CP+R guest blog on preventing injury

CP+R is an award-winning private cardiac rehabilitation service based in Harley Street, London. In this guest blog, they dispel some of the myths surrounding injury prevention and the factors to consider minimising the risk of muscular injury when exercising:

The myths...

Stretching

Whilst it is true that stretching does improve flexibility if performed consistently and correctly, what has now been proven is that doesn’t relate to injury risk. Indeed, it is not an individual’s flexibility that predicts injury risk but instead the control and ‘robustness’ they demonstrate within that range of motion. Current evidence shows us that there is likely a place for activity-specific stretching prior to an activity to improve performance but not likely to have much of an effect on injury. Stretching in fact is better for cooling down and helping the body return to a resting state post exercise.

Massage

Massage is often used by high performance athletes between events or sessions as a way of reducing injury risk. However, much like stretching, it is difficult to back this up with evidence. Instead, it appears that massage may have some benefit on recovery from exercise, but does not have much effect on injury risk. So those pre-races massages are for the mental preparation, routine and relaxation rather than injury prevention!

Where to focus...

Exercise

Surprise, surprise, exercise seems to be very effective at preventing injury. If we look at this issue in reverse, the greatest predictors of injury risk are low strength, poor balance, poor technique, and previous injury. Therefore, naturally any exercise that helps an individual to become accustomed to a certain movement is likely to reduce risk of injury in that movement. This clearly doesn’t eradicate risk and there still remains external risk factors, for example no amount of football training will prevent or reduce the risk of injury if another player comes flying in with a two footed tackle!

Specifically with exercise, resistance training has the greatest effect on injury risk, those who are stronger and leaner generally have a lower risk. This is because the soft tissues have a greater tolerance for stress, the nervous system is better able to adapt when placed under stress and generally the immune system is in a better state to deal with early injury effects such as inflammation or micro-damage.

Balance exercises have also been shown to be particularly effective in those who have had previous injuries as it helps improves the body’s proprioceptive skills; in short improves the body’s awareness of where the joints are and what they are doing.

Nutrition

There is now good research to suggest that nutrition plays a part in injury prevention. Consistent low-calorie intake is related to injury risk, this is because it can lead to under-nourishment of the soft tissues and immune system which can compromise injury tolerance.

In women a very low dietary fat intake has been associated with injury risk, particularly in bone injuries and runners. This is due to an enhanced inflammatory response which can weaken the bone structure.

Iron is another dietary component that correlates to injury risk, the risk increases with iron deficiency. The mechanisms for this at the moment are unclear, however it may be related to a hormone called hepcidin which impacts the bodies inflammatory response.

You can't go wrong getting strong:

There is still a lot of ongoing research in this area so it is likely there are plenty more factors that relate to injury risk.

To conclude, stretching and massage aren’t necessary for injury prevention, but maybe helpful for recovery and performance effects. The key areas that everyone can focus on for injury prevention are getting and staying strong, particularly in movements that are commonly repeated throughout the day and focussing on keeping nutrition levels appropriate with reasonable calorie, iron and vitamin intake.