How do injuries happen and what is the best way to avoid them? As Tim Gabbett, one of the leading sports coaching consultants of our time says, it’s not the load that injures us, it is the load that we are not prepared for. So whether you’re talking about a traumatic injury, or a repetitive stress injury (which account for the vast majority of injuries I see) the insult occurs because we performed an action we were unprepared for, that our body wasn’t physically able to do correctly.
So if you are a runner, and your glutes are under performing, your hamstrings or calves or something else is going to take up the slack. That is just an example of the endless amount of scenarios that can play out and result in injury. Rarely does somebody know how they tore their rotator cuff; even if they think they know the insult that caused their injury, such as a pitcher throwing too many curve balls. This begs the question of why some pitchers tear their rotator cuff and others don’t. It all comes down to being properly prepared for the load you are asking your body to bear.
Your body is a symphony of movement and your nervous system is the conductor. It is the proper interplay of all the muscles in our bodies that keep us upright against the force of gravity. It is the agonists and antagonists and synergists all working in unison. It’s the interchange between the glutes and hip flexors, or the abs and the diaphragm all working with the help of that motor program in your brain that keep us moving along without thinking of how to put one foot in front of the other. These motor programs begin to develop from birth as we develop strategies to reach, grab, crawl, stand upright and move. If all goes well the primary movers learn their jobs and the helpers (or synergists) lend a hand. The first assault on these motor programs is if we don’t progress properly through stages of development. As they say, you have to crawl before you can walk, and walk before you run.
It is also in youth, once exploration begins, that injuries start to happen and we begin to compensate. A seemingly innocent fall on the playground might have set off a compensatory cascade. We get older and more injuries ensue and then more compensations. A big one is too much sitting, which sets up a scenario where the hip flexors get too tight and the glutes (from sitting on your butt) become weak. Combine the sitting with looking down at a phone or a computer and then you have tight traps and weak neck flexors. Then when you do get out and run or bike you are doing so with a bad motor program and injury happens.
A large percentage of injuries are repetitive stress from the poor movement patterns over a long period of time. Over-tight hamstrings through miles of running will result in a tear. Other outcomes could be plantar fasciitis, or shin splints. There are endless scenarios that result from the breakdown of proper biomechanics.
Even injuries that are a “direct” result of trauma might have been set in motion because of poor form. The pitcher who tore his rotator cuff on a particular pitch might have set things in motion by using poor form over time. That one pitch where he felt something pop was actually just the straw that broke the camel’s back. Why do some athletes have long careers? Are they just lucky, or is proper form and biomechanics involved? Could a running back have avoided an MCL injury if his body could move more efficiently to avoid a hit or to perhaps mitigate a collision? Is it just bad luck when a point guard makes a sharp cut and blows out her ACL?
Obviously, some injuries can’t be avoided, but through proper movement many could. As I said at the beginning, it is not the load that injures us but the load we are unprepared for. The bottom line is all of us need to be checked to see if we are moving efficiently and if the proper muscles are doing their job.