2007
Regular aerobic exercise (exercise which gets you breathing heavily and your heart beating faster) helps to:
reduce or maintain body weight
control blood sugar (helpful for diabetics)
maintain mobility and muscle strength, allowing daily activities to be undertaken more easily
improve mood
It is advised that you should consult your doctor before undertaking regular exercise.
Although injuries sometimes occur during exercise or sporting activities, many of these injuries could be avoided.
Age is no barrier to physical activity, and there are many advantages to keeping fit at all ages.
It is very important to encourage children to exercise. Weight-bearing exercise in childhood and up to the mid-20s is important in building up the bones (maximizing bone density), which will reduce the risk of osteoporosis and fractures later in life.
As people get older they usually lose muscle bulk and strength. Exercise and training can help to prevent this. Weight-bearing exercise, such as walking, running and gym, can help to maintain bone density into later life.
As you grow older, you will be less able to make sudden explosive movements. You will tend to be less flexible and more prone to muscle and tendon tears. You may be more likely to suffer from pain in the joints, back and neck, and injuries may be slower to heal.
Because of these changes it is important to ensure that exercise, training and competitive sport are tailored to your individual capacity, background and age.
The generally wider pelvis of the female compared with the male means that the angle of the thigh relative to the knee is different. In turn, this means that the relationship between the line of pull of the front thigh muscles (the quadriceps) and the angle of the quadriceps tendon (patellar tendon) also differs.
The greater the angle between the line of pull of the quadriceps and the patellar tendon (known as the Q angle), the greater the risk of injury at the knee during running and jumping activities.
Malalignment
This is when bones or joints develop in separate ways. (Everyone has a slightly different joint configuration that falls within a normal range.) Examples of deviations from the normal are:
Excessive pronation (inward movement) of the foot/ankle causing the forces going through the foot, ankle. This in turn can result in the forces through the knee, hip and pelvis to change. This can result in some muscles working harder than others: tendons may lengthen or slightly twist making you vulnerable to an overuse injury such as tibia stress fractures, shin splints, achilles tendonosis, plantar fascitis and knee cap problems.
Knock knees (genu valgum) or bow legs (genu varus) can increase the risk of overuse injury.
Turning in of the hip (femoral anteversion) tilts the pelvis forwards excessively and may cause an overuse injury of the knee or contribute to injuries of the pelvis, hip and thigh muscles.
If you suffer an overuse injury, particularly one that re-occurs, seek appropriate treatment as soon as possible. All the above conditions can be diagnosed and treated through specific conditioning, muscle imbalance exercises and rehabilitation. Custom made inserts (orthotics) can be purchased or made for you in order to correct your foot posture, this in turn helps promote ‘normal alignment’ throughout your gait (walking) and movement.
Leg Length Discreapncy
It is not unusual for most people to have one leg longer than the other. The effect of a leg length discrepancy from an injury perspective is the potential for a change in the forces going through muscles and joints.
There are two types of leg length discrepancies:
True (structural) discrepancy
This is commonly as a result of a fracture to the lower limb or can be congenital (from birth). The resulting leg length difference is solely within the structure of the leg itself. The pelvis and spine may compensate for this difference causing the pelvis and spine to tilt sideways (scoliosis).
Apparent (functional) leg length discrepancy
This is when poor posture over a long period of time can cause a shortening of some muscle groups and a lengthening of others. These may not be a problem until it alters the mechanics of the pelvis, knee or ankle so that the normal stabilising and controlling action of specific muscles is altered. This may cause recurrent hamstring strains, lumbar and sacroiliac (lower back) problems and inflammation of muscles around the hip such as the tensor fascia lata/ilio-tibial band.
If such an injury occurs, it is important to firstly treat the injury, then correct the underlying problem through specific strengthening (of muscles that are weak) and stretching (of muscles that are restricting movement) exercises. Orthotics may also be prescribed in certain instances.
Muscle weakness and imbalance
If muscles are shortened or lengthened for long enough they will respond by becoming shorter or longer. This in turn may change the forces acting on bones and joints and usually causes postural change. For example, sitting slumped at a desk all day can result in lengthened, weak muscles between the shoulder blades/upper back, with possible shortening of the front chest muscles. This changes the workings of the shoulder joint, neck and upper spine and an increased risk of injury occurs. Exercise and postural guidance is essential.
Muscle weaknesses or imbalances can develop in sport that increase injury risk. For example, in racket sports serving and smashing can lead to an imbalance of specific muscles at the shoulder joint that place the joint at a massively increased risk of injury. Preventive conditioning aimed at strengthening muscles behind the shoulder can reduce the injury risk dramatically.
Flexibility and joint laxity
Flexibility refers to the range of motion possible at a joint or throughout a series of joints. It is influenced by several factors, including the type of joint, its structure (e.g. the position of ligaments, etc) and the position and tension of the muscles and tendons that cross it.
A joint is 'lax' if the ligaments do not hold the bones, and hence the joint, together particularly well, allowing considerable joint play. A range of motion that is greater than that which is ‘ normal' is known as hypermobility. Hypermobility and joint laxity usually go together and the freedom of movement at such a joint means that it is far easier to sublux or dislocate this type of joint.
A good general level of flexibility is required in most sports and some sports and activities (such as gymnastics and ballet) require extreme ranges of motion. However, if the muscles cannot control the limbs and joints throughout this extreme range of motion and the joint is lax, then the risk of injury is greatly increased. The ability to control movement throughout its full range is often referred to as joint stability.
Joint stability may be improved by developing the strength and control of specific muscles acting at the joint.
Execessive Load
The tissues of the body potentially withstand considerable stress but if they’re not used to such forces, they find it difficult to adapt to withstand them and an injury may occur when they are applied. Certain training demands that the body either develops force rapidly or must control force very quickly. Consequently, this type of training or activity must be gradually introduced as part of a training programme. Your current level of fitness should be assessed and an increase in intensity, volume, duration, frequency and recovery should be undertaken.
If your sport involves impact (running, jumping, etc.) then wearing appropriate footwear and exercising on a suitable surface are important for the impact force going through the body to be kept to a minimum. The appropriate footwear (dependant on your gait, joint mechanics and running surface), is essential. For example, someone with excessive pronation, has different footwear needs to someone who does not.
Training Errors
Usual culprits are those that result in excessive loads on the body. These include volume/distance and intensity. Many recreational sports performers often do not realise that the elite sports performers they sometimes try and emulate in training have spent many years of training consistently, gradually increasing the workload in order to do what they do.
All elite sports men/women plan their training so that the basic training (cardiovascular conditioning, general strength) is followed by a period of specific strength, prior to highly demanding speed, power and competition work. Woven throughout this progressive structure will be all the elements of preventive conditioning that each performer requires in order to minimise their injury risk.
They set goals, regularly assess their success in achieving these goals, and assess general and sports specific fitness (endurance, speed, etc.) regularly.
To help understand training errors that result in injury, keep a training diary incorporating brief details of the session (mileage/volume, speed/intensity, sets/reps, etc.) and the date and time you did the session. If an overuse injury occurs, having the diary can usually help pinpoint what changed, and therefore what may have contributed to the injury itself.
Technique
Overuse injuries can be related to sports or exercise technique. Some injuries are named after their sport (e.g. tennis elbow). Often the repetition of an action with faulty technique results in excessive load on tissues and subsequent injury.
It can be triggered by a change in equipment (racket size, grip size) or faulty technique (backhand, or top spin forehand in tennis, excessive forward tilt of pelvis in running and an incorrectly set handlebars or seat in cycling).
In all overuse injuries, sports technique should always be checked and advice should always be sought from the appropriate qualified instructor.
Note: Remember that skill breaks down the more tired you become, so the last few repetitions of any exercise in the gym should be watched carefully and should be as technically correct as the first few.
Modifying many of the extrinsic risk factors is often a case of planning a training programme more carefully, and improving exercise or sports technique.
Before strenuous exercise, training physical activity or competition a thorough warm-up is recommended as many of the body's tissues (particularly muscle) respond better to loading when they are warm. The warming up process should include whole body exercise (jogging, cycling, the sport itself at low intensity) that increases blood flow to muscles and makes then more responsive.
The length of this warm-up phase will depend upon the ambient temperature (the warmer it is, the less time needed to become warm) and what is going to be done. All out sprinting for example, is extremely demanding, and warming up to sprint is not just a case of increasing temperature and local blood flow, but of gradually preparing the muscles and joints to generate maximum forces very quickly. Movement specific or sports specific drills form part of the warm up phase, along with flexibility work aimed at taking muscles and joints through the range of motion that will be required during the activity or sport. Warming up for an exercise session may take as little as ten minutes, whilst warming up for demanding sports training or competition can take 30 minutes or more.
At the end of every training session, all sports performers will warm down, bringing their body back down to normal, usually through low intensity activity, followed by flexibility exercises to return the muscles back to their pre-exercise length. As with the warm up phase, the time course is similar according to what has been done.
Recovery from a sports injury involves intensive recovery programmes to get back to full sporting activity at the earliest opportunity.