Prehabilitation and Preseason Conditioning Chapter 7 Sports Medicine 1

Prehabilitation and Prehabilitation and Preseason ConditioningPreseason Conditioning

Chapter 7Chapter 7

Sports Medicine 1Sports Medicine 1

Rehabilitation and PrehabilitationRehabilitation and Prehabilitation

KEY CONCEPTKEY CONCEPT Prehabilitation decreases the chance of injury Prehabilitation decreases the chance of injury

by addressing areas of concern or deficit by addressing areas of concern or deficit identified before participation in a sporting identified before participation in a sporting event. A program can be implemented to event. A program can be implemented to strengthen and develop these areas, thus strengthen and develop these areas, thus reducing the chance of injury during reducing the chance of injury during participation.participation.

Rehabilitation and PrehabilitationRehabilitation and Prehabilitation A preventative A preventative

management program management program with the goal of with the goal of preventing injurypreventing injury

This program addresses This program addresses concerns or deficits concerns or deficits recognized by the recognized by the athlete’s family physician athlete’s family physician or other sports medicine or other sports medicine specialist prior to sports specialist prior to sports participation.participation.

Preseason ConditioningPreseason Conditioning

KEY CONCEPTKEY CONCEPT Preseason conditioning allows athletes to Preseason conditioning allows athletes to

gradually build up to a level of activity that will gradually build up to a level of activity that will be expected of them on the playing field. By be expected of them on the playing field. By starting slowly, the body is allowed to adjust starting slowly, the body is allowed to adjust to the new demands; once the body has to the new demands; once the body has accommodated, the athlete can once again accommodated, the athlete can once again increase the demand on the body. By increase the demand on the body. By working incrementally to get the body working incrementally to get the body adjusted, the athlete can prepare for the adjusted, the athlete can prepare for the demands of the season.demands of the season.


Whenever athletes start a fitness program, Whenever athletes start a fitness program, or after they take an extended period of or after they take an extended period of time off, their bodies need to time to adjust time off, their bodies need to time to adjust to the new stresses and demands.to the new stresses and demands.


Preseason conditioning focuses on developing Preseason conditioning focuses on developing the athlete in the off-season.the athlete in the off-season. The conditioning program should begin six to eight The conditioning program should begin six to eight

weeks prior to sports participation to allow the body to weeks prior to sports participation to allow the body to gradually adapt to the demands to be placed on it.gradually adapt to the demands to be placed on it.

Sports medicine physicians, certified athletic trainers, Sports medicine physicians, certified athletic trainers, and qualified youth coaches should prescribe a and qualified youth coaches should prescribe a preseason conditioning program and provide athletes preseason conditioning program and provide athletes with information on the type, frequency, intensity, and with information on the type, frequency, intensity, and duration of training. duration of training.

Strength TrainingStrength Training Strength training is a highly adaptive process Strength training is a highly adaptive process

whereby the body changes in response to whereby the body changes in response to increased training loads.increased training loads. AdaptationAdaptation requires a systematic application of requires a systematic application of

exercise stress sufficient to stimulate muscle fatigue exercise stress sufficient to stimulate muscle fatigue without injury.without injury.

If muscle is working beyond its normal limits, it adapts If muscle is working beyond its normal limits, it adapts by becoming larger (by becoming larger (hypertrophyhypertrophy).).

If a muscle is worked less than normal, it becomes If a muscle is worked less than normal, it becomes smaller (smaller (atrophyatrophy).).

The purpose of The purpose of progressive resistance exerciseprogressive resistance exercise is is to allow the body to adapt to the increased demand to allow the body to adapt to the increased demand placed upon it.placed upon it.

Strength TrainingStrength Training

KEY CONCEPTKEY CONCEPT Progressive resistance training allows the body to Progressive resistance training allows the body to

adapt to the increased demand placed upon it through adapt to the increased demand placed upon it through training. The rate and type of strength gain is training. The rate and type of strength gain is determined by four factors: 1. overload is the determined by four factors: 1. overload is the overwork of muscles at tensions close to their overwork of muscles at tensions close to their maximum; 2. specificity is the targeting of a particular maximum; 2. specificity is the targeting of a particular muscle group alone; 3. reversibility is the muscle group alone; 3. reversibility is the characteristic of muscles that cause decreases in characteristic of muscles that cause decreases in strength and mass with disuse;4. individual strength and mass with disuse;4. individual differences also account for an individual’s ability to differences also account for an individual’s ability to strengthen certain muscles at a particular rate. strengthen certain muscles at a particular rate. Genetics have a strong influence on strength gain.Genetics have a strong influence on strength gain.


OverloadOverload Muscles increase in size and strength when they are Muscles increase in size and strength when they are

forced to contract at tensions close to maximum.forced to contract at tensions close to maximum. Muscles must be overloaded at a progressively Muscles must be overloaded at a progressively

increased rate.increased rate. The ideal number of repetitions is between four and The ideal number of repetitions is between four and

eight, done in multiple sets of three or four.eight, done in multiple sets of three or four. Proper rest intervals between sets allows muscles to Proper rest intervals between sets allows muscles to

recover from exertion and prepare for the next work recover from exertion and prepare for the next work interval.interval.


SpecificitySpecificity Muscles adapt specifically to the nature of the work Muscles adapt specifically to the nature of the work

performed, an attribute known as specificity.performed, an attribute known as specificity. When muscles contract, they recruit different types of When muscles contract, they recruit different types of

motor unitsmotor units to carry out the contraction. to carry out the contraction.• Slow-twitch fibersSlow-twitch fibers are recruited for low-intensity activities are recruited for low-intensity activities

such as jogging, and are relatively fatigue-resistant.such as jogging, and are relatively fatigue-resistant.• Fast-twitch fibersFast-twitch fibers are used for high-speed or high-intensity are used for high-speed or high-intensity

activities, such as weightlifting, and fatigue more rapidly.activities, such as weightlifting, and fatigue more rapidly.


Specificity cont-Specificity cont- Increases in strength, including rehabilitation Increases in strength, including rehabilitation

after injury or surgery, are very specific to the after injury or surgery, are very specific to the type of exercise, which should be as close as type of exercise, which should be as close as possible to the desired movements of the possible to the desired movements of the activity.activity.

Muscle fiber type appears to play an Muscle fiber type appears to play an important role in determining success in some important role in determining success in some sports, such as distance running and sprints, sports, such as distance running and sprints, but not in others, such as shot-putting.but not in others, such as shot-putting.


ReversibilityReversibility Muscles atrophy with disuse, immobilization, Muscles atrophy with disuse, immobilization,

and starvation.and starvation. Slow-twitch fivers will typically atrophy faster Slow-twitch fivers will typically atrophy faster

than twitch fibers, an important factor to than twitch fibers, an important factor to consider when designing a rehabilitation consider when designing a rehabilitation program after immobilization.program after immobilization.


Individual differencesIndividual differences Some differences in the strength gain rate are Some differences in the strength gain rate are

due to the relative predominance of fast- and due to the relative predominance of fast- and slow-twitch motor units in muscles.slow-twitch motor units in muscles.

Fiber composition is genetically determined, Fiber composition is genetically determined, although a good training program can make although a good training program can make up for genetic deficiencies.up for genetic deficiencies.


Stretching and flexibilityStretching and flexibility Stretching, moving joints beyond their normal range, Stretching, moving joints beyond their normal range,

is useful for injury prevention as well as injury is useful for injury prevention as well as injury treatment.treatment.

Range of movement is increased due to increasing Range of movement is increased due to increasing the length of the muscles, which means that limbs the length of the muscles, which means that limbs and joints must move further before an injury occurs.and joints must move further before an injury occurs.

Warming up is an essential component of stretching Warming up is an essential component of stretching by increasing heart rate, blood pressure, and by increasing heart rate, blood pressure, and respiratory rate, consequently increasing oxygen and respiratory rate, consequently increasing oxygen and nutrient delivery to the muscles.nutrient delivery to the muscles.


Stretching and flexibility cont-Stretching and flexibility cont- Flexibility is the ability of a joint to move freely through Flexibility is the ability of a joint to move freely through

its full range of motion.its full range of motion.• An active person tends to be more flexible than an inactive An active person tends to be more flexible than an inactive

person.person.• Females tend to be more flexible than males.Females tend to be more flexible than males.• Older people tend to be less flexible than younger people.Older people tend to be less flexible than younger people.• Flexibility is an important as muscular strength and Flexibility is an important as muscular strength and

endurance.endurance.• To achieve flexibility in a joint, the surrounding muscles must To achieve flexibility in a joint, the surrounding muscles must

be stretched.be stretched.


Stretching and flexibility cont-Stretching and flexibility cont- Types of StretchingTypes of Stretching

• Static stretchingStatic stretching is a gradual stretching of a muscle through is a gradual stretching of a muscle through the muscle’s entire range of motion, done slowly until a the muscle’s entire range of motion, done slowly until a pulling sensation occurs.pulling sensation occurs.

• Ballistic stretchingBallistic stretching involves a rhythmic, bouncing action, involves a rhythmic, bouncing action, largely discounted today due to its tendency to increase the largely discounted today due to its tendency to increase the incident of injury.incident of injury.

• Proprioceptive neuromuscular facilitation (PNF)Proprioceptive neuromuscular facilitation (PNF) involves involves a combination of contraction and relaxation of the muscles, a combination of contraction and relaxation of the muscles, requiring an initial isometric contraction against maximum requiring an initial isometric contraction against maximum resistance at the end of the range of motion, and is designed resistance at the end of the range of motion, and is designed to be done with a qualified assistant.to be done with a qualified assistant.


KEY CONCEPTKEY CONCEPT Stretching and flexibility decrease the Stretching and flexibility decrease the

chances of injury. Stretching allows the chances of injury. Stretching allows the athlete to actually lengthen the muscle, athlete to actually lengthen the muscle, resulting in an increased range of motion. resulting in an increased range of motion. Therefore, joints and limbs can move further Therefore, joints and limbs can move further before an injury occurs.before an injury occurs.


Isometric exerciseIsometric exercise Muscle contract, but there is no movement in Muscle contract, but there is no movement in

the affected joints.the affected joints. Muscle fibers maintain a constant length Muscle fibers maintain a constant length

throughout the entire contraction.throughout the entire contraction. Isometrics are often used for rehabilitation Isometrics are often used for rehabilitation

because the exact area of muscle weakness because the exact area of muscle weakness can be isolated, and strengthening can be can be isolated, and strengthening can be administered at the proper joint angle.administered at the proper joint angle.


Isometric exercise cont-Isometric exercise cont- Blood pressure also increases rapidly, so Blood pressure also increases rapidly, so

individuals with circulatory problems and high individuals with circulatory problems and high blood pressure should avoid strenuous blood pressure should avoid strenuous isometric exercise.isometric exercise.


Dynamic (isotonic) exerciseDynamic (isotonic) exercise Movement of the joint does occur during the Movement of the joint does occur during the

muscle contraction.muscle contraction. Manual resistance trainingManual resistance training is accomplished is accomplished

using a training partner, somethimes called a using a training partner, somethimes called a spotter.spotter.


Dynamic (isotonic) exercise cont-Dynamic (isotonic) exercise cont-• The spotter adds enough resistance to allow the The spotter adds enough resistance to allow the

lifter to fatigue the muscles, and then releases lifter to fatigue the muscles, and then releases enough resistance so that the lift can be enough resistance so that the lift can be completed.completed.

• Advantages include the use of minimal equipment, Advantages include the use of minimal equipment, the spotter can help control technique, workouts the spotter can help control technique, workouts can be completed in less than 30 minutes, and can be completed in less than 30 minutes, and training can be done anywhere.training can be done anywhere.

• A disadvantage is getting an inadequately trained A disadvantage is getting an inadequately trained spotter. Both the lifter and spotter should be spotter. Both the lifter and spotter should be trained so that the exercise is safe and effective.trained so that the exercise is safe and effective.


Isokinetic exerciseIsokinetic exercise Machines are used to control the speed of Machines are used to control the speed of

contraction within the range of motion.contraction within the range of motion. Machines such as the Cybes and Biodex Machines such as the Cybes and Biodex

provide isokinetic results; they are generally provide isokinetic results; they are generally used by physical therapists and are not used by physical therapists and are not readily available to the general population.readily available to the general population.


Circuit trainingCircuit training Six to ten strength exercises are completed, Six to ten strength exercises are completed,

one after another until all are done.one after another until all are done. Each exercise is performed for a specific Each exercise is performed for a specific

period of time before moving on to the next period of time before moving on to the next exercise, with a brief rest time in between.exercise, with a brief rest time in between.

If more than one circuit is to be completed , If more than one circuit is to be completed , the circuits will be separated by a longer rest the circuits will be separated by a longer rest period.period.


KEY CONCEPTKEY CONCEPT In isometric exercise, the muscles maintain a constant In isometric exercise, the muscles maintain a constant

length throughout the contraction. This is a good type length throughout the contraction. This is a good type of exercise to target an exact area of weakness due of exercise to target an exact area of weakness due to an injury. In isotonic or dynamic exercise, there is to an injury. In isotonic or dynamic exercise, there is movement of the joint during muscle contraction. This movement of the joint during muscle contraction. This type of exercise helps improve blood circulation, type of exercise helps improve blood circulation, strength, and endurance. Isokinetic exercises use strength, and endurance. Isokinetic exercises use machines to control the speed of the contraction machines to control the speed of the contraction within a range of motion. These exercises provide within a range of motion. These exercises provide muscle overload at a constant, preset speed and full muscle overload at a constant, preset speed and full range of motion.range of motion.

Cardiorespiratory ConditioningCardiorespiratory Conditioning

KEY CONCEPTKEY CONCEPT Cardiorespiratory conditioning trains the heart Cardiorespiratory conditioning trains the heart

and other muscles to use oxygen more and other muscles to use oxygen more efficiently. This allows the athlete to perform efficiently. This allows the athlete to perform for longer periods of time.for longer periods of time.


Also known as aerobic or endurance Also known as aerobic or endurance training, cardiorespiratory conditioning training, cardiorespiratory conditioning refers to activities that put an increased refers to activities that put an increased demand on the lungs, heart, and other demand on the lungs, heart, and other body systems.body systems.

Large muscle groups are used for Large muscle groups are used for activities such as walking, jogging, activities such as walking, jogging, swimming, cross-country skiing, or cycling.swimming, cross-country skiing, or cycling.


The goal of cardiorespiratory conditioning is to The goal of cardiorespiratory conditioning is to train the heart and other muscles to use oxygen train the heart and other muscles to use oxygen more efficiently, allowing the athlete to perform more efficiently, allowing the athlete to perform exercise for longer periods of time.exercise for longer periods of time.

Results include an increase in heart size, thus Results include an increase in heart size, thus lowering the resting heart rate and blood lowering the resting heart rate and blood pressure. Also, oxygen transfer rates are more pressure. Also, oxygen transfer rates are more efficient and resting metabolism increases.efficient and resting metabolism increases.


Other benefits include reduced fatigue, Other benefits include reduced fatigue, improved self-confidence, improved improved self-confidence, improved muscle strength and tone, increased muscle strength and tone, increased endurance, reduced stress levels, reduced endurance, reduced stress levels, reduced body fat, and improved overall physical body fat, and improved overall physical and mental health.and mental health.

Special Individualized ProgramsSpecial Individualized Programs

Personal trainers can assist in strength training, Personal trainers can assist in strength training, cardiovascular fitness, speed and endurance cardiovascular fitness, speed and endurance work, and body composition. Personal trainers work, and body composition. Personal trainers should be certified and have proven knowledge should be certified and have proven knowledge and expertise.and expertise.

Certified athletic trainers are allied health Certified athletic trainers are allied health professionals who have a considerable professionals who have a considerable knowledge of anatomy and physiology. They knowledge of anatomy and physiology. They can be found at many high schools and most can be found at many high schools and most colleges and universities.colleges and universities.

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Prehabilitation and Preseason Conditioning Chapter 7 Sports Medicine 1