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Chapter 4: Preventing Injuries Through Fitness Training

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Kembra Mathis

on 10 November 2016

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Transcript of Chapter 4: Preventing Injuries Through Fitness Training

The Roles:
Athletic trainer and Strength and Conditioning Coach

Chapter 4 Training and Conditioning Techniques
At the end, you should be able to...
What you need to know!
Summary
is here
are important
is important too
are important
Reduce Injury
Prepare the Athlete for Activity
Injury Rehabilitation
Define the terms
o4.2 Examine the roles of the athletic trainer and the strength and conditioning coach on an athlete’s fitness.
-4.2.1 Differentiate between two roles and their impact on the athlete.
o4.3 Identify the principles of conditioning
-4.3.1 Express the importance of the warm-up and cool down periods.
-4.3.2 Evaluate the importance of flexibility, strength, and aerobic endurance for athletic performance and injury prevention.
-4.3.3 Compare and contrast techniques for improving flexibility, strength, and aerobic endurance.
-4.3.4 Apply the concept of periodization and identify the various training periods in each phase.
o4.4 Explain the role that overtraining plays in the risk of injury.
-4.4.1 Discuss the consequences the detrimental effects of overtraining can have on a given group of athletes.
o4.5 Develop goals of a training and conditioning program
-4.5.1 describe how to increase neuromuscular control
-4.5.2 create a plan for improving range of motion
-4.5.3 discuss how to improve postural stability and balance
-4.5.4 list ways to maintain cardiorespiratory fitness during rehabilitation
o4.6 Identify the tools needed for a comprehensive training and conditioning program
-4.6.1 compare core stabilization training with plyometric techniques
Terms: Cardiac output, Overload Principle, Domains of fitness, training affect, aerobic metabolism, anaerobic metabolism, Adenosine Tri Phosphate (ATP), Adenosine Di Phosphate (ADP), Creatine Phosphate (CP), muscle Contractions, Neuromuscular Control (NMC), Range of Motion (ROM), Plyometric, Proprioception, Muscle Spindle, Golgi Tendon Organ (GTO), Functional Progression, Agonist Muscle, Antagonist Muscle,
Terms
Cooperative relationship that serves to condition athletes in an effort to minimize injury and maximize performance
Knowledge of flexibility, strength, and cardiorespiratory endurance is necessary
Many strength coaches are certified through the National Strength and Conditioning Association
Athletic trainer may be called upon to review programs/make suggestions
Take into consideration components of particular sport and injury prevention

Rehabilitation of injuries is the responsibility of the athletic trainer

Different settings (professional, college, high school) will require differing levels of supervision by the athletic trainer
The Athletic Trainer
Principles of Conditioning and Training
Safety


Warm-up/Cool-down


Motivation


SAID principle


Consistency/routine
Progression


Intensity


Specificity


Individuality


Relaxation/Minimize Stress
Warm up
Precaution against unnecessary musculoskeletal injury and soreness

May enhance certain aspects of performance

Prepares body physiologically for physical work

Stimulates cardiorespiratory system, enhancing circulation and blood flow to muscles

Increases metabolic processes, core temperature, and muscle elasticity
Consists of...
Warm up should begin with 2-3 minutes of light jogging to increase core temperatures
Increases in core temperature have shown to be effective in reducing injury
Breaking a light sweat is an indication of this temperature increase

No evidence to suggest the effectiveness of stretching on injury reduction
Empirically, many people still include stretching
No evidence to indicate that it is harmful

Use of continuous motion to prepare body for activity
Hopping, skipping, jogging, bounding, foot work
Enhances coordination and motor ability, stimulates the nervous system
Prepares muscles and joints in a more activity specific manner
Requires focus and concentration
Should include activities for all of the major muscle groups
May last from 5-20 minutes
Activity should begin immediately following warm-up
Dynamic Stretching
Cool Down
Essential component of workout

Bring body back to resting state
Cardiorespiratory
endurance

Performance of whole body activity for an extended time frame.
Transport and useage
of VO2

4 parts: heart, Lungs, Blood Vessels, and Blood



VO2MAX=The greatest rate O2 can be taken in and used during exercise.
Effects on the Heart
3 factors
External respiration-pulmonary function
Gas transport by the cardiovascular system.
Internal respiration-use of O2 by the cells to produce energy.


Adaptations seen in Increases HR
Increased stroke volume-vol. of blood pumped with each beat. Heart pumps about 70ml per beat up to the 40% max HR after which time increases in blood pumped out per unit of time occur strictly as a result of increased HR.



C.O. increases 4 times that experienced at rest in a normal person and as many as 6 times in an elite endurance athlete.

Training effect-Stroke volume increases, resting HR decreases at a given standard exercise. The heart becomes more efficient
C.O.= SV X HR
Effects on Workability
The higher the VO2MAX, the more work can be done with less fatigue for a longer period of time.
Energy System

Adenosine triphosphate-Produced in the muscle from blood glucose (which is broken down from dietary carbs (from food) or glycogen. Ultimate useable form of energy for muscles.
Glucose not immediately used is stored in the resting muscle and liver as glycogen.
Once Muscle and liver glycogen is used stored fats are in adipose tissue are used to meet energy needs.
ATP is always available in the cell, however when it is depleted, more must be regenerated for muscle contraction to continue.
Making the environment safe
necesary in order to better prevent injury
Typically, Athletes are highly motivates however varying a routine helps prevent boredom and foster motivation
Specific adaptation to imposed demands.
the body will adapt to increases in demand over time.
Conditioning must be done regularly to be effective
Gradual increase in intensity
Increasing tempo or difficulty level, not length of time
creating a program with all fitness components that is specific to a sport or need
recognize that each athlete is different and workouts should need to accommodate.
important to take an athlete's level of stress into consideration when pushing them to their limits.
Aerobic vs Anaerobic
1. ATP-used up rapidly
2. Glycolytic- Glycogen is broken down to create glucose which is used to create ATP without O2-this creates lactic acid.
3. Oxidative systems-energy from complex carbs and fats-
1. Aerobic System burns up lactic acid from glucose breakdown creating far more ATP than with Anaerobic.
2. Takes 20 minutes to burn up the lactic acid
3. Lactic acid causes muscle fatigue.
3 levels of energy systems utilized to produce ATP
ATP: immediate energy source
Physiological and Biomechanical
factors of Muscle Strength

Muscle strength is proportional to the cross sectional diameter of the muscle fibers.
Size-the number of fibers is an inherited factor; the more muscle fibers a person has the greater their strength potential.
Hypertrophy-Bigger

Atrophy-Smaller


Other Adaptations
Three theories of muscle hypertrophy:
Improved Neuromuscular Efficiency
muscles work like levers, making their attachment locations very important.

The length of the muscle determines the tension that can be generated. Muscle is strongest at mid range because the interaction of the crossbridges between actin and myosin myofilaments within the sarcomere is at a maximum.
Biomechanics
sports vary in the types of energy requires.
Long distance running or swimming vs sprinting or jumping.
Anerobic in nature
Fats and proteins can also create ATP
Anaerobic.
aerobic
10-15 minutes total
Level of improvement will be determined by initial levels
Training techniques to improve CRE
Continuous Training
4 considerations-Frequency, intensity, Type and Time
Frequency (at least 3 times/week)
Intensity-Must elevate heart rate to 70% of maximum; Most critical factor
Type of activity- must be aerobic in nature
Time (at least 20 minutes)
Interval Training
220-age = HRmax
For min improv. must workout at 70% of HRmax
Athletes at 85% of HRmax
Intermittent activities involving periods of intense work and active recovery
Must occur at 60-80% of maximal heart rate
Allows for higher intensity training at short intervals over an extended period of time
Most anaerobic sports require short burst which can be mimicked through interval training
Alternating periods of Work
Speed Play

Cross-country running that originated in Sweden
Similar to interval training in the fact that activity occurs over a specific period of time but pace and speed are not specified
Consists of varied terrain which incorporates varying degrees of hills
Dynamic form of training
Must elevate heart rate to minimal levels to be effective
Popular form of training in off-season
Originally referred to as Fartlek
Strength: ability to generate force against resistance

Power: is the relationship between strength and time

Muscular endurance: repetitive muscular contractions (increase strength = increase endurance
The importance of Muscle Strength, Endurance, and Power
Muscle Contractions
No length change occurs during contraction
Pro: quick, effective, cheap, good for rehab
Con: only works at one point in ROM
Isometric contraction
Isotonic contraction
Shortening of muscle with contraction in an effort to overcome more resistance
Concentric
Lengthening of muscle with contraction because load is greater than force being produced
Both are considered dynamic movements
Eccentric
Increase in number of fibers
Infusion of blood - transient hypertrophy
Increase in protein myofilament number and size
PROVEN
-A muscle responds to an impulse to contract. Weight training can stimulate the response of more receptors, causing more parts of the muscle to fire at one time.
-Increased tensile strength of tendons and ligaments, increased mineral content in bone, max O2 uptake is improved if training is enough to increase HR.
Overtraining
Can result in psychological and physiological breakdown resulting in injury, fatigue and illness.

Training appropriately, eating right, and getting appropriate amounts of rest are critical for prevention
Reversibility
Gains in muscular strength resulting from resistance training can be reversed
Declines in training or stopping all together will result in rapid decreases in strength
Fast Twitch vs. Slow Twitch
Fibers within a particular motor unit display distinct metabolic and contractile capability

Slow twitch (Type I, slow oxidative):
Fatigue resistant
Time necessary to produce force is greater
Long duration, aerobic type activities
Generally major constituent of postural muscles
Fast twitch (Type II, fast oxidative glycolytic)
Fatigue
Anaerobic in nature
High force in short amount of time
Produce powerful movements
Types
IIa = Moderately fatigue resistant
IIx & IId = Fast glycolytic, short anaerobic burst, less mitochondrial density as compared to IIa
IIb = True fast-twitch; very low mitochondrial density
Individual make-up
Muscles contain both types of fibers

Fiber type ratios vary between muscles

Impacts muscle function

Postural vs. powerful movement

Genetically determined

Varies between people

May impact an individual’s abilities for a given sport
Metabolic capabilities can change in response to training
Techniques for
Resistance Training

Progressive resistance exercise

Overload principle must be applied

Must work muscle at increasingly higher intensities to enhance strength over time

If intensity of training does not increase, but training continues, muscle strength will be sustained
Activity must be increased and upgraded constantly in order to gain a higher response from the body

Work at or near maximum capacity

Applicable to conditioning and training
Overload Principle
Functional Training
Uses integrated exercises designed to improve functional movement patterns

Training for strength and neuromuscular control

Driven by the kinetic chain concept

Training in 3 planes of motion

Involves integration of proprioceptive feedback to perform tri-planar movement tasks

Avoids isolated single plane training

Designed to enhance neuromuscular efficiency
If any link in kinetic chain is not working efficiently compensations may occur



Designed to enhance functional movement patterns

Works on core strength and dynamic flexibility
-Leads to injury, predictable injury patterns, decreased performance
Training variables
Plane of motion, body position, base of support, balance modality, external resistance
Quiz
1. what is the role between the ATC and the CSCS?

2. Name and describe 5 principles of conditioning.

3. What are the major components of a good warm-up and cool down?

4. What is Cardiorespiratory Endurance?

5. What is VO2Max?

6. What is the Training Effect?

7. When talking about ATP energy systems, what's the differnce between the aerobic and the anaerobic systems?

8. what are 3 types of Training techniques

9. What's the difference between strength and power?

10. What adaptations does the body make when introduced to a strength training regimen?

Functional strength training
isometrics
PREs
isokinetic
circuit training
plyometrics.
Techniques of Resistance training Includes:
Core Stability
The core is the lumbo-pelvic-hip complex
Center of gravity is located there
Core training works to improve




Body must be adequately stabilized
Allows muscles (prime movers) to generate strong, powerful, movements
Dynamic postural control
Muscular balance
Functional strength
Neuromuscular efficiency
Isometrics
Contraction where muscle length remains unchanged
Muscle contraction that lasts 10 seconds and should be perform 5-10 times/daily
Pro: quick, effective, cheap, good for rehabilitation
Con: only works at one point in ROM, produces spiking of blood pressure due to Valsalva maneuver
Continue breathing to minimize increase in pressure
PRE's
Shortening/lengthening
Concentric vs. Eccentric
Various types of equipment can be utilized
(Free weights, machine weight)
Spotter is necessary for free weight training to prevent injury, motivate partner and instruct on technique
Isotonic Strength training
Concentric and eccentric training should be incorporated for greatest strength improvement
Concentric phase of lift should last 1-2 seconds, eccentric phase 2-4 seconds
Variations exist between free and machine weight lifting
Motion restrictions, levels of muscular control required, amount of weight that can be lifted
PRE techniques

Repetitions
Repetition maximum
One repetition maximum
Set
Intensity
Recovery period
Frequency
Circuit Training
When training, should be able to perform 3 sets of 6-8 repetitions
Increases should occur in increments of 10%
1 RM can be utilized measure maximum amount of weight that can be lifted - must be very careful
Training of a particular muscle group should occur 3-4 times per week (not on successive days)
Strength vs Endurance
Training for endurance enhances strength and vice versa
Training for strength should involve lower repetitions at heavier weight
Training for endurance requires lower weight at 12-15 repetitions
Persons that possess greater strength also tend to exhibit greater muscular endurance
Isokinetic Training
Muscle contraction at a constant velocity
Maximal and constant resistance throughout the full range of motion
Maximal effort = Maximal strength gains
Disadvantages
Cost
Need for maximal effort/motivation
Rehabilitation
Combination of exercise stations
8 - 12 stations, 3 times through
Design for different training goals
Flexibility
Calisthenics
Aerobic exercise
Calisthenics
Free exercise
Isotonic training
Gravity’s involvement determines level of intensity
Full range of motion, may incorporate holding phase
Pull-ups, push-ups, back extensions, leg extensions
Plyometrics
Rapid stretch, eccentric contraction followed by a rapid concentric contraction to create a forceful explosive movement
Training Techniques
for Females

Critical for females
Significant hypertrophy is related to testosterone present within body
Remarkable gains are experienced initially due to enhanced nervous system and muscle interaction (efficiency-not muscle bulk)
Following initial gains, plateau occurs, with females
Males tend to continue to increase strength with training
Critical difference is the ratio of strength to body fat
Females have reduced strength to body weight ratio due to higher percentage of body fat
Ratio can be enhanced through weight training and decrease in body fat percentage/increased lean weight
If properly supervised younger individuals can improve strength, power, endurance, balance and proprioception

Develop a positive body image

Results in improved sports performance while preventing injuries
Prepubescent and Adolescent
Strength Training

Strength gains can occur without significant muscle hypertrophy

Close supervision and instruction is critical

Progression = based on physical maturity

Calisthenic exercises and body weight as resistance can be utilized in a functional strengthening program
Strength Vs Flexibilty
Co-exist
Believed that individuals that are “muscle bound” = zero flexibility?
Strength training will provide individual with ability to develop dynamic flexibility through full range of motion
Develop more powerful and coordinated movements
Improving and Maintaining flexibility
Ability to move a joint(s) smoothly through a full range of motion (ROM)

Good flexibility is essential for successful physical performance

Normal ROM has been recognized as acceptable for normal daily function
Factors Limiting Flexibility
Bony structures
Tissue approximation
Excessive fat
Muscle and tendon lengths
Connective tissue
Scarring and contractures
Skin
Neural tissue tightness

Agonist vs Antagonist
Agonist
Muscle producing movement
Quadriceps contract to produce knee extension
Antagonist
Muscle undergoing stretch during movement
Hamstrings will stretch during knee extension
Neurophysiology
of a Stretch

Muscle is placed on stretch
Muscle spindles & Golgi tendon organs (GTO) fire relaying information to spinal cord
Spinal cord relays message to golgi tendon and increases tension
After 6 seconds GTO relays signal for muscle tension to decrease
Results in reflex relaxation of antagonist
Prevents injury - protective mechanism
Stretch Reflex
With static stretching golgi tendons are able to override impulses from muscle spindle following initial reflex resistance
Allows muscle to remain stretched without injury

Using PNF = benefit greatly from these principles
With slow-reversal hold technique, maximal contraction of muscle stimulates GTO reflex relaxation before stretch applied
ROM-Active vs. Passive
Static Stretching
Reciprocal Inhibition
During relaxation phase, antagonist is placed under stretch but assisted by agonist contraction to pull further

Contraction elicits additional relaxation of antagonist (protect against injury)
Relaxation of antagonist during contraction
autogenic Inhibition
Effects of Stretching on the muscle
Elongation of the muscle can create plastic changes in the muscle
Stretching Techniques

Bouncing movement in which repetitive contractions of agonist work to stretch antagonist muscle
Possible soreness due to repeated eccentric contractions of antagonist
Balistic
Dynamic

May more closely mimic muscle activity during sport/activity
Considered functional and often suggested for athletes prior to activity
Static

Passively stretching
6-8 second hold
Go to point of pain and back off and hold for 30 seconds (3 to 4 times)
Controlled, less chance of injury
Not dynamic
Does not require a partner

Initially used by physical therapists for neuromuscular paralysis
Slow-reversal-hold-relax
Contract-relax
Hold-relax
Best technique to improve flexibility
Autogenic inhibition (push = tension)
Reciprocal inhibition (pull = relax)
All techniques involve 10 sec contract and relax
Proprioceptive Neuromuscular
Facilitation Techniques
Neuro vs. Fascia
You have to know the difference between neural tightness and musculotendinous tightness!



Fascia can limit motion (pain, injury, inflammation). Can be performed manually or using foam roller
Other Methods...



Conditioning program that improves muscle control, flexibility, coordination, strength and tone
Enhances body awareness, improves body alignment and breathing, increases movement efficiency
Designed to stretch and strengthen muscles through a sequence of carefully performed movements
Pilates
Usually one on one in a studio session
Yoga
Based on philosophy that illness is related to poor mental attitude, posture and diet
Reduce stress through mental and physical approaches
Used to unite mind and body
Involves various postures and breathing exercises
Designed to increase mobility and flexibility
Additional considerations
Measuring ROM
Fitness Assessments
-Provides coaching and athletic training personnel with information relative to fitness and preparedness
-Baseline information
Periodization
Traditional seasons no longer exist for serious athletes
Achieve peak performance
Decrease injuries and overtraining
Program that spans various seasons
Modify program relative to athlete’s needs
Macrocycle
Mesocycle
Complete training cycle
Seasonal approach based on preseason, in-season, and off-season
Changes in intensity, volume, specificity of training occur in order to achieve peak levels of fitness for competition
Broken into mesocycles (lasting weeks or months)
Transition period:
Follows last competition (early off-season)
Unstructured (escape rigors of training)
Preparatory period:
Off-season
Hypertrophy/endurance phase (Low intensity with high volume)
-Allows for development of endurance base
-Lasts several weeks to 2 months
Strength Phase
Power Phase
-High intensity/ pre-season
Competition Period
May last a < week or several months for seasonal sports
High intensity, low volume, skill training sessions
May incorporate microcycles (1-7 days)

-Designed to ensure peak on days of competition
Last but not least...
Cross-Training
Training for a sport with substitutions of alternative activities (carryover value)
Useful in transition and preparatory periods
Can add variety to training regimen
Should be discontinued prior to preseason as it is not sport-specific
The roles overlap, the ATC is in charge of Rehab and can help supervise athletes on a strength and conditioning program, the CSCS is in charge of the S&C program. He or she may seek advise from the ATC.
Safety
warmup/cool down
motivation
overload
SAID
consistency
progression
intensity
specificity
individuality
relaxation/minimizing stress
warmup lasts 10-15 minutes and should
begin with 2-3 minutes of whole body activity.
Cooldown is 5-10 minutes of active recovery like walking, light jog, stretching etc.
1. Describe the relationship between the ATC and the Strength and Conditioning coach.
2. What is cardiorespiratory endurance?
3. What is the Training Effect?
4. What's the difference between strength and power?
5. Explain the SAID principle.
The Real Quiz!
1. They should work together to provide the best care for the athlete. ATC-oversees rehab and supervises athletes workout with the Strength and conditioning coach.
2. The ability to perform whole body mvmt over an extended period of time.
3. Stroke volume increases, resting HR decreases
4. Time. Strength is generating force against resistance while power is doing so in a short period of time.
5. The body will adapt to the demands placed on it.
Answers
Create 3 exercises for 3 major muscle groups of your choice.
1. Isometric
2. Concentric
3. Eccentric
Macro
Mesocycle
Transition
Preperatory
Competition
Performance of Whole body
activity over a period of time.
Max amount of O2 one can take in and use
during exercise.
Stroke volume increases, while
resting HR decreases as a result to a
conditioning program.
Aerobic requires 02 and will burn off Lactic Acid.
Anareobic system(glycolitic) creates Lactic Acid
and does not utilize O2.
Continuous training
Interval training
Speed Play-Fartlek
Strength is the ability to generate force
against resistance.
Power is the relationship between
strength and time.
Increased tensile strength of tendons and ligaments,
increased bone density
possible increase in VO2MAX if HR is increased sufficiently during training.
Decreased muscle soreness following training if time used to stretch after workout
Often ignored
5-10 minutes in duration
World class runner-70-80ml/kg/min.
Normal for college athletes is 45-60ml/kg/min
Presented in terms of the volume of O2 used relative to body weight per unit of time.(ml/kg/min)
Genetically determined-you may increase your VO2MAX within your predetermined range but you may not increase the range.
The greater the max O2 consumption required for an activity, the less time it can be maintained.
VO2MAX-Maximum aerobic capacity
Effects on the Heart
Cardiac Output-How much blood the heart is capable of pumping in 1 minute- Determined by Stroke volume and HR together.
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