Sports Injuries

For individuals who lift weights, are there ways to protect the wrists and prevent injuries when lifting weights?

Wrist Protection

The wrists are complex joints. The wrists significantly contribute to stability and mobility when performing tasks or lifting weights. They provide mobility for movements using the hands and stability to carry and lift objects securely and safely (National Library of Medicine, 2024). Lifting weights is commonly performed to strengthen and stabilize the wrists; however, these movements can cause wrist pain and lead to injuries if not performed correctly. Wrist protection can keep wrists strong and healthy and is key to avoiding strains and injuries.

Wrist Strength

The wrist joints are set between the hand and forearm bones. Wrists are aligned in two rows of eight or nine total small bones/carpal bones and are connected to the arm and hand bones by ligaments, while tendons connect the surrounding muscles to the bones. Wrist joints are condyloid or modified ball and socket joints that assist with flexion, extension, abduction, and adduction movements. (National Library of Medicine. 2024) This means the wrists can move in all planes of motion:

• Side to side
• Up and down
• Rotate

This provides a wide range of motion but can also cause excessive wear and tear and increase the risk of strain and injury. The muscles in the forearm and hand control finger movement necessary for gripping. These muscles and the tendons and ligaments involved run through the wrist. Strengthening the wrists will keep them mobile, help prevent injuries, and increase and maintain grip strength.  In a review on weightlifters and powerlifters that examined the types of injuries they sustain, wrist injuries were common, with muscle and tendon injuries being the most common among weightlifters. (Ulrika Aasa et al., 2017)

Protecting the Wrists

Wrist protection can use a multi-approach, which includes consistently increasing strength, mobility, and flexibility to improve health and prevent injuries. Before lifting or engaging in any new exercise, individuals should consult their primary healthcare provider, physical therapist, trainer, medical specialist, or sports chiropractor to see which exercises are safe and provide benefits based on injury history and current level of health.

Increase Mobility

Mobility allows the wrists to have a full range of motion while retaining the stability necessary for strength and durability. Lack of mobility in the wrist joint can cause stiffness and pain. Flexibility is connected to mobility, but being overly flexible and lacking stability can lead to injuries. To increase wrist mobility, perform exercises at least two to three times a week to improve range of motion with control and stability. Also, taking regular breaks throughout the day to rotate and circle the wrists and gently pull back on the fingers to stretch them will help relieve tension and stiffness that can cause mobility problems.

Warm-Up

Before working out, warm up the wrists and the rest of the body before working out. Start with light cardiovascular to get the synovial fluid in the joints circulating to lubricate the joints, allowing for smoother movement. For example, individuals can make fists, rotate their wrists, perform mobility exercises, flex and extend the wrists, and use one hand to pull back the fingers gently. Around 25% of sports injuries involve the hand or wrist. These include hyperextension injury, ligament tears, front-inside or thumb-side wrist pain from overuse injuries, extensor injuries, and others. (Daniel M. Avery 3rd et al., 2016)

Strengthening Exercises

Strong wrists are more stable, and strengthening them can provide wrist protection. Exercises that improve wrist strength include pull-ups, deadlifts, loaded carries, and Zottman curls. Grip strength is vital for performing daily tasks, healthy aging, and continued success with weightlifting. (Richard W. Bohannon 2019) For example, individuals who have difficulty increasing the weight on their deadlifts because the bar slips from their hands could have insufficient wrist and grip strength.

Wraps

Wrist wraps or grip-assisting products are worth considering for those with wrist issues or concerns. They can provide added external stability while lifting, reducing grip fatigue and strain on the ligaments and tendons. However, it is recommended not to rely on wraps as a cure-all measure and to focus on improving individual strength, mobility, and stability. A study on athletes with wrist injuries revealed that the injuries still occurred despite wraps being worn 34% of the time prior to the injury. Because most injured athletes did not use wraps, this pointed to potential preventative measures, but the experts agreed more research is needed. (Amr Tawfik et al., 2021)

Preventing Overuse Injuries

When an area of the body undergoes too many repetitive motions without proper rest, it becomes worn, strained, or inflamed faster, causing overuse injury. The reasons for overuse injuries are varied but include not varying workouts enough to rest the muscles and prevent strain. A research review on the prevalence of injuries in weightlifters found that 25% were due to overuse tendon injuries. (Ulrika Aasa et al., 2017) Preventing overuse can help avoid potential wrist problems.

Proper Form

Knowing how to perform movements correctly and using proper form during each workout/training session is essential for preventing injuries. A personal trainer, sports physiotherapist, or physical therapist can teach how to adjust grip or maintain correct form.

Be sure to see your provider for clearance before lifting or starting an exercise program. Injury Medical Chiropractic and Functional Medicine Clinic can advise on training and prehabilitation or make a referral if one is needed.

Fitness Health

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Erwin, J., & Varacallo, M. (2024). Anatomy, Shoulder and Upper Limb, Wrist Joint. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30521200

Aasa, U., Svartholm, I., Andersson, F., & Berglund, L. (2017). Injuries among weightlifters and powerlifters: a systematic review. British journal of sports medicine, 51(4), 211–219. https://doi.org/10.1136/bjsports-2016-096037

Avery, D. M., 3rd, Rodner, C. M., & Edgar, C. M. (2016). Sports-related wrist and hand injuries: a review. Journal of orthopaedic surgery and research, 11(1), 99. https://doi.org/10.1186/s13018-016-0432-8

Bohannon R. W. (2019). Grip Strength: An Indispensable Biomarker For Older Adults. Clinical interventions in aging, 14, 1681–1691. https://doi.org/10.2147/CIA.S194543

Tawfik, A., Katt, B. M., Sirch, F., Simon, M. E., Padua, F., Fletcher, D., Beredjiklian, P., & Nakashian, M. (2021). A Study on the Incidence of Hand or Wrist Injuries in CrossFit Athletes. Cureus, 13(3), e13818. https://doi.org/10.7759/cureus.13818

Any form of physical sports activity puts the body at risk for injury. Chiropractic care can prevent injury for all athletes, weekend warriors, and fitness enthusiasts. Regular massaging, stretching, adjusting, and decompressing enhances strength and stability, maintaining the body's readiness for physical activity. A chiropractor assists in sports injury prevention through analysis of the body's musculoskeletal system addressing any abnormalities from the natural frame and adjusts the body back into proper alignment. Injury Medical Chiropractic and Functional Medicine Clinic provides various sports injury prevention therapies and treatment plans personalized to the athlete's needs and requirements.

Sports Injury Prevention

Individuals involved in sports activities push themselves through rigorous training and play sessions to new levels. Pushing the body will cause musculoskeletal wear and tear despite meticulous care and training. Chiropractic addresses potential injuries by proactively correcting the problematic areas within the musculoskeletal system to improve body functionality. It ensures that all system structures, spine, joints, muscles, tendons, and nerves are working correctly and at their healthiest, most natural state.

Performance

When muscles are restricted from moving how they are designed to, other areas over-compensate and over-stretch to make the movement possible, increasing the risk of injury as they overwork. This is how the vicious cycle starts. Regular professional chiropractic:

• Regularly assesses the alignment of the body.
• Keeps the muscles, tendons, and ligaments loose.
• Spots any imbalances and weaknesses.
• Treats and strengthens the imbalances and deficiencies.
• Advises on maintaining alignment.

Treatment Schedule

Consecutive treatments are recommended to allow the musculoskeletal system to adapt to regular treatments. This allows the therapists to get used to how the body looks, feels, and is aligned. The chiropractic team gets used to the body’s strengths and weaknesses and learns the areas that need attention during each treatment. Initial treatment could be every week or two, allowing the chiropractor to spot any discrepancies in movement patterns and giving the body a chance to acclimate to the therapy. Then regular treatment every four to five weeks depending on the sport, training, games, recovery schedule, etc., helps maintain a relaxed, balanced, and symmetrically aligned body.

Pre-Workouts

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Hemenway, David, et al. “Injury prevention and control research and training in accredited schools of public health: a CDC/ASPH assessment.” Public health reports (Washington, D.C.: 1974) vol. 121,3 (2006): 349-51. doi:10.1177/003335490612100321

Nguyen, Jie C et al. “Sports and the Growing Musculoskeletal System: Sports Imaging Series.” Radiology vol. 284,1 (2017): 25-42. doi:10.1148/radiol.2017161175

Van Mechelen, W et al. “Incidence, severity, etiology and prevention of sports injuries. A review of concepts.” Sports medicine (Auckland, N.Z.) vol. 14,2 (1992): 82-99. doi:10.2165/00007256-199214020-00002

Weerapong, Pornratshanee et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004

Wojtys, Edward M. “Sports Injury Prevention.” Sports health vol. 9,2 (2017): 106-107. doi:10.1177/1941738117692555

Woods, Krista et al. “Warm-up and stretching in the prevention of muscular injury.” Sports medicine (Auckland, N.Z.) vol. 37,12 (2007): 1089-99. doi:10.2165/00007256-200737120-00006

The most common causes of golf injuries are playing and practicing too excessively, improper swinging mechanics, and little or no physical conditioning. Pain meds either over-the-counter or prescribed, bracing, and surgical procedures are how symptoms are treated instead of the root cause/s. If the cause/s are addressed then injury prevention comes naturally.

Overuse

Driving requires a great deal of effort and power that puts tremendous stress on the body. When done too frequently, injuries can result. The body can take all kinds of forces thrown at it. But there is a limit as to how much it can take before an injury occurs.

Too many swinging reps while playing and practicing could cause trauma to the muscles and connective tissues, which leads to inflammation and pain. Swinging and hitting with bucket after bucket of balls to improve performance will raise the risk of injury. Try practicing swinging without hitting any balls through imagery/imagination. This has become a standard tool utilized by athletes. Practice the perfect swing mentally without the risk/threat of overusing your arms and back.

Mechanics

Improper body and swinging mechanics can lead to injury. The constant swinging, bending, squatting, and walking places added stress on muscles that can lead to a shoulder sprain/strain, elbow pain, and rib fractures. Back injuries can happen when bending far too forward while in swinging motion. Common swing mistakes that can contribute to low back pain.

S-Posture

This can happen when golfers are told to stick out their rear but what happens is that they over arch their lower backs which cause hyperlordosis. This is known as an S-Posture and it inhibits the abs and glutes. Or this also happens with a lower crossed syndrome.

Early Extension

This is a term that comes from a forward swinging movement where the lower body does not rotate from the top of the backswing to follow-through. The hips and pelvis do not turn with the body. Spinal posture is extended, the head rises up and the pelvis moves toward the ball's position. When this happens the spine's muscles over-activate and force the spine into a fast extension. Forward movement of the lower body toward the golf ball can be a sign of early extension.

Reverse C

This happens at the swing's finish being in a full hyperextension position. It places added compression on the lower back right facet joints.

Overextending, Flexing, and twisting excessively, awkwardly, and improperly increases chances of injury. A bit of advice is to have your swing analyzed by a golf pro/instructor to make sure you have proper form and technique. Preventing back injuries can be achieved through proper body mechanics by properly lifting the golf bag and properly teeing the ball.

Conditioning

Muscles will be weak and inflexible when there is no conditioning. This causes them to become highly susceptible to injury. The spine is exceptionally vulnerable to increased pressure during a golf swing. This happens from rotating while leaning forward. When the low back and abdominal muscles do not have adequate strength or flexibility the high reps of swinging will eventually cause pain.

With a golf-specific strength and flexibility program, the risk of injury is lessened along with improved performance. Programs like these don't have to be complicated or take a long time. Stop potential golf injuries from happening by avoiding excessive practice sessions, swinging correctly, and regularly practicing golf-oriented strength and flexibility exercises.

Chiropractic Sports Injury Treatment

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Exactly how effective are injury-prevention programs in soccer? El Paso, TX.s Scientific chiropractor Dr. Alexander Jimenez looks at the very latest evidence...

Football is the world's most popular team sport. Injuries are a significant issue for both amateur and professional players. Indeed, previous research has estimated that soccer players are among the most injury-prone athletes having an estimated injury rate of 17-24 accidents per 1000 playing hours(1). Nineteen per cent of all sports injuries which exist in the Netherlands are because of soccer(two) and in Britain alone, the expense of therapy and time lost from work owing to football injuries is estimated to be approximately #1billion annually(1)!

In a landmark study, researchers followed two Champions League teams and gathered data on 2,229 players over seven seasons to examine the injury profile of muscular injuries in soccer players(3). They also analyzed the gamers' training schedules and data out of their games to construct a detailed picture of the injury risks that were associated. The findings were as follows:

• 2,908 muscle injuries have been enrolled;
• Normally, a player sustained 0.6 muscle injuries each season (equating to around 15 muscle injuries per season at a squad of 25 players);
• Muscle injuries constituted 31 percent of all injuries and caused 27% of the total injury lack;
• Ninety-two per cent of muscle injuries affected the four Big muscle groups of the lower limbs: hamstrings (37 percent), adductors (23 percent), quadriceps (19%), and calf muscles (13%);
• Sixteen per cent of the muscular injuries were re-injuries; nonetheless, these re-injuries caused significantly longer absences than did the first injuries.
• The prevalence of muscular injury increased with age.

The exact same group of researchers also carried out a follow-up study (published in 2013) in which they sought to establish the consequences of fixture congestion on injury rates among the gamers(4). Time-loss and exposure injuries were enrolled prospectively from 27 teams over 11 seasons. Matches were grouped based on the amount of recovery days before each match and the accident rates were compared between classes. The results showed that compared to a recovery interval of more or six days, muscular injury rates and overall injury rates were raised in league matches where players had had four or less recovery days.

Given the high levels of trauma among football players (a risk that is increased during periods of match congestion) and the financial pressure of the modern game, it's perhaps unsurprising that medical team caring for players find that treatment of injuries in players is quite a frustrating and also a never-ending struggle. In addition, it clarifies why some players end up returning to contest prior to the injury has healed completely, setting the stage for injury recurrence, together with protracted absence of this participant from competition and training.

Injury Treatment

Treating injuries in football is both time- consuming and expensive, particularly at the elite level. And while there's a large literature on the epidemiology of sports injuries, established protocols for treating muscular injuries and assessment criteria for imaging, and a number of clinical and functional tests that could assist the health staff in deciding the optimal point where an athlete can be safely returned to full participation(5,6), the current guidelines haven't translated into a significant reduction in muscle injury levels in professional sports such as soccer.

To simplify things further, the evidence indicates a new injury often occurs within a couple of weeks after return to contest, and typically costs the player more lost playing time than the key injury(7). The most probable reasons for this observation are likely associated with bodily alterations following the first injury, such as muscle stiffness and/or fatigue, scar tissue formation, biomechanical alterations, neuromuscular inhibition, as well as inadequate treatment -- for instance, overly aggressive or incomplete rehabilitation(8-10).

Injury-Prevention Programs

Even armed with knowledge that is up-to-date and the best technology is fraught with difficulty. Remembering the old adage that 'an ounce of prevention is worth a pound of cure', a alternative that is far better to attempt to prevent injuries from happening in the first place with an injury-prevention program. This is easier said than done. It is correct that there is an abundance of literature on the effectiveness of methods to avoid harm recurrence and muscle injury, such as enhancing flexibility eccentric and concentric exercises and drills. Despite this and apps like FIFA's 'The II' (see Box 1), the incidence of muscle injuries generally, and the recurrence rate particularly, remains stubbornly high(11-16).

More recent studies indicate that in higher levels of functionality, there might not be much in the way of significant added benefits, while some early study appeared to give evidence for the efficacy of programs in football, as described in box 1. At a follow up to the study described above(18) and that was published this past year, the same group of investigators looked to see if an injury prevention program comprising 10 exercises designed to enhance stability, muscle strength, co-ordination, and versatility of the back, hip and leg muscles (FIFA's 'The II') was effective concerning reducing injury levels and whether it offered any advantages in terms of reducing the related costs of following treatment for injuries that did occur(19).

From the analysis, 479 adult male amateur gamers aged 18-40 years have been split into two classes: the intervention group had been taught to do exercises focusing on core stability, bizarre training of thigh muscles, proprioceptive training, dynamic stabilization, and plyometrics with straight-leg orientation at every training session (2-3 sessions per week) through one season. The management team, meanwhile, continued their usual warm up.

As in the previous study, there were no significant differences in the percentage of players that are injured and injury rates between the two groups. What was intriguing was that in the intervention group, the price of injury treatment was 256 per participant. In the control group nonetheless treatment costs were twice at $606 per participant. The investigators commented that the cost savings in the intervention group may be the result of a rate of knee injuries, which have costs because of more lengthy rehabilitation periods and much more time lost at work compared to a number of different injuries.

Meanwhile, another study on an injury- prevention program (based on The II) in male amateur players had been printed in the end of last year(20). It discovered that (like the previous studies), an intervention program did not decrease the incidence of harm throughout the course of a season. However, such as the study, the players in the intervention group did incur less health care costs, although a justification for this finding wasn't given. As if to validate the confusion surrounding the value of injury-prevention programs for football players, then a recently published systematic overview of all of the previous studies released thus far fought to achieve a definitive conclusion(21). Six studies involving a total of 6,099 participants met the inclusion criteria and the results of these were conflicting two of the six studies (among large and one of moderate quality) reported a decrease in injury rates that were actual. Four of the six research an 'preventive effect', even though the effect of a single study wasn't statistically significant. Possible reasons for these contradictory findings might be subject choice (sex and level of ability), differences between the intervention programs implemented (content, training frequency and duration) and compliance with this application. What's clear, however, is that studies investigating the type and seriousness of exercises within an injury-prevention program are still required to reduce the incidence of accidents in soccer efficiently.

Good News On Prevention

Since the review study cited previously(21) was printed, two quite newly published studies on injury-prevention apps in soccer seem to provide more encouraging news -- for muscle injuries at least. In one, researchers studied elite players competing over two consecutive seasons, where the first (2008-2009) function as intervention period and the second, the management period (2009-2010)(22). In total, 26 (08/09) and 23 (09/10) elite male pro football players competing within the Scottish Premier League and European competition participated. The accident prevention training program was conducted twice weekly to the entirety of this season (58 avoidance sessions) and the results were compared with the control (no injury-prevention program) year.

On first inspection, the results were disappointing, showing an increase in the complete number of accidents within the intervention period (88 vs 72). But this was largely because of the greater quantity of contusion injuries sustained inside the intervention season (44) compared with control season (23). Assessing like for muscular injuries that were significantly fewer were observed during the intervention season, which had been even more impressive given the larger squad size at the intervention season.

Another newly published study by Italian scientists who researched the effect of a two-tiered injury-prevention program on initial injury and re-injury prevalence in 36 elite male football players also causes encouraging reading(23). During the season prior to that examined in the study, there had been 27 muscle injuries in the group, which accounted for 58.7 percent of the total injuries: 13 of these had occurred throughout practice and 14 during matches. The general incidence of muscular injuries was 5.6 injuries/1000 hours of training/playing exposure and the effect was 106.4 times absence/1000 hours exposure.

To try and decrease the speed of injury through the following season, the team doctor (also among the study's authors) found an injury-prevention program, conducted 2-3 times per week. This consisted of two elements: a collection of core stability exercises conducted by the whole group prior to each practice session (see Box 2) along with an individualized injury prevention program, which has been started after assessment with kinesiologic and diagnostic tests. At the start of the year, every athlete underwent testing of leg flexibility using the Ober evaluation, Thomas evaluation and straight-leg-raising [SLR] test(24-26). The prone instability test(27) was completed to show spinal instability along with the stork test (28,29) to assess sacroiliac dysfunction. Quadriceps and hamstring strength were measured isokinetically and attention was directed in evaluation of immunity of gluteus medius' power.

The injuries that happened based on MRI and clinical imaging findings were diagnosed by the medical team. An injury was defined as though it caused the participant to miss the next training session or match, and happened during a scheduled training session or match. An injured player was defined injured before the club medical staff cleared him for participation. Re-injuries were described as those that occurred as those that occurred at the same website no longer than three months following the player had returned to full involvement at early re-injuries and exactly the exact same site.

Results

Throughout the intervention season, a total of 64 injuries occurred -- 36 (56 percent) during practice and 28 (44%) during matches. Of them, 20 were muscle injuries, accounting for 31.3 percent of the total injuries; 14 of which occurred during practice and 6 during games. In all, three re-injuries happened and (15 percent of overall muscle injuries) and there were not any premature re-injuries. In comparison with the preceding season with no intervention-program set up, there was a reduction in the number of times and muscle injuries . Specifically, whereas muscle injuries accounted for 31 percent of harms they accounted for 59% of all injuries. Significantly, the number of injuries per 1000 hours of training and playing time was reduced by over half of 5.6 to 2.5. Meanwhile, the number of days fell by nearly two-thirds 106 into 37. The investigators put the success of this intervention down to three key aspects:

• An injury prevention program that comprised of core stability exercises similar to those in 'The II' program but which differed in its two-tiered arrangement (group and individual sessions), allowing for intense and special training. In contrast, the combined results in research into The II app are probably because of the non- special content and ineffective intensity.
• The program's continuity of commitment by the players to both the group and individual areas.
• The addition of bizarre hamstring training in the group program (2 sets of 5 repetitions per week) combined with all the personalized application for players with a history of injury.
• Using ice baths in the conclusion of every training session

The investigators cautioned that their study would have included a larger number of topics, but the data still showed a critical progress by the prior year over that. They also argued that by increasing the number of group and individual prevention training sessions, the outcomes could be enhanced.

Summary & Recommendations

Injury treatment in aggressive soccer is equally costly and time-consuming also given the pressures of the game, injury avoidance is more important than ever. But, despite extensive published literature on harm prevention strategies and initiatives such as FIFA's 'The II', the injury rates in soccer remain high, especially in the higher levels.

The latest research indicates that while overall injury prevention programs such as The II might reduce the incidence of trauma in amateur gamers, especially by reducing the incidence of knee injury. However, they will probably not benefit professional players or level. Instead, combining a more individualized approach (using a far greater emphasis on particular exercises determined by kinesiologic and diagnostic testing) with team sessions seems to be desirable. Additionally, it is important that gamers are 'on-board' with almost any program and take part regularly (at least twice weekly) to achieve all the potential advantages.

References
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19. J Physiother 2013 Mar; 59(1):15-23
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22.J Strength Cond Res 2013 Dec; 27(12):3275-85
23. J Muscles, Ligaments and Tendons Journal 2013; 324 3 (4): 324-330
24. J Bone & Joint Surgery 1936; 18:105-110.
25. Phys Ther Sport 2007; 8:14-21.
26.J Orthopaedic and Sports Physical Therapy 1981; 2:117-133
27. Magee DJ. Orthopedic Physical Assessment. 3rd ed. Philadelphia, PA: W.B. Sauders Company; 1997.
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29. Clinical Biomechanics 2004; 19:456-464

Softball and baseball require running, jumping, throwing, and swinging movements. Even for the fittest athletes and weekend warriors, the body and the neuromusculoskeletal system will go through overuse injuries, throwing-related injuries, sliding injuries, falls, collisions, and getting hit by the ball. Chiropractic and physical therapy can assist athletes by integrating strength training, body realignment, and rehabilitation injury recovery.

Softball and Baseball Injuries

Baseball and softball injuries are generally defined as either acute/traumatic or cumulative/overuse injuries. Both types can occur in various body areas, for example, a knee injury caused by a fall or quick repositioning shift.

Acute/Traumatic

• Injuries occur from traumatic force or impact.

Overuse/Cumulative

• These occur over time from repeated stress on the muscles, joints, and soft tissues.
• Often athletes return too soon to play, not giving the injury enough time to heal fully.
• They begin as small aches and pains that can progress into chronic conditions if not treated.

Shoulder

Shoulder overuse injuries are very common. Constantly performing the throwing movements and high-speed throwing strains the joints, muscles, tendons, and ligaments.

• In softball, bicep injuries are more common than shoulder injuries.
• In baseball, the overhead throwing position leads to shoulder problems.

Frozen Shoulder

• Characterized by a restricted range of motion and pain.
• Athletes with frequent shoulder injuries have an increased risk.

Shoulder Instability

• Softball and baseball players are more susceptible to injury from overhead throwing, which stretches the shoulder capsule and ligaments.
• Shoulder instability can lead to loose joints and dislocation.

Shoulder Separation

• This is the tearing of the ligaments that connect the shoulder blade to the collarbone.
• This is often a traumatic injury that occurs during a collision or fall with outstretched hands.

Shoulder Tendinitis, Bursitis, and Impingement Syndrome

• These are overuse injuries in which the shoulder joint becomes inflamed, restricting movement.

Torn Rotator Cuff

• The rotator cuff tendons develop tears from overuse.

Elbow

Elbow injuries are very common, especially damage to the ulnar collateral ligament, which stabilizes the elbow when pitching and throwing.

• Pitchers can also develop elbow sprains.
• Damage or tear to the ulnar collateral ligament
• Damage often is caused by pitchers throwing too much.

Bursitis

• This is inflammation of the joint sac.

Little League Elbow

• This is an injury to the growth plate on the inside of the elbow.
• It can be caused by the wrist flexors pulling on the inside.
• It is typically attributed to overuse and improper mechanics when throwing.

Tennis Elbow

• This overuse injury on the outside of the elbow makes it difficult to lift or grasp objects.

Hand and Wrist

Softball and baseball can cause hand and wrist injuries from catching, colliding, falling, and overuse. Damage to a hand or wrist is typically caused by repetitive stress and/or a sudden impact.

Finger Fractures

• These can be caused by impact on the ball or falls.
• This can happen during contact with another player or diving for a ball and hitting the ground hard or at an awkward angle.

Sprains

• A fall or impact from the ball or another player can cause these.

Tendinitis

• This is an overuse injury, often from pitching and/or throwing.

Back

• Catchers are especially prone to back injury because of the crouched position and overhead throwing.
• Softball pitchers also experience back strain from the windmill pitching action.
• Common conditions include chronic muscle strains, herniated discs, low back issues, sciatica symptoms, and pain.

Knee

Softball and baseball players quickly twist or rotate their knees, making them more susceptible to injuries. Sprains, meniscus tears, ACL tears, and hamstring strains are common.

• Aggressive twisting and pivoting can cause swelling, stiffness, and pain.
• Running and sudden changes in direction can result in acute knee injuries and overuse injuries.
• Knee issues require examination for proper diagnosis.
• Other common injuries include ankle sprains, stress fractures, and tendonitis in the foot and ankle.

Chiropractic

Chiropractors work with a massage therapy team to treat various musculoskeletal conditions. Chiropractic specializes in spinal adjustments and other treatments, including joint manipulation, myofascial release, MET techniques, trigger point therapy, and electrical stimulation. It encourages expedited recovery for sports-related injuries because instead of focusing on just the injuries, chiropractic assesses the mechanics of the whole body through proper alignment and release of constricted tissues. Adjustments of the spine and extremities allow the body to realign for better overall functionality, reduce pressure, improve blood circulation, and reduce inflammation to promote increased and thorough healing.

Improving Athletic Performance Through Chiropractic

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Greiner, Justin J et al. “Pitching Behaviors in Youth Fast-Pitched Softball: High Pitching Volumes With Unequal Pitch Counts Among Pitchers are Common.” Journal of pediatric orthopedics vol. 42,7 (2022): e747-e752. doi:10.1097/BPO.0000000000002182

Janda, David H. “The prevention of baseball and softball injuries.” Clinical orthopedics and related research,409 (2003): 20-8. doi:10.1097/01.blo.0000057789.10364.e3

Shanley, Ellen, and Chuck Thigpen. “Throwing injuries in the adolescent athlete.” International Journal of sports physical therapy vol. 8,5 (2013): 630-40.

Shanley, Ellen, et al. “Incidence of injuries in high school softball and baseball players.” Journal of athletic training vol. 46,6 (2011): 648-54. doi:10.4085/1062-6050-46.6.648

Trehan, Samir K, and Andrew J Weiland. “Baseball and softball injuries: elbow, wrist, and hand.” The Journal of hand surgery vol. 40,4 (2015): 826-30. doi:10.1016/j.jhsa.2014.11.024

Wang, Quincy. “Baseball and softball injuries.” Current sports medicine reports vol. 5,3 (2006): 115-9. doi:10.1097/01.csmr.0000306299.95448.cd

Zaremski, Jason L et al. “Sport Specialization and Overuse Injuries in Adolescent Throwing Athletes: A Narrative Review.” Journal of athletic training vol. 54,10 (2019): 1030-1039. doi:10.4085/1062-6050-333-18

Athletes train and practice constantly to prepare their mind and bodies for the big games, matches, etc. When the game is on, it is normal/natural to feel anxious and nervous, especially at the beginning, but then the athlete settles in and relaxes, letting their training take over. However, for some athletes, the anxiousness and nervousness doesn't go away but intensifies, the heart starts racing, and the individual can't stop thinking about choking, failing, and losing. This is known as sports performance anxiety, or competitive anxiety, and is common.

Competitive Anxiety

Research shows that 30 to 60 percent of athletes experience the disorder. Doctors divide the signs and symptoms into mental and physical categories.

Physical Symptoms

Rapid Heartbeat

• The stress can cause overproduction of adrenaline and cortisol, making the heart beat rapidly.

Muscle Tension

• The muscles can tighten up, become painful, and cause tension and pain in the head.

Trembling

• The hands could shake while holding the ball, bat, racket, or foot twitching could present.

Hyperventilation

• Individuals report a sensation of choking or being unable to catch their breath.

Digestion Issues

• The stress can cause foods to be quickly digested, causing cramping and/or the sudden urge to use the bathroom.

Mental Symptoms

Fear of Failing

• The athlete imagines themselves losing all the time.
• Worrying about letting the coach and team down or the audience or other athletes criticizing and laughing at your performance.

Unable to Focus

• The athlete may have concentration issues and become absorbed in how others react to their performance.

Overthinking

• The athlete can temporarily forget how to perform specific actions that are typically automatic.

Self-confidence issues

• The athlete can start doubting their abilities.

Stress and Anxiety

The Yerkes-Dodson law explains how stress, anxiety, and arousal levels affect performance and how stress levels must be maintained within a range to perform well.

Low Arousal

• It could be the athlete is not as into the sport as when they began, so they do not put forth the total effort.

High Arousal

• This means the sport could be causing so much stress that the athlete panics or freezes up.
• Competitive anxiety sets in.

Optimal Arousal

• This means the athlete is fully engaged in pushing themselves to the fullest.
• This can be applied to any performing task like play rehearsals to a tennis match.
• Individuals have different optimal levels of stress.

Recommended Steps

Some recommended steps can be taken to handle and prevent sports competitive anxiety when trying to overcome those overwhelming feelings of nervousness and tension.

Positive self-talk

• Self-talk is having a positive conversation with yourself.

Athletes who practiced positive self-talk reported:

• Improved self-confidence
• Reduced physical anxiety symptoms
• Improved sports performance

Listen to Music

• When anxious before a meet, game, match, etc., consider listening to some favorite or relaxing music.

Meditation

• Meditation has been found to reduce all types of anxiety, including sports.

Chiropractic

Chiropractic treatment specializes in the musculoskeletal system and can realign the body and release any muscle tension and restriction through hands-on manipulation techniques and mechanical decompression. Treatment involves manipulating the muscles, ligaments, tendons, fascia, and soft tissues to relieve pain through therapeutic muscle therapies that include:

• Massage
• Myofascial release
• Trigger point therapy
• Chiropractic adjustments
• Spinal decompression

One or a combination of therapies can alleviate symptoms related to muscle spasms, delayed onset muscle soreness, fascia restrictions, soft tissue injuries, and pain and dysfunction throughout the body, restoring function, movement, and strength.

Using The DRX9000 For Spinal Decompression

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Elliott, Dave, et al. "The effects of relaxing music for anxiety control on competitive sport anxiety." European journal of sports science vol. 14 Suppl 1 (2014): S296-301. doi:10.1080/17461391.2012.693952

Ford, Jessica L et al. "Sport-related anxiety: current insights." Open access journal of sports medicine vol. 8 205-212. 27 Oct. 2017, doi:10.2147/OAJSM.S125845

Rice, Simon M et al. "Determinants of anxiety in elite athletes: a systematic review and meta-analysis." British journal of sports medicine vol. 53,11 (2019): 722-730. doi:10.1136/bjsports-2019-100620

Rowland, David L, and Jacques J D M van Lankveld. "Anxiety and Performance in Sex, Sport, and Stage: Identifying Common Ground." Frontiers in psychology vol. 10 1615. 16 Jul. 2019, doi:10.3389/fpsyg.2019.01615

Walter N, et al. (2019). Effects of self-talk training on competitive anxiety, self-efficacy, volitional skills, and performance: An intervention study with junior sub-elite athletes. mdpi.com/2075-4663/7/6/148

Being physically fit does not mean training for a triathlon. Regular light exercise/activity is all that is needed. Just going for a 30-minute walk around the neighborhood or playing a 20-minute game regularly is highly beneficial to your health. And the more active you are the better for your health.

• Skating
• Bicycling
• Jogging
• Swimming
• Walking
• Playing

Regular Activity

Whatever the activity, so long as you get at least 20 minutes of exercise a day will go along way in the future. Regular activity/exercise can help prevent diseases and injuries, which include osteoporosis.

Nothing crazy, just begin to work some activity little by little into a routine. One way is after some sitting work/schoolwork once the brain has had enough is the perfect time to go outside and move around. Do some chores that require physical movement, like vacuuming, sweeping, hanging laundry, etc and turn it into a workout.  A daily routine of light to moderate physical activity strengthens and maintains the body by helping to:

• Build healthy bones, muscles, and joints
• Control weight
• Build lean muscle
• Reduce overall body fat
• Prevent the development of high blood pressure hypertension  

Here are a few suggestions on how to get 20-30 minutes of daily exercise/activity.

• Try an online fitness class.
• Check out your local gym for online to see what classes are available.
• Family time can become a fun activity/exercise time.
• Take a walk with the family, as many are already doing, play basketball, soccer, or other favorite sport together.
• Invite friends to be physically active online, maybe playing a workout video game and workout together.

If regular physical activity is difficult or you have a medical condition, consult your doctor to recommend the appropriate amount of physical activity and exercises that are safe to perform. But if you are a healthy person, but have not exercised for a while then try for 30 minutes of physical activity a day to keep you healthy and strong.

Core Exercises That Help With Back Pain

Here are some examples of abdominal exercises that can help develop strong abs and help with back pain prevention. These exercises and the number of repetitions are only suggestions. Talk to your doctor before trying these exercises, and remember to listen to your body. If it doesn't feel right, stop right away.

Elbow Planks

1. Lie down on your stomach with your body straight.
2. Elbows should be at 90-degrees and close to the body's sides.
3. Rest the forearms on the floor and interlace the fingers.
4. Gently push your body up using the forearms.
5. Don't' let the back fall/drop.
6. Stay straight.
7. Engage the core muscles during the entire movement.
8. Hold this position for 30 seconds, release, and repeat 3 times.
9. Do this once a day.

Crunches

1. Lie on your back with the knees bent and the feet flat on the floor, about hip-distance.
2. Interlace the fingers of your hands behind your head with the elbows out wide.
3. Inhale and then as you exhale, use the abdominal muscles and not the neck muscles to slowly raise the head, neck, and back off the floor.
4. Inhale and slowly lower the upper body back to the floor, and repeat.
5. Try for 3 sets of 10 crunches every day.

Push-ups

1. Lie down on the stomach so your body is straight.
2. Place the hands on the floor a little higher/further than the shoulders.
3. The hands should be wider than the shoulders.
4. Lift your body so that you're balanced on the hands and toes.
5. Maintain a straight back, lower your body to the floor, and slowly bend your elbows until at 90 degrees.
6. Push back up using arm strength, upper back, and chest muscles, and repeat.
7. Try for 3 sets of 10 every day.
8. Once the body becomes stronger, you can go for more reps.

Doing these along with other core exercises you will notice your core strength leading to overall and optimal body strength. Other exercise forms that can help develop core strength while keeping the spine safe are yoga and Pilates. A good idea is to work with a physical therapist/chiropractor that can create a specifically targeted exercise plan that involves core strengthening and flexibility exercises to keep the spine healthy and help maintain proper posture.

Correct Bad Posture with Custom Foot Orthotics

Groin pressure is behind only fracture and improvement in terms of time away from the game due to injury. Chiropractor, Dr. Alexander Jimenez investigates in the danger factors for groin injury in sport and what the research says about injury prevention...

Groin injuries and the pain they produce can be a issue for athletes, especially those whose sports involve rapid or lengthening accelerations and decelerations. Groin injury in sports' exact prevalence is unknown because athletes can play with abdominal pain and the injury goes unreported. Moreover, the incidence can be skewed by overlapping diagnoses. However, studies in this area generally suggest that groin injury accounts for between 2-5percent of sports injury(1). Of these, the most prevalent groin injury in sport is that the adductor strain, which such as in soccer players account for an incidence rate of around 10 percent-18% of groin strains(2,3).

Other studies have indicated that groin strain accounts for approximately 10% of injuries in elite Swedish ice hockey players(4), even whereas Molsa et al reported that pubic breeds accounted for 43 percent of all muscle breeds in elite Finnish ice hockey players(5). Meanwhile, another study showed the prevalence of groin strains in a single National Hockey League (NHL) team was 3.2 strains per 1000 player-game exposures(6) and Emery et al reported that the incidence of adductor strains among 26 US National Hockey League teams in the NHL rose from 2003 to 2009, with the rate of injury greatest during the preseason(7).

Injury Diagnosis

The hip region is made up of a number of different structures that interact (see Figure 1). These include the pubic bones and symphysis, musculature, tendons, aponeuroses, ligaments, the inguinal canal, hip joint etc.. Consequently athletes frequently report a pain or pain pattern that can not be assigned to a structure. There are a large number of nerves at the region responsible for providing which support movement and sensation. Any compression of these nerves (entrapment syndrome) can lead to important stress-related pain(9,10).

In addition to a detailed clinical Investigation, clinicians therefore require a good understanding of the (complicated) anatomy of the groin and pelvic area, and an understanding of the discussion of structures that are affected. Furthermore diagnostics are extremely helpful for a definitive diagnosis connected to the differential causes that are numerous. Table 1 gives a summary of possible differential diagnoses where a distinction can be made between extra- articular causes (by way of example muscle and tendon injuries) and also intra-articular sources of nuisance (for instance femoroacetabular impingement and labral lesions)(8,11-13).

Despite the large number of possible muscular injuries of the adductors, differential diagnoses, the muscle and abdominal musculature are the most frequent causes of stomach pain in sportsmen and women. As an instance, a 2009 study appeared at groin strain in elite European footballers that were looking for 23 of the best UEFA teams(14). Out of the 628 instances of coronary strain, 399 (63.5percent) resulted from adductor accidents, while injury to the iliopsoas muscle accounted for 52 (8.2%) cases -- a combined total of nearly 7% of those reported gut injuries. More generally, studies indicate that among most competitive athletes between the ages of 20 and 30, the myotendinous junction is that the largely such as website for muscle tears(8,15).

Danger Factors

On the basis that 'an ounce of prevention is worth a pound of cure', it's pertinent to ask what would be the risk factors that predispose an athlete to groin injury? In a 2013 paper, Bruckner et al indicated that there are several things which can predispose athletes to develop a groin injury(16). The researchers categorized these variables as intrinsic and extrinsic (see Table 2). It follows that conditioning programs can play an important role or really, a program aim at future prevention and rapid recovery -- something we'll return to soon.

There is certainly evidence in the literature showing an association between flexibility or strength and breeds in various populations that are athletic. As an instance, in a study into footballers, researchers discovered decreased pre-season hip abduction range of motion in players who then continued groin strains, compared with uninjured gamers(17).

In hockey players that are professional, adductor muscle strength has been connected with a muscle strain that was subsequent. By way of example, US researchers discovered that pre-season hip adduction power was 18% lower in NHL players who then continued groin strains, compared with the uninjured players(6). The hip adduction: abduction strength ratio was also significantly different between the 2 groups; in the players who sustained a groin strain, pre-season adduction: abduction strength ratio was lower on the side that subsequently sustained a groin strain (as compared with the uninjured side). Adduction strength was 86\% of abduction power on the side that is uninjured but just 70% of abduction power on the side that is.

Another research on adductor strains in Ice hockey players showed that players who practiced throughout the off-season were not as likely to sustain a groin injury(18). In this analysis, an additional risk factor was that the existence of a previous adductor strain -- consistent with a study to Australian Rules football players, in which researchers reported a 32% re-injury speed(19).

At a 2007 study, investigators conducted a systemic evaluation of this literature for risk factors in groin injury(20). They reasoned that there was lack of game specificity of coaching and training in addition to support for increased abductor into adductor strength ratios and an association of earlier injury, as risk factors in groin strain injury . They also said that onset or heart muscle fatigue of abdominal muscle recruitment that was transversus might boost the risk of strain injury. When it came to sport or age experience, in addition to levels of length and adductor strength, the evidence to support a causal association was weak.

Coming up to date review published earlier this year assessed the signs for injury risk factors across a broad ranges of sports(21). The researchers identified 2521 potentially research, of which 29 were contained and scored. The investigators reasoned that These factors are related to Groin injury: a gut injury, more elite levels of drama hip adductor strength (absolute and relative to the hip abductors), and also lower levels of sport- specific training.

Prevention

From the introduction to this report we looked at grain strain incidence. To focus purely on the incidence of the injury provides an incomplete picture of its effect because the morbidity attached to chronic groin pain signifies it's behind fracture and joint reconstruction. That being true, any strategies that can help stop or decrease the danger of groin strain are invaluable.

In a recent review on sport-induced groin strain injuries, researchers proposed a range of extrinsic and intrinsic factors in the progression of groin pain (see Table 2)(26).) It follows therefore that any prevention program should try and tackle one or more of those factors. Given that adductor injury accounts for a substantial percentage of groin injuries general, it is pertinent to ask whether adductor strength training might help.

A study on strength training to stop adductor breeds in professional ice hockey players produced favorable results(27). Before the 2000 and 2001 seasons, professional gamers were strength tested. Thirty three of the 58 players were classified as at risk, using an adduction: abduction strength ratio of less than 0.8 and were placed on a intervention program consisting of strengthening and functional exercises aimed at increasing adductor strength. Injuries were tracked over the course of both seasons and the results demonstrated that harm incidence was 0.71 adductor strains per 1000 player-game exposures (approximately 2% of injuries). This compared with a pre-intervention harm rate of 3.2 per 1000 player-game exposures (roughly 8% of all injuries -- 4 times higher). The validity of this intervention is supported by the fact that the pre-intervention injury rate in this study seems is consistent with that in other studies on groin strain injury in ice hockey players(28).

In footballers meanwhile, Junge et al showed a generalized conditioning program was appropriate for injury prevention in young males of diverse skill levels(29). The program was made up to improve endurance, reaction time, coordination extremity stability, plus strength and flexibility of the back, hip, and lower extremities. In addition to training harms, overuse injuries that were 41 percent fewer and nearly 50% fewer injuries, this program resulted in no groin accidents over the course of an entire year.

Further evidence for the advantages of strength training comes from a 1999 study on athletes(25). It found that 8-12 months of an strengthening program proved effective in treating chronic stomach strains. The program consisted on a slide board of resistive adduction and abduction exercises, balance training, abdominal strengthening, and movements. This was compared to a physical therapy program stretching, which was ineffective.

A good instance of the kind of conditioning program that appears to help groin strain prevention in athletes who suffer recurring groin injuries is shown in table 3(30). The example given is for ice hockey players but can be adapted (at the sports- specific conditioning phase) to other sports too. Different modalities are combined by this treatment program: passive treatment accompanied by an active training program, which highlights resistive exercises. Other studies provide solid evidence that this method of prevention and rehabilitation produces positive results(31,32).

Warm Ups & Their Role

One element of groin strain prevention which might also be significant is the proper warm up. Although there's a dearth of groin-injury particular studies into warm up, a 2004 research on 315 adult male professional footballers in US Major League Soccer provides a valuable insight(30). In an effort a thorough 20-minute warm-up application was designed as an alternative to a traditional warm-up program.

This warm up program was used 2-3 days per week. The players were registered into one of two groups:

• Group 1 -- 106 participants who conducted the groin injury prevention warm up before coaching and enjoying;
• Group 2 -- 209 participants who functioned as the matched control group (age, gender, ability) and who continued with their usual warm-up routines

The program consisted of a combination of dynamic stretching, core strengthening, and rectal proprioceptive exercises to promote a neutral pelvis during dynamic activities employing the lumbar paraspinals, multifidus, rectus abdominus, transversus, internal and external obliques, abductors, adductors, and hip external and internal rotators.

The results demonstrated that the overall incidence of groin injuries occurring over the span of the following season in the intervention group had been 0.44 injuries per 1000 hours of sport practiced. This contrasted with a rate of 0.61 accidents per 1000 hours in the control group -- ie a reduction of 28 percent. The incidence of athletes requiring spinal operation in the intervention group was lower at 0.13 per 1000 hours, compared with the control group prevalence of 0.18 per 1000 hours likewise, a decrease of 28 percent.

Summary & Conclusion

Groin injuries in athletes therefore are a significant cause of missed time out of sport, and length a vast range of conditions. To make things worse, once a groin injury has happened, an athlete can be at increased risk from a groin injury. The good thing is that many common groin injuries (eg involving the adductor muscles) respond well to power and conditioning applications -- both as part of a post-injury rehab program and concerning prevention. These programs should be aim to present passive treatment, quickly followed by an active exercise program emphasizing eccentric resistive exercises The evidence also indicates that warming up using a blend of dynamic stretching, core strengthening, and pelvic proprioceptive exercises can significantly lower the risk of injury in athletes -- even people with no previous history of coronary injury.

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