Exercises to help avoid sports injuries
How to stay fit and healthy, and more importantly, injury free
Sports injuries are frustrating, striking down the elite and rookies alike. Every time you play sport or exercise the repeated wear and tear on your body adds up and may lead to injury.
But it doesn't have to, fitness experts say. There is a lot you can do to stay healthy while enjoying your favourite sport or fitness regime.
Common injuries: leg injuries, particularly around the knee, such as patellofemoral syndrome, iliotibial band syndrome, achilles tendonitis, plantar fasciitis, hip bursitis and shin splints.
Prevention: although running injuries seem varied and complicated, they're often quite simple, says Rick Hartley, an osteopath and biomechanic at Joint Dynamics in Central. Many injuries occur due to a lack of mobility and an inability to properly control the movement in the joints, he says.
"The knee gets told what to do by the foot, the ankle and the hip. If you don't have good ankle and hip mobility, and stability, as the foot hits the ground and sends energy up the kinetic chain, as there are weaknesses in that chain, injury will result," he says.
The solution? Ensure that you've got good flexibility and strength in the muscles needed for your sport.
"Strengthening the quadriceps and gluteal muscles will help prevent the onset of the symptoms of many running injuries," says Sara Croker, physiotherapist at the Sports and Spinal Physiotherapy Centre Hong Kong.
Also, rethink your shoes. "Running is heavily influenced by footwear," says Kevin Moore, a movement therapist at Doctor Susan Jamieson and Holistic Central Medical Practice and the founder of Reembody (reembody.me).
"The most common running injuries stem from the same dysfunctional pattern of movement in the foot: the inability for the foot to correctly stabilise the heel bone while it rolls inward."
Moore, who is also a pilates coach, teaches patients to avoid injury by showing them how to make better use of their feet.
"Introducing how functional eversion works and teaching runners to be aware of its contribution to stride is enough to set the pattern right," he says.
Finally, regular stretching of the "calves, outer hips and buttock and iliotibial band" will help most running injuries, says Croker. Using a foam roller will help to loosen tight muscles.
Common injuries: wrist and hamstring strains and lower back injuries.
Prevention: no one should get injured in yoga. Most injuries occur for two reasons: bad form and being overzealous.
Yet injuries are common. "Yoga has moved so far into mainstream sport and fitness that it has taken on a competitive intensity, a quality it was never intended to have," says Moore.
At the limits of joint mobility, giving in to competitiveness means that compensation in other areas of the body is a guarantee, says Croker. "You should be working to the point of the stretch, and not into pain." Be wary of your limits during hot yoga, when the body is warmed up, she says.
The fix for many yoga injuries is easy, says Moore. "Stop trying so hard," he says, jokingly.
Ensuring good form is also crucial, says Croker. "Well placed wrists and hands and neutral positioning of feet, knees and hips in yoga postures will allow for good biomechanics and effective stretching."
She also cautions that poses, such as the "crow" and "handstand", require proper wrist and hand strength.
"Full strength is paramount before these lengthy loading poses. Although practice for short times in these poses will help strengthen these muscles, more specific weight training may be required to gain full strength," Croker says.
Common injuries: lower back pain, neck pain, patella tendonitis.
Prevention: unlike yoga, cycling injuries occur because of the long periods cyclists spend sitting in one position. "The active range of motion for a cyclist is a tiny fraction of what is available, so their joints become vulnerable to stiffness," says Moore.
Adds Hartley: "If you have really stiff hips, they won't allow you to get in an aerodynamic position. That shape will have to come from somewhere and will usually come from compensation in the lower back. Holding that forced flexed position for a long time is going to stretch the passive tissues in your back."
To prevent it, cyclists need to shorten or break up their rides and get stronger. "Strong core stability is essential and will allow for power and drive from the core to the legs, protecting the spine in prolonged positions," says Croker.
"This is also true of neck pain," she adds. She also suggests cyclists ensure correct posture when cycling.
Moore recommends cross training activities, such as swimming and running.
For patella tendonitis, the solution may be simpler, according to Croker: "Patella tendonitis [while cycling] can be caused by too low a seat and therefore overworking the quadriceps and not the glutes.
"A higher saddle and effective use of gluteal muscles during cycling may help. Also the knee is a hinge joint, so preventing any rotation of the knee will help."
SWIMMING AND PADDLING
Common injuries: any sort of shoulder injury, including shoulder impingement syndrome ("swimmers' shoulder") and shoulder instability. Other typical injuries include biceps tendonitis, sacroiliac joint pain, rib and thoracic injuries.
Prevention: while injuries differ between swimming and paddling, both sports are dominated by shoulder injuries. Key to avoiding injury is, surprisingly, ensuring adequate core and hip strength, and making sure muscles are working together to properly contribute the power to the upper body.
"If all of these parts don't move together properly, then the shoulders won't either, resulting in overworking of the shoulders and, eventually, strain," says Hartley.
Croker suggests swimmers and paddlers develop good shoulder strength, with a focus on sufficient rotator cuff and scapula strength, together with core strength.
"Good technique is also incredibly important," she adds. Moore agrees, adding there is a misconception about swimming being "low-impact". "Swimming does not put 'less impact' on the joints: it simply uses them differently, which doesn't always mean better, he says.
For example, many swimmers under-power their kicks, he says, which can contribute to shoulder injuries. "I see a lot of swimmers powering with their arms and shoulders. While an enormous thrust is generated by the upper body, the hips are much more effective spinal stabilisers than the shoulders, and a stable shoulder can only operate on a stable spine. "
Paddlers have an extra challenge, says Moore.
"Sitting is less efficient for generating power than standing. Paddlers have to be conscious of how they create spinal stabilisation because, for many, the task falls entirely to the upper body."
Again, pain in the sacroiliac joint for paddlers often stems from poor rotational mechanics in the mid-thoracic spine, he says. "Without the hips to anchor and guide effective rotation, big mobilising muscles like the lats and erector spinae try to behave like stabilisers, which they're not very good at.
"It becomes difficult to create rotation without also creating spinal compression, which is where the sacroiliac joint becomes vulnerable."
Understanding how your body moves and how that may contribute to injury can help you exercise and train for longer.
Joint Dynamics in Central offers "pre-habilitation" testing facilities to help prevent injury. "By considering an individual's physiology and the requirement of each sport … we believe injury is largely preventable," says Jessica Phillips, exercise physiologist.
"Instead of running hundreds of kilometres and developing an injury, we can identify areas that require adjustment, and recruit the right muscles to avoid injury."
Test how you move: Athletic 1080 Movement System.30 minutes/HK$700 The foundation of any human movement and physical performance is mobility and stability. Using the 1080 Movement System, Joint Dynamics can identify limitations in your mobility and stability, and potential injury sites.
Test how you run or walk: gait analysis. 30 minutes/HK$1,400 Gait analysis reveals any imbalances and asymmetries. Using visible infrared frequencies, Joint Dynamics measures flight time, stride length, cadence, speed, acceleration, contact time, and other variables, accurate to 1/1,000th of a second.
Test your size: body fat percentage analysis.30 minutes/HK$700 Obtaining your body composition and fat percentage shows whether you are in the recommended healthy range for your gender and age. It may also reveal a lower than expected muscle mass, which may cause injuries. Lowering your fat percentage will also improve your energy efficiency, flexibility and reduce the impact on joints.
Test your fitness: VO2 max testing.45 minutes/HK$1,000 VO2 Max is the maximal amount of oxygen your body can take in and use during aerobic exercise - essentially how hard you can push your body. The benefit is knowing which heart rates and exercise load correspond to your training zones and lactate threshold.