Maximum Wellness, Episode 99: Pinpointing Risk of Sports-Related Injuries

According to the Journal of Sport and Health Science, hamstring strains are one of the most common sports injuries. The journal reports that, “a review of the medical database of the National Football League (NFL) between 1987 and 2000 indicated that 10% of all injuries in American college football players likely to play in the NFL were hamstring strain injuries.” It’s also been reported that “12% of all injuries in NFL training camps were hamstring strain injuries—making it the second most commonly seen injury.”

One of the main causes of hamstring injury is fatigue—both systemic and muscular. Research, which appears in the December 2019 issue of the Journal of Strength & Conditioning Research reported that, “47% of hamstring injuries were sustained during the final 15 minutes of the first and second halves of match play in soccer.”

The take-away message is that excess fatigue—with deficits in hamstring strength-endurance – places the athlete at greater risk to sustain a hamstring strain, or tear—taking significantly longer to recover.

The December 2019 issue of the Journal of Athletic Training comments that, “lateral ankle sprains (LAS’s) are common musculoskeletal injuries among the general population.” As a sports-related injury, “approximately 11,000 ankle sprains occur per year in US collegiate athletes, and ankle-ligament sprains were most frequent in men’s basketball players,” notes the research.

Yet, many people do not perceive the LAS, as being a substantial injury – with 73% of those sustaining a LAS reporting reinjury. Up to 40% of these so called “copers” – with reoccurring LAS – will develop chronic ankle instability (CAI).

The researchers comment that individuals with CAI describe feelings of instability or episodic ‘giving way’ and physical or subjective dysfunction lasting more than 1 year, after the initial LAS.

The gluteal muscles, notes the journal, play an important role in global movement of the hip, as well as, pelvic stabilization during closed chain exercises.

The take-away message is that it’s important to develop hip abduction (away from midline) strength to reduced LAS and CAI.

The shoulder, specifically the posterior rotator cuff, is one of the most injured sites that overhead, throwing athletes experience in their throwing careers—at any level of play. Understanding scapular function and its dynamic role in rotator cuff function is critical to prevent needless, non-contact injury.

The serratus anterior (SA) and trapezius play important roles in moving and stabilizing the scapula during upper extremity motion, according to research— “Serratus Anterior and Upper Trapezius Electromyographic Analysis of the Push-Up Plus Exercise: A Systematic Review and Meta-Analysis”—which appeared in the November 2019 issue of the Journal of Athletic Training.

The serratus anterior—a muscle that originates on the surface of the 1st to 8th ribs at the side of the chest and inserts along the entire anterior length of the medial border of the scapula—acts to pull the scapula forward around the thorax. “Serratus anterior weakness is often present in overhead athletes and can result in shoulder dysfunction due to altered scapular kinematics, such as winging and tipping,” notes the research.

The trapezius—a diamond-shaped, flat, triangular muscle located on each side of the upper back—functions as a shoulder stabilizer with the serratus anterior and the rhomboids. The trapezius moves the scapula and supports the arm.

In overhead throwing athletes, there typically is an intramuscular imbalance between the SA and upper trapezius (UT). It appears that push-up plus exercise strengthens the SA, while minimally activating the UT.

Push-Up Plus Exercise: Get down on your hands and feet in push-up position. Spread your feet and bring your hands together making a diamond with your hands. Rotating only at your shoulder blades, lower your chest 3-6 inches and then back up again. Repeat motion for the desired amount of repetitions.

Before you perform any rehabilitative-type exercise on your own, be sure to first check with your physical therapist or attending physician.