Injury prevention system: Evaluate, Control and train
Author: Rui Santos
Strenght and Conditioning at Reading FC
Despite the amount of research and investment made about injuries there is still a significant impact on the player’s performance. It is crucial for coaches to have useful systems to protect and develop the player’s fitness allowing them to be available for the maximum number of games possible.
The injury is an occurrence that results from a combination of certain factors, which can be intrinsic or extrinsic, functioning as moderators at the moment they absorb the impact caused by the mediator represented by training load. The training load doesn’t represent by itself an injury risk but can represent a higher or lower injury risk when combined with the state of the athlete in the moment of his application. It is vital to identify the modifiable intrinsic factors of each athlete to develop them to a stage of greater robustness, making them capable of handling the workloads applied along the season .
According to the report made by UEFA related to the 18/19 Champions League edition, 20 of the 32 participant teams reported 868 injuries, 410 (47%) occurred during training and 458 (53%) occurred during games. From those 868 reported injuries:
• 177 represent several injuries (20%)
• 437 muscle injuries (50%)
• 126 ligament injuries (15%)
Looking at image 2, we can see a significant value reflecting the percentage of non-contact injuries, which can make us think that some work could have been done to avoid them. However, that doesn’t mean that a bad injury prevention program was applied by the teams involved.
We should also consider the financial impact that injuries can represent to the clubs. Beyond the sporting consequence from not using some players, the clubs are spending money – in some cases a great amount of it – in players that cannot help the team achieving success in the pitch.
If we focus on the athlete, we can notice a significant reduction in the number of hours spent on training or playing games, a negative effect on his athletic performance, a possible financial losses (a lot of contracts include bonus related to minutes of playing and other targets like number of goals or assists), and psychological disturbs (the player is happy when can play the game, so the time injured represents a though period). If we focus on the environment around the player is possible to identify side effects on his team (dependent on the player influence and role), family (they are used to live with a lot of intensity the athlete success or failure) and in the community (some players have a great impact in the local community) .
To have success in this area of intervention is vital to know the players through an application of a few tests that give us important data to develop their fitness levels and reduce the injury risk. This data is also very important to help us make good decisions in the moment of return to play after injury.
With this in mind, these are some of the tests that can be applied with players:
• Mobility – knee to the Wall, Thomas test, straight leg raise, hip rotators
• Stability – Y-balance, Rotary Stability
• Power – SJ, CMJ
• Strength – Isometric/ Eccentric (ex: quads, hamstrings, adductors e abductors)
• Agility – T test
• Aerobic Fitness – Yo-yo test
Once the analysis is done, individual plans can be done to correct some deficit found and improve the athletes general fitness.
It is also important to use some tools that allow us to monetarize the athletes along the season, to check if we are achieving results with our training system and to identify if someone is under a greater injury risk.
Internal Load Measurement:
- Wellbeing Quiz
- Heart Rate
The great advantage of the internal load measurements is the possibility of being applied in any context, no matter the club size, since only a notebook and a pen are required to note the data from RPE (the perception of training load by the athlete) and the Well being quiz (can provide us how the athlete classify the quality of sleep, energy levels or muscle soreness). This data is relevant because it demonstrates us how the athlete has reacted to the stimulus applied in training.
External Load Measurement:
- GPS Data
- Power and Strength Tests
In a more professional context we can find tools like GPS that can provide us data like total distance, high speed running and sprint distance, number of accelerations and decelerations or max velocity. On the days after games we can repeat some of the initial tests used, this time to identify levels of fatigue after comparing the results with the initial ones.
There is not a magical solution, but we must search for the best solution for a determined group of athletes. With this in mind we suggest the develop of individual plans based on previous analysis and the moment of move prep with the duration of 30 minutes per day. In the move prep is possible to apply different kind of stimulus adapted to the micro cycle day and aligned with the head coach ideas for the pitch session of that specific day. In the table 1, we can observe an example of how to apply loads in patronized micro cycle:
Players who didn’t play the game:
• In the example above, they play a small-sided game + sprints + lower body strength on the day 1
• If they have a double day off, the players do right after the game resistance running + sprints + lower body strength.
 – Windt, J. & Gabbett T. J. (2016). How do training and competition workloads relate to injury? The workload-injury aetiology model. British Journal of Sports Medicine, 51(5), 428-435. Doi: 10.1136/bjsports-2016-096653
 – Joyce, D., & Lewindon, D. (2016). Sports injury prevention and rehabilitation. London: Routledge.
 – Nicholson, P. (2019). Inside World Football – For the Business of Football. Retrieved 18 October 2019, from insideworldfootball.com/
 – UEFA. (2019). UEFA Elite Club Injury Study Report 2018/19. Genève: Jan Ekstrand. Retrieved from uefa.com/MultimediaFiles/Download/uefaorg/Medical/02/61/67/86/2616786_DOWNLOAD.pdf