Prehab – preseason preparation
The use of strength training for improved athletic performance is not a new phenomena. However, the value of specific strength training for injury prevention is only now beginning to be understood and applied across all levels of sport. Thanks to this, physios are becoming much more proactive in utilising strength training principles as part of their prehab physio approach for their patients.
In this blog we will look at some of the evidence for strength training for injury prevention / prehab physio. We discuss strength and conditioning physio applications for common musculoskeletal injuries.
Basic benefits of strength and conditioning physio and prehab physio
Strength training is an important component of improving athletic performance. It can help to enhance various physical qualities such as strength, power, speed, agility, and endurance. Scientific evidence suggests that strength training can provide a range of benefits for athletes, including:
Increased muscle strength: Resistance training has been shown to significantly increase muscle strength in athletes, which can improve their ability to generate force and power during athletic movements.
Improved power and explosiveness: Strength training can also enhance an athlete’s ability to generate power and explosiveness, which is important for activities such as jumping, sprinting, and throwing.
Enhanced speed and agility: Strength training has been shown to improve an athlete’s speed and agility, which can improve their performance in sports that require quick movements and changes in direction.
Increased endurance: Strength training can also improve an athlete’s endurance by increasing their muscle strength and improving their ability to sustain high levels of activity for longer periods.
Reduced risk of injury:
Strength training can also help to reduce an athlete’s risk of injury by strengthening their muscles, bones, and connective tissues, which can provide better support and stability during athletic movements.
It is on this final point that we want to focus today.
The science: Benefits of strength training for injury prevention
Several studies have investigated the relationship between strength training and injury prevention. Here are some key findings:
- Reduced risk of injury
A study published in the Journal of Strength and Conditioning Research found that strength training reduced the risk of injury in female soccer players. The researchers found that the players who participated in a strength training program had a lower incidence of lower limb injuries compared to those who did not participate in the program.
- Improved muscle strength and endurance
Strength training has been shown to improve muscle strength and endurance, which can help prevent injuries. A study published in the American Journal of Sports Medicine found that high school football players who participated in a strength training program had a lower incidence of knee injuries compared to those who did not participate in the program. The researchers attributed this to the improved muscle strength and control.
- Improved flexibility
Strength training – ironically – can also improve flexibility. This can reduce the risk of muscle strains and tears when exercises through full range of motion. A study published in the Journal of Orthopaedic and Sports Physical Therapy found that a strength training program combined with stretching improved hamstring flexibility in college-aged women.
- Improved balance and coordination
Strength training can improve balance and coordination, which can help prevent falls and related injuries. A study published in the Journal of Gerontology found that a strength training program improved balance and reduced the risk of falls in older adults.
- Reduced risk of back pain
Strength training can also help reduce the risk of lower back pain, a common injury. A study published in the Journal of Strength and Conditioning Research found that a 16-week strength training program reduced the incidence of lower back pain in firefighters.
In summary, the scientific research suggests that strength training can be effective at minimising injuries. This is by improving muscle strength and endurance, flexibility, balance, and coordination. These benefits can help support the joints and control the body during movement, reducing the risk of injury.
Being match fit is the best prehab physio
The best way to incorporate strength and conditioning physio work is through a structured program, performed consistently. This should be tailored to the requirements of the sport and individual. We never recommend shortcuts to this process. Being fit for the thedemans of your sport is simply the best “prehab” you can do.
Within this however, there are some key exercises that we like to incorporate to further reduce injury risk.
Nordic Hamstring Eccentrics – a prehab physio favourite
Nordic hamstring strength training has been studied extensively in recent years. There is strong evidence to suggest that it can be an effective tool for reducing the risk of hamstring injuries in athletes. Here are some of the key findings from the research:
- A meta-analysis of 17 studies (van der Horst et al., 2015) investigated the effect of Nordics on injuries. It found Nordic hamstring exercises were associated with a significant reduction in hamstring injury rates among athletes.
- A randomized controlled trial of Australian football players found that those who participated in a Nordic hamstring training program had a 51% lower risk of hamstring injury compared to a control group (Opar et al., 2015).
- A systematic review and meta-analysis of 15 studies found that Nordic hamstring training was associated with improved hamstring strength and reduced hamstring injury rates (Al Attar et al., 2017).
- A randomized controlled trial of soccer players found that those who participated in a Nordic hamstring training program had a 70% reduction in the incidence of hamstring injuries compared to a control group (van der Horst et al., 2019).
Overall, the evidence is fairly compelling. It suggests that Nordic hamstring strength training can help reduce the risk of hamstring injuries. It is recommended that this type of training be incorporated into regular exercise programs. It can be a great addition to strength sessions in off-season conditioning.
Copenhagen Adductor strengthening
Copenhagen adductor strengthening is a form of exercise that targets the muscles on the inner thigh. Adductors are commonly injured in sprinting and kicking sports – particularly soccer. Here are some of the key findings from research on this exercise:
- A randomized controlled trial of female handball players found that those who performed Copenhagen adductor strengthening exercises had a 41% lower risk of groin injuries compared to a control group (Hölmich et al., 2014).
- A study of male soccer players found that adding Copenhagen adductor strengthening exercises to a regular training program was associated with a significant reduction in groin injuries (Harøy et al., 2017).
- A systematic review and meta-analysis of 9 studies found that adductor strengthening exercises, including the Copenhagen adductor exercise, were associated with a reduction in the incidence of groin injuries in athletes (Serner et al., 2015).
- A study of male handball players found that incorporating Copenhagen adductor strengthening exercises into their regular training program was associated with improved adductor strength and reduced risk of groin injuries (Ishøi et al., 2016).
Overall, the evidence suggests that Copenhagen adductor strengthening exercises can be an effective tool for reducing the risk of groin injuries in athletes.
In combination with the Nordics outlined above, adding the Copenhagen’s to strength can be a great pre-season tool.
Strength and Conditioning physio and prehab physio summary
Other exercises we love for preseason injury prevention are:
- Skipping – great for developing strength and elasticity in calf/achilles complex
- Lunges / Step-ups – for focus on glute strength and controlling knee position in single leg work
- Plyometric exercises – jumps, hopping, bounding etc. This is great for force generation and absorption.
- Copenhagen Adductors Holds – See above
- Nordic Hamstring Eccentrics – See above
Most importantly, and especially for running sports – we need to tailor our running intensity and volume to our sport’s requirements.
With the winter sports season fast upon us, don’t leave your strength and conditioning physio work too late. Strength gains can be slow coming. However, the confidence and coordination we get from suitable prehab work can be beneficial quite early on.
Our Randwick Physios and Podiatrists are qualified in strength and conditioning particularly in the application of injury prevention and management. Come and see our team to get started on a program tailored for you and your sport.
