Injury Risk From Returning To Sports Too Fast

return to sports after covid injury risks

Detraining during injury and a quick return will increase injury risk

The injury risk while returning to sports after time off is greater than most coaches realize.

That time off may be anything from offseasons, in-season holidays, or unfortunately injury.

Preventing injuries has to be one of the highest priorities for coaches, teams, and organizations as athletes return to sports after time off. 

What’s the point of getting back to practice, if our athletes are getting hurt and missing sport anyway?

The detraining they have gone through means the athlete’s returning aren’t the same ones who left.  Their physical capacities will be different.

So how do we know if they will be at risk?

Return To Sport Lessons For Elite Sports

We know athletes’ have increased risks when returning after significant injury or surgery.  And we aren’t talking about just reinjuring the same body part, but the increased risk of other injuries since they haven’t been training.

We also can look at data from years in pro sports with shorter seasons and lockouts.  Consistently the number of injuries is much higher when the athletes return.

One of the risk factors in all these scenarios is the accumulation of fatigue.  As athletes fatigue, their injury risks increase.  The athletes coming off lockdown restrictions will fatigue faster.  They aren’t in the same shape to train and have a lower ability to recover.

If athletes have been consistently trying to maintain at least 25% of their normal training volume, consider how detrained they are over just 8 weeks.

Even if you ramp up training over the weeks at 40%, 60%, 80% and 100% the gap will be large and increase their risk of injury.

This also reinforces a key point about rehab and training during injury; maintain as much as possible. By keeping more training volume while injured you’re going to bounce back faster.

Stress As A Stimulus

Another factor in the injury risk returning to sports is how quickly they ramp up training again.

Practice, training, and competitions are a stimulus and stress for the athlete’s body.  We want some stimulus, so they adapt, putting some savings back in that bank account.  This is the increase in their readiness.  That’s the overall level of their abilities from training.

However, that same stimulus, when taken too far, overloads the athlete beyond their ability to adapt.  This level of stress can lead to immediate fatigue, which increases injury risk.  Remember, the athletes will likely have a diminished ability to recover as fast.  Both within a single practice session and between sessions.

When the stress overload is too high, it also damages tissues.  That damage may be a small injury that adds up to those chronic, overuse injuries.  It could also manifest as acute muscle strains and tendon sprains.

The Acute To Chronic Workload Ratio In Return To Sports

In elite sports, a lot of research and effort have gone into understanding how changes in training workload influence injury risk.  The general consensus is that if the volume of training drops too much, athletes detrain. Then their injury risk can go up.   If it increases too fast, then injury risks increase

For those planning the return to sport, this is an essential concept.

Chronic Training Load

Consider two measures of the training workload.  The first we call chronic workload.  This is the average workload that has been happening over time.  Often we look at the average of the last eight weeks, with some extra importance in the most recent weeks.

This should make intuitive sense for a coach.  The work, an athlete, has been doing in training over several weeks is what they can tolerate.  It’s what the athlete has adapted to.   Some practices are intense and some less severe, but it’s the average accumulated workload that they have adapted to.

Think about what this means for athletes right now.  They are getting drastically less workload.  Even if they are putting in their best efforts, they are getting far less than the total they were getting from practice, training, and competition before.

The workload is also relatively specific to the type and intensity of the work.  The workload from 60 minutes of high-intensity practice or games, is much different than 60 minutes of bodyweight training and modified conditioning programs.

So as each week of sports lockdown progresses, the athlete’s average for the last eight weeks is dropping.  Their chronic workload number is going down.  

Acute Training Load

On the other hand, acute training workload is what they are going through now.  This is typically looked at as the last 5-7 days.  Some days may be harder, others more relaxed, but the average is what the athlete’s bodies are working to recover from and adapt to.

The relationship to injury comes in when we see a significant gap in the acute and chronic training load.  This relationship is called the acute to chronic workload ratio (ACWR). 

ACWR – Acute:Chronic Workload Ratio

The average acute training load (last 5-7 days) divided by the average chronic training load (last 6-8 weeks).

CHRONIC Workload = 100 units

ACUTE Workload = 110 units (a 10% increase this week)

ACWR = 1.1

Any time there is an increase in the training load, we see the acute: chronic greater than 1.  Although the exact number varies by sport and finer details of workload, we still know when that number gets too big we have a problem.

Coaches have been pushing athletes for decades to train more and train harder, so they adapt. A jump in the training load itself won’t automatically increase injury risk.

On the other hand, it’s not hard to understand that if you keep doubling the amount of training every week, at some point, they are going to break down.

This graph is from Tim Gabbett, The training—injury prevention paradox: should athletes be training smarter and harder?, British Journal of Sports Medicine, 2016.

While the precise ratio may be debatable, the concept isn’t. Interestingly, lowering training too much also started to increase injury risk. With an injury athletes often end up far off the left side of this graph.

Recent research in pro sports has explored this ratio.  A few years ago, there was a big push based on some excellent research that a ratio of around 1.5 increased injury risk.  

The exact number is not what we are worried about per se because the athlete’s age and level and the sport have an impact. What does matter is the basic premise; increasing workload too quickly leads to elevated injury risk.

Coaches, if you return athletes to practice without a progressive plan, and follow your normal approach, you might be putting your athletes in harm’s way.

Athletes will have a greater injury risk when returning to sports

Most athletes are looking to get back into training and competition quickly.

However, in doing so, we must recognize and plan for the unique situation we are in as coaches, and organizations.

So be proactive. If you’re not back to practice yet, get your athletes some help and programming that addresses their specific needs when they return.

Get with a knowledgeable sports performance professional who can help you put a plan together to ramp back up as quickly as possible.

The vital point for sports coaches is that if you increase the training load too fast, the injury risk returning to sports goes up.

Is Icing Injuries Good or Bad: Debunking the Cold Therapy Conundrum

Guest Post from: Vive Recovery Studio

Is icing really the cool solution for your injury? Let’s break it down for competitive athletes and recreational adult athletes who are grappling with pain or injury and questioning whether icing injuries is good or bad? The answer may surprise you.

The Icing Dilemma: Two Perspectives

Is icing injuries good or bad

Contrary to the pro-icing camp, another perspective emphasizes the importance of allowing the body’s natural healing process to unfold without interference. This viewpoint argues that ice disrupts the natural inflammatory stages necessary for optimal tissue healing.

The Argument For Icing: Quick Relief and Continuity

One school of thought advocates for icing injuries as a means to reduce pain and excessive inflammation. The ice allows athletes to continue their sports or therapeutic activities.

Proponents argue that the immediate application of ice can provide immediate relief, numbing the affected area and enabling athletes to push through discomfort. They believe that by constricting blood vessels, ice helps control swelling and prevents further damage.

Ken Vick, a high-performance director in elite sports, explains, “We do know that ice won’t speed up the healing of injuries. In fact, it probably slows healing down. However, it can be an effective tool for managing pain and inflammation in the acute stage of an injury. It gives athletes a chance to get in the game sooner or so they can do the rehab work to get back.”

The Argument Against Icing: Trusting the Body’s Healing Process

Supporters contend that inflammation is a vital part of the body’s innate response, bringing crucial nutrients and cells to the injured site for repair.

Dr. Gabe Mirkin, the physician who popularized the R.I.C.E. (Rest, Ice, Compression, Elevation) protocol, has revised his stance on using ice for injuries. He stated, “Coaches have used my ‘R.I.C.E.’ guideline for decades, but now it appears that both ice and complete rest may delay healing, instead of helping.”

The Reality: Context is Key

Now, before we plunge into the icy depths or entirely abandon the frosty ritual, it’s essential to understand the broader context. The decision to ice or not to ice hinges on individual circumstances, goals, and the nature of the injury itself. Let’s shed light on this nuanced reality.

Goal-Driven Approach: What Do You Seek?

When considering whether to ice an injury, it’s essential to identify your primary goal. If your utmost priority is to reduce pain and inflammation swiftly, allowing you to continue training or participating in competitions, then ice might offer a viable solution. This approach prioritizes immediate activity over optimal tissue healing.

On the other hand, if you have the luxury of time and rest, and your main objective is to achieve optimal tissue healing, then giving nature its course without relying heavily on ice might be the wiser choice. By allowing inflammation to progress naturally, you support the body’s intricate healing mechanisms, potentially leading to better long-term outcomes.

From his perspective working with athletes Vick advises, “Consider your goals and the demands of your sport or activities. If you need to be active in the short term, ice can provide temporary relief. However, if long-term tissue healing is paramount, be patient. Skip the ice and adopt a movement-based approach to let your body heal naturally.”

AND, Not OR

In cases of more significant injuries, such as Grade 2/3 sprains, strains, or fractures, it’s a good practice of using ice during the initial 2-3 days before transitioning to a rehabilitation phase without it. During this early stage, ice can play a beneficial role in reducing pain, swelling, and inflammation.

By applying ice intermittently for short periods, athletes can gain immediate relief and create a more favorable environment for the subsequent stages of rehabilitation.

However, after a few days the focus should shift towards active rehabilitation exercises and other modalities that promote tissue healing and functional recovery. This approach allows athletes to harness the benefits of ice during the acute phase while gradually shifting the focus to more dynamic and active interventions for long-term recovery.

Embracing a Balanced Perspective

While the debate over whether icing injuries is good or bad rages on, it’s crucial to keep perspective. Remember that sports medicine is a dynamic field, continuously evolving with new insights and research. As an athlete, you have the power to make informed decisions based on the best available evidence.

It’s important to seek guidance from qualified healthcare professionals who specialize in sports medicine. They can assess your injury’s unique characteristics, understand your goals, and provide personalized recommendations tailored to your needs.

And keep in mind that there are other strategies to reduce excessive or chronic inflammation. Pneumatic compression, red light therapy and dietary strategies can all be used as well without interfering with the healing process.

Remember the ultimate goal is to support your recovery and get back in the game stronger than before. So, stay informed, consult the experts, and listen to your body. By doing so, you’ll make the coolest decision for your injury journey.

Disclaimer: The information provided in this article is for educational purposes only. and It not be considered a substitute for professional medical advice. Always consult with a qualified healthcare professional or sports medicine specialist for personalized recommendations.

Is Lifting Overhead Safe? It Depends.

No gym, now is a good time to workout doors

As a physical therapist specializing in sports rehabilitation, I often encounter questions and concerns regarding the safety and effectiveness of overhead shoulder exercises.

Today, I want to address these concerns and shed light on the importance of incorporating these exercises into your fitness routine. So let’s dive in!

The Power of Overhead Shoulder Exercises

Overhead lifting exercises, such as shoulder presses, pull-ups, and barbell snatches, have gained popularity among fitness enthusiasts and athletes alike. And for good reason!

They are fantastic for building muscle and strength in your shoulders, contributing to overall athletic performance.

Think about it – whether you’re reaching for something on a high shelf, loading your gear onto a roof rack, or hanging a picture frame, these daily activities often mimic the motion of an overhead press.

By incorporating overhead shoulder exercises, you can enhance your functional movement patterns and perform these activities with ease.

And its part of our design. Human shoulder complexes are designed to be able to function in a really big range of motion. That includes overhead.

Understanding the “It Depends” Factor

Now, let’s address the elephant in the room: the notion that overhead exercises are inherently bad or should be avoided. They are not.

However, there’s more to it.

Whether overhead exercises are suitable for you depends on a variety of factors. I want to emphasize that I am not advocating for blindly performing these exercises despite pain or shoulder issues.

Therefore, to answer this question, we need to take a more pragmatic approach and consider the bigger picture.

Mobility Matters

First and foremost, you must have adequate overhead mobility. Can you fully raise your arm overhead without arching your back, shrugging, or experiencing any discomfort?

If not, it’s crucial to address any mobility limitations before attempting overhead exercises.

This lack of mobility may stem from various areas, including the shoulder joint, the scapula-thoracic joint, or the thoracic spine. While many people focus on the shoulder itself, often the scapular muscles and lats are bigger culprits.

Additionally, muscular imbalances can also contribute to limited overhead mobility.

Remember, if you can’t lift your arm overhead comfortably, it’s best to work on improving your mobility before diving into overhead presses.

Stability is Key

scapular control is essential for overhead lifting

Another critical factor is shoulder and spine stability. To handle the demands of overhead lifting, you need adequate stability in your shoulder girdle.

This stability is achieved through a strong foundation created by your upper back, scapular muscles, rotator cuff, and even your trunk and core.

Muscular imbalances and stability deficits are common issues that can impact the shoulder girdle, so it’s important to address these through appropriate exercises and training techniques.

Remember, the heavier the weight you lift, the more stability your shoulder girdle requires.

Mastering Load Management

In the pursuit of optimal shoulder health and performance, many enthusiasts overlook the importance of load management.

  • Intensity (weight)
  • volume (sets and repetitions)
  • frequency (how often)

Even with excellent mobility and stability, improper load management can lead to soreness and shoulder discomfort over time.

It’s crucial to find the right balance and avoid overwhelming your body’s capacity to recover. Remember, depending on your goals, you may not need to lift maximal loads to get the benefits.

Just like pitchers monitor their pitch counts to prevent overuse injuries, you must understand that pushing too hard or too frequently can hinder your long-term fitness and performance goals.

The Art of Exercise Modification and Scaling

When it comes to maintaining shoulder health in the long run, understanding exercise modification, regression, and scaling is paramount.

Understand, there is no one-size-fits-all approach.

Each individual may have unique limitations or restrictions that require adjustments. Fortunately, any functional movement pattern can be modified or scaled to achieve the same goal of building strength and improving fitness.

For example, if a barbell overhead press feels uncomfortable, consider using dumbbells or kettlebells instead to allow more freedom of movement. Additionally, the use of a landmine setup can be an excellent alternative when a full overhead position is not possible.

The key is to find overhead lifting variations or positions that work for you while minimizing stress on the shoulders.

Whether you’re dealing with mobility restrictions, recovering from an injury, or experiencing shoulder discomfort, modifying and scaling exercises can help you achieve success while reducing excessive tissue stress.

To ensure effective modifications, regressions, or scaling, it’s advisable to seek guidance from a knowledgeable healthcare professional or fitness expert who can tailor exercises to your specific needs.

Embracing a Mindset of Control

In conclusion, let’s revisit our initial question: Are overhead lifting exercises safe? The answer is a resounding yes.

However, we must acknowledge that individual circumstances and factors come into play. It’s essential to take ownership of our bodies and understand that the exercises themselves are not to blame.

Instead, poor mobility, stability, and training habits are the culprits behind potential issues. By addressing these areas and seeking professional guidance, you can take control of your body’s capabilities and unleash your full potential.

Remember, if you’re new to exercising or currently dealing with an injury, it’s always wise to consult a qualified healthcare provider who can offer personalized advice based on your unique situation.

So, embrace the benefits of overhead shoulder exercises, focus on improving mobility and stability, manage your training load wisely, and don’t hesitate to modify or scale exercises when needed.

With the right approach, you’ll be on your way to achieving optimal shoulder health, enhancing your athletic performance, and enjoying the benefits of a well-rounded fitness routine.

Rebuild, Remodel, and Restore to Get Rid of Elbow Pain

Guest post from Vive Recovery Studio.

Elbow tendons are common sites of overuse injury in many athletes and active individuals. Tendonitis of the medial and lateral tendons often goes by names like Tennis Elbow, Golfers Elbow, Little League elbow, and Swimmers elbow.

If you’re struggling with elbow pain, understanding the causes and effective strategies for recovery can make a world of difference.

The Injury

Elbow tendonitis, or more accurately tendonosis in some cases, occurs when the tendons that connect the forearm muscles to the elbow joint become inflamed or damaged due to repetitive stress.

This condition can be excruciating and debilitating, affecting not only athletes but anyone who engages in repetitive arm motions.

Golfers elbow and tennis elbow are common injuries affecting different elbow tendons.
Golfers elbow and tennis elbow are common injuries affecting different elbow tendons.

Medial Elbow Tendonitis (Golfer’s Elbow)

Medial elbow tendonitis, is commonly known as Golfer’s Elbow. It is a condition that primarily affects the tendons on the inner side of the elbow. Individuals engaging in activities requiring repetitive gripping, lifting, or swinging motions often experience this.

Golfers, as the name suggests, are particularly prone to this condition. That’s due to the repetitive stress of swinging a golf club. However, it can also affect people involved in weightlifting, construction work, or even those who spend long hours typing on a keyboard.

Golfer’s Elbow is characterized by pain and tenderness on the inner side of the elbow. Sometimes that pain radiates down the forearm. Gripping objects, and simple tasks like shaking hands or turning a doorknob can be painful.

Lateral Elbow Tendonitis (Tennis Elbow)

"Tennis" elbow is a common tendon injury in racket sports like tennis and pickleball
“Tennis” elbow is a common tendon injury in racket sports like tennis and pickleball, but it can also occur from other repetitive forearm and wrist motions.

Lateral elbow tendonitis, or Tennis Elbow, is a condition that affects the tendons on the outer side of the elbow. This type of injury is frequently associated with activities that involve repetitive gripping and wrist extension. Think of the racquet motion while playing tennis or pickleball.

However, it can also occur in people using hand tools, or even working on a computer for extended periods.

The pain is often exacerbated during activities that involve gripping or lifting, like swinging a tennis racket or carrying heavy objects.

Inner elbow pain is also called Pitcher’s elbow. While it primarily affects baseball pitchers, it can also affect other athletes who engage in overhead throwing motions, such as softball players and javelin throwers.


1. REBUILD Tendon and Kinetic Chain Strength

To alleviate elbow pain and prevent further injury, you must focus on rebuilding strength. Strength in the tendon and in the entire upper kinetic chain.

Strengthen It

Strengthening the tendon involves a three-phase approach:

  1. Isometric: This phase focuses on reducing pain and initiating the strengthening process. Isometric exercises involve static contractions that don’t cause the tendon to lengthen or shorten.
  2. Eccentric Strengthening: This step is crucial for improving tendon function and reducing pain. Eccentric exercises require the muscle to lengthen under load, helping to build tendon resilience.
  3. Rapidly: Incorporating quick reactive loads into your training regimen helps the tendon prepare for sports movements and enhances its elasticity.

Strengthen the Entire Upper Kinetic Chain to Get Rid of Elbow Pain

Remember that excessive stress on the elbow tendon can result from weaknesses or limitations in other parts of the upper body, such as the shoulder, neck, and scapular-thoracic joint. A holistic approach to getting rid of your elbow pain is strength training to distribute the load more evenly and reduce the strain on your elbow.


2. REMODEL the Tendon and Collagen Fibers

collagen and fibrosis
You can use these remodeling tactics help align and change composition of collagen fibers

Remodeling the damaged tendon and realigning collagen fibers are vital for long-term recovery. Here are some techniques to consider:

  • Eccentric Strengthening: As mentioned earlier, eccentric exercises are not only beneficial for strength but also serve as a stimulus for remodeling damaged tendon tissue.
  • Manual Therapy: Techniques like myofascial release, myofascial decompression cupping, and cross-friction massage can stimulate collagen fiber realignment and promote healing.
  • Nutrition: Incorporating collagen peptides and vitamin C into your diet can support the remodeling process by providing essential building blocks for connective tissue repair.
  • Red Light Therapy: This non-invasive treatment has shown effectiveness in reducing pain and improving function in superficial tendons like those in the elbow. Learn more about Red Light therapy.
  • Blood Flow Restriction: An emerging technology, blood flow restriction, can help stimulate cellular healing and trigger the release of growth hormone, aiding in tissue repair.

Restore Pliability of Tendon and Upper Kinetic Chain

Restoring tissue pliability is a critical aspect of recovery when dealing with elbow pain, especially for athletes and active individuals. It involves addressing the flexibility and adaptability of the muscles, tendons, and fascia in the upper kinetic chain, from the shoulder down to the hand. This process not only reduces excessive stress on the elbow but also enhances overall performance and reduces the risk of future injuries.

tissue work to restore pliability and remove limitations in the fascial slings
Manual tissue work can help restore pliability to tissue throughout the kinetic chain and reduce stress on the elbow tendons.

Here are some effective methods to restore tissue pliability and get rid of elbow pain:

  • Tissue Work: Manual therapy techniques like massage, myofascial release, and myofascial decompression cupping can target specific areas of tension, breaking up adhesions, and improving tissue elasticity.
  • Assisted Stretching: Working with a qualified sports or physical therapist can help you perform assisted stretching exercises that target the muscles and fascia of the upper kinetic chain. This can help improve flexibility and range of motion.
  • Self Myofascial Release: Use Self-myofascial release techniques such as foam rollers, lacrosse balls, or specialized massage at home. This targets trigger points and tight areas in the muscles and fascia. This can be particularly beneficial for maintaining tissue pliability between therapy sessions.

By incorporating these methods into your recovery routine, you can enhance the pliability of your upper kinetic chain, reduce excessive stress on the elbow, and enjoy improved performance and comfort in your sports and activities.


TL:DR to Get Rid of Elbow Pain

These proven strategies help improve tendon health and alleviate the pain associated with conditions like Tennis Elbow and Golfer’s Elbow.

The key is to take action early, before the tendon degenerates into a chronic problem.

By rebuilding tendon and kinetic chain strength, remodeling collagen fibers, and restoring the pliability of the upper kinetic chain, you can return to enjoying your sports and activities without the burden of persistent pain.

Don’t let elbow pain hold you back; take these steps to reclaim your active lifestyle.

The Role of Scapular Control in Preventing Shoulder Injuries

Scapular control for stability

Expert Advice for Parents and Coaches of Young Athletes and Athletes

Shoulder injuries can be a common concern in sports that involve repetitive overhead movements.

However, by understanding the importance of scapular control, you can significantly reduce the risk of shoulder injuries. In this article, we will explore the role of scapular control and provide valuable tips to help prevent shoulder injuries.

Why Scapular Control Matters

The shoulder is a complex joint that allows for a wide range of motion. However, this mobility also makes it susceptible to injury, especially during sports that involve repetitive overhead movements like swimming, tennis, baseball, and volleyball.

The scapula, or shoulder blade, plays a crucial role in shoulder function and stability. It acts as a foundation for proper shoulder movement and helps distribute forces during athletic activities. Maintaining proper scapular control ensures that the shoulder joint operates smoothly and efficiently.

It is a foundation for proper movement and positions in overhead activities. If the shoulder blade is not rotating and elevating properly, there are consequences.

Overhead mechanics can be altered that impact performance and stress on the athlete’s body.

Compensations can occur in other body parts to get that arm overhead that contribute to impingement, tendonitis, and ligament strain.

scapular control is essential for overhead athletes

Weakness or dysfunction in the muscles that control the scapula can lead to imbalances and increased stress on the shoulder joint, increasing the risk of injury. This is why scapular control is essential for preventing shoulder injuries and optimizing athletic performance.

Understanding Scapular Control

Scapular control refers to the ability to move and stabilize the shoulder blade effectively. It involves the coordination of several muscles, including the trapezius, serratus anterior, and rhomboids. These muscles work together to control scapular movement, positioning, and stability during sports activities.

  • The trapezius muscle helps retract, rotate and elevate the scapula
  • Serratus anterior muscle plays a crucial role in protracting and stabilizing the scapula against the rib cage.
  • The rhomboids assist in retracting and stabilizing the scapula.
  • Levator scapulae helps to rotate and elevate the scapula.

When these muscles work harmoniously, the scapula moves smoothly, allowing for optimal shoulder function and reducing the risk of injury.

Scapular control for stability

However, if there is a muscle imbalance, weakness, or poor coordination, scapular dyskinesis can occur, leading to abnormal scapular movement patterns and an increased risk of shoulder injuries.

Tips for Improving Scapular Control

Now that we understand the importance of scapular control, let’s explore some practical tips to help improve scapular control and prevent shoulder injuries:

  1. Warm-Up and Stretching
    • Begin every practice session or game with a proper warm-up routine to prepare the muscles for activity.Perform mobility exercises that target the shoulder, thoracic spine, and hips promoting flexibility and range of motion.Include exercises that activate the rotator cuff, scapular muscles, and the core.
  2. Strengthening Exercises
    • Engage in specific exercises that target the muscles responsible for scapular control.
    • Include muscle that strengthen and integrate the scapular and shoulder muscles with the entire kinetic chain.
  1. Technique Awareness
    • Emphasize the importance of proper technique and form during sports activities.
    • Sport coaches should provide guidance on sport specific mechanics so the athlete moves efficiently and safely.
  2. Connected Training
    • Incorporate exercises that challenge the demands of the specific sport through the kinetic chain.
    • Engage in activities and exercises that challenge scapular control during whole body movements such as overhead kettlebell exercises and medicine ball throws.
  3. Consult with Professionals
    • If there are concerns about scapular control or the risk of shoulder injuries, seek guidance from sports medicine professionals or physical therapists.They can assess and provide personalized exercises and strategies to address any scapular control issues and reduce the risk of injury.

Strengthening Exercises

This article focuses on strengthening the scapular muscles and connecting them to the kinetic chain. So, while mobility work and other areas need strengthening for overall performance and health, we’ll keep this limited to a few key exercises.

Strengthening Scapular Muscles with Resistance Bands

Resistance bands are an effective tool for targeting the scapular muscles through exercises such as Ys, Ts, and Ws. Let’s explore how to perform these exercises using resistance bands:

Ts:
– Hold the band with an overhand grip, arms extended in front of you.
– Begin by squeezing your shoulder blades together and pulling the band outwards, creating a T shape with your arms.
– Maintain the contraction in your scapular muscles and control the band as you return to the starting position.
– Aim for 2-3 sets of 10-15 repetitions.
Ys & As (Diagonals):
– Hold the band with an overhand grip in front of body, one arm diagonally up and the other down.
– Begin by squeezing your shoulder blades together diagonally and pulling the band outwards and upwards with one hand, and outwards and downwards with the other.
– Maintain the contraction in your scapular muscles and control the band as you return to the starting position.
– Aim for 2-3 sets of 10-15 repetitions of each diagonal or alternate.
Ws:
– Hold the band with an overhand grip in front of body on one hand with the elbow at 90 degrees, the other arm other down.
– Begin by externally rotating the shoulder moving the top hand up and out.
– At the same time squeeze the scapula and move the upper back.
– Maintain the contraction in your scapular muscles and control the band as you return to the starting position.
– Aim for 2-3 sets of 10-15 repetitions of each diagonal or alternate.

Exercise Tips

When performing these exercises, keep the following tips in mind:

  • Focus on maintaining proper form throughout the movements.
  • Engage the scapular muscles by retracting and depressing the shoulder blades (…don’t let your shoulder come up by your ears).
  • Control the resistance band as you move through each exercise, avoiding jerky or rapid motions.
  • Perform the exercises in a slow and controlled manner to maximize their effectiveness.
  • Start with a lighter resistance band and gradually increase the intensity as your strength improves.

Incorporating Ys, Ts, and Ws exercises with resistance bands into your training routine can effectively target and strengthen the scapular muscles, promoting better shoulder mechanics and reducing the risk of shoulder injuries.

Strengthening the Serratus Anterior

The serratus anterior is a crucial muscle for scapular control and stability, playing a vital role in preventing shoulder injuries and optimizing athletic performance. Let’s explore some effective exercises that specifically target the serratus anterior:

Facing the Wall Slides with Thoracic Extension

  • This variation of wall slides not only strengthens the serratus anterior but also promotes thoracic (upper back) extension, further improving scapular control and mobility.

  • Stand facing a wall with your feet about shoulder-width apart.

  • Place your hands on the wall at shoulder height, slightly wider than shoulder-width apart.Keeping your arms straight, slowly slide your hands up the wall while maintaining contact with your palms and fingers.

  • As you slide your hands up, focus on protracting your shoulder blades (bringing them away from the spine) and maintaining a gentle squeeze between your shoulder blades.

  • At the top of the movement, actively extend your upper back by arching slightly backward.

  • Return to the starting position by sliding your hands back down the wall, maintaining control throughout the movement.

  • Perform several repetitions of this exercise.

Scapular Controlled Articular Rotations (CARs)

  • Scapular Controlled Articular Rotations are excellent exercises for improving the mobility, stability, and strength of the serratus anterior and other scapular stabilizers.

  • Stand tall with your arms extended forward at shoulder height, palms facing down.

  • Slowly rotate your shoulders in a circular motion, focusing on maintaining control and feeling the activation in your serratus anterior.

  • Perform clockwise and counterclockwise rotations for several repetitions.

Straight Arm Pushups

  • Straight arm pushups, also known as scapular pushups, specifically target the serratus anterior and promote scapular stability.

  • Start in a high plank position with your hands directly under your shoulders, arms fully extended, and body in a straight line.

  • Slowly lower yourself toward the ground while maintaining a stable scapula and keeping your arms straight.

  • Push back up to the starting position, focusing on protracting your shoulder blades and feeling the engagement in your serratus anterior.

  • Repeat for the desired number of repetitions.

Incorporate these exercises into your training routine will effectively target and strengthen the serratus anterior muscle, enhancing scapular control, stability, and reducing the risk of shoulder injuries.

Remember to perform the exercises with proper form and start with an appropriate intensity that challenges the

Connected Exercises Using a Kettlebell

In addition to the previously mentioned tips and exercises, incorporating kettlebell exercises can further enhance scapular control and shoulder stability. These are the most challenging because they coordinate more dynamic movements across more of the kinetic chain.

LEARN MORE ABOUT THE KINETIC CHAIN IN OVERHEAD ATHLETES HERE

Kettlebells provide a unique training stimulus because of the “off-balance” design. Because of this, they challenge stability in the entire body, including the scapular muscles.

Here are some connected exercises using a kettlebell that can benefit athletes:

Turkish Get-Ups (TGU)

  • The Turkish Get-Up is a full-body exercise that promotes scapular stability and control throughout the movement.

  • Start by lying on your back while holding the kettlebell with a straight arm.

  • Gradually transition to a standing position while keeping the kettlebell overhead and maintaining a stable scapula.

  • Reverse the movement back to the starting position.

Windmills

  • Windmills target the shoulder stabilizers and promote scapular control through rotational and lateral movements.

  • Start with the kettlebell in one hand, raised overhead.Keep the arm extended and slowly hinge at the hips, lowering the opposite hand toward the ground.

  • Maintain a stable scapula and a neutral spine throughout the movement.

  • Return to the starting position and repeat on the other side.

Halo

  • The Halo exercise targets the muscles surrounding the shoulder girdle, including the scapular stabilizers.

  • Start by holding the kettlebell upside down by the horns in front of your chest.

  • Slowly move the kettlebell in a circular motion around your head, keeping the scapula stable and engaged.

  • Perform the movement in both clockwise and counterclockwise directions.

Bottoms-Up Presses

  • Bottoms-Up Presses challenge scapular control and shoulder stability by holding the kettlebell upside down.

  • Start with the kettlebell in a bottoms-up position, gripping the handle with your palm facing upward.

  • Press the kettlebell overhead while maintaining a stable scapula and controlling the kettlebell’s instability.

  • Lower the kettlebell under control and repeat for the desired number of repetitions.

Incorporating these kettlebell exercises into your training routine can further improve scapular control, shoulder stability, and overall athletic performance.

However, it is crucial to ensure proper technique and start with an appropriate kettlebell weight that allows for proper form and control.

TL:DR Summary

Remember, scapular control plays a significant role in preventing shoulder injuries among young athletes.

You can improve this through;

  • Proper mechanics in sports (i.e. throwing, serving, hitting, and swimming strokes)
  • Strengthening the scapular stabilizing muscles
  • Build better function in the scapular muscles through kettlebell exercises that “connect” them to the torso and kinetic chain.

By implementing these tips and exercises, athletes can enhance their scapular control, reduce the risk of shoulder injuries, and optimize their performance on and off the field.

Preventing Shoulder Injuries in Overhead Sports: Capacity vs. Overload

Are you an athlete who loves sports like baseball, volleyball, or tennis? Are you a parent or coach of a young athlete involved in these overhead sports?

If so, it’s important to understand how to prevent shoulder injuries, as they are common in these activities. In this article, we will provide you with some valuable tips and insights to keep your shoulders healthy and strong.

Understanding the Causes of Shoulder Injuries

Shoulder injuries in overhead sports often occur due to a combination of factors. One crucial aspect is the capacity of the body to handle the demands placed on it.

When the forces generated during motion exceed what the body can handle, injuries can happen. Let’s dive into some key factors that contribute to shoulder injuries and how to address them.

Tissue Integrity: Keeping Your Ligaments and Muscles Strong

The strain on ligaments, like the ulnar collateral ligament in the elbow, can be too great for them to handle. This strain often occurs during specific phases of motion, such as the cocking phase and deceleration.

To maintain tissue integrity, it’s important to work on strengthening the surrounding muscles and improving flexibility. This can help alleviate stress on the ligaments and reduce the risk of injury.

Increasing capacity can be as important as managing load

Strength and Endurance: Building a Solid Foundation

Proper mechanics rely on sufficient strength and endurance in the muscles involved in overhead movements. Lack of strength, especially in eccentric strength, can lead to inefficient energy transfer and increased stress on the shoulder.

Gradually building strength and endurance in key muscle groups is essential. This can be achieved through targeted exercises and regular training. Remember, Rome wasn’t built in a day, and neither is a strong and healthy shoulder!

Recovery: Giving Your Body the Rest It Needs

Fatigue plays a significant role in reducing force capacity and increasing injury risk. Inadequate recovery time between practices, matches, or pitching outings can be detrimental.

It’s crucial to prioritize sufficient rest and recovery to allow your body to heal and recharge.

Coaches and parents should ensure that athletes have appropriate rest periods between intense training sessions or competitions.

Avoiding “Too Much, Too Soon”: Gradual Progression is Key

In the world of sports, understanding the relationship between workload and injury risk is essential.

Athletes who abruptly increase their training load without allowing their bodies to adapt are more prone to overuse injuries. This is particularly true at the beginning of a season when there’s a rapid change in workload after a period of reduced activity.

Gradual progression, giving your body time to adjust and adapt, is crucial for injury prevention.


The Role of Scapular Stability

Imagine trying to shoot a cannon from an unstable canoe. It’s not going to work well, right? The same principle applies to your shoulder during overhead motions.

The scapula, or shoulder blade, acts as the stable platform for energy transfer from the lower body to the arm.

Weak scapular stabilizing muscles and dysfunctional scapular movement can negatively impact throwing mechanics and increase the risk of injury.

Building Scapular Control: The Foundation for Healthy Shoulders

Scapular control for stability

Strong scapular stabilizing muscles create a solid platform for the shoulder. This platform ensures that the scapula remains stable during throwing motions, allowing efficient energy transfer from the lower body to the arm.

Clinical studies have shown that many throwing athletes, from youth to professional levels, have weak scapular muscles and scapular dyskinesis (dysfunctional movement).

Strengthening these muscles through targeted exercises can enhance scapular control and reduce the risk of shoulder injuries.


The Importance of Eccentric Strength to Prevent Shoulder Injuries

Eccentric forces, particularly during the deceleration phase of overhead

athletic movements, play a crucial role in the overall performance and health of overhead athletes. Eccentric forces refer to the lengthening of muscles under tension, and they are responsible for controlling and decelerating the arm after a powerful throw or serve.

Insufficient eccentric strength can contribute to injuries in the following ways:

Micro Damage: Protecting Your Musculoskeletal System

Repetitive overhead movements place significant stress on the tendons, muscles, and ligaments involved in deceleration.

Over time, this can lead to the accumulation of micro-damage in these structures, surpassing the body’s repair capabilities.

This breakdown of tissues can increase the risk of injuries such as tendon tears or strains.

Tissue Pliability Changes: Maintaining Flexibility

Eccentric loading can cause changes in the pliability of tissues, especially tendons. Excessive eccentric forces can make tendons stiffer, compromising their ability to absorb and distribute forces effectively.

This stiffness can disrupt the natural load-bearing capacity of tendons, making them more susceptible to injury. To counteract this, maintaining flexibility through regular stretching and mobility exercises is crucial.

Range of Motion: Balancing Mobility and Stability

Repetitive eccentric loading can affect an athlete’s range of motion, particularly in the opposite direction of the eccentric forces.

For example, excessive eccentric loading during the deceleration phase can lead to a decrease in shoulder internal rotation or abduction range.

This limitation in range of motion can increase the risk of shoulder injuries. Incorporating exercises that promote both stability and mobility can help maintain a balanced and functional range of motion.


The Path to Injury Prevention

Preventing shoulder injuries in overhead sports requires a proactive approach. Here are some practical tips for athletes, parents, and coaches:

  1. Listen to Your Body: Pay attention to any warning signs, such as persistent pain or discomfort in the shoulder. If you experience any symptoms, consult with a sports medicine professional to address them early on.
  2. Gradual Progression: Avoid sudden spikes in training load or intensity. Gradually increase your workload and allow your body to adapt and recover. Consistency and patience are key.
  3. Strength and Conditioning: Incorporate strength and conditioning exercises into your training routine. Focus on developing overall strength, including eccentric strength, and improving muscle balance. Consult with a sports rehabilitation expert to design a program tailored to your needs.
  4. Proper Technique: Work with a qualified coach or trainer to ensure you are using correct mechanics and form during overhead movements. Proper technique minimizes stress on the shoulder and optimizes performance.
  5. Rest and Recovery: Prioritize rest days and recovery strategies such as adequate sleep, hydration, and nutrition. Your body needs time to repair and rebuild to stay resilient and injury-free.
  6. Scapular Stabilization Exercises: Incorporate exercises that target scapular stability into your training regimen. These exercises can help improve control and positioning of the scapula, optimizing energy transfer and reducing injury risk.

Remember, injury prevention is a shared responsibility. Athletes, parents, and coaches must work together to create a safe and supportive environment for overhead sports. By implementing these strategies and staying proactive, you can enjoy the game you love while keeping your shoulders healthy and strong.

Athletes Guide To Improving Muscle Pliability

Guest Blog from Vive Recovery Centers

In the quest to improve movement quality & efficiency, as well as reduce the risk of injury, pliability has become a popular topic.

This guide will help you with ways to improve muscle pliability.

What Is Pliability?

Pliability describes the quality of muscle tissue. Function focuses on effective/efficient movement.  It’s not just about how much muscle, how much range of motion, or how much force.

Pliability is an underlying tissue quality that improves those things.

Sports medicine and tissue professionals use the term to describe muscle tissue.  Three components that they incorporate into the concept of pliability include;

  • Elasticity – has spring after yielding and while absorbing force
  • Smooth – layers of tissue glide freely, without adhesions
  • Supple – muscle may be dense but it is adaptable and unrestricted

Those are great descriptions of the qualities we want in the muscle of any active person or athlete. So improving muscle pliability is a worthwhile goal.

“Men are born soft and supple; dead they are stiff and hard. Plants are born tender and pliant; dead, they are brittle and dry. Thus whoever is stiff and inflexible is a disciple of death. Whoever is soft and yielding is a disciple of life. The hard and stiff will be broken. The soft and supple will prevail.” — Lao Tzu

Is Muscle Pliability the Same as Flexibility?

No. Muscle pliability is not the same as flexibility. 

Flexibility is the ability of joints and tissues to move through a full range of motion.  Its just a quantitative measure of passive motion.

Pliability, on the other hand, involves the tissue’s ability to move, and the quality it moves with. 

You might be able to move through a specific range of motion, but you can still lack pliability. Without pliability, that motion could come unevenly, with added stress, or lack of elasticity to spring back well.

So how far you can move and stretch a muscle, doesn’t entirely reflect if it is pliable.

Why Is Improving Muscle Pliability Important?

Movement and muscle contraction transmit forces through connected chains into the tissue of your body.

These forces can be dissipated effectively across tissues and joints or overload them. 

The forces can be used elastically like a new rubber band, or damage tissue like ones that are ragged and worn out.

The question of whether you can use that force effectively is answered by whether your muscles are adequately pliable.

The most important ability for an athlete is availability.  Injuries are the greatest setback for anyone who wants to be fit, active, and do the things they love.

 Pliability is key to your body remaining resilient when you go out and push it hard playing, training, and living.

Is Pliability Only a Muscle Quality?

No.  In humans, you can’t anatomically or functionally separate the muscle from connective tissue completely.

Muscle is surrounded by layers of fascia and connects to bones through tendons.  Fascia also is a tensional network transmitting forces through the body (Schleip ed. 2012).  It’s interwoven with-in your muscles like a web helping to give it structure and affecting its elasticity.

So while people commonly refer to “muscle” pliability, in fact, its “tissue” pliability that includes muscles, tendons, and fascia.

Is Muscle Pliability Based on Science?

Muscle pliability is more than just a term used by professionals, its a valid physiological construct (Science Direct) although there can be some confusion in popular media. The elements making up pliability are measurable and based in science.

First of all, the elasticity (Uffmann 2004) and compliance (Simons 1998 ) of myofascial tissue can be measured.

Secondly, muscle tone (Gubler-Hanna 2007) and stiffness (Prune 2016) can be measured in several different ways.

Furthermore, MSK ultrasound imaging visually shows how much fascial layers are sliding and it can be measured (Soares 2021).

So, pliability is not be universally defined or used appropriately in some social media posts. However, these are real, measurable qualities of muscle, tendinous, and fascial tissue.

How Do You Improve Muscle Pliability?

Pliability is key for movement, and it has scientifically measurable qualities. Therefore, improving muscle pliability is important. So, what can you do to make it better?

Move

Movement is key to tissue pliability.  “Motion is lotion” is a saying that emphasizes a scientific fact.

The contraction, relaxation, and stretching/sliding of muscles, tendons and fascia does in fact lubricate the joints and tissues.  Forceful contractions positively influence the hydration and chemical composition of muscles.

Lack of movement causes both functional (Campbell 2019 ) and physiological (Williams 1984) changes to tissues.  Furthermore, pliability gets worse when you don’t move enough (Cowman 2015).

Moving through a full range of motion helps prevent adhesions from developing in the fascia.  Additionally, it helps to prevent the densification of tissues.

Here are few things to consider to move well;

  • Train with full motion:  Training in multiple planes of motion (up/down, side/side, rotate, front/back) is a great step.  Too many athletes start using the same motions again and again.  That is to say, it’s also important to work through a full joint range of motion.
  • Different speeds of movement:  Grinding out slow heavy lifts or steady hikes are great.  However, sometimes you need to be moving faster, and bouncier.  Muscles need to move in different ways to stay pliable.
  • Active mobility work:  Mobility (both flexibility and stability) needs to be trained with specific intention, not just left to chance.

Hands-on Tissue Work

If you want to improve muscle pliability you can take a page from elite athletes and teams and focus on professional tissue work. 

IASTM muscle recovery
“Tooling” is one of several Instrument Assisted Soft Tissue Mobilization techniques used for improving muscle pliability.

We aren’t talking about a relaxing Swedish massage (although they can be great!)

The changes in tissue compliance and elasticity before and after tissue work (Jędrzejewski 2020, Costello 2016) are measurable.

Trained therapists use the skill of their hands along with specialized tools to get the results you need. These approaches can be highly targeted to specific tissues, structures, and myofascial chains. 

Tissue work targets both physiological structures and nervous system function.

In short, for improving muscle pliability, skilled hands-on tissue work is the gold standard.

Hydration

Hydration is a crucial factor in muscle pliability. Muscles that aren’t hydrated begin to look and feel like beef jerky instead of Grade-A steak. Consequently, they can’t absorb the forces thrown their way.

Proper hydration is critical for just about every biological process, including performance, recovery, and overall health. 

Did you know that muscles are ~75% water?!

Water is needed for lubricating the tissue of fascia and muscle as they slide freely.

Therefore, if you aren’t sufficiently hydrated, your muscles won’t perform, respond, or recover optimally.

a Mediterranean diet is one startegy to reduce inflammation which helps when improving muscle pliability
A Mediterranean diet is one strategy to reduce inflammation which helps when improving muscle pliability

Reduce Inflammation

Nutrition is also a crucial factor after hydration in ensuring muscle pliability. What we put inside of our bodies has a direct impact on our muscles and in particular, our bodies’ inflammatory responses to certain foods.

A good diet is important for improving muscle pliability because ongoing inflammation in your tissues can lead to the degeneration of those tissues (Howard 2020).

As a result, if you do this long enough, your tissues will lose elasticity. Firstly, this occurs by changing the extracellular matrix composition and fiber alignment.

Secondly, instead of aligned and sliding collagen fibers in your connective tissue, chronic inflammation can stimulate crosslinks that restrict motion

Stretching is Not Enough to Improve Muscle Pliability

Stretching is a piece of the puzzle to gain or maintain your muscle pliability, but it’s not enough on its own.  Movement through a full range is more effective because it stretches the muscles along with contracting them which has a greater effect.

For one thing, stretching helps more with the neurological control of muscle tension, not the actual physical muscle pliability (Ylinen, 2009).

Additionally, stretching doesn’t create the same stimulus for changes to the extra-cellar matrix in your connective tissue that influence pliability.

Foam Rolling

Foam rolling has become one of the go to practices in the fitness world as a way to “release” muscle adhesions. However, in recent years its taken some criticism as the pressures applied aren’t enough to actually deform fascial tissue or adhesions.

foam rolling for muscle pliability
Foam rolling is something everyone can do to help maintain tissue pliability

While true, this criticism may be missing the bigger picture.  Foam rolling can aid in an individual’s awareness of muscle pliability. It increases their neurological input to the brain.  Accessing the nervous system can help “release” muscle tension and trigger points neurologically, not structurally.

So along with moving, and between tissue work sessions, use that foam roller to help maintain your tissue quality!

Start Improving Your Muscle Pliability Today

Muscle pliability is a term that describes optimal muscle qualities. Pliable tissue is elastic and yielding. Furthermore, it is unrestricted, smooth, and supple. 

Pliability is about more than muscle. It includes complete myofascial chains of muscles, tendons, and fascia.

If you want to move better, stay healthy, and enjoy the things you love more, then focus on improving your pliability with these basic strategies.

Planning The Return To Sports After COVID-19 Restrictions in 2021

planning the return to sports

There are 3 goals coaches need to achieve when planning the return to sports for any athlete

As teams and sports organizations start returning to full sports practices and competition, they need plans to prepare the athletes. 

At Velocity, we’ve been working with everything from elite athletes and teams, to local clubs and high schools in devising effective strategies.  We are helping them to achieve the same three goals whenever we return an athlete to sports after extended times away.

Three Goals of Planning the Return to Sports

Working in higher-level sports, we’ve learned a lot about planning athletes’ return back to their sports practice after long layoffs. Most of this comes from athletes that were injured and required extended time out of sport to rehab and recover. Sometimes it’s with athletes who took a sabbatical year or had a pregnancy during their career.

No matter the case, we do know that without the right preparation, an athlete going back into their regular sports practice and training routine will be at higher risk of injury.

The three driving outcomes we are working to achieve for our players is that they can return safely, successfully, and sustainably.

1. Returning To sport SAFELY

We want athletes to return to sports without a sudden influx of injuries.  Injury defeats the entire purpose of reopening sports and eliminates the chance of success.  After all, you can’t play well if you are on the sidelines hurt.

Velocity is working with teams to create phased-in training plans, athlete readiness screenings, and load monitoring. This means helping athletes and coaches plan how to balance the needs of the athletes body, with the likely scenario of getting back to seasons quickly.

The first step is to do some basic screening of fitness and readiness as athletes return. Finding out what shape they are in is important because coaches have never faced this many athletes out of training for so long.

athlete monitoring can help improve performance and reduce injury risk
Velocity has simple tools that can help coaches monitor their athletes’ responses when returning to sports after COVID-19 shutdowns.

Next, we are helping coaches plan a ramp-up of both technical skills and the right physical qualities for the sport will lower the chance of injuries.

Monitoring how the athletes are responding to the increased load is another strategy that lets you get an early warning if the training is too much or too little. This feedback to coaches can help them adjust training plans to get back into shape and competitive form as fast as possible.

2. Returning to sports SUCCESSFULLY.

Successfully means being able to perform at a high level.  No coach wants to see their team come back out of shape and unable to play up to their abilities.  Plans for preparing the right physical qualities and skills begin now.

That means even before you are back, organize your athletes to complete specific types of training. They need to be preparing specific body parts and tissues for the stress of practicing again.

This is always important in preseason, but especially now when athletes have detrained. Their bodies are not the same as when they left.

Returning To Sports After COVID-19 - athletes are different now

Velocity is working with some teams and clubs to provide pre-return training that specifically reduces the risks of injury and increases the physical qualities they need in their sport.

While many athletes are trying to stay fit and ready with various exercises at home, exercising isn’t training. Training has a specific purpose and goal. While keeping a general level of strength, fitness and mobility were reasonable goals during time at home, athletes need to prepare for sport again.

Whether it’s through remote coaching and managed digital platforms, or in person, serious teams are getting their athletes ready now.

3. SUSTAINING the return to sports

Sustainable is a goal that often gets forgotten.  We don’t just want the first weeks to be a success, but the entire season. 

This means that we have to get the preparation and buildup right first, and then follow it with continued training, monitoring, and recovery.  Remember, these athletes aren’t going to be the same.  Some issues can creep in slowly. 

Velocity is helping teams and clubs plan their monitoring and supplemental recovery and training strategies for in-season. We have athletes that enter and rate daily responses on phone-based apps so coaches can see if their teams handling the demand.

When the fatigue is building or specific aches and pains are increasing, you can help implement and specific recovery plans and give athletes guidance on how to recover at home.

Another important strategy for sustainability while planning your return to sports after COVID-19 is to continue with their physical training during the season. This doesn’t mean a large volume of grueling physical training. That leads to excessive fatigue and takes away from their technical sports skills.

Instead, we recommend a strategy we use in elite sports called micro-dosing. Small, frequent, and high-intensity bouts of training. This may be dedicating 6-15 minutes of practice time to work on speed or specific explosive qualities.

It can also mean targeted high intensity interval training sessions or specific mobility work. What matters is that you pinpoint the physical qualities that will keep your players healthy and in top form, and then have a plan to build and maintain them.

A Shortened Time Frame

There will likely be a shortened time frame as we return in many sports. We are proposing an approach to achieve the three return to sport goals as quickly as possible.  We want to do it quickly because people want to be back in sports.

Some leagues will feel the pressure and schedules will start very fast. 

Some coaches will be under pressure to win and see this as an opportunity to get ahead of other teams.

We acknowledge that in many cases, a prolonged and steady buildup may not be feasible.  However, we don’t want the return to be so quick that it puts athletes at risk. Planning the return to sports after COVID-19 shutdowns starts with setting these three goals.

Improve Functional Strength To Prepare For The Return of Sports

Sports are returning after COVID-19 shutdowns, and athletes need to be preparing now, so they can get back and play at their best.

While at home or waiting for sports return, you can improve some basics that can help prevent injury and give you a foundation for improved performance.

With little to no equipment, you can work on your functional strength and stability to improve performance and reduce compensations.  

When deciding what you need to be doing, you should target areas you’ve had trouble with or are more critical for your sport. 

Maybe there is a part of your body where you have regularly had aches and pains?  If so, you may have already been told by a professional what you should be working on.  If not, get connected to a coach who will do a virtual or in-person assessment and give you a program.

3 Ways You Can Prepare For The Return of Sports

There are simple things you can do to improve your functional mobility and stability. These are important parts of the FOUNDATION phase when preparing for the return of sports to normal.

Return To Sport Pathway after COVID-19
These 3 strategies are important ways to prepare for the return of sports after the COVID-19 shutdowns. They are all part of step 3 in Velocity’s return to sport process.

Below are three things we commonly assign to athletes when they are working on step 3. One of the great things is that these can all be done at home.

If you’ve already been coached on strength training, stretching and mobility, it will be easy to add these in. If you need help, get a coach either in person or remotely to help.

SINGLE LIMB Exercises

While exercises that use two limbs at once (bilateral) are great for building strength and learning technique, they aren’t always the most sport-specific.

During most sports movements, you are moving off one leg, or the two legs are doing different things.  Just think about cutting, throwing, crossing over, and all the other things you do. Same with the upper limbs.

The bottom line, a lot of sports movement is on one leg or one arm.

So, that means that doing some exercise with only one limb (uni-lateral) can be a great addition to your training.  Some of the guidelines to start;

  • Do the same exercises you already know, just with a single limb.
  • You can use dumbbells, kettlebells, backpacks, or other items as your weight.
  • Start slow and focus on smooth, controlled movements.
  • As you have proper technique, go ahead and add weight.  You can actually do a lot in these exercises when you’re ready.

Using dumbbells or kettlebells are great opportunities to work with just a single arm or single leg.   Athletes will have to work more to stabilize joints when working unilaterally. Use movements that are slower at first and build reasonable control before adding weight or speed.

FLEXIBILITY

Working on the range of motion in your soft tissue structures can help eliminate restrictions that may be leading to movement compensations.  It’s something you can clearly do at home without equipment and prepare for sports returning.

We are talking about the range of motion you can achieve that’s limited by your muscles, fascia, and connective tissue.  This is what most people are thinking about when they imagine stretching.

They think about these structures kind of like a rubber band and make them more elastic. This isn’t the only piece for athletes (see mobility next), but it’s still essential.

To work on your tissue flexibility, you can combine self-myofascial release techniques with longer duration stretches and breathing. A standard sequence coaches prescribe for athletes would include;

  • Relax: use deep, diaphragmatic breathing to relax for 1-3 minutes before starting.  Continue this breathing through the rest of the session.
  • Release: use a foam roller or lacrosse ball to find trigger points in muscles. Stay on over-active spots for 1-3 minutes while continuing relaxation breathing.
  • Stretch: Use long duration or band-assisted/active stretches to target specific muscle groups.

MOBILITY

A lot of athletes know that stretching could benefit them.  However, flexibility is only the range of motion of tissues and joints. Your mobility is your body’s ability to control the range of motion and get into positions.  That’s really important for athletes.

Mobility requires flexibility, along with the strength and stability to protect your joints.  

We have athletes use exercises that work through active ranges of motion, such as Animal Flow, yoga, and Functional Range Conditioning. Coaches can help you select what’s right for you with some assessments, but here are some common tips to get the most benefit;

  • Breathe well during the movements and positions. Holding your breathe is cheating.
  • Move slow and smooth to start.
  • Get the movement right. in many of these movements you can look like you’re doing them, but if you’re not focused on the right muscles or patterns, you are losing benefits.
  • Pay attention. Just moving misses a lot of the benefit. Notice how your body is moving and how it’s connected to the ground.

Learn more about athletes’ needs for flexibility and mobility here.

Build Your Foundation To Come Back Stronger

While away from your regular training and practice routines, you can decide to turn this obstacle into an opportunity. Preparing for the return of sports is what serious athletes are doing.

The three tactics shared here are all part of the FOUNDATION phase in the return to sports process you can follow to be your best.

By working on some of the fundamentals, you can be ready to make faster gains when your training and sports return.

Injury Risk From Returning To Sports Too Fast

return to sports after covid injury risks

Detraining during lockdowns and a quick reopening will increase injury risk

The injury risk returning to sports after COVID-19 shutdowns is greater than most coaches realize.

Preventing injuries has to be one of the highest priorities for coaches, teams, and organizations as sports return.  What’s the point of reopening, if our athletes are getting hurt and missing sport anyways?

The detraining they have gone through means the athlete’s returning aren’t the same ones who left.  Their physical capacities will be different.

Few coaches have experienced anything on this scale before.  It’s probably been at least 10 to 20 years since a high school or college athlete has taken a full two months or more fully off from sports.  It just doesn’t happen anymore with year-round training and competition.

So how do we know if they will be at risk?

Return To Sport Lessons For Elite Sports

We know athletes’ have increased risks when returning after significant injury or surgery.  And we aren’t talking about just reinjuring the same body part, but the increased risk of other injuries since they haven’t been training.

We also can look at data from years in pro sports with shorter seasons and lockouts.  Consistently the number of injuries is much higher when the athletes return.

One of the risk factors in all these scenarios is the accumulation of fatigue.  As athletes fatigue, their injury risks increase.  The athletes coming off lockdown restrictions will fatigue faster.  They aren’t in the same shape to train and have a lower ability to recover.

If athletes have been consistently trying to maintain at least 25% of their normal training volume, consider how detrained they are over just 8 weeks.

Even if you ramp up training over the weeks at 40%, 60%, 80% and 100% the gap will be large and increase their risk of injury.

Stress As A Stimulus

Another factor in the injury risk returning to sports is how quickly they ramp up training again.

Practice, training, and competitions are a stimulus and stress for the athlete’s body.  We want some stimulus, so they adapt, putting some savings back in that bank account.  This is the increase in their readiness.  That’s the overall level of their abilities from training.

However, that same stimulus, when taken too far, overloads the athlete beyond their ability to adapt.  This level of stress can lead to immediate fatigue, which increases injury risk.  Remember, the athletes will likely have a diminished ability to recover as fast.  Both with-in a single practice session and between sessions.

When the stress overload is too high, it also damages tissues.  That damage may be a small injury that adds up to those chronic, overuse injuries.  It could also manifest as acute muscle strains and tendon sprains.

The Acute To Chronic Workload Ratio In Return To Sports

In elite sports, a lot of research and effort have gone into understanding how changes in training workload influence injury risk.  The general consensus is that if the volume of training drops too much, athletes detrain. Then their injury risk can go up.   If it increases too fast, then injury risks increase

For those planning the return to sport, this is an essential concept.

Chronic Training Load

Consider two measures of the training workload.  The first we call chronic workload.  This is the average workload that has been happening over time.  Often we look at the average of the last eight weeks, with some extra importance in the most recent weeks.

This should make intuitive sense for a coach.  The work, an athlete, has been doing in training over several weeks is what they can tolerate.  It’s what the athlete has adapted to.   Some practices are intense and some less severe, but it’s the average accumulated workload that they have adapted to.

Think about what this means for athletes right now.  They are getting drastically less workload.  Even if they are putting in their best efforts, they are getting far less than the total they were getting from practice, training, and competition before.

The workload is also relatively specific to the type and intensity of the work.  The workload from 60 minutes of high-intensity practice or games, is much different than 60 minutes of bodyweight training and modified conditioning programs.

So as each week of sports lockdown progresses, the athlete’s average for the last eight weeks is dropping.  Their chronic workload number is going down.  

Acute Training Load

On the other hand, acute training workload is what they are going through now.  This is typically looked at as the last 5-7 days.  Some days may be harder, others more relaxed, but the average is what the athlete’s bodies are working to recover from and adapt to.

The relationship to injury comes in when we see a significant gap in the acute and chronic training load.  This relationship is called the acute to chronic workload ratio (ACWR). 

ACWR – Acute:Chronic Workload Ratio

The average acute training load (last 5-7 days) divided by the average chronic training load (last 6-8 weeks).

CHRONIC Workload = 100 units

ACUTE Workload = 110 units (a 10% increase this week)

ACWR = 1.1

Any time there is an increase in the training load, we see the acute: chronic greater than 1.  Although the exact number varies by sport and finer details of workload, we still know when that number gets too big we have a problem.

Coaches have been pushing athletes for decades to train more and train harder, so they adapt. A jump in the training load itself won’t automatically increase injury risk.

On the other hand, it’s not hard to understand that if you keep doubling the amount of training every week, at some point, they are going to break down.

This graph is from Tim Gabbett, The training—injury prevention paradox: should athletes be training smarter and harder?, British Journal of Sports medicine, 2016.

Wile the precise ratio may be debatable, the concept isn’t. Interestingly, lowering training too much also started to increase injury risk. With the lockdowns athletes have experience they may currently be far off the left side of this graph.

Recent research in pro sports has explored this ratio.  A few years ago, there was a big push based on some excellent research that a ratio of around 1.5 increased injury risk.  

The exact number is not what we are worried about per se because the athlete’s age and level and the sport have an impact. What does matter is the basic premise; increasing workload too quickly leads to elevated injury risk.

Coaches, if you return to practice without a plan, and follow your normal approach, you might be putting your athletes in harm’s way.

Athletes will have a greater injury risk returning to sports

This pandemic has affected sports and we are all looking forward to getting back quickly.

However, in doing so, we must recognize and plan for the unique situation we are in as coaches, and organizations.

So be proactive. If you’re not back to practice yet, get your athletes some help and programming that addresses their specific needs when they return. Get with a knowledgable sports performance professional who can help you put a plan together to ramp back up as quick as possible.

The vital point for sports coaches is that if you increase the training load too fast, the injury risk returning to sports goes up. Your athletes’ average load over the last 1-3 months is probably lower than you’ve ever seen on a broad scale.