Injury prevention is a popular phrase in the sport and exercise industry. It normally conjures ups images of elaborate stretches and mobility drills that look like some kind of animalistic mating dance that's just missing a David Attenborough voiceover. Despite the familiarity of the phrase, information on injury prevention tends to come predominantly from the following, not so reputable, sources.
- Companies using the buzz words to sell you supplements or other nonsense that have little to no evidence of actually preventing injury.
- Strength coaches and personal trainers dishing out “simple hacks” or protocols for preventing injuries. This information can sometimes be useful but at best you may not be getting the full picture and at worst you could be doing yourself more harm than good. Bear in mind that musculoskeletal injury management is a complicated and specialised area of medicine, which is why injury advice should be sought from qualified and regulated medical professionals.
- Trev from the accounts department who, like a certain US president, considers himself to be “a pretty smart guy” tried x, y or z and it worked for him. So it will DEFINITELY work for you, right? Please don't listen to Trev.
Below are the strategies with the strongest scientific evidence for preventing injury. You will note the absence of stretching and flexibility. These concepts, in isolation, are not well advocated by the scientific literature despite their common use and promotion. If you're going to be a sheep, make sure you follow the right flock.
Avoid sharp spikes in training load
Doing too much too quickly, after too little for too long. It is well documented that injury rates are higher where there has been a recent and significant increase in training load.
Be weary of the following:
- Drastically increasing your running milage
- Starting that intense 12 week gym program after weeks/months of low activity levels
- The beginning of the season for organised sports
- Returning to sport after injury
Increase overall strength
The stronger you are, the less likely you are to injure yourself. The strength and conditioning world can get really technical around the best ways to get strong. But the science suggests it doesn't overly matter exactly how you do it, as long as you are exposing your body to a safe and consistent routine that gets progressively more challenging over time.
Maintain a high chronic training load (CTL)
CTL is the cumulative training dose that builds up over a long period of time. Essentially if you slowly build up to a high but consistent volume of training and you maintain that high volume, this significantly reduces your risk of injury.
Prioritise effective warm up
This is self explanatory and probably of no great surprise to anyone. Yet absent or ineffective warm up routines are a common feature in so many sports injuries. A lot of high level S&C coaches argue if you are well trained and know how to do things properly it’s fine to go in cold. I don't disagree in certain cases that can work but the vast majority of people, especially those battling with pain, would benefit from taking time to increase proprioception and the efficiency of neuromuscular pathways.Address side to side strength discrepancy
Studies, have shown differences in strength of more than 10-15% between the right and left side, especially in the legs, is associated with an increased risk of injury. In particular this can be common in recurrent injuries.
Injury specific/ function specific rehabilitation
Good quality management of current or recent injuries is more likely to protect against future recurrence. Nail your rehab properly.
Prioritise effective recovery
Sleep, hydration, adequate nutrition, management of stress levels. Again no big surprise but all of the above strategies are far less likely to work if this stuff isn't being prioritised.
Each of these strategies could be another article on their own. And I will in due course cover some of this in more detail. Stayed tuned.
Don’t take my word for it, take a look at the research yourself…
https://bjsm.bmj.com/content/50/5/273.short
https://breathe.edu.au/wp-content/uploads/2018/08/Strength-training-as-superior-dose-depen-2018.pdf
https://link.springer.com/article/10.1007/s40279-016-0619-5
https://link.springer.com/article/10.1007/s40279-015-0404-x
https://link.springer.com/article/10.1186/1741-7015-10-75
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0838.2008.00780.x