© NARRABEEN SPORTS MEDICINE PHYSIOTHERAPY CENTRE PTY LIMITED | PRIVACY POLICY | 2021

February 2019

Why is pre-season training so important?

© NARRABEEN SPORTS MEDICINE PHYSIOTHERAPY CENTRE PTY LIMITED | PRIVACY POLICY | 2019

PRE-SEASON TRAINING & HOW TO SURVIVE |  The weeks before competition starts are critical for any athlete at any level of competition.  It requires an assessment of where an athlete will start physically and the knowledge of what they need to achieve to compete safely and effectively once competition begins.  A consistent and full pre-season is the aim.   How can we make sure we get it right? 

Reduce the risk of injury.  Load may be the the magic word - but it’s not rocket science.

• Too little or too much pre-season training will increase risk of injury.  Injuries related to poor management of training load are considered largely preventable.  Pre-season loads that are appropriate, prescribed & progressive have a protective effect and reduce the risk of soft tissue injury during the season.
• Pre-season eccentric strength training and doses of high speed repeated efforts reduce the number of hamstring injuries in season.  

ACL INJURY PREVENTION:

• Adding a prevention program into your pre-season & regular in-season warm ups in netball will reduce the occurrence of ACL injuries.  “Netball Australia’s KNEE Program is designed to prevent these injuries occurring. Whether you are a coach to your child’s netball team, high performance coach, support staff or parent, this program is designed to keep your players on the court for longer and moving more efficiently when there.  As an athlete this program aims to keep you playing the sport you love without being sidelined by injury”

• FIFA 11 Is a program developed to reduce the number of ACL injuries in football. “The 11” is a simple, catchy and time-efficient preventive programme that comprises ten evidence-based or best-practice exercises and the promotion of Fair Play.

It requires no equipment other than a ball, and can be completed in 10-15 minutes (after a short period of familiarisation).

The exercises focus on core stabilisation, eccentric training of thigh muscles, proprioceptive training, dynamic stabilisation and plyometrics with straight leg alignment.

The programme is efficient as most of the exercises simultaneously train different aspects and can replace other exercises”

PREPARE TO PERFORM - NSW RUGBY UNION

“The Prepare to Perform programme or P2P is designed to modify the way rugby teams warm up before training sessions and matches in a bid to continue to make rugby a safe sport to play.

The 20-minute programme is a combination of exercises that develop overall stability, fitness, power and strength, and has the best impact when followed at least twice a week”

• Through pre-season, with the progression in each variable, muscles, tendons and joints become more resilient to the loads required and slowly adapt to what is needed.  This might include doses of sprinting, change of direction work in a multi directional sport & specific skills such as kicking, jumping/landing.  Upper body skills might involve racquet sports, be a particular tackling & ground work technique or shooting in court sports. 

Establishes an essential foundation for strength, speed & endurance.

• Pre-season development of lower body strength, speed and repeated sprint ability will increase an athlete’s resilience & tolerance to high workloads and reduce the risk of injury.

Allows technique correction, skill acquisition, identify injury deficits & risk factors.

• Initial sport specific screening & regular re-assessment of key variables allows the physiotherapist to pick up factors that may initially predispose an athlete to injury (like reduced hip internal rotation) and implement treatment to correct these. Regular treatment can ensure the athlete stays on track with these key variables as loads increase throughout pre-season.
• Pre-season allows time for “perfect practice” where complex skills can be broken down and trained in components.
• Must address footwear - running shoes, training shoes, boots.  Sports podiatrists are expert at assessing the lower limb, its effect on the biomechanics and related injuries.  Podiatrists are able to provide footwear advice & custom orthotics.

        Sydney Academy of Sport Podiatrist | West Pymble Sports Podiatrist

 

Where do we make our biggest mistakes in pre-season?

 Nutrition | maintain quality nutrition to fuel & hydrate your body.

• Don’t drop the ball on this one!  Let the experts outline some simple strategies to keep you healthy & fuelled up to do the job ahead.                      See the blog by Peta Carige @ Functional Food Solutions

Recovery | schedule in your rest.  Recovery is as important as the work.

Recovery - both psychological & physiological, must be planned.  Days off training, time off feet.  Athletes need time to recover as much as they need to train.  The physical body needs time to rest, repair and build - but the athlete also needs psychological downtime too.

• Cold immersion | May not be useful in pre-season | Cold water immersion (ice baths) is a controversial area - but essentially should be periodised or planned. Although ice baths are useful after intense competition, contact sports - especially those with short turn arounds (Rugby Sevens), during pre-season, the research suggests regular cold water immersion may be counter productive if the goal is increasing strength by blunting the hypertrophic (increase in size/volume of muscle cells) response to resistance training.  
• Sleep | Sleep is a key component of recovery.  Athletes who sleep an average of <8 hours per night are 1.7 times more likely to have had an injury compared with athletes who slept for ≥8 hours.  Lack of appropriate regular sleep can mean there will be impaired muscle glycogen repletion, impaired muscle repair and increased in mental fatigue
• Other modalities | Soft tissue massage & Compression pumps/sleeves | Massage benefits athletes by reducing muscle pain from training and reducing muscle fatigue. Helping maintain muscle length, reducing tightness and joint stiffness secondary to heavy pre-season training also helps prevent injury.

Load Progression - objective, measurable, planned & monitored.

• Knowing where an athlete starts and where he or she needs to get to from a volume, speed and skill level, is vital.  Loads & progressions must be planned objectively.
• When there is too little work over many weeks (such as after a break, illness or injury), followed by spikes in load, the risk of injury is high & this risk continues for up to 4 weeks.  
• When week to week increases in load are less than 10% of the previous week, there is a < 10% risk of injury.  However, if increased by > 15%, the risk of injury increases to up to 49%.  
• Find a way to monitor your athlete - there are simple and complex methods - but you need to know when they are reaching their physical & psychological limit - and make adjustments before they break.

“In summary,  acute:chronic workload ratio (ACWR) had a stronger association to non-contact injury risk in this cohort of English Premier League football layers than accumulated loads, suggesting the rapid increase in load is more indicative of injury than the cumulative amount of load performed. Specifically, very high acute spikes when the chronic loads were low corresponded to the greatest non-contact injury risk. We recommend that training programmes should involve progressive exposure to higher loads to enhance physical capacities while minimising the risks associated with rapid, excessive spikes.” (Bowen et.al., 2019)

Injury rehabilitation - last season injuries not rehabilitated are a liability.

• Not understanding the past injury history, the likelihood of past injury recurrence and the way it can impact the next pre-season leaves the athlete vulnerable to injury.
• All athletes should be assessed prior to a pre-season to ensure no deficits remain from past interruptions to training.

Athlete Monitoring - load, wellness, signs & symptoms of possible injury.

• Athlete monitoring - wellness/illness, physical markers (groin squeeze, heart rate testing) or using other simple tools, must be used to ensure the athlete remains well and injury free as loads increase over the pre-season.  Responding to changes in monitoring is also important - ignoring the signs of fatigue or over-training is unforgivable when it leads to athlete injury and subsequent time away from consistent training - which will then impact the competition.     

If you are not sure what you are doing - please ask an expert.  

There are sports physios, nutritionists and performance coaches who can help you navigate the pre-season.  

If you feel a niggle - please see a Sports & Exercise Physiotherapist - is the start of something that can interrupt your training?  

Remember - consistency and a full pre-season - uninterrupted, is the key.

REFERENCES

Allan, R & MawhinneyIs, C.  Is the ice bath finally melting? Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress in humans.  J Physiol. 2017 Mar 15; 595(6): 1857–1858.

Bangsbo et al. Muscle lactate metabolism in recovery from intense exhaustive exercise: impact of light exercise.  Volume 77. Issue 4. October 1994. Pages 1890-1895.

Bowen, L, Gross AS, Gimpel M, Bruce-Low S, Li F. (2019) Spikes in acute:chronic workload ratio (ACWR) associated with a 5–7 times greater injury rate in English Premier League football players: a comprehensive 3-year study. Br J Sports Med.

Hoffman, MD, Badowski, N, Chin, J, Stuempfle, KJ.  A Randomized Controlled Trial of Massage and Pneumatic Compression for Ultramarathon Recovery. Journal of Orthopaedic & Sports Physical Therapy, 2016 Volume:46 Issue:5 Pages: 320–326

Gabbett, T (2016). The training—injury prevention paradox: should athletes be training smarter and harder? British Journal Sports Medicine. Volume 50, Issue 5.

Joo CH, Allan R, Drust B, Close GL, Jeong TS, Bartlett JD, Mawhinney C, Louhelainen J, Morton JP & Gregson W (2016). Passive and post exercise cold water immersion augments PGC 1α and VEGF expression in human skeletal muscle. Eur J of Appl Physiol 116, 2315–2326.

Mandelbaum, BR, Silvers,HJ, Watanabe, DS, Knarr, JF, Thomas, SD, Griffin, LY, Kirkendall, DT, Garrett, W (2005).  Effectiveness of a Neuromuscular and Proprioceptive Training Program in Preventing Anterior Cruciate Ligament Injuries in Female Athletes: 2-Year Follow-up.

Milewski MD1, Skaggs DL, Bishop GA, Pace JL, Ibrahim DA, Wren TA, Barzdukas A. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Pediatr Orthop. 2014 Mar;34(2):129-33.

Nédélec M, Halson S, Abaidia AE, Ahmaidi S, Dupont G. tress, Sleep and Recovery in Elite Soccer: A Critical Review of the Literature. Sports Med. 2015 Oct;45(10):1387-400.

Roberts LA, Raastad T, Markworth JF, Figueiredo VC, Egner IM, Shield A, Cameron Smith D, Coombes JS & Peake JM (2015). Post exercise cold water immersion attenuates acute anabolic signalling and long term adaptations in muscle to strength training. J Physiol 593, 4285–4301.

Stares et al.  Identifying high risk loading conditions for in-season injury in elite Australian football players.  Journal of Science and Medicine in Sport.  Volume 21, Issue 1, January 2018, Pages 46-51.

Poppendieck, W et al. Massage and Performance Recovery: A Meta-Analytical Review. February 2016, Volume 46, Issue 2, pp 183–204.