Prehabilitation

Injury prevention using the weight room
by: Lisa Holcomb, CSBC
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There are many goals that the weight room and conditioning fields wish to obtain in order to increase the strength, stamina and speed of a football team. One of the most important facets, however, lies in their ability to prevent injury. By properly utilizing available resources, it is possible to recognize and steer away from potential injuries that could eventually take away from the team's caliber. This type of preventive measure is known in the field as prehabilitation. It is important to be able to recognize the most common reasons for an athlete to be sidelined, and then do all things possible to avoid them.

Neck

For example, it is common in a collision sport such as football for neck injuries to occur. Several simple neck exercises exist that may help reduce the severity of such an injury. Various companies make four-way neck machines that provide resistance as the athlete presses his head back and forth using the muscles in the neck. (Photos 1 & 2)




Photos 1 & 2

For schools that do not have the budget for such equipment, there are other cost and space efficient ways to obtain nearly the same results. One such way that requires only a partner and towel is manual neck strengthening. The athlete sits straight up on a bench with a towel over his head. A partner will provide the resistance against the athlete's head using their hands. As the athlete attempts to move his neck side to side and front to back, the partner provides just enough resistance to make it difficult, but not impossible, to do so. Another method involves the athlete, a towel, a flat bench and a weighted plate. The athlete lies on the bench on his back. He then places the towel on his forehead with the weight on top with his head hanging off of the bench. (Photo 3) He then uses a nodding motion to move the weight up and down through a full range of motion. (Photo 4) When finished, he turns over and repeats the exercise while lying on his stomach.




Photos 3 & 4

Hamstring

One major area of concern for coaches is the hamstring. Athletes often pull or strain this muscle. To reduce hamstring injuries, the muscle must first be strengthened properly to adapt to the demands of the sport and must secondly be warmed up properly. Strengthening exercises include everything from machine leg curls to partner leg curls (Photos 5 & 6) to physioball and medicine ball exercises.




Photos 5 & 6

(Photo 7) These goals are usually adequately accomplished in any strengthening program. However, warming up properly for both lifting and conditioning workouts usually gets neglected. Time constraints may be the main culprit to the omission of a proper warm up, in addition to its underrated importance. It is necessary to include as many drills as possible in a short amount of time to achieve the most efficient results.
Photo 7. Physioball

All warm-ups should begin with some type of exercise to loosen the leg muscles, and should not exclude the upper body. An unlimited number of dynamic flexibility drills exist to accomplish many goals at once. Dynamic flexibility drills adhere more directly to the athlete than the more traditional static stretching due to their inherent athletic attributes. These are exercises that ideally mimic several movements made during actual athletic play, but in a controlled and repetitive manner. Great choices to start off a conditioning session are hurdle walks (Photo 8), high knees, butt kicks, knee & ankle hugs (Photo 9) and straight leg raises. These will ensure that the hip flexors, hamstrings and glutes are warmed up and primed for the workout to follow, whether it is weight lifting, agility drills or game day.


Photo 8. Hurdle Walks


Photo 9. Knee & Ankle Hugs

Ankles

Another common injury is the ankle sprain. Ankle sprains most commonly occur from sharp cuts or turns made while running. Ligament stability and lower leg strength are two areas that deserve attention when preventing this injury. Balance boards, soft rubber discs or any other type of surface that is unstable can be used to stand on with one leg. This forces the ligaments to overcompensate for the instability, therefore becoming stronger. While it is common for attention to be given to the larger calf, or gastrocnemius muscle, the smaller anterior tibialis is often neglected. The anterior tibialis lies on top of the shin bone and is flexed when the toe is raised towards the body. Exercises for this muscle that help to balance out muscular differences between the calf and shin include heel walks and dorsiflexion. Heel walks can be performed on a treadmill or on a grassy field. The athlete should spend 5 minutes alternating between 1 minute of continuous heel walking and 30 seconds of regular walking. Dorsiflexion can be performed by simply sitting and lifting the toe up off the ground continuously for multiple sets of 30 repetitions, or by using resistance cords for added difficulty. (Photos 10 & 11)




Photos 10 & 11. Dorsiflexion

Back

Finally, back pain can hardly be avoided in a sport such as football, and its causes may be varied. The key to alleviating back pain is by building a strong back using proper technique. Often, technique in lifting is sacrificed in order to increase the weight being lifted. This may be a great boost for the athlete in the short term, but will eventually lead to bigger problems down the road. It is extremely important in all lifting exercises for the core to be strong and for the back to be aligned properly. The most common exercises in which the back is compromised include Hang Cleans, Squats (Photo 12), Deadlifts (Photos 13 & 14) and Romanian Deadlifts. In each one of these, it is imperitive that the back is always flat and not at all rounded.


Photo 12. Correct Squat


Photo 13. Deadlift: Incorrect


Photo 14. Deadlift: Correct

This means that the athletes shoulders must be pulled back as far as possible, and that their chest must be raised and sticking out. Telling the athlete to set their hips back is another cue that will help them acheive the correct position. In addition to allowing the back to round out in improper form, the use of a weight belt also keeps the back from obtaining its maximum strength. Instead of building the core muscles from within, the belt gives added support and cheats the muscles out of gaining that extra strength on their own. It is important, especially when performing repetitions greater than five, to teach proper technique without using a weight belt. The athlete will not be out on the football field using a weight belt to aid his strength, and should therefore only use it when performing very low reps with high weight during lifting.

There are, of course, a myriad of other injuries plaguing the sport. Detecting potential hazards are key in keeping the team healthy year round. It is important to do everything possible to keep the team functioning at 100%. As demonstrated here, it does not require an excessive budget or high tech machines to keep athletes up to speed in both the weight room and on the conditioning field. Teaching proper technique, incorporating variety and keeping the body strong will provide a sound foundation for many future, injury free seasons to come.

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