to handle that impact.

For runners, you definitely want to include some of this, especially jumping rope on your off days. If you do it every day within reason, you will build up that tissue. Again, we want to make sure we’re recovering from this, so get enough sleep while you’re jumping rope. Well, you can’t do it simultaneously, obviously. I wish I could jump rope in my sleep. Make sure you’re getting enough sleep to recover from the tissue preparation.

And then we also have band work. We include a lot of this in our gym. Movements like band face pulls, and band pull aparts are great for shoulders. Band terminal knee extensions, band hamstring curls, all that fun stuff. You’re doing it with a light band and very high volume. And what that does is it helps prep the tissues. Tissues around the muscles. Specifically, tendons and ligaments.

The elasticity of the bands allows them to – they’re basically put under different amounts of force throughout different pieces of the movement. Because it’s an elastic, the curve is not straight. As I stretch it more, I’m under more load. It’s great for developing your tendons and ligaments abilities to absorb force.

That’s all we got for this one. I told you guys it was quick. Bottom line – there are certain kinds of injuries that we can mitigate. Those are the overuse injuries. When it comes to freak accidents and catastrophic injuries of that sort, they’re uncontrollable. But the stronger that you are and the more prep work you’ve done, the faster your recovery is likely to be.

For the injuries that we can control, we can mitigate the likelihood of injury by getting enough sleep. Next, eating enough protein and total calories. Exposing ourselves to increased ranges of motion, building strength through those ranges of motion, and preparing our soft tissue by doing plyometrics and other impact absorbing work, and including some band work for our tendons and ligaments.

I hope that helps you guys. If anyone needs help with putting together specific protocols and organizing these elements into a training session be sure to hit us up. That is what we do. We’re happy to work with runners. I am currently in the process of training to run myself. It’s been a while, but I have worked with numerous people that I’ve helped to qualify for the Boston Marathon. We are happy to help; hit us up! As always, if you enjoy this content, give us a like, give us a subscribe, and we will catch you next time.

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