Injury Mitigation

An updated perspective on the concept of “injury prevention”

The proceeding discussion is in response to a discussion that resonated with me from this past weekend’s online summit. Our very own Jarred Boyd opened the floor to discuss the question of, “what is injury prevention?” and the responses were both phenomenal and humbling. “Injury prevention” is a rather nebulous term that means vastly differing things to different people.

The more that we think we know about reducing injuries, the more we realize the limitations of many of these beliefs. In all reality, there is no way to eliminate all risk of injury. In retrospect, it is easy to point fingers at what “caused” an injury, but forecasting them is a very different challenge.

“Injury mitigation” is a much better term that was proposed by one of the members of the group. In my mind, this is a perfect term for what we as coaches and clinicians are trying to accomplish — minimizing risk, but never fully eliminating it. Our ultimate goal with reconditioning is quite literally to identify, modify, and monitor specific qualities that may predispose a greater risk of injury to our clients.

The question then becomes, “well what are those qualities that matter most in mitigating injury?” This is where the uncertainty shines through the cracks. The answer is… we don’t entirely know.

Unfortunately, just throwing up ones’ hands and quitting probably isn’t the best answer either. This is where the scientific method and the use of reliable rules-of-thumb becomes highly applicable. Ideas like the “10% rule” for progressively increasing running volume and the concepts of periodization come to mind. These concepts serve as safeguards whose aim is to work within acceptable boundaries of progression — not too much, not too little.

In general, these theoretical boundaries work quite well when used across large populations, but may not serve outliers from the norm.

Herein lies the conundrum: we are constantly having to negotiate waters of uncertainty with individuals of all backgrounds, all levels of readiness, and countless physical demands. There will likely never be a formulaic regression that provides us with the answer.

So what are we to do? I would argue that our best bet is to learn how to ask the right questions.

  • What physical, psychosocial, and cognitive demands are most relevant to the individual?
  • How often and with what intensity do they have to perform said demands?
  • What is their current level of preparedness? (How much are they currently doing or prepared to do?)
  • What is the “lowest hanging fruit” for this individual?

With all of these questions, we have to consider the qualities with which we have the ability to directly influence. How do we ensure we are devoting our limited time and resources in the most efficacious manner possible? This inevitably leads into further discussions of causative factors of injury such as biomechanics and whether or not training elicits relevant and sustainable changes. That will be a topic for another day.

Now I would like to pose the same question to you: “in order to mitigate injuries, what factors matter most to you?”

– Dr. Mike Reinhardt; Site Director, Rehab 2 Perform – Germantown


Book: Applied Sprint Training – James Smith

  • By far one of the most practical and comprehensive deep dives into the realm of linear acceleration, sprint mechanics, and training considerations. Highly recommend this read to anyone who is looking to sharpen their understanding and implementation of sprint specific training.

Article: Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta analysis of randomized controlled trials. British Journal of Sports Medicine 2014;48:871-877. (READ HERE)

  • This meta-analysis looks at overall physical activity levels as it applied to relative injury risk. The populations discussed were highly heterogenous, but the overall findings suggest that physical activity effectively reduced sports related injuries across all populations. This effect was proposed to be greatest with strength training, while stretching showed no positive effects.

Social Media Follow: Mike Robertson @robtrainsystems

  • Mike has been a profound mentor of ours. He consistently puts out digestible and highly relevant training and coaching content. He is a master of taking the complex and boiling them down into easily trainable concepts and exercise strategies.

Podcast: PT Inquest: Episode 199 Change of Direction in Sport

  • This episode has a great discussion of all things change of direction. Guest speaker Richard Clarke explains important change of direction considerations, qualities, and their implications for return to sport. 

OK, now is your time to register and check out the Strength in Knowledge Summit!

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