What PTs Need to Know About Exercise & Injury

Injuries are very common in the fitness industry. As a fitness professional, it’s very important to have an understanding of why an injury has occurred. It is also necessary to have strategies in place to prevent injuries from happening in the first place, and to help clients rehabilitate, writes AIF team member Alarna Haintz.

Injury incidents are not random, uncontrolled acts of fate; they are understandable, predictable and preventable.

The 3 ‘E’s of Injury Prevention

Without question, prevention is better than cure – always. By considering the following three ‘E’ factors, the risk of an injury occurring can be reduced.

1. Environment

This refers to the area in which exercise is taking place. You must ensure the area is safe and the equipment is clean.

2. Enforcement

This requires having a process in place that holds both trainer and client accountable by checking that exercises are being performed with correct technique in a safe environment.

3. Education

This refers to informing clients about the importance of preventing injuries from occurring.

Types of Injury

There are three types of injury: overuse, acute and chronic.

Overuse

An overuse injury occurs when a micro-traumatic stress is placed on a particular region over a long period of time.

Factors contributing to overuse injuries include:

• inadequate recovery
• poor technique
• poor exercise selection
• lack of variety in a program.

An overuse injury most commonly occurs when movement or a powerful exercise is repetitively performed or there is an inadequate recovery period.

If an overuse injury does occur, encourage your client to:

• rest
• decrease the stressful activity
• ice prior to and after exercise
• include isometric strengthening exercises when returning to training.

Acute

Acute injuries are those that have occured within the prior 12 weeks. Common signs include instant pain and/or disability. Acute injuries are better known as tears, strains, sprains or fractures.

If an acute injury does occur, encourage your client to:

• complete the RICER protocol (Rest, Ice, Compression, Elevation and Referral)
• use slings or immobilisation materials
• pursue definitive care (X-rays).

Chronic

Chronic injuries are ongoing injuries. They have a gradual onset, which means your client will likely have a poor recollection of when the injury occurred or how it happened (as opposed to acute injuries which have a clear time and reason).

If a chronic injury is noticeable, encourage your client to:

• use ice
• gently stretch
• rest
• seek professional advice.

Most Common Workout Injuries

If an injury does occur, encourage your client to seek medical advice and explore other allied health professional options, such as seeing a physiotherapist, podiatrist or osteopath.

Foot and ankle

Foot and ankle injuries are very common in a gym setting because the general population is predominantly sedentary. This causes many to have rounded shoulders and distribute most of their weight to the front of the foot when standing.

Most running shoes have an elevated heel, which also encourages weight to be distributed to the front of the foot, which leads to a very unbalanced centre of gravity. Encourage your clients to wear correctly fitted footwear that is appropriate to their individual needs.

Knee

Like foot and ankle injuries, knee injuries are often a result of people having a sedentary lifestyle throughout the day and then performing explosive movements in the gym. This places the knee under great stress. If a knee injury occurs, assist your client’s rehabilitation by writing them a program that avoids any high impact exercises, and that also targets all stabilisation muscles around the knee.

Lower back

Lower back injuries are very common and are likely due to poor technique, lifting weights that are too heavy or overuse. To prevent a lower back injury from occurring, it is essential that correct technique is strictly observed and enforced. Also, ensure that the client’s exercise program includes exercises for strengthening the erector spinae and stretches to promote long and strong muscles.

Shoulder and neck

Lastly, shoulder and neck injuries are also common, again predominantly due to sedentary office jobs. Hunching over a desk all day creates tightness in the chest and weak lengthened muscles in the upper back and neck. To help with this issue, include exercises such as the Lat Pull Down, Seated Row or External Rotations using a resistance band. These increase the strength of the muscles used to retract and depress the scapula, enhancing posture.

Signs to Look For an Injury

Any injury should be treated sooner rather than later. As fitness professionals it is our job to avoid an injury by encouraging and enhancing good posture, strengthening the musculoskeletal system, and increasing flexibility and stabilisation of joints.

If your client is showing signs of weakness or tightness, or has an abnormality or deviation from normal movement, you need to be able to distinguish if an injury has occurred.

Preventing acute injuries

To prevent an acute injury from occurring, you must ensure an adequate warm-up involving:

• proprioceptive exercises
• closed chain to open chain exercises
• rhythmic full range of motion dynamic movements
• specific movements that replicate exercises to be performed in the actual workout to follow.

Preventing chronic or overuse injuries

To prevent an overuse or chronic injury, ensure your clients:

• progressively overload their training volume and intensity
• individualise their program
• allow sufficient recovery
• ensure an adequate warm-up and cool down.

Other preventative strategies

Additional preventative strategies that fitness professionals can employ include:

• Well-planned training sessions
• Regular comprehensive posture analysis
• Pre-screening questionnaires
• Effective teaching of correct technique
• 100% focus and monitoring during training sessions
• Appropriate exercise selection
• Prescribing realistic intensity and volume.

It is our responsibility to stay up-to-date with the latest research on injury prevention and pass on this in knowledge to our clients to remain injury free while being active.

This content is not intended to be used as individual health or fitness advice divorced from that imparted by medical, health or fitness professionals. Medical clearance should always be sought before commencing an exercise regime. The AIF and the author do not take any responsibility for accident or injury caused as a result of this information.

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AIF

The Australian Institute of Fitness

The Australian Institute of Fitness (AIF) is the largest and longest established fitness training organisation in Australia, with dynamic training methods and expert course coaches nationwide - spanning fitness, massage and nutrition. The AIF qualifies more fitness professionals than any other provider in Australia, as well as offering a broad range of continuing education courses (CEC), upskilling resources and partnership programs for existing industry.