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Sports injuries: why there can be benefits

You may not appreciate it at the time, but an injury can teach you a lot about how your body works

In this article I want to discuss the idea that an injury, if it is treated and acted on in the right way, can actually be a gift to a sportsperson. Some of you may wonder how one can possibly see an injury as a gift, when being injured can be the most annoying, and sometimes depressing, part of an athlete’s life, so let me explain.

 I would never wish an injury on any athlete, especially not what I call a ‘serious accident’ injury such as a bone fracture or ligament rupture. Yet injuries are a reality for most athletes and so it is wise to learn to look at them in a positive way and see them as an opportunity to learn about your body.

How on earth can we look at injuries positively? All injuries have causes, but these causes can be many and various: they could be related to the training programme, the athlete’s technique, the athlete’s level of conditioning, the equipment used or the conditions. By identifying the specific causes you can make an objective assessment of what you need to do to ensure the injury does not recur. Then, by working on your weaknesses and making any changes to training or equipment once the injury has healed, you will be a stronger, better prepared athlete who has less chance of getting injured again. This is how injury can be a gift, because it offers an opportunity to discover what you need to work on and a chance to become more aware of your body.

Take this javelin thrower
The following example should make my argument clearer. A javelin thrower was suffering from a shoulder injury, which was diagnosed by his physiotherapist as tendinitis in the ‘long head of biceps’. This tendon runs within the shoulder joint and can be damaged by poor shoulder mechanics, particularly impingement of the joint during overhead tasks, such as throwing or lifting.

The physiotherapist tested the strength of the athlete’s shoulder rotation muscles using an isokinetic machine, and discovered that his external rotators were relatively weak in comparison with the internal rotators. Examination also showed that he was tight in the pectoral minor and subscapularis muscles, which rotate the shoulder girdle forward, while in general the athlete’s posture was kyphotic, ie round-shouldered. All this meant that the athlete’s rotator-cuff muscles were probably not working effectively to control the throwing and lifting movements in his training programme, and this was exacerbated by the tightness and posture which were pulling the shoulder into a forwards and upwards position, increasing the stresses on the joint.

How he was treated
The athlete was treated for the injury by manipulating the shoulder joint to release the impingement and tightness. However, working with the physiotherapists, he commenced an active rehabilitation programme to improve the flexibility and stability of his shoulder. Initially, this involved learning to recruit the lower trapezius muscles during simple arm movements to keep the scapula in the correct position, carrying out basic rotator cuff exercises with the resistance band and stretches for the chest and upper back.

Once the athlete’s injury was healing, more strength exercises were added, specifically those developing rear shoulder and external rotation function, as these were his weak muscles. Analysis of his gym programme revealed that most of the exercises were of the ‘push’ or ‘press’ type, which mostly involve the upper trapezius, anterior deltoid and pectorals. By over-emphasising these exercises the athlete had created a strength imbalance around the shoulder, and so the goal now was to develop the latissimus dorsi, rear shoulder and lower trapezius muscles. It was decided that he must now always include a ‘row’ or ‘pull’ exercise for every ‘push’ or ‘press’ exercise in his programme.

What the physiotherapist suggested
In addition to the weights exercises, the physiotherapist suggested functional exercises to help the athlete improve shoulder strength and power. These involved rotational forwards and backwards movements, using resistance bands and then progressing to medicine balls. These exercises were specific to the athlete’s sport and allowed the rotator-cuff muscles to be trained in a plyometric fashion, increasing their ability to control the shoulder during the throwing motion. This would improve the athlete’s performance and decrease injury risks in the future.
Having worked with the physiotherapist on an active programme, this athlete had learned many things: first, that his posture and shoulder mechanics needed improving; secondly, new exercises for the muscles which had been overlooked in training; thirdly, advice on how to create a more balanced gym programme; fourthly, new ideas for specific power exercises. Finally, by the end of the rehabilitation process and having learned about conditioning, he was better developed than before and was more aware of how to look after his body to avoid any repetitions of the injury. In this way, one can argue the injury was a gift to this athlete.

What Sebastian Coe learned
Psychologically it is very important to always look for the positives, even in such stressful times as during an injury. Often young athletes will lose motivation or drop out of a sport when they suffer their first injury; however, the best athletes never allow injuries to get them down. In his biography, Sebastian Coe refers to the stress fracture he suffered at 17 as a blessing in disguise. He claims he benefited from allowing his body to rest and develop naturally and says that it forced him and his father to focus on high-quality training rather than high mileage. These two things, he believed, helped him achieve Olympic gold later in his career.
Amanda Owens, a BASES accredited sport psychologist, helps elite athletes through times of injury and illness. She recommends making positive action plans to help yourself stay motivated and focused during injury. The plans should include activities to maintain fitness and workouts to develop other fitness areas that do not stress the injury. For example, an athlete with a knee injury could maintain fitness with water running and spend 60 minutes per day working on stretching, dynamic flexibility and core stability. In this way, the athlete can use the time spent out of competition to develop other areas of his conditioning, which will help his performance and prevent future injuries.
A major part of success in sport is learning about your body, how it responds to training and what it needs to develop further. Sometimes being injured gives an athlete an ideal opportunity to reflect on these things and, by absorbing the knowledge of his physiotherapist, he can raise his level of understanding.

Positive injury guidelines
I personally believe that injury can be a gift, but it is up to you yourself to see it that way. If you follow these guidelines, you will always be able to learn something positive from injury.

1. Choose a physiotherapist who can find the causes of your injury and analyse your strength and flexibility as well as simply diagnosing and treating the symptoms;

2. Always follow an active rehab programme to strengthen weak muscles, improve stability skills, work on your posture and stretch tight muscles;

3. Make a plan to maintain fitness and work on aspects of training that don’t stress the injury;

4. Examine your training programme and plan how to improve it in order to increase the specificity and reduce injury risks;

5. Remain positive and see yourself as a more complete, better-conditioned athlete post-injury.

Raphael Brandon

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